The Vitality Mark E-Book

Mark Rowe

• Herausgeber: Gill Books
• Kategorie: Ratgeber
• Sprache: Englisch
• Veröffentlichungsjahr: 2022

Beschreibung

How can we live with more vitality? How can we wake up each morning feeling optimistic, invigorated and enthusiastic about the day ahead? Through his work as a lifestyle-medicine practitioner and practising GP, Dr Mark Rowe understands how our physical, mental, emotional and spiritual wellbeing all interconnect and impact on our health and ability to stay well. Balancing each of these elements forms the essence of vitality or 'the VitalityMark', as Dr Rowe has come to define it. This book can help you identify potential gaps in your wellbeing and offers a prescription of evidence-based strategies that will guide you from intention to action. By sharing insights from more than 25 years of helping others, Dr Rowe will direct you, too, towards health-enhancing habits to boost your energy, build resilience and better recharge from stress. Learn how the science of lifestyle medicine can transform the quality of your life and those of the people you love. Learn to live with more vitality.

Leseprobe

Contents

Cover

Title Page

Foreword

Introduction

Section One: The Heart of Vitality

The art of gratitude

The act of kindfulness

The negativity effect

Section Two: The Body of Vitality

Sleep: a natural vitality pill

Mindful movement

Mindful eating

Section Three: The Soul of Vitality

Purpose: finding yours

Meditation: an inner key

Viriditas: revitalising nature

Section Four: The Mind of Vitality

Mindful presence

Mindful choice

Choosing your responses

Mindful growth

Conclusion: Vitality – a new vital sign

Endnotes

Acknowledgements

Copyright

About the Author

About Gill Books

Foreword

I first met Dr Mark Rowe in person in 2017, when I was presenting a lecture on behaviour change for a Harvard Medical School CME (continuing medical education) course that he attended – and we’ve kept in contact digitally ever since. I’ve been able to follow Dr Rowe’s wisdom and insights through social media, videos and his podcast, In the Doctor’s Chair. This book now compiles his thoughts and theories into one easy-to-read resource; and, given the Covid-19 pandemic, the timing for The Vitality Mark could not be better, as people are struggling to find new ways to connect, to use stress-reduction techniques, to eat a healthy diet that can help our immune systems to best function and to set ourselves up for sound sleep at night.

How we move our bodies, what foods we enjoy, how many hours we sleep, how we handle stressful situations and our dedication to building high-quality connections all have an impact on our sense of wellbeing. Hippocrates spoke centuries ago about the first two of these important factors, and has been credited with saying ‘Walking is man’s best medicine’ and ‘If we could give every individual the right amount of nourishment and exercise, not too little and not too much, we would have found the safest way to health’.

More and more research supports these statements. Studies from the past couple of decades demonstrate how sleep impacts our bodies and brains, and how we suffer without sleep. It impacts many different areas of our lives and organs in our bodies, from the amount of food we crave and consume to the level of ghrelin (a hormone that increases our appetite) in our system. Psychiatrists and cardiologists have also been interested in the impact stress can have on the heart since at least 1988, when Alan Rozanski and colleagues demonstrated that mental stress could impact wall motion of the heart and myocardial ischemia. In fact, this research led me to study the impact of mental stress – specifically serial subtraction by seven, a test frequently used in dementia evaluations – on the heart–wall motion as well as EKG readings.

Our social connections also have a profound effect on our lives at every age. It was my own father’s heart attack and stroke, which he suffered at age 52, that put me on the path to medical school, and I have since gone on to further explore the prevention and treatment of heart attacks and strokes. The Covid-19 pandemic has brought the power of high-quality connections to the forefront of medicine and made it a priority for most people around the world. The six pillars of lifestyle medicine (exercise, healthy eating, sleep, stress resilience, social connection and avoidance of risky substances) all help to keep us healthy and add to our sense of wellbeing.

