Showing papers on "Lifestyle medicine published in 2014"
TL;DR: A narrative discussion of the major components of Lifestyle Medicine, consisting of the evidence-based adoption of physical activity or exercise, dietary modification, adequate relaxation/sleep and social interaction, use of mindfulness-based meditation techniques, and the reduction of recreational substances such as nicotine, drugs, and alcohol are outlined.
Abstract: The prevalence of depression appears to have increased over the past three decades While this may be an artefact of diagnostic practices, it is likely that there are factors about modernity that are contributing to this rise There is now compelling evidence that a range of lifestyle factors are involved in the pathogenesis of depression Many of these factors can potentially be modified, yet they receive little consideration in the contemporary treatment of depression, where medication and psychological intervention remain the first line treatments “Lifestyle Medicine” provides a nexus between public health promotion and clinical treatments, involving the application of environmental, behavioural, and psychological principles to enhance physical and mental wellbeing This may also provide opportunities for general health promotion and potential prevention of depression In this paper we provide a narrative discussion of the major components of Lifestyle Medicine, consisting of the evidence-based adoption of physical activity or exercise, dietary modification, adequate relaxation/sleep and social interaction, use of mindfulness-based meditation techniques, and the reduction of recreational substances such as nicotine, drugs, and alcohol We also discuss other potential lifestyle factors that have a more nascent evidence base, such as environmental issues (eg urbanisation, and exposure to air, water, noise, and chemical pollution), and the increasing human interface with technology Clinical considerations are also outlined While data supports that some of these individual elements are modifiers of overall mental health, and in many cases depression, rigorous research needs to address the long-term application of Lifestyle Medicine for depression prevention and management Critically, studies exploring lifestyle modification involving multiple lifestyle elements are needed While the judicious use of medication and psychological techniques are still advocated, due to the complexity of human illness/wellbeing, the emerging evidence encourages a more integrative approach for depression, and an acknowledgment that lifestyle modification should be a routine part of treatment and preventative efforts
260 citations
TL;DR: Undergraduate medical education has undergone significant changes in development of new curricula, new pedagogies, and new forms of assessment since the Nutrition Academic Award was launched more than a decade ago, with an emphasis on a competency-based curriculum.
83 citations
TL;DR: Clinicians and people with MS should be aware of the wide range of modifiable lifestyle factors that may reduce depression risk as part of a comprehensive secondary and tertiary preventive medical approach to managing MS.
Abstract: Depression is the most common co-morbidity for people with Multiple Sclerosis (MS); irrespective of disease severity, depression has the greatest impact on quality of life. An emerging paradigm in the treatment of depression is lifestyle medicine. There is significant potential to prevent and treat depression through modification of lifestyle risk factors for people with MS. This study sought to understand the association between lifestyle risk factors, medication and depression risk through the analysis of self-reported data from a large international sample of people with MS. This cross-sectional analysis recruited a total of 2459 participants via Web 2.0 platforms. Survey data included socio-demographics; a range of lifestyle risk factors; medication; disease variables and depression risk using the Patient Health Questionnaire-2 (PHQ-2). In total approximately one fifth (19.3%) of our sample screened positive for depression (PHQ-2 score ≥3). Several demographic factors were significantly associated with this depression risk in bivariate analysis. Regression analyses showed that poor diet, low levels of exercise, obesity, smoking, marked social isolation and taking interferon were associated with greater depression risk. Participants who supplemented with omega 3s, particularly flaxseed oil, had frequent fish consumption, supplemented with vitamin D, meditated, and had moderate alcohol consumption had significantly reduced depression risk. This study demonstrates a significant association between modifiable lifestyle factors and depression risk. Planned longitudinal follow up may clarify causality. Clinicians and people with MS should be aware of the wide range of modifiable lifestyle factors that may reduce depression risk as part of a comprehensive secondary and tertiary preventive medical approach to managing MS.
66 citations
TL;DR: Lifestyle-related diseases (LRDs) are defined as diseases where the pathophysiology is significantly influenced by lifestyle factors and where a change in these aetiological factors can significantly improve prevention and treatment of the disease.
