The case for Lifestyle Medicine: why you should care about it
Updated: Oct 16, 2019
“Health is the first wealth” - Ralph Waldo Emerson
Where we were
When I was a medical student, I remember lifestyle modification being taught as the first modality of treatment for many chronic diseases, such as hypertension, diabetes, depression and so on.
But … that was all!
There were not many details: what lifestyle changes? How do we accomplish these changes? And most importantly, there was barely any information on how significant an impact lifestyle therapy could have on these chronic ailments.
At that time, it seemed so simple: exercise, eat good food, sleep, and keep stress away. But simple doesn’t mean easy. Otherwise, lifestyle diseases would not have been the leading cause of mortality in the world, and people would not have been suffering.
Where we are
Times have changed, and there is an increased awareness about concepts such as total health and ways of healthy living. These do not qualify as “medicine” per se, perhaps, for the average person, but are still on people’s radar. You’ve probably heard of it, or read about it somewhere too.
However, the current situation is a far cry from ideal: children in schools are not being taught the basics of physical fitness, there is little governmental guidance on inculcating fitness-related habits in teens and young adults, and no broad social awareness of how important it is to adopt these habits.
This gap in our knowledge, along with the industrialized sedentary lifestyle, is translating into alarming proportions of lifestyle diseases. For e.g., the prevalence of diabetes in India has increased by 30% between 1990 and 2016. Similar trends of increasing diseases have been noticed across the world.
To top it off, only one doctor in three prescribes lifestyle change to patients, and even then, most of it is ineffective advice, with little measurable impact. Its mostly vague statements about losing weight and being more active.
How often do doctors enquire about your sleep? Your stress levels? And how would they, considering they are able to give only few minutes per patient, with the disproportionate doctor:patient ratio in the country.
What’s more, the majority of our physicians themselves have unhealthy lifestyle practices and are not fit. Doesn’t it seem a little hollow, even vaguely ironic, to receive advice on lifestyle from someone who is not implementing them in his/her own life?
Impact of Lifestyle medicine on our health
So, where are we lacking? We know there are benefits to healthy lifestyle changes, but do we know they can have life-changing (pun intended) effects? We know that exercise promotes cardiovascular health, but do we know it can reverse the clogging of arteries? We know a nutritious diet can help us in losing weight, but do we know it can keep off several chronic diseases? Are we aware of the type of nutrition, as well the kind of activity, we should incorporate in our life? Are we aware that positive lifestyle changes can not only transform our bodies but also our minds, making us calmer and more peaceful?
Globally, non-communicable diseases account for 63% of all deaths. Cardiovascular disease (ischaemic heart disease and stroke) alone is the leading cause of death in India, at 28% (2016). This implies, one in 4 Indians would die of cardiovascular disease at some time point. You must be knowing at least one person in your life suffering from heart disease, either in your immediate family, relatives, or friends.
Studies have shown that up to 80 % of heart disease, stroke, and type-2 diabetes, and more than 1/3 of cancers could be prevented by adopting principles of lifestyle medicine. Not only this, it can reverse some of the pathologic effects in patients with established disease. For e.g., regression of coronary atherosclerosis was observed in patients who made and maintained comprehensive lifestyle changes in Lifestyle Heart Trial.
Can you imagine the impact, both at a personal and at a socioeconomic level, if we all start adapting these principles?
And this is the reason why I am so passionate about Lifestyle medicine. I believe no other field of medicine has the power to make such a significant difference at such a large scale in our world, and reduce human suffering, stemming from an epidemic of lifestyle diseases.
What if you believe you have been failed by genetics? Think again. Studies have shown that our lifestyle can affect our genetic risk for chronic diseases. If our genes are like a loaded gun, the trigger is pulled by our toxic lifestyle. And by adopting the right lifestyle, you can defeat your genes!
So, why choose lifestyle medicine?
With lifestyle medicine, you choose to be healthy, not just free of disease. Health that is a state of physical, mental, and social well-being. You choose to have a calmer mind, fitter body, more energy, and a positive outlook towards life.
Lifestyle medicine can prevent, and in some cases reverse the pathological changes in chronic diseases. In contrast, our current health system focuses on controlling/managing the pathological changes; the ability of pills to treat the root cause of diseases is limited (more details on the differences here.
You can be in charge of your health, rather than having to depend on doctors to manage your disease.
Isn’t that an amazing concept? Very little cost, no potential side-effects, but results with a far-reaching impact.
Who is lifestyle medicine for?
One word. Everybody! You need it if:
· You are suffering from chronic conditions like hypertension, diabetes, cardiovascular diseases, metabolic syndrome, depression, obesity etc. If you are, LSM is essential for you. No matter the number of medications you are consuming, reducing the severity of disease should be your first priority.
· You are at risk of developing chronic diseases, i.e., high weight/body mass index, physical inactivity, unhealthy dietary habits, smoking, drinking, stress/anxiety.
· You want to stay physically and mentally fit, and march into your future with vigor and energy
In the end, I would just like to say that if you are satisfied with your life and enjoying it with super health and great energy, congratulations, keep doing what you’re doing: it’s obviously working!
However, if you feel you can (and want to) improve any aspect of your health and take control of your future, come along and let me take you through this amazing transformation.
01 September 2019
 Robert F Kushner. Lifestyle Medicine—An Emerging New Discipline. US Endocrinology, 2015;11(1):36–40
 India’s escalating burden of non-communicable diseases. www.thelancet.com Vol 6 December 2018
Robert F Kushner et al. Lifestyle Medicine—An Emerging New Discipline. US Endocrinology, 2015;11(1):36–40
 Dean Ornish. Intensive Lifestyle Changes for Reversal of Coronary Heart Disease. JAMA, December 16, 1998—Vol 280, No. 23