Vitality is defined by the Merriam Webster Dictionary as, firstly, ‘a lively or energetic quality’ and, secondly, ‘the power or ability of something to continue to live, be successful’. Vitality is wellbeing and more. By paying attention to our body, mind, heart and soul, we can increase our feeling of vitality – as Dr Rowe explains in this book. The Vitality Mark invites the reader to embark on a thorough exploration of each of these areas. As each person is unique, each reader will approach the book in his or her own way and will need different ingredients to increase their sense of vitality, which Dr Rowe’s VitalityMark assessment will help to identify.

It is an honour and delight to be a colleague and friend of Dr Rowe’s. I know you will enjoy The Vitality Mark, as his book comes to help save the day, save your life and, most importantly, add life to your years as well as your days.

Beth Frates

MD FACLM DipABLM

Introduction

‘If I’d known I was going to live this long, I’d have taken better care of myself.’

EUBIE BLAKE

‘My mission in life is not merely to survive, but to thrive; and to do so with some passion, some compassion, some humor, and some style.’

MAYA ANGELOU

I magine you feel energised and invigorated, when you might otherwise feel tired and depleted. Better able to withstand inflammation, illness and insidious disease. Your immune system reinforced, strengthening your natural defences against infection, while helping to buffer you from age-related degeneration. Your health span (the number of years you stay healthy) lengthened, and life added to your years. Your potential maximised.

As you become awake and alive to this possibility, your mind feels focused and clear. You become less reactive and more responsive as you develop crystal clarity in your decision-making. You wake in the morning with a sense of enthusiasm and optimism for a new day, fully present in the moment, finding joy in little things and a sense of flow in your lived experiences. You feel creative and more attuned to your senses and experiences, more connected to others. You care less about ‘me’ and more about ‘we’. You choose to spend more time in health-enhancing environments. Your spiritual energy is high, with a deep sense of fulfilment and inner contentment. You know that what you do – and, more importantly, who you are – really does matter. You are fuelled by a strong sense of purpose and meaning.

For me, these are the elements that form the essence of living with vitality: an opportunity to think, feel and become the best possible version of you. Vitality, as a word, is defined as ‘exuberant physical strength or mental vigour: a person of great vitality’, or someone with ‘capacity for survival or for the continuation of a meaningful or purposeful existence’. For me, vitality is a vibrant definition of wellbeing that incorporates the elements of emotion, physical health, mind, spirit and connection (in terms of relationships and environment) – all underpinned, of course, by a strong sense of purpose.

In Ancient Rome, Cicero wrote that philosophy teaches us to ‘be doctors to ourselves’. To me, this represents an enlightened idea of self-care – not just in terms of the individual, but a much broader definition that includes how you connect with and care for others. This combination of service to others, aligned to self-care in terms of body, mind, emotion and spirit, is the best way I know to live with vitality.

Throughout my career to date as a medical doctor, what I’ve come to appreciate more than anything else about wellbeing can be summarised in the short phrase: everything is connected. I’ve learned how physical, mental, emotional and spiritual aspects of your wellbeing, along with your relationships, environment and sense of purpose, all impact your vitality in an interconnected, synergistic way. They all influence who you are, and who you become. Small, positive changes can have a multiplying effect on other areas, compounding over time to create a big difference. Because, yes, I’ve said it already, but it’s worth repeating: everything is connected.

As I write this, the world is still undergoing a period of tremendous change and massive disruption. Covid-19 wreaked havoc on the health and everyday life of so many. The result: a surreal state of stress and fear, a sense of suspended animation, along with economic strife and concern over an uncertain future. I have tremendous respect for people who are able to smile through adversity and stay strong. I believe resilience starts the moment you acknowledge and accept the reality you find yourself in. Facing and embracing adversity leads to growth. Denying or suppressing it emotionally simply leads to more suffering. Acceptance becomes the new starting point from which to move forward, one step, one day at a time.

The paradox of Covid is that while everyday life changed for so many, the birds still sang sweetly, the sun still rose each morning, and nature remained as beautiful and effervescent as ever. Time alone to contemplate in nature has been a real gift for me – for my senses, spirit and sense of creative connection. It has opened up fresh understandings yet given rise to new questions.