Abstract: The leading causes of mortality worldwide are chronic non-communicable diseases (NCDs); cardiovascular disease (17 million), followed by cancer (7.6 million), respiratory disease (4.2 million) and diabetes (1.3 million) (1). The newly published Global Burden of Disease Study (2010) has systematically highlighted the epidemiological shift in morbidity and mortality resulting from infectious diseases and malnutrition, to NCDs (2). While we have gained approximately 10 years of life expectancy since 1970, we are spending more years living with injury and illness (2). Representing 63% of all deaths, most that die from NCDs are in the prime of their productive years (3). There is now overwhelming evidence that lifestyle factors such as poor dietary patterns, physical inactivity, tobacco use, excessive alcohol consumption and psychosocial factors, e.g. chronic stress and lack of social support and community, are key proximal factors in the pathogenesis and incidence of NCDs (4). Lifestyle factors may also be more distal stressors, including economic, political or a high density population (5). We define lifestyle-related diseases (LRDs) as diseases where the pathophysiology is significantly influenced by lifestyle factors and where a change in these aetiological factors can significantly improve prevention and treatment of the disease. The world’s population has more and more adopted an ‘unnatural’ environment to which it has not had a chance to adapt physiologically. This leads to numerous biological dysfunctions, probably stemming from a form of low-grade systemic inflammation, which underlies most chronic diseases and risk factors such as hyperlipidaemia and hypertension. The first sign of such an unadapted lifestyle accumulating allostatic load is often increased body weight through a hypercaloric diet and inadequate physical activity (6). It is imperative that we finally and systematically address the underlying causes of LRDs rather than superficially treating symptoms. Today, one in two Americans and Europeans is either overweight or obese (7). Average body mass indices have on average risen by as much as 2–2.5 kg/m per decade and is now 30 kg/m or higher in some countries (8). As humans, we are designed to move, yet we have never been more sedentary. Physical activity has decreased drastically over the past cetury, because of economic growth, digitalisation and urbanisation. Over 70% of people in much of the modern industrialised world are not achieving adequate levels of healthpromoting physical activity (7). The impact of poor lifestyle is not limited to physical diseases but also increases the risk for mental disorders such as depression and anxiety, which is increasing worldwide (9). The economic burden of poor lifestyle choices is no longer sustainable and is impossible to ignore. LRDs have been established as a clear threat not only to human health but also to development and economic growth (2). Paradoxically, however, it is the The leading causes of mortality and healthcare costs worldwide are chronic diseases, resulting from lifestyle and environmental factors. The economic burden of poor lifestyle choices is no longer sustainable and impossible to ignore. Most chronic diseases are preventable. To treat the causes of these diseases and to be successful in prevention, a strong focus must be placed on lifestyle medicine aspects. Lifestyle Medicine encompasses research, prevention, diagnosis and treatment of dysfunctions caused by a non-physiological lifestyle (lifestyle-related diseases, LRDs) and morbidogenic environments conducive to promoting such lifestyles. The ultimate goal and primary focus of Lifestyle Medicine is to promote healthier lives through salutary environments and healthier lifestyle choices. Treatment of LRDs includes nutritional, exercise, psychological, social, economic and environmental interventions. To successfully do this requires education, training and communication about Lifestyle Medicine at the professional and general public level, while avoiding the trap of ‘victim blaming’ of individuals whose lifestyles are influenced by circumstances beyond their control. Lifestylerelated Diseases are now the leading cause of death on the planet and modern medicine needs to address the underlying causes with a new medical speciality, lifestyle medicne
61 citations
TL;DR: The overarching goal is to demonstrate how physician-counselling and referrals for physical activity and exercise play a well-documented role in primary and secondary prevention for reducing morbidity and mortality from non-communicable chronic diseases.
