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Why Lifestyle Medicine?

  • Jeffrey I. MechanickEmail author
  • Robert F. Kushner
Chapter

Abstract

The question ‘Why Lifestyle Medicine?’ is answered by discussing the concept of chronic diseases and their increased prevalence rates that are resistant to current care models. The great burden of this problem is described and the need for a new chronic disease care model is proposed. Epidemiological dimensions as well as issues with health messaging and campaigns that are scalable to address this problem are presented. A new lifestyle medicine paradigm that incorporates the facets of preventive medicine, wellness, and health promotion, and disease complexity and residual risk is proposed and involves novel tools and metrics, such as the disability-adjusted life year (DALY) and the quality-adjusted life year (QALY). In short, the need for lifestyle medicine is based on persistent drivers of chronic disease and inadequacy of current care models to address complexity, residual risk, and challenging health-care socioeconomics.

Keywords

Lifestyle medicine Chronic disease Disease complexity Preventive medicine Health promotion 

Abbreviations

CDC

Centers for Disease Control and Prevention

CVD

Cardiovascular disease

DALY

Disability-adjusted life year

GBD

Global burden of disease

HBT

Health-based target

MMWR

Morbidity and Mortality Weekly Report

NCD

Noncommunicable diseases

QALY

Quality-adjusted life year

References

  1. 1.
    Go AS, Mozaffarian D, Roger VL, et al. Heart disease and stroke statistics—2014 update: a report from the American Heart Association. Circulation. 2014. doi:10.1161/01.cir.0000441139.02102.80. Accessed 22 June 2014.Google Scholar
  2. 2.
    CDC. Million hearts: strategies to reduce the prevalence of leading cardiovascular disease risk factors—United States, 2011. MMWR Morb Mortal Wkly Rep. 2011;60:1248–51.Google Scholar
  3. 3.
    Centers for Disease Control and Prevention. Prevalence of doctor-diagnosed arthritis and arthritis-attributable activity limitation—United States, 2010–2012. MMWR Morb Mortal Wkly Rep. 2013;62:869–92.Google Scholar
  4. 4.
    Coresh J, Selvin E, Stevens LA, et al. Prevalence of chronic kidney disease in the United States. JAMA. 2007;298:2038–47.CrossRefPubMedGoogle Scholar
  5. 5.
    Alzheimer’s Association. Alzheimer’s facts and figures. 2015. http://www.alz.org/alzheimers_disease_facts_and_figures.asp#prevalence/alzheimers_disease_facts_and_figures.asp#prevalence. Accessed 22 June 2014.
  6. 6.
    Wright NC, Looker AC, Saag KG, et al. The recent prevalence of osteoporosis and low bone mass in the United States based on bone mineral density at the femoral neck or lumbar spine. J Bone Mineral Res. 2014. doi:10.1002/jbmr.2269.Google Scholar
  7. 7.
    CDC. National Diabetes Statistics Report. 2014. http://www.cdc.gov/diabetes/pubs/statsreport14/national-diabetes-report-web.pdf/diabetes/pubs/statsreport14/national-diabetes-report-web.pdf. Accessed 22 June 2014.
  8. 8.
    CDC. Current depression among adults—United States, 2006 and 2008. MMWR Morb Mortal Wkly Rep. 2010;59:1229–35.Google Scholar
  9. 9.
    American Lung Association, Epidemiology and Statistics Unit. Estimated prevalence and incidence of lung disease. 2014 http://www.lung.org/finding-cures/our-research/trend-reports/estimated-prevalence.pdf/finding-cures/our-research/trend-reports/estimated-prevalence.pdf. Accessed 22 June 2014.
  10. 10.
