The Determinants of Health

In a number of my introductory posts I have mentioned that naturopathic physicians aim to create the conditions for health in their patients. In today’s post, I hope to elaborate on what exactly some of those conditions are, and why they are so vital to creating a strong foundation for achieving health, wellness, and wholeness.


According to the 2008 Physical Activity Guidelines for Americansadults should get at least 150 minutes of moderate-intensity or 75 minutes of vigorous-intensity exercise each week. The health benefits associated with exercises, like lowered risk of heart disease and type 2 diabetes, increase with increases in exercise. Therefore, it is even more beneficial for adults to aim for 300 minutes of moderate-intensity or 150 minutes of vigorous-intensity exercise. The guidelines also recommend strength training at least two times a week.

So what qualifies as moderate-intensity exercise? The CDC describes it as any activity that gets your heart rate up and gets you moving to the point that you are “able to talk, but not sing the words to your favorite song.” Activities that likely fall in this category are brisk walking, pushing a lawnmower, biking on flat ground, doubles tennis, or hiking. Vigorous-intensity exercise has your body working hard enough that it is difficult to get out more than just a couple of words at a time. Think about activities like running, swimming lapssingles tennis, or my personal favorite, HIIT workouts.

Exercise not only helps your physical body, but also your mental-emotional body. Studies, like this one, have shown that regular exercise can also reduce depression severity.  This study found that a bout of high intensity aerobic training before a learning task has been shown to improve immediate and long-term memory. Another study found that moderate-intensity exercise prior to learning task, but not after, improved memory recall.

One review provided a theory of how aerobic exercise benefits memory. The researchers uncovered evidence that supports the idea that acute cardiovascular exercise helps to prime the molecular mechanisms responsible for memory formation, which may explain why the other study I mentioned only found participants who exercised before, not after, a learning task improved their recall. The review also proposes that “long-term exercise optimizes that molecular process responsible for memory processing.” In other words, a combination of acute and long-term aerobic exercise can benefit your memory!

Personally, as a part of my daily morning routine, I have been enjoying HIIT workouts. I find it a great way to jump start my morning, and they leave me feeling energized all day long! Plus, by exercising in the morning, I consider it a way of helping me to “passively study” later on in my classes, since my brain will be literally primed to learn and retain information. I also always make it a point to get in a solid sweat session before an exam to make sure that I am alert and have improved recall.

person holding black barbell


We all know that eating healthy is important, but sometimes it is difficult to discern what constitutes a “healthy” diet. We receive so much conflicting information from health professionals and the media that sometimes it can be really challenging to know how to properly fuel our bodies. Personally, I like to look past the click-bait headlines journalist use to lure us in, and instead look at the actual published research.

I have read papers on longitudinal studies (following populations of people for extended periods of time), migration studies (tracking disease risk of populations of people that leave their native home, and often diet and lifestyle, for another country), and intervention studies (that get participants to stick to a particular diet protocol and compare the results to a control group) and time and time again, I find that a whole-foods, plant-based diet prevents, reverses, and can even cure disease, thus promoting longevity. The healthiest, longest lived populations of people on the planet consume diets that are almost, if not entirely, whole, plant foods.

If you are also interested in diving into some nutritional research or maybe you are thinking about transitioning to a plant-based diet, but are not sure where to start, check out my resources page for some of my favorite books. These doctors know the research inside and out, clear up questions regarding some of the most common conflicting information, provide additional resources on how to transition to a more plant-based diet, and they manage to do all of that in ways that are approachable and easily understood!

I started out eating a plant-based diet for ethical reasons (you can read about why I am more than just plant-based here), but when I started reading about the health benefits associated with the diet, I was shocked to say the least! Admittedly, before I started eating a plant-based diet and truly understood how to read research, I had fallen victim of the paleo, low-carb, and even keto craze. But the quality and the quantity of research highlighting the health benefits of a plant-based lifestyle have opened my eyes to how much stress and potential harm my old diet was doing to my body. It is now part of my life’s mission to share this powerful, life-changing information with as many people as possible, and is one of the reasons why I started this blog. Ultimately it is your decision to choose what goes into your body, but I hope that this blog will provide you with a resource that can aid you in making informed decisions.

