Lifestyle Medicine Insider News and Updates – January 2024

Disclaimer: The information included in Insider is intended to give our readers a sense of what is happening in the news, research journals and other channels related to lifestyle medicine. Inclusion does not imply ACLM endorsement. Note that some links may require registration or subscription.

MEDICAL PRACTICE

• The American Independent Medical Practice Association (AIMPA) launched in October 2023 as a new voice for physicians practicing independently.
• Past-President Cate Collings, MD, FACC, DipABLM, writes on the value and reimbursement of lifestyle medicine shared medical appointments in this new Medscape column.

HEALTH EQUITY

• This article in Self discusses the various reasons Blacks in the U.S. have a higher risk of heart disease.
• The Agency for Healthcare Research and Quality (AHRQ) has issued its 2023 report on healthcare quality and disparities to provide a comprehensive overview of the quality of healthcare received by the general U.S. population and disparities in care experienced by different racial and socioeconomic groups.
• ACLM partner The Root Cause Coalition has released a year-long study assessing social drivers of health. Housing and food security were of the greatest concern among study participants, while the most experienced issues in the past year were chronic health conditions and difficulty affording rent or mortgage.

PEDIATRICS

• This study published in Pediatric Research explored the relationship between sociodemographic factors and adherence to the MIND (Mediterranean-DASH [Dietary Approaches to Stop Hypertension] Intervention for Neurodegenerative Delay) diet in a demographically diverse, national U.S. population-based sample of 9- to 12-year-olds.

RESEARCH NEWS

• ACLM’s study “Lifestyle Medicine Practitioners Implementing a Greater Proportion of Lifestyle Medicine Experience Less Burnout” was selected as one of the “Papers of the Year” by the American Journal of Health Promotion (AJHP). Authors included: Kathryn J. Pollard, MS; Joel Gittelsohn, PhD; Padmaja Patel, MD, FACLM, DipABLM; Liana Lianov, MD, MPH, FACPM, FACLM, DipABLM; Kelly Freeman, MSN, RN, AGPCNP-BC, DipACLM; Kara L. Staffier, MPH; Kaitlyn R. Pauly MS, RDN, DipACLM; and Micaela C. Karlsen, PhD, MSPH.

MILITARY HEALTH

• A new study of over 700,000 veterans published in the American Journal of Clinical Nutrition concluded that a combination of eight lifestyle factors is associated with a significantly lower risk of premature mortality and an estimated prolonged life expectancy.

NURSING

• An article written by ACLM member Cody Stubbe, MSN, RN, on nursing’s role in lifestyle medicine was the cover feature of the December American Nurse.
• The benefit of eating a whole food, plant-based diet was the topic of this Healthy Nurse, Healthy Nation blog post.

CALL FOR PROPOSALS

• The Advanced Research Projects Agency for Health (ARPA-H) is seeking proposals to encourage investment in preventive care — especially in areas of the country where health outcomes are worse than the national average.

“SEAT AT THE TABLE”

• ACLM Board Member and Chair of ACLM’s Global Sustainability Committee Neha Pathak, MD, FACP, DipABLM, has been selected to serve on the Expert Committee for the National Academy of Medicine’s Communicating About Climate & Health Project.
• ACLM was invited by the Academy of Nutrition and Dietetics to join its Primary Care Provider Advisory Board. ACLM current and past board members, Melissa Bernstein, PhD, RD, FAND, DipACLM, and Brenda Rea, MD, RD, PT, DrPh, FACLM, FAAFP, DipABLM, will be serving as ACLM’s representatives.

NEW YORK

• Patients are “knocking down the doors” to join NYC Health + Hospital’s Lifestyle Medicine Program, says ACLM member Michelle McMacken, MD, DipABLM, the system’s executive director of nutrition and lifestyle medicine who was quoted in this Becker’s Hospital Review Piloted first in 2019 at its Bellevue hospital, the program is such a success that the initiative is expanding to six other sites throughout the city including NYC Health + Hospitals/Elmhurst, the first time the program will be available in Queens.
• The City of New York Office of Food Policy has distributed two new reports. The first, the Food Standards Compliance Report,  shows the nutritional quality of the 219 million meals served by City agencies in FY23. The second report, NYC Food by the Numbers, is a visual compilation of the latest data on food programs, public feeding services, diet-related diseases, the nexus between food and climate, and food retail.

PILLARS

SLEEP

• New research published in Sleep found that sleep regularity is more important than sleep duration.
• The International Journal of Environmental Research and Public Health recently published a study revealing that while a single dose of caffeine can improve attention in sleep-deprived individuals, regular high consumption of caffeine leads to diminished attentional performance, as well as alterations in brain activity.

CHRONIC DISEASE

TYPE 2 DIABETES

• Type 2 diabetes may have profound effects on mental health, especially if diagnosed earlier in life, according to this study published in PLOS Medicine.
• Kaiser Family Foundation Health News writes that some diagnosed with type 2 diabetes may actually have latent autoimmune diabetes of adults or LADA. Patients with it can be misdiagnosed with Type 2 diabetes and spend months or years trying to manage the wrong condition.

OBESITY

• Everyday Health has published a special section on obesity that includes interviews with a number of ACLM members.
• Late last month the FDA was evaluating whether to take regulatory action over reports that Mounjaro, Ozempic and other weight-loss and type 2 diabetes drugs have caused alopecia, aspiration and suicidal ideation, the agency revealed in its Adverse Event Reporting System webpage. “Preliminary evaluation has not found evidence that use of these medicines causes suicidal thoughts or actions,” the FDA now says in a statement.
• Adding one cup of navy beans to the usual diet of individuals with obesity and a history of colorectal cancer improved gut microbiome diversity and regulated metabolites and markers related to disease, according to research published in eBioMedicine.

INFLAMMATORY BOWEL DISEASE

• In a poster presentation at the recent Advances in Inflammatory Bowel Diseases annual meeting reported on by MedPage Today, researchers said their study showed red meat consumption was tied to a higher chance of ulcerative colitis flare, but a similar association was not seen for other high-fat foods.

PARTNERS IN THE NEWS

• Corewell Health’s lifestyle medicine program and ACLM member Carolyn Vollmer, MD, DipABLM, are featured in this WZZM13 Grand Rapids segment on a patient’s testimonial that the program changed her life.

