scholarly journals A Comprehensive Clinical Lifestyle Medicine Specialty Fellowship Program: What Intensive Lifestyle Treatment Can Do

2017 ◽  
Vol 11 (5) ◽  
pp. 414-418 ◽  
Author(s):  
John Kelly ◽  
Jeni Shull
Keyword(s):  
Clinical Training ◽  
Lifestyle Changes ◽  
Evidence Based ◽  
Lifestyle Medicine ◽  
Actual Patient ◽  
Inflammatory Conditions ◽  
Lifestyle Treatment ◽  
Specialty Training Program ◽  
And Function

Lifestyle medicine (LM) is recognized as an essential component of evidence-based medical treatment, particularly for chronic diseases. Multiple studies have shown that intensive therapeutic lifestyle change can arrest and reverse disease, including heart disease, type 2 diabetes, essential hypertension, metabolic syndrome, and autoimmune and inflammatory conditions. While more modest lifestyle changes can slow the onset or prevent disease, studies reveal that intensive therapeutic changes are required to arrest and reverse disease. As increasing numbers of clinicians have learned about the powerful treatment effects of intensive lifestyle interventions, interest in LM has greatly increased. This, in turn, has led to the need for evidence-based clinical LM training in how to effectively provide intensive LM interventions that can arrest and reverse disease. As with all clinical training, such training must include actual patient care guided by knowledgeable expert LM clinicians. The purpose of this article is to (1) describe the need for and function of clinical LM specialists, (2) describe the key components in the training of clinical LM specialists to treat and reverse chronic disease, and (3) describe the steps/components in establishing and implementing a clinical LM specialty-training program.

scholarly journals Walking for subjects with type 2 diabetes: a systematic review and joint AMD/SID/SISMES evidence-based practical guideline

2020 ◽  
Author(s):  
P. Moghetti ◽  
◽  
S. Balducci ◽  
L. Guidetti ◽  
P. Mazzuca ◽  
...  
Keyword(s):  
Systematic Review ◽  
Type 2 Diabetes ◽  
Glucose Control ◽  
Well Being ◽  
Lifestyle Changes ◽  
Sufficient Evidence ◽  
Diabetic Patients ◽  
Evidence Based ◽  
Therapeutic Tool

Abstract Aims Regular exercise is considered a cornerstone in the management of type 2 diabetes mellitus (T2DM). It improves glucose control and cardiovascular risk factors, contributes to weight loss, and also improves general well-being, likely playing a role in the prevention of chronic complications of diabetes. However, compliance to exercise recommendations is generally inadequate in subjects with T2DM. Walking is the most ancestral form of physical activity in humans, easily applicable in daily life. It may represent, in many patients, a first simple step towards lifestyle changes. Nevertheless, while most diabetic patients do not engage in any weekly walking, exercise guidelines do not generally detail how to improve its use. The aims of this document are to conduct a systematic review of available literature on walking as a therapeutic tool for people with T2DM, and to provide practical, evidence-based clinical recommendations regarding its utilization in these subjects. Data synthesis Analysis of available RCTs proved that regular walking training, especially when supervised, improves glucose control in subjects with T2DM, with favorable effects also on cardiorespiratory fitness, body weight, and blood pressure. Moreover, some recent studies have shown that even short bouts of walking, used for breaking prolonged sitting, can ameliorate glucose profiles in diabetic patients with sedentary behavior. Conclusions There is sufficient evidence to recognize that walking is a useful therapeutic tool for people with T2DM. This document discusses theoretical and practical issues for improving its use.

Reversing Chronic Diseases Using Lifestyle Medicine

2017 ◽  
Author(s):  
Benjamin R. Brown
Keyword(s):  
Chronic Diseases ◽  
Early Stage ◽  
Lifestyle Changes ◽  
Western World ◽  
New Paradigm ◽  
Lifestyle Medicine ◽  
Randomized Controlled ◽  
Medical Effectiveness ◽  
The Right

Many of the most common chronic diseases in the Western world are now preventable and even reversible using comprehensive lifestyle changes; this has spawned a new field named lifestyle medicine. Lifestyle medicine is a subset of integrative preventive medicine that focuses on changing the four or more core behaviors: nutrition, movement, relaxation, and social support. The diseases that have been shown to be reversible include even severe coronary heart disease, type 2 diabetes, hypertension, obesity, hyperlipidemia, and early-stage prostate cancer. Many forces are converging that make this the right idea at the right time. This chapter focuses on reviewing randomized-controlled trials and demonstration projects illustrating both the medical effectiveness and cost-effectiveness of lifestyle medicine as a new paradigm of healthcare—one that integrates the best of conventional treatments such as drugs and surgery with the power of comprehensive lifestyle changes.

