EMBRACING CHANGE
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fessionals . Worldwide , across 75 countries , 5,017 physicians and 1,671 other clinicians are certified , for a total of 6,688 . 2
The six pillars of lifestyle medicine embrace a whole-food , plant-predominant eating pattern , physical activity , restorative sleep , stress management , avoidance of risky substances and the importance of positive social connections . Studies have shown that a very low saturated fat diet that is high in plant sterols worked as well as lovastatin 20 mg in lowering cholesterol . Vegan diets were superior to the American Diabetes Association diet in controlling serum glucose in Type 2 diabetes in a 24-week randomized controlled trial . Patients with early-stage prostate cancer choosing active surveillance might be able to avoid or delay conventional treatment for at least two years when they adopt a low fat , plant-based diet and practice stress management . 10
For optimal health , aim to eat plenty of vegetables , mushrooms , fruits , legumes / beans , whole grains , nuts , seeds , herbs , spices and water . Limit sugary drinks like soda , juice cocktails and energy drinks , processed meats like sausage , bacon , salami and deli meat , processed snacks like crackers , chips , pretzels , cakes and pastries , and high fat dairy , red meat , poultry and eggs .
Exercise improves sleep , mood , brain function and perceived quality of life . It lowers blood pressure , improves insulin sensitivity , helps with weight maintenance and reduces risk for cognitive decline . Some studies have shown a 17-30 % decreased risk for colon cancer and 25 % reduced risk for breast cancer . Moore and his colleagues did a large pooled cohort analysis looking at years of life gained by individuals meeting physical activity guidelines compared to sedentary ( 0 MET ) age 40 and older . They found that up to 500 minutes of brisk walking per week leads to 4.5 years of life gained . Another study by Saint-Maurice et . al . showed that going from 2,000 steps to 4,000 steps reduces mortality rate by 5 % per 1,000 adults per year and walking 10,000 steps per day reduces mortality rate by 15 % per 1,000 adults per year . 10
It makes sense that the more active we are , the healthier we are , with less chronic health care cost . They found a 4.7 % reduction in the median health care cost for each additional day of physical activity . An inactive person costs $ 1,543 dollars more per year than an active person . According to a systematic review of 12 studies that looked at cost effectiveness of physical activity in primary care and the community , they found that the cost to change one person from “ inactive ” to “ active ” is between $ 500- $ 5,000 and that brief advice given in person , phone or mail were more cost effective than supervised activities ( gym or exercise programs ). 10 Tell your patients to get on the move ! Walking , yoga , structured exercise programs , personal trainer help , online classes you work out with at home : try to get your patients going as best you can .
Roughly 60 million U . S . adults ( 1 in 3 ) have difficulty sleeping . 11 The U . S . loses up to $ 411 billion a year due to low productivity and
absenteeism due to insufficient sleep . An individual who sleeps less than six hours per night has a 10 % higher mortality risk than a person sleeping between seven and nine hours . 12 Healthy , longer sleep leads to lower cortisol and glucose levels , with higher daytime leptin , associated with less carbohydrate intakes and reduced food-seeking behaviors . People who sleep for only four hours for five nights consume an extra 300 calories during the day ( mostly composed of saturated fats ). Short or disrupted sleep correlates with obesity , metabolic syndrome , diabetes , major depression , bipolar disorder and more . Sleep is important in DNA repair and remodeling . Poor sleep correlates with increased risk for breast , endometrial , prostate , colorectal cancer and AML . Meanwhile , Kripke et al ., found that receiving sleeping pill prescriptions was associated with a greater than threefold increased hazard of death even when only given less than 18 pills per year . 10
Tips for better sleep include : www . lifestylemedicine . org
• Beds are for sleeping , not working . Establish a regular sleep schedule .
• Minimize / eliminate bedroom noise and lights . Increase daytime exposure to sunlight .
• Move around a bit at least every hour during the day .
• Eliminate nighttime caffeine and limit daytime caffeine .
• Avoid alcohol within three hours of bedtime and avoid high-sodium foods close to bedtime .
• Eliminate / limit after dinner and late-night snacking .
• Maintain a healthy BMI and stay hydrated during daylight hours .
• Use cognitive behavior for treatment of insomnia .
• Increase exercise to 150 minutes of moderate intensity per
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