MEMBERS IN THE NEWS

• Cone Health and local North Carolina media featured the story of Gebreselassie (Gebre) Nida, MD, FACE, DipABLM, who was recently included in Marquis Who’s Who.
• Ajay Joseph, MD, FACC, DipABLM, and the St. Francis Health System’s Lifestyle Medicine Program in Tulsa, Okla., were featured by the system.
• Kayli Anderson, MS, RDN, DipACLM, ACSM-EP, was interviewed for this New York Times article on healthy snacks for traveling.
• Alka Gupta, MD, DipABLM, was interviewed by Medscape for a video segment on the importance of lifestyle medicine in primary care.
• Linda Shiue, MD, DipABLM, was among nine health experts interviewed by NBC News and picked up by the New York Post on the holiday food and drinks they avoid.
• Janel Gordon, MD, DipOBOM, DipABLM, urged individuals to explore the world of plant-based living in this WISH-TV Indianapolis segment on “Veganuary,” an annual challenge for people to abstain from meat, dairy, and ultra-processed foods.
• ABC4 Utah interviewed Jake Veigel, MD, a sports medicine physician at Intermountain Health’s Lifestyle Medicine and Wellness Center, about measuring New Year resolution success beyond just weight.
• Noemi Adame, MD, discusses five things that inhibit weight loss on the mindbodygreen blog.

FOOD FOR THOUGHT

• This viewpoint article in JAMA Network claims the medical and public health communities’ enthusiasm for food is medicine “seems unjustified by its likely benefit.”
• Nearly half of every dollar spent by Medicare drug plans goes to private health insurers’ pharmacy benefits managers and wholesalers, according to this Health Care un-covered post.
• This study published in BMC that evaluated the nutritional risk profile of food and beverage companies showed that the world’s largest businesses in the sector are heavily dependent on revenue that is derived from the sales of unhealthy products.

Most popular ACLM blog stories in 2023 

By Alex Branch, ACLM Director of Communications 

This article takes look back at some of our most popular blog stories published in 2023 and the topics they covered.

2023 was an impactful year for lifestyle medicine, and the stories published on the American College of Lifestyle Medicine blog captured many of the developments.    

Clinicians shared inspirational stories about how the practice of lifestyle medicine improved their job satisfaction and emphasized the role of lifestyle medicine in reducing health disparities in under-resourced communities. ACLM contributors wrote on a variety of topics, from the importance of making hospital food healthier, to the lifestyle health-related threat to the U.S. military, to how to deliver high-value, whole-person care in current payment models and much more.  

Here were the five most popular stories in 2023:  

1.Why Get Certified in Lifestyle Medicine? Ask These Four Clinicians 

ACLM interviewed four clinicians from different health professions but with one thing in common – the passion to become certified to practice lifestyle medicine. Certification indicates one has mastered the science to apply evidence-based, whole-person, prescriptive lifestyle therapies to prevent, treat and, when used intensively, often reverse chronic health conditions. 

2. How Lifestyle Medicine Can Prevent Burnout in Healthcare Professionals 

An important research study by ACLM published in the American Journal of Health Promotion highlighted the potential of lifestyle medicine to manage and reduce burnout among healthcare professionals. Of the 482 ACLM members surveyed for the study, 90% of respondents reported that the integration of lifestyle medicine into their medical practice had a positive impact on their professional satisfaction. 

3. ACLM Advocacy Priorities in Support of its Members and Lifestyle Medicine 

One year after the White House Conference on Hunger, Nutrition and Health, ACLM recapped its advocacy efforts on behalf of membership. ACLM’s priority areas of focus are lifestyle medicine in medical education; reimbursement and quality measures; health equity as it relates to lifestyle-related chronic disease health disparities; and military health for recruits and active-duty personnel. 

4. Hope and Healing: Type 2 Diabetes Remission with Lifestyle Medicine 

In this blog post ACLM delved into the critical issue of type 2 diabetes, its staggering economic costs, genetic predisposition, racial disparities, and dire complications, such as amputations. It explores how lifestyle medicine offers a beacon of hope and healing for both patients and clinicians.  

5. Delivering High-Value, Whole-Person Care in Current Payment Models  

A summary of ACLM’s inaugural Reimbursement Summit highlighted delivery and payment models used by lifestyle medicine clinicians in a variety of care settings across the country to deliver the high-value, whole-person, interdisciplinary care that lifestyle medicine offers. ACLM President-elect Padmaja Patel, MD, FACLM, DipABLM, said “I want us to change our narrative about reimbursement. For too long we have said that lifestyle medicine does not get reimbursed, but that is no longer true.” 

December Lifestyle Medicine Insider News and Updates

Disclaimer: The information included in Insider is intended to give our readers a sense of what is happening in the news, research journals and other channels related to lifestyle medicine. Inclusion does not imply ACLM endorsement. Note that some links may require registration or subscription.

Trends

• Business Group on Health highlights nine trends to watch in 2024.

Medical Economics

• It isn’t big pharma that profits most from the American healthcare system, according to this recent article in The Economist.
• The topic of pretax dollars to pay for certain types of healthful foods, gym memberships and even fitness trackers is featured in this Washington Post article.

Reimbursement

• In case you missed last week’s ACLM advocacy update email, here is ACLM Deputy Director Kaitlyn Pauly’s interpretation of the 2024 Medicare fee schedule and Quality Payment Program final rule for lifestyle medicine practice.
• AAFP discusses one item in the rule, G2211, a Medicare add-on code designed to pay more accurately for the complex, high-value visits that primary care physicians provide as part of a continuous relationship with a patient.
• The National Academy of Medicine has just published “Valuing America’s Health: Aligning Financing to Award Better Health and Well-Being (2023).”

Workforce

• AAMC has published its 2023 U.S. Physician Workforce Data Dashboard.

Primary Care

• Food as medicine is highlighted in this Fierce Healthcare article as one of four ways advanced primary care helps people thrive.

Health Equity

• The White House and the U.S. Department of Health and Human Services (HHS), through the Centers for Medicare and Medicaid Services (CMS), releasing the first- ever U.S. Playbook to Address Social Determinants of Health- PDF.

White House Conference Update

• ACLM has introduced availability of the second part of its $24.1 commitment made at the 2022 White House Conference on Hunger, Nutrition and Health. The National Training Initiative is a matching scholarship for one primary care physician at each of the nation’s 1,400 Federally Qualified Health Centers to be trained and certified in lifestyle medicine.
• The first part of ACLM’s commitment, the complimentary 5.5-hour CME/CE-accredited “Lifestyle Medicine and Food as Medicine Essentials” online course, has had 34,000 registrants and remains available until September 2025.

Chronic Diseases

Hypertension

• The results of a crossover trial recently presented at the American Heart Association Scientific Sessions and published in JAMA showed that switching to a low-sodium diet conferred blood pressure benefits similar to that of hydrochlorothiazide.

Obesity

• Mayo Clinic is the latest employer to limit weight loss drug coverage for employees, says this Becker’s Hospital Review article.
• Drugmaker Novo Nordisk paid U.S. medical professionals at least $25.8 million over a decade in fees and expenses related to its weight-loss drugs, a Reuters analysis found.
• The U.S. Preventive Service Task Force (USPSTF) has called for lifestyle, not medications, for kids with obesity, as reported in MedPage Today.
• A MdEdge Endocrinology commentary provides insights on fructose and obesity.

