When individuals follow good lifestyle habits, including choosing a balanced diet, being physically active, maintaining a healthy weight, becoming a non-smoker, and avoiding excessive alcohol consumption, overall health and well-being are achieved. The global burden of non-communicable diseases, which account for around 63 percent of all fatalities, is also rooted in unhealthy lifestyle habits.
What is Lifestyle Medicine?
Lifestyle medicine is an evidence-based approach to preventing, treating, and even reversing diseases by replacing unhealthy behaviors with positive ones such as eating healthfully, being physically active, managing stress, avoiding risky substance abuse, adequate sleep, and having a robust support system. In other words, lifestyle medicine integrates lifestyle practices into the modern practice of medicine to lower the risk factors for chronic disease and/or, if disease already present, serve as an adjunct in its therapy. Lifestyle medicine brings together sound, scientific evidence in diverse health-related fields to help the clinician treat disease and promote good health.
Lifestyle medicine focuses on six areas to improve health:
Nutrition: Food is Medicine. Choose predominantly whole, plant-based foods rich in fiber and nutrient-dense—vegetables, fruit, beans, lentils, whole grains, nuts, and seeds.
Exercise: Regular and consistent physical activity that can be maintained daily throughout life – walking, gardening, push-ups, and lunges – is an essential piece of the optimal health equation.
Substance abuse: The well-documented dangers of any addictive substance use can increase the risk for many cancers and heart disease. Positive behaviors that improve health include cessation of tobacco use and limiting the intake of alcohol.
Stress: Stress can lead to improved health and productivity – or it can lead to anxiety, depression, obesity, immune dysfunction, and more. Helping patients recognize negative stress responses, identify coping mechanisms and reduction techniques lead to improved well-being.
Sleep: Lack of or poor-quality sleep can lead to a strained immune system. Identify dietary, environmental, and coping behaviors to improve sleep health.
Relationships: Social connectedness is essential to emotional resiliency. Studies show that isolation is associated with increased mortality. Considering a patient’s home and community environment improves overall health.
Why Lifestyle Medicine?
The question “Why Lifestyle Medicine?” will be addressed by focusing on two key components: chronic disease and risk reduction. In general, chronic disease states are those lasting for more than three months, often lasting a lifetime, and since they involve multiple interacting factors (hormones, neurons, organs, drugs, behaviors, psychosocial factors, etc.), they are often described as complex.
According to the Centers for Disease Control and Prevention (CDC), cardiovascular disease (CVD), cancer, and diabetes are the leading preventable causes of mortality. There is a large body of evidence that the risk of chronic illnesses is decreased by practicing healthy lifestyle behaviors.
Multiple systematic reviews and meta-analyses have been published that demonstrate the beneficial impact of lifestyle interventions in reducing diabetes incidence in patients. Also, the beneficial effect of weight loss on diabetes control and reduction of cardiovascular risk factors has been demonstrated.
In the European Prospective Investigation Into Cancer and Nutrition (EPIC) study, 23 153 German participants aged 35–65 years were followed up for a mean of 7.8 years. Adherence to four health behaviors [not smoking, exercising 3.5h per week, eating a healthy diet (high intake of fruits, vegetables and whole-grain bread and low meat consumption) and having a BMI of <30 kg/m2] at baseline was associated with 78% lower risk of developing chronic disease (diabetes 93%, myocardial infarction 81%, stoke 50%, and cancer 36%) than participants without a healthy factor.
Despite the value of a healthy lifestyle, several population studies have shown that only a minority of individuals adopt a healthy lifestyle. Researchers identified five low-risk behaviors (a healthy diet, moderate alcohol consumption, no smoking, being physically active, and having a healthy waist circumference) associated with an 86 % lower risk of myocardial infarction events than the high-risk group with no low-risk factors. Despite the impact of healthy living, only 1 % of the population comprised the low-risk group and followed all five healthy lifestyle practices.
In summary, the reasons to implement lifestyle medicine can be broken down into the following:
1. Increased prevalence of the chronic disease.
2. Recognition of the importance of a preventive care paradigm to reverse trends and lower prevalence rates for chronic disease.
3. Awareness of a specific role for wellness and health promotion within the preventive care paradigm.
4. Addressing residual risk factors in complex pathologies, such as cancer and metabolic syndrome, using tools not generally learned in traditional medical training; and
5. Addressing specific risk management problems, such as tobacco cessation, weight management, healthy eating, physical activity, and glycemic control, using tools, metrics, and methods not traditionally taught.
Lifestyle medicine presents a new and challenging approach to address the prevention and treatment of non-communicable diseases, the most important and prevalent causes of increased morbidity and mortality worldwide.