Lifestyle Medicine—An Emerging New Discipline

2015 ◽  
Vol 11 (01) ◽  
pp. 36 ◽  
Author(s):  
Robert F Kushner ◽  
Jeffrey I Mechanick ◽  
◽  
Keyword(s):  
Chronic Disease ◽  
Behavior Change ◽  
Cardiovascular Health ◽  
Essential Element ◽  
Primary Source ◽  
Health Risk Behaviors ◽  
Noncommunicable Diseases ◽  
Lifestyle Behaviors ◽  
Lifestyle Medicine ◽  
Ideal Cardiovascular Health

Unhealthful lifestyle behaviors are a primary source of the global burden of noncommunicable diseases (NCDs) and account for about 63 % of all global deaths. Recently, there has been an increased interest in evaluating the benefit of adhering to low-risk lifestyle behaviors and ideal cardiovascular health metrics. Although a healthful lifestyle has repeatedly been shown to improve mortality, the population prevalence of healthy living remains low. The new discipline of lifestyle medicine has recently emerged as a systematized approach for the management of chronic disease. The practice of lifestyle medicine requires skills and competency in addressing multiple health risk behaviors and improving self-management. This article focuses on the effects of a healthful lifestyle on chronic disease and defining lifestyle medicine as a unique discipline. It also reviews the role of effective provider–patient communication as an essential element for fostering behavior change—the main component of lifestyle medicine. The principles of communication and behavior change are skill based and are grounded in scientific theories and models. Communication and counseling must be contextualized to the patients’ economic situation, access to care, social support, culture, and health literacy.

scholarly journals Lifestyle Medicine—An Emerging New Discipline

2015 ◽  
Vol 11 (2) ◽  
pp. 114
Author(s):  
Robert F Kushner ◽  
Jeffrey I Mechanick ◽  
◽  
Keyword(s):  
Chronic Disease ◽  
Behavior Change ◽  
Cardiovascular Health ◽  
Essential Element ◽  
Primary Source ◽  
Health Risk Behaviors ◽  
Noncommunicable Diseases ◽  
Lifestyle Behaviors ◽  
Lifestyle Medicine ◽  
Ideal Cardiovascular Health

Unhealthful lifestyle behaviors are a primary source of the global burden of noncommunicable diseases (NCDs) and account for about 63 % of all global deaths. Recently, there has been an increased interest in evaluating the benefit of adhering to low-risk lifestyle behaviors and ideal cardiovascular health metrics. Although a healthful lifestyle has repeatedly been shown to improve mortality, the population prevalence of healthy living remains low. The new discipline of lifestyle medicine has recently emerged as a systematized approach for the management of chronic disease. The practice of lifestyle medicine requires skills and competency in addressing multiple health risk behaviors and improving self-management. This article focuses on the effects of a healthful lifestyle on chronic disease and defining lifestyle medicine as a unique discipline. It also reviews the role of effective provider–patient communication as an essential element for fostering behavior change—the main component of lifestyle medicine. The principles of communication and behavior change are skill based and are grounded in scientific theories and models. Communication and counseling must be contextualized to the patients’ economic situation, access to care, social support, culture, and health literacy.

scholarly journals Cardiovascular Disease Prevention and Implications of Coronavirus Disease 2019: An Evolving Case Study in the Crescent City

2020 ◽  
Vol 9 (13) ◽  
Author(s):  
Alexander C. Razavi ◽  
Tanika N. Kelly ◽  
Jiang He ◽  
Camilo Fernandez ◽  
Paul K. Whelton ◽  
...  
Keyword(s):  
Public Health ◽  
Cardiovascular Disease ◽  
Access To Health Care ◽  
Cardiovascular Health ◽  
Case Fatality ◽  
Noncommunicable Diseases ◽  
Lifestyle Behaviors ◽  
Public Health Perspective ◽  
Access To Health ◽  
The Impact

