Lifestyle medicine is an evidence-based discipline which aims to support patients to prevent, manage and reverse certain chronic conditions, using supported behaviour change skills and techniques to create, and sustain lifestyle changes.
What is lifestyle medicine?
Lifestyle medicine focuses on helping patients to eat more healthily, stay active, sleep better, improve social connections and mental health, and reduce harmful substance use. It also considers broader factors impacting on individuals’ health and wellbeing including ecological health, poverty and health inequality.
The six pillars of lifestyle medicine
- Mental wellbeing
Lifestyle medicine teaches proven techniques to reduce stress and help people with relaxation. Lifestyle medicine doctors support people to find purpose in life and improve health through connection with nature. - Minimising harmful substances
Lifestyle Medicine supports people to stop smoking, reduce excessive alcohol consumption, avoid addictive substances and behaviours such as gambling or excessive internet or social media use. - Healthy relationships
Lifestyle Medicine supports people to develop and sustain healthy and meaningful relationships and increase social connection to reduce stress and promote both physical and mental health. - Healthy eating
Lifestyle Medicine supports people to reduce consumption of ultra- processed foods by teaching the knowledge and skills required to follow healthier eating patterns of people’s own choice. - Sleep
Lifestyle Medicine supports people to achieve good quality sleep and to avoid behaviours which have the potential to impair sleep quality. To assess your sleep quality by your own you can use a subjective questionnaire such as the Pittsburgh Sleep Quality Index (PSQI). This self-report questionnaire evaluates various aspects of sleep over a 1-month time interval. - Physical activity
Lifestyle Medicine supports people to choose ways in which they could incorporate more physical activity in their lives, as well as reducing time spent sitting down.
Pregnancy and reproductive health
Lifestyle medicine plays an outsized role in reproductive health as the impact on women in the months to years prior to pregnancy not only affects maternal health but also the health of her children throughout their lifespan.
The impact of maternal lifestyle during early pregnancy can affect the developing fetus in a variety of fundamental biological processes known as epigenetic imprinting. Maternal epigenetic imprinting can also affect the fetal ovarian cells and therefore the health of future grandchildren.
Given the importance of lifestyle choices, many women are highly motivated in the preconception period and during pregnancy to improve their health.
Cultural norms and peer influence can support or hinder these changes. Women whose partners continue to smoke have higher rates of relapse after smoking cessation.
Pregnant women exercise at lower rates than evidence-based guidelines recommend, often because physicians are reluctant to recommend exercise to pregnant women.
On a positive note, peer support can also support lifestyle change as shown by the Centering Pregnancy model where the power of supportive peers in group prenatal visits led to improved pregnancy outcomes.
Pregnancy and the preconception period offer many opportunities for research, education, and advocacy for lifestyle medicine. While prenatal vitamins, folic acid, and supplemental iron are widely prescribed and taken by women before and during pregnancy, natural, whole food sources of these necessary nutrients are often missing.
Improved diet quality not only improves fertility but can also decrease the risk of adverse pregnancy outcomes. Physiological changes of pregnancy may lead to insulin resistance and hypertension, not only increasing risk in the current pregnancy but also increasing risk for future development of hypertensive disease and diabetes.
Unfortunately, poor communication between prenatal and comprehensive primary care providers and inadequate postpartum care lead to lost opportunities to diagnose and provide early lifestyle change interventions.
As a result, women miss an opportunity to substantially delay, or even entirely prevent future onset of these lifestyle-related conditions.
The postpartum period is also a time when pressures of childcare and cultural norms promoting sedentary behaviour can lead to women not getting sufficient exercise.
Studies have shown a substantial benefit to exercise in the prevention of future disease, again pointing to the importance of lifestyle medicine in women’s health.
Restless leg syndrome is a frequent cause of insomnia in women and rises to nearly a third of all pregnant women, yet the fundamental mechanism and optimal intervention remain elusive. The syndrome is associated with low iron and folate levels, and patients should be informed that natural plant-based sources of these nutrients may decrease their symptoms and resulting insomnia.
Sleep apnea rises with the physiological changes of pregnancy and has been associated with the onset of preeclampsia, yet again remains underdiagnosed and undertreated.
In addition to the acute financial and physical stressors women encounter in pregnancy, many women enter pregnancy with the legacy of chronic stressors.
Eat to live, not live to eat
Most of the prevailing chronic diseases in the world have an important nutritional component by directly causing a specific disease, enhancing the risk through phenomena of promotion, exerting a beneficial effect in decreasing risk, or preventing the disease.
International studies in geographic pathology have shown that a given disease may have vastly different incidence and mortality as a function of residence. Laboratory research in animal models can reproduce accurately what is learned through international research and provide the basis for examining relevant hypotheses and, more importantly, proposed mechanisms of action.
Validation of these approaches can be the basis for public-health recommendations and health-promotion activities. Through such techniques, it has been found that regular intake of foods with saturated fats such as meat and certain dairy products raise the risk of coronary heart disease. The total mixed-fat intake is associated with a higher incidence of the nutritionally linked cancers, specifically cancer of the postmenopausal breast, distal colon, prostate, pancreas. ovary, and endometrium.
The associated genotoxic carcinogens for several of these cancers are heterocyclic amines, which also play a role in heart disease causation, and these are produced during the broiling and frying of creatinine-containing foods such as meats.
Monounsaturated oils such as olive or canola oil are low-risk fats as shown in animal models and through the observation that the incidence of specific diseases is lower in the Mediterranean region, where such oils are customarily used.
High salt intake is associated with high blood pressure and with stomach cancer, especially with inadequate intake of potassium from fruits and vegetables and of calcium from certain vegetables and low-fat dairy products.
Vegetables, fruits, and soy products are rich in antioxidants that are essential to lower disease risk stemming from reactive oxygen systems in the body. Green and black teas are excellent sources of antioxidants of a polyphenol nature. as is cocoa and some chocolates.
Nutritional lifestyles that offer the possibility of a healthy long life can be adopted by most populations in the world.
Supporting individuals to make positive changes
The lifestyle medicine approach seeks to support individuals to make positive behaviour changes. It is not about blaming or lecturing people.
It recognises the need for, and the continued importance of, other therapeutic interventions in healthcare including surgical and pharmaceutical where these are determined to be necessary, appropriate and effective. Where it has the proven potential to have the most impact, however, lifestyle medicine simply needs to be a greater part of the healthcare mix.
Stress management and lifestyle medicine are closely connected areas that focus on promoting well-being and preventing health issues by addressing lifestyle factors, particularly stress.
Adopting a healthy lifestyle, including stress management practices, can have a profound impact on preventing and managing various health conditions. It’s essential to tailor strategies to individual needs and circumstances for optimal effectiveness.
Lifestyle medicine is often considered a holistic approach to healthcare, as it recognizes the connection of various lifestyle factors and their impact on health.
Lifestyle medicine doctors typically work with patients to assess their current lifestyle habits and develop personalized plans to address areas that may be contributing to health issues. They may use a combination of diet and nutrition counselling, exercise prescriptions, stress management techniques, and behavioural therapies to help patients make sustainable changes that can improve their overall well being.
