lifestyle medicine essay

• General & Introductory Medical Science

Textbook of Lifestyle Medicine

ISBN: 978-1-119-70437-9

January 2022

Wiley-Blackwell

Digital Evaluation Copy

Labros S. Sidossis , Stefanos N. Kales

The Textbook of Lifestyle Medicine provides foundational knowledge essential to students and scientists across various disciplines to better understand this new area of research and practice. Incorporating the latest evidence-based research on the relationships between lifestyle factors and disease, this unique book discusses the practical tools necessary to address growing public health crises such as obesity, cancer, diabetes, and cardiovascular disease using a holistic approach to physical, mental, and spiritual wellness.

The book offers comprehensive and up-to-date coverage of how lifestyle medicine professionals can prevent and mitigate ‘Lifestyle Diseases’. Clear and accessible chapters explore modifiable lifestyle factors that positively affect health, nutrition, exercise, sleep, stress control, and social support, and highlight the negative impact of smoking, alcohol abuse, and other unhealthy lifestyles. Topics include sleep physiology, the genetic background and development of noncommunicable diseases (NCDs), the characteristics and principles of healthy lifestyle, the clinical significance of physical activity, and the mechanisms connecting social interaction and health implications. This important resource:

• Discusses the global burden and risk factors of the modern disease epidemic
• Covers a variety of nutritional approaches including the Mediterranean Diet and the Dietary Approaches to Stop Hypertension (DASH) diet
• Features in-depth coverage of the Mediterranean Lifestyle, a holistic approach to health and wellness
• Includes a clinical practice section and appendices on preventive medicine and public health tools and recommendations
• Contains key points, take-home messages, self-assessment questions, color artwork and numerous references, citations, internet links, and further reading suggestions

Written by two world experts in this growing field, the Textbook of Lifestyle Medicine is a must-have volume for students and practitioners in nutrition, exercise physiology, psychology, addiction therapy, sleep therapy, as well as physicians, nurses, and other health professionals wanting to expand their knowledge and practice.

Labros S. Sidossis, PhD, FTOS, FAHA, FNAK, Distinguished Professor and Chairperson, Department of Kinesiology and Health; Professor, Department of Medicine, Robert Wood Johnson Medical School; Director, Wellness and Lifestyle Science Initiative; Rutgers University, New Jersey, USA.

Stefanos N. Kales, MD, MPH, FACP, FACOEM, Professor of Medicine, Harvard Medical School; Professor and Director, Occupational Medicine Residency, Harvard TH Chan School of Public Health; Division Chief, Occupational Medicine, Cambridge Health Alliance, Cambridge, Massachusetts, USA.

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AP PHOTOS: Life continues for Ohio community after Trump falsely accused Haitians of eating pets

Alondra Nunez, left, and her sister Monserrat, second from right, sit with family members outside of The Market, where their brother owns the restaurant Chido’s Tacos, Monday, Sept. 16, 2024, in Springfield, Ohio. (AP Photo/Jessie Wardarski)

Karl Mattila, left, and his wife Linda, of Medway, Ohio, talk with Haitian and longtime Springfield resident Jacob Payen at Rose Goute Creole Restaurant in Springfield, Ohio, Monday, Sept. 16, 2024. (AP Photo/Jessie Wardarski)

The sun sets behind St. Raphael Catholic church, which holds services in Creole for Haitian immigrants, in Springfield, Ohio, Monday, Sept. 16, 2024. (AP Photo/Jessie Wardarski)

A Springfield police officer stands watch during a service in support of the Haitian community at St. Raphael Catholic church in Springfield, Ohio, Sunday, Sept. 15, 2024. (AP Photo/Jessie Wardarski)

Runners pass through Downtown Springfield, Ohio, Monday, Sept. 16, 2024. (AP Photo/Jessie Wardarski)