Abstract Medicine and public health have traditionally separated the prevention and treatment of communicable and noncommunicable diseases. The coronavirus disease 2019 ( COVID ‐19) pandemic has challenged this paradigm, particularly in the setting of cardiovascular disease ( CVD ). Overall, individuals with underlying CVD who acquire severe acute respiratory syndrome coronavirus 2 experience up to a 10‐fold higher case‐fatality rate compared with the general population. Although the impact of the pandemic on cardiovascular health continues to evolve, few have defined this association from a frontline, public health perspective of populations disproportionately affected by CVD and COVID ‐19. Louisiana is ranked within the bottom 5 states for cardiovascular health, and it is home to several parishes that have experienced among the highest COVID ‐19 case‐fatality rates nationally. Herein, we review CVD prevention and implications of COVID ‐19 in New Orleans, LA, a city holding a sobering yet resilient history with previous public health disasters. In particular, we discuss potential pandemic‐driven changes in access to health care, preventive pharmacotherapy, and lifestyle behaviors, all of which may adversely affect CVD prevention and management, while amplifying racial disparities. Through this process, we highlight proposed recommendations for how CVD prevention efforts can be improved in the midst of the current COVID ‐19 pandemic and future public health crises.

scholarly journals Lifestyle Strategies for Risk Factor Reduction, Prevention, and Treatment of Cardiovascular Disease

2018 ◽  
Vol 13 (2) ◽  
pp. 204-212 ◽  
Author(s):  
James M. Rippe
Keyword(s):  
Cardiovascular Disease ◽  
Cardiovascular Health ◽  
American Heart ◽  
Heart Association ◽  
Lifestyle Factors ◽  
Cvd Risk ◽  
Lifestyle Medicine ◽  
Ideal Cardiovascular Health ◽  
Overwhelming Evidence ◽  
The Impact

Daily habits and actions powerfully affect the risk of cardiovascular disease (CVD), in general, and coronary heart disease, in particular. Regular physical activity, sound nutrition, weight management, and not smoking cigarettes have all been demonstrated to significantly reduce the risk of CVD. In 2 large cohort studies a reduction of risk of CVD of >80% and diabetes >90% were demonstrated in individuals who followed a cluster of these lifestyle practices. The study of the impact of lifestyle factors on CVD risk has coalesced under the framework of “lifestyle medicine.” Despite the overwhelming evidence that lifestyle factors affect CVD, a distinct minority of individuals are following these practices. The American Heart Association estimates that only 5% of individuals follow all of these lifestyle factors as components of a strategy to achieve “ideal” cardiovascular health. The challenge to the medical and health care communities is to more aggressively incorporate this information into the daily practices of medicine.

Abstract P370: Cardiovascular Health Metrics, Lifetime Risks of Cardiovascular Disease and Chronic Disease Mortality, and Life Expectancy in Men and Women

Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
Chong Lee
Keyword(s):  
Cardiovascular Disease ◽  
Chronic Disease ◽  
Life Expectancy ◽  
Lower Risk ◽  
Cardiovascular Health ◽  
Heart Association ◽  
Men And Women ◽  
Ideal Cardiovascular Health ◽  
Disease Mortality ◽  
Cvd Mortality