scholarly journals Positive psychology in health care: defining key stakeholders and their roles

2020 ◽  
Vol 10 (3) ◽  
pp. 637-647
Author(s):  
Liana S Lianov ◽  
Grace Caroline Barron ◽  
Barbara L Fredrickson ◽  
Sean Hashmi ◽  
Andrea Klemes ◽  
...  
Keyword(s):  
Health Care ◽  
Positive Psychology ◽  
Translational Research ◽  
Well Being ◽  
Lifestyle Changes ◽  
Evidence Based ◽  
Lifestyle Medicine ◽  
Health Maintenance ◽  
Health Care Settings ◽  
Positive Psychology Interventions

Abstract Lifestyle-related diseases have common risk factors: physical inactivity, poor diet, inadequate sleep, high stress, substance use, and social isolation. Evidence is mounting for the benefits of incorporating effective methods that promote healthy lifestyle habits into routine health care treatments. Research has established that healthy habits foster psychological and physiological health and that emotional well-being is central to achieving total well-being. The Happiness Science and Positive Health Committee of the American College of Lifestyle Medicine aims to raise awareness about strategies for prioritizing emotional well-being. The Committee advocates for collaborative translational research to adapt the positive psychology and behavioral medicine evidence base into methodologies that address emotional well-being in nonmental health care settings. Another aim is to promote health system changes that integrate evidence-based positive-psychology interventions into health maintenance and treatment plans. Also, the Committee seeks to ameliorate health provider burnout through the application of positive psychology methods for providers' personal health. The American College of Lifestyle Medicine and Dell Medical School held an inaugural Summit on Happiness Science in Health Care in May 2018. The Summit participants recommended research, policy, and practice innovations to promote total well-being via lifestyle changes that bolster emotional well-being. These recommendations urge stakeholder collaboration to facilitate translational research for health care settings and to standardize terms, measures, and clinical approaches for implementing positive psychology interventions. Sample aims of joint collaboration include developing evidence-based, practical, low-cost behavioral and emotional assessment and monitoring tools; grants to encourage dissemination of pilot initiatives; medical record dashboards with emotional well-being and related aspects of mental health as vital signs; clinical best practices for health care teams; and automated behavioral programs to extend clinician time. However, a few simple steps for prioritizing emotional well-being can be implemented by stakeholders in the near-term.

scholarly journals When the Desire for Lifestyle Medicine Counseling Remains Unfulfilled: A Case Report

2021 ◽  
Vol 8 ◽  
pp. 237437352199694
Author(s):  
Maximilian Andreas Storz
Keyword(s):  
Case Report ◽  
Chronic Conditions ◽  
Lifestyle Changes ◽  
Lifestyle Modifications ◽  
Unhealthy Lifestyle ◽  
Lifestyle Medicine ◽  
American Hospital ◽  
Exercise Counseling ◽  
Poor Nutrition

More and more patients are suffering from multiple concomitant chronic conditions, which are often associated with an unhealthy lifestyle, including inadequate physical activity and poor nutrition. Patients increasingly seek thorough advice on lifestyle counseling, however, many physicians encounter this development with a pharmacotherapy-centered strategy—thereby paying insufficient attention to lifestyle modifications. This case report attempts to capture the concerning experience of a particular patient, who was hospitalized for uncontrolled type-2-diabetes in an American hospital. Despite curiosity and a great interest in lifestyle modifications, his desire for lifestyle medicine counseling was not addressed during a long inpatient stay. This case illustrates that patients wish to make sustainable lifestyle changes but apparently receive insufficient support from their physicians. This applies for both, dietary and exercise counseling. To address the patients’ needs and the increasing burden from chronic diseases, physicians must practice lifestyle medicine now. Appropriate educational resources for physicians are provided.

