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Klafke N, Bossert J, Boltenhagen U, Froehlich D, Mahler C, Joos S, Wensing M. Counseling lifestyle medicine in oncology: A qualitative analysis of interprofessional patient-nurse-physician interactions. PATIENT EDUCATION AND COUNSELING 2024; 127:108352. [PMID: 38905751 DOI: 10.1016/j.pec.2024.108352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Revised: 05/23/2024] [Accepted: 06/14/2024] [Indexed: 06/23/2024]
Abstract
OBJECTIVES Counseling plays a key role in promoting health behaviors, providing evidence-based information, and supporting patients with cancer during and after treatment. This study aimed to evaluate an interprofessional counseling service on Complementary and Integrative Health (CIH) for patients being treated at Comprehensive Cancer Centers (CCCs) in Southern Germany. METHODS Patients participating in the CCC-Integrativ study received three CIH counseling sessions within three months in addition to their conventional cancer treatment. Medical and nursing staff participated in a study-specific blended learning training program before conducting the counseling. As part of the process evaluation, 30 audio-recorded counseling sessions were transcribed verbatim and analyzed by conducting a content analysis using MAXQDA 2020. RESULTS Throughout the counseling, patients were conceded to address various health issues, which mainly revolved around symptom management interlaced with the areas of nutrition, exercise, and relaxation. The interprofessional teams conducted the counseling in a structured and patient-oriented manner. They worked together to motivate the patients to apply procedures from the CIH field independently, even if patients sometimes experienced difficulties in implementation. CONCLUSIONS Interprofessional collaboration improved healthcare quality, as patients received comprehensive and evidence-based advice on their supportive needs and lifestyle issues. Both professions could equally contribute their areas of knowledge and expertise and apply them to the benefit of the patients. PRACTICE IMPLICATIONS Providing an integrative counseling service and adequate training on interpersonal communication and CIH for healthcare professionals will improve patient-centered care.
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Affiliation(s)
- Nadja Klafke
- Department of General Practice and Health Services Research, University Hospital Heidelberg, Heidelberg, Germany.
| | - Jasmin Bossert
- Department of General Practice and Health Services Research, University Hospital Heidelberg, Heidelberg, Germany
| | - Ursula Boltenhagen
- Institute of Health Sciences, Department of Nursing Science, University Hospital Tuebingen, Tuebingen, Germany
| | - Daniela Froehlich
- Institute for General Practice and Interprofessional Care, University Hospital Tuebingen, Tuebingen, Germany
| | - Cornelia Mahler
- Institute of Health Sciences, Department of Nursing Science, University Hospital Tuebingen, Tuebingen, Germany
| | - Stefanie Joos
- Institute for General Practice and Interprofessional Care, University Hospital Tuebingen, Tuebingen, Germany
| | - Michel Wensing
- Department of General Practice and Health Services Research, University Hospital Heidelberg, Heidelberg, Germany
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Grega ML, Shalz JT, Rosenfeld RM, Bidwell JH, Bonnet JP, Bowman D, Brown ML, Dwivedi ME, Ezinwa NM, Kelly JH, Mechley AR, Miller LA, Misquitta RK, Parkinson MD, Patel D, Patel PM, Studer KR, Karlsen MC. American College of Lifestyle Medicine Expert Consensus Statement: Lifestyle Medicine for Optimal Outcomes in Primary Care. Am J Lifestyle Med 2024; 18:269-293. [PMID: 38559790 PMCID: PMC10979727 DOI: 10.1177/15598276231202970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024] Open
Abstract
OBJECTIVE Identify areas of consensus on integrating lifestyle medicine (LM) into primary care to achieve optimal outcomes. METHODS Experts in both LM and primary care followed an a priori protocol for developing consensus statements. Using an iterative, online process, panel members expressed levels of agreement with statements, resulting in classification as consensus, near consensus, or no consensus. RESULTS The panel identified 124 candidate statements addressing: (1) Integration into Primary Care, (2) Delivery Models, (3) Provider Education, (4) Evidence-base for LM, (5) Vital Signs, (6) Treatment, (7) Resource Referral and Reimbursement, (8) Patient, Family, and Community Involvement; Shared Decision-Making, (9) Social Determinants of Health and Health Equity, and (10) Barriers to LM. After three iterations of an online Delphi survey, statement revisions, and removal of duplicative statements, 65 statements met criteria for consensus, 24 for near consensus, and 35 for no consensus. Consensus was reached on key topics that included LM being recognized as an essential component of primary care in patients of all ages, including LM as a foundational element of health professional education. CONCLUSION The practice of LM in primary care can be strengthened by applying these statements to improve quality of care, inform policy, and identify areas for future research.
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Affiliation(s)
- Meagan L. Grega
- St. Luke's University Health Network, Easton, PA, USA; Kellyn Foundation, Tatamy, PA, USA (MLG)
| | - Jennifer T. Shalz
- Lifestyle Medicine Department, St. Luke’s Health System, Boise ID, USA (JTS)
| | - Richard M. Rosenfeld
- Department of Otolaryngology, SUNY Downstate Health Science University, Brooklyn, NY, USA (RMR)
| | - Josie H. Bidwell
- Department of Preventive Medicine, University of Mississippi Medical Center, Jackson, MI, USA (JHB)
| | - Jonathan P. Bonnet
- Palo Alto VA Health Care, Palo Alto, CA, USA; Department of Medicine and Division of Primary Care and Population Health, Stanford University School of Medicine, Stanford, CA, USA (JPB)
| | - David Bowman
- Department of Pediatrics, Howard University College of Medicine, Washington, DC, USA; Lifestyle Med Revolution, LLC, Upper Marlboro, MD, USA (DB)
| | - Melanie L. Brown
- Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD, USA (MLB)
| | - Mollie E. Dwivedi
- Department of Orthopaedic Surgery, Division of Physical Medicine and Rehabilitation, Washington University Living Well Center, St. Louis, MO, USA (MED)
| | | | - John H. Kelly
- Loma Linda University, Loma Linda, CA, USA; Lifestyle Health Education Inc., Rocky Mount, VA, USA (JHK)
| | - Amy R. Mechley
- University of Cincinnati College of Medicine, Cincinnati, OH, USA (ARM)
| | - Lawrence A. Miller
- Department of Psychiatry & Behavioral Medicine, Medical College of Wisconsin, Milwaukee, WI, USA (LAM)
| | - Rajiv K. Misquitta
- Department of Lifestyle Medicine, The Permanente Medical Group, Sacramento, CA, USA (RKM)
| | | | - Dipak Patel
- Community Health Center, Inc., Meriden, CT, USA; Connecticut Lifestyle Medicine, CT, USA (DP)Community Health Center, Inc., Middletown, CT, USA (DP)
| | - Padmaja M. Patel
- Lifestyle Medicine Center, Midland Health, Midland, TX, USA (PMP)
| | - Karen R. Studer
- Preventive Medicine, Loma Linda University Health, Loma Linda, CA, USA (KRS)
| | - Micaela C. Karlsen
- Department of Research, American College of Lifestyle Medicine, Chesterfield, MO, USA; Departments of Applied Nutrition and Global Public Health, University of New England, Biddeford, ME, USA (MCK)
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Zhang X, Li C, Liu M, Sun J, Yue H, Bao H. The mediation effect of health literacy on social support and health lifestyle of patients with chronic diseases. Appl Nurs Res 2024; 75:151763. [PMID: 38490794 DOI: 10.1016/j.apnr.2024.151763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 08/18/2023] [Accepted: 02/18/2024] [Indexed: 03/17/2024]
Abstract
BACKGROUND Previous studies have identified the antecedents of the lifestyle of many patients with chronic diseases. However, the mechanism of social support affecting the lifestyle of patients with chronic diseases is unclear, and the role of health literacy in social support affecting the lifestyle of patients with chronic diseases has not been found. Therefore, this study aims to explore the status quo of social support, health literacy and healthy lifestyle of patients with chronic diseases in China and the relationship among them. METHODS Through convenient sampling, 356 patients with chronic diseases were surveyed using a health promoting lifestyle scale, a chronic disease patients' health literacy scale and a social support scale. RESULTS There was a pairwise positive correlation between social support, health lifestyle and health literacy (R = 0.397,0.356,0.556, P < 0.01). After controlling gender, age and education level, it is found that social support has a positive impact on health lifestyle, and health literacy plays an intermediary role between social support and health lifestyle, accounting for 45.78 % of the total effect. CONCLUSION To promote the healthy lifestyle of patients with chronic diseases and delay the development of the disease, we should strengthen social support for patients with chronic diseases; We should simultaneously take various measures to improve their health literacy.
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Affiliation(s)
- Xuemin Zhang
- School of Psychology, Inner Mongolia Normal University, No. 81 Zhaowuda Road, Saihan District, Hohhot 010022, Inner Mongolia, China; School of Humanities and International Education, Baotou Medical College, No. 31 Jianshe Road, Donghe District, Inner Mongolia 014040, China.
| | - Cuiyun Li
- School of Psychology, Inner Mongolia Normal University, No. 81 Zhaowuda Road, Saihan District, Hohhot 010022, Inner Mongolia, China
| | - Min Liu
- School of Psychology, Inner Mongolia Normal University, No. 81 Zhaowuda Road, Saihan District, Hohhot 010022, Inner Mongolia, China
| | - Junfang Sun
- School of Psychology, Inner Mongolia Normal University, No. 81 Zhaowuda Road, Saihan District, Hohhot 010022, Inner Mongolia, China
| | - Heng Yue
- School of Psychology, Inner Mongolia Normal University, No. 81 Zhaowuda Road, Saihan District, Hohhot 010022, Inner Mongolia, China
| | - Hugejiletu Bao
- School of Physical Education, Inner Mongolia Normal University, No. 81 Zhaowuda Road, Saihan District, Hohhot 010022, Inner Mongolia, China.
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Matthews S. Nudging as a Support for Behavioral Change in Lifestyle Medicine. Am J Lifestyle Med 2023; 17:775-781. [PMID: 38511122 PMCID: PMC10948930 DOI: 10.1177/15598276221103476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2024] Open
Abstract
The practice of lifestyle medicine and its emphasis on behavioral change continues to grow around the world. Yet much of the burden of disease weighing on healthcare systems from chronic, modifiable conditions remains stubbornly present. From a behavior change perspective, efforts to date have primarily focused on public health messaging and public health campaigns (global approaches) to interventions such as health coaching (individual approaches). There exists an opportunity to consider contextual elements which support behavioral change. The practice of "nudging" behavior in primary care and allied health settings is proposed as a means of responding to these contextual opportunities. Nudging does not assure change; however, it can invite curiosity about change and small behavioral efforts in the direction of a desired change. Furthermore, its nature conserves autonomy and patient choice while inviting a health-creating behavior. As such, when considered and applied in the context of public health and individual treatment options, it creates a consistent milieu in which behavior change is facilitated.
