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When it comes to health, what is lifestyle anyway?
Lifestyle in health refers to the daily choices and behaviors we make that impact our overall well-being. When sustained overtime they are your health habits.
According to the World Health organization, diseases with significant lifestyle causes account for 74 % of deaths worldwide and 75% of these are premature, occurring before age 70.
Many aspects of life influence our health-related choices, including our access to primary healthcare, health services and health information. There are also powerful commercial determinants of health, including the lobbying and marketing influence of large corporations and social media influencers that influences the choices we make about our health.
Lifestyle factors that are essential to creating health habits include these 6 pillars of lifestyle medicine: diet, exercise, sleep, stress management, healthy relationships and avoidance of risky substances.
What is lifestyle medicine?
The 6 pillars of lifestyle medicine are a core foundation of habits for health.
Lifestyle medicine applies evidence-based, whole-person, prescriptive lifestyle change to treat medical conditions. When used intensively it often reverses chronic metabolic and inflammatory medical conditions.
The six pillars of lifestyle medicine support the body to maintain balance in all it's interconnected systems. Lifestyle medicine focuses on building health habits for life.
The 6 Pillars of Lifestyle Medicine
HEALTH HABITS FOR LIFE
There are six pillars of lifestyle medicine. These are health habits for life to help you thrive. They include: nutrition, physical activity, restorative sleep, stress management, social connectedness and minimisation of health harming substances. Let’s take a closer look at each one.
1. Eat Real Food
A whole-food, plant-predominant eating pattern promotes health. Whole foods are foods in a minimally processed state. Plant-based or plant-predominant means getting the majority of energy and nutrients from plants.
Food as Medicine
Eating diverse plant foods contains not only many vitamins and vegetables, but also phytonutrients, polyphenols and anti-oxidants that reduce inflammation, increase gene expression of health promoting proteins and enzymes. In this way food is more than just the provision of energy to the body, but is information, directing the body to switch on genes which repair and heal the body and keep it's systems in balance.
Many herbs and spices have beneficial effects on genes and cells for example:
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Rosemary, lemon balm and oregano exhibit angiotensin converting enzyme (ACE) inhibition - having effects that lower blood pressure and improve kidney function.
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Ginger, cinnamon and fenugreek have blood sugar lowering effects.
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Green tea, ginger, garlic and turmeric promote anti-inflammatory gene expression
Anti-inflammatory Food
Many plant-based food is high in anti-oxidants which reduce inflammation in the body. There are some important groups of anti-inflammatory plant foods:
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Cruciferous vegetables includes broccoli, cauliflower, boy choy, kale and cabbage. They contain sulforaphane and indole-3-carbinols (I3C) which act as anti-oxidants and promote death of damaged cells so have anti-cancerous effects. I3C also regulates estrogen activity and metabolism and estrogen receptor gene expression, having anti-breast cancer effects.
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Dark berries and fruits including blueberries, raspberries, strawberries, red grapes, cranberries and pomegranate contain ellagic acid, anthocyanidins and anthocyanins. These phytonutrients have anti-diabetic, anti-cancer, anti-inflammatory, antimicrobial, and metabolic enhancing effects.
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Alliums include garlic, onions, shallots and leeks. They are rich in organosulfurs which have multiple powerful effects in the body. They are antioxidants, anti-cancer, anti-inflammatory, anti-bacterial and promote lower blood pressure, lower cholesterol and blood sugar stabilising.
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Orange, yellow and dark green vegetables and fruits such as carrots, mangoes, pumpkin, and kumara are rich in carotenoids which are good for improving heart health.
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Dark green leafy vegetables are rich in fibre, folate, carotenoids, lutein, and zeaxanthin, vitamins C and K, iron and calcium. They are found in vegetables such a silverbeet (swiss chard), dark lettuces, mustard, beet and turnip greens. All of these nutrients are important for efficient cell function and metabolism.
Feed your Gut Microbiome
Diverse plant foods also provides both fibre and prebiotics, which is food for promoting gut microbiome diversity. Preferable animal products are chicken, fish, seafood and do not need to be consumed daily or with every meal.
