American Journal of Lifestyle Medicine

Purpose of the Research: Women’s reproductive health issues represent a major source of burden to quality of life, productivity, and health care cost, with uneven access to care. Foundational interventions based on lifestyle and food as medicine hold promise as one equitable way to improve individual and family health. In this paper, we summarize the lifestyle and culinary medicine approaches to two of the most common reproductive health diagnoses, polycystic ovary syndrome (PCOS) and infertility. Major findings: For women with PCOS and/or infertility, an overall healthy eating pattern, including a whole-food plant-based or Mediterranean diet, carries clear health benefits. Exercise is of benefit in the PCOS population, and likely so for infertility patients as well. Both diagnoses are risk factors for anxiety and/or depression, and so more attention to mental health and behavioral strategies is needed. Given these findings, the notion of lifestyle interventions holds promise, but studies are overall mixed. Conclusions: PCOS and infertility can respond well to lifestyle and culinary interventions. These approaches, currently underutilized, can be implemented widely with minimal cost, and can also improve obstetric, neonatal, and child health outcomes via epigenetic phenomena. More research is needed to elucidate the best target populations and delivery methods for such interventions.

This review is based on a presentation at the 2024 Annual Meeting of the American College of Lifestyle Medicine (ACLM), which showcased ACLM’s first clinical practice guideline on Lifestyle Interventions for Treatment and Remission of Type 2 Diabetes and Prediabetes in Adults. Our goal is to offer pragmatic implications of the guideline for everyday patient care, including case presentations showing how the guideline recommendations (key action statements) can be implemented. The target audience is any clinician or healthcare professional in a community or outpatient healthcare setting involved in managing non-pregnant adults with T2D, prediabetes or a history of gestational diabetes mellitus (GDM). Unique features of the ACLM guideline include placing lifestyle interventions as the foundation of T2D management and prevention, offering strategies for sustained behavior change, and emphasizing all six pillars of lifestyle medicine: plant-predominant nutrition, regular physical activity, restorative sleep, stress reduction, social connectedness, and avoiding risky substances. This review is not intended to substitute for the full guideline, which should be read before doing the recommended actions.

Background: The Philippines is facing a dual burden of managing both infectious and non-communicable diseases (NCDs). The Universal Health Care (UHC) Act mandates a transformative shift from curative focus to health promotion and disease prevention, where lifestyle medicine plays a crucial role. Objectivess: This paper outlines the initiatives taken by the Philippines to address the exponential burden of NCDs by integrating lifestyle medicine into the healthcare system. Specifically, we focus on: 1. Discussing the history and current state of evidence-based lifestyle interventions within the UHC framework. 2. How we have developed interprofessional competency-based lifestyle medicine education (CBME) programs for healthcare providers. 3. Our experience in establishing cross-sectoral collaboration and policy support for sustainable implementation of lifestyle interventions. Methods: The Philippine College of Lifestyle Medicine initiated the CBME framework integrated into hospitals, medical schools, and universities with pilot programs. Culturally relevant, community-engaged lifestyle medicine programs were initiated, resulting in the declaration of local ordinances. Conclusion: The realization of UHC priority goals can be enhanced by embedding lifestyle interventions within the healthcare system. Pilot programs demonstrate the scalability of lifestyle medicine interventions that require policy support, extensive cross-sectoral collaboration, community engagement, and recognition of lifestyle medicine as a reimbursable healthcare service.

Falls remain the leading cause of unintentional injuries across all age groups, prompting many emergency room visits. The annual estimated cost associated with falls is believed to exceed 100 billion dollars. In addressing this trend, health professional team members emerge as key players and can assume a crucial role in bridging the gap between lifestyle medicine and fall prevention. By imparting strategies aligned with the 6 pillars of lifestyle medicine, these professionals can educate individuals on risk factors, assess fall risk, and offer activities to mitigate the likelihood of future falls. This collaborative approach empowers all to take immediate and informed action, fostering a proactive stance against the prevalent issue of fall-related injuries. Through the background and practical strategies described in this paper, health professionals of various disciplines will have access to tools and knowledge to enhance their role in preventing falls using the lens of lifestyle medicine.

This article describes the factors contributing to ethnic health disparities and their impact on health equity in the United States. Historical examples of infectious diseases, such as smallpox, yellow fever, polio, HIV, and COVID-19, illustrate racial mortality differences that were eliminated by removing the diseases. In addition, disparities in cardiovascular death risk factors, including hypertension, type 2 diabetes, inflammation, hyperlipidemia, chronic kidney disease (CKD), and obesity, are examined. The adoption of whole food plant-based (WFPB) diets is proposed as a practical and culturally sensitive solution to mitigate these disparities and promote health equity. Evidence-based strategies are discussed to support implementation.