Whether cardiovascular health metrics relates to lifetime risks of cardiovascular disease (CVD) and chronic disease mortality and life expectancy in U.S. population remains less explored. PURPOSE: We investigated the combined impact of 7 ideal cardiovascular health metrics on lifetime risks of CVD and chronic disease mortality and life expectancy in US men and women at 30 years of age. METHODS: Lifetime risks of CVD and chronic disease mortality to 80 years of age were estimated for men and women, with death free of chronic diseases as a competing event. We followed 11,341 men and women, aged 30 to 80 years, who participated in the Third National Health and Nutrition Examination Survey. All participants completed baseline lifestyle factors and lifestyle behavior questionnaires. The 7 ideal cardiovascular health metrics was defined as physically active, never smoking, a healthy diet, waist girth (<102/88 cm), untreated blood pressure (<120/80 mmHg), untreated total cholesterol (<200 mg/dL), and untreated fasting glucose (<100 mg/dL) defined by the American Heart Association Strategic Committee. They were further categorized as having 0, 1, 2, 3, 4, 5, 6 or 7 combined cardiovascular health metrics. RESULTS: During an average of 13.7 years of follow-up (155,726 person-years), there were a total of 1834 chronic disease deaths (945 CVD, 579 cancer, 217 respiratory disease, 93 diabetes mellitus). The lifetime risks of chronic disease mortality (at 30 years of age) across 0, 1, 2, 3, 4, 5, and 6 or 7 ideal health metrics were (95% CI) 46.2% (41.6, 50.7), 40.3% (36.9, 43.8), 33.1% (30, 36.1), 27.2% (23.9, 30.5), 25.8% (21, 30.5), 24.8% (16.8, 32.9), and 12.7% (1.2, 24.1), respectively. Men and women who had adopted increasing number ideal health metrics had a substantially lower lifetime risk of chronic disease mortality. The lifetime risks of CVD mortality across 7 ideal health metrics showed trends similar to chronic disease mortality. After adjustment for multiple risk factors, men and women with all 6 or 7 combined ideal health metrics had a 75% (95% CI: 51% to 88%) lower risk of chronic disease mortality and 93% (95% CI: 53% to 99%) lower risk of CVD mortality, respectively, when compared with men and women with zero ideal health metrics. Men and women with 0 compared with 6 or 7 combined ideal health metrics had a shorter life expectancy by 16 years (95% CI: 13 to 19.1 years). Approximately 63% (95% CI: 26% to 82%) of chronic disease deaths might have been avoided if men and women had maintained all 6 or 7 combined health factors and healthy lifestyle behaviors. CONCLUSION: Maintaining an ideal cardiovascular health metrics is associated with lower lifetime risks of CVD and chronic disease mortality in men and women.

scholarly journals Implementation of a Tool to Modify Behavior in a Chronic Disease Management Program

2011 ◽  
Vol 2011 ◽  
pp. 1-5 ◽  
Author(s):  
Nicole D. Gillespie ◽  
Thomas L. Lenz
Keyword(s):  
Behavior Change ◽  
Transtheoretical Model ◽  
Cardiovascular Health ◽  
Healthcare Providers ◽  
Management Program ◽  
Lifestyle Changes ◽  
Lifestyle Behaviors ◽  
Lifestyle Modifications ◽  
Cardiovascular Risk Reduction ◽  
Patient Centered

Chronic diseases like diabetes, hypertension, and dyslipidemia continue to be a significant burden on the US health care system. As a result, many healthcare providers are implementing strategies to prevent the incidence of heart disease and other chronic conditions. Among these strategies are proper drug therapy and lifestyle modifications. Behavior change is often the rate-limiting step in the prevention and maintenance of lifestyle modifications. The purpose of this paper is to describe a tool used to guide the progression and assess the effectiveness of a cardiovascular risk reduction program. The tool uses the Transtheoretical Model of Behavior Change to determine the readiness and confidence to change specific lifestyle behaviors pertinent to cardiovascular health. The tool aids the practitioner in developing a patient-centered plan to implement and maintain lifestyle changes and can be tailored to use in any situation requiring a behavior change on the part of the patient.

scholarly journals The Doctor Will See You After Your Workout

2021 ◽  
pp. 155982762098828
Author(s):  
Jonathan P. Bonnet ◽  
Aaron E. George
Keyword(s):  
Chronic Disease ◽  
Medical Care ◽  
Health Care Access ◽  
Lifestyle Changes ◽  
Lifestyle Behaviors ◽  
Lifestyle Medicine ◽  
Care Access ◽  
Health Club ◽  
Health Clubs ◽  
Care Health

