A Doctor’s Tips to Create a Sustainable Cycle of Improved Health | Virginia Spine Institute
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A Doctor’s Tips to Create a Sustainable Cycle of Improved Health

Authored by Dr. Thomas Schuler, MD, FACS, FAAOS. January 19, 2024

How do we optimize our health? Is it losing weight? Exercising more? Eating healthy? We create resolutions with the desire to improve our health, yet are they effective and more importantly so sustainable? To get the optimal result, improved health, and quality of life, we need our efforts to produce short-term results but also long-term benefits.

Understanding one’s health is very interdependent on multiple factors and these factors all have interactions. You cannot ignore one part and expect overall success. I break these factors into avoidance, mental, exercise, diet, and sleep. Each of these factors impacts every one of the other factors and why this is so important as we look at our health as a well-interconnected cycle. Avoidance is a starting point since some behaviors are the most detrimental. The single best thing you can do for your long-term health is complete nicotine abstinence. Nicotine impairs tissue health and tissue healing. It impairs the ingrowth of new blood vessels into the injured tissues which creates an anoxic local environment that inhibits healing. Illicit drug use and overconsumption of alcohol are also critical areas to abstain. All of these taboo activities impair our health directly as well as through impaired exercise, mental well-being, and quality of sleep.

The mind is impacted by internal and external factors; some we can control and some we can’t. The key to the cycle of health is to control what you can. Eating healthy food; getting brain nutrients such as fish oil; obtaining quality sleep; and avoiding nicotine, drugs, and excessive alcohol are all critical for our mental well-being. Exercising improves blood flow and burns off stress. Mindfulness exercises further improve our mental state. Instead of activities, reading and socializing all improve our mental health.  Mental health is not a passive process but a very active process.

Diet is critical, for you are what you eat.

Healthy management of foods that come directly from plants and animals is the starting point. Processed foods add chemicals that are disruptive to our health. Our immune system, bone health, and our body fat are significantly impacted by our gut flora. Processed foods, soda, diet soda and beverages, and drug use can negatively impact our gut flora and thus our weight, immune status, and mental status are jeopardized. Vitamins are an insurance policy to fill in any holes in our diet to nutrition. Today, in our hectic lives, eating a properly balanced meal daily is often unrealistic. Vitamin supplements can fill this gap for better homeostasis in our nutritional quest. One area to cover regarding our diet is that a balanced diet of carbohydrates, proteins, and fats is needed. The issue is that most snack foods are simple carbohydrates which rapidly impact our blood sugars, insulin levels, and weight gain. Limiting how much one eats is also important. Portion control can be difficult, especially in the supersized world. It is essential to understand not only what we are eating but how much we are eating.

Exercise impacts the cycle of health directly and indirectly.

To maintain our cardiovascular health, mental health, and musculoskeletal health, we need an exercise program that is comprised of aerobic, anaerobic, endurance, strength as well as flexibility. By hitting all of these components, we improve our bone strength, mobility, and cardiac fitness. The indirect effect comes from stimulating and burning off endorphins. From a mental stress component, exercise allows us to burn off anxiety. We call this “burning off the crazy.” Walking outdoors, especially in a natural environment is a great way to clear the mind and problem-solve while further decreasing life stresses. It is not exactly an anaerobic activity, but it does get us mobility, cardiac stimulation, and some degree of aerobic fitness. Fatigue from exercise and mental clarity enhance sleep, putting us back into the cycle of health.

Sleep is the final part of the cycle of health.

We need to heal and recover our physical and mental wellness to the magical elixir of sleep. Quality sleep is required to remove toxins from our brains, clear our minds, and heal our bodies. This gives us the mental clarity and physical energy to have a successful next day. Just remember how hard a day is physically and mentally when you do not get enough sleep the night before. What we eat, what we drink, and what we consume all impact our sleep routines and the enjoyment of the next day.

At this time of New Year’s resolutions, let’s enjoy better health by focusing on building sustainable practices that positively impact all aspects of the cycle of health.

I summarized this as avoiding MEDS.

  • Avoidance (nicotine, drugs, alcohol)
  • Mental (stress reduction and mental clarity)
  • Exercise (anaerobic, aerobic, flexibility, strength, endurance)
  • Diet (balanced natural diet, vitamins, and water consumption)
  • Sleep (practice good sleep, hygiene)

As you strive for new goals and perspectives, just remember that each day is a new day and another chance to build your optimal cycle of health. Have a wonderful and healthy 2024 and beyond.


Dr. Thomas Schuler is a world-renowned, double board certified spine surgeon; trained in both neurosurgery and orthopedic surgery of the spine. He founded Virginia Spine Institute in 1992 and is a recognized international leader in the treatment of neck and lower back conditions. Dr. Schuler is noted among the 100 best spine surgeons in America, and serves as President of the National Spine Health Foundation as well as Chairman of its Medical and Scientific Board. Learn more about Dr. Schuler. 

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Dr. Thomas Schuler, MD, FACS, FAAOS

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