Pillars of Wellbeing: Nutrition, Movement, Sleep and Social Connection

Week 11: Pillars of Wellbeing: Nutrition, Movement, Sleep and Social Connection

This lecture explores the link between physical and mental health, the impact of lifestyle factors on mental health, and the pillars of health and wellbeing, including nutritional psychology, exercise, sleep, and social connection.

Learning Outcomes

By the end of this lecture, you will be able to:

• Understand the bidirectional relationship between physical and mental health.
• Explain the role of chronic inflammation on mental health and wellbeing.
• Describe how nutrition, exercise, sleep, and social connection influence psychological wellbeing.

The Mind-Body Connection

The connection between the mind and body is a foundational concept referring to the bidirectional relationship between mental processes (thoughts, emotions, cognition) and physical health (immune function, hormones, nervous system activity).

Brain-Body Communication Pathways: Examples

Example 1: Beth (High-Performing Marketing Executive)

Beth, a marketing executive in a fast-paced environment, experiences chronic pressure and interpersonal stress, leading to a near-constant state of "fight or flight."

Symptoms:

• High blood pressure.
• Digestive issues (bloating, constipation, acid reflux) due to reduced parasympathetic activity.
• Chronic fatigue.
• Frequent headaches and chest tightness.

Beth's symptoms illustrate how the autonomic nervous system (ANS) and chronic stress can affect physical health.

Example 2: David (Major Depressive Disorder)

David, experiencing major depressive disorder, reports persistent low mood, lack of motivation, poor sleep, social withdrawal, and weight gain due to emotional eating and reduced physical activity.

• Sedentary lifestyle and poor diet lead to insulin resistance.
• Elevated fasting glucose and HbA1c, confirming type 2 diabetes.
• Depression contributes to chronic stress, activating the HPA axis and increasing cortisol and inflammatory markers.
• Develops hypertension and elevated cholesterol, risk factors for coronary artery disease.

David’s symptoms illustrate the association between depression and increased risk of heart disease, diabetes, and stroke.

Inflammation

Inflammation is the body's natural response to injury, infection, or harmful stimuli and can be acute or chronic.

Acute vs. Chronic Inflammation

• Acute: Infections (bacterial, viral, fungal), injuries (cuts, sprains, burns), toxins or allergens, surgery/trauma.
• Chronic: Autoimmune disorders, mental health disorders, environmental toxins, persistent infections or unresolved injuries, lifestyle factors.

Lifestyle Factors & Chronic Inflammation

• Poor diet (high in sugar, trans fats, and processed foods).
• Obesity, especially visceral fat.
• Chronic stress.
• Lack of physical activity.
• Poor sleep or circadian rhythm disruption.
• Smoking and excessive alcohol use.
• Gut microbiome imbalance (dysbiosis).

Chronic inflammation can silently damage tissues and organs over time, interfering with neurotransmitter function, neuroplasticity, and potentially leading to neurodegeneration, contributing to conditions like depression, anxiety, and cognitive decline.

What Happens in Chronic Inflammation?

• Persistent Immune Activation: The immune system remains in a constant state of alert, releasing inflammatory chemicals like cytokines and free radicals.
• Tissue and Organ Damage:
  • Damage DNA, potentially leading to cancer.
  • Harden arteries, contributing to heart disease.
  • Disrupt insulin signaling, increasing the risk of type 2 diabetes.
  • Affect brain function, contributing to depression, anxiety, and cognitive decline.

Symptoms of Chronic Inflammation

• Persistent fatigue.
• Joint or muscle pain.
• Digestive issues (e.g., constipation, diarrhea, acid reflux).
• Mood disorders (e.g., depression, anxiety).
• Weight changes.
• Frequent infections.
• Brain fog or difficulty concentrating.

