Lifestyle plays a critical role in our health, and it is important to understand how it is linked to the lifespan of vital organs.
Approximately 90% of U.S. adults meet the criteria for CKM (Cardiovascular-Kidney-Metabolic) syndrome and 15% meet criteria for advanced stages of the systemic disorder. The good news is that people can lower the risk or slow the progression of CKM syndrome by making healthy lifestyle choices.
That’s often easier said than done. So, to offer people a manageable approach to combat CKM syndrome, while improving health in general, Niloofar Nobakht, MD, an associate clinical professor of nephrology at the David Geffen School of Medicine at UCLA, has devised “The Seven Ws of Wellness."
Dr. Nobakht’s wellness plan comprises seven "core lifestyle pillars" to improve physical and mental health: Water Intake, Weight, What to Eat, Wake & Sleep Hygiene, Walk & Work Out, Worry (Stress Management) and Waltz (Music & Joy).
She encourages everyone to implement these pillars to limit the risk of CKM syndrome.
CKM syndrome is a condition in which heart and kidney disease develop over time, often driven by earlier metabolic problems such as excess body fat (especially in the central abdomen), weight gain, high blood pressure, elevated blood sugar and abnormal cholesterol or blood fat panels. This can damage the brain, eyes, heart and kidneys, along with other vascular parts of the body.
"We are often overwhelmed by fragmented advice, trendy diets and quick fixes which might not fully address the whole person," Dr. Nobakht says. "This plan aims to improve vital organs’ health, while supporting metabolic balance and emotional resilience. Together, the ‘Seven Ws’ offer a practical roadmap toward healthier living, grounded in simplicity, consistency and joy."
Dr. Nobakht emphasizes that while the “Seven Ws” make logical sense, they also are based on scientific research.
1. Water Intake
Hydration is the foundation of health, supporting energy, mental cognition, metabolism, cardiovascular-kidney function, and overall physiological balance, Dr. Nobakht says.
The brain, heart and kidneys are heavily dependent on adequate water intake. Observational studies have found that poor hydration is linked to greater declines in cognitive performance. Good hydration promotes proper blood volume, while dehydration can have a negative effect on cardiovascular and kidney blood flow.
Adequate water intake can contribute to improved metabolism and weight loss. Dr. Nobakht suggests replacing sugar-added beverages with water. This can have a positive effect on calorie intake and metabolic health.
2. Weight
Dr. Nobakht says it’s important to focus on body weight plus the ratio of muscle to fat, rather than simply on body weight alone.
For example, she says, someone with low body weight and low muscle mass might be at higher risk for metabolic problems such as elevated blood glucose, compared to someone with higher body weight but more muscle mass. Dr. Nobakht suggests using more advanced scales at home that allow you to track your body composition, including body water, muscle, fat, bone and more.
“Maintaining a healthy body weight substantially reduces the risk and progression of obesity-related conditions such as type 2 diabetes, cardiovascular disease and chronic kidney disease,” Dr. Nobakht says. “Other benefits can include lower blood pressure, reduced risk of heart attacks and lower vascular risk factors linked to dementia and age-related cognitive decline.”
3. What to Eat
Dr. Nobakht recommends "nourishing the body with balanced, whole foods; fiber-rich meals; and reduced processed sugar to support glucose stability and long-term cardio-metabolic health."
She encourages strategies such as the Mediterranean or DASH (Dietary Approaches to Stop Hypertension) diets, which include fruits, vegetables, whole grains, lean proteins and low-fat dairy, and are low in saturated fat and sodium.
The DASH diet, she says, has been shown to improve brain, heart and kidney health; lower blood pressure; improve lipid profiles (the amount of fats in the blood); help people maintain a healthy weight; and reduce incidence of cardiovascular disease and type 2 diabetes. It also can improve insulin sensitivity and reduce inflammation.
4. Wake & Sleep Hygiene
We all have better mental and physical function with healthy sleep. Dr. Nobakht advocates focusing on the timing and quality of your sleep.
"Consistent sleep/wake rhythms, restoring sleep quality and protecting circadian health are essential for hormonal balance, metabolic health, appetite regulation, immune resilience and emotional well-being," she said.
Getting proper sleep "supports brain, cardiovascular and kidney health," she said. "Poor sleep elevates stress hormone release, promotes hypertension, impairs heart rate variability, and accelerates metabolic dysfunction, which can be linked to cardiovascular and kidney disease, cognitive decline and dementia risk."
