What are 7 Pillars of Holistic Health?
After you start looking into Holistic Health, and how you can apply it in your life, you may wonder what the major pillars or foundations of Holistic Health are.
In the video and video transcript below, doctor and author Dr. Sara Gottfried explains what she believes to be the 7 pillars of Holistic Health.
Who is Dr. Sara Gottfried?
Dr. Sara Gottfried, MD is a wife, mother, scientist, researcher, speaker, connector, scholar, seeker, and Harvard-educated MD with 25 years of experience, and author of four New York Times bestselling books. She is a board-certified physician who graduated from Harvard and MIT. She practices evidence-based integrative, precision, and functional medicine. She is a Clinical Assistant Professor in the Department of Integrative Medicine and Nutritional Sciences at Thomas Jefferson University and Director of Precision Medicine at the Marcus Institute of Integrative Health. Her three New York Times bestselling books include The Hormone Cure, The Hormone Reset Diet, and Younger, and WOMEN, FOOD, AND HORMONES.
Thank you so much for having me in Dubai. It’s my honor to be here.
We just heard two masterful talks about health versus disease and I want to get a little more practical. Thirty years ago, when I went to Harvard Medical School, I thought that health was the absence of disease; the absence of disease.
I want to share with you two models of health.
The first model was my beloved grandmother. This is my mother’s mother. I grew up in the state of Maryland in the United States. My mother worked full-time and my grandmother took care of me. She would bake cookies. She loved martinis and she used to watch a lot of soap operas. I think you have soap operas in Dubai, right? Not the most
stimulating. It’s not the BBC. My beloved grandmother, when I was seven years old, started to get lost driving home from my bus stop. It was only a few miles but she
began to lose her memory. In fact, as her memory faded, her personality faded and this was heartbreaking for me. Now, she did not have a diagnosis until several years later and then. she was diagnosed with Alzheimer’s disease. She went on to go to an assisted care facility where she languished for another 18 years, unable to recognize any of us. So,
that’s the first model of health. And I would argue that she had decades of no diagnosis of disease but she was not healthy because Alzheimer’s begins in the body thirty years before a diagnosis. And that’s when we have to bring in these seven pillars of health.
The second model was my great-grandmother. This is my mother’s paternal grandmother. My great grandmother believed that she did not find the answer to health at the bottom
of a pill bottle. You find it in the way that you architect your life. You find it in the choices that you make every day, with your lifestyle. She would show up at her house with suitcases of kale and wheat berries and other whole foods. I wanted a great-grandmother that would show up with candy. She did not believe in candy. At my wedding in 1997 while, my grandmother was in the nursing home, my great-grandmother came to my wedding in Sausalito, California, and flirted mercilessly with every man who was there. She danced with them. She was 97 years young. That’s health. That’s what I want. Now, she also outlived four husbands. She was what she would call a squeaky wheel. She did not drink. She used to joke, “I love wine but it does not love me.” She knew something about her liver detoxification system. She practiced yoga starting in the 1950s and before she died, she could still stick her foot behind her head. And, she would do this regularly at dinner parties. That’s my great-grandmother. To me, that is a model of health and that’s what I want.
So I want to speak to you today with a few hats on. I want to speak to you as bioengineer who graduated from MIT, and practices systems biology. I want to speak to you as a clinical researcher who has gone from doing randomized trials to doing n of one studies because I think that’s the future of evidence, especially when it comes to precision and personalized medicine. Which, is what I practice. I want to speak to you, especially as a mother. I have two daughters that are teenagers.
Do any of you have teenagers in the house? Okay, so there’s some stress in the room. So, I have two daughters and one of the indicators of health is life expectancy. Right, life expectancy. I noticed in the UAE that life expectancy has been increasing every year. In the United States, our life expectancy reached a maximum of 78, and it has been declining for the past three years. Declining, so for those two precious daughters of mine, they have a shorter life expectancy than I did when I was. That’s not a good direction. That is not health.
So let’s start with the first pillar. Eat. It seems so simple. When I went through my medical education, I was taught that food was calories. It’s fuel for yourselves. But, I would actually argue today that food is information for your DNA. And, as we just heard, not just for the DNA of your human cells which are outnumbered. The DNA is outnumbered 100 to 1 by your microbiome; by the DNA of the microbes in your gut. So food is meant to be information for your own DNA and for the DNA of the microbes that you carry.
