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Lifestyle medicine

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Lifestyle medicine is a branch of medicine dealing with research, prevention and treatment of disorders caused by lifestyle factors such as nutrition, physical inactivity, and chronic stress. Lifestyle Medicine focuses on educating and motivating patients to change personal habits and behaviors around the use of a whole food, plant-predominant dietary lifestyle, regular physical activity, restorative sleep, stress management, avoidance of risky substances and positive social connection.[1] In the clinic, major barriers to lifestyle counseling are that physicians feel ill-prepared and are skeptical about their patients' receptivity.[2]

Poor lifestyle choices like dietary patterns, physical inactivity, tobacco use, excessive alcohol consumption, as well as psychosocial factors, e.g. chronic stress and lack of social support and community, contribute to chronic disease.[3][4]

Lifestyle Medicine in Practice

The evidence that the body will heal itself when the factors that cause disease are removed is clear.[5][6]  Diseases such as cardiovascular disease and type 2 diabetes that were once thought to be irreversible have been reversed by lifestyle interventions.[7][8][9] Lifestyle interventions require behavior changes that may be challenging for health professionals, communities, and patients. The task of the LM practitioner is to motivate and support healthy behavior changes. Coaching and supporting people how to cook healthy food at home, for example, can be part of a lifestyle-oriented medical practice.[10]  

There are many theories of behavior change, the transtheoretical model (TTM) is particularly suited to Lifestyle Medicine. It posits that individuals progress through six stages of change: precontemplation, contemplation, preparation, action, maintenance, and termination.[11][12] Stage-matched interventions are most likely to result in successful behavior changes.  Lifestyle Medicine practitioners are encouraged to adopt counselling methods such as motivational interviewing (MI) to identify patient readiness to change and provide stage appropriate lifestyle interventions.[13]   

Levels of Lifestyle Medicine

LM may be practiced on three levels. The first level involves recognition by all health care professionals that lifestyle choices determine health status and is an important modifier of the response to pharmaceutical or surgical treatments. All practitioners are encouraged to include lifestyle advice along with standard treatment protocols.  The second level is specialty care where Lifestyle Medicine interventions are the focus of treatment and pharmaceutical or surgical treatments are an adjunct to be used as necessary. The third level is population/community health programs and policies. Lifestyle intervention advice should be included in public health/preventive medicine guidance and policies for the prevention and treatment of chronic diseases.[14]

Interprofessional Education/Collaboration in Lifestyle Medicine Practice

Healthcare professionals and their future patients would benefit if the basics of Lifestyle Medicine were incorporated into all professional training programs. Formal training and personal experience of evidence-based lifestyle interventions such as plant-based nutrition, stress management, physical activity, sleep management, relationship skills and substance abuse mitigation would transform our healthcare system. Lifestyle Medicine is uniquely suited to interprofessional education where students from two or more health care professions learn together during all or part of their professional training with the objective of cultivating collaborative practice for providing patient-centered care.[15][16][17][18]

