The American College of Lifestyle Medicine (ACLM) names six pillars: nutrition, physical activity, restorative sleep, stress management, connectedness and avoiding risky substances. Other frameworks count from four (Dean Ornish) to nine (Blue Zones). Across the 15 frameworks compared here, stress or mental health appears in 14, movement and food in 13, and sleep in 11.
Key takeaways
- The ACLM’s six pillars are the reference list for lifestyle medicine; the American Psychiatric Association’s lifestyle psychiatry work and the British Society of Lifestyle Medicine use six that match.
- Counts run from four (Dean Ornish: Eat Well, Move More, Stress Less, Love More) to nine (the Blue Zones Power 9).
- Across 15 frameworks, social connection and sleep each appear in 11; the American Heart Association added sleep in 2022.
- The lists differ most at the edges: purpose or spirit (5 frameworks), avoiding risky substances (4) and learning (3).
What are the pillars of lifestyle medicine?
Lifestyle medicine is a medical specialty that uses daily habits as therapy, and its best-known list is the ACLM’s six pillars. The ACLM describes the specialty as evidence-based care that addresses root causes with therapeutic lifestyle interventions, grounded in six interconnected pillars: optimal nutrition, physical activity, stress management, restorative sleep, connectedness and risky substance avoidance.
Two other professional bodies use six pillars that match it closely. The British Society of Lifestyle Medicine, founded in 2016, names healthy eating, physical activity, sleep, mental wellbeing, healthy relationships and minimising harmful substances. In psychiatry, a 2024 Psychiatric Times article co-written by Ramaswamy Viswanathan, who made lifestyle psychiatry the theme of his American Psychiatric Association (APA) presidency, names eating healthier, sleep, exercise, healthy relationships, less stress and avoiding harmful substances, and the APA approved a resource document on lifestyle psychiatry in June 2025.
How do the 15 frameworks compare?
Each framework below comes from a medical society, a public agency, a university program, a wellness organization or company, or a credentialed clinician or scientist. Each list is taken from the group’s own page or publication; the APA’s comes from a 2024 article by its then-president and colleagues.
| Framework | Pillars | What they are |
|---|---|---|
| Dean Ornish, Ornish Lifestyle Medicine | 4 | Eat Well, Move More, Stress Less, Love More |
| Rangan Chatterjee, The 4 Pillar Plan (2017) | 4 | Relax, eat, move, sleep |
| Drs. Dean and Ayesha Sherzai, NEURO plan | 5 | Nutrition, Exercise, Unwind, Restore, Optimize |
| Peter Attia, longevity levers (2020) | 5 | Exercise, sleep, nutrition, medications and supplements, distress tolerance |
| Thrive AI Health (2024) | 5 | Sleep, food, movement, stress management, social connection |
| American College of Lifestyle Medicine | 6 | Nutrition, physical activity, stress management, restorative sleep, connectedness, risky substance avoidance |
| American Psychiatric Association, lifestyle psychiatry | 6 | Healthy eating, sleep, exercise, healthy relationships, less stress, avoiding harmful substances |
| British Society of Lifestyle Medicine | 6 | Healthy eating, physical activity, sleep, mental wellbeing, healthy relationships, minimising harmful substances |
| Andrew Huberman (2023) | 6 | Morning sunlight, daily movement, quality nutrition, stress control, healthy relationships, deep sleep |
| National Wellness Institute, Six Dimensions of Wellness (1976) | 6 | Physical, emotional, intellectual, occupational, social, spiritual |
| Stanford Lifestyle Medicine | 7 | Movement & Exercise, Healthful Nutrition, Restorative Sleep, Stress Management, Social Engagement, Cognitive Enhancement, Gratitude & Purpose |
| American Heart Association, Life’s Essential 8 (2022) | 8 | Diet, physical activity, nicotine exposure, sleep, body weight, blood lipids, blood glucose, blood pressure |
| SAMHSA, Eight Dimensions of Wellness | 8 | Emotional, environmental, financial, intellectual, occupational, physical, social, spiritual |
| VA Whole Health, Circle of Health | 8 | Moving the Body; Food and Drink; Recharge; Family, Friends and Co-workers; Spirit and Soul; Power of the Mind; Personal Development; Surroundings (around Mindful Awareness) |
| Blue Zones Power 9 | 9 | Move Naturally, Purpose, Downshift, 80% Rule, Plant Slant, Wine @ 5, Right Tribe, Loved Ones First, Belong |
Which frameworks use the fewest pillars?
The shortest lists come from clinicians writing for the public. Dean Ornish’s program names four: Eat Well, Move More, Stress Less and Love More. Sleep and substances don’t get pillars of their own. Ornish has long argued that lasting change comes from feeling better, not from fear: “Joy of living is sustainable; fear of dying is not.”