As a family physician, this pandemic has impacted me in ways I never imagined, from conversations I’ve had with people, patients and myself to questioning and re-evaluating what matters most. A common theme in these conversations has been the importance of good ‘health’, including mind, body, emotion, spirit and connections. In short, life with vitality.

In a way, this book is my response to the pandemic. It is a paradigm shift from what you have lost to how you can grow as an active participant in your own wellbeing – rather than simply a passive consumer of healthcare. How to grow more in compassion, care and consideration to the needs of others as well as yourself. To understand that in any given moment you can choose how to respond. To choose to live with more vitality.

YOUR VITALITYMARK

The starting point, on this journey to living with more vitality, is to work out where you’re beginning from. That’s where my VitalityMark assessment comes in; it’s a subjective, ‘moment in time’ online measurement of your current wellbeing. The questionnaire scores you separately in each of the five areas of your vitality – emotion, physical, spirit, mind and connection – in addition to giving you an overall vitality score: your own VitalityMark.

Your individual scores may signal which area is of most relevance to you right now. Perhaps it’s your physical energy or attentive focus that needs the most attention; or maybe it’s your sense of purpose. Whatever it is, the reality is that everyone has gaps. And VitalityMark is not about being perfect, but rather about progress. What gets measured gets improved, and the smallest of actions can speak so much more loudly than the smallest of intentions.

Perhaps most important of all, however, is the remembrance that everything is interconnected. This is one of the key principles of VitalityMark, and it’s why improving any one element of your vitality may positively impact on other elements as well. VitalityMark supports you to become a more active participant in your own wellbeing and to express a more revitalised version of yourself in the world. The essence of VitalityMark as a wellbeing tool is that it allows you to identify and commit to adopting small, positive lifestyle habits that strengthen and support you in your self-care journey. It is your commitment to live with more vitality – to never stop starting.

Let’s try to get a rough sense of your VitalityMark now, with a look at some sample questions that I use in my online assessment. Read through the following statements carefully and decide whether you agree or disagree with each one. Then try to think about whether your answers highlight any areas where you could be living with more vitality.

Emotion

My life is filled with people and activities that interest and engage me

I am optimistic about the future

I never feel lonely or left out

I am satisfied with my life overall

Physical

I get eight hours of sleep each night

I get at least 150 minutes of moderately intense exercise each week (able to talk but not sing) or at least 75 minutes of intense exercise each week (can neither talk nor sing)

I move regularly throughout the day

I eat a wide variety of plant-based foods (beans, peas, lentils, vegetables, fruit, whole grains, nuts and seeds)

Spirit

If I could live my life over, I would change very little

I spend some time daily in solitude or silence

My values are an important guide to my choices and decisions

I have a great sense of purpose and meaning in my life

Mind

I focus my attention on one thing at a time, not distracted by email, texts or social media

I keep a written journal for reflective purposes

Learning new things is important to me

I find it easy to switch off from work

Connection

I experience feelings of burnout

I spend time regularly in nature

I make enough time for my friends

I value the importance of self-care

This is only a short, unscored sample of my VitalityMark assessment, but these are questions that everybody can benefit from thinking about consciously. And, as I’ve said, the aim of the measurement is progress – so it may be helpful to return to this section once you’ve finished this book and see if your answers have changed at all.

To learn more about VitalityMark, including how to get a full, accurate measurement of your current VitalityMark and benefit from associated resources, log on to drmarkrowe.com.

AGEING WELL

While knowledge cares about answers, wisdom is more interested in asking the right questions. By combining objective data from science, aligned to subjective experience in my work as a medical doctor, I believe that asking the right questions has never been more important. Questions that include:

Why do people suffer from toxic stress and anxiety?

Why do many people neglect their own self-care needs?

Why do some people grow older without the decrepitude of ageing?

