The Scientific Proof

The Physiology of Wellness: a Review

Introduction

Wellness is a state of being that influences health and social function (1). It may be considered to consist of two distinct componentsϒhedonic wellbeing and eudaemonic wellbeing (2). Hedonic wellbeing refers to a sense of happiness associated with a general satisfaction with one’s life, whereas the focus of eudaemonic wellbeing is on psychological function (3, 4). The World Health Organization (WHO) also describes wellbeing as being an “optimal state of health” with 5 facetsϒphysical psychological, social, spiritual, and economical (Figure 1).

Amongst the numerous variables that influence the 5 facets of wellbeing, results from the 2007 English National Psychiatric Morbidity Survey suggest that happiness does not vary with age, but may be predicted by social capital (feelings of belonging, trust, and pride in an individual’s local area) and participation (involvement in clubs or associations). However, in an elderly subpopulation a correlation was also observed between happiness and living with a partner, as well as attendance at religious services and having professional qualifications (5).

What is clear is that regardless of the definition employed or variable examined, wellness is a physiological state of being with physiological consequences. This fact is emphasized by the breadth of compelling evidence for a role of wellness in health and all-cause mortality (6). In fact, a recent meta-analysis estimated that people who were happy lived 14% longer than those who were unhappy. The importance of this finding is reinforced when the quality of the additional years lived by happy people are considered (7). Thus, while psychological wellness is often thought of in subjective terms, wellness has very real physical repercussions.

The Neuroanatomy of Wellness

The concept that pleasure and affect are biological phenomena is not new. Charles Darwin pioneered the scientific study of the evolution of emotions and suggested that affects are adaptive responses to environmental situations. More recently, enormous progress has been made in the field by focusing on objective aspects in behaviour, physiological and neural reactions. In fact evidence now exists suggesting that fundamental hedonic brain systems are involved in sensory pleasures including drug abuse, monetary, aesthetic and musical delights. It is hypothesized that pleasures related to social activities may have similar neurobiological roots (8).

The hedonic mechanisms within the brain are linked to a complex network of neural circuitry. Candidate regions of importance include the nucleus accumbens, ventral pallidum, brainstem, as well as regions of the cortex (orbitofrontal, cingulate, medial pre-frontal and insular cortices) (Figure 2). Other studies using function magnetic resonance imaging (fMRI) demonstrate that the amygdala is also activated by all basic emotions (9).

While areas of the brain implicated in coding for pleasure are well-defined and widespread, precise areas responsible for the causation of pleasure, as measured by increases in ‘liking’ reactions, are unclear. To date, causation has merely been loosely linked to subcortical structures. However, given that damage to the orbitofrontal region of the prefrontal cortex impairs pleasure-related decisions, including choices and context-related cognitions, a role for the orbitofrontal cortex may be inferred (10).

While further investigation needs to be conducted in order to ascertain definitive causal relationships between specific regions of the brain and the neural circuitry involved, it is clear that the outcome of hedonic sensations, such as pleasure and wellness, and learning can be linked to precise neuroanatomical structures.

Physiological Effect of Feelings

Beyond the neuroanatomy, there exist important physiological consequences of emotions, such as happiness, which constitute an important aspect of perceived wellness. A recent study of 160 healthy volunteers revealed an association between perceived happiness and inflammatory response. Levels of the pro-inflammatory cytokine interferon-ϒ (IFN-ϒ) were measured in volunteers and found to be lower in the high-happiness group than in the low-happiness group (11). Secreted by secreted by Th1 helper cells, cytotoxic T cells, and NK cells, IFN-ϒ has antiviral, immunoregulatory, and anti-tumorigenic properties (12). However, elevated chronic activation of the innate immune system and systemic inflammation can contribute to the development or progression of certain auto-inflammatory and Liking and autoimmune diseases (13). In the same study of IFN-ϒ, 7 romantic couples were also recruited for investigation into IFN-ϒ levels after evocation of happiness through physical contact with their partner. Induced happiness in these couples was found to reduce peripheral IFN-ϒ levels suggesting that happiness may suppress the peripheral circulation of pro-inflammatory cytokines and protect against a number of auto-inflammatory and autoimmune diseases (11).