    De Moor JS, Mariotto AB, Parry C, et al. Cancer survivors in the United States: prevalence across the survivorship trajectory and implications for care. Canc Epidemiol Biomark Prev. 2013;22:561–70.CrossRefGoogle Scholar
  11. 11.
    CDC. Diagnoses of HIV infection in the United States and Dependent Areas. 2011. http://www.cdc.gov/hiv/library/reports/surveillance/2011/surveillance_Report_vol_23.html#3/hiv/library/reports/surveillance/2011/surveillance_Report_vol_23.html#3. Accessed 22 June 2014.
  12. 12.
    Perrin EC, Newacheck P, Pless IB, et al. Issues involved in the definition and classification of chronic health conditions. Pediatrics. 1993;91:787–93.PubMedGoogle Scholar
  13. 13.
    O’Halloran J, Miller GC, Britt H. Defining chronic conditions for primary care with ICPC-2. Fam Pract. 2004;21:381–6.CrossRefPubMedGoogle Scholar
  14. 14.
    CDC. Chronic disease and health promotion. 2015. http://cdc.gov/chronicdisease/overview/index.htm. Accessed 18 July 2014.
  15. 15.
    CDC. Healthy people 2020. 2011. http://www.cdc.gov/nchs/healthy_people/hp2020.htm. Accessed 22 June 2014.
  16. 16.
    CDC. CDC grand rounds: childhood obesity in the United States. MMWR Morb Mortal Wkly Rep. 2011;60:42–6.Google Scholar
  17. 17.
    Chung A, Backholer K, Wong E, et al. Trends in child and adolescent obesity prevalence according to socioeconomic position: protocol for a systematic review. Systematic Rev. 2014;3:52–6.CrossRefGoogle Scholar
  18. 18.
    CDC. Awareness of prediabetes—United States, 2005–2010. MMWR. 2013;62:209–12.Google Scholar
  19. 19.
    Guariguata L, Whiting DR, Hambleton I, et al. Global estimates of diabetes prevalence for 2013 and projections for 2035. Diab Res Clin Pract. 2014;103:137–49.CrossRefGoogle Scholar
  20. 20.
    Slack T, Myers CA, Martin CK, et al. The geographic concentration of US adult obesity prevalence and associated social, economic, and environmental factors. Obesity. 2014;22:868–74.CrossRefPubMedGoogle Scholar
  21. 21.
    Eilerman PA, Herzog CM, Luce BK, et al. A comparison of obesity prevalence: military health system and United States populations, 2009–2012. Military Med. 2014;179:462–70.CrossRefGoogle Scholar
  22. 22.
    Thomas DM, Weedermann M, Fuenmeler BF, et al. Dynamic model predicting overweight, obesity, and extreme obesity prevalence trends. Obesity. 2014;22:590–7.CrossRefPubMedGoogle Scholar
  23. 23.
    CDC. Obesity—United States, 1999–2010. MMWR Surveill Summ. 2013;62:120–8.Google Scholar
  24. 24.
    Ostbye T, Stroo M, Eisenstein EL, et al. Is overweight and class I obesity associated with increased health claims costs? Obesity. 2014;22:1179–86.CrossRefPubMedGoogle Scholar
  25. 25.
    Tarleton HP, Ryan-Ibarra S, Induni M. Chronic disease burden among cancer survivors in the California behavorial risk factor surveillance system, 2009–2010. J Cancer Surviv. 2014. doi:10.1007/s11764-014-0350-x.Google Scholar
  26. 26.
    Forster M, Veeman JL, Barendregt JJ, et al. Cost-effectiveness of diet and exercise interventions to reduce overweight and obesity. Int J Obes (Lond). 2011;35:1071–8.CrossRefGoogle Scholar
  27. 27.
    Devleesschauwer B, Havelaar AH, Maertens de Noordhout C, et al. Calculating disability-adjusted life years to quantify burden of disease. Int J Public Health. 2014;59:565–9.CrossRefPubMedGoogle Scholar
  28. 28.
    Larson BA. Calculating disability-adjusted-life-years lost (DALYs) in discrete time. Cost Eff Res Alloc. 2013;11:18–24.CrossRefGoogle Scholar
  29. 29.
    Polinder S, Haagsma JA, Stein C, et al. Systematic review of general burden of disease using disability-adjusted life years. Popul Health Metr. 2012;10:21–36.CrossRefPubMedCentralPubMedGoogle Scholar
