Lifestyle medicine, a branch of evidence-based healthcare emphasizing disease prevention over curative medicine, seems greatly underemphasized in today’s Western medicine approach.
Lifestyle medicine operates from a holistic health approach that works to treat root causes of health issues. Based upon the idea that the body can heal itself, such practices focus on treating the entire physical and mental systems in order to improve overall function and well-being, through lifestyle intervention.
Lifestyle medicine uses evidence-based methods to uncover the source of the problem, its root cause, and then can more easily address symptoms. For example, working to relieve stress in an effort to combat tension headaches, digestive issues or insomnia, would represent a lifestyle medicine practice. Exercise figures prominently in these scenarios, as we will see below. Learn how we can help our clients by coming at fitness from a whole-mind-and-body place!
The Pillars of Lifestyle Medicine
Although the principles of lifestyle medicine seem similar across most platforms, we do see minor differences among professed lifestyle specialists. For purposes of this article, we delve into the seven most commonly listed lifestyle medicine pillars: movement & fitness, healthful nutrition, restorative sleep, stress management, social engagement, gratitude & reflection, and cognitive enhancement.
Movement and Exercise
As fitness professionals, we know that striving to include physical activity in daily life can improve health outcomes in just about everyone, regardless of age or gender. For this reason, consistent movement tops the list of effective interventions for optimizing overall health and well-being.
The 2018 Physical Activity Guidelines Advisory Committee reported current evidence on the relationship between active movement and health, specifically making note of benefits relating to physical activity:
- a decreased risk of chronic conditions such as heart disease, stroke, hypertension, and type 2 diabetes
- diminished risk of eight different types of cancer
- positive effect on brain function by reducing the risk of Alzheimer’s disease
- improvements in anxiety, depression, sleep and cognitive function
The CDC reports that, sadly, only 50% of adults in this country achieve the necessary physical activity levels required to reduce and prevent chronic diseases. To further compound the problem, such lack of activity accounts for 10% of all premature deaths. Not only have adults shown no significant uptick in regular aerobic activity over the past decade, but their sedentary behaviors have actually increased.
Tips that we can easily present to our adult clients to facilitate meeting suggested physical activity guidelines include:
- Move more/sit less throughout the day ~ Adults who sit less and engage in any amount of moderate-to-vigorous physical activity experience health benefits. **Suggest the following to sedentary clients:
- At least 150 to 300 minutes of moderate-intensity movement, spread throughout the week; OR
- 75 to 150 minutes a week of vigorous-intensity aerobic physical activity; OR
- Any combination of moderate- and vigorous-intensity aerobic activity.
- Muscle-strengthening activities ~ Involve all major muscle groups 2 or more days per week.
- Find ways to add balance training ~ This proves highly beneficial particularly for older adults.
Healthful Nutrition
Studies conducted by the True Health Initiative, a global network of lifestyle medicine advocates, revealed some sobering statistics:
- 70% of all Americans fall into the overweight or obese categories
- over 100 million Americans likely will fall prey to diabetes by 2050
- over 40% of the population current live with some form of chronic disease(s)
Studies led by Dean Ornish, a Clinical Professor at UCSF and a pioneer in lifestyle medicine, have indicated that nutritional interventions remain a key contributor to reversing the progression of chronic diseases (severe coronary artery disease, type 2 diabetes, high cholesterol, and high blood pressure, among others). Experts have also linked dietary factors to the development of anxiety and depression.
As we continue to preach to our clients, even small and incremental nutritional changes can have major positive impacts on overall health in addition to one’s fitness goals. Simply implementing a few healthy habits into one’s weekly lifestyle can add years of longevity, especially when such choices replace consistently unhealthy foods.