Pillars of Health and Wellbeing

The foundations and pillars of health are:

1. Nutrition
2. Exercise, Recovery & Sleep
3. Social Connection

Nutritional Psychology

Nutritional psychology (or psycho-nutrition) examines how nutritional factors affect psychological processes and the bidirectional relationship between nutrition and psychological factors. It considers how nutrition affects mental health and how stress, emotions, and mental state influence dietary choices and nutritional status (Bland, 1995; Horovitz, 2024).

Case Example – Sarah

Sarah, a 28-year-old marketing professional, experiences persistent low mood, fatigue, lack of motivation, brain fog, difficulty concentrating, and mild anxiety.

Dietary habits:

• Skips breakfast.
• Eats mostly processed foods and takeout.
• Drinks 3–4 cups of coffee daily.
• Low intake of fruits, vegetables, and omega-3s.
• Frequent sugar cravings and late-night snacking.

Lifestyle factors:

• High stress at work.
• Poor sleep quality.
• Sedentary lifestyle.

Intervention and Support Plan - Example

1. Stabilize blood sugar by introducing regular meals with protein and fiber.
2. Reduce inflammation by cutting back on ultra-processed foods and adding anti-inflammatory foods (e.g., berries, leafy greens, turmeric).
3. Support gut health with fermented foods (e.g., yogurt, kimchi) and prebiotic fibers (e.g., oats, bananas).
4. Boost mood-regulating nutrients:
   • Omega-3s (via fatty fish or supplements).
   • Magnesium (leafy greens, nuts).
   • B vitamins (whole grains, legumes).
5. Hydration and caffeine moderation to reduce anxiety and improve sleep.

Core Nutrition Principles

1. Food-Mood Connection: What you eat affects neurotransmitter production (like serotonin and dopamine), which directly influences mood and emotional regulation.
2. Nutrient Density Over Caloric Density: Focus on foods rich in vitamins, minerals, and phytonutrients rather than just counting calories.
3. Blood Sugar Stability: Balanced meals help prevent mood swings, irritability, and fatigue caused by blood sugar spikes and crashes.
4. Gut-Brain Axis: A healthy gut microbiome supports mental health through the production of neurotransmitters and anti-inflammatory compounds.
5. Anti-Inflammatory Eating: Diets that reduce inflammation can support better mental health.
6. Individualized Nutrition: Psychological and physiological responses to food vary—personalized approaches are key.
7. Behavioral Awareness: Emotional eating, food addiction, and disordered eating patterns are addressed alongside nutritional changes.

The MIND Diet

The MIND diet is a hybrid of the Mediterranean and DASH (Dietary Approaches to Stop Hypertension) diets specifically designed to support brain health and reduce cognitive decline.

• RCT in 2025* – found the adherence to the MIND diet significantly improved:
  • Mood
  • Quality of life
  • Dietary behaviour change motivation

A Word About Dieting

Some people need to lose weight for medical reasons, such as reducing the risk or severity of chronic diseases and improving overall health outcomes (e.g., high blood pressure, type 2 diabetes, dyslipidemia, heart disease, sleep apnea, certain cancers, joint pain and osteoarthritis).

However, many people diet due to body image concerns. Recent data suggests that a significant percentage of dieters, especially young adults and adolescents, are motivated by body dissatisfaction and appearance-related concerns.

Restrictive diets can perpetuate mental health and body image problems.

• The Dieting Cycle and Self-Blame: Most people regain lost weight, leading to feelings of failure, shame, and self-blame.
• Heightened Anxiety and Depression: Restrictive diets can create an unhealthy preoccupation with food and body image.
• Disordered Eating Patterns: Restriction can trigger binge eating, emotional eating, or obsessive food behaviors.
• Physiological and Cognitive Impacts: Restrictive eating can lead to nutrient deficiencies, fatigue, mood swings, and cognitive fog.
• Reinforcement of Weight Stigma: Dieting often stems from and reinforces weight stigma.

Exercise, Movement & Sleep

Exercise plays a powerful and well-documented role in supporting mental health.