Food for Thought on Pediatric Feeding and Swallowing

2008 ◽  
Vol 17 (3) ◽  
pp. 110-118 ◽  
Author(s):  
Joan C. Arvedson
Keyword(s):  
Developmentally Appropriate ◽  
Evidence Based ◽  
Silent Aspiration ◽  
Multiple Systems ◽  
Young Infants ◽  
Adequate Understanding ◽  
Nutrition And Hydration ◽  
Pediatric Feeding ◽  
Areas Of Concern ◽  
And Function

Abstract “Food for Thought” provides an opportunity for review of pertinent topics to add to updates in areas of concern for professionals involved with feeding and swallowing issues in infants and children. Given the frequency with which speech-language pathologists (SLPs) make decisions to alter feedings when young infants demonstrate silent aspiration on videofluoroscopic swallow studies (VFSS), the need for increased understanding about cough and its development/maturation is a high priority. In addition, understanding of the role(s) of laryngeal chemoreflexes (LCRs), relationships (or lack of relationships) between cough and esophagitis, gastroesophageal reflux (GER), and chronic salivary aspiration is critical. Decision making regarding management must take into account multiple systems and their interactions in order to provide safe feeding for all children to meet nutrition and hydration needs without being at risk for pulmonary problems. The responsibility is huge and should encourage all to search the literature so that clinical practice is as evidence-based as possible; this often requires adequate understanding of developmentally appropriate neurophysiology and function.

Outcomes of a digitally delivered, culturally-sensitive behaviour change platform for BAME adults with type 2 diabetes: 1 year health and engagement outcomes (Preprint)

2020 ◽  
Author(s):  
Charlotte Summers
Keyword(s):  
Type 2 Diabetes ◽  
Body Weight ◽  
Health Outcomes ◽  
Behavioural Change ◽  
Culturally Sensitive ◽  
Lifestyle Changes ◽  
Haemoglobin A1c ◽  
Central Asian ◽  
Increased Risk

BACKGROUND People from Black, Asian and Minority Ethnic (BAME) groups are known to have an increased risk of developing type 2 diabetes and face greater barriers to accessing healthcare resources compared to their “white British” counterparts. The main mediators of lifestyle behavioural change are gender, generation, geography, genes, God/religion, and gaps in knowledge and economic resources. Dietary and cultural practices of these individuals significantly vary according to gender, generation, geographical origin and religion. Recognition of these factors and implementing culturally sensitive interventions for type 2 diabetes prevention and management is essential in increasing knowledge of healthy eating, engagement in physical activity and improving health outcomes in BAME communities. Few health apps are tailored for BAME populations, and BAME communities are considered hard-to-reach. OBJECTIVE Our objective was to establish whether the Low Carb Program is a viable scalable solution that can be used as an effective tailored type 2 diabetes intervention for BAME communities. We hypothesized that by taking into account cultural sensitivities, providing the platform in native languages and personalising the platform in accordance with known barriers to health disparities including gender, generation, dietary preferences and religion, the app would engage BAME communities and improve type 2 diabetes related health outcomes. METHODS The study used a quasi-experimental research design comprised of an open-label, single-arm, pre-post intervention using a sample of convenience. All 705 adults with type 2 diabetes who had activated their referral to the Low Carb Program as a result of an NHS consultation between September 2018 and March 2019 were followed for a period of 12 months; mean age 54.61 (SD 16.69) years; 58.2% (410/705) women; 45.1% (318/705) white, 28.5% (201/705) Indian/Pakistani/Bangladeshi/Other Central Asian, 10.8% (76/705) Arab, 6.2% (44/705) Mixed/Multiple ethnic groups, 6% (43/705) black, 1.8% (13/705) other, (7/705) 1% Chinese/Japanese/Other East Asian. Mean starting glycated haemoglobin A1c (HbA1c) 7.99% (SD 2.05%); mean body weight 88.96kg (SD 23.25kg). RESULTS Of the 705 study participants, 513 (72.76%) had completed the Low Carb Program at 12 months. There were statistically significant reductions in body weight and HbA1c in white, Indian/Pakistani/Bangladeshi/Other Central Asian, Arabic and black participants with the most significant differences in the Indian/Pakistani/Bangladeshi/Other Central Asian population HbA1c -1.18% (SD 1.49%) and weight 8.03kg (SD 10.65kg). 82.9% of all participants (419/705) of all participants lost at least 5% of their body weight. CONCLUSIONS Offering the culturally tailored Low Carb Program that empowers members to make dietary and lifestyle changes to different BAME groups is an effective and engaging tool in the management of type 2 diabetes. Most importantly, BAME populations in particular people from Indian/Pakistani/Bangladeshi and Arabic groups who achieve better health outcomes than their white counterparts.

scholarly journals Maintenance of Type 2 Response by CXCR6-Deficient ILC2 in Papain-Induced Lung Inflammation