Novel approaches to deliver lifestyle medicine that are convenient and accessible to patients are needed. Patients generally seek medical care when they are not well, reinforcing the notion of a “sick” care health system. Conversely, health clubs represent beacons of wellness amid the mire of chronic disease. Many individuals visit health clubs with the goal of becoming or remaining healthy. Expanding health care access to these health club populations creates opportunities to engage those who do not typically seek medical care, and may also attract those who are highly motivated to make lifestyle changes to prevent, treat, and reverse chronic disease. Health club clinics could be expanded with in-person or virtual offerings that go beyond traditional models. Such offerings would stand to improve health and be mutually beneficial for the provider and health club. By decreasing the barrier to access such care and meeting highly motivated patients where they are, providers may be more successful in their efforts to deliver lifestyle medicine to patients who are ready, willing, and able to make lifestyle behaviors changes.

Tailoring Stroke Counseling for Risk Reduction Intervention to African American Men

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 422-422
Author(s):  
J Taylor Harden ◽  
Laura Salazar ◽  
Gayenell Magwood ◽  
Patricia Clark ◽  
Dawn Aycock
Keyword(s):  
Risk Reduction ◽  
Risk Perceptions ◽  
Cardiovascular Health ◽  
Stroke Risk ◽  
African American Men ◽  
Lifestyle Behaviors ◽  
Ideal Cardiovascular Health ◽  
Stage Of Readiness ◽  
Course Achievement ◽  
Risk Reduction Intervention

Abstract Early life course achievement and maintenance of ideal cardiovascular health is associated with reduced risk of developing stroke later in life. The Stroke Counseling for Risk Reduction (SCORRE) intervention is an age-and-culturally relevant intervention originally designed to correct inaccurate stroke risk perceptions and improve lifestyle behaviors to reduce stroke risk in AAs age 20-35. In a study testing SCORRE, fewer men participated, but most were not at a stage of readiness for behavior change; many did not think they were at risk despite averaging three modifiable risk factors, and while improvements in outcomes were observed in women they were not in men. These differences led to tailoring SCORRE to young AA men. The methods for tailoring SCORRE and resulting strategies for attracting, engaging, and empowering them towards stroke risk reduction, including hypotheses concerning food supply, housing, economic and social relationships, education, and mental health care will be raised for discussion.

Digital Lifestyle Medicine: Designing, Delivering, and Scaling for Impact

2021 ◽  
pp. 155982762110292
Author(s):  
Leanne Mauriello ◽  
Kristi Artz
Keyword(s):  
Behavior Change ◽  
Success Factors ◽  
Scientific Evidence ◽  
Multidisciplinary Care ◽  
Successful Implementation ◽  
Lifestyle Behaviors ◽  
Team Behavior ◽  
Lifestyle Medicine ◽  
Multidisciplinary Care Team ◽  
Digital Delivery

Digital Lifestyle Medicine (DLM) is a consumer-centric model of care which elevates the importance of daily behaviors in preventing and reversing chronic disease using virtual and digital modalities to reach patients in the context where lifestyle behaviors occur and empower them to stay well. DLM is health care reimagined, designed to inspire patients to live their best life by enabling skill-building, self-efficacy, and sustainable behavior change supported by peers, scientific-evidence, and a multidisciplinary team of lifestyle medicine (LM) clinicians. Importantly, it requires insights and collaboration from healthcare experts and technology entrepreneurs to provide a profoundly different “user experience” layered with context, relevance, and scalability. Using examples from our DLM practice, we describe how key components of LM practice, including a multidisciplinary care team, behavior change support, health coaching, and peer support, are prime for digital delivery. We conclude by providing preliminary patient outcomes to date, key success factors, and opportunities for enhancement and expansion to inform the adoption and successful implementation of DLM across the collective of LM practice.

scholarly journals Cardiovascular Health, Functional Disability, and Leisure Activities Profiles in Relation to Mental Aging