Healthy dietary guidelines advocate an eating pattern that includes of a variety of foods, to ensure that consumers receive as many vitamins and minerals as possible. When speaking with clients, consider offering the following key points:
- Substitute nutrient-dense foods in place of high-calorie foods with little to no nutritional benefits
- Be mindful of caloriesby focusing on appropriate serving sizes
- Choose a rainbow diet by consuming plenty of fresh fruits and vegetables
- Maintain a balanced ratioof macronutrients ~
- Unrefined carbohydrates– whole grains, barley, brown rice and vegetables
- Protein – fish, fresh meat and poultry, egg whites, legumes (beans, peas), soy-based products (tofu, tempeh) and non-fat dairy
- Healthy fats– fish oils, flaxseed oils, nuts/seeds/nut butters
- Minimize/Eliminate processed foodswhich contain added sugars, fats and salt
- Stay hydratedwith water or other unsweetened beverages
Restorative Sleep
We do not often consider sleep health when working with fitness clients; yet this aspect of life does mesh with other health care agendas. According to experts, sleep affects a plethora of our tissues, muscles and major organs and organ systems. A well-rested body also encourages better intellectual performance, cognitive functioning and mood resilience, thereby affecting our overall well-being.
Scientific data show that insufficient sleep increases the risk of developing chronic conditions such as obesity, diabetes, and cardiovascular disease. Despite research emphasizing the negative health outcomes of poor sleep, the CDC determined that approximately 33% of our population who claim to achieve less than 7 hours of shut-eye per night often suffer problems with daily functioning.
Cultivating a regular sleep routine can prove challenging in our world of busy schedules and multitasking throughout the day. We can assist clients by suggesting ways in which they can help foster “signals” to let the body know when to wind down and ultimately calm the mind:
- Sleep schedule ~Try to go to bed and wake up at approximately the same times each day/night. This helps to regulate the body’s internal clock.
- Ease into bedtime ~Allocate sufficient time prior to getting into bed to allow your mind to clear and settle. Warm milk, calming tea, or soaking in a hot tub can work wonders. Avoid stimulating or stressful activities before bedtime.
- Temperature ~ Sleep experts suggest maintaining a temperature of 60-68 degrees Fahrenheit in the bedroom to achieve optimal restful slumber.
Stress Management
Stress manifests itself in more ways than we consider. Our bodies may react with jitters, increased respiration/heartrate, or gastrointestinal troubles. Such occurrences reflect the cascade of internal triggers we often refer to as the “fight or flight” response. These internal mechanisms represent the convoluted interplay amongst our multiple organ systems.
The result of this can either foster help under pressure – such as the proverbial stories of individuals lifting cars when a child gets somehow trapped underneath – or, in the case of chronic stress, can lead to serious health problems.
According to research published in the American Journal of Lifestyle Medicine, over 75% of doctor’s visits involve patients with stress-related symptoms/illnesses. As personal trainers, we know that clients often come to the gym to “work off stress”, or “take it out on the weight stack”. Both represent prudent stress management actions. However, sometimes we need to dig a bit deeper and address the underlying causes of chronic stress.
Learning appropriate responses to stress can offer significant health benefits. The following often remain outside our scope of practice, but still merit mentioning to clients struggling with an emotionally-charged situation:
- Determine the cause/Recognize the signs
- Develop a stress management plan/Ask for help ~ This often involves discussions with a trained professional, who can assist with ideas for mindfulness techniques individualized to fit one’s lifestyle
- Choose a wise plan ~ Prudent nutrition, sleep, and exercise habits can help mitigate the negative repercussions of chronic stress
Social Engagement
As something literally encoded within our neurobiology, humans have a deep-seated need for interpersonal connectedness. Emma Seppala, Director of Stanford’s Center for Compassion and Altruism Research and Education (CCARE), identifies social connection as an integral aspect of physical, mental and emotional health. She further suggests that the number of social contacts pales in importance when compared with the quality of relationships. Whether on the giving or receiving end, shared experiences and emotional bonds create a connection that remains vital to our overall health and even longevity.