Eating real food stabilises your blood sugars, cholesterol and triglycerides, is better for heart health, prevention of cancer and diabetes.
2. Move Your Body
Your body evolved to move, throughout the day, gathering food and living in community. Modern life is largely sedentary so you need to craft movement into your day to replicate our natural regular movement.
Physical activity is important for every aspect of health and wellbeing, from maintaining bone and muscle strength, maintaining heart health, blood sugar stability, to supporting mood, energy levels and cognitive function.
Aerobic exercise
Recommendations are for 150-300 minutes of moderate activity per week or 75-150 minutes of vigorous activity. Exercise which gets the heart pumping, nitric oxide flowing, the muscles, joints and bones moving, is beneficial for every cell and system in the body, reduces inflammation, slows aging and slows and reverses disease.
Resistance Training
Additionally to maintain muscle strength, resistance training twice per week is recommended. Resistance training increases muscle strength by making the muscles work against a force or weight. Resistance training can be done using your own body weight - such as push-ups and squats, free weights, weight machines and resistance bands
Exercise can be enjoyed at any time, in short bursts and doesn't have to be complicated. In fact, if you are new to movement and exercise it is best to take a gentle, progressively increasing approach to build fitness and reduce the risk of injury.
3. Restorative Sleep
Most people know that getting a good night’s sleep is important for overall health, but many don’t realize just how crucial sleep is to our well-being.
There are 4 stages of sleep which occur in cycles. For sleep to be restorative, it is important to get both enough sleep, but also good quality sleep, particularly where the brain and body experience deep sleep and REM sleep. Restorative sleep enables the body to function adequately, remain resilient and resist disease.
During deep sleep, your breathing rate and blood pressure decreases, your muscles relax, your brain activity slows, and the immune system is primed allowing recovery and repair in the body and brain.
Rapid Eye Movement (REM) sleep is a mentally active phase where you experience your most vivid dreams. During REM sleep stage, your breathing and heart rate increases, and many muscles relax for rest and recovery. It is during REM sleep that your mind undertakes emotional processing.
There are a number of strategies that can be used to facilitate restorative sleep, including for shift workers, from supportive herbs/supplements, hormone support, exercise, sunshine, light therapy and mindful practices. Sometimes sleep needs a reset, but other times maintaining restorative sleep really is a daily practice.
4. Stress Management
Stress is a natural part of life. Some stress is positive and propels us to initiate action, take risks and fulfil meaningful lives. This type of stress is called eu-stress. It is stress that is positive and temporary and you have the resources to meet the challenge.
A work promotion, roller-coaster ride, a scary movie, travelling or a tough workout can be examples of this type of stress. Eustress has a beneficial effects on health, motivation, performance, and emotional well-being and feel-good chemicals called endorphins are released.
Dis-stress is stress which has a negative effect on health and wellbeing. Distress, particularly when prolonged such as chronic work-stress, bullying, financial stress, toxic relationship stress can contribute to ill-health.
Some effects of chronic dis-stress includes: insomnia, low energy, symptoms of ill-health such as headaches, reflux, indigestion, chronic pain, chest pain, and feeling overwhelmed. It can also impair the immune system resulting in recurrent or prolonged infections and slower recovery from injuries.
To manage distress you may need to reduce stressors or simplify your life. Other people may need to develop stress mitigating strategies to balance their distress with some mindfulness, leisure, fun and eustress activities.
There are many ways to reduce distress including:
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A deep breathing practice
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Talking to a friend, health professional or therapist.
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Exercise
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Spend time in nature
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Restorative sleep practices
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Journaling
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Daily gratitude practice
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Meditation, mindfulness, yoga nidra
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Yoga
5. Social Connection
Humans are social beings - social connectivity is a basic survival need that is hardwired into your nervous system. Social relationships are as important to health as diet, exercise and smoking habits. Toxic social relationships, including online relationships, isolation and loneliness increase your risk of chronic metabolic disease.
Social connection comes in many forms and can include family, friends, participating in groups via hobbies or sports. Additionally many people find meaningful spiritual social support through their religious community, or connection through prayer and yoga.