  30. 30.
    Schroeder SA. Incidence, prevalence, and hybrid approaches to calculating disability-adjusted life years. Popul Health Metr. 2012;10:19–26.CrossRefPubMedCentralPubMedGoogle Scholar
  31. 31.
    Struijk EA, May AM, Beulens JWJ, et al. Development of methodology for disability-adjusted life years (DALYs) calculation based on real-life data. PloS ONE. 2014;8:e74294. doi:10.1371/journal.pone.0074294.CrossRefGoogle Scholar
  32. 32.
    Gibney K, Sinclair M, O’Toole J, et al. Using disability-adjusted life years to set health-based targets: a novel use of an established burden of disease metric. J Public Health Policy. 2013;34:439–46.CrossRefPubMedCentralPubMedGoogle Scholar
  33. 33.
    Murray CJ, Lopez AD. The global burden of disease: a comprehensive assessment of mortality and disability from diseases, injuries and risk factors in 1990 and profected to 2020. Cambridge: Harvard University Press; 1996.Google Scholar
  34. 34.
    Lopez AD, Mathers CD, Ezzati M, et al. Global burden of disease and risk factors. New York: Oxford University Press; 2006.CrossRefGoogle Scholar
  35. 35.
    World Health Organization. The global burden of disease: 2004 update. 2015. http://www.who.int/healthinfo/global_burden_disease/2004_report_update/en/index.html. Accessed 12 July 2014.
  36. 36.
    Murray CJ, Vos T, Lozano R, et al. Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2013;380:2197–223.CrossRefGoogle Scholar
  37. 37.
    Soerjomataram I, Lortet-Tieulent J, Parkin DM, et al. Global burden of cancer in 2008: a systematic analysis of disability-adjusted life-years in 12 world regions. Lancet. 2012;380:1840–50.CrossRefPubMedGoogle Scholar
  38. 38.
    Russell LB. Preventing chronic disease: an important investment, but don’t count on cost savings. Health Aff. 2009;28:42–5.CrossRefGoogle Scholar
  39. 39.
    Zhang NJ, Wan THT, Rossiter LF, et al. Evaluation of chronic disease management on outcomes and cost of care for Medicaid beneficiaries. Health Policy. 2008;86:345–54.CrossRefPubMedGoogle Scholar
  40. 40.
    Rajgopal R, Cox RH, Lambur M, et al. Cost-benefit analysis indicates the positive economic benefits of the Expanded Food and Nutrition Education Program related to chronic disease prevention. J Nutr Educ Behav. 2002;34:26–37.CrossRefPubMedGoogle Scholar
  41. 41.
    Irvine L, Barton GR, Gasper AV, et al. Cost-effectiveness of a lifestyle intervention in preventing type 2 diabetes. Int J Technol Assess Health Care. 2011;27:275–82.CrossRefPubMedGoogle Scholar
  42. 42.
    Guy GP, Yabroff KR, Ekwueme DU, et al. Estimating the health and economic burden of cancer among those diagnosed as adolescents and young adults. Health Aff. 2014;33:1024–31.CrossRefGoogle Scholar
  43. 43.
    Erdem E, Prada SI, Haffer SC. Medicare payments: how much do chronic conditions matter? Medicare Medicaid Res Rev. 2013;3:E1–15.CrossRefGoogle Scholar
  44. 44.
    Parekh AK, Kronick R, Tavenner M. Optimizing health for persons with multiple chronic conditions. JAMA. 2014. doi:10.1001/jama.2014.10181.Google Scholar
  45. 45.
    Ryan JG. Race, risk, and behaviors: race and disproportionate burdens of chronic disease. Clin Therapeutics. 2014;36:464–8.CrossRefGoogle Scholar
  46. 46.
    Campbell DJT, Ronksley PE, Manns BJ, et al. The association of income with health behavior change and disease monitoring among patients with chronic disease. PloS One. 2014;9:e94007. doi:10.1371/journal.pone.0094007.CrossRefPubMedCentralPubMedGoogle Scholar
  47. 47.
    World Health Organization. The top 10 causes of death. http://www.who.int/mediacentre/factsheets/fs310/en/index2.html. Accessed 18 July 2014.