Convincing investigations have also been conducted examining the link between emotions and cardiac function. In 2010, Sugawara et al were amongst the first to demonstrate an association between a positive emotional state and cardiovascular health. In their study, Sugawara et al examined the effect of mirthful laughter on vascular function in 17 adults of 23 to 42 years of age. Vascular function of study participants was assessed by determination of heart rate, blood pressure, arterial stiffness, and flow-mediated dilatation, while participants watched a comedy to elicit laughter. Documentaries were used as a negative control. A significant increase in heart rate and blood pressure was observed when participants watched the comedy, but not the documentary. A 17% increase in brachial artery flow-mediated dilation was also observed subsequent to viewing of the comedy, whereas a 15% decline was noted following the documentary. It should be noted however that the duration of the observed change in vascular function was

An inverse relationship also appears to exist whereby cardiac afferent information influences emotional appraisal. fMRI was employed to measure brain responses to emotional facial stimuli displayed before and during cardiac systole. Gray et al observed differences in the processing of emotional stimuli concurrent to natural baroreceptor activation. During systole, participants viewed facial expressions of disgust with greater intensity. This interaction between cardiac timing and emotional assessment was found to be reflected in changes in activity within periaqueductal gray matter. In addition, increases in heart rate associated with visual stimuli were found to be correlated to activity in the pre-frontal and visual cortices. These results therefore highlight the existence of a close relationship between cardiac processes and emotional reactions (15).

Not all of the physiological consequences of emotions are positive. Fear and anxiety are two powerful stimuli that also evoke powerful responses. Attention control theory proposes that anxiety leads to shifting of attention to the threat-related stimuli, but may not impair performance effectiveness if compensated for (16). Inhalation of carbon dioxide has been successfully used in the study of anxiety to assist in the simulation of anxiety free from additional external variables associated with learned anxiety and with good test-retest reliability (17-19). This method was used by Diaper et al to evaluate the effects of anxiety on task performance (20). While inhaling a 7.5% CO2/21% O2/71.5% N2 mixture, study participants completed one of two tasksϒ a tracking task and a task involving division of attention. Measurement of heart rate and blood pressure, as well as subjective assessments of mood allowed Diaper et al to conclude that carbon dioxide-simulated anxiety resulted in increased heart rate, blood pressure, and subjective scores of panic, anxiety and tension (20). The use of carbon dioxide inhalation also holds promise in fear memory research as Ziemann et al demonstrated in 2009 an effect on the amygdala (21).

Consequences of Behaviour on Wellness

Diet

As is illustrated by the present epidemic of cardiovascular disease (CVD), obesity, and diabetes, daily lifestyle decisions also play a critical role in physical wellness. It is estimated that greater than 1 in 3 Americans suffer from CVD, making it the leading cause of death in The United States, with an average of 2300 lives claimed daily (22, 23). It is projected that a failure to address this issue will result in just over 40% or 116 million Americans suffering from some form of CVD by 2030 (24). In 2010, the estimated cost of CVD treatment was in excess of $500 billion or 17% of the American national health budget whereas prevention received only 3% (23). While these treatments have been estimated to have reduced major CVD events by more than 25%, the their cost emphasizes the need to prevent rather than treat CVD (25).

Today most clinical cases of CVD result from atherosclerosis (26). Atherosclerosis is a chronic disease in which inflammation of the arterial intima results from an accumulation of oxidized lipoproteins, cholesterol, and necrotic cells. Chronic inflammation and the development of atherosclerotic lesions are associated with thrombotic and ischemic cardiac events, including heart attacks and strokes.
Frighteningly, convincing evidence is now emerging demonstrating that atherosclerosis may begin in infancy and even in utero, only to progress throughout an individual’s lifetime (27, 28).