Abstract: Educating medical students and other health professionals in training on the importance of healthy lifestyles for prevention and treatment of disease is essential to transforming healthcare. At the University of South Carolina School of Medicine Greenville (USC SOM Greenville), we are incorporating the ‘Exercise is Medicine’ Knowledge, Skills and Abilities into all 4 years of the undergraduate medical curriculum to inform future physicians on the medical benefits of exercise and physical activity. As a partner with the Greenville Health System (GHS), USC SOM Greenville is striving to transform healthcare for the benefit of the people and communities it serves by healing compassionately, teaching innovatively and improving constantly. In addition, USC SOM Greenville and GHS are fostering relationships with the local YMCAs to improve healthcare delivery in upstate South Carolina using the ‘Exercise is Medicine’ solution. The overarching goal is to demonstrate how physician-counselling and referrals for physical activity and exercise play a well-documented role in primary and secondary prevention for reducing morbidity and mortality from non-communicable chronic diseases. In partnership with the Institute of Lifestyle Medicine (ILM) at Harvard Medical School, USC SOM Greenville also strives to spearhead a ripple effect in exercise curriculum by modelling for other medical school leaders throughout the country on how to adopt similar changes in curriculum and training for medical school students. Physician education regarding the benefits of exercise is vital for transforming healthcare.
Exercise counselling as part of healthcare delivery would have numerous evidence-based benefits for prevention and treatment of multiple non-communicable chronic diseases (NCDs) including type 2 diabetes, hypertension, cardiovascular disease and various forms of cancer.1–4 In addition, physician-based exercise counselling likely would have a major impact on reducing associated healthcare costs.5 Unfortunately, the majority of physicians, traditionally trained to manage disease and injury, have not been educated in the medical, …
40 citations
TL;DR: Despite overwhelming knowledge in this area, adherence to lifestyle strategies remains suboptimal and challenges remain in helping the public to act upon the current knowledge inThis area.
Abstract: Daily lifestyle practices and habits profoundly affect the likelihood of developing cardiovascular disease (CVD). Abundant research and multiple recent consensus documents support the role of regular physical activity, not smoking cigarettes, maintaining a healthy body weight, controlling cholesterol levels, and controlling blood pressure to lower the risk of CVD. These strategies also play important roles in avoiding ever developing risk factors. Despite overwhelming knowledge in this area, adherence to lifestyle strategies remains suboptimal. Challenges remain in helping the public to act upon the current knowledge in this area. Recent guidelines for managing cholesterol and blood pressure provide new guidance in these areas. Controversy, however, exists related to specific recommendations in both of these areas. Similar strategies that are applied to adults for improving lifestyle habits and practices to lower CVD risk also apply to children and adolescents. A clear consensus exists that lifestyle strategies play a critical role in preventing, managing, and reducing cardiovascular disease and its risk factors.
33 citations
TL;DR: This pilot study demonstrates the effectiveness of CHIP in an underserved, rural, and vulnerable Appalachian population and has the potential to help reduce the burden of preventable and treatable chronic diseases efficiently and cost-effectively.
Abstract: Most Western chronic diseases are closely tied to lifestyle behaviors, and many are preventable. Despite the well-distributed knowledge of these detrimental behaviors, effective efforts in disease prevention have been lacking. Many of these chronic diseases are related to obesity and type 2 diabetes, which have doubled in incidence during the last 35 years. The Complete Health Improvement Program (CHIP) is a community-based, comprehensive lifestyle modification approach to health that has shown success in addressing this problem. This pilot study demonstrates the effectiveness of CHIP in an underserved, rural, and vulnerable Appalachian population. Two hundred fourteen participants in CHIP collectively demonstrated significant reductions in body mass index, systolic and diastolic blood pressure, and fasting blood levels of total cholesterol, low-density lipoprotein, and glucose. If these results can be repeated in other at-risk populations, CHIP has the potential to help reduce the burden of preventable and treatable chronic diseases efficiently and cost-effectively.
30 citations
01 Jan 2014
TL;DR: In aboriginal tribes, eating behaviors had a strong religious imprint referring directly to obtain favors from the gods as health, wealth, healing and long life, being proven that it reduces the risk of cardiovascular disease, decreases incidence of obesity and diabetes, therisk of malignancy, psychiatric disorders and cognitive dysfunction.
