Two friends exchange smiles and a high-five, celebrating their completed workout, showing their commitment to the pillars of health.

We all want vibrant health.

One foundation of my medical practice is teaching people how to bring vibrancy into their lives, regardless of their baseline health levels. Today, I want to talk about one of the best ways to buttress every aspect of your health: the Four Pillars of Health. And of those four pillars, there’s one in particular that stands above the rest. Let’s take a look.

The Four Pillars of Health Make SENSE

You don’t have to be a general contractor to know that to be sound, a building needs a strong foundation. When it comes to our well-being, the Four Pillars of Health provide that foundation of support.

You can use the acronym SENSE to help you remember the Four Pillars of Health: Sleep, Exercise, Nutrition, and Stress Elimination. Each of these factors is essential to good health. The great news about the Four Pillars is that it’s never too late to start taking care of them, though it is lifelong work.

Strong pillars lower your risk of developing disease and aid in bodily repair and recovery. Illness and injury still occur, of course — they’re part of life — but maintaining strong SENSE helps you deal with and recover from whatever comes your way. Whether that’s an infection, an accident, or a genetic problem outside your control, stronger pillars produce better outcomes.

Weak pillars, on the other hand, are the root causes of disease. And when one pillar is compromised, the entire structure —your health — becomes destabilized.

So you can see that it’s important to maintain each pillar. They’re all important in their own right, and each relies on the others to bear the load. That said, there’s one pillar whose benefits are a little more far-reaching than the other three. This pillar’s stature is elevated because of its ability to positively affect the entire system.

Infographic: Which Pillar of Health Is MOST Important?

Say Hello to Your New Best Friend…

Of the Four Pillars, the one you need to befriend most intimately is exercise. Before you run away screaming (which — good for you! — is excellent aerobic exercise), consider that exercise doesn’t have to be miserable, and shouldn’t hurt.

You may wonder how exercise could be the most important pillar. And you have a good point. Let’s say you don’t exercise for 20 years. You can live like that. Whereas if you don’t sleep for two days, your mind shuts down. If you don’t eat for 30 days or drink for four days, you’ll die.

It’s true that exercise isn’t critical in the short — or even medium — term. So why would I claim that exercise is the most important pillar? When it comes to the Four Pillars, we’re talking about supporting optimal health, not scraping by in survival mode.

Why is exercise the most important pillar? The reasons are plentiful! Exercise does these great things:

Increases muscle mass. This isn’t just about looking fabulous. Muscle mass minimizes insulin resistance, fall risk and injury, and the likelihood of developing osteoporosis.

Promotes blood flow. In addition to encouraging good blood flow to and through the heart and circulatory system, exercise promotes blood flow to the brain. This minimizes the risk of cognitive decline.

Encourages socialization. Exercise often means getting out of the house and seeing others, whether you’re in a fitness class, going to the gym with a friend, running or walking around the neighborhood, or competing on a team. This added benefit is excellent for mental health.

Positively influences the other pillars. Each pillar affects the others, but exercise exerts an even greater influence — improving sleep, motivating better nutrition, etc. In fact, exercise can even buttress the other pillars when they’re in rough shape. For example, if your exercise is an A+ and your nutrition is a B-, exercise can make up the difference. If you have a stressful job and/or personal life, your exercise practice can directly treat your stress.

You can start anytime. If you’re not exercising now, the best first step is to — literally — take a step. Commit to a five-minute walk every day. Then do more. The most important part is to stick with it every day.

Quote: Which Pillar of Health Is MOST Important?


No matter your age, health status, or any other demographic marker, you can actively, profoundly, and broadly affect your health by remembering the common SENSE advice to tend to your Four Pillars of Health: sleep, exercise, nutrition, and stress elimination.

Of those four, paying special attention to exercise — whatever that means for you — will augment your efforts and catalyze vibrant health.

David C. Rosenberg

Dr. David Rosenberg

Dr. Rosenberg is a board-certified Family Physician who obtained a BS in Chemistry at Georgia's Mercer University in 1983 and a medical degree from the University of Miami in 1988. He completed his residency in Family Medicine at The Washington Hospital in Washington, Pennsylvania, in 1991 and then practiced Emergency Medicine at Palm Beach Gardens Medical Center for two years. In 1993 he started private practice in Jupiter.

Dr. Rosenberg has been married to his wife Mary for 38 years and they have three grown children together. Some of his interests include being a huge baseball fan, sailing, snow skiing, self-development, and learning to play piano.