A campaign sign for Vice President Kamala Harris and Gov. Tim Walz is seen in Downtown Springfield, Ohio, near the Springfield News Sun building, Monday, Sept. 16, 2024. (AP Photo/Jessie Wardarski)

A political advertisement for Republican presidential nominee and former President Donald Trump is painted on the side of an automotive business in Springfield, Ohio, Monday, Sept. 16, 2024. (AP Photo/Jessie Wardarski)

Springfield native Jaheim Almon, left, plays basketball with a group of neighbors in Springfield, Ohio, Monday, Sept. 16, 2024. (AP Photo/Jessie Wardarski)

Lifelong Springfield residents Lainey Bogard, left, Kelsey Fannon, center, and Kassidy Fannon sit on the front porch with their dog, Monday, Sept. 16, 2024, in Springfield, Ohio. (AP Photo/Jessie Wardarski)

Kassidy Fannon stands on the front porch of her home in Springfield, Ohio, Monday, Sept. 16, 2024. (AP Photo/Jessie Wardarski)

A man walks through Downtown Springfield, Ohio, Monday, Sept. 16, 2024. (AP Photo/Jessie Wardarski)

A mural depicting Hattie Moseley, a Springfield Civil Rights activist who was instrumental in battling the segregation of Fulton Elementary School, is painted on the WesBanco building on East Main Street in Springfield, Ohio, Monday, Sept. 16, 2024. (AP Photo/Jessie Wardarski)

Romane Pierre of Rose Goute Creole Restaurant in Springfield, Ohio, helps a line of customers, Monday, Sept. 16, 2024. (AP Photo/Jessie Wardarski)

The sun rises over the city of Springfield, Ohio, Monday, Sept. 16, 2024. (AP Photo/Jessie Wardarski)

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SPRINGFIELD, Ohio (AP) — Their city has been in the eye of a political storm since former President Donald Trump and his running mate, Ohio Sen. JD Vance , falsely accused legal Haitian immigrants in Springfield of eating dogs and cats.

One consequence: a rash of hoax bomb threats that forced evacuations and closures of schools, government buildings and elected officials’ homes.

But the immigrants and their neighbors in this predominantly white, blue-collar city of about 60,000 have gone on with their lives – going for a run through downtown, shooting hoops with friends, gathering with family for supper at a food hall called The Market.

Some out-of-towners – seeking to show support for the Haitians – have joined locals in patronizing the Rose Goute Creole Restaurant, which features Haitian cuisine.

Undismayed by the far-flung political rancor, lifelong Springfield residents Kelsey Fannon and Kassidy Fannon sat happily on their front porch Monday evening, playing with their new puppy and celebrating how they had spent the day deep-cleaning their entire house.

Thousands of Haitian immigrants have settled in recent years in Springfield, where they have found work in factories and warehouses that were struggling to fill job openings. The sudden influx has strained schools, health care facilities and city services and driven up the cost of housing – but the mayor, civic leaders and local pastors have welcomed them.

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“The pain was so bad that I really felt like I was going to die. It was intense. My entire body was burning and sore. There are no words strong enough to describe how it felt,” Sasinan Chuenlosang, 31, told Viral Press .

Chuenlosang, whose day job was in IT, complained of a sore throat and red eyes when she visited a Bangkok hospital on June 18.

Doctors diagnosed her with tonsillitis and administered Ceftriaxone, an antibiotic used to treat bacterial infections.

But it didn’t help and actually made things worse. The online model returned to the hospital three days later after experiencing chest tightness, a rash, blurred vision, a swollen mouth and an inability to walk properly.

Chuenlosang said she was given another dose of the same medicine and diagnosed with chicken pox .

She reports that her rash worsened, causing blindness in her left eye.

She was sent to the ICU, where the medics gave her a third shot of Ceftriaxone.

Chuenlosang felt dizzy, and her right eye became blurry and numb. She stayed in the ICU for seven days.

She was later transferred to another hospital, where she was diagnosed with severe Stevens-Johnson syndrome , a rare but potentially deadly reaction to medications or infections.

