Lifestyle Medicine for Health and Disease Management
Introduction[edit | edit source]
An article in The Permanente Journal indicates that "More than 80% of chronic conditions could be avoided through the adoption of healthy lifestyle recommendations."An original investigation in JAMA Internal Medicine (2020) indicates that "Various healthy lifestyle profiles appear to be associated with extended gains in life lived without type 2 diabetes, cardiovascular and respiratory diseases, and cancer." The authors go onto say that "Of the 16 different lifestyle profiles studied, all 4 that were associated with the longest disease-free life span included a BMI [Body Mass Index] less than 25 and at least 2 of the following health behaviours: never smoking, physical activity, and moderate alcohol consumption."
What is Lifestyle Medicine?[edit | edit source]
The first edition of the Lifestyle Medicine book, edited by James Rippe, MD, coined the term "lifestyle medicine" in 1999. The book defined lifestyle medicine as "the integration of lifestyle practices into the modern practice of medicine both to lower the risk factors for chronic disease and/or, if disease is already present, serve as an adjunct in its therapy. Lifestyle medicine brings together sound, scientific evidence in diverse health-related fields to assist the clinician in the process of not only treating disease but also promoting good health."
The Lifestyle Medicine Handbook states that lifestyle medicine is "The use of evidence-based lifestyle therapeutic approaches, such as a predominantly whole food, plant-based diet, regular physical activity, adequate sleep, stress management, avoidance of risky substance use, and other non-drug modalities to treat, oftentimes, reverse and prevent the lifestyle-related, chronic disease that's all too prevalent."
Finally, the Lifestyle Medicine book defines lifestyle medicine as "the application of environmental, behavioural, medical and motivational principles to the management of lifestyle-related health problems in a clinical setting" and further added in the third edition that lifestyle medicine also includes "self-care and self-management."
Figure 1 shows the basic components of lifestyle medicine. It can be seen that the main focus is on nutrition, physical activity or exercise, sleep, stress, avoidance risky substances, and social relationships.
Lifestyle Medicine for Health and Disease Management[edit | edit source]
Research has shown that various lifestyle medicine components may help treat and manage conditions such as:
- Chronic low back pain
- Cognitive impairment
- Rheumatoid arthritis
- Multiple sclerosis
- Parkinson’s disease
Figure 2 outlines modifiable risk factors affecting various diseases such as obesity, heart disease, diabetes, and cancer. All of these are areas physiotherapists can educate their patients and clients to improve their lifestyle in order to help manage and prevent disease.
Assessment Tools[edit | edit source]
The following are selected lifestyle medicine tools for assessing patients. For additional resources, see the American Academy of Family Physicians website.
- American Academy of Family Physicians. Tools for the Lifestyle Medicine Team. Accessed July 31, 2021.
- 36-Item Short Form Survey Instrument (SF-36) RAND. 36-Item Short Form Survey Instrument (SF-36). Accessed July 31, 2021.
- Alcohol Use Disorder Identification Test- Consumption (AUDIT-C) Frank D, DeBenedetti AF, Volk RJ, Williams EC, Kivlahan DR, Bradley KA. Effectiveness of the AUDIT-C as a screening test for alcohol misuse in three race/ethnic groups. J Gen Intern Med. 2008;23(6):781-787.
- Consensus Sleep Diary Carney CE, Buysse DJ, Ancoli-Israel S, et al. The consensus sleep diary: standardizing prospective sleep self-monitoring. Sleep. 2012;35(2):287-302.
- International Physical Activity Questionnaire (IPAQ) Craig CL, Marshall AL, Sjostrom M, et al. International Physical Activity Questionnaire: 12-country reliability and validity. Med Sci Sport Exerc. 2003;35(8):1381-1395.
- Meaning in Life Questionnaire Steger MF, Frazier P, Oishi S, Kaler M. The Meaning in Life Questionnaire: assessing the presence of and search for meaning in life. J Couns Psychol. 2006;53(1):80-93.
- Mediterranean Diet Adherence Screener (MEDAS) García-Conesa MT, Philippou E, Pafilas C, et al. Exploring the validity of the 14-item Mediterranean Diet Adherence Screener (Medas): a cross-national study in seven European countries around the Mediterranean region. Nutrients. 2020;12(10):1-18.
- Patient Health Questionnaire-9 (PHQ-9) and PHQ-2 Kroenke K, Spitzer RL, Williams JBW. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001;16(9):606-613. Kroenke K, Spitzer RL, Williams JBW. The patient health questionnaire-2: validity of a two-item depression screener. Med Care. 2003;41(11):1284-1292.
