Lifestyle Medicine for Dermatologic Disease: Emerging Evidence Through a Lens of Personalized Care.

Dementia and cognitive decline pose significant global public health challenges, with prevalence expected to rise in the coming decades. Lifestyle medicine offers a promising approach to mitigating cognitive issues through six key interventions: diet, physical activity, restorative sleep, social connections, stress management, and avoiding risky substances. Traditional methods like randomized controlled trials (RCTs) have limitations in capturing the long-term impacts of these interventions. To overcome these challenges, the American College of Lifestyle Medicine (ACLM) and the True Health Initiative (THI) developed the Hierarchies of Evidence Applied to Lifestyle Medicine (HEALM) framework, informed by the Evidence Threshold Pathway Mapping (ETPM) approach. This framework integrates diverse evidence sources to assess intervention effects over time. Applying HEALM, this review evaluates lifestyle factors' impact on dementia and cognitive decline. It finds strong evidence supporting plant-based nutrition, physical activity, restorative sleep, and avoiding risky substances in promoting cognitive health. Social connections may mitigate cognitive decline, while stress management requires further investigation due to inconclusive findings. Integrating these findings into public health strategies could effectively address the growing dementia burden and enhance overall well-being in aging populations, underscoring the need for continued research in cognitive health.

Lifestyle medicine (LM) is increasingly recognized in cancer survivorship guidelines. The 6 LM pillars are physical activity, a predominantly plant diet, restorative sleep, stress management, avoiding risky substance use, and social connections. Through a multidisciplinary LM clinic in oncology, we describe 2 illustrative cases and the implications for broader implementation and dissemination of this clinic model. In the multidisciplinary LM clinic in oncology, patients meet with an American College of Lifestyle Medicine (ACLM) board-certified physician or nurse practitioner, a registered dietitian, and, as needed, a clinical psychologist, a psychiatrist, an obesity medicine physician, a physical therapist, and/or a rehabilitation medicine physician. Patient 1 met with the physician, the registered dietitian, the psychologist, and an affiliated cancer center psychiatrist. Patient 2 met with the nurse practitioner and the registered dietitian. The 2 cases presented illustrate the diversity of LM pillars and strategies to increase health and well-being post cancer treatment. This paper details the model of implementation of a novel oncology-focused multidisciplinary LM clinic and the clinical focuses of 2 diverse patients. The LM needs of cancer survivors seeking lifestyle consultation are growing, and awareness of the benefits of LM for this population can enhance the quality of life for patients who are survivors of cancer.

There are currently four million breast cancer survivors in the United States and the number is expected to substantially increase in the decades to come. Oncologists are regularly managing issues of survivorship during periods of surveillance and the topic of prevention of cancer recurrence is a central theme of many outpatient oncology visits. Patients often seek counsel on tangible ways to reduce their risk of breast cancer recurrence and are met with generic suggestions to live healthfully. Overwhelmingly, clinical trials point toward substantial benefit of the adopting the six pillars of Lifestyle Medicine in a comprehensive cancer survivorship program to improve disease-free survival and all-cause mortality. These six pillars include 1) social connection, 2) physical activity, 3) whole food and plant-based nutrition, 4) stress management, 5) restorative sleep, and 6) avoidance of risky behaviors or toxins. In a review of the breast cancer literature, we present evidence for survival and quality of life benefit in breast cancer patients with the implementation of these six pillars of Lifestyle Medicine. Socially integrated patients and those who undergo cognitive behavioral therapy for management of stress were found to live longer and have better perceived quality of life than patients who are isolated or experiencing heightened anxiety. Collectively the literature is also clear that ongoing smoking and consumption of >6 grams of alcohol per day as a breast cancer survivor significantly increases risk of death from breast cancer. Finally, prospective and retrospective studies have shown that the maintenance of a healthy body weight with adequate nutrition through dietary interventions, aerobic and resistance exercise, and balanced circadian sleep, particularly in postmenopausal women, improve breast cancer mortality. These data suggest that breast cancer patients would benefit from a comprehensive Lifestyle Medicine approach to survivorship. Consensus on survivorship programming is currently lacking. We submit that formal implementation of programs that include each of these six pillars of Lifestyle Medicine could significantly impact cancer mortality and morbidity. Citation Format: Laura Wright, Preeti K. Sudheendra. A review of the evidence for survival benefit of six lifestyle medicine interventions in breast cancer patients [abstract]. In: Proceedings of the San Antonio Breast Cancer Symposium 2024; 2024 Dec 10-13; San Antonio, TX. Philadelphia (PA): AACR; Clin Cancer Res 2025;31(12 Suppl):Abstract nr P4-03-14.