According to the World Health Organization, two-thirds or more of all diseases worldwide will soon be the result of lifestyle habits. Currently, the leading causes of death in the United States are all lifestyle-related: poor diet, lack of exercise, obesity, tobacco use and overconsumption of alcohol.

In recent decades, the lifestyle habits of the Western World have contributed to a tsunami of chronic health conditions, from diabetes and dementia to coronary heart disease and countless others. An epidemic of anxiety, addiction and mental health conditions has emerged, with more people than ever searching for purpose and meaning. Conventional healthcare has traditionally embraced ‘a pill for every ill’, and the mindset on ageing is equated with retirement and the associated inexorable decline into senility.

When patients attend me in my practice, the computerised record tells me their ‘age’ and date of birth. Of course, no one can change this number staring out from the computer; your date of birth or chronological age is fixed – for you, for me, for all of us! But what I call your biological age – the miles on your clock – that’s a different story. Something that has intrigued me for many years is how older people with similar dates of birth can simply look and be so different in terms of their health. Could it simply be down to bad luck or genetics?

Well, an answer has been provided by a Danish twin study which found that only about 20 per cent of the difference in the health of identical twins was down to genetics. The remaining 80 per cent related to environmental and lifestyle differences1.

In medical school, we learn that our DNA is set in stone. Untouchable, unchangeable. That our biological blueprint determines our destiny. While part of a person’s genome clearly does remain fixed, perhaps up to 80 per cent of how your genes express themselves is regulated by something called your epigenome. The Greek word epi means ‘upon’, so epigenetics is essentially the study of what sits on top of genetics. The epigenome is the sheath of proteins and chemicals that cushions, protects and modifies each strand of your DNA. It can be switched on or off like a light switch, up and down like a thermostat. Furthermore, your epigenetics are influenced largely by your lifestyle. Therefore, assuming a fair wind and an element of good fortune (it always helps!), and within the confines of biological limits (which, for age, is thought to be about 100 for most people and up to 120 for outliers), then all things being equal, the healthiest lifestyle can be expected to maximise your life expectancy.

In other words, your genetic expression (excepting hereditary conditions) is to a large measure under your own control and responds to the lifestyle choices you make and the environments you experience each and every day of your life. Expressing your epigenetic potential in a health-enhancing way can help slow the ageing process, enhance your energy, normalise your metabolism and decrease your risk of developing many chronic diseases. Every day in my surgery, I see epigenetics in action when I meet people who look much older (or younger) than their age. In fact, many ‘elderly’ citizens over the age of 85 are much, much younger biologically (75, max). This is a big change from when I started in practice, when someone surviving to, never mind thriving at, age 85 was something of a rarity. The bottom line is that you have two ages, chronological and biological, and what I’ve learned from my experience to date is that your biological age is heavily influenced by your lifestyle.

The Dunedin Study, headed up by Duke University, tracked almost a thousand people from New Zealand born in 1972 and 1973 and calculated their biological age after their 38th birthday. While there is currently no definitive measure of biological age, the researchers used 18 separate biomarkers (including dental health, cholesterol levels, brain health, condition of blood vessels at the back of the eye) as well as other tests, including measures of balance and muscle strength. The researchers found that while most people aged by one biological year for each chronological year, some people aged much slower or faster than this. The biological age of the participants varied from 28 to 61! Some participants aged by as much as three years for each chronological year, and these people not only looked older but had evidence of brain ageing and generalised decline as well.

Blue zones are areas of the world where longevity is the rule rather than the exception; where people have a threefold increased chance of living to be 100. Not simply striving to or surviving, but actually thriving well beyond age 90 in every sense of what it means to be human. It turns out that inhabitants of these areas have a number of features in common. These include a largely plant-based or Mediterranean diet, regular movement and exercise, an ability to recharge from stress, in addition to connections with friends, community, having a strong sense of purpose, and a higher power. These areas include the Nicoya Peninsula in Costa Rica, the Barbagia region of Sardinia in Italy, Okinawa in Japan and the Greek island of Icaria.

