The wheel of health symbolizes Duke University’s unique approach to integrative medicine. Three concentric circles represent the three elements of optimal health. Each of the conditions and diseases in part 1 includes easily recognizable icons that represent the self-care concept introduced in the wheel of health. As you navigate through the encyclopaedia, you can refer back to this introduction for a thorough explanation of the framework of the wheel, the inter relatedness of mind, body and spirit in the treatment and prevention of disease, and moreover, in an individual’s ability to experience optimum vitality and wellness.




This is a pivotal concept that embodies awareness of physical, mental, social, and spiritual well-being. Self-awareness enables individuals to recognize symptoms as they emerge, when they are most readily treatable.


Individuals are encouraged to explore how the dynamic interplay of the self-care concept resonates in all aspects of health and wellness, and to develop proactive strategies to improve or maintain their health.


Recognizing symptoms early is key to diagnosing health problems when they are most treatable, and awareness of the need for professional care is an integral component of the integrative approach to medicine.





Very few people really exercise, despite the fact that the human body was designed to be in motion. This inertia has serious consequences for our health. A mere 20 minutes of physical activity a day will help to prevent a very large number of common diseases, including heart disease and diabetes. If you start exercising in your chosen way gently and build gradually, you will find yourself enjoying your achievement, what is more, you will feel better, have more energy, your work will be more efficient and you will feel less stressed.


You are what you eat. A healthy diet will both feed you and protect you from many illnesses, while a poorly balanced diet will make you vulnerable to substances that compromises your health. You need to consider not only what you eat, but also where you get it, how it is prepared and how much you eat. Choose foods that will protect, for example those containing omega-3 fatty acids rather than those that put you more at risk. You should listen to your body, distinguishing between real hunger and snacking because of boredom or anxiety.



Every aspect of your physical environment can influence your well-being. And the awareness of your environment goes beyond the elimination of any toxic or negative aspects, such as fuel emissions, harmful substances in food, or biological agents including viruses and bacteria. It involves being proactive and creating a healing environment in which to live and work. Consider how your health may be affected by noise, light, colour, and odors. By paying attention to all of your senses you can create environments that nurture them.



Positive social relationships and support are a key to well-being. If you communicate well with those about you, listening as well as speaking, you will benefit from the positive and powerful influence that this gives you over the development, progression, and recovery from many diseases. If communication is bad, this can be very harmful, even in some cases, fatal.

The quality of relationships is very important, as well, and you should be selective, spending more time with people who give you energy, and less with those that drain you.


Spirituality is the capacity to seek purpose and meaning in life in something larger than yourself. Spirituality allows people to transcend everyday life and see beyond themselves.

Self-awareness of this kind can have very positive beneficial effects on health and wellbeing. You need to look deep into yourself, searching the core of who you are. This will help you focus on what matters most to you, and give you strength to copy with times when your body and mind are faced with challenges to your health.


Your state of mind has a tremendous impact on how your body responds to stress- whether it reacts in ways that harm your health or ways that protect. Awareness of how to decrease stress is the key to optimizing health and well-being. Although life is full of events that are inherently stressful, you can use your mind to significantly impact your body’s response to such events. Breathing techniques, meditation, progressive muscle relaxation, and guided imagery can be used to activate the body’s relaxation response and so reduce stress.

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