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Affiliation(s)
- Simon Matthews
- Avondale University Lifestyle Medicine and Health Research Centre, Cooranbong, NSW, Australia (SM); and Wellcoaches Australia + Singapore, Bensville, NSW, Australia (SM)
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Fras Z, Jakše B, Kreft S, Malek Ž, Kamin T, Tavčar N, Fidler Mis N. The Activities of the Slovenian Strategic Council for Nutrition 2023/24 to Improve the Health of the Slovenian Population and the Sustainability of Food: A Narrative Review. Nutrients 2023; 15:4390. [PMID: 37892467 PMCID: PMC10610012 DOI: 10.3390/nu15204390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 10/10/2023] [Accepted: 10/12/2023] [Indexed: 10/29/2023] Open
Abstract
The health status of individuals in Slovenia across age groups is a matter of concern, as current unsustainable lifestyle choices are already leading to various chronic noncommunicable diseases (NCDs). Outdated national dietary guidelines, their inconsistent implementation, and a lack of structural changes represent obstacles to promoting healthy and sustainable nutrition. Limited access to and rising prices of healthy, sustainable foods, in addition to the high availability of low-priced, highly processed foods, increase the risk of NCDs. The lack of systematic health monitoring and early disease detection poses a challenge. Global and local environmental issues, resistance, and/or the inability to adopt healthier diets hinder individuals from changing their nutritional behaviours. In this narrative review, we provide an overview of the current situation in Slovenia as well as planned activities initiated by the Slovenian government and the Prime Minister's Strategic Council for Nutrition, aiming to make progress in supporting healthy and sustainable nutrition, limiting food waste, and increasing the availability of healthier foods for all. Improving the sustainability of the Slovenian food system can contribute to several Sustainable Development Goals (SDGs), ensuring Slovenia's commitment to internationally agreed-upon targets. This could lead Slovenia to take a role as a pilot country in testing and implementing the necessary systemic changes, which could be further applied in other countries.
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Affiliation(s)
- Zlatko Fras
- Division of Medicine, Centre for Preventive Cardiology, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia;
- Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
| | | | - Samo Kreft
- Faculty of Pharmacy, University of Ljubljana, 1000 Ljubljana, Slovenia;
| | - Žiga Malek
- Institute for Environmental Studies (IVM), Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands;
| | - Tanja Kamin
- Faculty of Social Sciences, University of Ljubljana, 1000 Ljubljana, Slovenia;
| | - Nika Tavčar
- Umanotera, The Slovenian Foundation for Sustainable Development, 1000 Ljubljana, Slovenia;
| | - Nataša Fidler Mis
- Ministry of Health, 1000 Ljubljana, Slovenia
- Division of Paediatrics, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia
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Braga JPC, Wolfgram E, Batista de Souza JP, Fausto Silva LG, Estavien Y, de Almeida R, Pestana CR. Lifestyle and Sense of Coherence: A comparative analysis among university students in different areas of knowledge. PLoS One 2023; 18:e0288624. [PMID: 37768963 PMCID: PMC10538790 DOI: 10.1371/journal.pone.0288624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 07/02/2023] [Indexed: 09/30/2023] Open
Abstract
BACKGROUND The concept of health has undergone profound changes. Lifestyle Medicine consists of therapeutic approaches that focus on the prevention and treatment of diseases. It follows that the quality of life of university students directly affects their health and educational progress. EXPERIMENTAL METHODOLOGY Socioeconomic, lifestyle (LS), and Salutogenesis Theory/sense of coherence (SOC) questionnaires were administered to college students from three different areas. The results were analyzed for normality and homogeneity, followed by ANOVA variance analysis and Dunn and Tukey post hoc test for multiple comparisons. Spearman's correlation coefficient evaluated the correlation between lifestyle and sense of coherence; p values < 0.05 were considered statistically significant. RESULTS The correlation between LS and SOC was higher among males and higher among Medical and Human sciences students compared to Exact sciences. Medical students' scores were higher than Applied sciences and Human sciences students on the LS questionnaire. Exact science students' scores on the SOC questionnaire were higher than Human sciences students. In the LS areas related to alcohol intake, sleeping quality, and behavior, there were no differences between the areas. However, women scored better in the nutrition domain and alcohol intake. The SOC was also higher in men compared to women. CONCLUSION The results obtained demonstrate in an unprecedented way in the literature that the correlation between the LS and SOC of college students varies according to gender and areas of knowledge, reflecting the importance of actions on improving students' quality of life and enabling better academic performance.
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Affiliation(s)
| | | | | | | | - Yonel Estavien
- Medical School, UNILA University, Foz do Iguaçu, Parana, Brazil
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7
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Wieczorek M, Meier C, Vilpert S, Reinecke R, Borrat-Besson C, Maurer J, Kliegel M. Association between multiple chronic conditions and insufficient health literacy: cross-sectional evidence from a population-based sample of older adults living in Switzerland. BMC Public Health 2023; 23:253. [PMID: 36747134 PMCID: PMC9901105 DOI: 10.1186/s12889-023-15136-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 01/24/2023] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Health literacy is the ability to find, understand, assess, and apply health information. Individuals suffering from multiple chronic conditions have complex healthcare needs that may challenge their health literacy skills. This study aimed to investigate the relationship between multimorbidity, the number of chronic conditions, and health literacy levels in a sample of adults aged 58+ in Switzerland. METHODS We used data from 1,615 respondents to a paper-and-pencil questionnaire administered as part of wave 8 (2019/2020) of the Survey of Health, Ageing and Retirement in Europe (SHARE) in Switzerland. Health literacy was measured using the short version of the European Health Literacy Survey questionnaire. The final score ranged from 0 to 16 and was categorised into three health literacy levels: inadequate (0-8), problematic (9-12), and sufficient (13-16). The number of chronic conditions was self-reported based on a pre-defined list. Associations were examined using multivariable ordinary least squares and ordered probit regression models, controlling for key socio-demographic characteristics. RESULTS Overall, 63.5% of respondents reported having at least one chronic condition. Respondents who reported one, two, and three or more chronic conditions were more likely to have lower health literacy scores compared to respondents who did not report any chronic condition (p<0.05, p<0.01, and p<0.001, respectively). Suffering from two and three or more chronic conditions (vs. no chronic condition) was significantly associated with a higher likelihood of having inadequate or problematic health literacy levels (both p-values <0.01). CONCLUSIONS Our findings suggest a need to improve health literacy in older adults suffering from chronic conditions. Improved health literacy could constitute a promising lever to empower individuals to better self-manage their health to ultimately reduce the double burden of chronic diseases and insufficient health literacy in this vulnerable population.
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Affiliation(s)
- Maud Wieczorek
- Swiss National Centre of Competence in Research LIVES - Overcoming vulnerability: Life course perspectives, University of Lausanne, Building Géopolis, CH-1015, Lausanne and Geneva, Switzerland.
| | - Clément Meier
- grid.9851.50000 0001 2165 4204Faculty of Biology and Medicine (FBM), University of Lausanne, Lausanne, Switzerland ,grid.9851.50000 0001 2165 4204Faculty of Business and Economics (HEC), University of Lausanne, Lausanne, Switzerland ,grid.9851.50000 0001 2165 4204Swiss Centre of Expertise in the Social Sciences (FORS), University of Lausanne, Lausanne, Switzerland
| | - Sarah Vilpert
- grid.9851.50000 0001 2165 4204Faculty of Business and Economics (HEC), University of Lausanne, Lausanne, Switzerland ,grid.9851.50000 0001 2165 4204Swiss Centre of Expertise in the Social Sciences (FORS), University of Lausanne, Lausanne, Switzerland
| | - Robert Reinecke
- grid.9851.50000 0001 2165 4204Swiss Centre of Expertise in the Social Sciences (FORS), University of Lausanne, Lausanne, Switzerland
| | - Carmen Borrat-Besson
- grid.9851.50000 0001 2165 4204Swiss Centre of Expertise in the Social Sciences (FORS), University of Lausanne, Lausanne, Switzerland
| | - Jürgen Maurer
- grid.9851.50000 0001 2165 4204Swiss National Centre of Competence in Research LIVES - Overcoming vulnerability: Life course perspectives, University of Lausanne, Building Géopolis, CH-1015, Lausanne and Geneva, Switzerland ,grid.9851.50000 0001 2165 4204Faculty of Business and Economics (HEC), University of Lausanne, Lausanne, Switzerland
| | - Matthias Kliegel
- grid.9851.50000 0001 2165 4204Swiss National Centre of Competence in Research LIVES - Overcoming vulnerability: Life course perspectives, University of Lausanne, Building Géopolis, CH-1015, Lausanne and Geneva, Switzerland ,grid.8591.50000 0001 2322 4988Centre for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva, Geneva, Switzerland
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Prather H, Fogarty AE, Cheng AL, Wahl G, Hong B, Hunt D. Feasibility of an intensive interprofessional lifestyle medicine program for patients with musculoskeletal conditions in the setting of lifestyle-related chronic disease. PM R 2023; 15:41-50. [PMID: 34713577 PMCID: PMC9046467 DOI: 10.1002/pmrj.12728] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 10/15/2021] [Accepted: 10/18/2021] [Indexed: 02/04/2023]
Abstract
BACKGROUND Lifestyle factors are associated with musculoskeletal pain and metabolic chronic diseases. To date, intensive lifestyle medicine programs have predominantly targeted metabolic rather than musculoskeletal conditions. OBJECTIVE To assess the feasibility of an intensive interprofessional lifestyle medicine program for patients with musculoskeletal conditions. DESIGN Prospective observational feasibility study. SETTING Tertiary academic medical center. PATIENTS Adults diagnosed with musculoskeletal condition(s) and lifestyle-related chronic disease(s) who previously completed standard-of-care musculoskeletal treatments, enrolled from 2018 to 2020. INTERVENTIONS Patients enrolled in an intensive interprofessional lifestyle medicine program led by a physiatrist, with options to interface with an acupuncturist, dietician, massage therapist, psychologist, physical therapist, and smoking cessation specialist. The physiatrist engaged in shared decision making with patients to establish program goals related to function, overall health, and required lifestyle changes. Bimonthly interprofessional team conferences facilitated communication between treatment team and patients. MAIN OUTCOME MEASURES Feasibility was measured by patient participation and goal attainment. Secondary outcomes included changes from program enrollment to discharge in patient anthropometric, metabolic lab, sleep apnea risk, and Patient-Reported Outcomes Measurement Information System (PROMIS) function, pain, and behavioral health measures. RESULTS Twenty-six patients enrolled in the program (18 [69%] female, mean age 59 [SD 14.5] years, baseline hemoglobin A1c 6.0% [0.8%], high-sensitivity C-reactive protein 7.7 [12.1] mg/dL, 25-hydroxy vitamin D 32.0 [14.2] ng/mL). Of 21 (81%) patients who completed the program, 13/21 (62%) met their goal. On average, program completers presented for 26.2 (10.6) total visits over 191 (88) days. By discharge, program completers achieved clinically meaningful improvement in PROMIS Anxiety (mean difference -3.5 points, 95% confidence interval [-6.5 to 0.5], p = .035), whereas noncompleters did not (p > .05). CONCLUSIONS An intensive interprofessional lifestyle medicine program for patients with musculoskeletal conditions is feasible. With training in lifestyle intervention, physiatrists are well suited to lead interprofessional teams aimed at assisting patients in making lifestyle changes to achieve personalized function- and health-related goals.
