It would be nice if dietary changes were the only thing required for improved health and wellbeing. One intervention that would be a silver bullet for sustained energy levels maintenance of a healthy weight balanced moods and a positive outlook and physical activity free of musculoskeletal pain and fatigue. Unfortunately as healthcare professionals know only too well while dietary changes can be nothing less than life-changing for many patients focusing solely on food doesn’t take them all the way to feeling great. A variety of other strategies that help integrate “mind-body medicine” can help augment the improvements brought on by a better diet and then take things to the next level. Whether it’s listening to music getting immersed in good books spending time in green spaces or doing yoga there’s more to wellbeing and vitality than just good food.

One important—but often overlooked—aspect of physical and mental health is social interaction. Having a network of good friends may be just as helpful as having a freezer full of frozen lamb or a pantry stocked with dried lentils and canned wild-caught salmon. Friends help each other navigate the ups and downs of life helping to celebrate when things go well and being there to commiserate and offer comfort (or a glass of wine!) when things aren’t going so well. 

So what happens when individuals don’t have friends they can depend on? Or when they have friends but still feel lonely and isolated? After all that seems to be one of the defining states of our time: feeling lonely despite being surrounded by people. Whether it’s on mass transit during the weekday commute at the gym supermarket or shopping mall it’s actually quite easy to feel desperately lonely in a sea of people. Nods of acknowledgement half smiles and a quick “thank you” to cashiers and baristas lack the depth of genuine human connection many people are hurting for in the 21^st Century but few people even realize this is missing from their life never mind the toll it may be taking on their mental wellbeing and physical health. 

The concept of social isolation isn’t new. A now classic work on the topic Robert Putnam’s book Bowling Alone was published in 2001—after the internet had connected friends and strangers all over the world but long before smartphones had Facebook Twitter and other social media outlets literally at our fingertips. The irony is we’re more “connected” than ever yet simultaneously many people feel more isolated and alone than ever. Hundreds of “friends” “likes” and “shares” mean precious little when someone feels alone in their real offline life and when there’s no one around who truly knows and understands them. The superficial interactions people experience online may be seen as the equivalent of social interaction junkfood: good for a quick pick-me-up and a bit of instant gratification but lacking in terms of true nourishment. “Friends” and networks on social media do provide an outlet for human interaction and their utility for professional networking shouldn’t be discounted. But for many people they’re not a sufficient substitute for in-person meetings handshakes eye contact and hugs. When a crisis strikes at 4 a.m. how many of those “friends” could be depended on to show up on the doorstep ready to help?

A study published recently in the Proceedings of the National Academy of Sciences titled “Social relationships and physiological determinants of longevity across the human life span” found that the depth of social relationships has a profound effect on mental and physical health. Effects on mental health are easy to imagine; it’s the physical parameters that came as a surprise. According to the abstract “a higher degree of social integration was associated with lower risk of physiological dysregulation in a dose–response manner in both early and later life. Conversely lack of social connections was associated with vastly elevated risk in specific life stages. For example social isolation increased the risk of inflammation by the same magnitude as physical inactivity in adolescence and the effect of social isolation on hypertension exceeded that of clinical risk factors such as diabetes in old age.”

Across the lifespan markers such as systolic blood pressure C-reactive protein and waist circumference were better among individuals with deeper social ties. It’s important to note that when it comes to social ties quality trumps quantity. Having a small close-knit group of friends who love and support one another despite each other’s foibles and follies is better than having more friends but among whom one feels less at ease or less like they can be themselves. Something else to keep in mind is that loneliness may be a subjective feeling. If an individual doesn’t have many deep and lasting friendships but doesn’t feel particularly lonely nor that something is “missing” from his/her life experience then they may not suffer ill effects the way someone might who recognizes their loneliness and is aware of the toll it takes on their wellbeing.

The role of friendships in supporting better health shows that close social ties mean more than the obvious such as bolstering and encouraging each other’s healthy habits like being gym buddies or both opting for a side of vegetables instead of fries at a restaurant. The psychological benefits of having good friends are quantifiable in the physical body as well.

For more on this crucial but little-discussed topic naturopathic physician Bryan Walsh provided a review of the medical literature plus clinical insights on the Nourish Balance Thrive podcast. (Also available through iTunes [episode date 11/12/15] or full transcript available here.)