Way of life medication: Medical doctors prescribe actions, not capsules

The majority of Americans are stressed, sleepless, and overweight, and suffer from largely preventable lifestyle diseases such as heart disease, cancer, stroke, and diabetes.

Being overweight or obese contributes to 50% of adults suffering from high blood pressure, 10% from diabetes and another 35% from pre-diabetes. And the cost is prohibitive and increasing. Approximately 90% of the nearly $ 4 trillion Americans spend annually on health care in the United States goes towards chronic illness and mental illness. However, there are new “lifestyle drugs” that doctors can prescribe for all of their patients.

Lifestyle medicine is the clinical application of healthy behavior to the prevention, treatment and reversal of diseases. Research underscores more than ever that the “pills” today’s doctor should prescribe to patients are the six areas of lifestyle medicine: whole foods, plant-based foods, regular physical activity, restful sleep, managing stress, reducing or eliminating addiction, and positive psychology and social connection.

We are a primary care preventive medicine doctor and a computer immunologist who are both committed to keeping lifestyle medicine clinical practice up to date with the latest research. Our results and recommendations have just been published. We highlight the key take home points for each of the following areas.

Use the Healthy Eating Plate as an evidence-based guide to healthy, balanced meals.

© 2011, Harvard University, CC BY-NC

Whole foods on a plant basis

Diets high in fruit, vegetables, and whole grains, as well as less animal-based and highly processed foods, have been linked to the prevention of many diseases. These diets have also improved health and even reversed common cardiovascular, metabolic, brain, hormonal, kidney, and autoimmune diseases, as well as 35% of all cancers.

We believe that future research should include larger studies or new research methodology focusing on the quality of nutrition. This would include more data on the micronutrient composition and protein sources of plant versus animal foods – not just the percentage of fat, carbohydrates and protein. Such studies should include children, as many diseases in adults are sown in infancy or in the uterus.

Regular physical activity

For decades, surgeon general guidelines have emphasized that daily moderate to vigorous aerobic exercise has both immediate and long-term health benefits. For example, why we age and how quickly we age – chronological age versus biological age – is determined by several molecular processes that are directly influenced by physical activity. And now scientists are gaining a better understanding of the cellular and molecular changes that exercise creates to reduce the risk of disease.

Research priorities for scientists and physicians include a deeper understanding of the type, intensity, and frequency of activity, as well as better insight into the molecular and cellular changes that occur during exercise.

coping with stress

While some stress is beneficial, prolonged or extreme stress can overwhelm the brain and body. Chronic stress increases the risk of cardiovascular disease, irritable bowel disease, obesity, depression, asthma, arthritis, autoimmune diseases, cardiovascular disease, cancer, diabetes, neurological disorders, and obesity.

One of the most powerful mechanisms for reducing stress and improving resilience is to use mind-body and cognitive-behavioral therapy to induce a relaxation response.

More research is needed to gain a better understanding of how these therapies work.

Addiction reduction and elimination

Many social, economic and environmental factors have fueled the national rise in drug abuse in general, and the opioid epidemic in particular.

Doctors and researchers are beginning to understand the underlying physiology and psychology of addiction.

However, the ongoing stigma and incoherent or lack of access to services remain a challenge. Clinicians and scientists need to study how to predict who is more prone to addiction and find ways to prevent it. Integrated care treatment that addresses all of the patient’s needs should be prioritized.

Positive psychology and social connection

Maintaining a positive attitude through gratitude and forgiveness has significant implications for psychological and subjective well-being, which in turn are associated with physical health benefits.

Social connectivity, namely the quantity and quality of our relationships, has perhaps the strongest health benefits.

Conversely, social isolation – such as living alone, having a small social network, participating in limited social activities, and feeling lonely – is associated with higher mortality, increased morbidity, decreased immune system function, depression, and cognitive decline.

More studies are needed to find out how more social interactions change an individual’s biology and chemistry for the better.

The role of inflammation in lifestyle diseases

Unhealthy lifestyle behavior creates a vicious circle of inflammation. While inflammation is a healthy, natural way the body fights infection, injury, and stress, too much inflammation actually promotes or worsens the diseases described above.

The inflammatory response is complex. We’ve used machine learning and computer modeling to understand, predict, treat, and reprogram inflammation – to preserve the healing elements while minimizing the more harmful chronic ones. Scientists are unraveling new mechanisms that explain how chronic stress can switch genes on and off.

Overcome challenges and obstacles

We and others studying lifestyle medicine are now discussing how we can use all of these approaches to improve clinical trials on the effects of lifestyle interventions.

At the same time, we and our colleagues realize that there are environmental challenges and barriers that prevent many people from accepting these lifestyle solutions.

There are food deserts where healthier foods are not available or affordable. Unsafe neighborhoods, harmful chemicals and substances cause constant stress. Bad education, poverty, cultural beliefs, and racial and ethnic differences and discrimination must be addressed so that all people and patients can appreciate and accept the six “pills”.

Lifestyle drug use is especially important now as an unhealthy lifestyle has caused a pandemic of preventable chronic diseases that is exacerbating the COVID-19 pandemic, which disproportionately affects people with these diseases.

Ask your doctor to “prescribe” these six “pills” for a longer and better life. After all, they are free, work better than or as good as drugs, and have no side effects!

Yoram Vodovotz, Professor of Surgery at the University of Pittsburgh; and Michael Parkinson, Senior Medical Director, Health and Productivity, UPMC Health Plan & Workpartners, University of Pittsburgh

This article is republished by The Conversation under a Creative Commons license. Read the original article.

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