Winter Wellbeing - Tips Using Lifestyle Medicine

Now the weather has changed, we have moved into winter and dark mornings and nights can start to affect our mood. So how can we use what the evidence has told us from lifestyle medicine to help stay well this winter?

We have 6 pillars of lifestyle medicine. These focus on:

• A Healthy diet
• Movement and Exercise
• Sleep
• Stress reduction and Emotional wellbeing
• Social Connection
• Avoiding risky substances (smoking, drugs, alcohol)

Beating the winter blues and seasonal affective disorder

Seasonal affective disorder (SAD) is a type of depression that follows a seasonal pattern, usually starting in autumn or winter and lifting again in spring or summer, according to the NHS. It’s thought to be linked to reduced daylight in winter, which can affect brain chemicals like melatonin and serotonin that influence mood and sleep. Everyday symptoms include a persistent low mood, low energy, sleeping more than usual, finding it harder to concentrate, and losing interest in things you’d normally enjoy. If low mood like this comes back at the same time every year and lasts for weeks rather than days, it’s worth speaking to a GP – effective treatments are available.

Everyday signs of the winter blues or SAD include:

• A low, flat or irritable mood that sets in over autumn and winter
• Sleeping more than usual, or finding it hard to get up in the morning
• Low energy and finding everyday tasks harder to face
• Difficulty concentrating, or losing interest in activities you’d normally enjoy
• Craving more carbohydrates and gaining weight over the winter months

This guide focuses on that mental-wellbeing side of winter; for a broader look at seasonal health tips for workplaces, see our festive winter wellness guide.

Getting daylight and light exposure

Getting outside in natural daylight, especially earlier in the day, is one of the simplest ways to support your mood and body clock through the darker months. A few practical ways to build more daylight into short winter days:

• Get outside within an hour or two of waking, even briefly, on your commute or a short walk
• Use your lunch break for a walk outdoors rather than staying indoors all day
• Sit near a window if you work indoors, rather than in the darkest part of a room
• Consider a light box for some extra light exposure in the mornings, which some people find helpful – ask a GP if you’re thinking about trying one
• Heat the rooms you use most to around 18 to 21°C, and keep bedroom doors closed to keep the warmth in
• Layer up with a few thinner layers rather than one thick one, which traps warmth more effectively
• Check in on older or vulnerable relatives and neighbours during cold snaps, as they can be more at risk from the cold

1) Nutrition in the winter

We have around 100 trillion bacteria in our gut that help to keep us healthy, they help all aspects of our health from our immune system to our mood. The food we eat, and our lifestyle can affect the type of bacteria which then affects our health. To boost your immune system at this time of year, be sure to include plenty of fruits, vegetables, and wholegrains in your diet. Experiment with new foods and try to make your plate colourful. The colours from fruits and vegetables have a variety of substances called phytonutrients which have antioxidant and anti-inflammatory properties to keep gut and therefore your body healthy. These foods also contain fibre which gut bacteria rely on to break down and produce chemicals that will help to maintain your health.

Try to include some prebiotics in your meals – these are foods that contain fibre that feed the “good” bacteria in your gut. Examples of prebiotic foods are:

• Garlic
• Onions
• Leeks
• Asparagus
• Cabbage
• Artichoke
• Apples and Bananas
• Barley and oats
• Flaxseeds

You may also want to include some probiotics which are live bacteria found in fermented foods such as sauerkraut, tempeh, miso, kimchi, kefir, kombucha, pickled gherkins and some live yoghurts.

Following Christmas we often have treats around the house but keeping some healthier snacks as an option such as nuts and seeds or chopped veggies with dips may help. To avoid overeating try some mindful eating techniques, chew your food slowly and appreciate the taste, smell, colour and texture. Keep to a normal portion size and wait 20 minutes before diving in for seconds, stop eating when you feel full.

For more ways to eat well through the colder months, see our winter nutrition tips guide.

At this time of the year, it is important to remember vitamin D supplements. In the UK, we do not get enough sun and although some foods such as oily fish, eggs, fortified cereals and plant milks will contain vitamin D, it is hard to get your requirement through food; so unless you plan on going to live in a sunny climate for winter, taking a supplement is a good idea. All other nutrients can be acquired if you have a healthy balanced diet.

The NHS recommends that everyone, including pregnant and breastfeeding women, consider taking a daily supplement containing 10 micrograms of vitamin D during autumn and winter, since UK sunlight isn’t strong enough for the body to make enough on its own. See our guide to winter vitamin supplements for more on choosing one.

2) Movement and exercise

The recommended physical activity guidelines for adults are:

• 150 minutes of moderate intensity exercise per week
• Resistance exercises twice a week (eg squats push-ups, plank)
• Avoid prolonged sitting and include 5 minutes of movement once an hour.