Working in a gym or fitness center, we can see close relationships develop among individuals who take the same group exercise classes, help spot each other on the weight room floor, or even participate in small-group personal training. However, many adults, especially those in the 70-90+ age bracket, remain isolated and lonely, thereby encouraging potentially damaging health issues.
If a client comes to you and expresses a need for support beyond that which friends and family can provide, perhaps consider mentioning a support group. Connecting with others who understand and can empathize with one’s feelings, or perhaps who have undergone a similar life experience, often helps mitigate stress. Such groups also offer inspiration and hope by witnessing others coping better with their issues since attending the group sessions.
Gratitude and Reflection
The act of practicing gratitude has been found to confer many positive effects on both physical and emotional health. Simply by “counting our blessings” and focusing upon all the good in our lives, experts tell us we can improve our immune system functions and might even extend our lives.
The simple act of gratitude meditation can directly and positively impact brain function. The region of our brain known as the amygdala–the control center for emotional processing – specifically demonstrates changes with regular meditative practice. After an 8-week gratitude meditation program, participants exhibited a lower activation of their amygdala and a faster return to baseline activation after exposure to depictions of negative emotional stimuli while in a non-meditative state. This tells us that implementing a regular gratitude meditation practice facilitates the managing of negative emotions, thereby raising levels of self-confidence and self-acceptance.
Cognitive Enhancement
According to a study conducted by the Global Council on Brain Health, we can challenge our cognition by engaging in a variety of activities throughout our lifetimes, inviting improvements in a host of brain functions.
As a leader in healthy-aging research, the National Institute on Aging tells us that diverse lifestyle changes which specifically focus upon cognition may improve memory, concentration, information processing and motor function. Cognitive enhancement may even reduce symptoms associated with neurodegenerative brain disorders such as Parkinson’s Disease.
Physical exercise stimulates the production of Brain- Derived Neurotrophic Factor (BDNF), a hormone that stimulates formation of synapses between neurons (the basis of memory). Regular exercise actually fosters changes in our genetic makeup to code for an increased production of BDNF; such positive alterations can last for the duration of a lifetime, as long as regular exercise continues to figure prominently in daily life. All of this points to the cultivation of a healthier brain as we age.
By implementing lifestyle changes that expose us to a variety of cognitively stimulating activities and ideas as well as regular physical activity, the human brain will respond with new connections and increased function. Personal trainers working with an older clientele have a prime opportunity to do just that, by taking clients through challenging but still age-appropriate exercise patterns. Changing up workouts with regular frequency keeps clients mentally engaged as well as physically fit.
Take-Home Message
As chronic health conditions continue to plague the nation, an increasing number of traditional medical practitioners find themselves embracing lifestyle medicine as part of their treatment plans. At its very essence, lifestyle medicine simply encourages maintaining healthy practices that care for both the corporeal and emotional states of being, setting the stage for a lifetime of health and wellness. These aforementioned seven pillars may prove to help almost all chronic diseases; and in time we might come to view them as a potential form of treatment.
References:
https://lifestylemedicine.org/certification/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9985951/
https://www.ncbi.nlm.nih.gov/books/NBK589672/
https://pubmed.ncbi.nlm.nih.gov/10938218/
https://www.truehealthinitiative.org/about-us/
https://journals.sagepub.com/doi/abs/10.1177/1559827607299725?journalCode=ajla
https://pubmed.ncbi.nlm.nih.gov/24470692/
https://mhanational.org/connect-others
Cathleen Kronemer is an NFPT CEC writer and a member of the NFPT Certification Council Board. Cathleen is an AFAA-Certified Group Exercise Instructor, NSCA-Certified Personal Trainer, ACE-Certified Health Coach, former competitive bodybuilder and freelance writer. She is employed at the Jewish Community Center in St. Louis, MO. Cathleen has been involved in the fitness industry for over three decades. Feel free to contact her at trainhard@kronemer.com. She welcomes your feedback and your comments!