While not many of us can choose to emigrate to these parts of the world, in reality, you don’t have to. By integrating positive health principles with the promising science of lifestyle as medicine, aligned to my practical tips, you can gift yourself more vitality in your everyday experiences, and your longer-term wellbeing.

LIFESTYLE AS MEDICINE

The idea of lifestyle habits as effective medicine is very old. Just think of Hippocrates (‘let food be your medicine and medicine your food’), or Cicero (‘it is exercise alone that supports the spirits and keeps the mind in vigour’) among many others espousing the many benefits. More recently, Thomas Edison wrote: ‘The doctor of the future will give no medicine, but instead will interest his patients in the care of the human frame, in diet and in the cause and prevention of disease.’ That future is now arriving, with the principles of lifestyle medicine gaining real traction around the world, underpinned by a growing body of scientific evidence. This is bringing to life the idea of taking care of your body as though you might really need it for one hundred years.

The European Prospective Investigation into Cancer and Nutrition (EPIC) study, involving almost 25,000 men and women, found that the presence of four healthy lifestyle factors – not smoking, normal weight, moderate exercise of at least 30 minutes per day, and a high intake of vegetables, fruit and whole grains with low meat intake – reduced the risk of chronic disease by 78 per cent. Another study by the Harvard School of Public Health found that people who exercised an average of 30 minutes a day, never smoked, didn’t drink alcohol to excess, weren’t overweight and ate a healthy diet lived an additional 12 to 14 years on average!2

The Harvard Study of Adult Development expands on these findings, listing six factors that are associated with healthy ageing – exercise, not smoking (or drinking alcohol to excess), healthy weight, healthy coping mechanisms with stress, stable mood and (in inner-city deprived areas) education which supports positive lifestyle change.

Mindset about ageing matters too, big time! Yale University research has found that simply having a positive view of ageing (seeing growing older as an opportunity to gain wisdom and fresh perspectives) as opposed to a negative view of ageing (sense of loss, disability) can support you to live at least seven years longer3.

This concept of a healthy lifestyle as a helping hand for more vitality has captivated me for years. The environments you spend your time in can be either health-enhancing or health-depleting – not just the outer environments you work and live in, but the inner environments of thought and emotion. All underpinned by a strong sense of purpose: knowing that what you do and who you are really does matter.

As a doctor, I’m a scientist at heart, swayed by the evidence. For me, this has two separate interrelated elements. First, randomised controlled trials and other pieces of objective research, some of which I have mentioned. Second, I also value subjective experience in terms of what I see in my surgery each day, and how my suggestions and strategies to improve health can have an impact.

IN MY PRACTICE

Which brings me to John, the quintessential doctor-avoiding Irish male. I met him for the first time when he was 70 years old and was legally required to see his doctor to have his driver’s licence renewed. While his wife had been regularly attending our practice for many years, this was our first time to meet up. It was John’s first time with a doctor ‘for as long as [he] could remember’. Even though he had access to free medical care by virtue of his medical card, that clearly hadn’t been enough to entice him to avail of the occasional check-up.

With the formalities of the driver’s licence dispensed with, I dug into his lifestyle. Very sedentary, no exercise worth talking about, little enough movement throughout his day. Poor eating habits with plenty of takeaways loaded with salt and fat, washed down with ‘slabs of beer’ at the weekends. Unsurprisingly, his blood pressure was up. He looked every day of his 70 years. Biologically, he was at least 77.

‘At least you don’t smoke,’ I said, gently cajoling him into having some simple blood tests with a planned review scheduled for a week later. The results revealed what I suspected: a ticking time bomb. Blood pressure high. Raised total and LDL (bad) cholesterol, raised blood fat and low HDL (good) cholesterol. Raised blood sugar and ninety-day blood sugar test (HbAIc) putting him in the diabetes range. Raised liver function tests suggesting fatty liver disease. Raised uric acid suggesting attacks of gout were on the way. Belly circumference of 44 inches, confirming the presence of metabolic syndrome, a condition that puts you at significantly increased risk of stroke, heart disease and diabetes. I didn’t know where to start!