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Affiliation(s)
- Heidi Prather
- Department of Physiatry, Hospital for Special Surgery, Weill Cornell Medical College, New York, USA
| | - Alexandra E Fogarty
- Department of Neurology, Division of Physical Medicine & Rehabilitation, St. Louis, Missouri, USA
| | - Abby L Cheng
- Departments of Orthopaedic Surgery and Neurology, Division of Physical Medicine and Rehabilitation; Department of Surgery, Division of Public Health Sciences, Chesterfield, Missouri, USA
| | - Garett Wahl
- Washington University School of Medicine, St. Louis, Missouri, USA
| | - Barry Hong
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Devyani Hunt
- Departments of Orthopaedic Surgery and Neurology, Division of Physical Medicine and Rehabilitation, Washington University in St. Louis School of Medicine, St. Louis, Missouri, USA
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Abdelzaher H, Tawfik SM, Nour A, Abdelkader S, Elbalkiny ST, Abdelkader M, Abbas WA, Abdelnaser A. Climate change, human health, and the exposome: Utilizing OMIC technologies to navigate an era of uncertainty. Front Public Health 2022; 10:973000. [PMID: 36211706 PMCID: PMC9533016 DOI: 10.3389/fpubh.2022.973000] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 08/17/2022] [Indexed: 01/25/2023] Open
Abstract
Climate change is an anthropogenic phenomenon that is alarming scientists and non-scientists alike. The emission of greenhouse gases is causing the temperature of the earth to rise and this increase is accompanied by a multitude of climate change-induced environmental exposures with potential health impacts. Tracking human exposure has been a major research interest of scientists worldwide. This has led to the development of exposome studies that examine internal and external individual exposures over their lifetime and correlate them to health. The monitoring of health has also benefited from significant technological advances in the field of "omics" technologies that analyze physiological changes on the nucleic acid, protein, and metabolism levels, among others. In this review, we discuss various climate change-induced environmental exposures and their potential health implications. We also highlight the potential integration of the technological advancements in the fields of exposome tracking, climate monitoring, and omics technologies shedding light on important questions that need to be answered.
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Affiliation(s)
| | | | | | | | | | | | | | - Anwar Abdelnaser
- Institute of Global Health and Human Ecology, The American University in Cairo, New Cairo, Egypt
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10
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Pasarica M, Boring M, Lessans S. Current practices in the instruction of lifestyle medicine in medical curricula. PATIENT EDUCATION AND COUNSELING 2022; 105:339-345. [PMID: 34116891 DOI: 10.1016/j.pec.2021.05.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 04/23/2021] [Accepted: 05/29/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE A review of current practices of educational interventions for lifestyle medicine was performed to inform the design of interventions with long-term goals of improving patient outcomes. METHODS Systematic review of PubMed, MedEdPORTAL, and Cochrane using keywords "lifestyle medicine," "education," "medical students," and "medical school" was done by 3 independent reviewers. Location, learner, curricular hours, focus, outcomes, and impact are reported. RESULTS Of 452 identified citations, 32 met criteria. Most studies (81%) were conducted in the U.S. and designed for medical students (72%). Studies focused primarily on nutrition (78%) and exercise (59%). Curricula were delivered on average across 13.7 h. Lectures were used in 53% of papers. The outcomes most commonly studied were satisfaction (66%,), knowledge perception (66%), and reported clinical practices (34%). Intervention impact at level 2b (31%) and level 3 (34%) were most common. CONCLUSION Medical educators looking to integrate lifestyle education curriculum should consider current resources as a starting point, especially ones with higher outcome measurements. PRACTICE IMPLICATIONS Novel interventions should target lifestyle medicine competencies with equitable distribution among learners using active learning approaches. The authors propose initial efforts focusing on instruction of clinical educators and practicing physicians, with advocacy for increased reimbursement.
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Affiliation(s)
| | - Michael Boring
- College of Medicine, University of Central Florida, Orlando, USA
| | - Spencer Lessans
- College of Medicine, University of Central Florida, Orlando, USA
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11
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Lifestyle medicine in community-engaged health promotion. J Public Health (Oxf) 2022. [DOI: 10.1007/s10389-020-01300-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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12
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Lamb JJ, Stone M, D’Adamo CR, Volkov A, Metti D, Aronica L, Minich D, Leary M, Class M, Carullo M, Ryan JJ, Larson IA, Lundquist E, Contractor N, Eck B, Ordovas JM, Bland JS. Personalized Lifestyle Intervention and Functional Evaluation Health Outcomes SurvEy: Presentation of the LIFEHOUSE Study Using N-of-One Tent-Umbrella-Bucket Design. J Pers Med 2022; 12:115. [PMID: 35055430 PMCID: PMC8779079 DOI: 10.3390/jpm12010115] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 12/31/2021] [Accepted: 01/11/2022] [Indexed: 12/20/2022] Open
Abstract
The working definition of health is often the simple absence of diagnosed disease. This common standard is limiting given that changes in functional health status represent early warning signs of impending health declines. Longitudinal assessment of functional health status may foster prevention of disease occurrence and modify disease progression. The LIFEHOUSE (Lifestyle Intervention and Functional Evaluation-Health Outcomes SurvEy) longitudinal research project explores the impact of personalized lifestyle medicine approaches on functional health determinants. Utilizing an adaptive tent-umbrella-bucket design, the LIFEHOUSE study follows the functional health outcomes of adult participants recruited from a self-insured employee population. Participants were each allocated to the tent of an all-inclusive N-of-one case series. After assessing medical history, nutritional physical exam, baseline functional status (utilizing validated tools to measure metabolic, physical, cognitive, emotional and behavioral functional capacity), serum biomarkers, and genomic and microbiome markers, participants were assigned to applicable umbrellas and buckets. Personalized health programs were developed and implemented using systems biology formalism and functional medicine clinical approaches. The comprehensive database (currently 369 analyzable participants) will yield novel interdisciplinary big-health data and facilitate topological analyses focusing on the interactome among each participant's genomics, microbiome, diet, lifestyle and environment.
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Affiliation(s)
- Joseph J. Lamb
- Personalized Lifestyle Medicine Center, Gig Harbor, WA 98332, USA; (M.S.); (D.M.)
| | - Michael Stone
- Personalized Lifestyle Medicine Center, Gig Harbor, WA 98332, USA; (M.S.); (D.M.)
- Office of Personalized Health and Well-Being, Medical College of Georgia, AU/UGA Medical Partnership, Athens, GA 30606, USA
- Institute for Functional Medicine, Federal Way, WA 98003, USA; (C.R.D.); (D.M.); (M.C.)
| | - Christopher R. D’Adamo
- Institute for Functional Medicine, Federal Way, WA 98003, USA; (C.R.D.); (D.M.); (M.C.)
- Center for Integrative Medicine, University of Maryland, Baltimore, MD 21201, USA
| | | | - Dina Metti
- Personalized Lifestyle Medicine Center, Gig Harbor, WA 98332, USA; (M.S.); (D.M.)
| | - Lucia Aronica
- Metagenics, Inc., Aliso Viejo, CA 92656, USA; (L.A.); (M.C.); (I.A.L.); (N.C.); (B.E.)
- Department of Medicine, Stanford Prevention Research Center, Stanford University, Stanford, CA 94305, USA
| | - Deanna Minich
- Institute for Functional Medicine, Federal Way, WA 98003, USA; (C.R.D.); (D.M.); (M.C.)
- Human Nutrition and Functional Medicine, University of Western States, Portland, OR 97213, USA
| | | | - Monique Class
- Institute for Functional Medicine, Federal Way, WA 98003, USA; (C.R.D.); (D.M.); (M.C.)
- The Center for Functional Medicine, Stamford, CT 06905, USA
| | - Malisa Carullo
- Metagenics, Inc., Aliso Viejo, CA 92656, USA; (L.A.); (M.C.); (I.A.L.); (N.C.); (B.E.)
| | - Jennifer J. Ryan
- Helfgott Research Institute, National University of Natural Medicine, Portland, OR 97201, USA;
| | - Ilona A. Larson
- Metagenics, Inc., Aliso Viejo, CA 92656, USA; (L.A.); (M.C.); (I.A.L.); (N.C.); (B.E.)
| | - Erik Lundquist
- Personalized Lifestyle Medicine Center, Aliso Viejo, CA 92656, USA;
| | - Nikhat Contractor
- Metagenics, Inc., Aliso Viejo, CA 92656, USA; (L.A.); (M.C.); (I.A.L.); (N.C.); (B.E.)
| | - Brent Eck
- Metagenics, Inc., Aliso Viejo, CA 92656, USA; (L.A.); (M.C.); (I.A.L.); (N.C.); (B.E.)
| | - Jose M. Ordovas
- Jean Meyer USDA Human Nutrition Center on Aging, Tufts University, Boston, MA 02111, USA;
| | - Jeffrey S. Bland
- Personalized Lifestyle Medicine Institute, Bainbridge Island, WA 98110, USA;
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13
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Negreiros A, Maciel RBT, Carvalho de Barros B, Padula RS. Quality assessment of smartphone fitness apps used to increase physical activity level and improve general health in adults: A systematic review. Digit Health 2022; 8:20552076221138305. [DOI: 10.1177/20552076221138305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 10/21/2022] [Indexed: 11/17/2022] Open
Abstract
Introduction Mobile exercise apps for smartphones have been used with intervention measures to increase physical activity. This study aimed to identify and evaluate the quality of fitness apps for smartphones that were used to increase the level of physical activity and improve the overall health of healthy adults. Methods The systematic review was performed in five electronic databases EMBASE, MEDLINE, CINAHL, Academic Research Premier e Cochrane Reviews, and Trials. The search terms were grouped into three categories according to the principles of population, intervention, comparison, and outcomes. The following includes examples of the group terms: population (healthy adults), intervention (smartphone apps), and outcomes (physical activity level). Results Of the 3924 potential articles, 74 were read for full-text analysis. Only seven studies were included in the review. The methodological evaluation of the studies and the apps’ quality showed that only one study and one app were evaluated with good quality. All studies used a type of application to improve the level of physical activity (measured by the number of daily steps), reporting an increase and improvement in some general health indices (calorie expenditure, weight, BMI) in healthy adults, regardless of frequency and duration of intervention and applications. Conclusion We cannot say that the use of smartphone applications improves the level of physical activity and general health. The low methodological quality of the studies and the possibility to evaluate the applications used (Mars Scale) due to the lack of technical standardization presented in the studies, despite the app used showing positive results in all studies.
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Affiliation(s)
- Alexandher Negreiros
- Master and Doctoral Program in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, Brazil
- DepartmentofPhysicalTherapy, Universidade Cidade de São Paulo, São Paulo, Brazil
| | - Roberto B T Maciel
- Master and Doctoral Program in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, Brazil
- Departmentof Life Sciences, Universidade do Estado da Bahia, Salvador, Brazil
| | | | - Rosimeire Simprini Padula
- Master and Doctoral Program in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, Brazil
- DepartmentofPhysicalTherapy, Universidade Cidade de São Paulo, São Paulo, Brazil
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14
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Glass DR. Lifestyle medicine: A positive approach to stemming the tide of non-communicable diseases in South Africa. S Afr Fam Pract (2004) 2021; 63:e1-e4. [PMID: 34797100 PMCID: PMC8603158 DOI: 10.4102/safp.v63i1.5394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 09/13/2021] [Accepted: 09/10/2021] [Indexed: 11/01/2022] Open
Abstract
Non-communicable diseases account for most deaths globally and they are the main reason for patient consultations. Conventional medicine focuses on pharmaceutical and surgical interventions to manage these diseases. Most management protocols recognise the foundational role of lifestyle changes, but practical lifestyle medicine interventions need to become part of the medical curriculum and part of each consultation to make an impact. This article presents the rationale for the launch of the South African Lifestyle Medicine Association as an important facilitator of that process.