Dementia

• A newly published study of the effect of lifestyle changes on cognition and dementia risk in JAMA Internal Medicine earned this Medical News Today article headline: “Personalized lifestyle changes could improve Alzheimer’s risk profile by 145%.”
• A study published in Cell Metabolism showed time-restricted feeding recovered sleep and activity rhythms and improved cognition in mouse models of Alzheimer’s.

Atrial Fibrillation

• The American College of Cardiology (ACC) and the American Heart Association (AHA) have issued a new guideline for preventing and optimally managing atrial fibrillation (AFib) that calls for a stronger, more prescriptive focus on healthy lifestyle habits as well as early and more aggressive rhythm control.

Cancer

• This article from the European Journal of Nutrition discusses the role of adiposity in the associations between ultra-processed food consumption and head and neck cancer and oesophageal adenocarcinoma.
• A new study from St. Jude Children’s Research Hospital in the Journal of Oncology sheds light on the incidence of prediabetes and diabetes in childhood cancer survivors.

Pillars

Nutrition

• In a randomized clinical trial of 22 healthy, adult, identical twin pairs published in JAMA Network, those consuming a healthy vegan diet showed significantly improved low-density lipoprotein cholesterol concentration, fasting insulin level, and weight loss compared with twins consuming a healthy omnivorous diet. This study, by Christopher Gardner, a professor of medicine at the Stanford University School of Medicine, will soon be the subject of a Netflix documentary featuring many other familiar ACLM faces.
• A recently published study in The Lancet Regional Health suggests that higher consumption of ultra-processed food increases the risk of cancer and cardiometabolic multimorbidity.
• This Gaples Institute podcast discusses diet quality as a key determinant of health in the age of weight-loss drugs, including for patients who have achieved their target weight.
• NPR Health News highlights that some fiber-rich foods can naturally boost levels of semaglutide.
• A national experiment comparing food labels found people were less likely to select products described as “vegan” and “plant-based” than those touting health and sustainability benefits, according to a study in the Journal of Environmental Psychology.

Physical Activity

• New research published in Atherosclerosis and reported on in Fortune Well now backs up the tip to choose the stairs over the elevator.
• The Federation of American Scientists has published a strong argument that, similar to other public health issues over past decades such as sanitation and tobacco use, federal policies may be the best way to coordinate large-scale changes empowering Americans to move more.
• USA Today highlights the optimal frequency of workouts.

Social Connection

• A new study published in the journal Epidemiology and Psychiatric Sciences shows that the influence of friends – for good and for well, mischief – extends into our older years, as well.

Healthy Aging

• This National Institute on Occupational Safety and Health Science Blog article talks about older workers, including tips for creating a work environment that is supportive of workers of all ages.
• This article published in Metabolites explores in depth why the klotho protein could be a promising lifestyle biological marker used to monitor the effectiveness of a health program, given that the protein is directly involved in all of the six pillars of lifestyle medicine.

Planetary Health

• The American Medical Association (AMA) passed a resolution calling for increased regulation of industrialized farms.
• The Protein Problem is an Associated Press series that examines the question: Can we feed this growing world without starving the planet?

Members in the News

• Bradley Biskup, PA-C, MHS, MA, DipACLM, was interviewed by Hartford Healthcare for its article on working out on the weekends versus daily workouts.
• Linda Shiue, MD, Chef, DipABLM, director of Culinary and Lifestyle Medicine at Kaiser Permanente San Francisco, talks about ways to keep up healthy eating habits during the holiday season on this Fox 2 KTVU segment.
• Philip Clerc, MD, is highlighted for his successful use of food as medicine to treat and reverse type 2 diabetes on this “5 on Your Side” feature on KSDK in St. Louis.
• Jacob Mirsky, MD, MA, DipABLM, and Kristi Artz, MD, DipABLM, were published in ScienceDirect for their article on lifestyle medicine shared medical appointments as a proposed framework for high-value chronic disease care.
• Supriya Rao, MD, DipABLM, DipABOM, was interviewed for Well + Good’s “How a Gastroenterologist Eats for Digestive Balance During Stressful Meals (and Holidays).”
• Joy DeBellis, DNP, DipACLM, provided an expert opinion answer on health during the holidays for Auburn University.
• Robyn Tiger, MD, DipABLM, wrote on recognizing and recovering from burnout for Thrive Global.

Residency News

• ACLM Lifestyle Medicine Residency Curriculum trainee Cindy Ciccotelli, MD, a third-year resident with the UPMC Williamsport Family Medicine Residency program, wrote on holiday health that was published in the Williamsport Sun-Gazette.

Partner News

• New York City Mayor Eric Adams’ office has reported that since the New York City Public Schools’ Cafeteria Enhancement Experience was announced in June, there has been a 25% increase in student lunch participation, staff ability to serve 300 students in just 15 minutes, and an exponential increase in the selection of fresh fruits and vegetables.
• NYC Health + Hospitals has announced that its nationally recognized Lifestyle Medicine Program has expanded to NYC Health + Hospitals/Woodhull in Brooklyn. This is the second of six new sites to make the program available citywide.
• Local 5 Live in Green Bay featured Bellin Health’s Lifestyle Medicine Program in a segment about losing weight by replacing unhealthy behaviors with good ones.
• Blue Shield of California has announced members now have virtual access to Ornish Lifestyle Medicine, an innovative intensive cardiac rehab program designed to help prevent, treat, and even reverse heart disease through lifestyle change.
• Rooted Santa Barbara County has launched online resource libraries to foster community health and wellness.

Resources

• The Center for Food as Medicine, a nonprofit working to bridge the gap between traditional medicine and the use of food as medicine, publishes a weekly newsletter on food and nutrition.

Calls for Application

• CMS is now accepting applications for the Guiding an Improved Dementia Experience (GUIDE) Model. Eligibility requirements and additional model details can be found in the Request for Applications (RFA) (PDF). Interested applicants should submit their application via web portal by Tuesday, January 30, 2024, at 11:59 pm EST.

Food for Thought

• A  five-part USA Today series investigated why America hasn’t solved its long struggle with type 2 diabetes.
• Key physical health metrics have notably worsened since before the COVID-19 pandemic, including obesity, diabetes and eating habits according to a Gallup survey report.

Health Coaching: The science and art of behavior change 

Scientific evidence supports the use of lifestyle medicine to treat and even reverse common chronic diseases but how do patients turn that information into sustainable lifestyle behavior changes? Lifestyle medicine clinicians are increasingly embracing the power of health coaching to help patients achieve their health goals.

Ample scientific evidence supports the use of lifestyle medicine to treat many common chronic diseases. But what does it take for patients to turn that medical guidance into sustainable lifestyle behavior changes? 

Health and wellness coaching has emerged as a catalyst to help patients achieve their health goals within the framework of lifestyle medicine. Coaching builds judgment-free, collaborative partnerships with patients, empowering them to set realistic goals and personalized action plans with practical steps to address the root causes of their disease. 

