What does the word “lifestyle” mean to you? Does it bring back memories of Robin Leach’s popular show Lifestyles of the Rich and Famous?  On that show, the term lifestyle was about the tastes, habits, attitudes, standards of living, and general way of life for rich folks.  It was fun to watch, but hardly the same “lifestyle” that doctors are talking about when they talk about improving your lifestyle for health reasons.  

From a medical perspective, “lifestyle” is a powerful medicine. In fact, studies have repeatedly shown that 80% of chronic diseases could be prevented with diet and lifestyle changes alone. That type of lifestyle is all about how we choose to use our three F’s…our Feet, Forks, and Fingers. Our feet to move our bodies. Our forks to make good food choices, and our fingers to put out the cigarettes. That’s all it takes to improve your lifestyle today!  This article by my team at UpWellness may not help you get rich or famous…but it will help you improve your lifestyle today!  

Be Well, 

Dr. Josh 

The statistics are in, and they are staggering, to say the least. Lifestyle illnesses are on the rise, and millions of people are dying needlessly because poor lifestyle choices have made them sick. Almost half of all American adults  (that’s almost 120 million people) have one or more preventable chronic conditions, many of which are related to poor diet and lack of physical activity. Let’s uncover just how bad things are and what can be done.

Lifestyle illnesses include cardiovascular disease, high blood pressure, type 2 diabetes, some cancers, and poor bone health. Take a look around, almost two-thirds of adults and nearly one-third of children and youth are either overweight or obese. For more than two decades, these statistics have persisted and come with skyrocketing health risks and high costs. 

The costs associated with obesity were estimated to be about $147 billion in 2008. In 2012, the total estimated cost of persons diagnosed with diabetes was $245 billion. This included $176 billion in direct medical costs and another $69 billion in decreased productivity. Over 80% of spending on healthcare in America is tied up in the treatment of conditions related to poor lifestyle choices.

Food intake trends show that Americans eating habits are atrocious. This, combined with low physical activity, answers the question as to why rates of obesity and chronic lifestyle illnesses have continued to climb. Type 2 diabetes alone is on the brink of global pandemic levels 

Unpacking the truth about lifestyle medicine

Lifestyle medicine as defined by the American College of Lifestyle Medicine is,

“The use of a whole food, plant-predominant dietary lifestyle, regular physical activity, restorative sleep, stress management, avoidance of risky substances and positive social connection as a primary therapeutic modality for treatment and reversal of chronic disease.”

If poor lifestyle choices have gotten this country and millions of Americans into such a sickly state, it begs to reason that good lifestyle choices can help restore health. That is what lifestyle medicine is all about. Working with individuals and groups to educate and encourage personal responsibility when it comes to health is instrumental in getting a grip on unnecessary deaths and excessive spending on controllable diseases.

The truth is hard to avoid

The data is in, the statistics don’t lie, and just a simple walk through many of America’s towns speak volumes to the truth that poor lifestyle choices pose a significant threat to most people in this country. 

Hundreds, if not thousands, of research studies, supply evidence that regular physical activity, maintenance of a healthy weight, eating a well rounded, whole food diet, and not smoking cigarettes can add to both the quality and duration of one’s life. 

Sadly, less than half of the adult population the United States meet the minimum requirements for aerobic exercise and less than 20% of adolescents get enough physical activity to reap any health benefits

Fewer than one-third of the population eats enough fruits and vegetables and follows other healthy nutritional principles. Over one-third of Americans have high blood pressure, and if the new blood pressure guidelines from the American Heart Association and the American College of Cardiology are widely adopted, this number increases to a whopping 46%.

Consensus statements abound, all backed by evidence-based clinical guidelines outlining the prevention and treatment for metabolic diseases. The statements below place emphasis on lifestyle medicine principles and practices as integral parts of the prevention and treatment of disease.