- Physical Activity Readiness Questionnaire for Everyone (PAR-Q+) American College of Sports Medicine. ACSM’s Guidelines for Exercise Testing and Prescription, 11th ed. Philadelphia, PA: Wolters Kluwer; 2022.
- Quality Of Life Physiopedia
- Readiness Ruler Indiana University. Readiness Ruler. Accessed July 31, 2021.
- Screener and Opioid Assessment for Patients with Pain-Revised (SOAPP-R) Butler SF, Fernandez K, Benoit C, Budman SH, Jamison RN. Validation of the revised screener and opioid assessment for patients with pain (SOAPP-R). J Pain. 2008;9(4):360-372.
- Social Needs Screening Tool American Academy of Family Physicians. Social Needs Screening Tool. Accessed July 31, 2021. www.aafp.org/dam/AAFP/documents/patient_care/everyone_project/hops19-physician-form-sdoh.pdf
Related Articles[edit | edit source]
- Bodai BI, Nakata TE, Wong WT, et al. Lifestyle medicine: a brief review of its dramatic impact on health and survival. Perm J. 2018;22:17-025.
- Rippe JM. Lifestyle medicine: the health promoting power of daily habits and practices. Am J Lifestyle Med. 2018;12(6):499-512.
- Phillips EM, Frates EP, Park DJ. Lifestyle medicine. Phys Med Rehabil Clin N Am. 2020;31(4):515-526.
- Worman RS. Lifestyle medicine: the role of the physical therapist. Perm J. 2020;24:18.192. doi:10.7812/TPP/18.192
- Zollinger JM, Katuli SD. Knowledge, attitude, and practice of orthopedic manual physical therapists toward lifestyle screening and education: a descriptive study. Am J of Lifestyle Med. July 19, 2021.
Resources[edit | edit source]
- Academic Consortium for Integrative Medicine & Health
- Academy of Integrative Health & Medicine
- American College of Lifestyle Medicine
- National Center for Complementary and Integrative Health
References [edit | edit source]
- Bodai BI, Nakata TE, Wong WT, et al. Lifestyle medicine: a brief review of its dramatic impact on health and survival. Perm J. 2018;22:17-025. doi:10.7812/TPP/17-025
- Nyberg ST, Singh-Manoux A, Pentti J, et al. Association of healthy lifestyle with years lived without major chronic diseases. JAMA Intern Med. 2020;180(5):760-768. doi:10.1001/jamainternmed.2020.0618
- Rippe JM, ed. Lifestyle Medicine, 3rd ed. Boca Raton, FL: CRC Press; 2019.
- Frates B, Bonnet JP, Joseph R. & Peterson JA. Lifestyle Medicine Handbook: An Introduction to the Power of Healthy Habits. Monterey, CA: Healthy Learning; 2019.
- Egger G, Binns A, Rossner S, Sagner M, eds. Lifestyle Medicine: Lifestyle, the Environment and Preventive Medicine in Health and Disease, 3rd ed. London, UK: 2017.
- Williams A, van Dongen JM, Kamper SJ, et al. Economic evaluation of a healthy lifestyle intervention for chronic low back pain: A randomized controlled trial. Eur J Pain. 2019;23(3):621-634. doi:10.1002/ejp.1334
- Kivipelto M, Mangialasche F, Ngandu T. Lifestyle interventions to prevent cognitive impairment, dementia and Alzheimer disease. Nat Rev Neurol. 2018;14(11):653-666. doi:10.1038/s41582-018-0070-3
- Sarris J, O'Neil A, Coulson CE, Schweitzer I, Berk M. Lifestyle medicine for depression. BMC Psychiatry. 2014;14:107. doi:10.1186/1471-244X-14-107
- Forsyth C, Kouvari M, D'Cunha NM, et al. The effects of the Mediterranean diet on rheumatoid arthritis prevention and treatment: a systematic review of human prospective studies. Rheumatol Int. 2018;38(5):737-747. doi:10.1007/s00296-017-3912-1
- Olsson T, Barcellos LF, Alfredsson L. Interactions between genetic, lifestyle and environmental risk factors for multiple sclerosis. Nat Rev Neurol. 2017;13(1):25-36. doi:10.1038/nrneurol.2016.187
- Wadden TA, Tronieri JS, Butryn ML. Lifestyle modification approaches for the treatment of obesity in adults. Am Psychol. 2020;75(2):235-251. doi:10.1037/amp0000517
- Paul KC, Chuang YH, Shih IF, et al. The association between lifestyle factors and Parkinson's disease progression and mortality. Mov Disord. 2019;34(1):58-66. doi:10.1002/mds.27577