‘To be honest John,’ I said, ‘you need treatment for your blood pressure, diabetes and cholesterol. We are talking about at least six tablets a day and that’s just for starters. But there is an alternative. No guarantees, but if you can make major lifestyle changes, then you will be able to avoid at least some of the medication.’

To my genuine and great surprise, John said that’s what he wanted to do. We had a conversation about what needed to happen next as part of a ninety-day simple action plan. Cut out the slabs of beer. Move as much as possible. Eat real food, lots of colour, mainly vegetables and fruit. Most importantly, stay on track. If you have the odd slip, don’t worry, just get back on track again as soon as you can. Focus on progress, not perfection.

As planned, John had his bloods rechecked and came back for a review appointment, without needing to call him in. Six months after our initial meeting, his results were now astonishingly good. Diabetes reversed. Liver function normal. Blood fat and cholesterol back in normal range. Uric acid normal. On examination, his blood pressure was down. He had taken more than four inches off his belly circumference. He said he felt great, with much more energy, and felt his mood had improved as well. Of note, his subjective wellbeing (a score between zero and ten in terms of his perceived mood) was seven out of ten. When I had met him first, he had said it was five (not depressed, but certainly flat). He said he was sleeping better, and he wasn’t waking up feeling tired in the mornings any longer. Perhaps best of all, he looked terrific – much younger, with a real vibrancy about him.

What had John really done after my advice was dispensed? That’s what interests me, because actions speak louder than words. John had walked the walk. He loaded up on fresh vegetables and only ate food from his own kitchen. He made regular pots of vegetable soup and stews with lots of chopped sweet potatoes, chickpeas and lentils to bulk them out. Committed to eating and drinking nothing after six o’clock in the evening, apart from some herbal tea. Made sure never to shop when hungry and stopped buying treats ‘just in case we have visitors’. Ditched the slabs of beer. Started walking, firstly the 10 minutes or so to and from the local shop instead of driving, then built the walking habit until he was averaging about 12,000 steps a day. Perhaps best of all, he took my advice to buy an exercise bike. Piggybacking exercise with his favourite hobby of watching some TV at night, he quickly built up to more than an hour or more each day on the bike. He brought micro-moments of movement into his day. When sitting down watching TV, he committed to standing up and walking around during every commercial break.

I was delighted to celebrate John’s achievements with him. Not so much the blood results per se, more that he had chosen to become an active participant in his own wellbeing, as opposed to being a passive consumer of healthcare. That commitment by John had made all the difference. Furthermore, he spoke about how he was now actively encouraging his wife to become healthier. This was the ripple effect of positive lifestyle changes in evidence before my own eyes.

John and I have joked since about how he has become my ‘poster boy’ for positive lifestyle change. I’m proud to know John and for his efforts to improve his own health. It’s never easy to change the habits of a lifetime, but can be so worthwhile, especially when it comes to your greatest asset, your health.

IN WITH THE OLD

The conventional concept of health is defined through the lens of illness: if you’re not sick or feeling unwell, then your health is fine. What I’ve learned is that health is so much more than just the absence of disease. Good health is a priceless gift, the greatest gift of all. More than 70 years ago, in 1948, the World Health Organization (WHO) defined health as not merely the absence of disease, but a state of complete physical, mental and relational wellbeing. Unfortunately, this statement has gathered dust for far too long. It’s only recently that elements of the medical profession are ‘waking up’ to this WHO definition.

In life we are all formed by our own experiences. For me, the aftermath of the 2009 financial crash fundamentally changed how I viewed ‘health’. With a deluge of people suffering from fear, financial pressure and toxic stress now attending me in my medical practice, it rapidly became apparent that people needed – more than pills – hope and what I call realistic optimism – understanding that things can improve through the power of your own efforts. Let me be clear: this was not an attempt to denigrate or pooh-pooh the potential benefits of medication for many health conditions (including depression and anxiety). Far from it. Rather it was a growing awareness that, on its own, medication was not enough. While talk therapy can be invaluable, at that time it was only available if you could pay. This was the eureka moment that prompted me to research additional ways to support my many patients who were struggling or suffering. It led to my interest in learning more about the potential benefits of positive psychology interventions and how prescribing positive lifestyle changes as ‘medicine’ can make such a difference in the health, wellbeing and everyday lived experience for many.