Background/Objective: Connective tissue diseases (CTDs) are a group of over 200 disorders that significantly impact quality of life due to chronic inflammation and systemic complications. While pharmacological interventions remain the cornerstone of treatment, lifestyle medicine offers a complementary approach to managing these conditions. This article explores the application of lifestyle interventions in CTDs to improve clinical outcomes and reduce disease burden. Methods: A review of current evidence on lifestyle factors, including nutrition, physical activity, sleep, stress management, avoidance of harmful substances, and social connections, was conducted. This review integrates findings from epidemiological studies, clinical trials, and expert recommendations to provide actionable insights for managing CTDs. Results: Key findings highlight the significant role of diet in influencing inflammatory activity and supporting overall health. Specifically, ultra-processed foods and other lifestyle factors could impact the risk of systemic lupus erythematosus (SLE). In contrast, the Mediterranean diet is particularly beneficial for rheumatoid arthritis (RA), offering anti-inflammatory properties and potential improvements in symptoms. Additionally, regular physical activity plays a vital role in preserving joint and muscle function across these conditions. Restorative sleep and effective stress management are critical in mitigating disease activity, as poor sleep and high stress are associated with worsened outcomes. Smoking and alcohol consumption were identified as modifiable risk factors that exacerbate disease progression, emphasizing the importance of lifestyle interventions for improved disease management and overall quality of life. Conclusion: Incorporating lifestyle medicine into the management of CTDs offers a patient-centered approach that complements pharmacologic treatments. By addressing modifiable risk factors, healthcare providers can empower patients to improve quality of life, reduce reliance on medications, and potentially slow disease progression. Further research is needed to establish long-term outcomes and refine intervention strategies.

Within gerontology, various theoretical perspectives on what it means to age successfully have emerged over recent decades (e.g. Rowe & Kahn, etc.) and garnered empirical support. Within medicine and related healthcare fields, research is prolific regarding engaging in healthy living in terms of physical health, mental health, and well-being. In recent years, a theoretical perspective of Lifestyle Medicine has emerged to describe the role of such lifestyle factors on health. The present work includes a scoping review of both literatures with the ultimate goal of determining overlaps and distinctions between theoretical concepts of successful aging and lifestyle medicine. We take a holistic approach to develop a model that identifies linkages between the principles of successful aging and lifestyle medicine. The resultant ‘Lifestyle Model of Optimal Aging’ merges the core pillars of Lifestyle Medicine (nutrition, physical activity, stress management, restorative sleep, social connection, and avoidance of risky substances) with the core principles of successful aging from the models put forth by Rowe and Kahn (1997) and expanded upon by Urtamo et.al., (2019). This new, holistic approach to exploring the linkages between the principles of LM and the essential components of successful aging highlights how proactive behavioral health strategies related to nutrition, exercise, sleep, stress, and substances can foster optimal aging in cognitive and physical functioning and disease prevention, thereby potentially yielding more positive outcomes for aging well. Discussion explores how concepts underlying successful aging may be enhanced by incorporating a lifestyle medicine approach.

