Lifestyle medicine (LM) is a branch of

medicine Medicine is the science and Praxis (process), practice of caring for patients, managing the Medical diagnosis, diagnosis, prognosis, Preventive medicine, prevention, therapy, treatment, Palliative care, palliation of their injury or disease, ...

focused on

preventive healthcare Preventive healthcare, or prophylaxis, is the application of healthcare measures to prevent diseases.Hugh R. Leavell and E. Gurney Clark as "the science and art of preventing disease, prolonging life, and promoting physical and mental health a ...

and

self-care Self-care has been defined as the process of establishing behaviors to ensure holistic well-being of oneself, to promote health, and actively manage illness when it occurs. Individuals engage in some form of self-care daily with food choices, ...

dealing with prevention, research, education, and treatment of disorders caused by lifestyle factors and

preventable causes of death Preventable causes of death are causes of death related to risk factors which could have been avoided. The World Health Organization has traditionally classified death according to the primary type of disease or injury. However, causes of death ...

such as

nutrition Nutrition is the biochemistry, biochemical and physiology, physiological process by which an organism uses food and water to support its life. The intake of these substances provides organisms with nutrients (divided into Macronutrient, macro- ...

physical inactivity Physical inactivity refers to the lack of moderate-to-vigorous physical activity in a person's lifestyle. It is distinct from sedentary behavior. Health effects The World Health Organization (WHO) has defined physical inactivity as a global public ...

chronic stress Chronic stress is the physiological or psychological response induced by a long-term internal or external stressor. The stressor, either physically present or recollected, will produce the same effect and trigger a chronic stress response. There ...

, and

self-destructive behavior Self-destructive behavior is any behavior that is harmful or potentially harmful towards the person who engages in the behavior. Self-destructive behaviors are considered to be on a continuum, with one extreme end of the scale being suicide. S ...

s including the consumption of

tobacco products Tobacco is the agricultural product of the leaves of plants in the genus ''Nicotiana'', commonly termed ''tobacco plants''. All species of ''Nicotiana'' contain the addictive drug nicotine—a psychostimulant alkaloid found in all parts of t ...

and

drug A drug is any chemical substance other than a nutrient or an essential dietary ingredient, which, when administered to a living organism, produces a biological effect. Consumption of drugs can be via insufflation (medicine), inhalation, drug i ...

alcohol abuse Alcohol abuse encompasses a spectrum of alcohol-related substance abuse. This spectrum can range from being mild, moderate, or severe. This can look like consumption of more than 2 drinks per day on average for men, or more than 1 drink per ...

. 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 disease Cardiovascular disease (CVD) is any disease involving the heart or blood vessels. CVDs constitute a class of diseases that includes: coronary artery diseases (e.g. angina, heart attack), heart failure, hypertensive heart disease, rheumati ...

diabetes Diabetes mellitus, commonly known as diabetes, is a group of common endocrine diseases characterized by sustained high blood sugar levels. Diabetes is due to either the pancreas not producing enough of the hormone insulin, or the cells of th ...

metabolic syndrome Metabolic syndrome is a clustering of at least three of the following five medical conditions: abdominal obesity, high blood pressure, high blood sugar, high serum triglycerides, and low serum high-density lipoprotein (HDL). Metabolic syndro ...

and

obesity Obesity is a medical condition, considered by multiple organizations to be a disease, in which excess Adipose tissue, body fat has accumulated to such an extent that it can potentially have negative effects on health. People are classifi ...

. Lifestyle medicine focuses on

educating Education is the transmission of knowledge and skills and the development of character traits. Formal education occurs within a structured institutional framework, such as public schools, following a curriculum. Non-formal education also fol ...

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 food An ultra-processed food (UPF) is a grouping of processed food characterized by relatively involved methods of production. There is no simple definition of UPF, but they are generally understood to be an industrial creation derived from natural ...

s such as a

Mediterranean diet The Mediterranean diet is a concept first proposed in 1975 by the American biologist Ancel Keys and chemist Margaret Keys. The diet took inspiration from the eating habits and traditional food typical of Crete, much of the rest of Greece, and s ...

or whole food, plant-predominant dietary patterns. Poor lifestyle choices like dietary patterns, physical inactivity,

tobacco use Tobacco is the common name of several plants in the genus ''Nicotiana'' of the family Solanaceae, and the general term for any product prepared from the cured leaves of these plants. More than 70 species of tobacco are known, but the chi ...

alcohol addiction Alcoholism is the continued drinking of alcohol despite it causing problems. Some definitions require evidence of dependence and withdrawal. Problematic use of alcohol has been mentioned in the earliest historical records. The World Hea ...

and dependence,

addiction Addiction is a neuropsychological disorder characterized by a persistent and intense urge to use a drug or engage in a behavior that produces natural reward, despite substantial harm and other negative consequences. Repetitive drug use can ...

and dependence, as well as psychosocial factors, e.g. chronic stress and lack of social support and community, contribute to

chronic disease A chronic condition (also known as chronic disease or chronic illness) is a health condition or disease that is persistent or otherwise long-lasting in its effects or a disease that comes with time. The term ''chronic'' is often applied when the ...

. 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 The transtheoretical model of Behavioural change theories, behavior change is an Integrative psychotherapy, integrative theory of therapy that assesses an individual's readiness to act on a new healthier behavior, and provides strategies, or proc ...

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 Motivational interviewing (MI) is a counseling approach developed in part by clinical psychologists William R. Miller and Stephen Rollnick. It is a directive, client-centered counseling style for eliciting behavior change by helping clients to e ...

(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 Pharmacotherapy, also known as pharmacological therapy or drug therapy, is defined as medical treatment that utilizes one or more pharmaceutical drugs to improve ongoing symptoms (symptomatic relief), treat the underlying condition, or act as a p ...

. 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 Exercise medicine is a branch of medicine that deals with physical fitness and the prevention and treatment of injuries and illness with exercise. In some countries, Sport and Exercise Medicine (SEM) is a recognized medical specialty (with simi ...

and

Physiatry Physical medicine and rehabilitation (PM&R), also known as physiatry, and outside the United States as physical and rehabilitation medicine (PRM), is a branch of medicine that aims to enhance and restore functional ability and quality of life ...

) 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 Interprofessional education (also known as inter-professional education or "IPE") refers to occasions when students from two or more professions in health and social care learn together during all or part of their professional training with the obj ...

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.

Characteristics

See also

References

Further reading