Lifestyle is Medicine

Picture6The term “lifestyle” refers to the way that an individual lives, this includes what they eat, the work and social activities they engage in, and the relationships that they have. Lifestyle reflects conscious and unconscious beliefs, attitudes, interests, social values and self concept.  It is influenced by culture, family, friends, education, membership in social groups and economic status.

Lifestyle Medicine is the therapeutic use of evidence-based lifestyle interventions to treat and prevent lifestyle-related health conditions. Lifestyle-related health conditions include: allergies, anxiety, arthritis, asthma, back pain, certain cancers, chronic inflammatory conditions such as ulcerative colitis, chronic pain syndromes such as fibromyalgia, depression, diabetes, gallbladder disease, heart disease, hypertension, obesity, and skin disorders such as psoriasis. These conditions all have one or more of the same underlying causes: Eating habits that lead to inflammation and fat storage, lack of physical activity, unresolved emotional conflicts and uncontrolled stress responses. Evidence-based interventions include plant-based nutrition, stress management techniques, fitness assessments with physical activity prescriptions and relationship skills workshops. Lifestyle medicine empowers individuals with the knowledge and skills to make effective behavior changes that address the underlying lifestyle causes of disease.

Table 1: Lifestyle Medicine Compared to Other Approaches to Patient Care

Type of Practice Features
 

Lifestyle Medicine1

-Emphasis on promoting behavior changes that allow the body to heal itself.
-Focus on evidence-based optimal  nutrition, stress management and fitness prescriptions
-Patients are active partners in their care
-Treats the underlying lifestyle causes of disease
-Physician/Provider educates, guides and supports patients to make behavior changes
-Medications used as an adjunct to therapeutic lifestyle changes
-Patient’s home and community environment are assessed as contributing factors..
Conventional Medicine1 – Emphasis on making a diagnosis and treatment with pharmaceuticals or  surgery
-Patient is passive recipient of care
-Focuses on symptoms or signs of disease not the underlying lifestyle causes.
-Patient is not expected to make significant behavior changes
– Physician/Provider directs care – medical model.
– Medications are the primary therapeutic intervention.
-Patient’s home and community environment are typically not considered
Integrative Medicine2 -Emphasis on integrating conventional treatment with alternative treatments.
Focus on treatments such as acupuncture, biofeedback and nutraceuticals along with some evidence-based lifestyle interventions.
-Patient may be an active or passive recipient of care
Treats symptoms or signs of disease not the underlying lifestyle causes.
-Patient may not be required to make significant behavior changes
-Physician/Provider directs care – medical model
-Patient’s home and community environment typically not considered
Functional Medicine3,4 -Emphasis on evidence-based, systems biology approach that addresses underlying dysfunction rather than treating symptoms.
-Focus on evidence-based lifestyle interventions with the use of pharmaceuticals, nutraceuticals, and biologicals when appropriate.
-Patients are active participants in their care.
-Patients are encouraged to make lifestyle changes to improve their health.
-Physician guides and supports patients to take control of their own health.
-Environmental exposures and social dynamics are assessed as contributing factors.
Naturopathy/
Homeopathy5
-Emphasis on homeopathic and naturopathic treatments such as herbs and colonics.
-Treatments may be based on traditional practices rather than scientific evidence.
-Focuses on treating presenting symptoms but may address underlying lifestyle causes
-Patients may be active or passive recipients of care depending on the practitioner.
– Patient may be required to make significant behavior changes
-Provider directs care based on medical model
-Patient’s home and community environment may be considered.

Picture7Another field that is often confused with lifestyle medicine is nutrition. Most of what we eat is based on unconscious cultural beliefs and custom not scientific evidence. In fact the scientific evidence indicates that many of the foods we commonly eat may be harmful and directly cause ill health and disease. The body will heal itself when the ongoing damage stops. Lifestyle medicine advises patients about which foods to avoid to stop damaging their bodies and which foods to eat to promote healing.

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References
1.  Egger G, Binns A, Rossner S.  Lifestyle Medicine.  Syndney: McGraw Hill; 2008.
2.  Rakel D.  Integrative Medicine, 3rd Ed.  Philadelphia: Saunders; 2012.
3.  Jones DS, Hofmann L, Quinn S, 21st Century Medicine: A New Model for Medical Education and Practice, The Institute for Functional Medicine: Gig Harbor, WA, 2009.
4.  Baker SM, et al.  Textbook of Functional Medicine. The Institute for Functional Medicine:        Gig Harbor; 2010.
5.  Dooley T.  Homeopathy, Beyond Flat Earth Medicine, 2nd Ed.  San Diego: Timing       Publications; 2002.