It usually starts with flu-like symptoms, followed by a painful rash, causing the top layer of skin to die and peel off.

Chuenlosang was still bedridden as of Monday and had to cut her long hair to let her rashes heal.

She has wounds around her eyes and mouth and on her forehead and cheeks. Her neck is covered in gauze to seep the blood and pus that trickled down her face.

“Before this, I was employed at an IT company, and I was [an] online model in my spare time,” Chuenlosang recalled. “This condition has shattered my dreams. It’s destroyed the life I had before.”

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She is seeking an ophthalmologist to help restore her vision, so she can return to work.

In the meantime, Thanakrit Jitareerat, Thailand’s vice-minister for public health, said the government is investigating if Chuenlosang’s treatment “adhered to medical practices.”

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NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.

StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-.

StatPearls [Internet].

Overview of lifestyle medicine.

Daniel Keyes ; Nabila I. Patel ; Kelly A. Correa .

Affiliations

Last Update: February 4, 2023 .

• Definition/Introduction

Lifestyle medicine is a branch of evidence-based healthcare emphasizing disease prevention over curative medicine. Contemporary medicine follows the same basic approach to the clinical encounter: data-gathering, conducting any needed tests, providing the patient with a treatment plan, and possibly a referral or hospital admission. This approach can be described as essentially end-stage care. The modern character of healthcare has neglected prevention. Patients often receive little or no practical education on disease prevention. Studies employing direct observation of primary care practices have reported that preventive care has been underemphasized. [1]  

The reasons for this may be varied, with some suggesting that too much time is required to provide the information needed by the typical patient visit. [2]  This reactive, curative approach has important implications for healthcare financing.

The cost of healthcare in the United States has become prohibitive. At the time of this publication, it is estimated that the cost to provide care to the average adult is over $13,000 annually in the US. [3]  The Centers for Disease Control (CDC) reports that six in ten Americans have a chronic disease, and two in four have two or more chronic diseases. These conditions account for approximately 75% of all healthcare costs. [4] [5]  

Chronic diseases include heart disease, Alzheimer disease, type II diabetes, cancer, stroke, and other similar disease processes. The United States is the outlier of all countries in healthcare expenditures, spending far more per capita as a function of GDP (gross domestic product). [6] Thus, if healthcare providers intervene to integrate prevention into their workflow, then we may see a significant decrease in the number of chronic diseases for individuals, the associated suffering, and healthcare costs for both individuals and the government.

• Issues of Concern

A major, compelling solution to the challenge of healthcare, both on the individual and collective levels, is to effect preventive change through lifestyle modification. This concept is not new: Hippocrates taught about the importance of prevention over 2000 years ago. [7]  The medieval physician and philosopher Maimonides asserted that the most important cause of poor health is the food we choose to eat. [8]  

It has been estimated that only one-fifth of the modifiable determinants of healthcare come from the care medical practitioners provide (see Image. Prevalence of Self-Reported Obesity, 2011). [9]  Despite this, modern healthcare has heavily emphasized curative treatment over prevention. Preventing chronic disease may be the key to the healthcare financing crisis in the US and other nations and the overall improved health of the population taken as a whole.

In 2009, researchers analyzed lifestyle and body weight using pre-existing data from the large European Prospective Investigation Into Cancer and Nutrition–Potsdam study. [10] [11] [12]  They identified four healthy lifestyle practices and body weight characteristics among German adults that predicted a composite healthy outcome. They noted a significant decrease in major chronic diseases for those with all four characteristics. The four predictive factors included having a body mass index (BMI) of less than 30 kg/m2, performing 3.5 h/wk of moderate physical activity, consuming a predominantly plant-based diet (whole-grain with low meat consumption), and never smoking.