Abstract: Lifestyle describes a complex behavioral strategies and routines, attitudes and values, norms assumed in order to individual or group to score as convenient in a social context. The importance of medical education in terms of healthy lifestyle is very well recognized nowadays. Lifestyle medicine offers important information about nutrition, physical activity, stress control and social support systems. Lifestyle can be treated as an indicator of social attitudes and of the ideologies that are functioning in the social space. In aboriginal tribes, eating behaviors had a strong religious imprint referring directly to obtain favors from the gods as health, wealth, healing and long life. Even if blatant promotion of a lifestyle can produce civilization, modelling behaviours, yet strongly promoting a lifestyle can become a subtle tool of manipulation and control. Following a healthy lifestyle, regardless of age, will have numerous health benefits, being proven that it reduces the risk of cardiovascular disease, decreases incidence of obesity and diabetes, the risk of malignancy, psychiatric disorders and cognitive dysfunction. The actual guidelines in preventive cardiovascular medicine provide the most important rules for physical training and healthy diet.
17 citations
TL;DR: These domains and educational experiences represent the range of competencies previously noted as important in the practice of LM and inform the educational objectives and future evaluation of this fellowship.
Abstract: Background: The emerging field, Lifestyle Medicine (LM), is the evidence-based practice of assisting individuals and families to adopt and sustain behaviors that can improve health While competencies for LM education have been defined, and undergraduate curricula have been published, there are no published reports that address graduate level fellowship in LM This paper describes the process of planning a LM fellowship curriculum at a major, academic teaching institution
12 citations
TL;DR: The review discusses ways that scientific information is often distorted and how conjecture may sometimes be confused with proof, and some recommendations for how lifestyle medicine practitioners can ground their recommendations on sound scientific evidence.
Abstract: As the lifestyle medicine movement continues to gain traction and strength, it is critically important that lifestyle medicine practitioners base their recommendations on the best available evidenc...
7 citations
TL;DR: It was demonstrated that there is sufficient evidence that justifies the College of Lifestyle Medicine, as observed by the content and quality of the information shared at the conference in Arlington, Virginia in October 2013.
Abstract: This article explores and reviews the available evidence pertaining to lifestyle, disease, and economic losses in the workplace. The literature shows clearly that higher levels of health risks and behaviors lead to the development of disease and moving to a high-cost status. The data suggest that those individuals with lower health risks and those individuals who achieve a reduction in health risks and unhealthy behaviors result in lower probability of disease and high health care costs. The business case for wellness and prevention is also discussed, as is the concept of investing in health as opposed to a strict focus on health care cost reduction. Furthermore, additional determinants of health such as the social–emotional states and positive characteristics of the individual and of the environment and culture are described. Since health is much more than simply the absence of disease, the members of the College of Lifestyle Medicine are encouraged to expand their interests and research inquiry and effo...
TL;DR: The results suggest that charity challenge events can play a role in introducing individuals to the physical health benefits of cycling, and encourage mental health and well-being through the creation of new social relationships, development of a sense of achievement, and experiencing positive emotions.
Abstract: Many developed countries, including Australia, are experiencing an increase in lifestyle-related disease such as obesity, heart disease, and mental distress. A new model of health care known as lifestyle medicine encourages individuals to be active partners in their health care and take responsibility for their long-term health, as well as address causes of lifestyle-related disease and concentrate on prevention. Focusing on a cycling-based charity challenge event designed to raise funds to support cardio health, the Yellow Pages Cardiac Challenge, this article considers the role of charity challenge events, and more broadly cycle tourism, within lifestyle medicine. Using survey-based primary and secondary data, the study addresses two questions: To what extent do the socio-demographic profiles of charity challenge participants and lifestyle disease "at-risk" groups overlap and what is the cycling involvement and experience of charity challenge participants? The results suggest that charity challenge events can play a role in introducing individuals to the physical health benefits of cycling, and encourage mental health and well-being through the creation of new social relationships, development of a sense of achievement, and experiencing positive emotions. Whereas a number of questions remain to be answered, this study's results contribute to existing health policy debates by exploring the role of sports tourism in supporting lifestyle medicine initiatives.
TL;DR: By identifying and implementing self-identified lifestyle modifications, learners increased confidence in their abilities to produce evidence-based outcomes for patients and improved their overall health.
