Abstract
Declining life expectancy and increasing all-cause mortality in the United States have been associated with unhealthy behaviors, socioecological factors, and preventable disease. A growing body of basic science, clinical research, and population health evidence points to the benefits of healthy behaviors, environments and policies to maintain health and prevent, treat, and reverse the root causes of common chronic diseases. Similarly, innovations in research methodologies, standards of evidence, emergence of unique study cohorts, and breakthroughs in data analytics and modeling create new possibilities for producing biomedical knowledge and clinical translation. To understand these advances and inform future directions research, The Lifestyle Medicine Research Summit was convened at the University of Pittsburgh on December 4–5, 2019. The Summit's goal was to review current status and define research priorities in the six core areas of lifestyle medicine: plant-predominant nutrition, physical activity, sleep, stress, addictive behaviors, and positive psychology/social connection. Forty invited subject matter experts (1) reviewed existing knowledge and gaps relating lifestyle behaviors to common chronic diseases, such as cardiovascular disease, diabetes, many cancers, inflammatory- and immune-related disorders and other conditions; and (2) discussed the potential for applying cutting-edge molecular, cellular, epigenetic and emerging science knowledge and computational methodologies, research designs, and study cohorts to accelerate clinical applications across all six domains of lifestyle medicine. Notably, federal health agencies, such as the Department of Defense and Veterans Administration have begun to adopt “whole-person health and performance” models that address these lifestyle and environmental root causes of chronic disease and associated morbidity, mortality, and cost. Recommendations strongly support leveraging emerging research methodologies, systems biology, and computational modeling in order to accelerate effective clinical and population solutions to improve health and reduce societal costs. New and alternative hierarchies of evidence are also be needed in order to assess the quality of evidence and develop evidence-based guidelines on lifestyle medicine. Children and underserved populations were identified as prioritized groups to study. The COVID-19 pandemic, which disproportionately impacts people with chronic diseases that are amenable to effective lifestyle medicine interventions, makes the Summit's findings and recommendations for future research particularly timely and relevant.
Highlights
A recent 60-years review of mortality in the United States, with special focus on the past two decades, revealed declining life expectancy that is pronounced in ages 25–44, typically Americans’ most productive years
Can we develop flexible, stepped substance use disorder (SUD) treatment interventions that can be modified over several months, based on a patient’s response to each incremental stage of treatment
Positive psychology interventions have been shown to improve subjective well-being, which is associated with improved health behaviors, health outcomes, and longevity
Summary
A recent 60-years review of mortality in the United States, with special focus on the past two decades, revealed declining life expectancy that is pronounced in ages 25–44, typically Americans’ most productive years. Patients exist within communities, embedded in complex interactions with their environment—the social, cultural, political, pharmacological, and economic environment—which is intrinsically connected to their lifestyle and their health This complex collection and integration of multiple personal and potentially sensitive data sources will require intensive efforts, and new approaches to ensure the understanding, trust, and consent of studied populations. This may be challenging when partnering with groups and communities that have been underserved or understudied and discriminated against, and/or are often the most susceptible to poor health outcomes associated with lifestyle behaviors and unhealthy environments.
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