What is lifestyle medicine

The current generic structure of the field is summarised here under four main headings: the science, the art, the materials and the procedures. Specific aspects of the discipline are covered in other articles in this issue of Australian Journal of General Practic e. Anthropogens have varying levels of potency depending on a range of factors such as genes, environment and exposure. Isolating nutrients from foods ignores the interactive relationship of nutrients found in complete meals, just as considering inactivity, sleep or social factors in the absence of nutrition provides only part of the answer to chronic disease manifestation.

The systems model of interactions between determinants is an important aspect of a modern lifestyle medicine approach to chronic diseases and conditions because it implies that all influencing determinants, and not just the obvious, need to be managed for an optimal health outcome. The basic clinical skills required for lifestyle medicine are similar to those necessary for conventional healthcare — diagnosis, prescription and counselling in particular.

However, in lifestyle medicine the components require a significant emphasis on motivation and can include both academic and professional skills in behaviour change.

These comprise skills used in persuasion and advertising, such as coaching, 17 coaxing and nudging patients from extrinsic to intrinsic motivation to facilitate change in lifestyle behaviours. Diagnosis in lifestyle medicine is focused more on determinants and their drivers, rather than the disease itself. Pharmaceutical prescription is still important but is best seen as an adjunct to therapeutic lifestyle prescription and intervention. In cases of iatrogenesis, this may also include programmed deprescription to reduce ineffective medication use or combinations.

Counselling in lifestyle medicine relies heavily on motivational interviewing but also focuses on self-management. This can come through such techniques as general practitioner management counselling, referrals, peer-to-peer contact, social prescription and support through shared medical appointments outlined later in this article. The role of the patient evolves from a minimally informed recipient to an active collaborator in the patient—provider relationship.

The digital revolution has resulted in a vast array of tools that can be used to monitor and provide feedback on determinants related to lifestyle such as exercise, cardiac activity, blood pressure, blood glucose, sleep and a growing list of other factors.

Mobile health mHealth is becoming more widespread, with monitoring and advice applications available on mobile phones. Internet reminders, education and information about disease management are increasingly more available and conveniently accessed through wearable devices, 18 although the effectiveness of some of these remains to be proven. Several existing and developing procedures are appropriate for lifestyle medicine.

These include existing practices from conventional medicine — such as referral, medication and surgery — as well as some new, albeit currently less evidence-based, procedures. These are covered in more detail elsewhere, 2 but discussed here in summary.

This should be a component of all lifestyle-related chronic disease management. Training can be standalone and range from individual assistance given by a health professional 20 to group learning processes. SMAs provide more time with the doctor, faster access to care, increased peer support and greater opportunity for self-management. A doctor provides individual sequential consultations during part of the session, with participation and input of the group.

As well as referrals to other health professionals, referrals can be to a range of activities, interests and services in a community, as well as to community centres with lifestyle programs.

This has yet to be evaluated in the clinical medical setting. Although most commonly used in health services training, peer-to-peer learning has value in lifestyle medicine, where people who have had a specific disease for a long time can help others with the same disease, either through online or face-to-face interaction.

Telephone triaging is used increasingly in the UK to direct patients to the most appropriate form of management or type of program. This allows physicians to better make use of professional time to deal with the wide span of chronic diseases. Cases are triaged by telephone within a centre according to levels of need, with different health professionals assigned to counsel for low-acuity chronic disease management cases, leaving the physician to deal with higher-acuity cases. This means that patients with long-term conditions, which require more attention and self-management opportunities, can get the required level of help while the centre manages limited resources.

Although not a departure from conventional medicine, lifestyle medicine provides an adjunct approach to managing lifestyle and environmental determinants of many modern chronic diseases. Lifestyle medicine fits a role between clinical medicine and public health, encouraging clinicians to consider both the proximal and distal determinants anthropogens of chronic disease, as well as markers, risk factors and behaviours.

Self-management, SMAs, social prescription and deprescription , telephone triaging and peer-to-peer assistance provide adjunct procedures for conducting lifestyle medicine consultations. New tools such as mHealth may be useful to capitalise on modern technological developments and increase treatment options. This is a work in progress, and the field will expand considerably with testing and evaluation of these approaches.

Did you know you can now log your CPD with a click of a button? Background Changes in living conditions throughout history typically result in changes in the pattern of diseases. The Pillars of Lifestyle Medicine Mental Wellbeing Lifestyle medicine teaches proven techniques to reduce stress and help people with relaxation. Practitioners support people to find purpose in life and improve health through connection with nature. 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.

These eating patterns may include Mediterranean, plant-based or lower carbohydrate diets, as well as other evidence-based eating patterns. Physical Exercise Lifestyle Medicine supports people to choose ways they could incorporate more physical activity in their lives, as well as reducing time spent sitting down.

Sleep Lifestyle Medicine supports people to achieve good quality sleep and avoid behaviours which can impair sleep quality. Minimising harmful substances or behaviour Lifestyle Medicine supports people to stop smoking, reduce excessive alcohol consumption, avoid addictive substances and behaviors such as gambling or harmfully excessive internet or social media use.

It also raises awareness of avoidable environmental toxins and the risks associated with polypharmacy. A multidisciplinary multi-system approach To be an effective antidote to the chronic disease problem, lifestyle medicine requires a multidisciplinary multi-system approach — which embraces and works alongside other approaches such as self care, self management, social prescribing and group consultations. Supporting individuals to make positive changes The lifestyle medicine approach seeks to support individuals to make positive behaviour changes.

In practical terms, Lifestyle Medicine bridges the gap between health promotion and clinical practice. It involves clinicians, public health professionals, healthcare executives, researchers, scientists and educators working together to prevent, manage and treat conditions that result from:.

In fact, the future of Lifestyle Medicine, while rooted in clinical practice and health policy, will be innovative community applications of the principles of Lifestyle Medicine both small and large scale , and by utilising technology to improve processes, outcomes, cost effectiveness and accessibility.

Lifestyle Medicine is growing in popularity around the world as a comprehensive, evidence-based approach to the challenges faced by our society and our health system. If you support what we are doing, please become a member or sign up to our newsletter in the footer below to be kept informed. As well as being an evidence-based discipline, Lifestyle Medicine is a global movement for change in health, healthcare, society, environment and our future.

It relies on the collective will of health professionals from around the world to help advocate for and inspire tangible change. If you support lifestyle intervention as the first-line treatment for many chronic diseases, and advocating for policy change to create a healthier society and environment, join a like-minded group of passionate, resourceful and driven change-makers, and help us achieve our mission.

With every new or renewing member or supporter, our collective voice gets louder, politicians take more notice, and our initiatives have more impact. No other medicine can match that. In order to address this growing burden, we must actively and effectively deal with the root causes of the problem.

Many chronic conditions — the most common including cardiovascular disease, cancer, chronic respiratory conditions, chronic musculoskeletal conditions, diabetes and mental health conditions- share common risk factors that are largely preventable or treatable.