Over 15 years ago, Jessica Matthews, DBH, NBC-HWC, DipACLM, FACLM, embraced the power of health coaching after seeing too many people struggle to adopt and sustain the very lifestyle changes that had the ability to transform their health and effectively treat their various chronic diseases.  

“I had accumulated immense knowledge about the science of lifestyle medicine, but I recognized that I needed a deeper understanding of the foundation of it all, which is the science and art of behavior change,” said Dr. Matthews, assistant professor and program director in the College of Health Sciences at Point Loma Nazarene University (PLNU), where she developed and implemented a graduate degree program blending lifestyle medicine and health and wellness coaching. The program built upon her board certification in both areas as well as her doctoral training in behavioral health with a focus in clinical integrated care. 

“I realized that the ability to not only educate, but to coach, support and empower people to take the lead in making these lifestyle behavior changes that I was advocating was the key ingredient that I was missing, as it is ultimately knowledge translated into empowered patient action that is the real secret sauce for unleashing the power of lifestyle medicine.” 

Information isn’t enough 

Lifestyle medicine and health coaching naturally complement each other. Lifestyle medicine is an evidence-based medical specialty that uses therapeutic lifestyle interventions as a primary modality to treat chronic conditions including, but not limited to, cardiovascular diseases, type 2 diabetes, and obesity. Lifestyle medicine-certified clinicians empower patients to replace unhealthy habits with healthy ones by understanding the science and practical skills that support health behavior change.  

Health and wellness coaches commonly address with patients many of the six pillars of lifestyle medicine—a whole food, plant-predominant eating pattern, physical activity, restorative sleep, stress management, avoidance of risky substances and positive social connections. Health coaching in a physician-led health team is shown to improve outcomes for chronic conditions like hypertension and type 2 diabetes. 

The growing availability of virtual medical appointments since the COVID-19 pandemic has made health coaching an option for more Americans.  

“Evidence-based lifestyle behavior interventions are proven to treat, prevent and even reverse many chronic conditions, but simply telling a patient what lifestyle changes to make is not enough,” ACLM President Beth Frates, MD, FACLM, DipABLM, said. “Knowledge is important but, to achieve lasting behavior change, patients and clients also need coaching to motivate them and help them determine how to make and maintain lifestyle behavior changes to improve their health and wellbeing.” 

Art and a science 

Changing deeply engrained lifestyle habits is a complex and multifaceted process. Physical activity and eating patterns are complex behaviors. Health coaches and clinicians with health coaching skills take into consideration each individual’s culture, values, family dynamics, living environments and other unique circumstances to help them create a personalized plan with small yet meaningful action steps forward.  

Dr. Matthews, also director of integrative health coaching at UC San Diego Health in the Department of Family Medicine, said her team will soon publish data showing that health coaching interventions reduced blood pressure and A1c levels in patients at a rate greater than other interventions offered within the health system. 

“I describe behavior change as both a science and an art,” Dr. Matthews said. “The science is learning from the decades of evidence available on behavior change; what works and what doesn’t in terms of initiating lifestyle changes, as well as examining the growing body of research to better understand what sustains it. The art is the communication skills— both verbal and non-verbal— used, not as a directive but in a manner that invites an individual to be an active and engaged participant in identifying practical steps forward.  

“Coaching is saying ‘I may be the expert on the medical science, but you’re the expert on yourself. Let’s combine our valuable knowledge and collaboratively work together.’” 

An example of coaching 

As a registered dietitian, Tasnim El Mezain, MS, RDN, NBC-HWC, is passionate about optimal nutrition. But participating in Dr. Matthews’ program at PLNU made her aware of how the other pillars of lifestyle medicine and nutrition interconnect and are optimized by coaching. 

El Mezain, lead clinical health coach at UC San Diego Health in the Centers for Integrative Health, recently coached a patient who was eating well but sleeping poorly and struggling to fit more physical activity into her busy life.   

“She said her long-term goal was to get to sleep by 10 or 11 p.m. instead of 2 a.m. and take walks five days a week,” said El Mezain, who was also a 2023 recipient of ACLM’s HEAL (Health Equity Achieved through Lifestyle Medicine) scholarship. “But the idea of that was completely overwhelming. So, we worked together to identify incremental and realistic steps she could achieve in the next two weeks towards her overall goal.” 

With El Mezain asking questions, the patient concluded a reasonable goal was to start taking a walk one morning a week at a nearby lake, at a time she knew there would be available parking but also other people there. She identified changes to her bedtime routine the night before her walk so she would wake up earlier and with more energy.  

“By asking her open-ended and strategic questions, so I was not directing her answers in a certain direction, she was able to talk through the obstacles and what motivated her personally,” El Mezain said, “She identified her goal–not my goal for her. It was no longer overwhelming and she was excited to try it out.” 

Future of health care 

The integration of health coaching into multidisciplinary health teams whose members are trained in lifestyle medicine can enhance whole-person, person-centered care. Certified health and wellness coaches work in tandem with physicians, dietitians, exercise specialists, nurses and physician associates to effectively address all facets of patients’ health. 

To further uncover the benefits of coaching skills within the lifestyle medicine paradigm, ACLM and the National Board for Health & Wellness Coaching (NBHWC) this year announced a strategic partnership. NBHWC, an affiliate of the National Board of Medical Examiners, has board certified more than 9,400 health and wellness coaches. 

National board-certified health and wellness coaches (NBC-HWCs) are valuable members of the health care team, but team members from different fields must still prioritize developing their own coaching skills to support patients in the journey of health behavior change, said Dr. Matthews, Vice Chair of the NBHWC Board of Directors.  

“Imagine the future of health care as an interdisciplinary health team whose members are educated and trained in both lifestyle medicine and coaching skills to support health behavior change, all speaking the same language and focused on achieving the same healthy outcomes in genuine partnership with patients,” Dr. Matthews said. “That is how you create meaningful and sustainable lifestyle behavior changes.” 

Significant strides to improve health outcomes start outside of the clinic

By Qadira M. Ali, MD, MPH, DipABLM 

The intersection of lifestyle medicine and health equity emphasizes the need for real-time screening for social influencers of health and the power of collaborative networks.

At the heart of health equity-driven care lies the idea that individuals must not only be provided recommendations for clinical best practices to optimize health, but also the tools to make implementing those recommendations achievable. Every individual or community possesses a unique constellation of historical, social, environmental, and political influencers on their ability to live a robust, healthy life. It is well established just how influential these factors are in determining health outcomes, with estimates ranging as high as 60% to 80%. 

But how do we, as lifestyle medicine practitioners, know what these unique factors are? We must ask, or better yet, we must screen for social influencers of health universally.  

A move toward screening 

Nationwide, hospitals and clinics are adopting screening for health-related social needs (like food insecurity, employment status, and transportation) at increasing rates, as described in a recent Journal of the American Medical Association article.  The move towards screening for social needs has revealed the importance of collaborative relationships between healthcare settings and external, community-based partnerships or interventions whose mission it is to address the social needs identified through screening.  

