Focus | nutrition, sleep, physical activity, stress management, tobacco/alcohol cessation, and healthy relationships.. |
---|---|
Significant diseases |
|
Specialist | Lifestyle medicine physician |
Lifestyle medicine (LM) is a branch of medicine focused on preventive healthcare and self-care dealing with prevention, research, education, and treatment of disorders caused by lifestyle factors and preventable causes of death such as nutrition, physical inactivity, chronic stress, and self-destructive behaviors including the consumption of tobacco products and drug or alcohol abuse. [1] The goal of LM is to improve individuals' health and wellbeing by applying the 6 pillars of lifestyle medicine (nutrition, regular physical activity, restorative sleep, stress management, avoidance of risky substances, and positive social connection) to prevent chronic conditions such as cardiovascular diseases, diabetes, metabolic syndrome and obesity. [1] [2]
Lifestyle medicine focuses on educating and motivating patients to improve the quality of their lives by changing personal habits and behaviors around the use of healthier diets which minimize ultra-processed foods such as a Mediterranean diet or whole food, plant-predominant dietary patterns. Poor lifestyle choices like dietary patterns, physical inactivity, tobacco use, alcohol addiction and dependence, drug addiction and dependence, as well as psychosocial factors, e.g. chronic stress and lack of social support and community, contribute to chronic disease. [1] [3] In the clinic, major barriers to lifestyle counseling are that physicians feel ill-prepared and are skeptical about their patients' receptivity. [4] However, by encouraging healthy decisions, illnesses can be prevented or better managed in the long-term.
Lifestyle Medicine in Practice
Lifestyle interventions require behavior changes that may be challenging for health professionals, communities, and patients. The task of the LM practitioner is to motivate and support healthy behavior changes through evidence-based approaches to prevent and manage chronic conditions. LM emphasizes personalized care and uses patient-centered approaches such as goal-setting, shared decision-making, and self-management. Coaching patients how to cook healthy food at home, for example, can be part of a lifestyle-oriented medical practice. [5] Focusing on the health needs of an individual includes looking at the person's social and economic needs, as well.[ citation needed ]
LM uses behavioral science to equip and encourage patients to make lifestyle changes. There are many theories of behavior change; the transtheoretical model is particularly suited to lifestyle medicine. It posits that individuals progress through six stages of change: precontemplation, contemplation, preparation, action, maintenance, and termination. [6] [7] Stage-matched interventions are most likely to result in successful behavior changes. LM practitioners are encouraged to adopt counseling methods such as motivational interviewing (MI) to identify patient readiness to change and provide stage appropriate lifestyle interventions. [8] These skills have shown to be more effective than giving advice like "Exercise more and eat healthy". [9]
LM is similar to preventive medicine in that it also bridges the gap between conventional medicine and public health. LM interventions such as behavioral change counseling are used in adjunct with pharmacotherapy. [10] Like all of medicine, LM promotes healthy lifestyle choices to prevent and treat diseases. Overall wellness and self-management are a crucial components of lifestyle medicine and enforce the idea of living healthier through behavioral change. Health promotion is the foundation of LM and encourages individuals to participate in their own care and well-being. [11]
Levels of Lifestyle Medicine
LM may be practiced on three levels. The first level involves recognition by all healthcare professionals that lifestyle choices determine health status and are important modifiers of the response to pharmaceutical and/or surgical treatments. All practitioners are encouraged to include lifestyle advice along with standard treatment protocols. The second level is specialty care (e.g., Exercise medicine and Physiatry) in which LM interventions are the focus of treatment and pharmaceutical and/or surgical treatments are an adjunct to be used as necessary. [12] The third level is population/community health programs and policies. Lifestyle intervention advice should be included in public health/preventive medicine guidance and policies for the prevention and treatment of chronic diseases. [13]
Interprofessional Education/Collaboration in Lifestyle Medicine Practice
Healthcare professionals and their future patients would benefit if the basics of LM were incorporated into all professional training programs. Formal training and personal experience of evidence-based lifestyle interventions such as plant-based nutrition, stress management, physical activity, sleep management, relationship skills, and substance abuse mitigation would transform the American healthcare system. LM is uniquely suited to interprofessional education in which students from two or more healthcare professions learn together during professional training with the objective of cultivating collaborative practice of patient-centered care. [14] [15] [16] [17] Physicians and other healthcare providers should feel comfortable talking with their patient about behavioral lifestyle changes and assessing needs in determinants of health. Engaging patients in these conversations can better help them achieve their lifestyle and healthcare goals.[ citation needed ]
There are many educational pathways to becoming an expert in LM. Physicians can become certified or accredited from the International Board of Lifestyle Medicine (IBLM), American Board of Lifestyle Medicine (ABLM), and British Society of Lifestyle Medicine (BSLM). [18] [19] [20] [21] [22] The Lifestyle Medicine Global Alliance (LMGA) is an organization that connects LM professionals from nations around the world to collaborate, share resources, and create solutions to preventing and reversing non-communicable and chronic diseases. [23]
Health has a variety of definitions, which have been used for different purposes over time. In general, it refers to physical and emotional well-being, especially that associated with normal functioning of the human body, absent of disease, pain, or injury.