Patients with these four characteristics had almost a four-fifths reduction in chronic disease (78%, 95% CI 27 to 83%) after adjusting for sex, age, occupational and educational status. A subsequent study using the National Health and Nutrition Examination Survey found that only 2.7% of Americans have a lifestyle that approximates the four factors mentioned in the previous study. [13]  Although it is possible to avoid chronic disease through commonly attainable lifestyle changes, very few Americans take advantage of this opportunity.

• Clinical Significance

Most people do not seek care until a disease process has already manifested, and this trend worsened with the COVID-19 pandemic. [14] [15]  Patients with diabetes or congestive heart failure (CHF) typically present for medical attention months after a symptom has been bothering them. Many of them have not seen a medical professional for months to years. Thus, how much time does a medical provider have to intervene before the disease process takes root? They may be presenting very late in the course of their illness. Obesity is also an important risk factor for many chronic diseases. Obesity rates have been increasing in the US, as evident in the CDC geographic data comparison of 1985 versus 1995 (see  Images.  Prevalence of Self-Reported Obesity, 2011 and Prevalence of Self-Reported Obesity, 2020). Based on the evidence presented in the studies mentioned above and others, prevention is key. 

Evidence shows that the sequelae of adverse health behavioral choices can be partially corrected. In a non-controlled study from a single physician practice, Dr. Caldwell Esselstyn reported on patients who were rejected as candidates for bypass surgery and put on a lipid-lowering drug and a vegetarian diet with little vegetable oils. These patients demonstrated a subsequent widening of their coronary arteries. [16]  

In 1998, a seminal study by Dr. Dean Ornish and collaborators was a landmark for initiating change. The article, entitled "Intensive Lifestyle Changes for Reversal of Coronary Heart Disease," compared 28 patients who had coronary artery disease and tried lifestyle intervention, compared to a cohort of patients who did not receive any intervention. [17]  The study was conducted over five years. Lifestyle interventions included maintaining a primarily vegetarian diet emphasizing whole foods, exercise, smoking cessation, and counseling. A clinically and statistically significant reduction in the stenosis in coronary arteries was experienced in the intervention cohort versus those in the control group, who continued to use lipid-lowering pharmacotherapy. This seminal trial demonstrated that coronary artery disease could be reversed.  

The American College of Lifestyle Medicine promulgates evidence that reinforces the importance of a diet containing fruits, vegetables, whole grains, unprocessed foods, and limited amounts of meat. These diet changes may have a substantial impact on obesity. A recent meta-analysis by Schlesinger et al. examined the risk of weight gain in relation to certain food groups. [18]

They saw a decreased relative risk of fat in muscle the more a vegetarian diet was invoked. This and other studies suggest that increasing vegetables in one's diet are associated with a decreased relative risk of obesity, and increasing red meat intake is associated with a greater risk. There are multiple reasons for this, one of them being that the saturated fat content in red meat is often neglected. Saturated fats exist not only in red meats but also in other foods such as butter and cheese. Therefore, through education in lifestyle choices, one can choose to avoid saturated fats, achieving less future chronic disease and the associated pain and suffering.

Diabetes mellitus is another chronic disease process that is very common and significantly affects a patient's health and lifestyle. In 2002, Knowler et al. demonstrated that lifestyle interventions focusing on weight loss outperformed metformin in patients with type II diabetes mellitus. [19]  

They compared three interventional groups: lifestyle changes, metformin, and placebo. The lifestyle group was given a low-calorie & low-fat diet (almost vegetarian) and 150 minutes of physical activity per week. From this study, it is noteworthy that lifestyle changes outperformed metformin for preventing diabetes. Diabetes is also highly associated with obesity, and healthcare providers need improved strategies for weight loss. Obesity is increasing at alarming rates in the US. In 1985, no state had greater than a 14% prevalence of obesity. However, on the map 2010, greater than 30% of American adults are obese (see  Images.  Prevalence of Self-Reported Obesity, 2011 and Prevalence of Self-Reported Obesity, 2020). In 2005, Dansinger et al. compared four diets regarding weight loss and heart disease risk reduction: Atkins , Ornish , Weight Watchers(R), and Zone diets. [20] [21]  

