Adherence to Selected Pillars of Lifestyle Medicine in the United States: A Cross-Sectional Analysis

Abstract

Background: The American College of Lifestyle Medicine proposed 6 evidenced-based pillars to tackle the increasing burden from chronic non-communicable diseases, including regular physical activity, 7+ hours of restorative sleep, a whole-food plant-based diet, stress management, avoidance of risky substances and positive social connections. Methods: We used cross-sectional nationally representative data from the National Health and Nutrition Examination Surveys to analyze the degree of adherence to 4 of these pillars in the US general population. Results: We analyzed data from n = 1217 participants (representing n = 64,468,933 US adults). Results suggested a low population prevalence of established lifestyle medicine behaviors. Less than 50% of the population met the minimal weekly physical activity goal of 150 minutes of moderate intensity activity. We observed a high prevalence of risky substances (excessive alcohol and tobacco) in younger participants aged 20-38 years. Only .52% met common indicators of a whole-food plant-based diet. We found substantial differences between sexes and age groups, with an alarmingly low percentage of young adults achieving optimal levels of common lifestyle practices. Conclusions: Lifestyle medicine as a cost-effective strategy to reduce premature mortality is widely established. Our findings reiterate the required shift from symptom management via interventions towards “tackling the cause” of chronic diseases.