One of the things I tell my patients because let’s face it; nutrition can be confusing. A lot of my patients come to me and they’re paralyzed. They don’t know what to do with food. One day, eggs are good. The next day, they’re bad. When coffee is a bad idea, the next day, we’re supposed to put butter in it. What do we do well? There is great consensus about vegetables. What I tell my patients is I want you to be eating a pound of vegetables every day. Bonus prize, if you eat two pounds. What kind of vegetables? I don’t want that to only be broccoli or romaine lettuce. I want it to be 20 to 30 species of vegetables each week. Because that’s the way our ancestors ate and our DNA evolved millions of years ago to use vegetables and other healthy whole foods as information for DNA. When I went to breakfast this morning, I had 30 species of vegetables in one meal. I love this hotel. My DNA got everything it needed. So, you have a meal coming up and what I most hope for you is that you take this information. You take this first pillar of health and you get as many species on your plate as possible with your next meal which I hope is lunch.
It’s not just what you eat, it’s also when you eat it. What I found in my practice, over the past 25 years, is that caloric restriction was the way that we advise patients to lose weight. We have an obesity epidemic, but unfortunately, it’s not very successful. Only about two to ten percent of patients can do it. On the other hand, intermittent fasting where you restrict the window that you eat is successful by 90 to 95 percent of patients. It’s a strategy that’s very effective and it makes sense, especially when you consider the way that our genome developed. So we did not evolve on the savanna, eating breakfast, lunch, dinner, and snacks in between. We evolved eating a few hours after the sun comes up, restricting our eating window probably to about eight hours and finishing our last meal a few hours before the sun goes down. So that there’s a period of metabolic rest. So that you can get all the gunk out of your cells.
Intermittent fasting. There are many different protocols many which are proven in randomized trials. What I think is the simplest is called 16/8. So what does that mean? It means that you eat within an eight-hour window and then you fast overnight for 16 hours. There is even data showing that if you eat on the earlier side, it can reset the signal with your blood sugar. Very important. We used to think that there were about 12 genes that are involved in your regulation of blood sugar. Now, we think there are about 6,000. So, as you can imagine, the data is pretty complex. When you look at the gene-environment interaction, this is a way to simplify it. I eat between 8:00 in the morning and 4:00 p.m. Not everyone can do that. It makes you a bit of a social pariah. It’s very hard to socialize at night. A lot of my patients eat between noon and 8:00 p.m. Now, from my hotel room, I could see people enjoying their meals until about 11 o’clock or midnight last night. Right. I don’t think they started eating at 3 p.m. or 4 p.m. I think they had a very long eating window which is not so good for your blood sugar.
Second pillar. Move. I always knew it was a good idea to exercise regularly. So in the United States, we have the recommendation that you have 150 minutes per week of moderate activity. I went to a spa two years ago with my husband and we did something called High-Intensity Interval Training (HIIT) classes. Do any of you practice HIIT? some okay so I go to this class and the instructor warms us up I go with my husband and he puts this box in front of me the box is about 18 inches high and he says we’re going to box jump you’re gonna jump up on this box and then jump back down he demonstrates he does it impeccably I go and look at this box I think I was a gymnast as a teenager I think I got this so I muster my courage I jump up on this box I land it and I jump back down and I think oh I survived I didn’t wipe out and then he says 14 more times what I discovered is that the first set of muscles muscle fibers that you lose as you get older is called the to be muscle fibers they are the ones that are responsible for explosive effort including box jumping in including swinging a kettlebell including burpees any fans of burpees in the room so those are the muscle fibers we actually have to be cultivating as part of movement and movement is function which is not part of that definition that I learned when I went to Harvard Medical School but it’s part of my new definition
Sleep. How many of you wear trackers? Raise your hand. Okay. So right now, about 50% of people in the world where trackers. In ten years’ time, that will be a hundred percent and 50 percent of those will be implantable. That’s coming and trackers generally track health. I have a few of them when it comes to sleep. We know that you must get 7 to 8.5 hours every night for health. 7 to 8.5 hours. Now, when I tell especially a type-a man in my practice that he needs 7 to 8.5 hours, he usually says to me. Oh, no, no, no. You don’t understand, I am just fine with 6 hours. I’m just fine with 5 hours. I’m super productive. I just drink my coffee. I’m good. 3% of the population has the short sleep gene so 97% of the rest of us need our 7 to 8.5 hours. And I would even challenge you to go one step further. Wear a tracker and measure your deep sleep. You should get a minimum of 90 minutes every night. Why is this important? I did my residency training at the University of California at San Francisco where Elizabeth Blackburn used to have her lab. Elizabeth Blackburn got the Nobel Prize in 2009 for her work on telomeres. Telomeres are the little caps on your chromosomes that are a marker of your biological aging as opposed to your chronological aging. Do any of you know your telomere length? Okay, sleep is essential to keeping your telomeres long and lovely to slowing down the aging process. In the United States, we measure telomere length we’re still not quite sure how clinically valid that is. But it’s something that’s coming.