All diets were noted to be successful at weight loss, directly related to regimen compliance. Ketogenic diets have become quite popular recently and often lead to successful weight loss. However, there is evidence that ketogenic diets (that encourage meat consumption) appear to be correlated with increased mortality. [21] This may be a result of the increase in saturated fats. [21]

In another study, the Portfolio diet (a diet of cholesterol-lowering foods) was administered to patients with high cholesterol levels. [22]  The interventional group was compared to a control cohort taking lovastatin (a known cholesterol-lowering drug). In both groups, serum lipids and C-reactive protein were tracked. Cholesterol-lowering foods included whole grains, low-fat cereals, and increased use of vegetables. This study showed that it is possible to duplicate the benefits of statin with a targeted diet. The  Adventist study  was a large population-based longitudinal study of 96,000 patients, which compared vegetarians to meat-eaters. [23]  

Over a decade of observation, vegetarians had lower all-cause mortality and lower ischemic heart disease, cardiovascular disease, and cancer incidence. Diabetes was also less prevalent among vegetarians. The article concluded that vegetarians were healthier. A subgroup analysis compared three groups: vegans, lacto-ovo vegetarians, and pescatarians. It was reported that the "pescatarian" group was associated with the lowest all-cause mortality rate and decreased incidence of type II diabetes mellitus. Studies like this one suggest that diet is generally the most crucial lifestyle modification.

Another important, well-established aspect of preventive health is exercise. The effect of decreasing mortality through exercise is greatest with the first 150-200 minutes of moderate exercise per week, with additional exertional duration providing incrementally less benefit. [24]  According to the US Preventive Services Taskforce (USPSTF), almost 70% of mortality reduction benefit is achieved with 150 minutes of moderate exercise per week. [25] [26]  That roughly equals 30 minutes of moderate activity per day for five days a week. The talk test is a useful estimation of moderate exercise. [27]  If one can talk but not sing, that can be considered moderate exercise to comply with the USPSTF recommendations for exercise. If one is exercising and cannot talk, that is considered vigorous.

Sleep is another area emphasized in lifestyle preventive health. Analyzing all-cause mortality in a sleep duration study published by the American Heart Journal, it is noted that mortality decreases as one approaches a daily sleep duration of seven hours and increases with sleep duration beyond eight hours. [28]

Sometimes societal constructs use lack of sleep as a feature of strength and "hard work," but it must be noted that this is not conducive to overall life performance. Lack of sleep is shown to decrease productivity and have consequences in the form of chronic diseases, including total cardiovascular disease and stroke. [28] Additionally, multiple studies suggest insufficient sleep is associated with Alzheimer disease. [29] [30] [31] [32]  Thus, current evidence suggests that achieving seven to eight hours of sleep is an appropriate lifestyle modification recommendation. 

Smoking, if habitual, is another significant risk factor for disease and mortality. [33]  Many well-documented dangers of addictive substances increase cancer risk and heart disease risk. Smoking is a more substantial risk factor for chronic disease than diet and exercise. [34] Thus, smoking must be eliminated from all lifestyles to avoid severe, predictable chronic diseases.  

Stress and social isolation are other risk factors affecting chronic disease. Stress has been described as a risk factor for disease and overall mortality. [35] [36]  As such, stress management can aid in identifying positive and negative stress responses, identify coping mechanisms, and teach stress-reduction techniques for improved well-being. Social isolation has also been associated with increased mortality, so social connectedness as a preventive strategy is also an area of recent investigation, especially among the aging population. [37] [38] [39]  Social connections can also aid in emotional resiliency and overall health.