As momentum builds to shift health services from a fee-based to value-based care model, healthcare institutions have even more motivation to build strong networks of resources, programs, and services that help patients navigate short- and long-term barriers to better health. 

Addressing social needs 

This network of resources may include a far-reaching array of services, from temporary housing vouchers to federal nutrition assistance programs and to work training programs. Research has shown, unsurprisingly, that addressing social needs in conjunction with the provision of clinical care improves patient satisfaction, outcomes, and quality of life. 

Evidence supporting the use of therapeutic lifestyle interventions, like plant-based nutrition and physical activity, to transform health are compelling. Yet, we cannot stop there. Screening for proximate health-related social needs during clinical encounters is imperative, as is building a network of resources with which to connect patients once needs are identified. 

How to learn more 

The upcoming HEAL webinar series called HEALers Healing will highlight the work of exemplary community partners who model what it means to simultaneously address lifestyle medicine pillars and social influencers on health.  

The series will launch in 2024, so stay tuned!

Hope and Healing: Type 2 Diabetes Remission with Lifestyle Medicine

By Jean Tips, Sr. Director of Communications and Public Affairs

To call type 2 diabetes a pandemic may sound overly dramatic. But given its global prevalence and growth in incidence, “epidemic” may fall short in describing the scale of the problem. Once a disease affects large populations across borders, it can be regarded as a pandemic. It is one of the fastest growing health conditions inside and outside the U.S. This burgeoning chronic disease creates human suffering among both adults and children, lowered workforce productivity, clinician burnout, and financial unsustainability for families and the nation as a whole. Something must be done about this preventable, treatable, and reversible problem.

This article delves into the critical issue of type 2 diabetes, its staggering economic costs, genetic predisposition, racial disparities, and dire complications, such as amputations. It explores how lifestyle medicine offers a beacon of hope and healing for both patients and clinicians. 

Table of Contents

Incidence of Type 2 Diabetes in Adults
Incidence of Type 2 Diabetes in Childhood
Financial Costs of Diabetes
Genetic Predisposition
Diabetes Disparities
Complications from Diabetes
There is a Solution
ACLM’s Position Statement
Expert Consensus Statement
Clinical Resources
Clinical Education
Patient Advocacy–Informed Consent
Conclusion

Incidence of Type 2 Diabetes in Adults

From 2001 to 2020, diabetes prevalence significantly increased among U.S. adults 18 or older. As of the latest data reported by the Centers for Disease Control (CDC):

• 37.3 million people (about 1 in 10) have diabetes, approximately 90-95% of whom have type 2 diabetes—that’s 11.3% of the U.S. population.
• 28.7 million people have been diagnosed with diabetes.
• 8.5 million people who have diabetes have not been diagnosed and do not know they have it.
• 96 million people aged 18 years or older have prediabetes (38.0% of the adult U.S. population)
• 65 years or older: 26.4 million people aged 65 years or older (48.8%) have prediabetes
• Diabetes is the eighth leading cause of death in the United States (and may be underreported).

Incidence of Type 2 Diabetes in Childhood

Historically, type 2 diabetes usually developed later in life, and hence used to be termed “adult-onset diabetes.” However, in recent decades, type 2 diabetes has increased among U.S. children and adolescents aged 10 to 19. Rates differ by racial and ethnic group.

The American Diabetes Association (ADA) reports that researchers forecast a growing number of people under age 20 newly diagnosed with diabetes during 2017–2060. This expected upward trend may lead to as many as 220,000 young people having type 2 diabetes in 2060 —a nearly 700% increase.

Financial Costs of Diabetes

The financial costs of diagnosed diabetes are astronomical. Growth in the absolute number of people with diabetes contributes to increased health care expenditures, particularly per capita spending on inpatient hospital stays and prescription medications.

The enormous economic toll of diabetes burdens society through direct medical and indirect costs. According to a new report from the ADA:

• The total estimated cost of diagnosed diabetes in the U.S. in 2022 was $412.9 billion, including $306.6 billion in direct medical costs and $106.3 billion in indirect costs attributable to diabetes.
• For cost categories analyzed, care for people diagnosed with diabetes accounts for 1 in 4 health care dollars in the U.S., 61% of which are attributable to diabetes.
• On average people with diabetes incur annual medical expenditures of $19,736, of which approximately $12,022 is attributable to diabetes.
• People diagnosed with diabetes, on average, have medical expenditures 2.6 times higher than what would be expected without diabetes.
• Glucose-lowering medications and diabetes supplies account for ∼17% of the total direct medical costs attributable to diabetes.
• Major contributors to indirect costs are reduced employment due to disability ($28.3 billion), presenteeism ($35.8 billion), and lost productivity due to 338,526 premature deaths ($32.4 billion).

Genetic Predisposition

Type 2 diabetes is said to have a stronger link to family history and lineage than type 1, and studies of twins have shown that genetics play a very strong role in the development of type 2 diabetes. Race can also play a role.

Yet, it also depends on environmental factors and lifestyle influences. Obesity tends to run in families, and families often have similar eating and exercise habits.

The lifetime risk of developing Type 2 diabetes if a parent has it is 40%. If both parents have it, the risk jumps to 70%.

Diabetes Disparities

Certain racial and ethnic groups are at higher risk of developing type 2 diabetes, with American Indian/Alaska Native, Black, and Hispanic populations having higher prevalence rates.

Complications from Diabetes

A toe, foot or leg is cut off by a doctor about 150,000 times a year in America, making the United States a world leader of these amputations according to the National Institutes of Health. The CDC reports lower-limb amputations are increasing in the US, and 80% are a result of complications from diabetes. From 2009 to 2019, the number of diabetes-related hospitalizations due to amputation doubled.

According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), about 130,000 people in the United States who have diabetes have amputations each year. The ADA says lower-extremity amputations are 10 times more common in people with diabetes than in persons who do not have diabetes.

Time Magazine has reported that Blacks who live in Southern States with diabetes are the most apt to receive amputations.

There is a Solution

Type 2 Diabetes Is Preventable, Treatable and In Some Cases Reversible

A diagnosis of type 2 diabetes doesn’t have to be permanent, sentencing patients to a lifetime of medication, procedures, devastating complications, and hospitalizations. And for clinicians, there is hope and healing provided by a growing specialty area that treats the root cause of T2D, not merely managing symptoms but offering health restoration.

That specialty is lifestyle medicine.

In lifestyle medicine, the clinical goal is health with no evidence of disease. Remission is the return to a state of non-disease as determined by the failure to meet the recognized criteria for diagnosing the disease. Remission does not necessarily equate to a state of no evidence of disease. For example, a return to glucose levels in the range of “prediabetes” are consistent with various definitions of remission of type 2 diabetes but are not adequate to meet criteria for no evidence of disease.

