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Most people want to feel energized and experience a sense of vitality. In the 1970s, Dr. John Travis created a spectrum of wellness, with illness on one side, a point of neutrality in the middle (when a person has no signs or symptoms of disease), and on the other side wellness.

Wellness is a state of health and flourishing beyond simply not experiencing illness. In this state people feel confident, open to challenges, curious, and thirsty for action. They are thriving. People who experience wellness may seek to hike a mountain, read a new book, learn how to play a new instrument, or actively connect with new people.

The most common health conditions facing people today include heart disease, stroke, diabetes, and cancer. When people are experiencing these (and other) conditions, they fall into the illness side of the spectrum. Lifestyle factors that put you at risk for developing these conditions include smoking, alcohol substance use disorder, lack of exercise, sleep deprivation, and a diet rich in processed foods, sugar, saturated fat, and artificial flavors. An unhealthy weight is another factor that can put one at risk for these conditions, especially carrying extra weight around your midsection.

To move to the wellness side of the spectrum, you can include more movement in your day; enjoy a whole-food (unprocessed), plant-predominant style of eating; avoid smoking; sleep seven to nine hours a night; practice stress reduction techniques like deep breathing, yoga, meditation, tai chi, and mindfulness; and spend time with family and friends.

Think about what your body can do for you — and what you can do for your body

People of many sizes and shapes can be healthy and well, especially when they are connected to a calm mind that is practicing mindfulness, self-compassion, and a growth mindset. A body that is in the neutral point on the wellness spectrum can move to the side of thriving and flourishing when healthy lifestyle habits are adopted and sustained, and that has little to do with your body’s shape or size.

The body neutrality movement emphasizes the incredible functions, actions, and physiology of our bodies without regard for how our bodies look. We can see, hear, smell, taste, and feel. We can jump, skip, sing, hug, and dance. Our muscles have mitochondria that give us energy.

Our digestive system is one example of the wondrous process of the body. The digestive system has billions of microbes living in it that help us to ferment fiber from vegetables, fruits, and whole grains, and create short-chain fatty acids that help us with energy metabolism, glucose metabolism, lipid metabolism, inflammation, immunity, and more. This is why it’s important to eat fiber, including whole grains, vegetables, and fruits.

Connected to our bodies are our brains, and they are full of neurons (brain cells), synapses (connections), neurochemicals, and hormones that help to protect brain cells and make new ones. Moving our bodies helps to increase these chemicals. In addition, moving our bodies regularly helps us to increase serotonin, which may help us feel less anxious and depressed. Hugging increases oxytocin in the brain, and this “love hormone” helps us feel a sense of belonging and bonding. The body’s actions have a powerful impact on the brain, and vice versa.

Body positivity versus body neutrality

Body positivity is a movement that invites people to appreciate the body size and shape they have now without worrying about unrealistic body standards. With body positivity, society’s unhealthy standards for body shapes and sizes are challenged. It’s also important to remember that cultural norms and what’s considered an ideal body change with time.

The goal with body positivity is to honor and appreciate all body types, especially your own body. Feeling confident about the way you look feels good and can be empowering.

With body neutrality, the focus is on the function of your body: finding happiness and fulfillment, appreciating the power of our muscles, the strength of our bones, the protection our skin offers, and the rewards of the dopamine system in our brains. Connecting with friends and family, reaching small, meaningful goals, and enjoying physical activity are healthy ways to approach your body. A focus on finding pleasure in the wellness journey will serve your body — at any size — and your brain.

Remember all the things your body can do for you

• Transport you from one place to another (quickly or slowly)
• Release neurochemicals that give you pleasure, like from hugging a loved one
• Move your arms and/or legs with joy following the rhythm and beat of music
• Take deep breaths to calm your mind
• Perform stretches that release endorphins
• Practice yoga, tai chi, or qigong, which can help calm the body and mind.

A new scientific report supports research suggesting that even low levels of pollution — well below the current national regulatory cutoffs — may harm our health.