Lifestyle medicine (LM) is the use of therapeutic lifestyle changes (including a whole-food, plant-predominant eating pattern; regular physical activity; restorative sleep; stress management; avoidance of risky substances; and positive social connection) to prevent and treat chronic illness. Despite growing evidence, LM is still not widely implemented in health care settings. Potential challenges to LM implementation include lack of clinician training, staffing concerns, and misalignment of LM services with fee-for-service reimbursement, but the full range of factors facilitating or obstructing its implementation and long-term success are not yet understood. To learn important lessons for success and failure, it is crucial to understand the experiences of different LM programs. This study aims to describe in depth the protocol used to identify barriers and facilitators impacting the implementation of LM in health systems. The study team comprises team members at the American College of Lifestyle Medicine (ACLM), including staff and researchers with expertise in public health, LM, and qualitative research. We recruited health systems that were members of the ACLM Health Systems Council. From among 15 self-nominating health systems, we selected 7 to represent a diversity of geographic location, type, size, expertise, funding, patients, and LM services. Partway through the study, we recruited 1 additional contrasting health system to serve as a negative case. For each case, we conducted in-depth interviews, document reviews, site visits (limited due to the COVID-19 pandemic), and study team debriefs. Interviews lasted 45-90 minutes and followed a semistructured interview guide, loosely based on the Consolidated Framework for Implementation Research (CFIR) model. We are constructing detailed case narrative reports for each health system that are subsequently used in cross-case analyses to develop a contextually rich and detailed understanding of various predetermined and emergent topics. Cross-case analyses will draw on a variety of methodologies, including in-depth case familiarization, inductive or deductive coding, and thematic analysis, to identify cross-cutting themes. The study team has completed data collection for all 8 participating health systems, including 68 interviews and 1 site visit. We are currently drafting descriptive case narratives, which will be disseminated to participating health systems for member checking and shared broadly as applied vignettes. We are also conducting cross-case analyses to identify critical facilitators and barriers, explore clinician training strategies to facilitate LM implementation, and develop an explanatory model connecting practitioner adoption of LM and experiences of burnout. This protocol paper offers real-world insights into research methods and practices to identify barriers and facilitators to the implementation of LM in health systems. Findings can advise LM implementation across various health system contexts. Methodological limitations and lessons learned can guide the execution of other studies with similar methodologies. DERR1-10.2196/51562.

Aging is not a disease; it is a natural evolution of human physiology. Medical advances have extended our life expectancy, but chronic diseases and geriatric syndrome continue to affect the increasingly aging population. Yet modern medicine perpetuates an approach based on treatment rather than prevention and education. In order to help solve this ever-growing problem, a new discipline has emerged: lifestyle medicine. Nutrition, physical activity, stress management, restorative sleep, social connection, and avoidance of risky substances are the pillars on which lifestyle medicine is founded. The aim of this discipline is to increase healthspan and reduce the duration of morbidity by making changes to our lifestyle. In this review, we propose the use of klotho protein as a novel biomarker for lifestyle medicine in order to quantify and monitor the health status of individuals, as no integrative tool currently exists.

The biopsychosocial model assumes good health is determined by biological, psychological, and social factors that interact to promote health and disease. Lifestyle medicine is an evidence-based lifestyle therapeutic intervention—including a whole-food, plant-predominant eating pattern, regular physical activity, restorative sleep, stress management, avoidance of risky substances and positive social connection—as a primary modality, delivered by clinicians trained and certified in this specialty, to prevent, treat and often reverse chronic disease. Chronic diseases are developed, prevented, managed, and treated through a complex array of biological, psychological, and social influences. The behaviors, social connections, and emotions that characterize people’s lives shape their quality of life and physical health.

Systemic inflammation is a root cause of lifestyle-related chronic diseases and may also play a role in the development and progression of osteoarthritis (OA). Lifestyle medicine seeks to treat, prevent, and reverse lifestyle-related chronic disease via 6 pillars: nutrition, sleep health, stress management, physical activity, social connections, and risky behavior avoidance/reduction. This article presents a review of the literature in which we assess the connections between the 6 pillars of lifestyle medicine, chronic systemic inflammation, and OA. We also discuss the whole-person approach that lifestyle medicine interventions can provide to reduce chronic systemic inflammation and affect the development or progression of OA.

Chronic diseases account for the highest morbidity and mortality among adults and, increasingly, adolescents and young adults in the United States. This imposes great economic stress on the healthcare system. Chronic diseases can largely be attributed to several key harmful lifestyle behaviors, including poor diet, low physical activity, substance abuse, and stress, to mention just a few. Recent research demonstrates that sustained healthy lifestyle behaviors can not only prevent and treat but may even reverse many of these chronic diseases. The American College of Lifestyle Medicine (ACLM) defines Lifestyle Medicine (LM) as "the use of evidence-based lifestyle therapeutic intervention—including a whole-food, plant-predominant eating pattern, regular physical activity, restorative sleep, stress management, avoidance of risky substances, and positive social connection—as a primary modality, delivered by clinicians trained and certified in this specialty, to prevent, treat, and often reverse chronic disease.” ACLM has worked to establish and update LM core competencies over the last decade. Many training programs have adopted evidence-based LM didactic and clinical training across various health professions students to ensure trainees meet these competencies. We aim to provide a brief overview of LM, discuss the six pillars of LM: nutrition, physical activity, avoidance of risky substances, restorative sleep, stress reduction, and positive social connection, and discuss their significance in wellness from the patient’s and the physician’s perspectives.