Reversal is the process of disease treatment with the clinical goal of health with no evidence of the disease. LM intensivists are best poised to support patients in achieving optimal health and remission of disease, by engaging in reversal in the context of ITLC treatment.

ACLM’s Position Regarding Type 2 Diabetes

“The American College of Lifestyle Medicine (ACLM) published a position statement in the American Journal of Lifestyle Medicine in June of 2020, “Type 2 Diabetes Remission and Lifestyle Medicine – A Position Statement from the American College of Lifestyle Medicine” that concludes:

“Sufficiently intensive lifestyle intervention (intensive therapeutic lifestyle change), particularly adopting a predominantly whole food, plant-based dietary pattern, exercise, and sleep, may be comparable to bariatric surgery, a commonly recognized means of effectively achieving T2D remission, but without the potential for side effects.”

Furthermore, studies have shown that the approach advocated by lifestyle medicine physicians can often and reduce or eliminate the need for prescription medications, including insulin.

T2D Assets from ACLM

ACLM aims to help eradicate this scourge through a broad array of assets:

Expert Consensus Statement

To assist clinicians in achieving remission of type 2 diabetes in adults using diet as a primary intervention, ACLM published an expert consensus statement in the American Journal of Lifestyle Medicine in May 2022, “Dietary Interventions to Treat Type 2 Diabetes in Adults with a Goal of Remission.”

The statement was endorsed by the American Association of Clinical Endocrinology (AACE), supported by the Academy of Nutrition and Dietetics (AND) and co-sponsored by the Endocrine Society.

Expert consensus was achieved for 69 statements pertaining to diet and remission of T2D, dietary specifics and types of diets, adjuvant and alternative interventions, support, monitoring, adherence to therapy, weight loss, and payment and policy.

Clinicians can use these statements to improve quality of care, inform policy and protocols, and identify areas of uncertainty.

Clinical Resources

Research

The following research highlights key findings supporting the efficacy of lifestyle medicine in the treatment of type 2 diabetes.  (To read more about current projects and other research in support of the advancement of knowledge in the field of lifestyle medicine visit Lifestyle Medicine Research.)

“Remission of Type 2 Diabetes After Treatment With a High-Fiber, Low-Fat, Plant-Predominant Diet Intervention: A Case Series,” published in the June 2023 American Journal of Lifestyle Medicine, outlines how a lifestyle-based treatment intervention promoting adherence to a plant-predominant diet and integrated as part of routine care can successfully achieve T2D remission in wellness clinic patients.

The series demonstrates that achieving type 2 diabetes remission is possible through a healthy diet without severe calorie restriction or liquid meal replacements. In the study, 59 patients with type 2 diabetes enrolled in a cardiac wellness program and experienced significant improvements in blood glucose control, and some even achieved full remission, by following a low-fat, whole food, plant-based diet. This highlights the significance of offering all patients the chance to make lifestyle changes as part of their routine care for treating type 2 diabetes.

“Medication Deprescribing Among Patients with Type 2 Diabetes: A Qualitative Case Series of Lifestyle Medicine Practitioner Protocols,” published in Clinical Diabetes in August 2022, provides protocols for medication deprescribing in type 2 diabetes patients following successful lifestyle medicine interventions. The study addresses the need for safe and effective deprescribing guidelines, as intensive lifestyle changes can lead to decreased blood sugar levels, potentially causing hypoglycemia if medication adjustments are not made. These protocols will be valuable resources for clinicians to reduce the reliance on prescription medications and support patients in achieving remission through evidence-based lifestyle medicine practices.

A meta-epidemiological study, “Commonalities among dietary recommendations from 2010-2021 clinical practice guidelines: A meta-epidemiological study from the American College of Lifestyle Medicine,” published in Advances in Nutrition in May 2023, synthesizes recommendations from 78 clinical practice guidelines for major chronic conditions and general health promotion. This study concluded:

“…These findings support both ACLM’s dietary position statement and its recent expert consensus statement that the most effective dietary intervention for achieving T2D remission is whole, plant-based foods with minimal consumption of meat and other animal products…”

Clinical Education

Created by the foremost experts in lifestyle medicine and food as medicine, ACLM’s array of diabetes and food as medicine CME/CE courses address the need for quality, evidence-based nutrition education, missing in medical education.

These include:

• “Remission of Type 2 Diabetes and Reversal of Insulin Resistance Certificate Course.” This 18-hour CME/CE/MOC certificate course equips clinicians to use intensive, evidence-based lifestyle medicine therapies to send type 2 diabetes into remission and reverse insulin resistance. Created by experts and researchers who have had proven success in treating patients with diabetes using lifestyle medicine, upon completion you will earn a certificate and be immediately prepared to address diabetes and insulin resistance in powerful new ways.

Patient Advocacy

Informed Consent

In 2020 ACLM introduced a Type 2 Diabetes Bill of Rights aimed at empowering patients and raising awareness about their rights to evidence-based lifestyle medicine therapeutic approaches as a primary treatment option. ACLM believes that it is crucial to offer this treatment option at the time of diagnosis to ensure fully informed consent.

Conclusion

Using lifestyle medicine, clinicians can learn how to treat and, in some cases, reverse type 2 diabetes. ACLM can be your resource for restoring health to those with an existing diagnosis of this disease and preventing those with prediabetes from progressing to full diagnosis. It is not the life sentence that some may think.

ACLM Story Project: Putting Diabetes Into Remission

November Lifestyle Medicine Insider News and Updates

Disclaimer: The information included in Insider is intended to give our readers a sense of what is happening in the news, research journals and other channels related to lifestyle medicine. Inclusion does not imply ACLM endorsement. Note that some links may require registration or subscription.

Notable

• The Danish government has published the first-ever national action plan outlining how the country can transition towards a more plant-based food system.
• As reported in this recent article in The Guardian, the group US Right to Know claims that almost half of the 2030 Dietary Guidelines Advisory Committee (DAGC) members have significant ties to big agriculture, ultra-processed food companies, pharmaceutical companies and other corporate organizations with a significant stake in the process’s outcome.
• A new study suggests that chronic disease among older Americans is the biggest factor affecting life expectancy.
• ACLM partner the Primary Care Collaborative has issued its 2023 PCC Evidence Report, “Health is Primary: Charting a Path to Equity and Sustainability,” looking at factors driving the downward trends in primary care: fewer clinicians practicing primary care, fewer available primary care appointments for patients, lower spending on primary care as a share of total spending, and fewer adults reporting that they have a usual source of primary care.
• With the prevalence of some chronic diseases trending up, the U.S. needs to revamp its approaches to preventative care and disease management, experts said at the recent Milken Future of Health Summit.

