Translational Behavioral Medicine

, Volume 4, Issue 1, pp 117–123

Developing a new treatment paradigm for disease prevention and healthy aging


    • Psychology DepartmentVirginia Tech
  • Brenda M Davy
    • Human Nutrition, Foods, and ExerciseVirginia Tech
  • Elaina Marinik
    • Human Nutrition, Foods, and ExerciseVirginia Tech
  • Jyoti Savla
    • Human DevelopmentVirginia Tech
  • Sheila G Winett
    • Personal Computer Resources, Inc.
  • Stuart M Phillips
    • Kinesiology DepartmentMcMaster University
  • Lesley D Lutes
    • Psychology DepartmentEast Carolina University
Practice and Public Health Policies

DOI: 10.1007/s13142-013-0225-0

Cite this article as:
Winett, R.A., Davy, B.M., Marinik, E. et al. Behav. Med. Pract. Policy Res. (2014) 4: 117. doi:10.1007/s13142-013-0225-0


An increasingly prevalent pattern of risk factors has emerged in middle-aged and older adults that includes the presence of type 2 diabetes or prediabetes, overweight or obese weight status with central obesity and very high body fat, low cardiorespiratory fitness (CRF), low strength, and a low lean-body-mass-to-body-fat ratio. Traditionally, these problems have been approached with a low-fat and low-calorie diet and with lower to moderate intensity activity such as walking. While the treatment has some clear benefits, this approach may no longer be optimal because it does not reflect more recent findings from nutrition and exercise sciences. Specifically, these fields have gained a greater understanding of the metabolic and functional importance of focusing on reducing body fat and central obesity while maintaining or even increasing lean body mass, a quality weight loss, and how to efficiently and effectively increase CRF and strength. Evidence is presented for shifting the treatment paradigm for disease prevention and healthy aging to include the DASH nutrition pattern but with additional protein, higher intensity, brief aerobic training, effort-based, brief resistance training, and structured physical activity. Recent interventions based on social cognitive theory for initiating and then maintaining health behavior changes show the feasibility and efficacy of the approach we are advocating especially within a multiple health behavior change format and the potential for translating the new treatment paradigm into practice.


DiabetesQuality weight lossTreatment paradigmMultiple health behaviors

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© Society of Behavioral Medicine 2013