We are complex organisms living and interacting in a complex world. We now face unprecedented times, with many people enduring very high levels of stress, loss of control over their lives, loss of livelihoods, increasing food shortages, breakdown in relationships through polarisation and division – and so much more. That’s before you even consider the need to contend with a new virus.

Our health at any point in time is dependent on how our genes express themselves, and that in turn is greatly affected by our internal and external environments. To understand how we can optimise our health, especially during these difficult times, we must recognise the complexity and use a systems approach; one in which we see ourselves as a living system that functions within much bigger social, environmental and, ultimately, ecological systems.

This has been the central tenet of the blueprint for health system sustainability that’s been a core project of ours, the ultimate objective of which is to facilitate a transition to future-fit health systems that put the individual and his or her community at the heart.

>>> Click here to find out more about The Great Health System Reset and our blueprint

At the heart of our blueprint is the 12-domain Ecological Terrain, that we also refer to as our EcoTerrain.


If you prefer to listen you can download the podcast here.


Each domain represents a part of our ecological system that can be assessed according to its status or function – and is amenable to change according to what, when and how we eat, how we move, rest, relax, what supplements we take, how we interact with others, and, among other things, what gives our life meaning.

Behavioural and lifestyle changes can have profound effects, many of them being detectable relatively quickly (typically days or weeks) after a change is made – but perhaps influencing whole system health somewhat (typically months) later when multiple systems have come into balance.

This of course brings us into the arena of lifestyle, integrative, nutritional or functional medicine, many of the principles of which have been embodied within long-standing traditional systems of medicine such as Ayurveda and traditional Chinese medicine (TCM).

In the table below, we’ve suggested important measures or proxies of function or status for each of the 12 domains. In some cases you’ll see numbered links to references that will give you more information. Our blueprint model provides three levels of assessment (self-assessed, practitioner-guided and biomedical testing), we’ve focused here particularly on the self-assessed measures and proxies as these can be done easily at no additional cost.



Measures/proxies of function or status

Method of assessment


Genetic & epigenetic background

ACE1 and 2 receptor polymorphisms

Genetic testing[1],[2],[3],[4]

Cytokine signalling (e.g. IL-6, IL-10, TNFα, Apo E4)

Type 2 diabetes- & obesity-related polymorphisms among different ethnicities (e.g. ADIPOQ, LepR, PPARG)

Vitamin D binding protein (VBD) and vitamin D receptor (VDR) polymorphisms


Glycaemic control and metabolic flexibility

Suffer ‘sugar crashes’


Find it difficult to burn fat (if your weight to height ratio [WHR] is over 0.5 you may benefit from losing ‘fat around the middle’ which in turn lowers your metabolic disease risk)

Self-assess using tape measure

Bioelectrical impedance analysis (BIA) to track changes in skeletal/lean muscle, body fat and visceral fat

Self-assess using body composition scale (e.g. Tanita, Omron)

Beta-hydroxybutyrate (BHB) – metabolically flexible individuals can burn fat as an energy carrier and enter nutritional ketosis (with BHB levels 0.5 - 3 mmol/L)

Self-assess using ketone meter (blood [preferably], breath or urine)

Glycated haemoglobin (HbA1c) test

Doctor evaluated


Gastrointestinal system and microbiome function

Digestive discomfort e.g. bloating, flatulence, heartburn, nausea.


Microbiota communities in gut

Stool test via practitioner or specialist lab

Bowel movements or regularity


Intolerance or sensitivities to particular foods

Self-assess (elimination diets) and/or food intolerance testing


Mitochondrial function

Fatigued, feeling tired all the time (TATT)


Low lean muscle

Self-assess using body composition scale

Brain fog



Immune system function and inflammatory status

Prone to infections, long recovery post-infection

Self- or practitioner-assess

Chronic inflammation signals: body pain, myalgia

Self-, doctor- or practitioner-assess[5]

Diseases caused at least in part by chronic inflammation e.g. cardiovascular disease, metabolic diseases, COPD, arthritis, rheumatoid arthritis


