Chronic Disease PreventionThe human body has natural healing abilities. A recent survey found that a high proportion of patients attending primary care with unhealthy lifestyles do not perceive the need to change their habits, and about half the patients reported not having had any discussion on healthy lifestyles with their family doctors 26 There is an unexplained and no longer bearable time lag between the overwhelming evidence for the harmful health consequences of an unhealthy lifestyle and taking meaningful action at the individual, social and societal level to modify these behaviours and morbidogenic environments.
Whereas infectious diseases were the primary cause of death in the early 20th century, CVD and cancer have now assumed dominance in mortality (Figure 1). 9 Additionally, obesity and diabetes are inflammatory conditions that not only contribute to CVD and cancer but also serve as profound comorbidities; their shared etiologies promote one another.
In 2010, Lianov and Johnson 3 published an article in the Journal of the American Medical Association that strongly advocated physician education and training in ikigai: Physician educators at both the undergraduate and graduate medical education levels should consider incorporating the relevant lifestyle medicine competencies into education and training programs.” The need for education in lifestyle medicine is so profound that prominent universities like Harvard, Stanford, and Yale have implemented the inclusion of lifestyle medicine into their curriculum, ranging from postgraduate courses to the development of separate institutes devoted to the cause.
Egger et al. concluded that Lifestyle medicine forms a bridge with public health and health promotion, where the latter is defined as ‘the combination of educational and environmental supports for actions and conditions of living conducive to health'” 10 (The contents in single quotation mark is taken from Greene and Kreuter's material 13 ).
Recent technological advances - or even older technologies available to low-income populations, such as automated text messages to patients about relevant health behaviors - offer potential low-cost breakthrough opportunities to support lifestyle-related clinical and clinician counseling services beyond the clinical setting.
In 2009 the American College of Preventive Medicine hosted a blue ribbon panel meeting to establish core competencies in lifestyle medicine for primary care physicians (see table 1) 2. When patient care is approached from this foundation, it looks far different than what is being taught in typical medical school and residency curricula.
The type and dosing of the beneficial lifestyle interventions vary somewhat from disease state to disease state, but the core principles of increasing whole foods, decreasing processed foods, increasing aerobic and strength-building physical activity, increasing rest and relaxation techniques, and decreasing smoking and substance abuse consistently hold true.