You don’t have to have a gruelling work out at the gym and at this time of year there may be a tendency to want to flop down on the sofa watching hours of TV and having a rest will be well deserved. However, to keep energy levels and your mood in check, wrap up warm and start a tradition of walking off that winter dinner. If there are children at home, get them outdoors to play. If you don’t want to go out, an impromptu mad dance to some favourite music can be just as effective to get the heart rate up. Moderate exercise is when you can still talk but are too breathless to sing. Keeping active will drastically improve your mood and help you to destress (notice how you feel after a brisk walk in nature). It is important not to overdo things though and getting rest is just as vital for your wellbeing and health which leads into the next 2 pillars.

These figures follow the NHS physical activity guidelines for adults, which also recommend spreading activity across four or five days a week and cutting down on long periods of sitting still.

3) Sleep

When life is busy, it is often sleep that is pushed to the side, especially at this time of year as we try to fit everything into the day and then attend festive parties. This can mean late nights. Sleep is vital for our health; we all need 7-9 hours of good quality sleep for our bodies to restore and repair. We produce the hormone leptin when we sleep – this is what tells us we are full and so people having less sleep tend to eat more and are twice as likely to gain weight and have medical issues; there is also a correlation with some cancers and poor sleep. During dream sleep – rapid eye movement (REM) sleep – we process memories and undergo emotional regulation, so this is vital for our mood. Knowing this, it may help to make sleep more of a priority, especially if you know the following day could be challenging. Try to go to bed at roughly the same time and wake up at the same time each day. Have a pre-bed routine, dim the lights, use candles, avoid screens for 1 hour before you go to sleep. Avoid large meals 2-3 hours before bedtime and keep your bedroom cool.

For more practical ways to protect your sleep, see our top tips for better sleep.

4) Stress reduction and emotional wellbeing

Self-care is vital, and it is important that we listen to our body. If you are feeling overwhelmed or exhausted, stop. It’s ok to say no and to excuse yourself or decline a social gathering.

Schedule downtime for yourself – even if only 10 minutes – set an alarm, stop for a warm drink, a slow walk, listen to some relaxing music or try a 10-minute breathing exercise. Try a gratitude habit, spend 3 minutes on waking writing down 3 things you are grateful for and 3 minutes in the evening writing down 3 good things that happened today. You will feel the benefits of this much more than scrolling through social media. Have a regular “self-care Sunday” – that could mean anything from a yoga practice or class to a regular Sunday evening bath and an early night. Keep a sense of humour, (laughter really can be medicine) and make time to see the people that lift you and whose company you enjoy.

See our mental health tips and advice for more ways to support your emotional wellbeing.

5) Social connectedness

Social connectedness is just as important for health and wellness as the above pillars and is linked to happiness and a longer life. We can see how the pandemic and social isolation has had an effect especially on mental health. Family relationships, social networks and work situations can all feature at this time of year and can all affect wellbeing in a positive or negative way.

Try switching off from the news and social media to be present with those around you. Play some games, see the funny side of those who get a little competitive! To feel connected in general – try a loving kindness meditation if you are alone, (you can find many of these on the internet or on meditation apps such as calm, headspace or insight timer). Doing something for others will also increase your sense of wellbeing, so paying a visit to someone or volunteering or donating to the many charities in need can also help.

6) Risky substances

Try and keep your alcohol content down, while still enjoying yourself. Avoid sugary mixers and alternate with glasses of water. There are lots of non-alcoholic alternatives to try. As alcohol affects sleep quality (you may pass out, but you are not getting the restorative deep sleep the body needs), try to have an alcohol cut off time so that you can still enjoy a glass or two of wine without it interfering too much with your sleep.

The NHS advises not drinking more than 14 units a week on a regular basis, spread across three or more days.

Keeping warm and staying well at home

A few simple habits can help you stay well at home when temperatures drop:

• Heat the rooms you use most to around 18 to 21°C, and keep bedroom doors closed to keep the warmth in
• Layer up with a few thinner layers rather than one thick one, which traps warmth more effectively
• Check in on older or vulnerable relatives and neighbours during cold snaps, as they can be more at risk from the cold

Winter illness and vaccinations

Flu and COVID-19 both circulate more over winter, so it’s worth checking whether you’re eligible for a free flu vaccine – this currently includes people aged 65 and over, those with certain long-term health conditions, pregnant women, care home residents, and main carers for an older or disabled person, according to the NHS. Regular handwashing helps reduce the spread of coughs and colds, and most mild coughs, colds and sore throats can be managed at home with rest, fluids and over-the-counter remedies – see a GP if symptoms are severe, don’t improve, or you’re in a higher-risk group.

Following the pillars of lifestyle medicine will help ensure you have many more happy healthy festive years to come. We are all allowed to enjoy ourselves at this time of the year and if you have a bad day, don’t feel guilty and dwell on this or feel things aren’t achievable, just start again the next day. Once you start to look after yourself and feel the benefits, this will usually motivate you to keep going.