The goal of lifestyle modification as a preventative medicine is to make daily changes that are relatively easy to perform, adjust to, and uphold in terms of future daily habits. By educating our patients about these preventative lifestyle modifications, we can help them understand the consequences and implications of poor choices. In this regard, one can minimize future pain and suffering caused by a chronic disease process that has poor prospects for a cure but appears to be preventative and/or reversible – such as strokes, heart attacks, kidney failure, and the use of chronic dialysis.

In summary, even though prevention is not a revolutionary topic in medicine, it is neglected in most modern medical practices. Evidence-based lifestyle changes must be increasingly emphasized in the practitioner-patient encounter. Nutrition and exercise are the most important lifestyle modifications for nonsmoking patients. Patients should be encouraged to choose a diet predominantly of fiber-filled, nutrient-dense foods, thus promoting health. Additionally, regular and consistent physical activity is essential to an optimal health equation. Lack of quality sleep can detrimentally impact both of these modifications mentioned above. Substance abuse must be considered an essential modification as well.

• Nursing, Allied Health, and Interprofessional Team Interventions

The commercial media heavily promotes unhealthy lifestyle choices. Another popular example of a dangerous element of the western diet is bacon. Bacon is an example of processed meat that is now classified as a Group 1 carcinogen by the International Agency for Research on Cancer (IARC) list, the same as many more well-known carcinogens. [40] [41]  Yet, despite being known to cause cancer, bacon can be found at nearly every commercial fast food establishment across the U.S. and every grocery store.

There has also been some interest in making healthy food the default option in hospitals and medical centers. It is crucially important for these institutions to provide food prepared for patients based on a healthy lifestyle approach. [42]  

All interprofessional healthcare team members should be included in the patient education and support process. Therefore, all healthcare team members must participate in preventive education and support of the patients in their care.

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Prevalence of Self-Reported Obesity, 2011. Prevalence of self-reported obesity among U.S. adults by state and territory, BRFSS, 2011 Centers for Disease Control and Prevention. CC BY 3.0.

Prevalence of Self-Reported Obesity, 2020. The prevalence of self-reported obesity among U.S. adults by state and territory, BRFSS, 2020 Centers for Disease Control and Prevention. CC BY 3.0.

Disclosure: Daniel Keyes declares no relevant financial relationships with ineligible companies.

Disclosure: Nabila Patel declares no relevant financial relationships with ineligible companies.

Disclosure: Kelly Correa declares no relevant financial relationships with ineligible companies.

This book is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) ( http://creativecommons.org/licenses/by-nc-nd/4.0/ ), which permits others to distribute the work, provided that the article is not altered or used commercially. You are not required to obtain permission to distribute this article, provided that you credit the author and journal.

• Cite this Page Keyes D, Patel NI, Correa KA. Overview Of Lifestyle Medicine. [Updated 2023 Feb 4]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-.

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Guest Essay

Gen Z Has Regrets

By Jonathan Haidt and Will Johnson

Dr. Haidt is a social psychologist at New York University’s Stern School of Business; Mr. Johnson is the chief executive of the Harris Poll.

Was social media a good invention? One way to quantify the value of a product is to find out how many of the people who use it wish it had never been invented. Feelings of regret or resentment are common with addictive products (cigarettes, for example) and addictive activities like gambling, even if most users say they enjoy them.

For nonaddictive products — hairbrushes, say, or bicycles, walkie-talkies or ketchup — it’s rare to find people who use the product every day yet wish it could be banished from the world. For most products, those who don’t like the product can simply … not use it.

What about social media platforms? They achieved global market penetration faster than almost any product in history. The category took hold in the early aughts with Friendster, MySpace and the one that rose to dominance: Facebook. By 2020 , more than half of all humans were using some form of social media. So if this were any normal product we’d assume that people love it and are grateful to the companies that provide it to them — without charge, no less.

But it turns out that it can be hard for people who don’t like social media to avoid it, because when everyone else is on it, the abstainers begin to miss out on information, trends and gossip. This is especially painful for adolescents, whose social networks have migrated, since the early 2010s, onto a few giant platforms. Nearly all American teenagers use social media regularly, and they spend an average of nearly five hours a day just on these platforms.