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Affiliation(s)
- Dave R Glass
- Private Obstetrics/Gynaecology Practitioner, Port Shepstone.
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15
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Ogeil RP, Nguyen M, Savic M, Lubman DI. Assembling a ‘good’ and ‘bad’ night's sleep: A multifactorial proposition. LIFESTYLE MEDICINE 2021. [DOI: 10.1002/lim2.48] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Affiliation(s)
- Rowan P. Ogeil
- Turning Point Eastern Health Richmond Victoria Australia
- Eastern Health Clinical School and Monash Addiction Research Centre Monash University Clayton Victoria Australia
| | | | - Michael Savic
- Turning Point Eastern Health Richmond Victoria Australia
- Eastern Health Clinical School and Monash Addiction Research Centre Monash University Clayton Victoria Australia
| | - Dan I. Lubman
- Turning Point Eastern Health Richmond Victoria Australia
- Eastern Health Clinical School and Monash Addiction Research Centre Monash University Clayton Victoria Australia
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16
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Doraiswamy S, Cheema S, Mamtani R. The COVID-19 and lifestyle nexus: settling the debate. Glob Health Promot 2021; 29:96-100. [PMID: 34165015 DOI: 10.1177/17579759211018417] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
A recent debate that has gained our attention is that of coronavirus disease 2019 (COVID-19) being referred to as a lifestyle disease by the Royal College of General Practitioners (in the title of an online event) for which they later apologized and withdrew the reference. In this commentary, we demystify diseases related to 'lifestyle' and put this in the context of the age-old public health way of classifying diseases as communicable and non-communicable (NCDs). Evidence indicates that unhealthy lifestyles, in addition to causing NCDs, can also result in reduced immunity and/or cause injury to organs predisposing individuals to diseases, and their severity, traditionally defined as 'communicable' such as COVID-19. COVID-19 has demonstrated the nexus between communicable and NCDs as never before in no uncertain terms. Two important messages that have emerged from the pandemic are: (1) there is close proximity of communicable diseases to NCDs; and (2) individual personal hygiene-related lifestyles can influence the occurrence, severity and prevention of communicable diseases such as COVID-19.
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Affiliation(s)
| | - Sohaila Cheema
- Institute for Population Health, Weill Cornell Medicine - Qatar, Qatar
| | - Ravinder Mamtani
- Institute for Population Health, Weill Cornell Medicine - Qatar, Qatar
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17
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Páscoa R, Teixeira A, Gregório M, Carvalho R, Martins C. Patients' Perspectives about Lifestyle Behaviors and Health in the Context of Family Medicine: A Cross-Sectional Study in Portugal. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18062981. [PMID: 33799435 PMCID: PMC8001049 DOI: 10.3390/ijerph18062981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 03/10/2021] [Accepted: 03/11/2021] [Indexed: 11/17/2022]
Abstract
Lifestyle interventions are recognized as essential in the prevention and treatment of non-communicable diseases. Previous studies have shown that Portuguese patients tend to give more importance to diagnostic and laboratory tests than to lifestyle measures, and seem unaware that behavioral risks are the main modifiable risk factors. The study aimed to analyze patients’ perspectives about lifestyle behaviors and health in the context of family medicine in Portugal. A population-based cross-sectional study was carried out in Portugal (the mainland). A total of 900 Portuguese patients aged ≥20 years, representative of the population, were surveyed using face-to-face questionnaires. Participants were selected by the random route method. Descriptive statistics and non-parametric tests were performed to evaluate differences between the personal beliefs and the personal behavior self-assessment, as well as between the level of importance given to the family doctor to address health behaviors and the reported approach implemented by the family doctor, and its association with bio-demographic variables. The results indicate that the vast majority of this Portuguese cohort has informed beliefs regarding lifestyle behaviors, tends to overestimate their own behavior self-assessment, and strongly agrees that it is important that their family doctor asks/advises on these lifestyle behaviors, although the proportion of those who totally agree that their family doctor usually does this is significantly lower. Differences concerning bio-demographic variables were found. Future research directions should focus on the politics, economics, and policy aspects that may have an impact in this area. It will also be important to understand more broadly the relationships between lifestyle behaviors and clinical, physical, and sociodemographic variables.
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Affiliation(s)
- Rosália Páscoa
- Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, 4200-450 Porto, Portugal; (A.T.); (M.G.); (C.M.)
- Centre for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto, 4200-450 Porto, Portugal
- Correspondence: ; Tel.: +351-220-426-600
| | - Andreia Teixeira
- Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, 4200-450 Porto, Portugal; (A.T.); (M.G.); (C.M.)
- Centre for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto, 4200-450 Porto, Portugal
- Instituto Politécnico de Viana do Castelo (IPVC), 4900-347 Viana do Castelo, Portugal
| | - Micaela Gregório
- Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, 4200-450 Porto, Portugal; (A.T.); (M.G.); (C.M.)
| | - Rosa Carvalho
- #H4A Primary Healthcare Research Network, 4460-027 Porto, Portugal;
| | - Carlos Martins
- Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, 4200-450 Porto, Portugal; (A.T.); (M.G.); (C.M.)
- Centre for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto, 4200-450 Porto, Portugal
- #H4A Primary Healthcare Research Network, 4460-027 Porto, Portugal;
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Cena H, Porri D, De Giuseppe R, Kalmpourtzidou A, Salvatore FP, El Ghoch M, Itani L, Kreidieh D, Brytek-Matera A, Pocol CB, Arteta Arteta DS, Utan G, Kolčić I. How Healthy Are Health-Related Behaviors in University Students: The HOLISTic Study. Nutrients 2021; 13:675. [PMID: 33669884 PMCID: PMC7926492 DOI: 10.3390/nu13020675] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 02/10/2021] [Accepted: 02/17/2021] [Indexed: 12/12/2022] Open
Abstract
The aim of this cross-sectional study was to assess the health-related behaviors among university students, with emphasis on health sciences students from Croatia, Italy, Lebanon, Poland, Romania, Spain and Turkey. We included 6222 students in Medicine, Dentistry, Nursing, Pharmacy, Nutrition and Dietetics, Sports Sciences, Veterinary, and Economics enrolled between April 2018 and March 2020. We assessed dietary patterns, sleeping habits, physical activity and perceived stress among students by means of validated questionnaires. The median age ranged between 19 and 24 years, smoking prevalence between 12.0% and 35.4%, and body mass index (BMI) ranged between 21.1 and 23.2 kg/m2. Breakfast was less often and more often consumed daily in Turkey (36.7%), and Italy (75.7%), respectively. The highest Mediterranean diet score was recorded in Spain and Italy, and the lowest in Turkey, followed by students from Croatia, Lebanon, Poland and Romania. Sleep duration, physical activity and stress perception also differed between countries. Multivariable regression analysis revealed a small, but positive association between BMI and several characteristics, including age, female gender, smoking, physical activity, mobile phone use, and perceived stress. A negative association was found between BMI and sleep duration on non-working days. Self-rated health perception was positively associated with female gender, breakfast, physical activity, and time spent studying, and negatively with BMI, smoking and stress. Our results demonstrated diverse habits in students from different countries, some of which were less healthy than anticipated, given their educational background. Greater emphasis needs to be placed on improving the lifestyle of these adolescents and young adults, who will be tomorrow's healthcare workers.
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Affiliation(s)
- Hellas Cena
- Laboratory of Dietetics and Clinical Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy; (H.C.); (D.P.); (A.K.); (G.U.)
- Clinical Nutrition and Dietetics Service, Unit of Internal Medicine and Endocrinology, ICS Maugeri IRCCS, 27100 Pavia, Italy
| | - Debora Porri
- Laboratory of Dietetics and Clinical Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy; (H.C.); (D.P.); (A.K.); (G.U.)
| | - Rachele De Giuseppe
- Laboratory of Dietetics and Clinical Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy; (H.C.); (D.P.); (A.K.); (G.U.)
| | - Aliki Kalmpourtzidou
- Laboratory of Dietetics and Clinical Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy; (H.C.); (D.P.); (A.K.); (G.U.)
| | | | - Marwan El Ghoch
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University, P.O. Box 11-5020 Riad El Solh, Beirut 11072809, Lebanon; (M.E.G.); (L.I.); (D.K.)
| | - Leila Itani
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University, P.O. Box 11-5020 Riad El Solh, Beirut 11072809, Lebanon; (M.E.G.); (L.I.); (D.K.)
| | - Dima Kreidieh
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University, P.O. Box 11-5020 Riad El Solh, Beirut 11072809, Lebanon; (M.E.G.); (L.I.); (D.K.)
| | | | - Cristina Bianca Pocol
- Department of Animal Production and Food Safety, University of Agricultural Sciences and Veterinary Medicine of Cluj Napoca, 400372 Cluj Napoca, Romania;
| | | | - Gözde Utan
- Laboratory of Dietetics and Clinical Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy; (H.C.); (D.P.); (A.K.); (G.U.)
| | - Ivana Kolčić
- Department of Public Health, University of Split School of Medicine, 21000 Split, Croatia;
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19
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Seyedsadjadi N, Grant R. The Potential Benefit of Monitoring Oxidative Stress and Inflammation in the Prevention of Non-Communicable Diseases (NCDs). Antioxidants (Basel) 2020; 10:E15. [PMID: 33375428 PMCID: PMC7824370 DOI: 10.3390/antiox10010015] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 12/21/2020] [Accepted: 12/22/2020] [Indexed: 12/12/2022] Open
Abstract
The significant increase in worldwide morbidity and mortality from non-communicable diseases (NCDs) indicates that the efficacy of existing strategies addressing this crisis may need improvement. Early identification of the metabolic irregularities associated with the disease process may be a key to developing early intervention strategies. Unhealthy lifestyle behaviours are well established drivers of the development of several NCDs, but the impact of such behaviours on health can vary considerably between individuals. How can it be determined if an individual's unique set of lifestyle behaviours is producing disease? Accumulating evidence suggests that lifestyle-associated activation of oxidative and inflammatory processes is primary driver of the cell and tissue damage which underpins the development of NCDs. However, the benefit of monitoring subclinical inflammation and oxidative activity has not yet been established. After reviewing relevant studies in this context, we suggest that quantification of oxidative stress and inflammatory biomarkers during the disease-free prodromal stage of NCD development may have clinical relevance as a timely indicator of the presence of subclinical metabolic changes, in the individual, portending the development of disease. Monitoring markers of oxidative and inflammatory activity may therefore enable earlier and more efficient strategies to both prevent NCD development and/or monitor the effectiveness of treatment.
