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We get better together- Do you have a strong social support network?


The start of a new year is often a time when we make new goals or renew existing goals.  Goals may include improving health and/or fitness and we look into how we can improve diet, exercise more and even manage our stress better. Of course, all of these are extremely important, but another factor to consider is the health of our relationships.  It is well known that health behaviours (exercise, diet, smoking, alcohol consumption, etc…) are a key determinant of wellness and these behaviours are influenced by our social environment.  In other words, our relationships can influence our health behaviours, which in turn may affect our wellness.  This is why one question that we routinely ask in our history taking is “how is your social support system” and “how would you describe your relationships”.  Sometimes, this question catches patients off-guard because it is the first time in awhile that they were forced to think about their relationships, how they affect their own identity and how they might be affecting their health.  Despite the fact that humans are naturally social beings, the busyness of everyday life greatly reduces the quantity and quality of our social interactions.  How many times have I heard from my patients that they have wonderful friends and family that they would love to talk to and spend time with, but there just is no time!?


Several research studies have been conducted to show the importance of healthy social relationships in improving our health.  A study that looked at the effects of relationships on mortality showed that people with stronger relationships had a 50% increased likelihood of survival than those with weaker relationships (Holt-Lunstad et al. 2010).  These results also showed that the influence of social relationships on the risk of death was comparable to other known influences including smoking and alcohol intake and even exceeded the influence of factors such as physical inactivity and obesity.  A recent study confirmed that both health compromising behaviours and health promoting behaviours in Americans aged 60 and over were strongly associated with marital status and/or friendship networks (Watt et al. 2014).


Other studies have even shown that the negative aspects of close personal relationships that cause stress, problems or worries may be associated with increased risk of heart disease (De Vogli et al. 2007), increased body mass index and waist circumference (Kouvonen et al. 2011), and even decreased mental function (Liao et al. 2014).  Most of you probably did not need all this research to convince you that relationships can affect your health because you already know how you feel (physically and emotionally) when you are in an unhealthy relationship or when you are lonely versus being in relationships where you feel truly supported and valued.  Take some time to evaluate your relationships and remember that they can be dynamic.  If a relationship has to change, commit to putting in the work and effort needed.  If there is someone you would like more consistently in your life, reach out to them.  And if there is a relationship that is really not working out for you, perhaps it is time to let go?  Most importantly, make plans to spend quality time with loved ones and plug it into your schedule just as you would a work event or appointment.


Not only should we work on forming and maintaining strong healthy relationships, but when planning to make lifestyle changes, I strongly recommend that you either create a community or integrate yourself in an existing community of people that have similar goals and work together.  There is an on-going study involving thousands of subjects called The Look Ahead Study, which is comparing an intensive group lifestyle change program for diabetes prevention to regular medical care with individual visits to the diabetic educator, nutritionist, and doctor. As of now, the group lifestyle program has been shown to be significantly more effective in lowering weight, cholesterol, blood sugar, and blood pressure than conventional medical care (Look AHEAD Research Group, 2010).  Other studies have also confirmed that group therapies produce better results for mood disorders, weight loss and even cancer.  When making changes, it is always easier and more fun when you have a community who can help motivate you and keep you accountable.  We get better together!

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De Vogli R, Chandola T, Marmot MG. Negative aspects of close relationships and heart disease. Arch Intern Med 2007;167(18):1951-1957.

Holt-Lunstad J, Smith TB, Layton JB: Social relationships and mortality risk: a meta-analytic review. PLoS Medicine 2010, 7:e1000316.

Kouvonen A, Stafford M, De Vogli R, et al. Negative aspects of close relationships as a predictor of increased body mass index and waist circumference: the Whitehall II study. Am J Public Health 2011;101(8):1474-1480.

Look AHEAD Research Group, Wing RR. Long-term effects of a lifestyle intervention on weight and cardiovascular risk factors in individuals with type 2 diabetes mellitus: four-year results of the Look AHEAD trial. Arch Intern Med. 2010;170(17):1566-75

Watt RG, Heilmann A1, Sabbah W, Newton T, Chandola T, Aida J, Sheiham A, Marmot M, Kawachi I, Tsakos G. Social relationships and health related behaviors among older US adults. BMC Public Health. 2014;14:533

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