What is Lifestyle Medicine?

On your list of goals, improved eating habits and fitness will likely always have a place. However, when was the last time these issues were addressed at your doctor’s appointment?

While much of conventional medicine focuses on treating disease, lifestyle medicine takes a more holistic approach.

“Lifestyle medicine (LM) involves the use of evidence-based therapeutic approaches, such as a predominantly whole food, plant-based diet, regular physical activity, adequate sleep, stress management, and avoidance of risky substance use, to prevent, treat, and, oftentimes, reverse the chronic disease that’s all too prevalent,” said Sarah Keyes, a certified lifestyle medicine professional at Baylor College of Medicine.

The four pillars of LM are sleep and stress management, physical activity, relationships, and nutrition. LM is recommended by several organizations as the primary foundational approach in conventional medicine.

“When you look at studies about actual causes of death, tobacco use, poor diet, physical inactivity and alcohol consumption all are primary contributors,” Keyes said. “All of the diseases we worry about in our patients, ourselves or family members result from lifestyle-related behaviors that we often don’t talk about.”

Nutrition and ‘mood foods’

Keyes says many people often look for a “magic bullet” when it comes to healthy eating, but there are several factors to consider for nutrition.

“Most Americans will look for the easiest answer: ‘What’s the pill I need to take or the food I need to eat every day?’ My answer is it’s not just one thing, it’s the whole lifestyle we need to address,” she said. “There are dietary patterns that have strong evidence behind them in disease treatment, prevention and reversal.”

Keyes says choosing the right foods can also improve your mood. Nutrition psychiatrists cite the “gut-brain” connection as critical to managing anxiety and depression.

Mood-boosting foods include:

• Clams, mussels, oysters
• Leafy greens
• Wild salmon
• Organ meats
• Nuts
• Beans
• Seeds

Physical activity and becoming a ‘N.E.A.T’ freak

By now you know that being physically active can reduce your risk of heart disease, stroke, diabetes and some cancers – but it can also protect memory and thinking skills.

“Being sedentary is its own risk factor for disease. Regular exercise lowers blood pressure and can help prevent and treat depression,” Keyes said. “Areas of the brain that control thinking and memory are greater in volume in those who exercise versus those who don’t.”

LM endorses the CDC’s recommendations for physical activity, which include 150 minutes a week of moderate intensity physical activity and strength training two days every week. Increasing non-exercise activity time (N.E.A.T.), can help improve overall fitness.

“Instead of trying to get 150 minutes in by running for 30 minutes, try taking the stairs or getting up and moving every 30 to 60 minutes. You can also increase activity by parking further away from your office or having walking meetings when on the phone,” Keyes said.

Sleep and stress management

The benefits of avoiding sedentary behavior are well documented, but what is the connection between stress and disease?

“When we are chronically stressed, we produce more adrenaline and cortisol, which can cause clotting, increased heart rate, blood pressure and decreased heart rate variability,” Keyes said. “Stress also leads to poor sleep, which leads to irritability, memory issues, depression and accidents.”  To improve sleep you should:

• Follow a regular sleep schedule
• Avoid napping in the evening
• Develop a bedtime routine
• Reduce screen time before bed
• Limit caffeine and alcohol

Keyes says that expressing gratitude and appreciation, enjoying nature, limiting social media and scheduling time for activities you enjoy can all help reduce stress.

Relationships

Along with reducing stress and improving sleep, maintaining a healthy social life also positively contributes to preventive health. For example, our pets are often some of our closest friends, but there are other benefits to being a pet owner.

“Having pets can decrease blood pressure, cholesterol levels, triglyceride levels, and feelings of loneliness,” Keyes said. “They also increase opportunities for exercise, outdoor activities and socialization.”

Research shows that loneliness is a risk factor for premature mortality. Friendships (with humans or pets) can reduce stress, protect immunity, and decrease risk of developing dementia.

Implementing LM curriculum

For the past two years, Keyes, an assistant professor in the Physician Assistant Program at Baylor, has been implementing LM training with Baylor students.

Students learn to perform a prevention and lifestyle assessment as part of their history and physical diagnosis course and apply LM knowledge to a standardized patient encounter in which they give a nutrition prescription.

“Trainees get lots of training on how to treat disease, but not as much on how to use nutrition and physical activity to prevent disease. Through lifestyle medicine training, we are trying to change that and help the medical community treat disease by improving lifestyle-related behaviors.”