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Affiliation(s)
- Neda Seyedsadjadi
- Australasian Research Institute, Sydney Adventist Hospital, Sydney, NSW 2076, Australia;
- School of Biotechnology and Biomolecular Sciences, Faculty of Science, University of New South Wales, Sydney, NSW 2052, Australia
| | - Ross Grant
- Australasian Research Institute, Sydney Adventist Hospital, Sydney, NSW 2076, Australia;
- Department of Pharmacology, School of Medical Sciences, Faculty of Medicine, University of New South Wales, Sydney, NSW 2052, Australia
- Sydney Adventist Hospital Clinical School, University of Sydney, Sydney, NSW 2076, Australia
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20
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Navarro C, Yáñez AM, Garcia A, Seguí A, Gazquez F, Marino JA, Ibarra O, Serrano-Ripoll MJ, Gomez-Juanes R, Bennasar-Veny M, Salva J, Oliván B, Roca M, Gili M, Garcia-Toro M. Effectiveness of a healthy lifestyle promotion program as adjunctive teletherapy for treatment-resistant major depression during COVID 19 pandemic: A randomized clinical trial protocol. Medicine (Baltimore) 2020; 99:e22958. [PMID: 33157937 PMCID: PMC7647547 DOI: 10.1097/md.0000000000022958] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 09/29/2020] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Treatment-resistant depression (TRD) has a high prevalence and can be exacerbated by poor physical health and economic hardships, which have become common stressors during the current COVID-19 pandemic. The therapeutic approaches used to treat these patients are not always available, may be not be accepted by some patients, and often require face-to-face interactions. OBJECTIVE The main aim of this study will be to evaluate the effectiveness of an Internet-based adjuvant lifestyle-based intervention for patients with TRD. METHODS This will be a parallel, randomized, and controlled clinical trial. A total of 180 patients with TRD will be randomly allocated (1:1:1) to 1 of 3 groups: treatment prescribed by the mental health team and written suggestions for lifestyle changes (placebo control group); treatment prescribed by the mental health team, written suggestions for lifestyle changes, and an 8-week mindfulness-based cognitive therapy program (active control group); or treatment prescribed by the mental health team, written suggestions for lifestyle changes, and an 8-week lifestyle change promotion program (intervention group). We will perform this study during the COVID-19 pandemic, and will administer interventions by teletherapy, and contact participants by telephone calls, text messages, and/or teleconferences. We will collect patient data using questionnaires administered at baseline, immediately after the intervention, and after 6 and 12 months. The primary outcome will be score on the Beck Depression Inventory-II. The secondary outcomes will be score on the Clinical Global Impressions Scale (used to quantify and track patient progress and treatment response over time) and health-related quality of life measured using the European Quality of Life-5 Dimensions Questionnaire. DISCUSSION Patients with TRD are especially vulnerable when face-to-face psychotherapy is unavailable. The main strength of the proposed study is the novelty of the intervention to be used as an adjuvant therapy. Our results may provide guidance for treatment of patients with TRD in future situations that require lockdown measures. CLINICALTRIALS REGISTRATION NUMBER NCT04428099.
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Affiliation(s)
| | - Aina M. Yáñez
- Department of Nursing and Physiotherapy and Research Group on Global Health and Human Development
| | - Aurora Garcia
- Research Institute of Health Sciences (IUNICS-IDISBA)
| | - Andrea Seguí
- Research Institute of Health Sciences (IUNICS-IDISBA)
| | | | | | - Olga Ibarra
- Research Institute of Health Sciences (IUNICS-IDISBA)
| | - Maria J. Serrano-Ripoll
- Primary Care Research Unit of Majorca, Balearic Islands Health Services and Department of Psychology, University of the Balearic Islands, Palma
| | | | - Miquel Bennasar-Veny
- Department of Nursing and Physiotherapy and Research Group on Global Health and Human Development
| | - Joan Salva
- Research Institute of Health Sciences (IUNICS-IDISBA)
| | - Bárbara Oliván
- Department of Psychology and Sociology, University of Zaragoza and Preventive Activities and Health Promotion Network, REDIAPP (G06/170), Zaragoza, Spain
| | - Miquel Roca
- Research Institute of Health Sciences (IUNICS-IDISBA)
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21
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Rauchwerk A, Vipperman-Cohen A, Padmanabhan S, Parasram W, Burt KG. The Case for a Health at Every Size Approach for Chronic Disease Risk Reduction in Women of Color. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2020; 52:1066-1072. [PMID: 32948446 DOI: 10.1016/j.jneb.2020.08.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 08/10/2020] [Accepted: 08/12/2020] [Indexed: 06/11/2023]
Abstract
The conventional approach to chronic disease management in women of color is a dieting-for-weight-loss approach, which has not been proven to be effective. The purpose of this article is to highlight the shortcomings of the dieting-for-weight-loss approach and demonstrate the potential efficacy of the Health at Every Size approach when working with women of color to prevent and address chronic diseases. The article's areas of focus are weight stigma, bias, and size discrimination; the implications of differing weight perceptions and motivations for change; and weight as the primary determinant of health and biological factors affecting weight.
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Affiliation(s)
- Autumn Rauchwerk
- Program in Nutrition, Health, and Behavior Studies, Teachers College, Columbia University, New York, NY
| | - Anne Vipperman-Cohen
- Program in Nutrition, Health, and Behavior Studies, Teachers College, Columbia University, New York, NY
| | - Sridevi Padmanabhan
- Program in Nutrition, Health, and Behavior Studies, Teachers College, Columbia University, New York, NY
| | - Woheema Parasram
- Program in Nutrition, Health, and Behavior Studies, Teachers College, Columbia University, New York, NY
| | - Kate G Burt
- Dietetics, Foods, and Nutrition, Department of Health Sciences, Lehman College, City University of New York, New York, NY.
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Abstract
Lifestyle medicine is a growing field of medicine that addresses key health behaviors, which are the root causes of most premature death, chronic disease, and health care costs. Coaching patients with evidence-based behavior change strategies can help them to make lasting habits in key areas, such as physical activity, healthy eating, improved sleep, cessation of tobacco, forming and maintaining relationships, and stress management. Similarities in philosophy between lifestyle medicine and physical medicine and rehabilitation make them complementary and synergistic in treating the whole patient in their social context.
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Pasarica M, Kay D. Teaching lifestyle medicine competencies in undergraduate medical education: active collaborative intervention for students at multiple locations. ADVANCES IN PHYSIOLOGY EDUCATION 2020; 44:488-495. [PMID: 32795122 DOI: 10.1152/advan.00148.2019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The aims of this study are to 1) design feasible active collaborative educational approaches to teach and assess three of the newly described lifestyle medicine (LM) competencies to students at multiple locations; and 2) determine whether a mixed, flexible instructional delivery approach impacts students' learning and perception of confidence in LM. The educational interventions were part of the undergraduate clinical medical education curriculum and have two parts: 1) an asynchronous session [online self-learning module (SLM)], and 2) a synchronous session using case-based collaborative learning delivered either mostly face to face, as determined by the instructor (approach A) or mostly virtual, as determined by the student (approach B). Both approaches were delivered in the curriculum as planned to 27 students in approach A (26% attending virtually) and 31 students in approach B (90% attending virtually). Approach B required more planning time. Approach A students (26 of 27) agreed that the SLM was valuable as an educational tool. The performance in the summative assessment was similar (P = 0.49) in both approaches [means (SD): 33.2 points (SD 10.6) approach A vs. 33.2 points (SD 10.1) approach B]. Students reported a similar increase in confidence (P = 0.33) with setting lifestyle change goals. The two educational approaches presented here address three of the new LM competencies using active collaborative learning. Both approaches are feasible for synchronous delivery to students located at local and distant sites, either face to face or virtual. The increase in the proportion of students attending virtually did not decrease the measured outcomes of learning and perceptions of confidence.
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Affiliation(s)
- Magdalena Pasarica
- Department of Medical Education, University of Central Florida College of Medicine, Orlando, Florida
| | - Denise Kay
- Department of Medical Education, University of Central Florida College of Medicine, Orlando, Florida
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Smirmaul BPC, Chamon RF, de Moraes FM, Rozin G, Moreira ASB, de Almeida R, Guimarães ST. Lifestyle Medicine During (and After) the COVID-19 Pandemic. Am J Lifestyle Med 2020; 15:60-67. [PMID: 33456421 DOI: 10.1177/1559827620950276] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 07/01/2020] [Accepted: 07/27/2020] [Indexed: 12/15/2022] Open
Abstract
The COVID-19 pandemic has made it challenging for individuals and families to maintain a healthy lifestyle, quality of life, and well-being. Preliminary evidence have suggested that higher odds of both mortality and severity of the COVID-19 are closely associated to unhealthy lifestyle behaviors. Thus, in an effort to contribute to this challenging global situation, we joined a group of lifestyle medicine researchers and/or practitioners to provide scientifically sound information, recommendations, resources, and suggestions related to the main pillars of lifestyle medicine (healthy eating, physical activity, sleep, tobacco/alcohol, stress management, relationships, and planetary health) that may help health practitioners to support clients and patients maintain a healthy lifestyle during (and after) the COVID-19 crisis.
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Affiliation(s)
| | - Regina Fumanti Chamon
- Centro de Oncologia Especializada e Centro Paulista de Oncologia, Indianópolis, São Paulo (SP), Brazil
| | | | - Gabriel Rozin
- Colégio Brasileiro de Medicina do Estilo de Vida (CBMEV), São Paulo (SP), Brazil
| | | | - Roberto de Almeida
- Universidade Federal de Integração Latino-Americana (UNILA), Foz do Iguaçu (PR), Brazil
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Shimizu S, Nakatani Y, Kakihara Y, Taiyoji M, Saeki M, Takagi R, Yamamura K, Okamoto K. Daily administration of Sake Lees (Sake Kasu) reduced psychophysical stress-induced hyperalgesia and Fos responses in the lumbar spinal dorsal horn evoked by noxious stimulation to the hindpaw in the rats. Biosci Biotechnol Biochem 2020; 84:159-170. [DOI: 10.1080/09168451.2019.1662278] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
ABSTRACT
We tested whether Sake Lees (SL) had inhibitory effects on hyperalgesia in the hindpaw under psychophysical stress conditions. Male rats were subjected to repeated forced swim stress treatments (FST) from Day −3 to Day −1. Intraperiotoneal administration of SL which contained low concentration of ethanol (SLX) was conducted after each FST. On Day 0, formalin-evoked licking behaviors and Fos responses in the lumbar spinal cord (DH) and several areas within the rostral ventromedial medulla (RVM) were quantified as nociceptive responses. FST-induced hyperalgesia in the hindpaw was prevented by repeated SL and SLX treatments. Fos expression was significantly increased in DH and some areas within the RVM under FST, which was prevented by repeated SL or SLX. These findings indicated that daily administration of SL had the potential to alleviate stress-induced hyperalgesia.
