What Is Lifestyle Medicine And Why Is It Needed?

There are several definitions of lifestyle medicine

The British Society of Lifestyle Medicine (BSLM) defines it as “Lifestyle Medicine is evidence-based healthcare that supports behavior change through person-centered techniques to improve mental well-being, healthy relationships, physical activity, healthy eating, sleep and minimization of harmful substances or behaviors”.⁸

The American College of lifestyle medicine (ASLM) defines it as “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”.⁹

It is based on the three fundamental principles: the socio-economic determinants of health, behavioral change, and the six pillars, and is founded on the idea that unhealthy lifestyle habits, including a poor diet, inactivity, and excessive use of harmful drugs, are to blame or make many chronic diseases that concern us today—including heart disease, diabetes, and obesity—worse.

The core components of Lifestyle Medicine include “healthy eating, physical activity, stress management, sleep hygiene, healthy relationships,” and avoidance of harmful substances such as tobacco and excessive alcohol consumption.¹⁰ These lifestyle interventions effectively prevent and treat a wide range of chronic diseases.¹¹

Contrary to conventional medicine, lifestyle medicine places more emphasis on disease prevention than on the treatment of chronic conditions. It recognizes that lifestyle behaviors are the preventable causes of death and disability and that these behaviors can be altered using behavioral, environmental, and motivational approaches to address the underlying causes of disease.

Why is it needed?

The prevalence of chronic diseases has reached epidemic proportions worldwide, and lifestyle behaviors are primarily responsible for this trend. World Health Organization states that 74% of all deaths globally (41 million) are accountable to non-communicable diseases (NCDs) every year. Before age 70, 17 million people die due to NCDs, and 86% of these premature deaths happen in low- and middle-income countries. The majority of NCD deaths, or death of 17.9 million people per year, are caused by cardiovascular illnesses, which are followed by malignancies (9.3 million), chronic respiratory diseases (4.1 million), and diabetes (2.0 million). Furthermore, the chance of dying from an NCD is increased by using tobacco products, being inactive, drinking alcohol harmfully, and eating poorly.¹²

The two “killer diseases” that account for more than half of all deaths in the US are cancer and cardiovascular disease (CVD).¹³ Similarly, 88.8% of fatalities in England in 2019 (Figure 1) were caused by NCDs & according to estimates, 6.4 million people in England were expected to have cardiovascular diseases in 2020.¹⁴ In addition, obesity and diabetes are inflammatory diseases that encourage one another and act as significant comorbidities; they both cause inflammation, which in turn contributes to CVD and cancer.⁵ Another report suggests that the leading causes of death in males and females in England are ‘Suicide and injury or poisoning of undetermined intent (external)’.¹⁵

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Figure 1.

Deaths from sex-related circulatory illnesses in England, 2019¹⁷

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Figure 2.

Obesity prevalence in India ¹⁹

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Additionally, more than 135 million people in India suffer from obesity. In India, the prevalence of obesity varies according to factors including age, gender, and place (geographical and socio-economic). According to a 2015 ICMR-INDIAB study, “the prevalence rates of central obesity and total obesity range from 16.9% to 36.3% and 11.8% to 31.3%, respectively”. Abdominal obesity is one of the critical risk factors for cardiovascular disease (CVDs) in India. According to numerous studies, women are far more likely than males to be obese.¹⁷

These illnesses, which are modifiable, are present in the most affluent country in the world, which spends more per person on healthcare than any other modern economy while having some of the worst health results.¹⁹ The primary issue is the poor lifestyle decisions made because of incomplete knowledge.^20,21 Changes in our approach to maintaining our own and our patient’s health can help improve this,⁵ and finding reasonable, practical, and simple solutions for people to access is also essential, both of which can be addressed through Lifestyle Medicine.

Lifestyle Medicine offers a new paradigm for preventing and treating chronic diseases by focusing on the root causes of these diseases rather than just managing their symptoms. It recognizes that lifestyle behaviors are the leading causes of preventable death and disability worldwide and that modifying these behaviors can significantly impact public health. Lifestyle Medicine also recognizes that lifestyle interventions can be more cost-effective than traditional medical interventions and reduce the burden of chronic diseases on the healthcare system.

Lifestyle Medicine is also needed because traditional medical approaches to chronic disease management have limitations. For example, pharmacological interventions for chronic diseases often have side effects and may not address the root causes of the disease. In contrast, lifestyle interventions are effective in preventing and treating chronic diseases and do not have the same side effects as pharmacological interventions.

The potential impact of Lifestyle Medicine on public health

With its ability to reduce the burden of chronic diseases and enhancement of general health outcomes, lifestyle medicine has the potential to affect public health significantly. Many chronic diseases, and some malignancies, have been demonstrated to be effectively prevented and treated by lifestyle modifications such as keeping a healthy body mass index (BMI), eating a nutritious diet, increasing physical activity, and reducing stress.^22-24 One of the most extensive interventional studies, ‘Diabetes Prevention Program’ conducted across 27 clinical centers in the US on 3,234 individuals, found that compared to metformin, which decreased the risk of type 2 diabetes by 31%, a lifestyle intervention comprising diet and exercise lowered the risk by 58%.²⁵

Furthermore, lifestyle medicine can also advance health equity by addressing the socio-economic determinants of health that contribute to health inequities. For example, those who reside in low-income areas might need access to wholesome diets or secure workout facilities. With the promotion of healthy behaviors and the development of surroundings that support healthy lifestyles, lifestyle medicine can address these social determinants of health.²⁶

Role of Physician in Lifestyle Medicine

Although awareness is created among clinicians about lifestyle medicine, only a few have been trained, and many must undertake this training in lifestyle medicine to better their patients. Spending meaningful time and spreading knowledge to the patients is the need of the hour. This cost-effective means will reduce people’s suffering and improve the nation’s economic stability.

Many countries are now offering this board-certified course across the world. Expert clinicians in the field are heading this program in their respective countries and are providing the skills required for practicing. Examples of the same include exemplary efforts from the British Society of Lifestyle Medicine – Doctor’s Kitchen Website in sighting about healthy recipes, Regional Directors, NHS GPs, and TV presenters ran the pandemic series podcasts on staying fit physically and mentally during the COVID lockdown and Physicians are creating awareness about physical activity by writing blogs on ‘No Pain No Gain’ concept. Similarly, the ACLM is creating awareness by offering free courses on the ‘Lifestyle Medicine & Food as Medicine Essentials Bundle’ for physicians and many more educational opportunities. In addition, the Indian Society of Lifestyle Medicine in India puts tremendous efforts into spreading awareness among Health care providers by conducting various activities like webinars, grand rounds, marathons, monthly case study discussions, research activities, and other programs. Evidence-based lifestyle medicine pioneers in India have also put in tremendous amounts of effort. Overall, these medical trailblazers are influencing the next generation of doctors to adopt the Lifestyle medicine attitude, and educational changes are starting to emerge for practicing physicians who feel underprepared.