Mind–body interventions (MBI) or mind-body training (MBT) are health and fitness interventions that are intended to work on a physical and mental level such as yoga, tai chi, and Pilates.
Preventive healthcare, or prophylaxis, is the application of healthcare measures to prevent diseases. Disease and disability are affected by environmental factors, genetic predisposition, disease agents, and lifestyle choices, and are dynamic processes that begin before individuals realize they are affected. Disease prevention relies on anticipatory actions that can be categorized as primal, primary, secondary, and tertiary prevention.
Community health refers to non-treatment based health services that are delivered outside hospitals and clinics. Community health is a subset of public health that is taught to and practiced by clinicians as part of their normal duties. Community health volunteers and community health workers work with primary care providers to facilitate entry into, exit from and utilization of the formal health system by community members as well as providing supplementary services such as support groups or wellness events that are not offered by medical institutions.
Health psychology is the study of psychological and behavioral processes in health, illness, and healthcare. The discipline is concerned with understanding how psychological, behavioral, and cultural factors contribute to physical health and illness. Psychological factors can affect health directly. For example, chronically occurring environmental stressors affecting the hypothalamic–pituitary–adrenal axis, cumulatively, can harm health. Behavioral factors can also affect a person's health. For example, certain behaviors can, over time, harm or enhance health. Health psychologists take a biopsychosocial approach. In other words, health psychologists understand health to be the product not only of biological processes but also of psychological, behavioral, and social processes.
Health education is a profession of educating people about health. Areas within this profession encompass environmental health, physical health, social health, emotional health, intellectual health, and spiritual health, as well as sexual and reproductive health education. It can also be defined as any combination of learning activities that aim to assist individuals and communities improve their health by expanding knowledge or altering attitudes.
Behavioral medicine is concerned with the integration of knowledge in the biological, behavioral, psychological, and social sciences relevant to health and illness. These sciences include epidemiology, anthropology, sociology, psychology, physiology, pharmacology, nutrition, neuroanatomy, endocrinology, and immunology. The term is often used interchangeably, but incorrectly, with health psychology. The practice of behavioral medicine encompasses health psychology, but also includes applied psychophysiological therapies such as biofeedback, hypnosis, and bio-behavioral therapy of physical disorders, aspects of occupational therapy, rehabilitation medicine, and physiatry, as well as preventive medicine. In contrast, health psychology represents a stronger emphasis specifically on psychology's role in both behavioral medicine and behavioral health.
Health promotion is, as stated in the 1986 World Health Organization (WHO) Ottawa Charter for Health Promotion, the "process of enabling people to increase control over, and to improve their health."
The social determinants of health (SDOH) are the economic and social conditions that influence individual and group differences in health status. They are the health promoting factors found in one's living and working conditions, rather than individual risk factors that influence the risk or vulnerability for a disease or injury. The distribution of social determinants is often shaped by public policies that reflect prevailing political ideologies of the area.
A chronic condition is a health condition or disease that is persistent or otherwise long-lasting in its effects or a disease that comes with time. The term chronic is often applied when the course of the disease lasts for more than three months. Common chronic diseases include diabetes, functional gastrointestinal disorder, eczema, arthritis, asthma, chronic obstructive pulmonary disease, autoimmune diseases, genetic disorders and some viral diseases such as hepatitis C and acquired immunodeficiency syndrome. An illness which is lifelong because it ends in death is a terminal illness. It is possible and not unexpected for an illness to change in definition from terminal to chronic. Diabetes and HIV for example were once terminal yet are now considered chronic due to the availability of insulin for diabetics and daily drug treatment for individuals with HIV which allow these individuals to live while managing symptoms.
Self-care has been defined as the process of establishing behaviors to ensure holistic well-being of oneself, to promote health, and actively manage illness when it occurs. Individuals engage in some form of self-care daily with food choices, exercise, sleep, and hygiene. Self-care is not only a solo activity, as the community—a group that supports the person performing self-care—overall plays a role in access to, implementation of, and success of self-care activities.