Besides heredity, the single most significant risk factor associated with CVD is diet. Diet is a key factor in CVD as it provides a source of lipoproteins in the bloodstream; however other lifestyle decisions such as smoking and a lack of physical activity are contributing factors in sustaining inflammation (29). Dietary proteins may also be protective against CVD, as past evidence suggests that they are effective antihypertensive compounds, as well as displaying antithrombotic, hypoglycemic and hypolipidemic properties (30). While questions still remain as to the quantities required and the specificity of the effect, there is evidence that soy protein consumption may also be beneficial in reducing circulating low-density lipoprotein (LDL) cholesterol and triglyceride levels and increasing high-density lipoprotein (HDL) cholesterol (31).

LDL or “bad” cholesterol is removed from circulation by the LDL receptor. The importance of this event, and of the levels of circulating LDL cholesterol, is unmistakable in adults with mutations in the proprotein convertase subtilisin-like/kexin type 9 serine (PCSK9) gene. PCSK9 functions to remove the LDL receptor from the surface of hepatocytes where the receptor interacts with, and internalizes, circulating LDL cholesterol. Thus, circulating PCSK9 levels are correlated with BMI, triglycerides, total cholesterol, LDL cholesterol, blood pressure, and fasting blood glucose (32). Mutations in the PCSK9 gene which result in a loss of its function (i.e., higher LDL receptor levels) have been demonstrated to result in LDL cholesterol levels approximately 28% lower than nonvariants and a corresponding 88% reduction in CVD risk (33, 34). In contrast, individuals with mutations in the PCSK9 gene that result in a gain of function (i.e., lower LDL receptor levels) result in familial hypercholesterolemia (35).

Unlike, LDL cholesterol, high HDL cholesterol levels (>60mg/dL) are protective against future CVD events (36). While the primary determinant for HDL cholesterol levels is genetics, lifestyle choices such as alcohol consumption and tobacco use, as well as obesity and diabetes, negatively impact HDL cholesterol levels. The beneficial effects of HDL are a consequence of lipid modulation, anti-oxidative, anti-inflammatory, and anti-thrombotic events (reviewed in (28)).

C-reactive protein (CRP) is another biomarker whose levels are associated with CVD as well as infections, cancer, and autoimmunity. Elevated CRP levels, an indication of inflammation, reflect lifestyle, including visceral obesity, metabolic syndrome, a lack of physical activity, fruit, vegetable, and omega-3 fatty acid
consumption, and alcohol intake (37-41). Unlike, LDL and HDL cholesterol, lifestyle, not genetics, is the most significant determinant of CRP levels (42). Weight loss and a Mediterranean diet have both been demonstrated to result in lower CRP levels (43, 44).

Moreover, dietary changes alone have been demonstrated to be capable of completely reversing CVD lesions in primates (45). Prospective studies suggest that population-based prevention of CVD through a healthy lifestyle would reduce CVD-associated deaths by 10% and eliminate up to 90% of heart disease (28, 46-48). Given that lifestyles affecting CVD risk factors are learned early in life, health education is recommended to begin at that time as well (49).

Landmark clinical trials in pre-diabetics show that lifestyle changes (improved diet and exercise) are also associated with a reduced risk of diabetes (reviewed in (50, 51)). In particular, a diet of leafy green vegetables was found to be associated with a 14% reduction in the risk of type II diabetes (52). It is hypothesized that a high intake of vegetables is beneficial due to their ability to increase levels of antioxidants (carotenoids and vitamin C) and lower markers of oxidative stress (53, 54). A diet rich in fruits and vegetables has also been linked to a reduced incidence of cancer, whereas a Western-style diet, rich in sugar, salts and fat, has been associated impairment of renal vascularization, steatosis, inflammation, hypertension, and hormonal regulation leading to chronic kidney disease ((55)and reviewed in (56)).

Exercise

Physical activity is another lifestyle component that has been demonstrated to improve CVD risk factors. Discouragingly, it is estimated that less than 15% of Americans exercise sufficiently and over 60% do not perform any vigorous activity (28). In fact, up to 250,000 deaths annually in The United States may be attributed to the consequences of a lack of physical activity. In addition to CVD, a physically active lifestyle is protective against conditions such as type II diabetes, hypertension, osteoporosis and colon cancer (reviewed in (57)). The benefits of physical activity may be ascribed to:

• A reduction in body weight
• A reduction in blood pressure
• A reduction in total and LDL cholesterol
• An increase in HDL cholesterol
• An increase in insulin sensitivity (57).

