Lifestyle medicine

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. 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.

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. In the clinic, major barriers to lifestyle counseling are that physicians feel ill-prepared and are skeptical about their patients' receptivity. However, by encouraging healthy decisions, illnesses can be prevented or better managed in the long-term.

Characteristics
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. Focusing on the health needs of an individual includes looking at the person's social and economic needs, as well.

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. 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. These skills have shown to be more effective than giving advice like "Exercise more and eat healthy".

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. 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.

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. 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.

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. 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.

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). 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.