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Affiliation(s)
- Shiho Shimizu
- Division of Oral Physiology, Niigata University Graduate School of Medical and Dental Sciences, Niigata City, Japan
- Division of Oral and Maxillofacial Surgery Niigata University, Graduate School of Medical and Dental Sciences, Niigata City, Japan
| | - Yosuke Nakatani
- Division of Oral Physiology, Niigata University Graduate School of Medical and Dental Sciences, Niigata City, Japan
- Division of Oral and Maxillofacial Surgery Niigata University, Graduate School of Medical and Dental Sciences, Niigata City, Japan
| | - Yoshito Kakihara
- Division of Dental Pharmacology, Niigata University Graduate School of Medical and Dental Sciences, Niigata City, Japan
- Department of Sakeology, Niigata University, Niigata City, Japan
| | - Mayumi Taiyoji
- Food Research Center, Niigata Agricultural Research Institute, Kamo City, Japan
| | - Makio Saeki
- Division of Dental Pharmacology, Niigata University Graduate School of Medical and Dental Sciences, Niigata City, Japan
| | - Ritsuo Takagi
- Division of Oral and Maxillofacial Surgery Niigata University, Graduate School of Medical and Dental Sciences, Niigata City, Japan
| | - Kensuke Yamamura
- Division of Oral Physiology, Niigata University Graduate School of Medical and Dental Sciences, Niigata City, Japan
| | - Keiichiro Okamoto
- Division of Oral Physiology, Niigata University Graduate School of Medical and Dental Sciences, Niigata City, Japan
- Department of Sakeology, Niigata University, Niigata City, Japan
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Subramaniam M, Zhang Y, Lau JH, Vaingankar JA, Abdin E, Chong SA, Lee ES. Patterns of physical activity and health-related quality of life amongst patients with multimorbidity in a multi-ethnic Asian population. BMC Public Health 2019; 19:1612. [PMID: 31791301 PMCID: PMC6889682 DOI: 10.1186/s12889-019-7941-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Accepted: 11/12/2019] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND The co-occurrence of two or more chronic medical conditions in an individual is defined as multimorbidity. Lifestyle factors, including poor dietary patterns, physical inactivity, tobacco use, and excessive alcohol consumption are key modifiable risk factors that play a role in the development of chronic medical conditions and potentially multimorbidity. The current study aimed to examine the level of physical activity among those with multimorbidity and its association with socio-demographic factors, clinical parameters, and health-related quality of life (HRQoL) among community-dwelling adults attending a primary care clinic in Singapore. METHODS This cross-sectional study was conducted among patients with multimorbidity between August 2014 and June 2016. Physical activity was measured using the International Physical Activity Questionnaire (IPAQ) Short Form. HRQoL was measured using the EuroQol-5 Dimension (EQ-5D-3 L). Data on clinical parameters including hemoglobin A1c (HbA1C), low-density lipoprotein cholesterol (LDL-C), and blood pressure were collected from patient records. Multivariable logistic regression analysis and linear regression were performed to determine the association between IPAQ and clinical health outcomes, as well as HRQoL measures, respectively. RESULTS In all, 932 respondents with multimorbidity were recruited for the study. Of these, 500 (53.8%) had low physical activity, 325 (35.0%) had moderate physical activity, while 104 (11.2%) had high physical activity. Respondents who were insufficiently active had significantly higher odds of being overweight/ obese (OR: 1.5, 95% confidence interval [CI]: 1.1-1.9, p = 0.01) as compared to those who were sufficiently physically active. The multiple linear regression model revealed that insufficient activity level was negatively associated with EQ-5D index score (β = - 0.05, p < 0.001) and the visual analogue scale (β = - 4.4, p < 0.001) measuring HRQoL as compared to sufficient activity levels in respondents with multimorbidity. CONCLUSIONS The low levels of physical activity among patients with multimorbidity, and its association with overweight status and poorer HRQoL emphasizes the importance of increasing physical activity in this population. Family physicians treating patients with chronic diseases need to continue encouraging and helping individuals to initiate and maintain appropriate physical activity levels.
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Affiliation(s)
- Mythily Subramaniam
- Research Division Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore.
| | - Yunjue Zhang
- Research Division Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Jue Hua Lau
- Research Division Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Janhavi Ajit Vaingankar
- Research Division Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Edimansyah Abdin
- Research Division Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Siow Ann Chong
- Research Division Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Eng Sing Lee
- National Healthcare Group Polyclinics, Singapore, Singapore
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Lifestyle Medicine – New Concept, Innovative Discipline. ROMANIAN JOURNAL OF DIABETES NUTRITION AND METABOLIC DISEASES 2019. [DOI: 10.2478/rjdnmd-2019-0031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
A large percentage 63% of premature deaths and chronic diseases could be prevented by adhering to healthy dietary patterns, being physically active and avoid smoking. The concept of lifestyle medicine introduced 20 years ago by Rippe is defined as the integration of modern lifestyle practices into evidence-based medicine, in order to lower risk factors or to be support for chronic therapies. A new taxonomy is proposed in lifestyle medicine, with determinants, as drivers for chronic diseases, anthropogens and metaflammation, the metabolic inflammatory state. Other possible determinants are proposed for lack os scope in life, estrangement and lost identity. Despite all health messages, healthy behaviors are exceptions, not the rule. It will be important in the future to change how practitioners will support individuals in their efforts to live healthier. More psychological and social factors should be analyzed. Many doctors are not self-confident with prescribing healthy lifestyle or nutritional recommendations. Creating a new discipline should foster development of preventive recommendations. General practitioners will need specific academic trainings to learn how to promote recommendations for lifestyle changes for health, for prevention and for diseases management, starting by adopting themselves healthy lifestyles.
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White ND, Packard K, Kalkowski J. Financial Education and Coaching: A Lifestyle Medicine Approach to Addressing Financial Stress. Am J Lifestyle Med 2019; 13:540-543. [PMID: 31662717 PMCID: PMC6796220 DOI: 10.1177/1559827619865439] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
Economic stability is a well-documented social determinant of health, and financial stress is an important driver for the health disparities observed in the poor. Persons under financial stress are more likely to engage in smoking, alcohol consumption, overspending, poor diet, and reduced exercise. Financial education and coaching is one strategy that can be used to reduce financial stress and potentially improve engagement in healthy lifestyle behaviors, quality of life, and objective health outcomes. A conceptual model describing the link between financial education/coaching and health is described along with preliminary data from a randomized controlled trial evaluating this intervention.
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Affiliation(s)
- Nicole D. White
- Nicole D. White, PharmD, CDE, Creighton
University School of Pharmacy and Health Professions, 2500 California Plaza,
Omaha, NE 68178; e-mail:
| | - Kathleen Packard
- Department of Pharmacy Practice, Creighton
University School of Pharmacy and Health Professions, Omaha, Nebraska (NW,
KP)
- Financial Hope Collaborative, Creighton University
Heider College of Business, Omaha, Nebraska (JK)
| | - Julie Kalkowski
- Department of Pharmacy Practice, Creighton
University School of Pharmacy and Health Professions, Omaha, Nebraska (NW,
KP)
- Financial Hope Collaborative, Creighton University
Heider College of Business, Omaha, Nebraska (JK)
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Logan AC, Prescott SL, Katz DL. Golden Age of Medicine 2.0: Lifestyle Medicine and Planetary Health Prioritized. J Lifestyle Med 2019; 9:75-91. [PMID: 31828026 PMCID: PMC6894443 DOI: 10.15280/jlm.2019.9.2.75] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Accepted: 02/22/2019] [Indexed: 12/16/2022] Open
Abstract
The 'golden age of medicine' - the first half of the 20th century, reaching its zenith with Jonas Salk's 1955 polio vaccine - was a time of profound advances in surgical techniques, immunization, drug discovery, and the control of infectious disease; however, when the burden of disease shifted to lifestyle-driven, chronic, non-communicable diseases, the golden era slipped away. Although modifiable lifestyle practices now account for some 80% of premature mortality, medicine remains loathe to embrace lifestyle interventions as medicine Here, we argue that a 21st century golden age of medicine can be realized; the path to this era requires a transformation of medical school recruitment and training in ways that prioritize a broad view of lifestyle medicine. Moving beyond the basic principles of modifiable lifestyle practices as therapeutic interventions, each person/community should be viewed as a biological manifestation of accumulated experiences (and choices) made within the dynamic social, political, economic and cultural ecosystems that comprise their total life history. This requires an understanding that powerful forces operate within these ecosystems; marketing and neoliberal forces push an exclusive 'personal responsibility' view of health - blaming the individual, and deflecting from the large-scale influences that maintain health inequalities and threaten planetary health. The latter term denotes the interconnections between the sustainable vitality of person and place at all scales. We emphasize that barriers to planetary health and the clinical application of lifestyle medicine - including authoritarianism and social dominance orientation - are maintaining an unhealthy status quo.
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Affiliation(s)
- Alan C Logan
- in-VIVO Planetary Health, West New York, NJ, USA
| | - Susan L Prescott
- in-VIVO Planetary Health, West New York, NJ, USA.,School of Medicine, University of Western Australia, Perth, WA, Australia
| | - David L Katz
- Yale University, Prevention Research Center, Griffin Hospital, Derby, CT, USA
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Pasarica M, Kay D, Cameron R. Using active pedagogies to advance learning for lifestyle medicine: an approach for medical students. ADVANCES IN PHYSIOLOGY EDUCATION 2019; 43:191-195. [PMID: 30998102 DOI: 10.1152/advan.00195.2018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- Magdalena Pasarica
- Department of Medical Education, University of Central Florida College of Medicine , Orlando, Florida
| | - Denise Kay
- Department of Medical Education, University of Central Florida College of Medicine , Orlando, Florida
| | - Rebecca Cameron
- Department of Medical Education, University of Central Florida College of Medicine , Orlando, Florida
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31
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Rowin J. Integrative neuromuscular medicine: Neuropathy and neuropathic pain: Consider the alternatives. Muscle Nerve 2019; 60:124-136. [DOI: 10.1002/mus.26510] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/07/2019] [Indexed: 12/17/2022]
Affiliation(s)
- Julie Rowin
- Wellness and Integrative Neurology, Advanced Pain and Anesthesia ConsultantsCenters for Pain Management Westchester Illinois USA
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32
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Egger G, Stevens J, Binns A, Morgan B. Psychosocial Determinants of Chronic Disease: Implications for Lifestyle Medicine. Am J Lifestyle Med 2019; 13:526-532. [PMID: 31662714 DOI: 10.1177/1559827619845335] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2016] [Revised: 01/31/2019] [Accepted: 04/01/2019] [Indexed: 11/16/2022] Open
Abstract
We have previously identified a number of "determinants" of chronic disease, using the acronym NASTIE ODOURS. These have been given the collective term "anthropogens," in this journal and other publications, to help direct the management of modern chronic ailments to a monocausal focus, akin to that afforded infectious diseases by the "germ theory." We suggested the acronym NASTIE ODOURS as a starting point for a taxonomy of lifestyle medicine determinants. In the current article, we add 3, less quantifiable, but currently increasingly more important psychosocial experiences to these: Lack of Meaning, Alienation, and Loss of culture, changing the previous acronym to NASTIE MAL ODOURS. As with other determinants, all have accumulating evidence of an underlying low-grade, systemic, inflammatory physiological base ("metaflammation"), but with the need for further research to solidify these findings.
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Affiliation(s)
- Garry Egger
- School of Health and Human Sciences, Southern Cross University, Lismore, New South Wales, Australia (GE, JS).,Goonellabah Medical Centre, Lismore, New South Wales, Australia (AB).,Wollotuka Institute, Indigenous Education and Research, University of Newcastle, Newcastle, New South Wales, Australia (BM)
| | - John Stevens
- School of Health and Human Sciences, Southern Cross University, Lismore, New South Wales, Australia (GE, JS).,Goonellabah Medical Centre, Lismore, New South Wales, Australia (AB).,Wollotuka Institute, Indigenous Education and Research, University of Newcastle, Newcastle, New South Wales, Australia (BM)
| | - Andrew Binns
- School of Health and Human Sciences, Southern Cross University, Lismore, New South Wales, Australia (GE, JS).,Goonellabah Medical Centre, Lismore, New South Wales, Australia (AB).,Wollotuka Institute, Indigenous Education and Research, University of Newcastle, Newcastle, New South Wales, Australia (BM)
| | - Bob Morgan
- School of Health and Human Sciences, Southern Cross University, Lismore, New South Wales, Australia (GE, JS).,Goonellabah Medical Centre, Lismore, New South Wales, Australia (AB).,Wollotuka Institute, Indigenous Education and Research, University of Newcastle, Newcastle, New South Wales, Australia (BM)
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Vandenberghe D, Albrecht J. Tackling the chronic disease burden: are there co-benefits from climate policy measures? THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2018; 19:1259-1283. [PMID: 29696460 DOI: 10.1007/s10198-018-0972-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Accepted: 04/03/2018] [Indexed: 06/08/2023]
Abstract
Each year, non-communicable diseases (NCDs) kill 40 million people worldwide and impose an estimated economic burden of $600 billion. Without effective policymaking, NCDs will continue to undermine health and economic systems globally. We propose that climate policy measures-such as carbon pricing-can yield significant health-related co-benefits aside from their intended greenhouse gas emission reduction. We simulate three carbon tax scenarios in the energy and food sector in Belgium and assess the resulting health-related co-benefits. These benefits originate from decreased exposure to two leading NCD risk factors: fine particulate matter and dietary regimes excessive in animal products. The carbon tax could prevent 42,300-78,800 Disability-Adjusted Life Years in Belgium, or save 0.6-1.1% of total health care expenditure and an additional 0.06-0.12% of Belgian GDP. We conclude that these health-related co-benefits should be included in the cost-benefit analysis of carbon pricing.