A recent analysis of a series of molecular epidemiological studies suggests that physical activity decreases oxidative damage to nuclear DNA, DNA-adducts and mitochondrial DNA damage. In these studies, a cohort of 107 mostly male subjects (all active smokers) was divided into 2 groups based upon their levels of physical activity. The first group (48%) performed a minimum of 45 minutes of light physical activity 5-times a week, whereas the second group (52%) were sedentary. During a 15 year period (1992-2007) all of the subjects underwent surgical removal of aortic atherosclerotic lesions at the same hospital. Smooth muscle cells of the aortic specimens were analyzed for DNA alterations (e.g., 8-hydroxy-2’-deoxyguanosin, bulky DNA adducts, and the common 4977bp deletion of mitochondrial DNA) and genetic polymorphisms (e.g., GSTM1, GSTT1, NAT1 NAT2, MTHFR, pro-thrombin, and factor V Leiden). The results of these studies demonstrated that, as compared to their sedentary counterparts, physically active subjects had lower levels of DNA alterations (a 2.8-fold decrease in 8-hydroxy-2’-deoxyguanosin levels, p

Substance Abuse

As is evident from the significant impact of diet and exercise, lifestyle choices play a critical role in overall physical wellness. Lifestyle choices may impact wellness positively or, in the case of substance abuse, negatively. Drug addiction, as defined in 2010 by Koob and Volkow, is the continued use of mood-altering addictive substances despite negative consequences. Addictive substances function by initially inducing a sense of pleasure or relieving displeasure, however continual use results in changes in the central nervous system leading to tolerance, dependence, cravings, and relapse (59). Studies have shown that habitual behaviours are recorded sequentially in the basal ganglia (60, 61). The habit may then be triggered by a specific context, even subsequent to giving up the behaviour (62). The phenomenon of “cross-priming” between addictive substances has also been demonstrated whereby a small dose of one substance results in enhanced craving for another substance. This phenomenon is said to be the result of activation of a common mesolimbic dopamine system (63). Thus, for example, nicotine consumption increases alcohol consumption (64).

Addiction to nicotine is a serious issue that continues to plague public health systems given its association with cardiovascular disease, chronic obstructive pulmonary disease, and cancer of at least 18 different organs (65). Smoking has been estimated to be responsible for approximately 5.4 million (1 in 10) deaths worldwide annually (60). While the toxicity of tobacco is related to a complex mixture of chemicals, findings demonstrate that nicotine is responsible for the addictive nature of smoking (66, 67). It is believed that the molecular mechanisms of nicotine addiction are a result of stimulation of monoamines, dopamine in particular, in the brain (68).

Lifestyle Recommendations

• Not smoking or quitting
• Body mass index less than 25kg/m2
• 150 minutes of exercise weekly (or 75 minutes of vigorous exercise)
• Eating a “healthy diet”

• 4 servings of nuts, legumes, and seeds per week
• Daily sodium intake of less than 1.5g
• Weekly sweetened beverage intake of less than 36oz
• 4.5cups or more of fruits and vegetables daily
• 3 x 1ounce servings or more of fiber-rich whole grains daily
• 2 x 3.5ounce servings or more of oily fish weekly
• Total cholesterol less than 200mg/dL
• Blood pressure smaller than 120/80mmHg
• Fasting blood glucose less than 100mg/dL

Summary of the Evidence for and Importance of Wellness

Wellness is a physiological state of being, with physiological consequences that are greatly impacted by lifestyle decisions. A general sense of satisfaction, hedonic wellness, has been linked to activation of nucleus accumbens, ventral pallidum, brainstem, amygdala, and regions of the cortex (orbitofrontal, cingulate, medial pre-frontal and insular cortices) (8, 9). Additionally, wellbeing has been tied to the inflammatory response (11), cardiac function (14), and task performance (20). Wellbeing can be greatly moderated by lifestyle decisions, including diet, physical activity, and substance abuse. The importance of these effects on wellbeing may be observed by the improved life-expectancy of individuals who consider themselves to be well (6, 7). Importantly, governments are beginning to acknowledge the importance of wellbeing by measuring happiness as an indicator of national progress, instead of relying solely on gross domestic product (GDP) (69).