Abstract: Objective. To design an immersive, active learning, lifestyle medicine (LM) elective and evaluate its impact on a pharmacy learners’ ability to understand the challenges of implementing lifestyle changes.Design. A 3-credit elective was developed that incorporated goal setting and immersion into the realm of LM as experienced by both the patient and the practitioner. Learners were assessed via a survey instrument, formal assignments, reflections, and the Presidential Fitness Challenge.Assessment. Learners reported that their ability to initiate LM as a primary intervention within a care plan significantly increased after taking this course. They also improved their overall health.Conclusion. By identifying and implementing self-identified lifestyle modifications, learners increased confidence in their abilities to produce evidence-based outcomes for patients. Learners were able to understand the challenges of trying to change their daily habits as they undertook their own personal goals.
TL;DR: The American Journal of Lifestyle Medicine (AJLM) is proud to play a role in bringing together these diverse experts in multiple areas of lifestyle medicine to discuss the “The Treat the Cause Movement.
Abstract: Dr Rippe: The American Journal of Lifestyle Medicine (AJLM) is proud to play a role in bringing together these diverse experts in multiple areas of lifestyle medicine to discuss the “The Treat the Cause Movement.” Our goal at AJLM has always been to provide a platform for serious, evidence-based discussion on how issues related to lifestyle impact on both shortand long-term health and quality of life. We recognize that expertise in this area resides in many places and covers numerous bodies of literature. In our expert panel, we are delighted to have individuals with expertise in multiple areas related to lifestyle medicine. Let me briefly introduce our panelists. Each of them is a leading expert in his or her field with numerous accomplishments. I will only briefly highlight several of each of their qualifications: Rosanne Rust, MS, RDN, LDN is a registered, licensed nutritionist with over 25 years of experience in clinical and community nutrition, and currently works as a nutrition communications consultant. Dr Arthur Frank is a world-renowned expert in the field of weight management and obesity treatment. Dr Steven Blair is Professor in the Departments of Exercise Science and Epidemiology and Biostatistics at the Arnold School of Public Health, at the University of South Carolina and a widely quoted expert in the area of physical activity and exercise. Dr Wayne Dysinger is the Chair of the Department of Preventive Medicine and Director of the Family and Preventive (Lifestyle) Medicine Residency at Loma Linda University. He is also Medical Director of the Lifestyle Medicine Institute. Dr Michael Parkinson is the Senior Medical Director of Health and Productivity for the UPMC Health Plan and WorkPartners overseeing employer strategies to improve health and competitiveness. He is the former President of the American College of Preventive Medicine (ACPM).
TL;DR: Examples of practical applications that one lifestyle medicine program has made with the psychological theories of the health belief model, the social cognitive theory, and the transtheoretical model are presented.
Abstract: Health behavior modification is perhaps the single most important and fundamental concept in lifestyle medicine. Understanding the psychological theories that explain “why” people act as they do when initiating a health behavior change can be the key factor in determining program success or program failure. Application of these theories into clinical practice is both important and challenging. Presented in this article are examples of practical applications that one lifestyle medicine program has made with the psychological theories of the health belief model, the social cognitive theory, and the transtheoretical model.
TL;DR: Pupils report a high rate of compliance with currently available guidelines, thus making appropriate modifications to clinical care for this high-risk group of women.
TL;DR: This article begins a conversation based on the premise that health care will only reach its full potential with the integration of traditional medical care, which relies on the application of pharmacologic and surgical intervention after the development of illness, and lifestyle medicine, the use of optimal nutrition and exercise.
Abstract: In response to personal and institutional history and articles published in The Permanente Journal, this article begins a conversation based on the premise that health care will only reach its full potential with the integration of traditional medical care, which relies on the application of pharmacologic and surgical intervention after the development of illness, and lifestyle medicine, the use of optimal nutrition and exercise.
01 Jan 2014
TL;DR: The doctor of the future will become an integrative healer whose practice differs in many ways from that of today’s typical physician, with medical care focused more extensively on preventing disease and injury.
