Lifestyle medicine

Lifestyle Medicine is a branch of medicine dealing with research, prevention and treatment of disorders caused by lifestyle factors such as nutrition, physical inactivity, chronic stress. The leading causes of mortality and healthcare costs worldwide are chronic diseases, resulting from lifestyle and environmental factors. The economic burden of poor lifestyle choices is no longer sustainable and impossible to ignore. Most chronic diseases are preventable. To treat the causes of these diseases and to be successful in prevention, a strong focus must be placed on lifestyle medicine aspects. Lifestyle Medicine encompasses research, prevention, diagnosis and treatment of dysfunctions caused by a non-physiological lifestyle (lifestyle-related diseases, LRDs) and morbidogenic environments conducive to promoting such lifestyles. The ultimate goal and primary focus of Lifestyle Medicine is to promote healthier lives through salutary environments and healthier lifestyle choices. Treatment of LRDs includes nutritional, exercise, psychological, social, economic and environmental interventions. To successfully do this requires education, training and communication about Lifestyle Medicine at the professional and general public level, while avoiding the trap of ‘victim blaming’ of individuals whose lifestyles are influenced by circumstances beyond their control.

Lifestyle Medicine

The leading causes of mortality worldwide are non-communicable diseases (NCDs) (synonym: chronic diseases); cardiovascular disease (17 million), followed by cancer (7.6 million), respiratory disease (4.2 million) and diabetes (1.3 million).[1] The newly published Global Burden of Disease Study (2010) has systematically highlighted the epidemiological shift in morbidity and mortality resulting from infectious diseases and malnutrition, to NCDs.[2] While humans have gained approximately 10 years of life expectancy since 1970, more time is spent living with injury and illness. Representing 63% of all deaths, most that die from NCDs are in the prime of their productive years.[3]

There is now overwhelming evidence that lifestyle factors such as poor dietary patterns, physical inactivity, tobacco use, excessive alcohol consumption and psychosocial factors, e.g. chronic stress and lack of social support and community, are key proximal factors in the pathogenesis and incidence of NCDs.[4] Lifestyle factors may also be more distal stressors, including economic, political or a high density population.[5]

The American College of Lifestyle Medicine, the Institute of Lifestyle Medicine, the European Lifestyle Medicine Organization, Australasian Society of Lifestyle Medicine and the Italian Lifestyle Medicine Association define Lifestyle Medicine (LM) as:[5]

Lifestyle Medicine is a branch of evidence-based medicine in which comprehensive lifestyle changes (including nutrition, physical activity, stress management, social support and environmental exposures) are used to prevent, treat and reverse the progression of chronic diseases by addressing their underlying causes. Lifestyle medicine interventions include health risk assessment screening, health behavior change counseling and clinical application of lifestyle modifications. Lifestyle medicine is often prescribed in conjunction with pharmacotherapy and other forms of therapy.

Lifestyle medicine is an inter-disciplinary field of internal medicine, psychosocial and neurosciences, public and environmental health, and biology. Key LM principles include prevention strategies that address lifestyle habits, the underlying biological causes (also more distant causes such as urban design initiatives to make cities and neighborhoods more social and conducive to healthier lifestyles), and the pathophysiology common to LRDs (e.g. low-grade systemic inflammation, dysregulated stress axis, metabolic dysfunctions etc.). As such, LM is an adjunct form of treatment that helps to bridge the best aspects of public health and conventional clinical medicine.

Hippocrates can be seen as the father of lifestyle medicine. He often used lifestyle modifications such as diet and exercise to treat diseases such as diabetes, what is today called lifestyle medicine. He is often quoted with "Let food be your medicine, and medicine be your food" and "Walking is man's best medicine".[6]

Lifestyle medicine is often prescribed in conjunction with a typical medicine approach of pharmacotherapy. For example, diabetic patients who may be on medication to help control the blood glucose levels in the short term might also be prescribed a lifestyle intervention of a healthy diet and exercise to assist in the long term management of their pathology. In some cases lifestyle interventions are more effective when augmented with appropriate pharmacotherapy, as with tobacco use where medications such as bupropion may be prescribed to assist the patient to quit smoking and adopt a healthy lifestyle change.

The Australasian Society of Lifestyle Medicine (ASLM) has been set up by representatives of professions involved in the field under the auspices of Southern Cross University. It is intended to represent the 14 disciplines eligible for medical benefits under the Enhanced Primary Care (EPC) system.

The European Lifestyle Medicine Organization (ELMO) is a scientific, medical organization dedicated to research, prevention and treatment of chronic diseases and lifestyle-related diseases (syn: noncommunicable diseases NCDs). ELMO is located in Geneva, Switzerland.

The American College of Lifestyle Medicine (ACLM) provides leadership and assistance, facilitating lifestyle medicine clinicians' pursuits of continuing medical education, practice knowledge, leadership skills, and research information needed to provide quality patient care and best counsel patients with respect to lifestyle-related diseases.

The Italian Lifestyle Medicine Association leads health promotion and lifestyle as medicine in Italy. Founded in 2015 in the home of Mediterranean Diet, ILMA community is growing rapidly and its Board has immediately organized and supported the first Lifestyle Medicine course at "Sapienza" University of Rome - School of Medicine and Dentistry. ILMA also contributed to Lifestyle Medicine growing with the first book about it written in Italian language.[7]

See also

References

  1. ↑ World Health Organization. "Global status report on noncommunicable diseases 2010". World Health Organization. Retrieved 7 July 2015.
  2. ↑ Stephen, Lim (December 2012). "A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010". The Lancet 380 (9859): 2224–2260. doi:10.1016/S0140-6736(12)61766-8. PMID 23245609. Retrieved 7 July 2015.
  3. ↑ Bloom. "The global economic burden of noncommunicable diseases. Program on the global demography of aging." (PDF). Harvard School of Public Health. Harvard Initiative for Global Health. Retrieved 7 July 2015.
  4. ↑ Kvaavik, Elisabeth (April 2010). "Influence of Individual and Combined Health Behaviors on Total and Cause-Specific Mortality in Men and Women: The United Kingdom Health and Lifestyle Survey". JAMA Internal Medicine 170 (8): 711–8. doi:10.1001/archinternmed.2010.76. PMID 20421558. Retrieved 7 July 2015.
  5. 1 2 Sagner, Michael (October 2014). "Lifestyle medicine potential for reversing a world of chronic disease epidemics: from cell to community". International Journal of Clinical Practice 68 (11): 1289–1292. doi:10.1111/ijcp.12509. PMID 25348380. Retrieved 7 July 2015.
  6. ↑ Hakim, Chishti (1988). The Traditional Healer's Handbook. Vermont: Healing Arts Press. p. 11. ISBN 0892814381.
  7. ↑ Maselli, Luigi (2015). Lifestyle Medicine: la scienza del cambiamento efficace. Italy: Edizioni SAPIO. ISBN 9788862283472.

External links

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