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Our bodies are about 60% water, so making sure we are adequately hydrate is essential for daily life processes. Water helps our cells function, our digestion to be smooth, lubricates our joints, helps our bodies eliminate toxins and wastes, and so much more! Being dehydrate can make us feel tired and groggy, so next time you find yourself yawning in the afternoon, maybe try reaching for a tall glass of water before your next caffeinated drink. Dehydration can also present as feelings of hunger, so being adequately hydrated ensures that we are able to be better attuned to our body’s natural hunger signals.

So how much water should we be drinking each day? It is tough to say exactly since we all have different health conditions, live in different areas, and have different levels of activity. “The National Academies of Sciences, Engineering, and Medicine determined that an adequate daily fluid intake is:

  • About 15.5 cups (3.7 liters) of fluids for men
  • About 11.5 cups (2.7 liters) of fluids a day for women

These recommendations cover fluids from water, other beverages and food. About 20 percent of daily fluid intake usually comes from food and the rest from drinks” (Mayo Clinic). Many plant foods like fruits and vegetables have a particular high water content, so eating a whole-foods, plant-based diet can help not only flood your body with vitamins and nutrients, but with water, too.

You can know if you are adequately hydrated by checking the color of your urine. It should be clear or nearly clear if you are consuming enough water. Over-hydration is rare, but can be serious medical condition, so try not to go crazy and over do it.

Caffeinated beverages like coffee are diuretics and can leave us dehydrated; therefore, for every cup of coffee I drink, I try to make sure I drink a glass of water to compensate for it.

I like to start my mornings by drinking a big glass of water as soon as I wake up. Also, whenever I go anywhere, I am always sure to bring a reusable water bottle, to make sure that I can stay adequately hydrated. Not only that, it is much cheaper and more-sustainable than buying bottled water (most places will fill up a reusable water bottle for free if you ask). I find that if I have my water bottle full and near me, I will drink it, so I do my best to set my self up for success.

clean clear cold drink


I feel like sleep is one of the most overlooked and underrated determinants of health. We live in a society that is always hustling, working, and trying to get ahead. It is almost like some kind of right-of-passage to brag to our friends and coworkers about how little sleep we are able to get, while still being productive. We often put off sleep for the sake of getting more work completed, but at what cost to the quality of our work and more importantly our health?

I am not going to act like I always prioritize sleep as much as I should. I went to a very rigorous undergraduate institution and am currently in medical school, so there have been, and will probably be, more nights where I am up late studying for finals or finishing an assignment. I just try to prioritize sleep the best that I can given the situation I am in, and definitely feel the effects on my performance cognitively, socially, and physically if and when I do not sleep enough.

According to the National Sleep Foundation, different age groups of people require more or less sleep. For adults between the ages of 18 to 64, they recommend getting, on average, about 7-9 hours of sleep. They have a really nice infograph on their website that includes information on all the age groups as well as potentially adequate, although not necessarily recommended, ranges of sleep.

We all know not getting enough sleep can effect our mood and our mental focus, probably from first-hand experience. What you might not know is that chronic lack of sleep is also associated with increased mortality risk and a number of physical and cognitive issues. These issues include, but are not limited to, higher risk of obesity, diabetes, lower glucose tolerance, cardiovascular disease, anxiety, depressed mood, and alcohol use (this information as well as a more in depth look at the science, can be found here).

Interestingly, a recently published study in Nature describes that a lack of sleep can lead to observable neural and behavioral changes that increase social withdraw and feelings of loneliness. Taken one step further, others are able to perceive these changes in sleep-deprived individuals, which leads them to feel lonelier themselves. I found this to be super fascinating and could see it having the potential for creating a negative feedback loop that gives rise to a community of lonely people.

If you’re interested in learning ways that you can improve your sleep quality and quantity let me know in the comments below. I’d be happy to talk more about it!

close up photography of sleeping dog


Sunshine is a fundamental aspect of our existence. Our circadian rhythms that dictate our sleep-wake cycles are closely tied to the sun. Getting daily exposure to the sun can help to increase melatonin production later at night. This is good news for people who have trouble sleeping at night, as melatonin is a hormone that tells the body that it is time to sleep. Early morning sun exposure, in particular, can help the body release melatonin earlier in the night, so that people can slip into sleep sooner.