For me to effectively embrace this truth, I needed to look backwards to look forwards. In 2017, Gensler (a global architecture, design and planning firm) hosted me at their headquarters in Washington, DC for several days to address their clients and staff about wellbeing. While there, I was introduced through a fascinating conversation with someone to the Tao Te Ching, a classic Chinese text written by Lao Tzu. I had heard of Lao Tzu (who famously wrote that ‘the journey of a thousand miles begins with a single step’), but the teachings of the Tao Te Ching were completely new territory for me. When I got back home to Ireland, I immediately ordered a copy of the text to learn more.

Dating back to pre-Confucian times (about 400 BC), the essence of the Tao essentially concerns a way of being in the world where ‘being’, rather than knowing or having, is the highest order there is. My key takeaways were that it espouses inner integrity, a sense of balance, proportion and a way of living that is in harmony with nature and the world you live in. By emphasising the importance of simplicity, universal compassion and humility, it also highlights that emotional energy connects in turn to physical, spiritual and mental energy. In other words, it shows how interconnected the various elements of your wellbeing really are.

Bearing this ancient philosophy in mind, I then began looking forward again, to embrace the environment of the epigenome, habits that help health span and support living with more vitality. It may have taken many years of practising the ‘old way’ for me to wake up to this new reality, but as they say, better late than never. What’s even better is that once you see things differently, then there’s no going back to the old way.

Personal reflections, as well as professional observation of and interaction with my patients over many years, has enabled me to open my eyes to this concept of vitality. That’s what this book is about: an opportunity for me to share what I’ve learned so far in giving you knowledge, skills and ideas to reset your course towards habits that are more health-enhancing and revitalising. In turn, you may become an even more positive influence on those people around you, as well as have fun along the way.

USING THIS BOOK

Perhaps the most important (even the only) question for you to answer right now is: why read this book? Whether you are struggling with your wellbeing, or simply looking to further enhance your vitality, then this book is for you.

The book is broken into sections that can be read either sequentially or on a stand-alone basis. My promise is that you will learn some science-based strategies and suggestions to live with more vitality. This book is about those small changes that stick, from the inside out. Not massive changes, but simply appreciating the potential that comes from thinking small, and that small positive changes over time can make a real difference.

The book is broken into four parts: the heart, body, soul and mind of vitality. As I’ve already said, my belief is that all areas of our health are intrinsically connected, and each part of the book will focus on strategies and techniques that can lead to improvements in each part of your life. I have also included case studies to illustrate how these concepts have worked in my practice – real-life examples of patients who derived benefit from lifestyle changes.

There are also sections throughout the book where I ask you to engage in personal reflection. Keeping a written journal can be invaluable to become really clear about your goals and your written plan for achieving them. It teaches you objective perspective, enabling you to see things more clearly and to evaluate your progress. A good intention is far more likely to result in action with advance planning and proper preparation. For example, it can be helpful to reflect on what worked for you before and why. What could go better next time and how? What are the situations, people and places that can provide support (or indeed hinder) your proposed change?

Reviewing each week in this way allows your unfolding experiences to become the best curriculum to learn from. Leveraging your own previous successes and ‘failures’, planning for success while anticipating roadblocks and challenges can support you in making lasting change. This is perhaps the best way to make sustainable progress towards any worthwhile life change. Fail to prepare, prepare to fail!

Living your life through the lens of ‘vitality’ has many benefits. You will think, feel and become closer to your creative best, expressing a better version of yourself in the world.