Health Equity

• According to 2022–2023 data from the Association of American Medical Colleges (AAMC) reported in The Lancet, only 1% of total enrolled medical students self-identified as American Indian or Alaska Native. AI/AN medical students were the only racial group that did not experience an absolute increase in medical school enrollment.
• This article outlines a CDC report showing the U.S. infant mortality rate rose 3% in 2022. There were 610 more infant deaths in 2022 over 2021, with increases among all ethnicity groups except for infants born to Asian women. Deaths among infants of Black women remained the highest of all ethnicity groups, and the mortality rate for infants of Native American or Alaskan Native women also increased significantly. This is the first year-over-year increase since 2001-2002.

Health Systems

• Becker’s Hospital Review asked C-suite executives from hospitals and health systems across the U.S. to share their organization’s areas of growth for the next few years. Here are their responses.

Military Health

• U.S. Army Fort Jackson in Louisiana has opened Victory Fresh at the U.S. Army Drill Sergeant Academy. Victory Fresh, a healthy alternative to fast food, offers heathy grab-and-go wraps and salads, as well as a build-your-own power bowl available to service members, Department of Defense civilians, and their guests.

CHRONIC DISEASE

Type 2 Diabetes

• A study by ACLM’s LM23 speakers Walter Willett, Frank Hu, et. al., published in this American Journal of Clinical Nutrition article, supports current dietary recommendations for limiting consumption of red meat intake and emphasizes the importance of different alternative sources of protein for T2D prevention.
• Emerging data show an increased use of continuing glucose monitors among people with prediabetes, especially those with an HbA1c of 6% or higher, and those with gestational diabetes.

Cancer

• Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine has received a $4-million, five-year grant from the National Cancer Institute to study whether lifestyle interventions such as exercise and intermittent fasting in patients with advanced breast cancer help them better tolerate treatment side effects.
• A randomized trial of an exercise and nutrition intervention on chemotherapy relative dose intensity and pathologic complete response in women diagnosed with breast cancer was reported in the Journal of Clinical Oncology.

Cardiovascular Disease

• The Portfolio Diet Score was associated with a lower risk of CVD, including CHD and stroke, and a more favorable blood lipid and inflammatory profile, in three large prospective cohorts in a study published in Circulation.

Overweight and Obesity

• Weight loss companies Weight Watchers and Noom both now offer access to anti-obesity medications in a shift from their dieting approaches, and Noom recently announced that it is expanding its Noom Med service to its employer benefits program.
• Some researchers publishing in BMJ are expressing optimism about an apparent plateau in prevalence of unhealthy weight among children in some high-income countries, particularly among young children.
• A new study extended the benefits of diet and exercise from mere weight loss to the loss of harmful, visceral fat in older people.

CKD

• Data presented at the American Society of Nephrology Kidney Week 2023 conference showed nearly all patients in a recent study reported difficulty implementing lifestyle changes recommended by their physician, but successful implementation led to improvements across several dimensions of physical health, mental health, and overall quality of life.

Non-Alcoholic Fatty Liver Disease

• Nutrition and modifiable factors can prevent or promote non-alcoholic fatty liver disease, according to this BMJ article.

Behavioral Health

• The economic burden of brain and mental health-related disorders has prompted the need for a “brain science-inspired industrial strategy” that will build America’s brain capital. A full explanation of this strategy and a road map of how to achieve it were unveiled at the recent United Nations General Assembly Science Summit and reported on by Rice University.
• This Vital Signs report contains an analysis from the CDC Quality of Worklife survey focused on well-being and working conditions, comparing data from 2018 to 2022. Reports of poor mental health symptoms increased more for health workers than for other worker groups.

PILLARS

Nutrition

• A review in Preventive Nutrition and Food Science discusses the latest insights into innovative approaches used to extract proteins from underutilized legumes.
• Protein from plant-based sources is examined in this article from ACLM partner American Institute for Cancer Research.
• From unexpected flavor combinations to plant-based foods galore, here are the 10 trends Whole Foods says to look out for in 2024, discussed in this Eating Well article.
• A recent study published in The BMJ reports that ultra-processed foods can be as addictive as smoking.
• A study published in Circulation explained the first randomized controlled trial of its kind, a produce prescription program significantly improved HbA1c among low-income patients on Medicaid with poor glycemic control at baseline.

Physical Activity

• Researchers in this Psychology Today article say resistance exercise can help almost anyone control cognitive decline.
• Exercising for at least 30 minutes three times a week can be just as effective as Viagra and similar medications at improving erectile function, according to a new analysis published in the Journal of Sexual Medicine.
• Prolonged sitting raises your odds for an early death, but just 20 to 25 minutes of physical activity a day may offset that risk, researchers found in a study published in the British Journal of Sports Medicine.

Avoidance of Risky Substances

• Is there a “healthier” alcoholic drink? The Cleveland Clinic answers.

Food for Thought

• The tools designed to enhance our health awareness, such as wearables and digital health metrics, can inadvertently lead to “digital health anxiety,” causing stress and self-doubt, according to a writer in The Medical Futurist.
• This Forbes article asks why, by so many measures—most notably cost relative to population outcomes—our system not only often lags behind those of our peer countries, it fails to live up to the incredibly high standards most of us expect of our healthcare system.
• An analysis of content accuracy reported in Cureus revealed that ChatGPT provided reasonably accurate information in the majority of the cases, successfully addressing queries related to lifestyle-related diseases or disorders.
• A new report from IHME on the Pandemic Recovery Survey offers insights on the effects of the pandemic on health care and health-seeking behavior, attitudes, and practices around vaccinations, education, and household financial and food security in 21 countries.
• This opinion piece in The Hill says the NIH must address our abysmal diet and nutrition.
• Stat explores why preventative care is such a tough sell in the U.S. according to chronic disease experts.

Veterans Day: A Time for Appreciation and Action

By Susan Benigas, ACLM Executive Director

Celebrating Veterans Day, ACLM pays tribute to our courageous heroes while addressing the hidden threat of lifestyle-related chronic diseases that affect our military and our nation. ACLM’s evidence-based lifestyle medicine solutions are positioned to help strengthen national security, improve the health of Americans, and support our veterans.

On Veterans Day, the American College of Lifestyle Medicine (ACLM) honors the brave men and women who have served our nation with dedication and sacrifice. We recognize that the freedoms we enjoy as Americans only exist because of our veterans’ incredible courage and commitment to defending our values. With gratitude and humility, we thank you—our veterans—for your service. 

ACLM is fortunate to count many outstanding veterans as members, staff, partners and advocates who, after having defended our country from external threats, are now defending it from one of our greatest internal threats: the pandemic of lifestyle-related chronic disease and the deeply entrenched factors that drive it.

Today 60% or more of all adults have been diagnosed with one chronic disease, and more than 40% have been diagnosed with two or more. Type 2 diabetes can no longer be called “adult-onset” because so many children are now being diagnosed with this degenerative condition that degenerates far more rapidly in young, growing bodies. These same lifestyle-related health issues that have had a long-standing impact on disease and death in the U.S. are now affecting our military across the spectrum of service. This threat spans throughout every stage of the military lifecycle, significantly impacting recruitment, retention, and readiness across all branches of the U.S. Armed Forces. Veteran populations are also disproportionately burdened by these lifestyle-related health concerns. 