The question remains though as how best to promote a healthy lifestyle and a decision-making process that favours wellbeing. One recent systematic review of dietary and physical activity interventions revealed a causal relationship between program effectiveness, social support, addressing multiple lifestyle habits (diet and exercise), and providing well-defined techniques (i.e., self-monitoring, goal setting, self-reinforcement, and action plans). No evidence was found to link effectiveness to method of delivery (Table 1) (70).

While there are countless diet, exercise and smoking cessation programs, what differentiates the MoovJam program is its ability to address overall wellbeing through a multifaceted approach that is aligned with these empirically proven recommendations. Such a holistic approach to improving
wellbeing has the potential to increase health and happiness while simultaneously saving lives and downstream healthcare costs.

The MoovJam Program

Program Overview

Moovjam is a unique program which addresses in a concurrent fashion two basic components essential to overall wellness: psychology and physiology. Moovjam’s uniqueness is tied to an approach which primes healthy lifestyle choices through the use of neuroscientifically-demonstrated techniques. These techniques are integrated into the Moovjam tracking program which encourages users to reflect on issues tied to diet, physical activity levels, as well as awareness of self and interaction with others. Given the complexity of wellness, it cannot be achieved solely through diets or workout programs, nor can it be independently attained through wishful thinking. Moovjam’s holistic pathway leads to an integrated treatment of wellness in a flexible, personalized, and professionally-supported manner.

Priming Behavior

Until recently neuroscientists and psychologists believed that the brain and its connections were formed during gestation and infancy and remained pretty much unchanged through childhood. It was believed that humans had a given number of neurons in a specific brain structure, and while the number might vary among people, once a person was done with childhood development, they maintained a constant number of neurons arranged in an unchanging circuitry. In other words, once the connections were made, the learning and growing period in the brain was over. In the last decade, however, researchers have found significant evidence that this is not so, and that neuroplasticity continues throughout our lives.

Neuroplasticity is any change in neuron structure or function. The concept of a malleable, or “plastic”, nervous system was first introduced by William James in 1890. James defined plasticity as “a structure weak enough to yield to an influence, but strong enough not to yield all at once.” However, the modern definition of neuroplasticity arose from findings testing the neural plasticity hypothesis. These findings included demonstrations that electrical stimulation of nerve fibers could strengthen synaptic responses in both the spinal cord and the brain. Later studies of rats raised in enriched environments illustrated increases in synapses in the cerebral. Behavioral training paradigms were subsequently shown to exist
in insects, invertebrates, as well as primates, including humans. Thus, it now widely accepted that experiential neuroplasticity is both evolutionarily conserved and a fundamental property of nervous tissue (reviewed in Kleim et al, 2010). With our ever growing understanding of the functionality of the brain, it is becoming apparent that with the right type of stimulation and training, the human brain can be primed to dramatically change and remodel itself to become more efficient and effective, and influential on behaviour and physicality. By stimulating and training target-specific areas of the brain, individuals can be empowered to achieve maximum performance.

If the neural circuitry of our brains and the way that it functions can be influenced by externalities in our environment, then by directing and controlling the stimuli presented to us in our environment, we may influence the way in which we think. This is the hypothesis behind brain-training for specific thought processes and behaviors. Brain-training can be considered a highly specialized cognitive-behavioural task, which can be repeated until the desired affect is achieved. It is similar in nature to cognitive-behavioural tasks (thinking-behaving) that are completed in the real-world, and in real-time, only it is target specific and pre-determined to stimulate certain brain areas that are responsible for both cognitive and behavioural functions.