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Affiliation(s)
- Désirée Vandenberghe
- Faculty of Economics and Business Administration, Ghent University, Tweekerkenstraat 2, 9000, Ghent, Belgium.
| | - Johan Albrecht
- Faculty of Economics and Business Administration, Ghent University, Tweekerkenstraat 2, 9000, Ghent, Belgium
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Nakatani Y, Kakihara Y, Shimizu S, Kurose M, Sato T, Kaneoke M, Saeki M, Takagi R, Yamamura K, Okamoto K. Japanese Rice Wine can reduce psychophysical stress-induced depression-like behaviors and Fos expression in the trigeminal subnucleus caudalis evoked by masseter muscle injury in the rats. Biosci Biotechnol Biochem 2018; 83:155-165. [PMID: 30286696 DOI: 10.1080/09168451.2018.1524705] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
We determined if Japanese Rice Wine (Sake) had inhibitory effects on stress-induced enhancement of masseter muscle (MM) nociception in the rats. Male rats were subjected to the repeated forced swim stress (FS) or sham conditionings from Day -3 to -1. Daily administration of Sake or saline was conducted after each stress conditioning. At Day 0 the number of Fos positive cells, a marker for neural activity, was quantified at the trigeminal subnucleus caudalis (Vc) region by MM injury with formalin. FS increased MM-evoked Fos expression in the Vc region, which was inhibited by Sake compared to saline administration. Sake did not alter the number of Fos positive cells under sham conditions, indicating that inhibitory roles of Sake on neural activity in the Vc region were seen under FS conditions. These findings indicated that Sake had inhibitory roles on stress-induced MM nociception at the Vc region in our experimental conditions.
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Affiliation(s)
- Yosuke Nakatani
- Division of Oral Physiology, Niigata University Graduate School of Medical and Dental Sciences, Niigata City, Japan.,Division of Oral and Maxillofacial Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata City, Japan
| | - Yoshito Kakihara
- Division of Dental Pharmacology, Niigata University Graduate School of Medical and Dental Sciences, Niigata City, Japan.,Sakeology Center, Niigata University, Niigata City, Japan
| | - Shiho Shimizu
- Division of Oral Physiology, Niigata University Graduate School of Medical and Dental Sciences, Niigata City, Japan.,Division of Oral and Maxillofacial Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata City, Japan
| | - Masayuki Kurose
- Division of Oral Physiology, Niigata University Graduate School of Medical and Dental Sciences, Niigata City, Japan
| | - Tsutomu Sato
- Department of Applied Biological Chemistry, Faculty of Agriculture, Graduate School of Science and Technology, Niigata University, Niigata City, Japan
| | - Mitsuoki Kaneoke
- Sakeology Center, Niigata University, Niigata City, Japan.,Niigata Prefectural Sake Research Institute, Niigata City, Japan
| | - Makio Saeki
- Division of Dental Pharmacology, Niigata University Graduate School of Medical and Dental Sciences, Niigata City, Japan
| | - Ritsuo Takagi
- Division of Oral and Maxillofacial Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata City, Japan
| | - Kensuke Yamamura
- Division of Oral Physiology, Niigata University Graduate School of Medical and Dental Sciences, Niigata City, Japan
| | - Keiichiro Okamoto
- Division of Oral Physiology, Niigata University Graduate School of Medical and Dental Sciences, Niigata City, Japan.,Sakeology Center, Niigata University, Niigata City, Japan
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Sibbald SL, Brown R, Schmidt L. Creating an Interprofessional Network in Lifestyle Medicine: The Journey of the Canadian Academy of Lifestyle Medicine. Am J Lifestyle Med 2018; 15:68-74. [PMID: 33447171 DOI: 10.1177/1559827618767633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Canada's population is increasing, and aging. These demographic patterns are accompanied by a growing awareness and evidence base of the benefits to society of leading a healthy and active life. The Canadian Academy of Lifestyle Medicine (CALM) was created to fill a knowledge gap in the Canadian public: how to lead a healthier and more active life. CALM aimed to address these challenges by confronting the lack of assistance modern medicine provides. As a diverse collaborative network using a lifestyle medicine philosophy, CALM's objective was to generate discussions and examine lifestyle medicine approaches to improving overall health and well-being for Canadians. CALM aimed to engage patients whose access to health care is through a physician and provide an innovative platform to support care and healthy decision making. Despite perceived widespread support, intense planning, and extensive development, CALM was slow to gain traction and realize its full potential. This article describes the experiences and lessons learned in creating CALM from the perspective of the leadership team. Although most CALM activities have ceased, virtual space and social media remain active so too does the work of the leadership team, striving to enable Canadians to develop behaviors that will improve their lifestyle, and their overall well-being.
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Affiliation(s)
- Shannon L Sibbald
- School of Health Studies, Faculty of Health Sciences (SLS), Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.,Department of Family Medicine (RB, LS, SLS), Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.,Schulich Interfacutly Program in Public Health (SLS), Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Rebecca Brown
- School of Health Studies, Faculty of Health Sciences (SLS), Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.,Department of Family Medicine (RB, LS, SLS), Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.,Schulich Interfacutly Program in Public Health (SLS), Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Larry Schmidt
- School of Health Studies, Faculty of Health Sciences (SLS), Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.,Department of Family Medicine (RB, LS, SLS), Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.,Schulich Interfacutly Program in Public Health (SLS), Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
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Hedayat LMA, Murchison CC, Foulds HJA. A systematic review and meta-analysis of cardiorespiratory fitness among Indigenous populations in North America and circumpolar Inuit populations. Prev Med 2018; 109:71-81. [PMID: 29339114 DOI: 10.1016/j.ypmed.2018.01.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Revised: 12/13/2017] [Accepted: 01/08/2018] [Indexed: 11/17/2022]
Abstract
Indigenous populations experience health disparities including increased obesity, diabetes and cardiovascular disease rates. Cardiorespiratory fitness is beneficial for maintaining positive health outcomes. The objective of this systematic review is to evaluate cardiorespiratory fitness among Indigenous populations including comparisons across genders, Indigenous identities, age groups, decades, socio-demographic variables and in comparison to non-Indigenous groups. Included articles reported various cardiorespiratory fitness measures using maximal treadmill or cycle ergometer tests, 20 m shuttle run, 1 mile run/walk test and 6 min walk test. From 14 databases searched in March 2017, including MEDLINE, EMBASE and Scopus, 1069 citations were evaluated and 39 articles included, representing 32 investigations and 10,579 individuals. First Nations/American Indian (FN/AI) adults have greater cardiorespiratory fitness than Inuit. Inuit and FN/AI men and boys have higher cardiorespiratory fitness than women and girls. Lower cardiorespiratory fitness is associated with obesity, metabolic syndrome and a western lifestyle. Cardiorespiratory fitness has declined among Inuit adults, averaging 51.7 ± 7.9 mL·kg-1·min-1 in 1970 to 37.7 ± 6.9 mL·kg-1·min-1 in 2000. Among men, FN/AI have greater cardiorespiratory fitness compared to European-descents, and European-descents have greater cardiorespiratory fitness compared to Inuit. The 1 mile run/walk time showed that FN/AI boys, girls, and youth had faster times compared to European-descendants, but 20 m shuttle run showed that European-descent boys and youth advanced to further stages compared to FN/AI populations. Cardiorespiratory fitness is declining, and among some Indigenous populations to lower levels than European-descent populations. Improving cardiorespiratory fitness for Indigenous populations should be considered a primary health strategy.
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Affiliation(s)
- Lila M A Hedayat
- College of Kinesiology, University of Saskatchewan, Saskatoon, Canada
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Pasarica M, Kay D. Teaching evidence-based lifestyle management in family medicine training. EDUCATION FOR PRIMARY CARE 2017; 29:60-61. [PMID: 29139334 DOI: 10.1080/14739879.2017.1402375] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
| | - Denise Kay
- a University of Central Florida , Orlando , Florida USA
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Pasarica M, Harris DM, Franklin AL. Medical students teaching peer athletes: an innovative way of instructing the physiology of exercise, nutrition, and sleep as fundamentals for lifestyle medicine. ADVANCES IN PHYSIOLOGY EDUCATION 2017; 41:432-435. [PMID: 28679583 DOI: 10.1152/advan.00201.2016] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Revised: 04/13/2017] [Accepted: 06/04/2017] [Indexed: 06/07/2023]
Affiliation(s)
- Magdalena Pasarica
- Department of Medical Education, College of Medicine, University of Central Florida, Orlando, Florida
| | - David M Harris
- Department of Medical Education, College of Medicine, University of Central Florida, Orlando, Florida
| | - Ashley L Franklin
- Department of Medical Education, College of Medicine, University of Central Florida, Orlando, Florida
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Warren M. Defining Health in the Era of Value-Based Care: The Six Cs of Health and Healthcare. Cureus 2017; 9:e1046. [PMID: 28367385 PMCID: PMC5362276 DOI: 10.7759/cureus.1046] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Accepted: 02/07/2017] [Indexed: 11/05/2022] Open
Abstract
INTRODUCTION While healthcare expenditure continues to increase overall health outcomes in the United States continue to be submarginal. The changes we make in our healthcare system need to be informed by a comprehensive and actionable definition of health that can unite patients, healthcare professionals, and policymakers. METHODS A literature review across multiple disciplines was conducted to assess a broad range of factors associated with health and well-being and based on this literature review a novel definition of health was developed. RESULTS Development of a definition of health as the ability to dynamically recognize and resolve dissonance in one's physical, mental, social and spiritual worlds via cooperation with social and spiritual connections, the medical community and with the natural world in a way that fosters and promotes harmony, resilience, and relief from suffering. This definition is then expanded into six domains (connection, communication, creativity, cooperation, cost-consciousness, and computerization) which are applicable to individuals, society and the healthcare system and which form the basis for actionable guidelines to promote measurable and sustained change on a public health scale. CONCLUSION Healthcare in the United States is changing and in order to move forward in an evidence-based and compassionate way, we need to understand what we mean by 'health' and how that definition can be operational at individual, societal, and public policy levels.