An alarming 77 percent of Americans between the ages of 17 and 24 are unqualified physically to enter the armed forces. That is a 6% increase from 2017 and, as a result, every branch of the military is struggling to find recruits. Moreover, basic trainees from states with the poorest level of health are injured more frequently during their service. Another recent study showed that between 2018 and 2021, the prevalence of obesity, prediabetes, and diabetes increased among active service members.  

A panel of experts on military health convened at ACLM’s annual conference last week in Denver shared that this sad state of health constitutes a very real and serious threat to our nation.   

How has this happened? I often say that our fiercest enemy could not have designed a more insidious, destructive force that what we face today. Americans walk into the local grocery store, assuming that everything is FDA-approved and unharmful; yet, the reality is that too much of what fills store shelves is what Michael Pollan refers to as “edible food-like substances” and far from health promoting. Kids, who once spent their daylight hours playing outside, are now sedentary, tied to their electronic devices. While we’re grateful for modern medicine, with ACLM representing conventional medicine clinicians, too much of our healthcare system is devoted solely to disease and disability care, generating immense profits fueled by lifestyle-related chronic disease. From agriculture subsidies that make unhealthful foods cheap and plentiful to the sad reality that 70% of American adults and 90% of all seniors are taking one or more prescription medications, the entire system is designed to “feed the beast,” so to speak.  

Thankfully, there is good news. The American public, clinicians—and select government leaders—are awakening to this unsustainable and untenable reality. They are beginning to understand and embrace the vision that ACLM has been championing since its inception nearly 20 years ago. From the White House spotlighting ACLM’s commitment to educate 100,000 health professionals in lifestyle and food as medicine (now expanded to 200,000) to the military’s ongoing integration of lifestyle medicine into the care it provides active service members and its veterans, our leaders are recognizing that evidence-based lifestyle medicine is, without question, the best medicine.  

Our veterans deserve the health, hope and healing that lifestyle medicine delivers, and our great nation must be the beneficiary of the national security and military preparedness that is only enabled with service members who have been educated, equipped and empowered with lifestyle medicine to achieve optimal health. 

On Veterans Day, let us thank again our brave veterans for their selfless courage and sacrifice and, at the same time, recommit ourselves to ensuring that those in our armed forces, and those who wish to enlist, are healthy in mind, body and spirit. 

Expert Consensus: Lifestyle Medicine in Primary Care 

The American College of Lifestyle Medicine (ACLM) has taken a significant step forward by publishing an expert consensus statement (ECS) titled “Lifestyle Medicine for Optimal Outcomes in Primary Care” in The American Journal of Lifestyle Medicine.

This influential statement defines best practices for the integration of lifestyle medicine into primary care settings, offering a roadmap for physicians to follow in their pursuit of improving patient health and well-being.

In this article, we will delve into the importance of this consensus statement and highlight examples of statements that reached consensus among the expert panel, demonstrating the practical implementation of lifestyle medicine in primary care.

The Significance of the Expert Consensus Statement

This ECS is a significant advancement in healthcare. Its primary objective is to raise awareness among clinicians about the remarkable benefits of lifestyle medicine in primary care settings. Furthermore, it systematically synthesizes expert perspectives to help healthcare professionals integrate lifestyle medicine into their practice, ultimately leading to optimal patient outcomes.

Examples of Statements that Reached Consensus

The consensus statement is a product of collaboration among experts from diverse backgrounds, including physicians, nurse practitioners, physician assistants, clinical psychologists, and other health professionals practicing lifestyle medicine. Their shared goal was to identify best practices for integrating lifestyle medicine into primary care. Here are some examples of statements that achieved consensus:

“Optimal lifestyle medicine services in primary care are best delivered through a multi-disciplinary team approach utilizing a qualified clinician lead and qualified supporting health professionals.”

“Integrating lifestyle medicine into primary care can reduce clinician burnout while increasing professional satisfaction and fulfillment.”

“Effective deprescribing of medications is an essential part of safe and effective lifestyle intervention treatment.”

“Lifestyle medicine is an essential component of primary care in patients of all ages.”

“Lifestyle medicine is intended to complement, not replace, conventional medical approaches such as pharmaceutical treatment, if those treatments are necessary for the patient to achieve optimal metabolic outcomes.”

These statements, among others, provide guidance for physicians and healthcare professionals on how to incorporate lifestyle medicine principles into their primary care practice. They emphasize the importance of a multidisciplinary approach, ongoing education, evidence-based interventions, and collaboration with patients to achieve the best possible health outcomes.

Meagan Grega, MD, DipABLM, FACLM, chair of the expert panel, emphasized the significance of the work, saying “This panel of experts from diverse backgrounds agreed on many key aspects of lifestyle medicine that can be incorporated into the primary care setting to achieve improved quality and outcomes, while also identifying benefits such as decreased health-related costs and enhanced patient and clinician satisfaction.”

Why It Matters for Primary Care Clinicians

The consensus statement’s implications for primary care clinicians are profound. The primary care team members are often the first point of contact for patients, and they play a pivotal role in disease prevention and management.

Improved Patient Outcomes

By embracing lifestyle medicine, physicians and members of the primary care team can meaningfully improve patient outcomes and enhance their quality of life. This approach addresses the root causes of chronic diseases, leading to better long-term results.

Reducing the Burden of Chronic Disease

Chronic diseases such as type 2 diabetes, heart disease and obesity are strongly influenced by lifestyle choices. Lifestyle medicine offers a proactive approach to reduce the burden of these conditions.

Professional Fulfillment

Implementing lifestyle medicine can reduce burnout and increase professional satisfaction. It empowers physicians to engage in more meaningful patient interactions and witness positive, sustainable changes in their patients’ health.

Conclusion

The ACLM’s expert consensus statement “Lifestyle Medicine for Optimal Outcomes in Primary Care” is a significant milestone in healthcare. It defines best practices for integrating lifestyle medicine into primary care settings, offering physicians a clear roadmap to improve patient outcomes and quality of life.

By embracing lifestyle medicine, physicians and all members of the primary care team can address the root causes of chronic diseases, reduce the burden of these conditions, and align their practice with national recommendations for high-quality primary care. This approach not only benefits patients but also enhances professional satisfaction and fulfillment for healthcare professionals.

Primary care practitioners have a unique opportunity to lead the way in implementing lifestyle medicine and reshaping the future of healthcare. By adopting the principles outlined in the consensus statement, they can play a pivotal role in improving the health and well-being of their patients while contributing to a healthcare system that prioritizes prevention and holistic care.

Read the full statement: American College of Lifestyle Medicine Expert Consensus Statement: Lifestyle Medicine for Optimal Outcomes in Primary Care