  48. 48.
    President of the General Assembly, United Nations. Draft political declaration of the high-level meeting on the prevention and control of non-communicable diseases. http://www.un.org/en/ga/ncdmeeting2011/pdf/NCD_draft_political_declaration.pdf. Accessed 15 July 2014.
  49. 49.
    World Health Organization. Non-communicable diseases and mental health. http://www.who.int/nmh/publications/9789241597418en/nmh/publications/9789241597418en/. Accessed 15 July 2014.
  50. 50.
    Mokdad AH, Marks JS, Stroup DF, et al. Actual causes of death in the United States, 2000. JAMA. 2004;29:1238–45.CrossRefGoogle Scholar
  51. 51.
    American Association of Clinical Endocrinologists. 2014 AACE/ACE Consensus Conference of Obesity. http://mms.businesswire.com/media/20140325006164/en/408761/1/aace.pdf [see EC.5. in document]. Accessed 18 July 2014.
  52. 52.
    Harmon P. A glossary of commonly used business process terms. http://www.ispi.org/archives/Glossary/PHarmon.pdf. Accessed 7 Sept 2014.
  53. 53.
    Sturmberg JP. Multimorbidity and chronic disease: an emergent perspective. J Eval Clin Pract. 2014. doi:10.1111/jep.12126.Google Scholar
  54. 54.
    McGrath JW, Winchester MS, Kaawa-Mafigiri D, et al. Challenging the paradigm: anthropological perspectives on HIV as a chronic disease. Med Anthropol. 2014. doi:10.1080/01459740.2014.892483.Google Scholar
  55. 55.
    Higgins JP. Nonlinear systems in medicine. Yale J Biol Med. 2001;75:247–60.Google Scholar
  56. 56.
    Vanuzzo D. The epidemiological concept of residual risk. Intern Emerg Med. 2011;6(Suppl 1):S45–51.CrossRefGoogle Scholar
  57. 57.
    Dieci MV, Arnedos M, Delaloge S, et al. Quantification of residual risk of relapse in breast cancer patients optimally treated. Breast. 2013;22:S92–5.CrossRefPubMedGoogle Scholar
  58. 58.
    Bradbury KE, Appleby PN, Key TJ. Fruit, vegetable, and fiber intake in relation to cancer risk: findings from the European Prospective Investigation into Cancer and Nutrition (EPIC). Am J Clin Nutr. 2014;100(suppl 1):394S–8S.CrossRefPubMedGoogle Scholar
  59. 59.
    Jacka FN, Cherbuin N, Anstey KJ, et al. Dietary patterns and depressive symptoms over time: examining the relationships with socioeconomic positions, health behaviours and cardiovascular risk. PloS One. 2014;9:e87657. doi:10.1371/journal.pone.0087657.CrossRefPubMedCentralPubMedGoogle Scholar
  60. 60.
    Riley TA, Janosky JE. Moving beyond the medical model to enhance primary care. Popul Health Manage. 2012;15:189–93.CrossRefGoogle Scholar
  61. 61.
    Sadler LS, Newlin KH, Johnson-Spruill I, et al. Beyond the medical model: interdisciplinary programs of community-engaged health research. Clin Transl Sci. 2011;4:285–97.CrossRefPubMedCentralPubMedGoogle Scholar
  62. 62.
    Dyer AR. The need for a new ‘New Medical Model’: a bio-psychosocial-spiritual model. South Med J. 2011;104:297–8.CrossRefPubMedGoogle Scholar
  63. 63.
    Buja A, Damiani G, Gini R, et al. Systematic age-related differences in chronic disease management in a population-based cohort study: a new paradigm of primary care is required. PloS One. 2014;9:e91340. doi:10.1371/journal.pone.0091340.CrossRefPubMedCentralPubMedGoogle Scholar
  64. 64.
    Rieck AM. Exploring the nature of power distance on general practitioner and community pharmacist relations in a chronic disease management context. J Interprof Care. 2014. doi:10.3109/13561820.2014.906390.Google Scholar
  65. 65.
    Liddy C, Mill K. An environmental scan of policies in support of chronic disease self-management in Canada. Chr Dis Inj Can. 2014;34:55–63.Google Scholar