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Affiliation(s)
- Mark Warren
- Boise Veterans Administration Medical Center, University of Washington Department of Psychiatry and Behavioral Sciences
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Introduction to the Role of Lifestyle Factors in Medicine. LIFESTYLE MEDICINE 2017. [DOI: 10.1016/b978-0-12-810401-9.00001-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] Open
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Ski CF, Thompson DR, Castle DJ. Trialling of an optimal health programme (OHP) across chronic disease. Trials 2016; 17:445. [PMID: 27612634 PMCID: PMC5018188 DOI: 10.1186/s13063-016-1560-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Accepted: 08/20/2016] [Indexed: 11/11/2022] Open
Abstract
Population ageing is a worldwide phenomenon, most advanced in developed countries and expected to continue over the next few decades. As people are surviving longer with age-associated disease and disability, there is an imperative to identify innovative solutions for an already overburdened health care system. Such innovations need to be focused on disease management, taking into consideration the strong associations that have been established between psychosocial factors and pathophysiological mechanisms associated with chronic disease. Aside from personal and community costs, chronic diseases produce a significant economic burden due to the culmination of health care costs and lost productivity. This commentary reports on a programme of research, Translating Research, Integrated Public Health Outcomes and Delivery, which will evaluate an optimal health programme that adopts a person-centred approach and engages collaborative therapy to educate, support and improve the psychosocial health of those with chronic disease. The effectiveness of the optimal health programme will be evaluated across three of the most significant contributors to disease burden: diabetes mellitus, chronic kidney disease and stroke. Cost-effectiveness will also be evaluated. The findings derived from this series of randomised controlled trials will also provide evidence attesting to the potential applicability of the optimal health programme in other chronic conditions.
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Affiliation(s)
- Chantal F Ski
- Centre for the Heart and Mind, Australian Catholic University, Melbourne, VIC, 3000, Australia. .,Department of Psychiatry, University of Melbourne, Melbourne, VIC, 3010, Australia. .,Mental Health Service, St. Vincent's Hospital, Melbourne, VIC, 3065, Australia.
| | - David R Thompson
- Centre for the Heart and Mind, Australian Catholic University, Melbourne, VIC, 3000, Australia.,Department of Psychiatry, University of Melbourne, Melbourne, VIC, 3010, Australia
| | - David J Castle
- Centre for the Heart and Mind, Australian Catholic University, Melbourne, VIC, 3000, Australia.,Department of Psychiatry, University of Melbourne, Melbourne, VIC, 3010, Australia.,Mental Health Service, St. Vincent's Hospital, Melbourne, VIC, 3065, Australia
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Synergistic Effects of Six Chronic Disease Pairs on Decreased Physical Activity: The SMILE Cohort Study. BIOMED RESEARCH INTERNATIONAL 2016; 2016:9427231. [PMID: 27274994 PMCID: PMC4871954 DOI: 10.1155/2016/9427231] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Revised: 04/05/2016] [Accepted: 04/14/2016] [Indexed: 01/07/2023]
Abstract
Little is known about whether and how two chronic diseases interact with each other in modifying the risk of physical inactivity. The aim of the present study is to identify chronic disease pairs that are associated with compliance or noncompliance with the Dutch PA guideline recommendation and to study whether specific chronic disease pairs indicate an extra effect on top of the effects of the diseases individually. Cross-sectional data from 3,386 participants of cohort study SMILE were used and logistic regression analysis was performed to study the joint effect of the two diseases of each chronic disease pair for compliance with the Dutch PA guideline. For six chronic disease pairs, patients suffering from both diseases belonging to these disease pairs in question show a higher probability of noncompliance to the Dutch PA guideline, compared to what one would expect based on the effects of each of the two diseases alone. These six chronic disease pairs were chronic respiratory disease and severe back problems; migraine and inflammatory joint disease; chronic respiratory disease and severe kidney disease; chronic respiratory disease and inflammatory joint disease; inflammatory joint disease and rheumatoid arthritis; and rheumatoid arthritis and osteoarthritis of the knees, hips, and hands.
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Disease Combinations Associated with Physical Activity Identified: The SMILE Cohort Study. BIOMED RESEARCH INTERNATIONAL 2016; 2016:9053578. [PMID: 26881231 PMCID: PMC4736229 DOI: 10.1155/2016/9053578] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/09/2015] [Revised: 12/17/2015] [Accepted: 12/20/2015] [Indexed: 11/17/2022]
Abstract
In the search of predictors of inadequate physical activity, an investigation was conducted into the association between multimorbidity and physical activity (PA). So far the sum of diseases used as a measure of multimorbidity reveals an inverse association. How specific combinations of chronic diseases are associated with PA remains unclear. The objective of this study is to identify clusters of multimorbidity that are associated with PA. Cross-sectional data of 3,386 patients from the 2003 wave of the Dutch cohort study SMILE were used. Ward's agglomerative hierarchical clustering was executed to establish multimorbidity clusters. Chi-square statistics were used to assess the association between clusters of chronic diseases and PA, measured in compliance with the Dutch PA guideline. The highest rate of PA guideline compliance was found in patients the majority of whom suffer from liver disease, back problems, rheumatoid arthritis, osteoarthritis, and inflammatory joint disease (62.4%). The lowest rate of PA guideline compliance was reported in patients with heart disease, respiratory disease, and diabetes mellitus (55.8%). Within the group of people with multimorbidity, those suffering from heart disease, respiratory disease, and/or diabetes mellitus may constitute a priority population as PA has proven to be effective in the prevention and cure of all three disorders.
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Meldrum H, Katz D, Egger G. Letter to the editor: lifestyle medicine in Expert Review of Cardiovascular Therapy. Expert Rev Cardiovasc Ther 2016; 14:263. [PMID: 26679061 DOI: 10.1586/14779072.2016.1134229] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Affiliation(s)
- H Meldrum
- a Australasian Society for Lifestyle Medicine , Northcote , Melbourne, Australia
| | - D Katz
- b American College of Lifestyle Medicine , Woodburn , OR , USA
| | - G Egger
- a Australasian Society for Lifestyle Medicine , Northcote , Melbourne, Australia
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Abstract
BACKGROUND Less than 50 per cent of US primary care doctors routinely provide guidance to their patients on lifestyle behaviours such as diet, physical activity or weight control, despite the prediction by the World Health Organization that by 2020, two-thirds of disease worldwide will be the result of poor lifestyle choices. This gap in patient-clinician dialogue is perhaps the result of a lack of structured training in medical school surrounding the components of lifestyle medicine. CONTEXT Although Harvard Medical School does have a required course in nutrition, there are no requirements for the other components of lifestyle medicine, including physical activity, behaviour change and self-care. INNOVATION Since 2009 Harvard Medical School has addressed this absence in the curriculum by developing a student-led, faculty member-advised, parallel curriculum in lifestyle medicine. Medical student participants were invited to take part in anonymous questionnaires between 2009 and 2013, which gathered data about personal ability and attitude in counselling patients on lifestyle behaviours, as well as subjective data on the curriculum content and applications to effective medical practice. Less than 50 per cent of US primary care doctors routinely provide guidance to their patients on lifestyle behaviours IMPLICATION: Each year, students have pointed to a lack of lifestyle medicine knowledge because of a gap in the traditional curriculum surrounding topics such as physical activity, nutrition and behaviour-change strategies, and indicated that the inclusion of this knowledge and these skills was an important component of medical education. Although participation is currently voluntary, this is the first such curriculum of this type and addresses a critical gap in undergraduate medical education.
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Affiliation(s)
- Rachele Pojednic
- Institute of Lifestyle Medicine, Joslin Diabetes Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Elizabeth Frates
- Institute of Lifestyle Medicine, Joslin Diabetes Center, Harvard Medical School, Boston, Massachusetts, USA
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Loprinzi PD, Loenneke JP, Blackburn EH. Movement-Based Behaviors and Leukocyte Telomere Length among US Adults. Med Sci Sports Exerc 2015; 47:2347-52. [PMID: 25970659 PMCID: PMC10597460 DOI: 10.1249/mss.0000000000000695] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
INTRODUCTION Short leukocyte telomere length (LTL) has become a hallmark characteristic of aging. Some, but not all, evidence suggests that physical activity (PA) may play an important role in attenuating age-related diseases and may provide a protective effect for telomeres. The purpose of this study was to examine the association between PA and LTL in a national sample of US adults from the National Health and Nutrition Examination Survey. METHODS National Health and Nutrition Examination Survey data from 1999 to 2002 (n = 6503; 20-84 yr) were used. Four self-report questions related to movement-based behaviors (MBB) were assessed. The four MBB included whether individuals participated in moderate-intensity PA, vigorous-intensity PA, walking/cycling for transportation, and muscle-strengthening activities. An MBB index variable was created by summing the number of MBB an individual engaged in (range, 0-4). RESULTS A clear dose-response relation was observed between MBB and LTL; across the LTL tertiles, respectively, the mean numbers of MBB were 1.18, 1.44, and 1.54 (Ptrend < 0.001). After adjustments (including age) and compared with those engaging in 0 MBB, those engaging in 1, 2, 3, and 4 MBB, respectively, had a 3% (P = 0.84), 24% (P = 0.02), 29% (P = 0.04), and 52% (P = 0.004) reduced odds of being in the lowest (vs highest) tertile of LTL; MBB was not associated with being in the middle (vs highest) tertile of LTL. CONCLUSIONS Greater engagement in MBB was associated with reduced odds of being in the lowest LTL tertile.
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Affiliation(s)
- Paul D. Loprinzi
- Center for Health Behavior Research, Department of Health, Exercise Science, and Recreation Management, The University of Mississippi, University, MS
| | - Jeremy P. Loenneke
- Kevser Ermin Applied Physiology Laboratory, Department of Health, Exercise Science, and Recreation Management, The University of Mississippi, University, MS
| | - Elizabeth H. Blackburn
- Blackburn Laboratory, Department of Biochemistry and Biophysics, University of California, San Francisco, San Francisco, CA
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Conceição RDDO, Laurinavicius AG, Kashiwagi NM, de Carvalho JAM, Oliva CAG, Santos RD. Check-up and cardiovascular risk progression: is there a room for innovation? EINSTEIN-SAO PAULO 2015; 13:196-201. [PMID: 26154540 PMCID: PMC4943809 DOI: 10.1590/s1679-45082015ao3216] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Accepted: 01/07/2015] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To evaluate the impact of traditional check-up appointment on the progression of the cardiovascular risk throughout time. METHODS This retrospective cohort study included 11,126 medical records of asymptomatic executives who were evaluated between January, 2005 and October, 2008. Variables included participants' demographics characteristics, smoking habit, history of cardiovascular diseases, diabetes, dyslipidemia, total cholesterol, HDL, triglycerides, glucose, c-reactive protein, waist circumference, hepatic steatosis, Framingham score, metabolic syndrome, level of physical activity, stress, alcohol consumption, and body mass index. RESULTS A total of 3,150 patients was included in the final analysis. A worsening was observed in all risk factors, excepting in smoking habit, incidence of myocardial infarction or stroke and in the number of individuals classified as medium or high risk for cardiovascular events. In addition, a decrease in stress level and alcohol consumption was also seen. CONCLUSION The adoption of consistent health policies by companies is imperative in order to reduce the risk factors and the future costs associated with illness and absenteeism.
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Affiliation(s)
| | | | | | | | - Carlos Alberto Garcia Oliva
- Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
- Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - Raul Dias Santos
- Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
- Instituto do Coração (InCor), Universidade de São Paulo, São Paulo, SP, Brazil
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Affiliation(s)
- David L Katz
- Editor-in-Chief, Childhood Obesity; Director, Yale University Prevention Research Center , Griffin Hospital, Derby, CT
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