Lifestyle MedicineLifestyle Medicine is the use of a whole food, plant-predominant dietary lifestyle, regular physical activity, restorative sleep, stress management, avoidance of risky substances and positive social connection as a primary therapeutic modality for treatment and reversal of chronic disease. Modern technologies and environmental changes have not only reduced activity and led to the consumption of more food that is less healthy, they have also led to a more rushed and stressed society that is less able to find adequate rest, sleep, and social and spiritual support systems.
Whereas infectious diseases were the primary cause of death in the early 20th century, CVD and cancer have now assumed dominance in mortality (Figure 1). 9 Additionally, obesity and diabetes are inflammatory conditions that not only contribute to CVD and cancer but also serve as profound comorbidities; their shared etiologies promote one another.
It is vital that health professionals clearly communicate that there is no doubt about the basic constituents of a healthy lifestyle; including daily moderate vegan diet physical activity, avoidance of tobacco and chronic stress, a diet high in whole plant‐based foods and minimising consumption of meat and processed foods.
Additionally, the cost per quality-adjusted life-years (QALYs) was much lower for the lifestyle intervention relative to the implementation of metformin therapy (cost per QALY: $1,100 versus $31,300, resp.). Thus, lifestyle costs less and performs better in one of the largest, growing chronic diseases in developed countries, type 2 diabetes.
Recent technological advances - or even older technologies available to low-income populations, such as automated text messages to patients about relevant health behaviors - offer potential low-cost breakthrough opportunities to support lifestyle-related clinical and clinician counseling services beyond the clinical setting.
Furthermore, compelling evidence is emerging for the role of persistent organic pollutants (POPs), such as polychlorinated biphenyls, dioxins, and pesticides, in chronic diseases such as type 2 diabetes 72 - 75 by impacting beta-cell function 72 , insulin signaling and secretion 73 , and mitochondrial function 74 , as well as in the development of obesity by influencing adipocyte differentiation and neural circuits that control eating behavior (these toxicants have also thus been termed obesogens”) 76 Porta et al. 77 analyzed serum concentrations of 19 POPs in 919 people in Spain and found that more than half of the population studied had concentrations in the top quartile of ≥1 POPs.
Because stress reactions are so closely related to sleep patterns, lifestyle prescriptions for increased meditation and relaxation techniques are the initial treatment of choice for insomnia.58 Incorporation of rest and renewal into a patient's daily life frequently requires an understanding of a patient's spiritual resources and perspective on life.