So what does Gen Z really think about social media? Is it more like walkie-talkies, where hardly anyone wished they had never been invented? Or is it more like cigarettes, where smokers often say they enjoy smoking, but more than 71 percent of smokers (in one 2014 survey ) regret ever starting?

We recently collaborated on a nationally representative survey of 1,006 Gen Z adults (ages 18-27). We asked them online about their own social media use, about their views on the effects of social media on themselves and on society and about what kinds of reforms they’d support. Here’s what we found.

Daily time spent by Gen Z on social media

For 18- to 27-year-olds who use social media

4 to 6 hours

3 hours or less

7 hours or more

Source: Harris Poll/Zach Rausch

Note: Figures may not add up to 100 percent due to rounding.

What type of impact has social media had on your emotional health?

For 18- to 27-year-olds

Non-L.G.B.T.Q.

Almost half of Gen Z wishes social media platforms like X and TikTok didn’t exist

Percentage of Gen Z respondents who agree with the statement “I wish ___ had never been invented”

Smartphones

Messaging apps

The internet

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Large health organizations leverage training packages to accelerate lifestyle medicine into care delivery  

Insurers like Humana and Blue Cross Blue Shield, health systems and even the U.S. military are utilizing organizational training bundles from ACLM to equip their healthcare teams with the skills and resources they need to practice lifestyle medicine and help patients restore their health .  

Alex Branch Director of Communications

September 19, 2024

Major health systems, health plans and even the U.S. military are increasingly investing in large-scale training opportunities to prepare their physicians and health professionals to incorporate evidence-based lifestyle medicine into patient care.   

More than 35 organizations, including Humana, Blue Cross Blue Shield of Arizona and New York Health + Hospitals, have partnered with the American College of Lifestyle Medicine (ACLM) to utilize lifestyle medicine organizational training packages. The U.S. Navy, Air Force and Army have done the same.   

The urgent emphasis on lifestyle medicine stems from the realization that the traditional model of healthcare that manages the symptoms of chronic disease through ever-increasing quantities of pharmaceuticals and risky procedures is failing. Lifestyle medicine-certified clinicians use therapeutic lifestyle interventions as a first-line treatment to address the root cause of chronic disease, with the clinical outcome goal of health restoration. Lifestyle medicine is aligned with the quintuple aim of better health outcomes, reduced costs, improved patient and clinician satisfaction and advancement of health equity.  

Humana, one of the nation’s largest health insurance companies, announced a partnership with ACLM in 2022 to advance lifestyle medicine training to all healthcare professionals contracted by Humana nationwide.   

“We are committed to supporting access to high-quality care and improving the health for all of our members and patients,” said Humana Chief Medical Officer Kate Goodrich, MD, MHS. “Motivating lifestyle change is critical in preventing and treating chronic diseases, like diabetes. This partnership will ensure our clinicians receive evidence-based lifestyle change and behavioral motivation training to treat chronic disease more effectively.”  

Team-based care  

Clinicians who are individually trained in lifestyle medicine bring enormous value to healthcare teams. But organizational lifestyle medicine training can equip every member of the team with lifestyle medicine skills that support coordinated, whole-person care.  

Consider a patient who receives a diagnosis of type 2 diabetes. An entire healthcare team trained in lifestyle medicine is available to support dietary recommendations, practical strategies for increasing physical activity and managing stress. Such a unified approach can help patients make sustainable changes, leading to better outcomes and reduced reliance on pharmaceuticals,  

Since certification began in 2017 by the American Board of Lifestyle Medicine, almost 6,700 physicians and health professionals have become board certified in lifestyle medicine globally.  

