American Journal of Lifestyle Medicine

The majority of deaths in the United States are attributable to lifestyle-associated chronic diseases. Therapeutic encounters must now routinely address lifestyle-related behavior changes and promote patients’ active involvement in self-care and chronic disease management. Positive psychology has been recognized in the realm of lifestyle medicine for its potential applications in effecting patient behavior change. One notable framework within positive psychology that is well suited for facilitating specific behavior changes is hope theory, which can be used to elicit change talk and build agency among patients with chronic diseases. This review explores key literature in positive psychology and hope theory and its practical applications to direct patient care, which includes an illustrative case study. There are still many unexplored intersections of health-related variables and hope. The cognitive framework of hope theory lends itself well to a broad range of situations, including brief ambulatory encounters. Clinicians will be instrumental in increasing our understanding of how hope theory can be applied to the therapeutic encounter. There are simple and efficient ways to innovate in this area. Having information about a patient’s hope has the potential to make empathic connections easier and create opportunities to ask specific questions to help patients overcome barriers.

There is a large amount of food waste in the United States, with high financial and environmental costs. Okara, also known as soybean (curd) residue or soy pulp, is the byproduct of tofu and soy milk, has high nutrition value, and is available at a reasonable price. While it is often disposed, it may instead be incorporated into our daily diet in a variety of novel healthy products. Public health practitioners may help address the issue of food waste by encouraging the use of “waste” such as okara through work with consumers and companies. These efforts may lead to increased food security and promote the health of humans and the environment.

Financial behaviors play an important role in promoting or reducing financial stability and may have an impact on health outcomes, in general. Hope theory is a framework applicable to promoting behavior change, including financial behavior change. This article describes the hope promoting components of a novel financial education and coaching program and the significant improvement in hopefulness demonstrated by women who participate in the program, as measured in the Finances First randomized controlled trial.

Chronic diseases pose many challenges to health care providers and the health care system from a human capital, logistic, and financial perspective. To overcome these challenges, efficient and effective health care delivery models that address multiple chronic conditions need to be leveraged. Shared medical appointments are one potential solution to address these issues. This article offers a brief history of group visits and shared medical appointments and reviews the available data regarding their outcomes. It describes the benefits of using lifestyle medicine as the primary therapeutic modality within a shared medical appointment to treat, reverse, and prevent chronic disease. Key considerations and action steps for the implementation of lifestyle medicine shared medical appointments (LMSMAs) are outlined and the potential delivery of these services via telehealth is explored.

Background. Differences in socioeconomic status contribute to inequalities in lifestyle habits and burden of noncommunicable diseases. We aimed to examine how the effects of a 1-year structured lifestyle education program associate with the participant’s educational level and socioeconomic area (SEA) of residence. Methods. One hundred individuals (64% women) with high cardiovascular risk were included. Education level (nonuniversity vs university degree) was self-reported and SEA (low vs high) defined by living in different SEAs. Lifestyle habits and quality of life were self-reported, cardiovascular risk factors and Framingham 10-year cardiovascular disease risk were measured at baseline and after 1 year. Results. Sedentary behavior decreased in both nonuniversity degree and low SEA group over 1 year, with a significantly greater improvement in daily activity behavior in low- compared with high-SEA group. Abdominal obesity decreased significantly more in the nonuniversity compared with the university degree group. Cardiovascular risk and quality of life improved in all groups, however, with greater discrimination when using educational level as the dichotomization variable. Conclusion. The results are clinically and significantly relevant, suggesting that low socioeconomic status measured both as educational level and SEA are no barriers for changing unhealthy lifestyle habits and decreasing cardiovascular risk after participation in a lifestyle program.

There is a tendency to accept anxiety as an inevitable part of living in a stressful modern world. However, simple dietary changes can help attenuate the stress response. While there are several approaches to treating anxiety, research by Peter Roy-Byrne in 2015 has shown that only 50% to 60% of people respond to medication and psychotherapy, and only a quarter of patients have complete resolution of their symptoms. According to statistics from the National Institute of Mental health, prior to the COVID-19 pandemic, anxiety disorders were the most common mental health disorder in the United States, about 3 times more common than depression (18.1% vs 6.7%). A recent Express Scripts survey showed the percent increase in the number of new prescriptions for antianxiety medications by the middle March 2020 for antianxiety medications was 37.7%, underscoring the likely rise in anxiety associated with the pandemic. While traditional medications and therapies are well needed, to beat stress during times of a pandemic, it is important to think more broadly about how we can best affect our mental well-being. One of those ways is through our nutrition and dietary habits, and research by Opie et al in 2015 demonstrates that our dietary choices are more crucial than ever. This column reviews foods and substances that are important to consider in managing anxiety.

A child’s development is embedded within a complex system of relationships. Among the many relationships that influence children’s growth and development, perhaps the most influential is the one that exists between parent and child. Recognition of the critical importance of early parent-child relationship quality for children’s socioemotional, cognitive, neurobiological, and health outcomes has contributed to a shift in efforts to identify relational determinants of child outcomes. Recent efforts to extend models of relational health to the field of child development highlight the role that parent, child, and contextual factors play in supporting the development and maintenance of healthy parent-child relationships. This review presents a parent-child relational health perspective on development, with an emphasis on socioemotional outcomes in early childhood, along with brief attention to obesity and eating behavior as a relationally informed health outcome. Also emphasized here is the parent–health care provider relationship as a context for supporting healthy outcomes within families as well as screening and intervention efforts to support optimal relational health within families, with the goal of improving mental and physical health within our communities.

