Incorporating lifestyle medicine in practice to reduce chronic disease burden

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LAS VEGAS – Relatively small lifestyle improvements that are maintained over time, such as 30 minutes of daily exercise or a 100 kcal reduction in daily caloric intake, can reduce the risk for and progression of chronic diseases in women, according to a speaker at the 39th American Academy of Physician Assistant Annual Meeting.

Healthy lifestyle behaviors are included in nearly all practice guidelines for chronic disease prevention and management, according to Anne Nedrow, MD, MBA, medical director of women's primary care and integrative medicine in the Center for Women's Health at Oregon Health & Science University in Portland, Ore.

Not smoking, reducing alcohol intake, exercising regularly and maintaining a healthy diet and a BMI within the range of 18.5 and 24.9 can reduce the risk for cardiovascular disease and cancer by 75%, yet only about 3% of the U.S. adult population adhere to these healthy habits.

“The challenge is no longer in proving that lifestyle changes work. Now, clinicians are faced with the task of deciding how to incorporate these strategies into their practices,” Nedrow said.

Strategies for accomplishing this include incorporating lifestyle medicine competencies into leadership and management skills assessment programs and advocating for wider workplace and community support in order to enhance patient education about lifestyle changes.

To transition from traditional medicine to lifestyle medicine, health care providers can use a number of practical tools and adhere to certain philosophies, according to Nedrow.

First, clinicians should be committed to help each patient regardless of the outcome and should partner with the patient to monitor progress.

Next, the clinician should assess how willing the patient is to institute lifestyle changes into his or her daily life. This can be done through cognitive behavioral therapy or by promoting and assessing the patient's self-agency.

Lastly, the clinician should identify the patient's motivational anchors — whether he or she is a learner, goal-oriented or thrill-oriented and help the patient find a program well suited to this aspect.

“Lifestyle changes are a powerful way to prevent chronic disease,” Nedrow said. “Physician assistants should incorporate lifestyle medicine into practice when appropriate to help diminish the high incidence of chronic disease.”

Nedrow A. "Lifestyle medicine for women." Presented at: 39th Annual American Academy of Physician Assistants Conference. 2011: Las Vegas, Nevada. 

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