Lifestyle Medicine – Six Pillars : Old wine in new bottle?

Dr Jitesh Chavhan

MBBBS MD (Anaesthesia) IDCCM .

Present working as physician (for 5 years) at self-owned Swasthya clinic, Umrer, Dist. Nagpur.

Just like the tremendous progress in the field of technology, medical science too is growing by leaps and bounds. There are innumerable research studies being conducted at genetic and molecular level and our armamentarium to fight diseases is ever expanding. Yet the number of diseases and disabilities seems to be growing at an even larger pace. This forces us to ponder whether we are heading in the right direction or we are missing something. In pursuit of detail, are we losing the larger picture?

      As much as the advances in science have been a boon for fighting infectious diseases, trauma and chronic diseases comprise over 80 percent of the current illness burden. These have largely remained non-curable and are just being treated with a plethora of pharmaceutical and surgical interventions that focus on managing complications, rarely addressing the root causes.

       Throughout most of human history, food was scarce and hard to come by and hard physical activity was required for survival and unavoidable. Modern cultures have devised worlds where physical activity is scarce and hard to come by. Foods are abundant and engineered to be irresistible. Hectic schedules propagate stress and sabotage sleep. Increasing pre-occupations with screens at the cost of time-honoured human connections is threatening our empathetic human nature. Toxic and addictive substances tempt us to cope with these circumstances, but unfortunately are ones to which we are poorly adapted and can get addicted.

      Lifestyle, the manner in which people live, is fundamental to health, wellness and prevention of disease. Lifestyle medicine addresses how we should live in order to be healthy. It is a rapidly growing discipline that focuses on the role of lifestyle factors in preventing, managing and reversing chronic disease.

What Is Lifestyle Medicine?

       According to the American College of Lifestyle Medicine (ACLM), lifestyle medicine is “a medical specialty that uses therapeutic lifestyle interventions as a primary modality to treat chronic conditions, including but not limited to CVDs, type 2 diabetes, and obesity.”1

       Although some overlap exists between lifestyle medicine and other fields like integrative medicine or preventative medicine, lifestyle medicine is unique. In lifestyle medicine, evidence-based lifestyle changes are prescribed as first line treatment for disease. Other evidence-based interventions, such as medications or procedures, also can be used, but only as supplementary to lifestyle change. Lifestyle medicine certainly can be used for disease prevention, but the focus is primarily on treatment, reducing disease severity, and sometimes the reversal of existing disease. Lifestyle medicine goes beyond just helping the healthy get healthier. It aims to significantly improve disease markers and quality of life for patients who need it most.

The Six Pillars

        The ACLM identifies six areas of lifestyle that can be used therapeutically to improve health outcomes: nutrition (whole food and plant based), physical activity, restorative sleep, stress management, social connection, and avoidance of risky substances.