Abstract: Integrative Medicine is defined as a post-modern healing-oriented medicine that reaffirms the importance of the relationship between practitioner and patient All appropriate therapeutic approaches, both conventional and alternative/complimentary informed by evidence are explored with a focus on the whole person (body, mind and spirit) To achieve optimal health the principles of Functional Medicine needs to be applied to address the underlying causes of disease, using a systems-oriented approach and engaging both patient and practitioner in a therapeutic partnership [1] In the South African context Integrative Medicine includes modern Western (allopathic) medicine, various recognized alternative and complementary models, traditional healers, lifestyle medicine, functional medicine, and the therapeutic doctor/patient relationship Integrative healthcare services demand interprofessional collaboration between bio-medically trained doctors and traditional, complementary and alternative practitioners to facilitate the process The main reason for developing integrative healthcare was the increased demand for holistic care from patients The doctor is expected to provide care that is patient-centered and comprehensive by incorporating high-tech genomic information, systems biology, and functional medicine into routine clinical practice The doctor of the future will become an integrative healer whose practice differs in many ways from that of today’s typical physician Patients will increasingly take responsibility for their own health, with medical care focused more extensively on preventing disease and injury
TL;DR: This review highlights factors that prevent most people from enjoying optimal health and to provide evidenced based equitable lifestyle medicine interventions that prevent chronic non-communicable diseases and prevent quality longevity.
Abstract: Background: Life expectancy in many developing countries is generally low. The quality of life of most people in such countries especially among those who live longer than the average life expectancy is poor. The aging process in most people in such countries is associated with many preventable chronic medical problems. Lifestyle medicine offers the evidenced based interventions that will enable most people in the world but more importantly in developing countries improve on both their quality of life and longevity. Objectives: This review highlights factors that prevent most people from enjoying optimal health and to provide evidenced based equitable lifestyle medicine interventions that prevent chronic non-communicable diseases and prevent quality longevity. Method: This narrative review was carried out following a detailed search of pubmed, Medicine, Google scholar and other online databases on the subject. Conclusion: Lifestyle medicine providers the essential package for optimal health and longevity. Lifestyle modification of multiple health behaviors is an evidenced based strategy for the practice of lifestyle medicine at individual level. Starting with the four core health behaviors is a well tested approach on the pathway to quality life and longevity.
TL;DR: Lifestyle medicine vital signs, charting lifestyle medicine, and the importance of electronic medical records in the communication of lifestyle medicine practices are discussed.
Abstract: The release of the new practice guidelines for blood cholesterol in 2013 has placed an increased emphasis on the importance of lifestyle medicine to reduce cardiovascular risk. This may lead more patients and health care professions toward the adoption of lifestyle medicine practices. Documenting lifestyle medicine practices will soon emerge as an important component of the success of lifestyle medicine practices and ultimately patient outcomes. This article briefly discusses lifestyle medicine vital signs, charting lifestyle medicine, and the importance of electronic medical records in the communication of lifestyle medicine practices.
TL;DR: An entire issue of AJLM is devoted to the Proceedings of the National Meeting of the American College of Lifestyle Medicine, which was held from October 27 to 30, 2013, in Washington, DC.
Abstract: We at the American Journal of Lifestyle Medicine (AJLM) are delighted to devote an entire issue of AJLM to the Proceedings of the National Meeting of the American College of Lifestyle Medicine, which was held from October 27 to 30, 2013, in Washington, DC. I had the pleasure of chairing a plenary session and also moderating an Expert Panel discussion at this annual meeting. Based on what I saw and experienced, I am pleased to report that the lifestyle medicine movement is alive and well and growing exponentially! The theme of the ACLM conference was “The Treat the Cause Movement.” It is clear from the diversity and expertise of the assembled speakers and the passion and knowledge of the audience that the field of lifestyle medicine has grown both broader and deeper over the past 5 years. There is no longer any serious question that the practices and habits that each of us has in our daily lives profoundly affect both our short-term and long-term health and quality of life. It is also clear that for the field of lifestyle medicine to continue to grow and have the impact that it deserves, it must be tied directly to the overwhelming evidence that exists in these areas. We must articulate the important messages of lifestyle medicine to multiple audiences including our patients, the health care medical professions, the media, and public policy makers in the most dynamic and thoughtful way possible. These, of course, were key issues that we had in mind when we founded the American