Chronic wounds impact 4.5% of the US population, necessitating a comprehensive understanding of their types and underlying mechanisms. Diabetic foot ulcers (DFUs), prevalent in 25% of individuals with diabetes, contribute significantly to lower limb amputations. The pathophysiology involves neuropathy, peripheral arterial disease, impaired immunity, glycemic control, and mechanical stress. Lifestyle medicine emerges as a pivotal aspect of care, offering both prevention and treatment by integrating plant-predominant nutrition, physical activity, stress management, avoidance of harmful substances, restful sleep, and social connectedness. These interventions impact gene interactions, immune function, and tissue regeneration, playing a crucial role in chronic wound management. The standard of care involves a multidisciplinary approach, emphasizing infection and vascular management, pressure offloading, conducive wound healing environments, and lifestyle adjustments. As diabetes prevalence rises, a proactive integration of lifestyle interventions is crucial, offering a promising avenue to alleviate the growing healthcare burden associated with chronic wounds.

The field of Lifestyle Psychiatry aims to prevent, treat, and sometimes reverse chronic physical and mental health conditions through evidence-based interventions. The foundational pillars of this field are physical activity & exercise, nutrition, restorative sleep, stress management, toxic exposure reduction, and connectedness. Connection has been defined as "feeling part of something larger than yourself, feeling close to another person or group, feeling welcomed, and understood." Within Lifestyle Psychiatry, however, we emphasize that connectedness encompasses not only our relationships with other individuals but also our connection to ourselves and with the world at large. We have identified these three relationships as three core or pivotal needs. Similarly, we have expanded our previous model of connectedness to include six domains: (1) Happiness, (2) Purpose in Life & Meaning-Making, (3) Empathy & Compassion, (4) Social Connection & Community, (5) Nature, and (6) Spirituality & Religion. In this paper, we present psychological and scientific data supporting the necessity of the six domains of connectedness. By combining the six domains with the three core needs, practitioners of lifestyle psychiatry can develop impactful and sustainable interventions that promote connectedness, decrease negative health outcomes, and promote psychological growth through increasing resilience, emotional development, and the ability to be alone without loneliness.

Dementia is growing exponentially worldwide. Unfortunately, the treatment available does not reverse any type of cognitive impairment. As a result, healthcare professionals are focusing on other evidence-based options, such as lifestyle medicine (LM). Current evidence demonstrates improvement in neurocognitive decline by applying the six pillars of LM, which includeplant-based nutrition, physical activity, stress management, avoidance of risky substances, restorative sleep, and social connections. Plant-based nutrition has a positive impact on cognition by decreasing the risk for Alzheimer's disease (AD) with high adherence to the Mediterranean-Dietary Approach to Systolic Hypertension (DASH)Intervention for Neurodegenerative Delay (MIND). Physical activity also might prevent neurocognitive decline by increasing fibronectin type III domain-containing protein 5 (FNDC5) and Irisin in the hippocampus, which increases energy expenditure and prolongs endurance. Additionally, higher perceived stress in adulthood and the use of risky substances such as alcohol, nicotine, and opioids are significantly associated with developing mild cognitive impairment and all-cause dementia. Furthermore, there is a positive correlation between poor sleep and social isolation with a rapid progression in cognitive decline. Lifestyle changes have a substantial impact on brain health. Therefore, the focus should always be on prevention as the primary treatment tool.

Examining Social Determinates of Health in Adult Sickle Cell Disease Patients

The deterioration of planetary health-from threats such as climate change, environmental pollution, biodiversity loss, and ocean acidification-are a growing hazard to the foundation of health and the "healthspan." For those with chronic conditions-a large and growing subset of the global population-the health dangers are even greater. Climate change is a threat to the very pillars of lifestyle medicine that we rely on to prevent and manage chronic disease. Already, the planetary crisis is limiting our ability to prescribe healthy nutrition, safe outdoor physical activity, stress management strategies, social connection, restorative sleep, and toxic substance avoidance. In this article, we discuss the proceedings of our workshop at the American College of Lifestyle Medicine (ACLM) annual conference LM2021, "Lifestyle Medicine for Personal and Planetary Health." We examine how lifestyle medicine (LM) interventions are a prescription for individual, community, and planetary health. Our prescriptions work to not only restore the health of individuals and families, but also to bolster health equity while allowing us to mitigate and adapt to the health impacts of the planetary crises.