Healthy relationships reduce your stress level, are important for emotional health, and boost your immunity and gives your life fulfilment.
6. Minimise health harming substances
Many substances commonly and frequently used recreationally such as tobacco, alcohol and even excess caffeine can have a harmful effect on health and longevity.
Additionally toxic air, soils and water via chemicals, pesticides and building exposure via chemicals, mould and dampness can have detrimental effects on health.
Exposure to risky substances should be minimised to reduce negative effects on health.
Frequently Asked Questions about Lifestyle Medicine
What conditions can be treated with lifestyle medicine?
Lifestyle medicine can be used to treat most chronic conditions and diseases at any stage. The intensity of the treatment is a collaboration between your lifestyle medicine practitioner and yourself and will be influenced by a number of factors including your preferences.
Some examples of women's health conditions where lifestyle medicine can be applied: endometriosis, PCOS - polycystic ovarian syndrome, chronic and recurrent thrush or bacterial vaginosis, relative energy deficiency in sports (RED-S), preconception, infertility, pregnancy, post-natal care, and more.
Women in every stage of life can benefit from the principles of Lifestyle Medicine, including from adolescence through to perimenopause, menopause and beyond.
In terms of general health conditions, lifestyle medicine is commonly used to prevent / treat heart disease, stroke, diabetes, obesity, cancer, mental health conditions, respiratory, musculoskeletal conditions such as osteoporosis, sarcopaenia, osteoarthritis, gout and some autoimmune diseases.
Is lifestyle medicine different to standard medicine?
Lifestyle medicine is the foundation of standard medicine. Most clinical guidelines for chronic disease management include advice around health habits and behaviours to manage these conditions. There is an increasing body of medical evidence that this is beneficial at reducing medications and ill-health over time.
Is lifestyle medicine new?
The principles of lifestyle medicine are not new. Indigenous cultures and human history have demonstrated that these principles of caring for sick people have been the basis of medicine for centuries.
Food including herbs and spices and nourishing broths, movement, social connection, including community rituals, circadian sleep patterns that mirror the seasons and solar and lunar patterns have all been instrumental in maintaining human health and longevity.
What is new is that the emerging medical field of lifestyle medicine is bringing together this age-old wisdom, combined with a growing science-base that supports that diseases of modern living, which are many of our chronic diseases we commonly see in general practice can be prevented, treated and with intensive change, reversed.
Lifestyle medicine is where preventive medicine meets public health medicine. It not only involves 1: 1 lifestyle medicine practitioner and client consults, but includes group consultation, health promotion events, community building and advocacy. Lifestyle medicine principles can be utilised in every medical specialty.
What is equally amazing, is that applying these health habits have systems and body wide effects, so that making lifestyle changes to support your blood pressure, can also help with your reflux, migraines and blood sugars.
Do doctors get additional training in lifestyle medicine?
As diet, exercise, sleep, stress management are not a major focus of a standard medical degree, doctors (and other health professionals) who work in lifestyle medicine train and receive lifestyle medicine certification with a relevant board of lifestyle medicine. This enables lifestyle medicine physicians to gain specialized training to become proficient in a lifestyle medicine approach to preventing, managing and reversing chronic diseases.
References
American College of Lifestyle Medicine. www.lifestylemedicine.org
American Board of Lifestyle Medicine. www.ablm.org
Australasian Society of Lifestyle Medicine. www.lifestylemedicine.org.au
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Bayat Mokhtari R, Baluch N, Homayouni TS, et al. The role of Sulforaphane in cancer chemoprevention and health benefits: a mini-review [published correction appears in J Cell Commun Signal. 2017 Aug 26;:]. J Cell Commun Signal. 2018;12(1):91-101.
Amagloh FK, Atuna RA, McBride R, et al. Nutrient and Total Polyphenol Contents of Dark Green Leafy Vegetables, and Estimation of Their Iron Bioaccessibility Using the In Vitro Digestion/Caco-2 Cell Model. Foods. 2017 Jul 22;6(7):54.
Singh R, Pattisapu A, Emery MS. US Physical Activity Guidelines: Current state, impact and future directions. Trends Cardiovasc Med. 2020;30(7):407-412.