What is lifestyle medicine?

Where the approach came from

Most deaths in the United States and worldwide are now caused by noncommunicable diseases: heart disease, type 2 diabetes, several cancers and chronic lung disease. A large share of that risk is linked to habits. The Global Burden of Disease study, for example, estimated that about 11 million deaths worldwide in 2017 were attributable to poor diet (Afshin et al., 2019).

In 2010, a paper in JAMA described the competencies physicians need to "prescribe" lifestyle change (Lianov & Johnson, 2010). The American College of Lifestyle Medicine (ACLM), a U.S. professional society founded in 2004, works in the same direction and popularized the six-pillar model.

The six pillars

1. Nutrition: whole, mostly plant-based food. What to eat day to day to lower your risk of heart disease, type 2 diabetes and other chronic conditions.
2. Physical Activity: regular physical activity. How much movement you really need and how to fit it into an ordinary day, no gym required.
3. Sleep: restorative sleep. How much to sleep, how to fall asleep more easily and why sleep underpins physical and mental health.
4. Stress: stress management. How stress affects the body and which simple, evidence-based practices help you recover.
5. Risky Substances: avoiding risky substances. Tobacco, alcohol and other addictive behaviors: what the data say and how to change habits.
6. Social Connection: relationships and community. Why loneliness is a health risk and how support and community protect your health.

What the research shows

A classic example is Dean Ornish's Lifestyle Heart Trial: in a small group of patients with coronary heart disease, an intensive program (plant-based eating, exercise, stress management and group support) was followed by regression of coronary narrowing after one year (Ornish et al., 1990). Current WHO physical activity guidelines (Bull et al., 2020) and U.S. federal guidelines draw on thousands of studies and point in the same direction.

Studies of "Blue Zones", regions with many centenarians, describe similar habits: natural movement, mostly plant-based food, a sense of purpose and community (Buettner & Skemp, 2016). These are observational data that show associations rather than proof of cause.

What it is not

• It is not a substitute for medication or "alternative medicine".
• It is not about strict diets or perfection, but about gradual, lasting change.
• It is not a government program, but a professional field with an evidence base.

Our relationship with ACLM

Well Day Media is an independent publication. We organize our content around the six pillars promoted by ACLM and rely on published research, but we are not a partner or representative of the organization. For official information, visit lifestylemedicine.org.

Sources

1. Lianov (2010). Physician Competencies for Prescribing Lifestyle Medicine. JAMA 304(2):202. doi:10.1001/jama.2010.903
2. Ornish et al. (1990). Can lifestyle changes reverse coronary heart disease?. The Lancet 336(8708):129-133. doi:10.1016/0140-6736(90)91656-U
3. Afshin et al. (2019). Health effects of dietary risks in 195 countries, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. The Lancet 393(10184):1958-1972. doi:10.1016/S0140-6736(19)30041-8
4. Bull et al. (2020). World Health Organization 2020 guidelines on physical activity and sedentary behaviour. British Journal of Sports Medicine 54(24):1451-1462. doi:10.1136/bjsports-2020-102955
5. Buettner et al. (2016). Blue Zones. American Journal of Lifestyle Medicine 10(5):318-321. doi:10.1177/1559827616637066
6. American College of Lifestyle Medicine. lifestylemedicine.org