Currently one of two adults in the United States suffers from at least one chronic health condition such as obesity, heart disease or diabetes. According to the Centers for Disease Control and Prevention, more than 80 percent of health care costs are related to the management of these chronic diseases. Numerous medical management guidelines call for lifestyle modification as a first line of treatment, which means that health care providers should offer education and support on healthier lifestyle choices to manage these conditions. This is the basic foundation of lifestyle medicine. Lifestyle medicine is founded on the scientific evidence that our body can heal itself when disease-causing factors are removed. Chronic diseases such as cardiovascular disease, diabetes and Crohn’s disease that were once thought to be irreversible can actually be reversed by comprehensive lifestyle changes. The goal of lifestyle medicine interventionis to shift from unhealthy behaviors to behaviors that promote health. Generally, most lifestyle-related diseases benefit from the same simple lifestyle behavior changes, which include optimal nutrition, consistent physical activity, effective stress management, tobacco cessation, and improved interpersonal social relationships.

(1) Nutrition

Nutrition is the core foundation of lifestyle medicine, and is the underlying cause of many diseases. Changing eating habits alone can reverse many chronic diseases. Although all agree that a high-quality diet is essential for health, there is an abundance of disagreement regarding what type of diet is best. Proponents of each of the leading dietary approaches—the Mediterranean diet, a vegetarian/vegan diet, the Paleo diet—can all cite abundant (and carefully selected) research in support of their chosen diet’s health benefits, and it is becoming increasingly obvious that no single dietary approach is optimal for all. The most current scientific evidence available recommends the use of whole, unprocessed plant foods as treatment for most lifestyle-related illnesses. The key issue when it comes to diet is the quality of foods consumed. Regardless of whether the diet is Mediterranean, Paleo, vegetarian or vegan, it is most important that the diet is based on whole foods that are rich in micronutrients, fiber, phytonutrients and healthy fats.

Recommended plant-based diet guidelines include:

  • Unlimited daily intake of: green vegetables, raw vegetables, non-starchy cooked vegetables, low-GI-fresh fruit, beans/legumes
  • Limiteddaily intake of: cooked starchy vegetables, whole grains, raw nuts, seeds
  • Infrequent consumption of: red meat (when consumed, should be grass fed, organic, non-GMO), refined grains, full-fat dairy, cheese, sweets, refined oils, processed foods (to eliminate hydrogenated and trans fats)

(2) Physical Activity

Regular physical activity leads to improved health and reduces the risk of adverse health outcomes. Exercise without dietary changes may help maintain current weight, but will not lead to significant weight loss or reversal of lifestyle diseases. Exercise is most effective when it is prescribed as part of a comprehensive lifestyle management treatment program that includes plant-based nutrition, stress management and other lifestyle modifications. For healthy adults without diagnosed diseases, the American College of Lifestyle Medicine recommends at least 150 minutes a week of moderate-intensity activity, or 75 minutes a week of vigorous-intensity aerobic physical activity.

(3) Stress Management

Stress is not an easy term for scientists to define because it is highly subjective and so different for each of us. Stress can lead to improved productivity or to depression, anxiety, immune dysfunction, obesity and poor health outcomes.

Effective stress management techniques that are backed by research include guided imagery, cognitive behavioral therapy, diaphragmatic breathing and meditation.

(4) Tobacco Cessation

In the US, tobacco use significantly contributes to more than 480,000 deaths per year and almost $100 billion in lost productivity. Despite the known risk factors, one in five American adults still smokes regularly. Tobacco use increases the risk of mouth, throat and lung cancer; heart disease; and chronic obstructive pulmonary disease. It is considered a chronic disease that requires repeated interventions and multiple attempts to resolve. Numerous treatments are proven to be effective for smokers who want to quit, including individual and group counseling, behavioral therapies and even programs that deliver treatments using mobile phones (such as ProChange, offered at STR!VE). Recently, there has been emerging interest in the use of complementary therapies such as hypnotherapy, yoga or mindfulness meditation to aid in smoking cessation.

(5) Social Relationships

Relationships are just as important to our health and wellness as diet and exercise. In fact, research suggests that people with strong, supportive relationships live longer, happier lives. Studies also show that negative social relationships, isolationand loneliness are associated with increased risk of chronic disease. Volunteering for a meaningful cause, getting involved in a social or community activity, or engaging in healthy activities with friends and family can help improve both our mental and physical health.

Lifestyle interventions when delivered in a group setting are even more effective. Whether it be for weight loss, physical training, or substance abuse, research concludes that lifestyle-focused support groups improve outcomes. For this same reason, lifestyle workshops offered in the workplace can be highly effective. Most importantly, lifestyle interventions must be convenient. The STR!VE care model has been developed to offer a convenient, patient-centered ecosystem to support the wellness journey of our members. This includes nutrition counseling, lifestyle management program, partnerships with local fitness and wellness organizations, and massage therapy.

 

References:
American College of Lifestyle Medicine: Lifestyle Medicine Standards. (2012). Retrieved from https://www.lifestylemedicine.org/Resources/Documents/ABOUT/ACLM Standards_Adopted Fall 2012.pdf
CHIP Lifestyle Program at Vanderbilt University Demonstrates an Early ROI for a Diabetic Cohort in a Workplace Setting: A Case Study. (2015). Journal of Managed Care Medicine, 15(4).
Esselstyn, C. Resolving the Coronary Artery Disease Epidemic Through Plant Nutrition. (2001). Preventive Cardiology, 4:171-177.
Making Lifestyle Medicine Standard Practice: What’s More Valuable Than Choice? (2017, July). Retrieved from https://catalyst.nejm.org/valuable-healthier-lifestyle-choices/
Pizzorno, L. (2014). Highlights From the Institute for Functional Medicine’s 2014 Annual Conference: Functional Perspectives on Food and Nutrition: The Ultimate Upstream Medicine. Integrative Medicine: A Clinician’s Journal, 13(5), 38–50.
King, N., Hopkins, M. Exercise, Appetite and Weight Management: Understanding the Compensatory Responses In Eating Behaviour and How They Contribute to Variability In Exercise-Induced Weight Loss. Br. J. Sports. Med. 2012;46:5:315-322.
The American Institute of Stress. What is Stress? (2017). Retrieved from https://www.stress.org/what-is-stress/
Smoking & Tobacco Use. (2017). Retrieved from https://www.cdc.gov/tobacco/data_statistics/fact_sheets/cessation/quitting/index.htm
Complementary Health Approaches for Smoking Cessation. (2017). Retrieved from https://nccih.nih.gov/health/providers/digest/smoking-science
Larzelere, M. M., & Williams, D. E. (2012). Promoting Smoking Cessation. Retrieved from https://www.aafp.org/afp/2012/0315/p591.html