What is it?
As defined by The American College of Lifestyle Medicine it is the, “evidence-based practice of helping individuals and families adopt and sustain healthy behaviors that affect health and quality of life.” The most deadly and crippling disease processes seen today certainly have a genetic component, but research strongly suggests many diseases are multifactorial. This means that our environment or behavior plays a major role in even the leading causes of death in America.
What is killing us now?
The leading causes of premature death in the United States include cardiovascular disease, cancer, stroke, chronic respiratory disease, and diabetes. Current Center for Disease Control trends predict 1/3 of the U.S. adult population will be diabetic by 2050 and certain ethnic groups may be towards 1/2. Also alarming is the instance of strokes, obesity, and diabetes rising in young adults (5-14 year olds). These diseases don’t just take years from our life, but life from our years.
What can we do about it?
The good news is that numerous studies link most premature deaths to three things that can be modified by the patient. These modifications include: tobacco cessation, improved diet and increase in physical activity. This has been researched extensively for decades. One study released in 2009 called ‘Healthy Living is the Best Revenge’ released pertinent data regarding 23,000 people studied in Germany. This group was followed for eight years using a point system for physical activity, diet habits, smoking, and body mass index. The conclusion of the study states that adhering to the 4 basic principles listed above strongly impacts the prevention of chronic disease, in fact by 80%. Implementing these changes can eliminate 80% of cardiovascular disease, 80% diabetes, and 60% cancer. If the FDA approved a drug that could boast similar results millions would be buying it.
Lifestyle medicine can be very straightforward and achievable. Hippocrates seen as the father of lifestyle medicine stated, “Let food be your medicine” and, “walking is man’s best medicine”. Dr. David Katz, the President of the American College of Lifestyle Medicine has similar views and breaks it down into 6 categories: Feet, forks, fingers, sleep, stress, and love.
Jogging was once called “roadwork” for the few that were athletes decades ago. Most people a few generations back would get their exercise through their day job. Now it is commonplace to have desk jobs that require little to no physical effort. This has become a major problem if exercise isn’t implemented outside of work. It is widely understood that physical activity improves cardiovascular health, decrease risk of diabetes, obesity, etc. But there are so many additional benefits. Multiple studies show that aerobic exercise can significantly improve anxiety and depression symptoms and protects against harmful consequences of stress. Do you have problems with memory and focus? Several studies have documented that physical activity improves brain health and plasticity as well. If you don’t like “roadworking” find something else to get your feet moving and you too can reap the significant benefits.
“Eat your veggies”, your mom would exclaim! We all know moms know best and there are hundreds of studies out there proving just that. The number of studies and overwhelming evidence released on the benefits of eating fruits and vegetables is significant, yet there is not much publicity. Why? Big money is generated in other studies that can sell weight loss pills instead. There is a meta-analysis of 9 studies consisting over 200,000 men and women that showed a significant decrease in cardiovascular disease risk by the consumption of fruits and vegetables. Another source examined 200 studies that found a relationship between fruits and vegetables and 10 different types of cancer. Strong evidence from these studies suggests that there is a protective effect from several common cancers by simply consuming fruits and vegetables. This just skims the surface.
It is a well-known fact that smoking can cause lung cancer, but it can also cause bladder, esophagus, stomach, and several other types of cancer. There are other disease processes caused by smoking. It causes heart disease and strokes as it affects the arteries in the cardiovascular system. Smoking can also have reproductive side effects in women such as ectopic pregnancies and premature, low birth-weight babies. It can have an impact on bone health and increases the risk of periodontal disease, cataracts, and macular degeneration. It suppresses the immune system and increases inflammation throughout the body. This is a short summary of all the effects of smoking. There is no surprise that smoking is bad for us, but it may be astonishing to see so many other parts of the body affected by smoking.
Sleep is essential for optimal physical health, immune function, mental health and cognition. Insufficient sleep is a public health problem. Nearly 30% of adults in the United States report sleeping 6 or less hours per day. Sleep deprivation has adverse effects such as cognitive impairment, poor mood and judgment, poor cardiovascular health, obesity and metabolism just to name a few.
Mental stress has its importance, but its function is different now than it was 1,000-10,000 years ago. Stress then would function to keep humans alive and safe. For example, a lion spotted across the plains would activate stress hormones causing the human to run away and live. Stress is used to protect us from immediate, short-term harm. It can be the motivation to prepare and perform in school and work and other functions in life. Yet if it’s chronic it can cause major health problems such as high blood pressure, diabetes, chronic headaches, decreased immune system, anxiety, and depression. Stress is the gateway to anxiety and depression. Anxiety disorders effects 1/5 of the people in the U.S. today.
Love promotes health. Meaningful relationships with friends and family can activate areas in the brain responsible for emotion, attention, motivation and memory. Studies have demonstrated that those with loving relationships are far less vulnerable to chronic disease and premature death than those without. The opposite is certainly true. In fact there is a disease called broken heart syndrome. It is a disease that physically weakens part of the heart commonly mistaken for a heart attack. Fortunately, most people recover rapidly with no long-term heart damage.
Our society is always looking for the silver bullet. We live in a culture that is continually advertising unsustainable diets, promising quick exercise schemes, and pushing pills. We always buy into the “best kept secret”’ that are “quick” and “easy” with minimal effort required. Lifestyle medicine reminds us that the things that will make us strong and healthy both physically and mentally are not secrets at all.
It is our goal as family physicians to examine multiple areas that contribute to the wellbeing of the patient. We don’t want to exclusively treat and manage diseases that have already happened, although we do that too. We would like to help prevent disease through a myriad of critical health factors, some mentioned above. Archimedes once said, “Give me a lever long enough I could move the world.” These tools are long enough to help us all live a long, healthy, happy, and prosperous life. And we are excited to help!
Contributed by Mike Snarr, DO