Lifestyle medicine (LM) is transforming health care by addressing the root causes of chronic diseases through evidence-based practices in nutrition, physical activity, stress management, sleep, social connection, and substance use risk reduction. The keynote panel discussion, “Cultivating the Future: The Intersection of Education and Lifestyle Medicine,” held at the 2024 American College of Lifestyle Medicine (ACLM) conference, LM2024, highlighted the critical need and opportunities for integration of LM across the education spectrum. Panelists, including leaders from the Association of American Medical Colleges (AAMC), Accreditation Council for Graduate Medical Education (ACGME), and prominent ACLM LM education leaders, shared milestones, strategies, and a vision for advancing LM education to cultivate the next generation of health professionals equipped to address the nation’s chronic disease epidemic. This article summarizes the session, emphasizing actionable insights, key challenges, and opportunities to foster LM integration in medical and health professional education and training.

The field of psychiatry has evolved over the past 2500 years. Between dynamic psychotherapy and psychopharmacology, lifestyle psychiatry holds a different space. This approach capitalizes on the lifestyle medicine movement, as it promotes change within 6 domains of activity. Apart from incorporating these lifestyle pillars as adjunctive therapy for either psychodynamic therapy or psychotropic medication regimens, lifestyle psychiatry is on the frontier similar to the other growing fields of precision psychiatry, advanced learning in psychiatry, psychedelics in psychiatry, digital mental health, and psychiatric genetics. Any disruption into the historical practice of psychiatry, particularly with the prescription of medications, can be met with scrutiny. We encourage the field of psychiatry to keep an open mind as our field continues to evolve. What makes lifestyle psychiatry particularly powerful and unique in its ability to assess and evaluate internal and external factors that contribute to individual behaviors, and may impact the ability to incorporate healthy lifestyle actions. Internal factors include: emotional regulation, internalized trauma, cognitive factors, and personality traits. On the other hand, external factors include environmental barriers and work-related burnout.

Background/Objective: Connective tissue diseases (CTDs) are a group of over 200 disorders that significantly impact quality of life due to chronic inflammation and systemic complications. While pharmacological interventions remain the cornerstone of treatment, lifestyle medicine offers a complementary approach to managing these conditions. This article explores the application of lifestyle interventions in CTDs to improve clinical outcomes and reduce disease burden. Methods: A review of current evidence on lifestyle factors, including nutrition, physical activity, sleep, stress management, avoidance of harmful substances, and social connections, was conducted. This review integrates findings from epidemiological studies, clinical trials, and expert recommendations to provide actionable insights for managing CTDs. Results: Key findings highlight the significant role of diet in influencing inflammatory activity and supporting overall health. Specifically, ultra-processed foods and other lifestyle factors could impact the risk of systemic lupus erythematosus (SLE). In contrast, the Mediterranean diet is particularly beneficial for rheumatoid arthritis (RA), offering anti-inflammatory properties and potential improvements in symptoms. Additionally, regular physical activity plays a vital role in preserving joint and muscle function across these conditions. Restorative sleep and effective stress management are critical in mitigating disease activity, as poor sleep and high stress are associated with worsened outcomes. Smoking and alcohol consumption were identified as modifiable risk factors that exacerbate disease progression, emphasizing the importance of lifestyle interventions for improved disease management and overall quality of life. Conclusion: Incorporating lifestyle medicine into the management of CTDs offers a patient-centered approach that complements pharmacologic treatments. By addressing modifiable risk factors, healthcare providers can empower patients to improve quality of life, reduce reliance on medications, and potentially slow disease progression. Further research is needed to establish long-term outcomes and refine intervention strategies.

This LM2024 Keynote Address outlines the Blue Zones story, beginning with the methodology that led Dan Buettner to identify the original blue zones, five regions in the world with disproportionately high concentrations of centenarians, low rates of middle-age mortality, and seniors living in good health. We glimpse the lifestyle of these long-lived people by journeying briefly to Sardinia, Italy; Okinawa, Japan; the Seventh Day Adventist community in Loma Linda, California, USA; Nicoya, Costa Rica; and Ikaria, Greece. Rigorous research, interviews and fieldwork in these communities have yielded surprising insights about the environmental and lifestyle factors that produce the world’s longest-lived people. The Power 9, a summation of these factors, suggests an approach to longevity that runs counter to the prevailing American focus on diet, supplements and exercise. In contrast to an intentional pursuit of health, the insights drawn from the world’s blue zones demonstrate that longevity ensues from the right environment, an ecosystem of factors that make the healthy choices both easy and unconscious.