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 663-663
Author(s):  
Dorina Cadar ◽  
Celine De Looze ◽  
Christine McGarrigle
Keyword(s):  
Longitudinal Study ◽  
Cognitive Aging ◽  
Representative Sample ◽  
Cardiovascular Health ◽  
Functional Disability ◽  
Physiological Stress ◽  
Leisure Activities ◽  
Functional Decline ◽  
Functional Impairments ◽  
Ideal Cardiovascular Health

Abstract We investigated cardiovascular health, functional disability and leisure activities profiles independently and in relation to cognitive decline and dementia in high and low-medium income countries using data from the English Longitudinal Study of Ageing, Irish Longitudinal Study on Ageing and Brazilian Bambui Cohort Study of Aging. Functional loss among older Brazilians has shown a hierarchical sequence over the 15-year follow-up, with the highest incidence in functional disability reported for dressing, followed by getting out of bed, bathing/showering, walking across a room, using the toilet and eating (de Oliveira). Using the Life’s Simple 7, an ideal cardiovascular health scoring system evaluating the muscular strength, mobility and physiological stress, we showed a reliable prediction of cognitive trajectories in a representative sample of Irish individuals (De Looze). Within the same cohort, we report discrepancies between men and women in functional decline driven by domestic tasks, rather than determining differential cognitive trajectories (McGarrigle). In an English representative sample, we found that participants with an increasing number of functional impairments over almost a decade were more likely to be classified with subsequent dementia compared with those with no impairments and this may imply a more comprehensive ascertainment during the prodromal stage of dementia (Cadar). In contrast, a reduced risk of dementia was found for individuals with higher levels of engagement in cognitively stimulating activities, that may preserve cognitive reserve until later in life (Almeida). Identifying factors that influence cognitive aging and dementia risk in a multifactorial perspective is critical toward developing adequate intervention and treatment.

scholarly journals Rationale and design of a type 2 diabetes prevention intervention for at-risk mothers and children at a Federally Qualified Healthcare Center: EPIC El Rio Families Study Protocol

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
David G. Marrero ◽  
Robert M. Blew ◽  
Kelly N. B. Palmer ◽  
Kyla James ◽  
Denise J. Roe ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
At Risk ◽  
Cardiovascular Health ◽  
Excess Body Weight ◽  
Lifestyle Behaviors ◽  
Increased Risk ◽  
Group Randomized Trial ◽  
Prevention Model ◽  
History Of

Abstract Background Exposure to gestational diabetes mellitus (GDM) is associated with increased risk for type 2 diabetes (T2DM) in mothers, and poor cardiovascular health among offspring. Identifying effective methods to mitigate T2DM risk has the potential to improve health outcomes for mothers with a history of GDM and their children. The goal of the EPIC El Rio Families Study is to implement and evaluate the effects of a 13-week behavioral lifestyle intervention on T2DM risk factors in at-risk mothers and their 8- to 12-year-old children. We describe herein the rationale for our specific approach, the adaption of the DPP-based curriculum for delivery to patients of a Federally Qualified Health Center (FQHC), and the study design and methodology. Methods The effects of the intervention on reduction in excess body weight (primary outcome), hemoglobin A1c, blood pressure, and changes in lifestyle behaviors associated with weight trajectory and T2DM risk in mother-child dyads will be evaluated during a 13-week, group randomized trial wherein 60 mothers and their children will be recruited to the intervention or wait-listed control conditions at one of two FQHC locations. Intervention participants (n = 30) will begin the group program immediately, whereas the wait-listed controls (n = 30) will receive a booklet describing self-guided strategies for behavior change. Associated program delivery costs, acceptability of the program to participants and FQHC staff, and potential for long-term sustainability will also be evaluated. Discussion Successful completion in our aims will produce a scalable program with high potential for replication and dissemination, and estimated intervention effects to inform T2DM prevention efforts on families who use the FQHC system. The results from this study will be critical in developing a T2DM prevention model that can be implemented and scaled across FQHCs serving populations disproportionately burdened by T2DM. Trial registration ClinicalTrials.gov NCT03781102; Date of registration: 19 December 2018.

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