Interesting evidence comes from the world of e-learning, online computer games, and specialized technologies. Green and Bavelier (2003) showed that video game players performed better in measures of visual attention than non-players. Interestingly, when non-players were asked to play an action video game intensively over a period of several weeks, those individuals visual attention capacities improved to look more like gamers’. Tetris is a game that has been implicated greatly in the brain change literature. Haier and colleagures (2009) asked a group of adolescent girls to practice for a period of three months, taking brain recordings before and after training. The brains of the girls were changed both functionally and structurally from the training. Cortical thickness was increased in certain areas, while levels of activation were increased in others.

Interactive multimedia software technology and platforms, such as those used for e-learning, online computer games and specialized technology, can be used to present specific task demands to individuals in a form that can range from introductory to intensive, repeatable, adjustable, adaptive and highly targeted. This advance in technology, combined with a new understanding of the brain’s ability to reshape itself (and subsequently influence behaviour), has led to an explosion in interest in using
computer based technology to train the brain. There are now several examples of studies performed with targeted brain-training programs that have achieved positive outcomes.

Brain-training in Adults

One area of active research in brain-training is the cognitive (and behavioural) decline associated with the normal cause of aging. The Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) study was a large, randomized, controlled trial testing the effects of three kinds of cognitive training (Ball, et al., 2002). The 2832 participants, all 65 years of age or older, were randomly assigned to one of four conditions. One group received no training, and served as the control. The three intervention groups received either memory, reasoning, or speed of processing training. Participants in each intervention underwent approximately 10 one-hour sessions of training over approximately six weeks. In the reasoning intervention, participants worked with trainers to learn and practice skills related to inductive reasoning and problem solving. The memory training focused on verbal episodic memory, and taught participants to use mnemonic strategies for remembering lists and other specific information. The speed of processing training involved a computer-based training procedure that required participants to simultaneously identify a central visual target and locate another stimulus in the periphery.

A number of interesting results came out of this very large NIH-funded trial. As expected, all participants in all groups learned to perform the brain-training tasks more efficiently. What was even more impressive was that the effects of the training generalized to measures of real-world functioning (behaviour). For example, those receiving training showed slower declines in instrumental activities of daily living (ADL’s) than the controls, and these differences were significant for the speed of processing and reasoning groups (Willis, et al., 2006). These functional benefits were observed five years after training was completed, indicating the the benefits were sustained for a substantial period of time. The ACTIVE study demonstrates that brain-training can have highly beneficial real-world benefits for seniors.

Brain-training in Children

Research related to cognition in children is another area of intense interest. Researchers from the Karolinska Institute in Stokholm, Sweden, conducted a series of experiments testing the effects of a working memory training program on children with attention deficit hyperactivity disorder (ADHD). The premise of this work is that increasing working memory capacity in these children will improve their
ability to attend to and process information in their environments, improving behavioural and school performance outcomes. By brain-training with tasks that challenge the child to remember a sequence of targets and hold on to and manipulate those memories, a variety of positive cognitive (and behavioural) outcomes were achieved. The memory challenge was adjusted adaptively to match the user’s performance and improvement. In one study, improvements were seen in visual memory and response inhibition after training, relative to controls (Klingberg, et al., 2005). Increased levels of activation in the prefrontal cortices (the parts of the brain most responsible for working memory and attention) were seen in children following training (Olesen, et all, 2004). Improved mathematical reasoning performance has been observed following training, as well (Holmes, et al., 2009). This research lends more proof to the notion that the right kind of brain-training can improve cognition (and behaviour), change the brain, and have positive impacts on young people’s lives.

Brain-training Improves Health-related Outcomes

One of the most significant predictors of health-related outcomes today (mental and physical), is addictive behaviour (eating, drinking, smoking, substance abuse, and the like). Researchers at the University of Amsterdam (2011) were able to lower the drinking rates of problem drinkers using brain-training. Participants in this study -all problem drinkers who had trouble controlling their impulses to drink alcohol were split into a training group and a control group. The training group had twenty-five daily sessions of challenging brain-training tasks for working memory (which controls impulses), while the control group trained with easier levels of those tasks. Not only did the training group improve memory capacity and drink less than the control group, but these effects were still visible one month after the study ended. This study provides valuable insight into how brain-training can help people to control highly addictive and resistant-to-treatment behaviours, and make healthier life-choices. It also confirms what other studies have consistently show, which is that the effects of brain-training are long lasting and resistant to regression.