2019 ◽  
Vol 20 (21) ◽  
pp. 5493 ◽  
Author(s):  
Meunier ◽  
Chea ◽  
Garrido ◽  
Perchet ◽  
Petit ◽  
...  
Keyword(s):  
Immune Response ◽  
Immune Responses ◽  
Nk Cell ◽  
Lymphoid Cells ◽  
Inflammatory Conditions ◽  
Airway Diseases ◽  
Type 2 Cytokines ◽  
Lymphoid Organogenesis ◽  
Deficient Mice

Innate lymphoid cells (ILC) are important players of early immune defenses in situations like lymphoid organogenesis or in case of immune response to inflammation, infection and cancer. Th1 and Th2 antagonism is crucial for the regulation of immune responses, however mechanisms are still unclear for ILC functions. ILC2 and NK cells were reported to be both involved in allergic airway diseases and were shown to be able to interplay in the regulation of the immune response. CXCR6 is a common chemokine receptor expressed by all ILC, and its deficiency affects ILC2 and ILC1/NK cell numbers and functions in lungs in both steady-state and inflammatory conditions. We determined that the absence of a specific ILC2 KLRG1+ST2– subset in CXCR6-deficient mice is probably dependent on CXCR6 for its recruitment to the lung under inflammation. We show that despite their decreased numbers, lung CXCR6-deficient ILC2 are even more activated cells producing large amount of type 2 cytokines that could drive eosinophilia. This is strongly associated to the decrease of the lung Th1 response in CXCR6-deficient mice.

A Powerful Antidote to Physician Burnout: Intensive Healthy Lifestyle and Positive Psychology Approaches

2021 ◽  
pp. 155982762110066
Author(s):  
Liana Lianov
Keyword(s):  
Healthy Lifestyle ◽  
Meaningful Work ◽  
Well Being ◽  
Evidence Base ◽  
Lifestyle Changes ◽  
Lifestyle Interventions ◽  
Physical And Mental Health ◽  
Physician Burnout ◽  
Lifestyle Medicine ◽  
Persistent Symptoms

Burnout rates among physicians are rapidly rising. Leaders in the movement to address burnout have made the case that health care workplaces need to foster a culture of well-being, including trusting coworker interactions, collaborative and transparent leadership, work-life balance, flexibility, opportunities for meaningful work and for professional development, and effective 2-way communication. The rationale for focusing on organizational change to prevent burnout has pointed to persistent symptoms of burnout even when individual healthy lifestyle interventions are adopted. However, a case can be made that the lifestyle interventions were not implemented at the level of intensity recommended by the lifestyle medicine evidence-base to secure the desired improvement in physical and mental health when facing significant personal and environmental stressors. The lifestyle medicine community has the ethical mandate to advocate for intensive healthy lifestyle approaches to burnout prevention, in conjunction with organizational supports. By combining comprehensive and intensive lifestyle changes with organizational cultures of well-being, we can more effectively turn the tide of physician burnout.

scholarly journals Telomere Length and Oxidative Stress and Its Relation with Metabolic Syndrome Components in the Aging

Biology ◽  
2021 ◽  
Vol 10 (4) ◽  
pp. 253
Author(s):  
Graciela Gavia-García ◽  
Juana Rosado-Pérez ◽  
Taide Laurita Arista-Ugalde ◽  
Itzen Aguiñiga-Sánchez ◽  
Edelmiro Santiago-Osorio ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Metabolic Syndrome ◽  
Telomere Length ◽  
Scientific Evidence ◽  
Telomeric Dna ◽  
Biochemical Alterations ◽  
The Metabolic Syndrome ◽  
Age Related ◽  
And Function

A great amount of scientific evidence supports that Oxidative Stress (OxS) can contribute to telomeric attrition and also plays an important role in the development of certain age-related diseases, among them the metabolic syndrome (MetS), which is characterised by clinical and biochemical alterations such as obesity, dyslipidaemia, arterial hypertension, hyperglycaemia, and insulin resistance, all of which are considered as risk factors for type 2 diabetes mellitus (T2DM) and cardiovascular diseases, which are associated in turn with an increase of OxS. In this sense, we review scientific evidence that supports the association between OxS with telomere length (TL) dynamics and the relationship with MetS components in aging. It was analysed whether each MetS component affects the telomere length separately or if they all affect it together. Likewise, this review provides a summary of the structure and function of telomeres and telomerase, the mechanisms of telomeric DNA repair, how telomere length may influence the fate of cells or be linked to inflammation and the development of age-related diseases, and finally, how the lifestyles can affect telomere length.

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