Outdoor air pollution stems largely from the burning of fossil fuels (coal, gas, oil), which generate noxious gases, smog, and soot. Smog, which makes air look hazy, is created by ground-level ozone. Soot is fine particles — you may see a dusting of soot on a windowsill, for example. The burning of fossil fuels is a major contributor to climate change that occurs over years, but it has more immediate health effects.

How can air pollution affect our health?

Research links increased levels of fine particles in the air that are tiny enough to be easily inhaled (called PM2.5) to more hospitalizations for heart disease, stroke, diabetes, and pneumonia. It also worsens existing lung disease, known as chronic obstructive pulmonary disease (COPD), and may cause other serious health problems. Both long-term exposure and short-term exposure seem to matter to our health.

A 2021 study looked at global models of pollution levels and risk assessments of the world population over 14 years. It tied fossil fuel alone to nearly nine million premature deaths worldwide in 2018 — that’s one in five deaths — including more than 350,000 in the United States. Most of these deaths are due to heart attacks and strokes.

People with underlying health conditions like asthma, heart disease, or diabetes, older adults, and people who live in low-income communities, which are often situated near polluting sources, are among those who are more likely to be harmed by air pollution.

How does low-level pollution affect us?

In the US, air pollution has improved quite a bit since the passage of the 1970 Clean Air Act. Current air quality standards set by the Environmental Protection Agency (EPA) spell out a certain annual threshold of particulates aimed at protecting health. But as we learn more about complex relationships between pollution and our ecosystem, growing evidence suggests that harm may occur at PM2.5 levels lower than the current standard.

The new Health Effects Institute report (note: automatic download) studied 68 million older Americans from all but two states across the US over a 16-year period.

The researchers had set themselves an incredibly challenging question to answer. There are innumerable variables to calculate: an individual’s exposure to pollution based on where they live, the independent contribution of the major air pollutants separately, health and behavior confounders that factor into mortality, and more.

The study drew on Medicare demographic and mortality data from more than 68 million Americans ages 65 and older. Calculations of yearly average pollution exposures came from multiple sources, including the EPA Air Quality System monitoring and satellite-derived data. The authors adjusted for many factors known to affect health, such as socioeconomic status, smoking, and body mass index. They developed several statistical models, all of which demonstrated similar results: between 2000 and 2016, death rates rose by 6% to 8% for each incremental increase in PM2.5 exposure.

Just how small were these increases in exposure to air pollution? Particle pollution is measured in micrograms per cubic meter of air (μg/m3). Each time exposure levels rose by 10 μg/m3, death rates also rose by 6% to 8%. Excess deaths occurred even at low levels of PM2.5 exposure (2.8 μg/m3), which is well below the current EPA standards cutoff. The study authors estimate that adjusting the cutoff down from the current level of 12 μg/m3 to 10 μg/m3 could save more than 143,000 lives over 10 years.

What are the limitations of this study?

One limitation is that the variety of data are compiled at different levels: the individual, zip code, and county level. For example, pollution exposure is estimated in clusters by zip code. Yet someone living near a highway may have higher exposure than another person living further from the highway in the same zip code.

Additionally, the groups with the lowest PM2.5 exposure most likely exclude many cities and include a higher proportion of rural areas. Rural areas tend to be less dense, have fewer air quality data points, and may have zip codes spanning greater distances. Details like these may affect the certainty of conclusions that can be drawn. Nonetheless, this study has many groundbreaking features with sound science.

Staying healthy: The bottom line

Air pollution is known to contribute to disease and death. Now we have more evidence suggesting that this is true even at low levels of pollution. Currently the US is considering whether to adjust regulatory cutoffs for annual fine particulate matter pollution known as PM2.5 to protect human health.

But don’t wait. You can take steps described in my previous blog post to reduce your exposure (and contribution) to pollution, and thus your health risks. And some of these steps have the added benefit of combatting climate change and improving planetary health.

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