The doctor of the future will give no medicine, but will interest his patients in the care of the human body, in diet, and in the cause and prevention of disease.
- Thomas Edison
Lifestyle Medicine is the evidence-based practice of helping individuals and families adopt and sustain healthy behaviours that affect health and quality of life. Examples include smoking cessation, improving diet, increasing physical activity, reducing stress, avoiding substance abuse and moderating alcohol consumption.
This decade, medical care must continue the move into this form of medicine in order to prevent the expected tsunami of chronic disease in our community like obesity, diabetes, heart disease, stroke, cancer and alzheimers disease.
In the USA, chronic diseases account for 78% of the health spend, and I suspect it is similar here.
Lifestyle medicine research has consistently shown tremendous benefits. As individuals increasingly adopt positive lifestyle behaviours their disease rate and mortality reduces even more. Lifestyle medicine not only prevents disease, but treats it.
A study published in the American Journal of Public Health in 2011 has shown that having never smoked, having adequate exercise, a healthy diet and moderate alcohol consumption reduced mortality. More specifically, exercise was defined as 3 or more aerobic exercise activities per week. The diet had to have adequate fruit and vegetables, nuts etc. Moderate alcohol was considered to be one or fewer alcoholic drinks per day on average, but they emphasized that moderate alcohol drinking was good for reduction of heart disease but of no help for cancer prevention. The researchers found that as people adopted more positive lifestyle behaviours, they gained more benefits. People with all 4 positive lifestyle behaviours were 63% less likely to die over the 16 years period that the patients were followed. Also they were 66% less likely to die of a cancer, 65% less likely to die of heart disease or stroke, and 57% less likely to die of other causes.
There have been numerous other studies over the years in numerous countries that have shown similar results. The positive results of lifestyle medicine are well known.
Too often the way our healthcare system is set up makes it difficult for a conscientious doctor to spend time advising lifestyle changes to help health. Reasons could include the short consultation time with family doctor, poor rebates from health insurers for a long appointment, and our health systems gearing towards acute care rather than prevention.
In addition, it takes a lot of effort and support for someone to change their diet. Many patients don’t have the right supports and family doctors don’t have the time to spend helping in this area. Involving practice nurses and more chronic care incentives will help in this area more and more.
If however, the move towards lifestyle medicine in our healthcare community continues, there will be a reduction of chronic diseases, the cost of running the healthcare system with reduce and our disease-care system will truly be transformed into a healthcare promotion and prevention system.
Earl S. Ford, MD, MPH et al. Low-risk Lifestyle Behaviors and All-cause Mortality. Findings From the National Health and Nutrition Examination Survey III Mortality Study. American Journal of Public Health. 2011;101(10):1922-1929. © 2011 American Public Health Association
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