Choice Partners Spotlight: Ardmore Institute of Health
The Case for Evidence-Based Lifestyle Medicine
Ron Stout MD MPH FAAFP, Janet Calhoun MA, Paul Martin MFAArdmore Institute of Health; Home of Full Plate LivingLifestyle Medicine (LM) is the use of evidence-based, lifestyle, therapeutic intervention—including a whole-food, plant-predominant eating pattern, regular physical activity, restorative sleep, stress management, avoidance of risky substances, and positive social connection—as a primary modality, delivered by clinicians trained in these modalities, to prevent, treat, and often reverse disease. Early detection of chronic disease has too often been defined as prevention. Mounting evidence indicates that modifiable behavioral risk factors drive the leading causes of morbidity and mortality in the United States. Data analyzed from more than 190 countries found that what people eat and fail to eat, is the leading cause of disease and death.Addressing lifestyle is recommended as a first-line treatment option in many chronic disease guidelines. However, when surveyed, physicians indicate having received little training in behavior change, clinical nutrition, and Lifestyle Medicine therapeutic domains. Increasingly there is a recognition that medications and procedures have been insufficient to alter the negative trajectory of our collective health. (VOL 71, NO 1 | JANUARY/FEBRUARY 2022 | MDEDGE.COM/FAMILYMEDICINE A FAMILY PHYSICIAN'S INTRODUCTION TO LIFESTYLE MEDICINE) Increasingly, the evidence suggests that poor lifestyle habits combined with environments that discourage healthy behaviors have resulted in adverse changes in our epigenetics, microbiome, neuroplasticity, and cellular function. This leads to chronic inflammation and clinical disease. When addressed with improved lifestyle and environment, chronic disease progression can actually be reversed and overall health improved. These findings are summarized in the publication from the Lifestyle Medicine Research Summit (Frontiers in Medicine, Prioritized Research for the Prevention, Treatment, and Reversal of Chronic Disease: Recommendations From the Lifestyle Medicine Research Summit, 2020)The six domains of lifestyle medicine (whole food plant-predominant eating, physical activity, stress, sleep, addictions, and social connections) and effective interventions address the vast majority of inflammatory-mediated chronic diseases. Case studies of rapid improvement in common chronic diseases have been reported based on both the science and practice of lifestyle medicine. (ACLM case series, Craig et al. 2021) Studies showing disease reversal and prescription medication reduction and elimination for advanced inflammatory-related chronic disease are increasingly being described and embraced as evidence of the need for more systematic approaches. (J. Environ. Res. Public Health 2021, 18(21), 11364) Intensive cardiac rehabilitation programs such as those by Ornish, Esselstyn, and Pritikin have proven to be effective and exceed the clinical outcomes of traditional approaches to preventing recurrent cardiac events and arterial plaque progression. (Barnard et al 2020, Bodai et al 2018)Physicians looking to deliver Lifestyle Medicine can begin by exploring the following resources:
Physician training programs can leverage a host of tools including:
The American College of Lifestyle Medicine’s Lifestyle Medicine Residency Curriculum (LMRC). The LMRC is currently used by over 200 residencies, the majority of which are Family Practice. Health Meets Food/Culinary Medicine is another comprehensive training program utilized in various ways at over 60 medical schools.
ACPMs Lifestyle Medicine Resources/CME has been used as a Brand differentiator by MDVIP and similar direct to primary care entities.
The University of South Carolina sponsors an open-source curriculum LMed.
Approaches to engaging patients in therapeutic Lifestyle Medicine include:
The free Full Plate Living online nutrition programs, group facilitated materials and support resources. It is a proven, small-step approach that helps individuals obtain positive health outcomes. Resources to share Full Plate Living with your patients are available at fullplateliving.org/resources
