The Three Pillars of Mental Health

 By Jim Windell

             Mother always knew best. Especially when she nagged you about getting a good night’s sleep, going outside for exercise and eating plenty of fruits and vegetables. Now, this sage advice is confirmed by science.

           A study, published in Frontiers in Psychology, surveyed more than 1100 young adults from New Zealand and the United States about their sleep, physical activity, diet, and mental health.

            The outcome of the study, from researchers at the University of Otago, finds that getting good quality sleep, exercising, and eating more raw fruits and vegetables predicts better mental health and well-being in young adults.

           Lead author Shay-Ruby Wickham, who completed the study as part of her Master of Science, says the research team found sleep quality, rather than sleep quantity, was the strongest predictor of mental health and well-being.

           “This is surprising because sleep recommendations predominantly focus on quantity rather than quality,” Shay-Ruby Wickham says. “While we did see that both too little sleep – less than eight hours – and too much sleep – more than 12 hours – were associated with higher depressive symptoms and lower well-being, sleep quality significantly outranked sleep quantity in predicting mental health and well-being.” Depressive symptoms were lowest for young adults who slept 9.7 hours per night, and feelings of well-being were highest for those who slept 8 hours per night.

           To Wickham, this suggests that sleep quality should be promoted alongside sleep quantity as tools for improving mental health and well-being for young adults.

           However, along with quality sleep, exercising, and eating more raw fruits and vegetables – in that order – were three modifiable behaviors which correlated with better mental health and well-being in young adults. Well-being was highest for young adults who ate 4.8 servings of raw fruit and vegetables per day. Those who ate less than two servings, and also more than eight servings, reported lower feelings of well-being.

           While it can be concluded that sleep, physical activity, and a healthy diet can be thought of as three pillars of health, all three are important for predicting which young adults are flourishing versus suffering.

           Senior author, Associate Professor Tamlin Conner, of the Department of Psychology, at the University of Otago in New Zealand, points out that the study’s findings were correlations only. "We didn't manipulate sleep, activity, or diet to test their changes on mental health and well-being, “Dr. Conner says. “Other research has done that and has found positive benefits. Our research suggests that a 'whole health' intervention prioritizing sleep, exercise, and fruit and vegetable intake together, could be the next logical step in this research."

           To read the original article, find it at:

Shay-Ruby Wickham, Natasha A. Amarasekara, Adam Bartonicek, Tamlin S. Conner. The Big Three Health Behaviors and Mental Health and Well-Being Among Young Adults: A Cross-Sectional Investigation of Sleep, Exercise, and Diet. Frontiers in Psychology, 2020; 11 DOI: 10.3389/fpsyg.2020.579205