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The Lifestyle Medicine Revolution

We live in an age of amazing medical technologies that help with a wide range of circumstances.  Still, it’s hard to not be disappointed with the high cost and the notion that very few of these technologies address the root causes of disease.  This isn’t a surprise given that what most people suffer from is caused by lifestyle and for which lifestyle change remains the best medicine.

Fortunately, a new era for evidence-based lifestyle medicine is coming to our aid.  Often what technology cannot do, our body’s innate ability through simple yet powerful lifestyle changes can accomplish.  Often lifestyle change is the best medicine for preventing and reversing the progression of the most common chronic diseases.

When given the right conditions, our bodies often have a remarkable capacity to self-heal.  Evidence now shows that this can happen much more quickly than once believed.  What we eat, how we respond to stress, how much exercise we get, and how much support we have all make a difference.

This is part of what is making evidence-based lifestyle medicine one of the most promising changes in medicine.

There is recognition that high-tech medicine has not significantly increased longevity or quality of life beyond a few specialized areas. At the same time, there is growing evidence that lifestyle medicine can improve the quality of life, extend life and reverse a wide variety of chronic diseases.

            Escalating health care cost with little to show for it makes lifestyle medicine the right idea at the right time.  This is why the United States Preventative Services Task Force has raised its recommendation for lifestyle medicine and why Medicare and many insurance companies are now covering lifestyle medicine programs for reversing heart disease at Ornish-Certified locations.  This is happening because the latest studies show that lifestyle changes are better than medications or surgery for many conditions.  Here are two examples:

  • Coronary heart disease: A review of eight randomized controlled trials concluded that stents don’t prevent heart attacks, don’t reduce the need for bypass surgery, don’t reduce angina (chest pain), and don’t prolong life in most patients with stable coronary heart disease.  One patient awaiting a heart transplant reversed his heart disease and avoided a lifetime of immunosuppressive medications not to mention a million dollar procedure.  Still, there is a place for technology.  Stents and heart transplants can be lifesaving for someone who is having a heart attack or is in an unstable condition.
  • Early stage prostate cancer: Two randomized controlled trials described in The New England Journal of Medicine documented that surgery and radiation do not prolong life after 10 years in men with early-stage prostate cancer.  In contrast, randomized controlled trials at Memorial Sloan-Kettering Cancer Center and at UCSF have shown that lifestyle medicine may slow, stop, or even reverse the progression of early-stage prostate cancer, without medications or surgery.  For a relatively small subset of men with aggressive forms of prostate cancer, there are possible benefits from surgery or radiation. Given that most men are much more likely to die with prostate cancer than from prostate cancer, lifestyle medicine is a welcomed alternative.

There is a place for medications and surgery.  In a crisis, they can be lifesaving.  Also in the early stages of treating and reversing chronic diseases, medications may be used to complement lifestyle changes.  And, in some disease states people will need medications or surgery even after making a comprehensive lifestyle change.  The advantage of modern high tech medicine is the potential to complement the body when a disease state has progressed to the point it can’t be reversed.  The advantage of lifestyle medicine is the ability to keep a disease state from advancing to the point where it isn’t reversible.

By one recent estimate, 86 percent of the $3.2 trillion in annual U.S. healthcare costs go toward treating chronic diseases.  For these diseases, lifestyle medicine is a change that can make better care available to more people at lower costs.

For perspective on the effects of lifestyle on quality of life and longevity, consider the leading causes of death as they are typically reported.  If the bar chart below looks familiar, it’s because of an unfortunate choice in the language with which health is explained.  When the causes of death are heart disease, stroke, or cancer it gives the impression that disease is somehow unavoidable.

In contrast, compare the actual causes of death shown in the bar chart below.  A comparison of the two bar charts leaves little doubt that the leading causes of death are lifestyle choice related.

Calling the leading cause of disease the “Tobacco Disease” would at least emphasize that lifestyle is the root cause and not a mysterious thing that happens.  While at it, we could rename heart disease as the “Bacon Cheeseburger Disease” or perhaps the “Couch Potato Disease.”

While cancer and heart disease have causes other than lifestyle, evidence shows that lifestyle is a factor we have control over.  Evidence also shows that when these diseases are detected early enough, lifestyle changes can greatly improve the chances for recovery.            

Nancy Neighbors, MD

By Nancy Neighbors, MD

... Dr. Neighbors provides a blend of traditional family medicine and evidence-based lifestyle medicine in Huntsville, Alabama. When indicated, lifestyle change is recommended as the first line of therapy.

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