See also

References

  1. ^ Lifestyle Medicine. Wiley.
  2. ^ Hivert, Marie-France; Arena, Ross; Forman, Daniel E.; Kris-Etherton, Penny M.; McBride, Patrick E.; Pate, Russell R.; Spring, Bonnie; Trilk, Jennifer; Horn, Linda V. Van; Kraus, William E.; Health, On behalf of the American Heart Association Physical Activity Committee of the Council on Lifestyle and Cardiometabolic; the Behavior Change Committee, a joint committee of the Council on Lifestyle and Cardiometabolic Health and the Council on Epidemiology and Prevention; the Exercise, Cardiac Rehabilitation; Nursing, and the Council on Cardiovascular and Stroke (1 January 2016). "Medical Training to Achieve Competency in Lifestyle Counseling: An Essential Foundation for Prevention and Treatment of Cardiovascular Diseases and Other Chronic Medical Conditions: A Scientific Statement From the American Heart Association". Circulation. 134 (15): e308–e327. doi:10.1161/CIR.0000000000000442. ISSN 0009-7322. PMID 27601568.
  3. ^ Kvaavik, Elisabeth (April 2010). "Influence of Individual and Combined Health Behaviors on Total and Cause-Specific Mortality in Men and Women: The United Kingdom Health and Lifestyle Survey". JAMA Internal Medicine. 170 (8): 711–8. doi:10.1001/archinternmed.2010.76. PMID 20421558. Retrieved 7 July 2015.
  4. ^ Sagner, Michael (October 2014). "Lifestyle medicine potential for reversing a world of chronic disease epidemics: from cell to community". International Journal of Clinical Practice. 68 (11): 1289–1292. doi:10.1111/ijcp.12509. PMID 25348380.
  5. ^ Esselstyn, Caldwell B. (2017-05-28). "A plant-based diet and coronary artery disease: a mandate for effective therapy". Journal of Geriatric Cardiology. 14 (5): 317–320. doi:10.11909/j.issn.1671-5411.2017.05.004. PMC 5466936. PMID 28630609.
  6. ^ Ornish, D.; Brown, S.E.; Billings, J.H.; Scherwitz, L.W.; Armstrong, W.T.; Ports, T.A.; McLanahan, S.M.; Kirkeeide, R.L.; Gould, K.L.; Brand, R.J. (July 1990). "Can lifestyle changes reverse coronary heart disease?". The Lancet. 336 (8708): 129–133. doi:10.1016/0140-6736(90)91656-U.
  7. ^ Ornish, Dean (1998-12-16). "Intensive Lifestyle Changes for Reversal of Coronary Heart Disease". JAMA. 280 (23): 2001. doi:10.1001/jama.280.23.2001. ISSN 0098-7484.
  8. ^ Davis, Brenda C.; Jamshed, Humaira; Peterson, Courtney M.; Sabaté, Joan; Harris, Ralph D.; Koratkar, Rohit; Spence, Jamie W.; Kelly, John H. (2019-06-05). "An Intensive Lifestyle Intervention to Treat Type 2 Diabetes in the Republic of the Marshall Islands: Protocol for a Randomized Controlled Trial". Frontiers in Nutrition. 6: 79. doi:10.3389/fnut.2019.00079. ISSN 2296-861X. PMC 6560078. PMID 31231656.{{cite journal}}: CS1 maint: unflagged free DOI (link)
  9. ^ Sandefur, Kelsea; Kahleova, Hana; Desmond, Alan N.; Elfrink, Eden; Barnard, Neal D. (2019-06-20). "Crohn's Disease Remission with a Plant-Based Diet: A Case Report". Nutrients. 11 (6): 1385. doi:10.3390/nu11061385. ISSN 2072-6643. PMC 6628285. PMID 31226766.{{cite journal}}: CS1 maint: unflagged free DOI (link)
  10. ^ Polak, R; Phillips, EM; Nordgren, J; La Puma, J; La Barba, J; Cucuzzella, M; Graham, R; Harlan, TS; Burg, T; Eisenberg, D (January 2016). "Health-related Culinary Education: A Summary of Representative Emerging Programs for Health Professionals and Patients". Global Advances in Health and Medicine. 5 (1): 61–8. doi:10.7453/gahmj.2015.128. PMC 4756781. PMID 26937315.
  11. ^ Prochaska, James O.; Velicer, Wayne F. (September 1997). "The Transtheoretical Model of Health Behavior Change". American Journal of Health Promotion. 12 (1): 38–48. doi:10.4278/0890-1171-12.1.38. ISSN 0890-1171.
  12. ^ Norcross, John C.; Krebs, Paul M.; Prochaska, James O. (February 2011). "Stages of change". Journal of Clinical Psychology. 67 (2): 143–154. doi:10.1002/jclp.20758.
  13. ^ Resnicow, Ken; McMaster, Fiona (2012). "Motivational Interviewing: moving from why to how with autonomy support". International Journal of Behavioral Nutrition and Physical Activity. 9 (1): 19. doi:10.1186/1479-5868-9-19. ISSN 1479-5868. PMC 3330017. PMID 22385702.{{cite journal}}: CS1 maint: unflagged free DOI (link)
  14. ^ Lianov, Liana (2010-07-14). "Physician Competencies for Prescribing Lifestyle Medicine". JAMA. 304 (2): 202. doi:10.1001/jama.2010.903. ISSN 0098-7484.
  15. ^ Urkin, Jacob; Merrick, Joav (March 2008). "The Principles and Framework for Interdisciplinary Collaboration in Primary Health Care". Journal of Policy and Practice in Intellectual Disabilities. 5 (1): 75–75. doi:10.1111/j.1741-1130.2007.00144.x. ISSN 1741-1122.
  16. ^ Dow, Alan W.; DiazGranados, Deborah; Mazmanian, Paul E.; Retchin, Sheldon M. (July 2013). "Applying Organizational Science to Health Care: A Framework for Collaborative Practice". Academic Medicine. 88 (7): 952–957. doi:10.1097/ACM.0b013e31829523d1. ISSN 1040-2446. PMC 3695060. PMID 23702530.
  17. ^ Meleis, Afaf I. (January 2016). "Interprofessional Education: A Summary of Reports and Barriers to Recommendations: Interprofessional Education". Journal of Nursing Scholarship. 48 (1): 106–112. doi:10.1111/jnu.12184.
  18. ^ Godin, Isabelle; Kittel, France; Coppieters, Yves; Siegrist, Johannes (December 2005). "A prospective study of cumulative job stress in relation to mental health". BMC Public Health. 5 (1): 67. doi:10.1186/1471-2458-5-67. ISSN 1471-2458. PMC 1177967. PMID 15958170.{{cite journal}}: CS1 maint: unflagged free DOI (link)
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