In medical training, we use a host of memory tools to reinforce important information.
Yet we have no simple strategies to help patients and clinicians prioritize and advocate for their health.
On this website, I share a simple, evidenced-based tool to support health, called the SMILE Score. It enables both patients and clinicians to prioritize healthy behaviors and simultaneously advocate for change in their work and home environments.
This tool is being used by clinicians in primary care clinics and during wellness seminars, by educators as part of health curricula, and by individuals striving to consistently live and perform better.
I hope this tool helps you and your patients prioritize health, and more importantly, live healthier and happier lives.
The SMILE Score is a daily self-assessment. Each letter (S, M, I, L, E) represents one healthy habit and counts as one point.
The daily score ranges from 0 to 5. When my score is high (4 or 5), I often feel better. When my score is low (0 to 2), my energy and mood are also lower.
This tool gives me a consistent strategy to prioritize and advocate for my health. I hope it will help you too.
S - Sleep enough.
Did I rest today? Was my sleep restorative?
Sleep is essential for health.
Sleep deprivation not only compromises our immune system and increases the risk of getting sick, it also makes us more likely to feel depressed and to overeat.
Chronic sleep deprivation is linked to obesity, diabetes, heart disease, high blood pressure, and stroke. Further, when we don’t sleep enough or feel restored in the morning, we may not have the energy or motivation to make other healthy choices.
There are many reasons why we don’t get the recommended 7 to 8.5 hours of sleep per night. Stress, anxiety, artificial light at night, shift work or long working hours, too much caffeine, chronic pain, and urinary issues can all contribute.
These strategies can help improve sleep:
Keep your bedroom dark, quiet, and cool. Keep the television out of the bedroom and turn off audible phone notifications.
Be consistent. Go to bed and arise at the same times each day. If you are a shift worker or work long hours (like I do), prioritize sleep when you can.
Reduce your exposure to artificial light at night by decreasing evening screen usage, turning on the night shift feature on your phone, or by wearing blue-light blocking glasses.
If you have a medical reason for not sleeping well, such as chronic pain, anxiety, frequent urination, sleep apnea, or hot flashes, talk to your doctor about strategies to help.
M - Move my body.
Did I exercise today?
Regular physical activity helps us live longer.
It decreases risk for heart disease, diabetes, dementia, and some cancers. It also reduces the risk of osteoporosis and falls in older adults. In the short term, it boosts mood and energy, improves sleep, and reduces stress.
Current guidelines recommend that adults get at least 150 minutes of moderate-intensity exercise (such as brisk walking) or 75 minutes of vigorous-intensity exercise per week. Adults should perform strengthening activities at least twice per week.
Here are some ways to be more active:
If you have time constraints, add small amounts of exercise into your routine. Do 10 minutes of yoga or strength-training before showering, or add 20 minutes of stairs at lunchtime. Consider adding a brisk evening walk to your routine.
If you get easily bored with exercise, vary your workout routine. Consider interval training, group fitness classes, or asking a friend to join you.
If you have a chronic condition or disability, work with a physical therapist to determine which activities are best.
I - Inhale. Exhale.
Did I meditate today?
Research has shown that meditation increases the level of neurochemicals in our brain that decrease anxiety and stress. Meditation has also been shown to improve sleep, reduce pain, and increase creativity.
There are many types of meditation, and there is no right or wrong way to meditate. Components of meditation can include breathing deeply, focusing on different parts of the body to increase awareness, repeating a mantra, praying, walking in nature, focusing on gratitude, or even reflecting on literature.
If you are new to meditation, consider taking a group class or using an app to help guide you. Start with a few minutes each day and see how it makes you feel.
L - Love & connect.
Did I meaningfully connect with someone today?
Social connection is essential for health and longevity.
It strengthens our immune system and decreases anxiety and depression. Studies have shown that lack of social connection is more harmful to our health than obesity or smoking.
It is important to foster connections with others, and it is not the quantity, but the quality of relationships that matters most. Consider calling a loved one, saying a kind word to your spouse, spending intentional time with your children, or having coffee with a friend. Even small connections with your colleagues, patients, or clients can provide meaning at work and added health benefits.
If you do not have close connections, it is never too late to foster relationships. Find new ways to connect with others, such as joining a faith group or community organization.
E - Eat to nourish.
Did I choose healthy foods today?
The choices we make about food affect our health to a high degree.
Unhealthy eating habits are linked to diabetes, heart disease, stroke, and certain types of cancer. Eating well can decrease inflammation in our bodies, improve energy levels, and prolong our lives.
Nutritional recommendations can be conflicting and confusing at times. The good news is that emerging data provides a simpler message: we should consume mostly plant-based foods that are not highly processed.
This means getting most of our nutrition from vegetables, nuts, legumes (such as beans or lentils), fruits, and whole grains. We should also try to eat in moderation, limit sugar-filled beverages, and choose organic and local foods whenever possible.
In my mind, the key to nutritious eating is finding true enjoyment of real food, and sharing it with people we care about.