IN MY PRACTICE

I saw this clearly with a recent patient of mine, Richard, who attended me for a series of lifestyle consultations. He had taken my wellbeing assessment tool, and his overall score was 60 per cent – reasonably good, with plenty of room for improvement. VitalityMark had provided him with a written pdf and targeted video resources, based on how he had answered. One recommendation was for him to keep a written journal.

Richard hadn’t written anything down regularly since homework assignments at school, decades earlier. Yet he was now curious about the potential benefits of keeping a written journal, termed ‘thinking on paper’ and so loved by philosophers of old, especially given that it didn’t require much time, just a few minutes each day. Richard began by writing down his main health goals for the week in terms of his exercise and eating habits and then simply tracked each day what actually happened.

What’s interesting is that the executive and writing parts of the brain are located close together, which is why written goals can be so affirming. Actions speak louder than words, of course, written or otherwise. Reviewing his progress each week was key to enabling Richard to become crystal clear about how he was matching up. Learning what had gone well and why, as well as those days when he had fallen short, allowed his own experiences to become a template for potential improvement. By getting to know himself better, he became more aware of his intention gaps, as well as the people, places, environments and situations that supported his health goals. This habit of self-reflection supported Richard to make lasting improvements over time. In his own words, he became ‘more aware of what I was really doing each day, and by holding myself accountable, naturally became more active and a healthier eater over time. For such a simple idea, the journal can have a big impact. It did for me anyway and I’d highly recommend anyone to give it a try and see if it works for them.’

THE HAND OF VITALITY

I developed this Hand of Vitality model as a practical means of, firstly, better understanding just how interconnected the various elements of your vitality are. Secondly, it can also help you to appreciate that living with more vitality is about simplicity, how small changes can lead to big improvements over time. Small positive changes in one element of your vitality provide a multiplicity of benefits in other elements. Take a look at your own hand: try and picture where each element fits in as you read through the descriptions below, and as you read through this book. The Hand of Vitality provides an opportunity to know yourself well enough to discover those elements of the model that can work best for you.

  Little Finger: The Heart of Vitality

The little finger represents emotional essence, the heart of vitality. Its three segments are the art of gratitude, the act of kindfulness and flourishing emotional energy – an antidote to negativity.

  Ring Finger: The Body of Vitality

The ring finger represents physical energy, or the body of vitality. Its three segments are restorative sleep, exercise and mindful eating.

  Middle Finger: The Soul of Vitality

The middle finger represents spiritual essence, the soul of vitality. Its three segments are purpose, meditation and nature.

  Index Finger: The Mind of Vitality

The index finger represents mental energy, the mind of vitality. Its three segments are mindful presence, mindful choice and mindful growth.

  Thumb: Self-care

The thumb is a reminder of the fundamental importance of self-care. Its two segments are self-care and care for others. As you extend your hand to others, the base of your thumb points towards you, highlighting the importance of self-care; taking good care of yourself as a starting point to sustainably support others in your life.

  Centre of Your Hand

Purpose, located at the base of your middle finger, connects to the centre of your hand as a reminder of the importance of authenticity. Authentic connection engages you with the essence of who you are – raw, unscripted and real.

  Fingerprint

Your Hand of Vitality has a unique fingerprint – yours! A reminder that you are a unique individual, with the likelihood of two people sharing identical fingerprints by chance estimated to be less than one in 64 billion. Do you appreciate just how unique and special you are?

  The Area Around Your Hand

The area around your hand represents the environments you spend your time in. These environments can either be health-enhancing or health-depleting. They can influence your emotions, body, spirit, mind and indeed your self-care as well as your connection with others.

Your second hand represents attitudinal and emotional contagion. The mirror neurons in your brain lead to you being influenced by those people you spend most time with, in person or online. Emotional contagion means that emotion can spread outwards to three degrees of separation.

  Pulse

The pulse represents the vibrancy and positive energy that you can bring to the world through the interconnection of the various elements of your vitality. A reminder to become more of an active participant in your own wellbeing, as opposed to simply a passive consumer of healthcare.

  Movement