Rangan Chatterjee, a UK family doctor, also uses four in The 4 Pillar Plan (2017): relax, eat, move and sleep. Neurologists Dean and Ayesha Sherzai, who led the Brain Health and Alzheimer’s Prevention Program at Loma Linda University Health, use five for brain health, spelled NEURO.
Neuroscientist Andrew Huberman has listed five daily pillars (sleep, sunlight, movement, nutrition and social connection) and, in an October 2023 post, six, adding stress control. He is the only one of the 15 to make morning sunlight a pillar, the habit closest to the body clock.
Which frameworks add more pillars?
The longer lists widen the frame from habits to the conditions around them. Stanford Lifestyle Medicine names seven pillars: next to the ACLM’s core it adds Cognitive Enhancement and Gratitude & Purpose, and it has no substances pillar. The American Heart Association’s Life’s Essential 8 pairs four behaviors (diet, activity, nicotine and sleep) with four numbers a clinician measures: weight, blood lipids, blood glucose and blood pressure. It replaced Life’s Simple 7 in 2022, adding sleep.
The wellness-dimension models go wider still. The National Wellness Institute’s six dimensions, developed by co-founder Bill Hettler in 1976, include occupational and intellectual wellness. SAMHSA’s eight, adapted from Peggy Swarbrick’s 2006 model, add financial and environmental. The VA’s Circle of Health places eight areas of self-care around mindful awareness.
The Blue Zones Power 9 come from studying places with many long-lived people, and they include habits none of the medical societies names, such as Belong (a faith community) and Wine @ 5. A UCL researcher, Saul Newman, questions the age records behind those places, and blue zone researchers dispute his critique.
What do all the frameworks agree on?
Most lists share a core of movement, food, stress and people: each appears in at least 11 of the 15. This table counts a pillar when a framework gives it a pillar of its own, under any name; a broad Physical dimension doesn’t count.
| Pillar | Frameworks that name it | Which ones |
|---|---|---|
| Stress, relaxation or mental health | 14 of 15 | All but the AHA’s Life’s Essential 8 |
| Movement | 13 | All but NWI and SAMHSA, which use one broad Physical dimension |
| Food | 13 | All but NWI and SAMHSA |
| Social connection | 11 | All but the AHA, Chatterjee, the Sherzais and Attia |
| Sleep | 11 | All but Ornish, Blue Zones, NWI and SAMHSA |
| Purpose, meaning or spirit | 5 | Stanford, Blue Zones, VA, NWI, SAMHSA |
| Avoiding risky substances | 4 | ACLM, APA, BSLM, AHA (nicotine) |
| Learning or intellect | 3 | Stanford, NWI, SAMHSA |
| Surroundings or environment | 2 | SAMHSA, VA |
| Work or money | 2 | NWI, SAMHSA |
Sleep is the pillar most often renamed. Two lists cover it under another name: the Sherzais’ Restore calls for seven to eight hours of restorative sleep, and the VA defines Recharge as getting enough sleep, rest and relaxation. Ornish, Blue Zones, NWI and SAMHSA give it no pillar of its own, while every medical society list here names it.
Do more pillars mean better advice?
Not necessarily. Read side by side, the frameworks mostly say the same thing in different languages for different audiences. The medical societies keep a pillar for risky substances, a clinical concern. Cardiology adds the numbers it measures. Public health and recovery programs widen to work, money and surroundings. Authors writing for the public shrink the list to what a reader can remember.
A shared, transparent taxonomy, one core list with agreed definitions that other frameworks map onto, would let clinicians, researchers and apps compare notes. Until then, the useful question is which pillar is thinnest in your own days.
What’s one change to make?
Pick the shared-core pillar your days are missing and give it a fixed time. For most people that means one of five: movement, food, stress relief, people or sleep. A short walk at the same time each morning covers two at once: movement and daylight. For timing, see the best time to exercise and how to fix your sleep schedule.
Your day on My BodyClock
The day on My BodyClock in this post fits the shared core into 24 hours: a full night of Sleep, a morning walk in daylight, plant-forward meals, a Relax break, strength training and an evening with family. Owaves began in 2014 with five lifestyle vital signs: exercise, nutrition, sleep, relationships and mindfulness. Five of its eight categories (Eat, Move, Sleep, Relax and Love) line up with ACLM pillars, and Owaves has followed the field from the ACLM conference to precision lifestyle medicine.
If your framework names a pillar the built-in categories don’t, BodyClock Plus lets you create custom categories with your own colors, so Purpose, Nature or Learning can get a block of its own and you can follow the framework you trust. Find your Body Clock Type with the free quiz, then build the day in Owaves on the App Store. On Android? Join the waitlist.
FAQ
What are the 6 pillars of lifestyle medicine?
The American College of Lifestyle Medicine names nutrition, physical activity, restorative sleep, stress management, connectedness (social connection) and avoiding risky substances. The British Society of Lifestyle Medicine and the American Psychiatric Association’s lifestyle psychiatry work use six that cover the same ground.
