A blog submission by PHA Board Member and American College of Lifestyle Medicine President Dexter Shurney, MD, MBA, MPH, FACLM, DipABLM
The American College of Lifestyle Medicine defines Lifestyle Medicine (LM) as the combined use of a whole food, plant-predominant diet, regular physical activity, restorative sleep, stress management, avoidance of risky substances and positive social connection in a prescribed synergistic manner as a primary therapeutic modality for the treatment and reversal of chronic disease. While these positive lifestyle habits are an established component of wellness and disease prevention and a core component of Population Health, it’s the most rigorous application of these concepts and their use as “the first-line medicine” that highlights LM’s65 contribution within the larger Population Health family. In other words, LM compliments and helps to enhance the core tenets of the Population Health in powerful ways. We find that the health synergies created by prescribing a therapeutic dose, individualized to the patient, in each of the lifestyle domains simultaneously is the key to breakthrough outcomes. The change to a patient’s health is often so rapid and profound that it can necessitate a simultaneous and rapid reduction in the patient’s prescription medications.
For instance, type-2 diabetics receiving an intensive LM prescription will often need to reduce their insulin dose by one-half within the first week of treatment to avoid a potentially harmful medication overdose (hypoglycemic) situation. Because of this often-rapid change for the need of medications, partnership with an appropriately trained LM practitioner is important, working hand-in-hand with other population health teammates, to provide the proper patient support and education is ideal.
LM is a powerful intervention, for the simple fact that lifestyle is at the center of so many common chronic conditions like heart disease, type-2 diabetes, pre-diabetes, obesity, dementia, and cancer. Therefore, a single but comprehensive LM intervention can be used to treat multiple disease states. For example, the type-2 diabetic that is experiencing a reduction in the need for insulin will also see an average reduction of 20% in their cholesterol numbers within 7-8 weeks, assuming their cholesterol was elevated to start with. When explaining LM I sometime use the analogy of vegetable gardening. When a plant has the proper soil, sun exposure, and water (not too much/not too little), the entire plant is healthy. The same is true for the human organism. Given the proper sleep, physical activity, nutrition, stress, etc. we see improvements in all the most common chronic conditions (diabetes, obesity, hypertension, heart disease, etc.), i.e. the “entire” human organism becomes healthy. It makes sense that for the 80+ percent of preventable chronic conditions that are rooted in poor lifestyle, that a lifestyle directed treatment option would prove to be tremendously effective.
Population health is a team sport. The complimentary role of Lifestyle Medicine as part of the Population Health Management framework is of vital importance and cannot be overemphasized.
About ACLM: Founded in 2004, the American College of Lifestyle Medicine (ACLM) is the medical professional society for physicians and other professionals dedicated to clinical and worksite practice of Lifestyle Medicine as the foundation of a transformed and sustainable health care system. ACLM educates, equips, empowers and supports its members as they provide evidence-based Lifestyle Medicine as the first treatment option in clinical practice and worksite settings through live and online CME-accredited events and educational offerings, certification, clinical practice tools, patient education resources, economic research, networking opportunities and advocacy efforts.