Oxidative stress

Feeling TATT, lacking in energy


Poor recovery post-exercise


Premature ageing



Neuroendocrine function

Poor stress tolerance

Self-assess, including use of Heart Rate Variability (HRV)[6],[7]

Hormonal imbalances

Feel, f testing

Mood swings

Self- or practitioner-assess

Gut-brain issues/vagal tone

Self- or practitioner-assess[8]


Circulatory system

Heart + blood vessels & lymphatic system (lymph, lymph nodes, vessels, collecting ducts, spleen, etc)

Practitioner-or doctor- testing

Family history of cardiovascular disease(s)

Medical record

Out of breath climbing stairs


Swollen ankles



Toxic burden & biotransformation

Food quality e.g. pesticides heavy metals in canned fish

Self-assess food choices or be guided by nutritional practitioner

Liver health

Practitioner- or doctor-assess

Low endogenous glutathione

Practitioner- or doctor-assess


Structural integrity status

Skeletal and musculoskeletal status (incl. orientation, pain, sarcopenia)

Self- or practitioner-assess

Standing long-jump (SLJ) and handgrip tests to assess lower and upper body muscular fitness

Self- or practitioner-assess

Nutrients/intake/assimilation e.g. vit D, Mg, K2, BCAAs, B vits, Se

Self- or nutritional practitioner-assess


Psychological & cognitive function

Anxiety, depression

Self-, doctor- or practitioner-assess

Difficulty concentrating

Self-, doctor- or practitioner-assess

Loss of memory

Self-, doctor- or practitioner-assess


Psychosocial-emotional status

Meaning in life? [Japanese: Ikigai]


Great relationships: Feeling loved, able to offer love, feeling you’re part of tribe


Happy much of the time

Self-assess, e.g. Pemberton Happiness Index[9]


[1] AL-Eitan & Alahmad (2020)

[2] Sayed (2021)

[3] Al-Jaf et al (2021)

[4] Hashemi et al (2021)

[5] Pahwa et al (2021)

[6] Kim et al (2018)

[7] EliteHRV

[8] Bonaz et al (2018)

[9] Hervás & Vázquez (2013)

Getting your TerRAIN back on the rails

The great thing is that if you have less than optimal function in several of your domains (which is very common), you don’t have engage in different interventions for each. Our domains are all inter-connected and the dysfunction we experience is often the result of things we’ve done over many years or specific traumatic events that occurred long ago. We call these ‘upstream’ events or causes – and they often produce a diversity of ‘downstream’ consequences. In lifestyle medicine, we’re much less interested in treating symptoms, and much more interested in changing our pattern of response by changing our behaviour and choices. The 3R approach often applies, in which we look at:

  1. Removing toxins, foods and chemicals to which we’re sensitive or intolerant,
  2. Restoring function to organs, tissues or systems that have been deprived of key nutrients, and,
  3. Repair, where we provide all the resources needed for the body to engage in repair to damaged cells, membranes and tissues.

In our view, among the most important to help bring balance and resilience back to our bodies and minds, are the following:

  • Ensuring that you have metabolic flexibility
  • That you have a no excess fat around your middle (central adiposity), i.e. a waist to height ratio of less than 0.5, as well as low visceral fat and good lean muscle mass to body fat composition
  • Resolve chronic inflammation and oxidative stress
  • Achieve good stress tolerance.

>>> ANH Pathfinder members can access generalised interventions and protocols here that aim to rebalance any of the EcoTerrain domains that are less than optimal in function or status.

With surprisingly few upstream changes to your life, be they changes to how you eat, move, relax or sleep, along with continued monitoring of your domain function, you can sort out multiple issues across multiple domains. This might include sorting imbalances in the communities of microbiota in your gut, rebalancing your vagal tone, improving your cognitive function and the quality of your relationships with others – and, of course, improving your immune system resilience so you not only reduce your risk to infectious agents like SARS-CoV-2, regardless of the variant, you also reduce your risk of chronic, degenerative diseases.

This is real, natural medicine – something we haven’t been hearing a lot about on the airwaves of late.

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