• Reduces Depression and Anxiety: Regular physical activity lowers symptoms of depression and anxiety by promoting the release of endorphins and serotonin.
• Improves Cognitive Function: Exercise enhances memory, attention, and executive function.
• Builds Psychological Resilience: Exercise boosts mindfulness and psychological resilience.
• Regulates Stress and Sleep: Physical activity helps regulate the hypothalamic-pituitary-adrenal (HPA) axis and improves sleep quality.
• Supports Emotional Regulation: Movement enhances introspective awareness and emotion regulation.

Types of Exercise

Refer to WHO guidelines on physical activity and sedentary behavior.

Recovery and Sleep

Recovery is a crucial component of both physical and mental health.

1. Mental and Emotional Restoration: Recovery allows the nervous system to reset, reducing stress and emotional fatigue.
2. Physical Repair and Growth: During rest, the body repairs muscle tissue, replenishes energy stores, and reduces inflammation.
3. Sleep and Cognitive Function: Quality sleep is a key part of recovery.
4. Hormonal Balance: Recovery helps regulate hormones like cortisol and serotonin.
5. Performance and Motivation: Recovery improves motivation, creativity, and resilience.

Types of Recovery

• Physical: Sleep, rest-days, stretching, massage.
• Mental: Meditation, journaling, digital detox.
• Emotional: Social connection, therapy, creative expression.
• Nutritional: Replenishing nutrients post-exercise or stress.

A Word About SLEEP

Circadian rhythms are biological processes that follow a roughly 24-hour cycle, regulating sleep-wake cycles, hormone release, body temperature, and mood and alertness.

Disruption of circadian rhythms is linked to psychiatric disorders.

• Circadian misalignment affects serotonin and dopamine systems.
• Poor circadian alignment leads to insomnia, hypersomnia, and fragmented sleep.

Recovery is most effective when aligned with your circadian rhythm. Sleeping at consistent times enhances REM sleep, which is vital for emotional processing.

Sleep Stage Cycles:

• Three non-rapid eye movement stages and one rapid eye movement stage make up one sleep cycle.
• A person will typically go through four to six sleep cycles per night, although the duration of each stage may vary.
• Adults should aim for 20–25% of total sleep time in both deep and REM stage

Social Connection

Social connection plays a critical role in mental health.

• Protective Against Mental Illness: Strong social ties reduce the risk of depression, anxiety, and suicidal ideation.
• Enhances Emotional Resilience: People with close relationships tend to have better emotional regulation, higher self-esteem, and greater life satisfaction.
• Improves Cognitive Function: Regular social interaction stimulates the brain.
• Boosts Positive Emotions: Acts of connection release oxytocin and dopamine.
• Reduces Loneliness and Isolation: Loneliness is now recognized as a public health crisis.

Social Isolation vs. Loneliness

• Social Isolation: A pervasive lack of social contact, interaction, or connectedness due to poor social networks, structural constraints, or health issues.
• Loneliness: The negative feelings associated with the discrepancy between actual and desired social relationships and connections.

Social isolation can pose a health risk even if a person doesn't feel lonely.

Social Isolation & Loneliness: Global Epidemic

• Social isolation and loneliness are associated with increased risk of premature death, dementia, heart disease, stroke, depression, anxiety, and suicide.

Social Isolation & Loneliness: Who Is At Risk?

• Anyone, generally; Older and young adults are at greater risk than those in middle age; those in rural areas; those who live alone

General Recommendations

• Make new connections, reach out, join a group, volunteer, focus on reciprocity, quality over quantity, identify and work on barriers, take care of yourself, reduce screen time, and seek help.

Targeted Approaches & Interventions

• Psychological therapies, community-based activities, technological and phone-based support, health education and skill development, and support groups.

Concluding Remarks

• Ensure a solid foundation for physical and psychological wellbeing.
• Consider lifestyle factors in any presenting mental health issue.
• Interdisciplinary approaches are crucial.