Think. We heard this morning about the gut-brain axis. We know that all disease begins in the gut and I think the gut-brain access and its integrity is essential to your health. It’s one of the problems that my grandmother experienced and it’s what led to this path of Alzheimer’s disease. So I tested negative for the Alzheimer’s gene but I can tell you I do these seven pillars of health every single day because I want to dance and my great grandchildren’s wedding. That’s very important to me as a definition of health, one of the things that can interfere with our thought process is the way that we rise above stress and it’s not so much that stress is a problem, it’s that those who have high perceived stress are at greatest risk. It shrinks your telomeres, it ages you faster, it shrinks the brain, it pokes holes in the gut lining, and increases intestinal permeability and this can disrupt your ability to think.
The fifth pillar of health is to soothe. To understand what are the top three things that you can do to reduce your perceived stress, to buffer the matrix of your body from high cortisol. Today, I went to the gym at 4 o’clock in the morning. There were only about three people there. Exercise is one of the best ways that I buffer stress. It increases stress resilience. I practice yoga. I’m a yoga teacher. Sit up straight, lengthen your spine. If you’re sitting with a little bit of an anterior tilt of your low back, that puts 400% increased stress on your low back. You only get one spine so take care of it.
The sixth pillar of health is to connect. And I’m not talking about this type of connection with cellphones. I’m talking about this type of connection. There’s this new area of social genomics that I think is really important to health. And one of the things that we know is that we are anciently wired to scan the environment for three things: Social rejection, social conflict, and social isolation. And when you experience any one of those three things, it triggers your immune system to go into high alert. It triggers an inflammatory cascade and it’s probably at the root of why we have an epidemic of autoimmune disease. Connection.
The last pillar of health is to detox and this used to be a luxury. I was taught in my medical training that detoxification occurs naturally; that the body just takes care of it. Don’t worry about it. That’s not been my experience in the past 25 years of taking care of patients. So what I found is that my patients are very commonly toxic; whether it’s from drinking too much alcohol or getting exposed to something like glyphosate. I understand in the UAE, you banned glyphosate in 2017. That is fantastic because glyphosate disrupts the gut-brain access. It gives, it disrupts the integrity of the gut lining. It leads to problems with brain inflammation. Detoxification. We have to do it actively.
So let me finish with an analogy. We’ve talked a little bit about genomics, your set of DNA. You have 20,000 to 25,000 genes. We’ve talked a bit about the environment. Francis Collins, the head of the National Institutes of Health in the United States, said the following. “When it comes to genomics, genes load the gun, environment pulls the trigger.” What that means is that only about 10% of your risk of disease is due to your genes. 90% is due to your environment, much of which is under your control.
So I would say, it’s our sacred opportunity to uphold these 7 pillars of health. And I agree with the World Health Organization (WHO) which has redefined health, not as the absence of disease, which in my mind is a double negative, but as the state of physical mental, and social well-being.
Dr. Sara Gottfried, Doctor and Author talks about the 7 pillars of Holistic Health during the Redesigning Medicine forums. One of the facts that she shares is that intermittent fasting and restricting the eating window is successful for 95% of patients struggling with weight loss.