The COVID-19 pandemic has made it challenging for individuals and families to maintain a healthy lifestyle, quality of life, and well-being. Preliminary evidence have suggested that higher odds of both mortality and severity of the COVID-19 are closely associated to unhealthy lifestyle behaviors. Thus, in an effort to contribute to this challenging global situation, we joined a group of lifestyle medicine researchers and/or practitioners to provide scientifically sound information, recommendations, resources, and suggestions related to the main pillars of lifestyle medicine (healthy eating, physical activity, sleep, tobacco/alcohol, stress management, relationships, and planetary health) that may help health practitioners to support clients and patients maintain a healthy lifestyle during (and after) the COVID-19 crisis.

Canada’s population is increasing, and aging. These demographic patterns are accompanied by a growing awareness and evidence base of the benefits to society of leading a healthy and active life. The Canadian Academy of Lifestyle Medicine (CALM) was created to fill a knowledge gap in the Canadian public: how to lead a healthier and more active life. CALM aimed to address these challenges by confronting the lack of assistance modern medicine provides. As a diverse collaborative network using a lifestyle medicine philosophy, CALM’s objective was to generate discussions and examine lifestyle medicine approaches to improving overall health and well-being for Canadians. CALM aimed to engage patients whose access to health care is through a physician and provide an innovative platform to support care and healthy decision making. Despite perceived widespread support, intense planning, and extensive development, CALM was slow to gain traction and realize its full potential. This article describes the experiences and lessons learned in creating CALM from the perspective of the leadership team. Although most CALM activities have ceased, virtual space and social media remain active so too does the work of the leadership team, striving to enable Canadians to develop behaviors that will improve their lifestyle, and their overall well-being.

Research demonstrates lower school participation in children with sensory disorders. However, the scientific body of evidence supporting existing sensory intervention modalities is difficult to tackle. More specifically, the literature appears poorly organized, with a highly variable terminology, often with nonoverlapping definitions and lack of good keywords classification that would help organize the diversity of approaches. This systematic review organizes the body of evidence for 3 specific approaches (sensory based, sensorimotor, and sensory integration) and questions their efficacy in improving school participation for children with sensory disorders. Two methods were compared: first, a standard systematic review of the literature in 3 databases using appropriate keywords and descriptors, then an original method based on forward and backward citation connections. A total of 28 studies were retrieved, of which only 7 used the standard method for systematic reviews. For sensory-based approaches, the efficacy of weighted-vest varies according to different factors such as the protocol of use. For sensorimotor approaches, the efficacy of therapy balls, air cushions, platform swing, and physical exercise varies according to the child’s sensory characteristics. The efficacy of the sensory integration approach remains mixed across studies.

Objective. Physician physical activity (PA) counseling remains low due partly to lack of knowledge, emphasizing the importance of providing learning opportunities to develop competency, given the strong associations between PA and health. This study aimed to describe the behavior change techniques (BCTs) used in an “Exercise Expo” workshop and examine the workshop’s effectiveness for improving social cognitions to discuss exercise with patients. Methods. Second-year medical students (N = 54; M_age ± SD = 25.4 ± 2.95 years) completed questionnaires assessing attitudes, perceived behavior control (PBC), subjective norms, and intentions to provide PA counseling pre- and postworkshop. Repeated-measures analyses of variance evaluated changes in these theory of planned behavior constructs. Results. The most used BCTs included presenting information from credible sources, with opportunities for practicing the behavior and receiving feedback. Significant increases in attitudes, PBC and intentions to discuss PA were observed from pre-post Exercise Expo (P ≤ .01). No statistically significant differences in subjective norms were observed (P = .06). Conclusions. The Exercise Expo significantly improved social cognitions for PA counseling among medical students. Future interventions should target improvements in subjective norms to increase the likelihood the workshop improves PA counseling behavior. The evidence supports the usefulness of a workshop-based educational strategy to enhance medical students’ social cognitions for PA counseling.

Purpose. Regular physical activity is a cornerstone in the prevention and treatment of cardiovascular disease thanks to its anti-inflammatory effects. Thus, favoring the access to sports is of importance for promoting well-being. The aim of the present study was to investigate how the practice of different sports is distributed among different age groups and between men and women, by taking a picture of the medical certificate request in 2017 for sports in the population of the province of Modena, Italy. Methods. We analyzed the difference in distribution of requested medical certificate from 18 874 males and 7625 females stratified for age (<18 years, 18-40 years, and >40 years) and for different sporting disciplines (athletics, football, bike, swimming, basketball, volleyball, tennis, other team sports, other individual sports, and disabled sports). Results. Men requested medical certificates more than women (more than 2.5 times). The distribution of requested certificates differs significantly (chi-square test P < .0001) at different ages and between males and females of same age. Certificate for men aged less than 18 years were 7550 and for women were 4131 and the difference increase with age. Conclusions. In order to decrease the imbalance between men and women access to sports, it is mandatory to promote a healthy lifestyle and reduce, as consequence, cardiovascular risks, mostly in women after 40 years.