Stanford Medicine Newsletter Updates For the Local Community

Building on science to improve wellness

John Ioannidis, MD, is leading an international study to identify and quantify the factors that can improve lifestyle behaviors and health.


For thousands of years, everyone from philosophers such as Aristotle, Epictetus and Buddha to smooth-talking snake-oil salesmen has tugged at the problem of what makes for a good life.

What does it mean to be well? If we want to improve wellness for everyone, we have to be able to define it and measure it. Once we can calculate wellness, we can find out which factors increase it or decrease it.

Using a quantitative approach, Stanford researchers are undertaking an ambitious project to tackle anew the age-old question of wellness. Scientists at the Stanford Prevention Research Center study ways to help populations improve their lives by doing things like eating healthier foods or quitting smoking. Although the SPRC continues to tackle health problems separately, the center recently launched the Wellness Living Laboratory, or WELL, to improve the overall health of entire populations.

Funded by a $10 million gift from the Amway Nutrilite Health Institute Wellness Fund, WELL proposes to identify the factors that help maintain health and wellness and develop ways for people to control those factors as a way to enhance individual wellness.

In one project, WELL for Life, researchers will observe more than 30,000 people in several countries and search for the keys to wellness. WELL for Life also will test behavioral modifications to determine which interventions help people quit smoking, eat better, exercise more or take other steps to improve well-being. Scientists at SPRC’s Health Improvement Program will promote the proven interventions to a wider population.

“This is an effort to change the world of medicine and health,” said John Ioannidis, MD, DSc, professor of medicine and of health research and policy and lead investigator on the project. “It may sound very ambitious, but I see this as a way to refocus the key priorities of biomedical research.” The project is in keeping with Stanford Medicine’s mission of precision health, which aims to predict and prevent disease, rather than just treat acute illness.

“The vast majority of biomedical research has focused on treating diseases,” he added. “A much smaller part has focused on maintaining health and maybe some prevention efforts. But there is very, very little research that has tried to look at the big picture — what makes people happy, resilient, creative, fully exploring their potential and living not only healthy but more-than-healthy lives.”

Among the things the WELL team wants to know: Is wellness the same for everyone, or do factors like gender or age influence how it is perceived? For example, among young adults, wellness might revolve around finances, career and athleticism. But as we age, social connectedness and resilience to stress may become more important factors in our sense of how well we feel.

During the first five years of WELL for Life, the 30,000 participants — 10,000 each in China, Taiwan and the United States — will supply mountains of personal health information ranging from general health and personal habits to genetic markers, said Sandra Winter, PhD, director of WELL. And it’s likely that WELL will expand to other countries in the future.

Participants will periodically answer scores of questions such as, “During the last two weeks, did your diet, physical activity and sleep habits influence your well-being?” or “How confident are you that you can bounce back quickly after hard times?”

“We want to not only ask what is the profile of someone who feels good about life,” said Ioannidis, “but how can we make that profile better? And how can we intervene with simple means — things that we do in everyday life — not with drugs or devices or complex procedures in the hospital?”

It’s known that a person’s likelihood of exercising more or eating well is influenced by environmental factors such as neighborhood safety, social relationships and public policies. But how does a sense of well-being impact the ability to make and maintain healthy changes in behavior? For example, could it be that having the strength to build a garden is more motivating to encourage exercise than knowing the risk of a heart attack 20 years from now? That is the kind of question that WELL seeks to answer.

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