What are the Blue Zones Power 9?
They are Move Naturally, Purpose, Downshift, 80% Rule, Plant Slant, Wine @ 5, Right Tribe, Loved Ones First and Belong. Blue Zones drew them from places with many long-lived people, though a UCL researcher questions the age records behind those places and blue zone researchers dispute it.
What are Andrew Huberman’s pillars of health?
In an October 2023 post, Huberman named six: morning sunlight, daily movement, quality nutrition, stress control, healthy relationships and deep sleep. An earlier list of his had five, without stress control.
Is sleep one of the pillars of health?
Yes, in 11 of the 15 frameworks compared here, including every medical society list. The ACLM, the American Psychiatric Association’s lifestyle psychiatry work, the British Society of Lifestyle Medicine and Stanford all name it, and the American Heart Association added it in 2022.
Sources
- American College of Lifestyle Medicine. Lifestyle medicine and its six pillars. https://lifestylemedicine.org/
- Merlo G, Sugden SG, Viswanathan R. Lifestyle Psychiatry: Evidence-Based Lifestyle Interventions for Mental and Physical Health. Psychiatric Times, 25 June 2024. https://www.psychiatrictimes.com/view/lifestyle-psychiatry-evidence-based-lifestyle-interventions-for-mental-and-physical-health
- American Psychiatric Association. Resource Document on Lifestyle Psychiatry, approved June 2025. https://www.psychiatry.org/psychiatrists/search-directories-databases/resource-documents/2025/lifestyle-psychiatry
- British Society of Lifestyle Medicine. What is Lifestyle Medicine? https://bslm.org.uk/lifestyle-medicine/what-is-lifestyle-medicine/
- British Society of Lifestyle Medicine. About us. https://bslm.org.uk/about/about-us/
- Stanford Lifestyle Medicine. The Seven Pillars of Lifestyle Medicine. https://lifestylemedicine.stanford.edu/
- Lloyd-Jones DM, et al. Life’s Essential 8: Updating and Enhancing the American Heart Association’s Construct of Cardiovascular Health. Circulation, 2022. doi:10.1161/CIR.0000000000001078. https://www.ahajournals.org/doi/10.1161/CIR.0000000000001078
- American Heart Association, Eastern States. American Heart Association adds sleep to cardiovascular health checklist, 25 October 2022. https://easternstates.heart.org/2022/10/25/american-heart-association-adds-sleep-to-cardiovascular-health-checklist/
- SAMHSA. Learn the Eight Dimensions of Wellness (SMA16-4953), 2016, adapted from Swarbrick M, Psychiatric Rehabilitation Journal, 2006. https://library.samhsa.gov/sites/default/files/sma16-4953.pdf
- National Wellness Institute. The Six Dimensions of Wellness. https://members.nationalwellness.org/page/Six_Dimensions
- U.S. Department of Veterans Affairs, Whole Health. What is the Circle of Health? https://www.va.gov/WHOLEHEALTH/features/What_is_the_Circle_of_Health.asp
- Blue Zones. Power 9. https://www.bluezones.com/power-9/
- Lawler D, AFP. Report on blue zone age records and the researchers’ rebuttal. Fortune, 14 December 2024. https://fortune.com/europe/2024/12/14/are-blue-zones-myth-extreme-aging-pension-fraud-century-old-lies/
- Ornish Lifestyle Medicine. Eat Well, Move More, Stress Less, Love More. https://www.ornish.com/
- Ornish D. Excerpt: Dean Ornish’s The Spectrum. ABC News. https://abcnews.com/GMA/PersonalBest/story?id=4077021
- Penguin. The 4 Pillar Plan by Dr Rangan Chatterjee, 28 December 2017. https://www.penguin.co.uk/books/305279/the-4-pillar-plan-by-chatterjee-dr-rangan/9780241303566
- Loma Linda University Health. Brain health 101: what you need to know to stay sharp, 13 March 2019. https://news.llu.edu/brain-health-101-what-you-need-know-stay-sharp
- Huberman A. Post on X, 23 October 2023. https://x.com/hubermanlab/status/1716517278269997072
- Fortune. Andrew Huberman’s five daily habits for mental and physical health, 5 September 2023. https://fortune.com/well/2023/09/05/andrew-huberman-daily-habits-optimal-mental-physical-health/
- Attia P. AMA #12, 10 February 2020. https://peterattiamd.com/ama12/
- Altman S, Huffington A. Op-ed introducing Thrive AI Health. TIME, 8 July 2024. https://time.com/6994739/ai-behavior-change-health-care/
- Apple App Store. Owaves: My BodyClock (BodyClock Plus: custom categories). https://apps.apple.com/us/app/owaves-my-bodyclock/id869648628
- Owaves. Custom categories announcement, 17 December 2024. https://owaves.com/day-life-precision-lifestyle-medicine-starts-with-owaves-plus/
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