The precursor to melatonin is a hormone called serotonin. You might know it as the “happy hormone” because moderately high levels of serotonin are associated with a more positive mood and mental focus. Research has revealed that mammalian skin can produce serotonin and convert it into melatonin, and some skin cells have receptors for both serotonin and melatonin. The researchers therefore stress the importance of getting outside periodically since so many of us live our lives indoors.

Sun exposure is most notably known to increase blood levels of Vitamin D. Vitamin D is a key nutrient to our existence. Low levels of Vitamin D have been associated with increased risk of developing different kinds of cancer, MS, cardiovascular disease, type 2 diabetes, hypertension, and metabolic disorders. It is also important to note that too much exposure to sunlight can also put people at risk for getting skin cancer. Balancing the two can be seem tricky, so feel free to check out this video or read this review to learn more about what a few professionals think about the matter.

light nature sky sunset

Social Interactions

We are social creatures by nature. We all want and need to be loved. The quantity and the quality of our relationships with others have huge consequences for our overall physical, mental, and emotional health.

Did you know that strong social relationships are correlated with increased lifespan? The researchers of this meta-analysis state that their “findings indicate that the influence of social relationships on the risk of death are comparable with well-established risk factors for mortality such as smoking and alcohol consumption and exceed the influence of other risk factors such as physical inactivity and obesity.”

It appears that the quantity of our relationships matters. This study found that people with the fewest number of social ties had twice the risk of dying compared to those with the most social ties. This finding held true even after controlling for socioeconomic status and health behaviors, among other variables. People that are the most socially connected, despite documented medical conditions, like coronary heart disease, may live longer as well.

As you might imagine, having positive and negative social ties appears to play a large role in our wellness. For example, stress in relationships seems to contribute to poor health habits in childhood, adolescence, and adulthood. This review states, “Relationship stress also undermines a sense of personal control and mental health, both of which are, in turn, associated with poorer physical health.”

If you’re curious to learn more about how our social relationships affect our health, I highly recommend checking out that review. It goes into great depth and even proposes a few mechanisms to explain the association between wellness and socialization. I also enjoyed that it discusses social variation within the association.

ground group growth hands


In my opinion, this may be the determinant of health that is overlooked the most. I myself am guilty of not always incorporating some kind of mindfulness or spiritual practice in my daily routine. Spirituality here does not necessarily mean that you subscribe to any one religion, although it does not necessarily mean that you do not. In this sense, I am talking about a practice that connects you to something greater than yourself, whether that be some kind of religious figure(s), the universe, nature, or simply the human race. It is about taking time throughout the day to be mindful and present since so much of our days are spent thinking about the past or the future. When was the last time you found yourself totally experiencing the present moment?

An excellent introduction to spiritual practice is mediation. Neuroscientists have uncovered that meditation affects processes in the brain involved in self-regulation including emotional regulation, attention control, and self-awareness. Meditation has has not only been shown to reduce stress, but can also to help people connect their awareness to the present moment. Some research suggests that meditation may also help to reduce anxiety, depressive symptoms, and pain in adolescents.

You do not need to meditate in order to incorporate mindfulness into your life. Having a mindfulness practice as a part of your daily routine can be be as simple as taking time each morning to make a cup of tea and truly experience every aspect of it as you drink it and inhale its pleasurable aroma. Taking a walk through the woods while disconnecting from technology, your worries, and your to-do list, and instead focusing your attention on the present moment, including the sounds you hear, the sights you see, the smell of the forest, and the feeling of the ground beneath your feet (walking barefoot can really help this) could also be a way that you incorporate a mindfulness activity as a part of your daily life. As you walk, connect to the fact that you are one entity that is part of the greater ecosystem that is directly around you, while also being connected to the human race and all of nature.

person meditating

So do you have any thoughts or questions about anything I have discussed so far? What kind of health related topics would you like to see in future posts? Please comment below, as always, I’d love to hear from you.

Disclaimer: I am a naturopathic medical student, not a licensed physician. The opinions expressed are my own, and do not reflect the opinions of the entire naturopathic doctor community. Nothing on my blog is intended to be taken as medical advice. Always consult a licensed physician before making any lifestyle or dietary changes.