Psychosocial Determinants of Chronic Disease: Implications for Lifestyle Medicine

Exploring the longitudinal clustering of lifestyle behaviors, social determinants of health, and depression

Lifestyle behaviors such as exercise, sleep, smoking, diet, and social interaction are associated with depression. This study aimed to model the complex relationships between lifestyle behaviors and depression and among the lifestyle behaviors. Data from three waves of the Midlife in the United States study were used, involving 6898 adults. Network models revealed associations between the lifestyle behaviors and depression, with smoker status being strongly associated with depression. Depression, smoker status, age, time, and exercise were some of the most central components of the networks. Future lifestyle intervention research might prioritize specific behaviors based on these associations and centrality indices.

Adverse Childhood Experiences as “Upstream” Determinants of Lifestyle-Related Chronic Disease: A Scoping Perspective

We have previously proposed a list of determinants (causes) of modern lifestyle-related chronic disorders, which provides a structure for the emerging discipline of lifestyle medicine. This consists of lifestyle factors with a common immune biomarker ( metaflammation) that interact in a systems fashion linked with chronic disease outcomes. We considered this to be a work in progress and later added 3 psychosocial determinants into the causal mix: meaninglessness, alienation, and loss of culture and identity (MAL). Here, we propose adverse childhood experiences (ACEs) as deeper, or even more distal, disease drivers that may act directly or indirectly through MAL to influence later chronic disease. The links with metaflammation and the need for recognition of these embedded scars in the management of lifestyle-related health problems is discussed.

Is a better planned day a healthier day? A daily diary study

OBJECTIVE

Previous research has shown that intentions, implementation intentions, active planning and coping planning predict engagement in important health behaviours. This study investigated the role of general daily planning as opposed to specific behaviour planning as a predictor of engagement in lifestyle behaviours. The study also examined conscientiousness and mean levels of planning as moderators of that relationship.

DESIGN

This study utilised a daily diary approach wherein 76 adults were recruited to complete daily diary surveys for 14 days. Multilevel models assessed the within- and between-person relationships between planning and five lifestyle behaviours.

MAIN OUTCOME MEASURES

Physical exercise, fruit and vegetable intake, time spent in social interaction, time spent in nature and heavy alcohol intake.

RESULTS

Within-person general daily planning predicted engagement in exercise. Interactions were found between within-person general daily planning and between-person general daily planning as predictors of exercise, social interaction and time spent in nature.

CONCLUSION

These findings introduce general daily planning as a potentially influential variable for explaining engagement in some lifestyle behaviours. Further, the interactions shed further light on when planning may be more and less helpful depending on individual differences.

Lifestyle Medicine – New Concept, Innovative Discipline

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.

Financial Education and Coaching: A Lifestyle Medicine Approach to Addressing Financial Stress

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.