Workplace wellness, also known as corporate wellbeing outside the United States, is a broad term used to describe activities, programs, and/or organizational policies designed to support healthy behavior in the workplace. This often involves health education, medical screenings, weight management programs, and onsite fitness programs or facilities. It can also include flex-time for exercise, providing onsite kitchen and eating areas, offering healthy food options in vending machines, holding "walk and talk" meetings, and offering financial and other incentives for participation.
Chronic care management encompasses the oversight and education activities conducted by health care professionals to help patients with chronic diseases and health conditions such as diabetes, high blood pressure, systemic lupus erythematosus, multiple sclerosis, and sleep apnea learn to understand their condition and live successfully with it. This term is equivalent to disease management for chronic conditions. The work involves motivating patients to persist in necessary therapies and interventions and helping them to achieve an ongoing, reasonable quality of life.
Health coaching is the use of evidence-based skillful conversation, clinical interventions and strategies to actively and safely engage client/patients in health behavior change. Health coaches are certified or credentialed to safely guide clients and patients who may have chronic conditions or those at moderate to high risk for chronic conditions.
An ambulatist is a licensed health care provider who specializes in the prevention, management, and care coordination of ambulatory patients with chronic diseases by using lifestyle medicine and drug therapy.
Holistic nursing is a way of treating and taking care of the patient as a whole body, which involves physical, social, environmental, psychological, cultural and religious factors. There are many theories that support the importance of nurses approaching the patient holistically and education on this is there to support the goal of holistic nursing. The important skill to be used in holistic nursing would be communicating skills with patients and other practitioners. This emphasizes that patients being treated would be treated not only in their body but also their mind and spirit.. Holistic nursing is a nursing speciality concerning the integration of one's mind, body, and spirit with his or her environment. This speciality has a theoretical basis in a few grand nursing theories, most notably the science of unitary human beings, as published by Martha E. Rogers in An Introduction to the Theoretical Basis of Nursing, and the mid-range theory Empowered Holistic Nursing Education, as published by Dr. Katie Love. Holistic nursing has gained recognition by the American Nurses Association (ANA) as a nursing specialty with a defined scope of practice and standards. Holistic nursing focuses on the mind, body, and spirit working together as a whole and how spiritual awareness in nursing can help heal illness. Holistic medicine focuses on maintaining optimum well-being and preventing rather than just treating disease.
Workplace health promotion is the combined efforts of employers, employees, and society to improve the mental and physical health and well-being of people at work. The term workplace health promotion denotes a comprehensive analysis and design of human and organizational work levels with the strategic aim of developing and improving health resources in an enterprise. The World Health Organization has prioritized the workplace as a setting for health promotion because of the large potential audience and influence on all spheres of a person's life. The Luxembourg Declaration provides that health and well-being of employees at work can be achieved through a combination of:
Childhood chronic illness refers to conditions in pediatric patients that are usually prolonged in duration, do not resolve on their own, and are associated with impairment or disability. The duration required for an illness to be defined as chronic is generally greater than 12 months, but this can vary, and some organizations define it by limitation of function rather than a length of time. Regardless of the exact length of duration, these types of conditions are different than acute, or short-lived, illnesses which resolve or can be cured. There are many definitions for what counts as a chronic condition. However, children with chronic illnesses will typically experience at least one of the following: limitation of functions relative to their age, disfigurement, dependency on medical technologies or medications, increased medical attention, and a need for modified educational arrangements.
Obesity medicine is a field of medicine dedicated to the comprehensive treatment of patients with obesity. Obesity medicine takes into account the multi-factorial etiology of obesity in which behavior, development, environment, epigenetic, genetic, nutrition, physiology, and psychosocial contributors all play a role. As time progresses, we become more knowledgeable about the complexity of obesity, and we have ascertained that there is a certain skill set and knowledge base that is required to treat this patient population. Clinicians in the field should understand how a myriad of factors contribute to obesity including: gut microbiota diversity, regulation of food intake and energy balance through enteroendocrine and neuroregulation, and adipokine physiology. Obesity medicine physicians should be skilled in identifying factors which have contributed to obesity and know how to employ methods to treat obesity. No two people with obesity are alike, and it is important to approach each patient as an individual to determine which factors contributed to their obesity in order to effectively treat each patient. Physicians specializing in obesity medicine may choose to obtain board certification by the American Board of Obesity Medicine.
The taxonomy of the burden of treatment is a visualization created for health care professionals to better comprehend the obstacles that interfere with a patient's health care plan. It was created as a result of a worldwide, qualitative-based study that asked adults with chronic conditions to list the personal, environmental, and financial barriers that burden a patient. The purpose of this visualization is to help health care providers develop personalized management strategies that the patient can follow through a narrative paradigm. The goal is to target interventions, achieve an interpersonal doctor-patient relationship, and improve health outcomes.