Registered Dietitian Nutritionists (RDNs) are uniquely positioned to lead in Lifestyle Medicine, Culinary Medicine and Food is Medicine, overlapping initiatives currently gaining momentum in health care. To become a credentialed practitioner, RDNs must demonstrate competency as outlined in The Scope and Standards of Practice defined by the Commission on Dietetic Registration (CDR), the credentialing agency for the Academy of Nutrition and Dietetics. Many CDR competencies align with the interventional and operational components necessary to deliver and direct effective Lifestyle Medicine (LM) and Culinary Medicine (CM) initiatives. Capitalizing on the skills and expertise of RDNs trained in LM and CM is an effective strategy to address the Quintuple Aim of better health care outcomes, lower cost, improved patient satisfaction, improved provider wellbeing and the advancement of health equity. Successful examples like Cooking with Plants, Trinity Health Ann Arbor’s virtual CM series, showcase the positive impact of RDN-led CM initiatives on culinary literacy and health behavior change. This article provides an overview of the Cooking with Plants program and practical guidance for initiating similar programs at other institutions. Guidance includes strategies for assessing community needs, identifying funding sources, engaging stakeholders, and developing and evaluating curriculum.

Objective: To explore the interconnected crises of chronic disease, environmental degradation, and social inequity through the lens of food systems and to highlight the potential of plant-based dietary patterns to mitigate these challenges. Main Outcomes and Measures: Evidence demonstrates that plant-based diets reduce the prevalence of chronic diseases, including heart disease and type 2 diabetes, alleviate environmental harm by reducing greenhouse gas emissions and water usage, and promote health equity by increasing access to affordable, nutritious foods. Quantitative outcomes include projected savings of trillions of dollars in health care and climate-related costs and the prevention of millions of premature deaths globally. Results: Transitioning to plant-forward food systems has been associated with a reduction in chronic disease risk by up to 90%, a significant decrease in health care expenditures, and a 75% reduction in agricultural land use. Key interventions, such as produce prescriptions and plant-based meal programs, demonstrate the effectiveness of systemic solutions in improving health outcomes while addressing structural inequities. Conclusion: Aligning individual and collective efforts toward sustainable, health-focused food systems presents a transformative opportunity to improve global health, conserve natural resources, and foster social equity. By adopting plant-based diets and supporting equitable food policies, individuals, health care professionals, and policymakers can collaboratively create a more resilient, sustainable, and just future for generations to come.

The American College of Lifestyle Medicine was founded just over 20 years ago. As the organization grew, it incubated an impressive array of structures and processes to foster professional standards, training, credentialing, networking, and scholarship. A compelling and accelerating drumbeat of peer-reviewed publications has demonstrated the advancing base of evidence in which lifestyle medicine practice is rooted. Despite all this good effort, however, the indicators of population health that matter most—longevity and vitality and healthspan, years in life and life in years—have largely trended away from, rather than toward, aspirations. The life course of ACLM has introduced an area of great allure and tremendous promise to health professionals seeking beyond reactive disease care. The processes, structures, and knowledge are in place to advance the goals of vitality and longevity at the population level. Needed, still, are the means of translating that accumulated knowledge into the power of routine, and effective action. Those of us committed to the full potential of lifestyle both in and as medicine have promises yet to keep and miles to go before we sleep. We can, however, see the light on the horizon from here.

There is an increase in the amount of time spent on our screen devices over the last couple of decades. More aspects of our daily lives have shifted to internet-based services, schooling, and work, especially since the COVID-19 pandemic. Many people are finding it hard to step away from social media, gaming or other screen-based entertainment. When overuse of screens starts having severe consequences, the diagnosis of a behavioral addiction should be considered. Nonsubstance addictions have been studied for brain imaging characteristics as well as diagnostic reliability. Resources for evidence-based treatment are hard to find. Treatment is based on a biopsychosocial approach, with therapy, medication, mindfulness, support groups as primary sources of help. Ill effects of youth and social media use are a growing concern and a focus of future work as well as advocacy. Lifestyle medicine focuses on building our internal as well as external resources for recovery, similar to the concept of recovery capital in addiction medicine. Future research on diagnostic criteria, treatment methods and treatment retention are needed to form robust treatment approaches for a growing problem.

Without intentional and collaborative input from stakeholders and members of the communities we serve, Lifestyle Medicine (LM) is at risk of evolving in ways that are inapplicable and even alienating to diverse and underserved populations. To mitigate this risk, this paper advocates for implementing transdiagnostic, culturally affirmative, trauma-informed, and integrative treatment frameworks that address mental, social, and physical health in tandem. It demonstrates how the Community as Medicine model can bridge the divide between clinical settings such as Federally Qualified Health Centers (FQHCs) and community settings, such as YMCAs, improving accessibility for diverse groups. It also shows how emerging professional identities—exemplified by health coaches—can be cultivated to expand the reach of care while simultaneously opening pathways to employment. By centering inclusivity, cultural affirmation, and interprofessional collaboration, LM can more effectively meet the needs of vulnerable communities and enhance overall public health outcomes.