Speaking the same language  

The U.S. Air Force Medical Service care strategy starts by addressing the patient’s personal health goals, identifying what is most important to the patient, and by developing a treatment plan that includes addressing the pillars of lifestyle medicine. The healthcare team may include primary care physicians, dietitians, exercise physiologists, physical therapists, and behavioral health specialists, as well as other specialty providers trained in lifestyle medicine.  

“It is different than what we have done in the past where the primary care provider will see the patient, recommend the patient see a specialist who may not have any training in lifestyle medicine, and both provide a treatment plan that is more in line with traditional medicine,” said U.S. Air Force Col. (Ret) Mary Anne Kiel, MD, FAAP, FACLM, DipABLM, CP. “We want providers speaking the same language about the treatment plan through lifestyle medicine foundations to better address the patient’s personal health goals. This new approach provides a more impactful way to sustain health and readiness.”  

Reducing burnout  

Integrating lifestyle medicine into health systems and practices may also help boost clinician well-being and satisfaction. A 2023 study published in the American Journal of Health Promotion found the more that lifestyle medicine clinicians were able to incorporate lifestyle medicine into their medical practices, the less likely they were to experience burnout.  

Improved self-care, such as incorporating lifestyle behavior changes into their own lives, was among the top reasons reported for reduced experiences of burnout. One respondent to the survey reported that in addition to helping patients make lifestyle changes “I also implemented my own lifestyle medicine changes–increased physical activity, switched to plant-based diet, and managed stress better.”   

Leaders at University Hospitals (UH) in Cleveland cited the potential benefit on workforce well-being in 2023 when they announced an initiative to provide lifestyle medicine training to their 32,000 employees.   

“Taking care of others starts with taking care of ourselves. Health is one of our most precious gifts, and in healthcare we know it should never be taken for granted,” said University Hospitals Health System Chief Whole Health & Well-being Office Francoise Adan, MD, who also serves as UH’s Christopher M. & Sara H. Connor chair in Integrative Health, and director, UH Connor Whole Health.  

Lifestyle medicine educational resources  

ACLM offers an extensive inventory of expert-led courses across the education spectrum, including CME/CE courses and materials for preparing for and maintaining certification. ACLM’s large-scale organizational training packages start with a minimum purchase of training resources for 10 individuals. These packages can be customized to align with an organization’s specific needs and goals, ensuring that the training is targeted and impactful. Plus, organizations that purchase 10 or more resources are eligible for discounts, making it more cost-effective to invest in professional development.  

Organizations have partnered with ACLM on bundles that included 175 “Foundations of Lifestyle Medicine Board Review” (LMBR) courses. The LMBR, a prerequisite for the the ACLM and American Board of Lifestyle Medicine ( ABLM ) certification exam, is a 350-page board review manual with 10 sections, 12 online review lectures by lifestyle medicine experts and 180 review questions. The course provides 30 hours of CME/CE and is a comprehensive course that builds a foundation for practicing lifestyle medicine . ACLM’s Question Bank , a compilation of 200 practice questions is designed to help prepare clinicians for the lifestyle medicine certification exam and support maintenance of certification.  

Other courses available for organizational training packages include ACLM’s “ Physician and Health Professional Well-Being, ” Introduction to Lifestyle Medicine ,” “ Food as Medicine ,” “ Lifestyle Medicine for Coaches ” and “ Remission of Type 2 Diabetes and Reversal of Insulin Resistance Certificate Course ,” as well as packages for ACLM membership and annual conference registrations.  

Ready to transform your healthcare organization with the power of lifestyle medicine? Learn more about how ACLM’s large-scale organizational training packages can equip your team with the skills needed to deliver whole-person care and improve patient outcomes. Contact ACLM Director of Education & Training Advancement Chelsey Hoffman at [email protected] to discuss training options tailored to your organization’s needs.  

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Tools and resources of interest.

FREE 5.5 CME/CE for Clinicians: Lifestyle Medicine & Food as Medicine Essentials Bundle

Remission of T2 Diabetes & Reversal of Insulin Resistance

Learn More About LM Certification