Dr. Anett Gyurak/Stanford University, conducted a study which demonstrated that brain-training is also an effective technique to help regulate emotional wellness. Dr. Gyurak created two distinct groups –one of healthy adults and another of those suffering from Generalized Anxiety Disorder/Major Depressive Disorder- and used brain-training as part of an intervention program. The participants underwent a combined training regimen to target executive function, and also used a separate training regimen to target emotional regulation. The idea was that cognitive training could target executive functioning
(which is involved in planning, impulse control, and abstract thinking) and emotional regulation, both of which are linked to successful social interaction and emotional well-being. After thirty days of brain-training, complete with a variety of pre/post tests and diary entries, only the training group demonstrated reductions in anxiety and depression, and increases in beneficial emotional processing. While further research is still necessary in this subject area, the initial findings are extremely positive. Dr. Gyurak’s study provides a valuable foundation for our understanding of the processes by which brain-training can enhance emotional regulation.

MoovJam’s Approach to Brain-training

MoovJam successfully uses the concept of brain-training to promote healthy emotional and physical lifestyles. In order to accomplish this, MoovJam’s participants spend 5 to 10 minutes daily completing an online questionnaire that assesses diet, physical activity, social connectedness, and emotional wellness. Participants may then reflect on and track their overall wellness on a daily basis. Moreover, based on their responses participants are directed to online resources and tools, as well experts online in real-time in a variety of related fields. By creating an awareness of lifestyle decisions and their impact on overall wellness, MoovJam’s program trains participants to adopt behaviors and strategies that lead to positive outcomes.

MoovJam completed a cumulative pilot study in 2011 revealing that an improvement in engagement and healthy living behaviors can be achieved with its web-based healthy living and tracking program that uses brain science based behavior priming and modification. Volunteer participants were recruited from student and teacher populations in Laval, Quebec. Training and testing were conducted on each participants personal computer to simulate conditions of actual use in real-time. Results and compliance data were captured automatically via the online program and through trained observation. Participants were required to invest five minutes once daily completing program questions online. At the end of this time period the group improved significantly in measures of engagement, interest in healthy living behavior, and social interaction.

Program Delivery

MoovJam’s tracking program has the capacity to capture data and allows specialists to interpret an individual’s behavior and patterns over time. In addition, participants can receive in real-time, individual
counsel from a variety of MoovJam experts. These experts communicate with participants in a secure and confidential environment via ZenLive©, a web-conferencing platform. MoovJam’s experts may offer participants additional support by sharing in real-time videos, presentations, and other appropriate resources on an as needed basis. As ZenLive is a web-based platform, it may be accessed by participants from any browser at any time.

The Use of Biomarkers to Promote Wellness

MoovJam’s participant tracking program includes questions that provide information on several key predictors, or biomarkers, of participants’ risk of certain diseases. Biomarkers, defined as characteristics of normal biological or pathogenic processes, may result from heritable or environmental factors. These characteristics, once measured and compared to established normal values, aid in assessing cause, diagnosis, progression, regression, or outcome of treatment of a disease. However while biomarkers have the power to provide objective risk assessments, variability is often an important concern (71). MoovJam addresses this issue by not only allowing specialists in a variety of fields to view information on a participant’s biomarkers at a discrete point in time, but for the entire length of time that the participant is enrolled in the program. This is accomplished by tracking and graphically representing key data that is available on a daily basis each time a participant completes the online questionnaire. Participants may also view their biomarker data and reflect upon how their lifestyle choices and habits are impacting their risk of disease. To date, the biomarkers assessed by MoovJam include body mass index (BMI) and heart rate, as well as important risk factors such as substance abuse, alcohol consumption, diet, and physical activity. With such an awareness, MoovJam participants are armed with the information, skills, personalized support, and resources to make decisions that lead to wellness.

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