Deep sleep (slow-wave sleep) is strongest in the first third of the night (as defined by an individual’s circadian rhythm – so timing matters.
Dr. Nobakht offers these tips for achieving the best sleep quality: having a fixed wake-up time, getting morning sunlight, no caffeine or alcohol later in the evening, and regular exercise during the day, with meditation, breathing and proper music before bedtime.
By following this guidance, she says, you can experience less nighttime awakening, fewer remembered dreams, and a more refreshed feeling in the morning.
5. Walk & Work Out
Even light or moderate exercise can improve many aspects of health and can help prevent or mitigate several medical conditions including CKM syndrome, Dr. Nobakht says.
Health guidelines suggest at least 150 minutes of moderate‐intensity aerobic activity per week, along with strength and flexibility training "to optimize metabolic, brain, cardiovascular and kidney health." This improves mood, mental clarity and organ health, she says.
"Beyond metabolic effects, aerobic exercise supports brain health by increasing cerebral blood flow, oxygenation and enhancing cognitive performance and mood, offering protection against cognitive decline and dementia," Dr. Nobakht says.
Almost anyone can dramatically improve their health with “moderate‐intensity activity such as brisk daily walking for 15-20 minutes," she says, achieving a lower resting heart rate and lower blood pressure, while substantially reducing "the risk of cardiovascular events and mortality."
Muscle uptake of glucose is significant during activity. If you eat carbohydrates (such as rice, bread, potato or pasta) during the day and walk or exercise a few hours after that, the blood glucose will remain lower than if you eat meals with carbohydrates and have no activity afterward.
Check with your physician before starting a new fitness routine.
6. Worry (Stress Management)
It is widely accepted that reducing stress can lower the risk of CKM syndrome, Dr. Nobakht says. She says reducing stress with meditation, yoga, tai chi, regular breathing exercises, creating art, playing music and participating in other mindful activities, as well as getting positive support from friends and family, can help.
"Managing stress through mindfulness, emotional regulation, boundaries, community and cognitive strategies can reduce the physiological burden of chronic stress," she says. "Mindfulness and meditation can positively influence the autonomic nervous system and contribute to brain, cardiovascular, kidney and metabolic health."
The autonomic nervous system is the collection of nerves responsible for automatic actions such as breathing and the beating of the heart.
Dr. Nobakht says mindfulness approaches have been associated with improved glycemic control and reduced stress in people with metabolic abnormalities such as obesity and diabetes, as well as lower blood pressure, reduced inflammation and positive neurobiological changes in the brain.
7. Waltz (Music & Joy)
To support their health, Dr. Nobakht strongly encourages people to participate in activities that make them happy.
“I play music, and I’ve noticed that on the days I play the piano or listen to pieces such as a waltz, I function more effectively at work,” she says. “It is very beneficial to engage with music, dance, creativity and joyful activities that enhance mood, reduce sympathetic stress responses and strengthen brain-body connections.”
Dr. Nobakht is a strong believer in the connection between music and health.
"I hope to see a future where music is integrated into medical education, recognizing its health benefits for both patients and providers,” she says. "Listening to music – especially pieces with defined rhythm and tempo such as the waltz – can impact mood and the autonomic nervous system by engaging widespread brain networks that regulate emotion and bodily functions."
Music stimulates neural circuits involved in reward, emotion and arousal, leading to the release of neurotransmitters such as dopamine and serotonin that enhance a positive mood and emotional well-being, and helping to decrease pain level, she says.
“Slower, harmonious music often increases parasympathetic activity, promoting relaxation and lower heart rate and blood pressure,” Dr. Nobakht says. “Rhythmic or faster music modulates sympathetic activation, which can influence arousal and energy levels."
Research suggests that listening to classical music, such as well-structured pieces by Mozart and Strauss, can acutely influence cardiovascular physiology by modulating the autonomic nervous system. Music can improve quality of life, reduce anxiety and lower blood pressure, she says.
Each of the 7 Ws reinforces the others, says Dr. Nobakht.
"They can benefit body weight, muscle health, blood glucose, blood pressure, fat panel, sleep health and brain function, which all together impact vital organs’ health including heart and kidneys,” she says. “They contribute to a better state of health when practiced together and regularly.”