• 2017 Guideline for the Prevention, Detection, Evaluation and Management of High Blood Pressure in Adults

• 2013 AHA/ACC/TOS Guideline for the Management of Overweight and Obesity in Adults

• 2015-2020 Dietary Guidelines for Americans

• American Heart Association Strategic Plan for 2020

• Preventing Cancer, Cardiovascular Disease and Diabetes: A Common Agenda for the American Cancer Society, the American Diabetes Association and the American Heart Association

• 2018 Physical Activity Advisory Committee Scientific Report

The power of daily healthy habits

There is power in adopting healthy daily practices. This has been seen in several randomized controlled trials. The Nurses’ Health Study found that more than 80% of all heart disease and more than 91% of all diabetes in women could be eliminated if people would adopt a group of healthy and positive lifestyle habits. These include maintaining a healthy body weight, exercising regularly (at least 30 minutes daily), and avoiding tobacco products. Nutritional habits include increasing whole grains and eating more fruits and veggies while limiting alcoholic beverage intake to one per day.

The US Health Professionals study had similar findings for men who adopted positive lifestyle choices. Additionally, a number of randomized controlled trials also support the massive health benefits of positive lifestyle habits.

Why aren’t more physicians recommending lifestyle changes?

Your general practitionel has likely only had minimal hours of education relative to preventative measures via lifestyle changes. It is just not a hot topic in most med schools.

Most physicians are quite surprised to find out that negative lifestyle choices can have a profound impact on the increased risk of cancer. It is true that cigarette smoking is the leading cause of lung cancer as well as other cancers, a fact that has been widely recognized by everyone in the healthcare field. However, the American Institute for Cancer Research and the International Agency for Research on Cancer has found that there is a significant link to 14 human malignancies and obesity. Excess body fat is the second leading cause of preventable cancer, following cigarette smoking.

Less than 40% of physicians are counseling patients on lifestyle issues regularly. With greater than 70% of adults visiting their primary care physician at least annually – this seems like a sadly missed opportunity. 

Why is the answer simple yet complex?

On the outside looking in, it seems so simple, and in many ways, it is. If everyone would eat right, exercise, and quit using tobacco products, lifestyle illnesses would drop rapidly. However, there is also a complex side to the equation that lies in the fact that making behavioral changes can be incredibly hard. There are many factors that push against making good choices, like increased use of mobile phones and the ease of living in a society where being sedentary is encouraged in many ways. Easy access to unhealthy and calorie-laden food means that most people are consuming an extra 450 calories of empty food per day, a practice that has been going on for the last 30 years!

What should the medical community be doing?

The answer to this question is also simple and complex. Simply, more time needs to be spent educating and discussing with patients the overwhelming benefits of making good lifestyle choices. The complex part has to do with things that push against physicians making this difficult, such as time demands, lack of reimbursement, lack of knowledge (as mentioned above), and a disturbing skepticism that patients will ever change their behavior.

There needs to be a heavy emphasis on the health benefits of lifestyle habits, and physicians need the knowledge and ability to put this into action. It is arguably wrong to not see the elephant in the room anymore. Clearly, if we are going to practice evidence-based medicine, we cannot ignore what is true any longer. Millions of Americans are dying needlessly, and medical costs are through the roof because of poor lifestyle choices.

Small changes are being seen

Author of the book Lifestyle Medicine, third edition, James M. Rippe, MD, shows us a glimmer of hope,

“There are signs that the concept of lifestyle medicine is beginning to take hold. As a cardiologist, I was pleased that the council within the American Heart Association that I sit on changed its name in 2013 from the Council on Nutrition, Physical Activity, and Metabolism to the Council on Lifestyle and Cardiometabolic Health. The American Academy of Family Practice has inaugurated a study track in lifestyle medicine, as has the American College of Preventive Medicine. A fledgling healthcare organization, the American College of Lifestyle Medicine has been launched and has doubled its membership each year for the past 5 years.”

Dr. Rippe says that it is essential for physicians to adopt healthy lifestyle practices themselves. They are, after all, an example, and their patients are watching. 

The time is now and the efforts of the medical community along every citizen of this country to practice healthy lifestyle choices must happen in order to save lives! Everyday we make hundreds of small choices. Each of these choices has the power to heal or the power to hurt…you decide!

-The UpWellness Team