  66. 66.
    Simmons LA, Wolever RQ, Bechard EM, et al. Patient engagement as a risk factor in personalized health care: a systematic review of the literature on chronic disease. Genome Med. 2014;6:16–29.CrossRefPubMedCentralPubMedGoogle Scholar
  67. 67.
    Mackenzie L. Can chronic disease management plans including occupational therapy and physiotherapy services contribute to reducing falls risk in older people? Austr Fam Phys. 2014;43:211–5.Google Scholar
  68. 68.
    Brooks AT, Andrade RE, Middleton KR, et al. Social support: a key variable for health promotion and chronic disease management in Hispanic patients with rheumatic diseases. Clin Med Insights Arthr Musculoskel Dis. 2014;7:21–6.Google Scholar
  69. 69.
    Drutchas A, Anandarajah G. Spirituality and coping with chronic disease in pediatrics. Rhode Island Med J. 2014;97:26–30.Google Scholar
  70. 70.
    Vorderstrasse AA, Ginsberg GS, Kraus WE, et al. Health coaching and genomics—potential avenues to elicit behavior change in those at risk for chronic disease: protocol for personalized medicine effectiveness study in Air Force primary care. Global Adv Health Med. 2013;2:26–38.CrossRefGoogle Scholar
  71. 71.
    Hussey PS, Schneider EC, Rudin RS, et al. Continuity and the costs of care for chronic disease. JAMA Intern Med. 2014;174:742–8.CrossRefPubMedCentralPubMedGoogle Scholar
  72. 72.
    Jones A, Hedges-Chou J, Bates J, et al. Home telehealth for chronic disease management: selected findings of a narrative synthesis. Telemed e-Health. 2014;20:346–80.CrossRefGoogle Scholar
  73. 73.
    Owen N, Salmon J, Koohsari MJ, et al. Sedentary behavior and health: mapping environmental and social contexts to underpin chronic disease prevention. Br J Sports Med. 2014;48:174–7.CrossRefPubMedGoogle Scholar
  74. 74.
    Shaughnessy AF. Focusing on patient-oriented evidence that matters in the care of patients with diabetes mellitus. Pharmacotherapy. 2004;24:295–7.CrossRefPubMedGoogle Scholar
  75. 75.
    Wigg AJ, Chinnaratha MA, Wundke R, et al. A chronic disease management model for chronic liver failure. Hepatology. 2014. doi:10.1002/hep.27152.Google Scholar
  76. 76.
    Ritsema TS, Bingenheimer JB, Scholting P, et al. Differences in the delivery of health education to patients with chronic disease by provider type, 2005–2009. Prev Chronic Dis. 2014;11:130175. doi:10.5888/pcd11.130175.CrossRefGoogle Scholar
  77. 77.
    Bloem BR, Munneke M. Revolutionising management of chronic disease: the ParkinsonNet approach. BMJ. 2014;348:g1838. doi:http://dx.doi.org/10.1136/bmj.g1838.CrossRefPubMedGoogle Scholar
  78. 78.
    Bain L, Kennedy C, Archibald D, et al. A training program designed to improve interprofessional knowledge, skills and attitudes in chronic disease settings. J Interprof Care. 2014. doi:10.3109/13561820.2014.898622.Google Scholar
  79. 79.
    Patel KK. Practical and policy implications of a changing health care workforce for chronic disease management. J Ambul Care Manage. 2013;36:302–4.CrossRefPubMedGoogle Scholar
  80. 80.
    Clarke JL. Preventive medicine: a ready solution for a health care system in crisis. Popul Health Manage. 2010;10:S3–11.Google Scholar

Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  1. 1.Division of Endocrinology, Diabetes and Bone DiseaseIcahn School of Medicine at Mount SinaiNew YorkUSA
  2. 2.Northwestern Comprehensive Center on ObesityNorthwestern University Feinberg School of MedicineChicagoUSA

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