Lifestyle medicine potential for reversing a world of chronic disease epidemics

International Journal of Clinical Practice

The leading causes of mortality and healthcare costs
worldwide are chronic diseases, resulting from lifestyle and
environmental factors
. The economic burden of poor lifestyle
choices is no longer sustainable and impossible to
ignore. Most chronic diseases are preventable. To treat the
causes of these diseases and to be successful in prevention,
a strong focus must be placed on lifestyle medicine
aspects. Lifestyle Medicine encompasses research, prevention,
diagnosis and treatment of dysfunctions caused by a
non-physiological lifestyle (lifestyle-related diseases, LRDs)
and morbidogenic environments conducive to promoting
such lifestyles. The ultimate goal and primary focus of
Lifestyle Medicine is to promote healthier lives through
salutary environments and healthier lifestyle choices.
Treatment of LRDs includes nutritional, exercise, psychological,
social, economic and environmental interventions.
To successfully do this requires education, training and
communication about Lifestyle Medicine at the professional
and general public level, while avoiding the trap of
‘victim blaming’ of individuals whose lifestyles are influenced
by circumstances beyond their control.
The current health crisis
The leading causes of mortality worldwide are chronic
non-communicable diseases (NCDs); cardiovascular
disease (17 million), followed by cancer (7.6 million),
respiratory disease (4.2 million) and diabetes (1.3 million)
(1). The newly published Global Burden of Disease
Study (2010) has systematically highlighted the
epidemiological shift in morbidity and mortality
resulting from infectious diseases and malnutrition,
to NCDs (2). While we have gained approximately 10
years of life expectancy since 1970, we are spending
more years living with injury and illness (2). Representing
63% of all deaths, most that die from NCDs
are in the prime of their productive years (3).
There is now overwhelming evidence that lifestyle
factors such as poor dietary patterns, physical inactivity,
tobacco use, excessive alcohol consumption
and psychosocial factors, e.g. chronic stress and lack
of social support and community, are key proximal
factors in the pathogenesis and incidence of NCDs
(4). Lifestyle factors may also be
more distal stressors, including economic,
political or a high density
population (5).
We define lifestyle-related diseases
(LRDs) as diseases where the pathophysiology
is significantly influenced
by lifestyle factors and where a
change in these aetiological factors
can significantly improve prevention
and treatment of the disease.
The world’s population has more
and more adopted an ‘unnatural’
environment to which it has not
had a chance to adapt physiologically.
This leads to numerous biological
dysfunctions, probably
stemming from a form of low-grade
systemic inflammation, which
underlies most chronic diseases and
risk factors such as hyperlipidaemia
and hypertension. The first sign of
such an unadapted lifestyle accumulating
allostatic load is often
increased body weight through a
hypercaloric diet and inadequate
physical activity (6). It is imperative
that we finally and systematically address the underlying
causes of LRDs rather than superficially treating
symptoms. Today, one in two Americans and Europeans
is either overweight or obese (7). Average body
mass indices have on average risen by as much as
2–2.5 kg/m2 per decade and is now 30 kg/m2 or
higher in some countries (8).
As humans, we are designed to move, yet we have
never been more sedentary. Physical activity has
decreased drastically over the past cetury, because of
economic growth, digitalisation and urbanisation.
Over 70% of people in much of the modern industrialised
world are not achieving adequate levels of healthpromoting
physical activity (7). The impact of poor
lifestyle is not limited to physical diseases but also
increases the risk for mental disorders such as depression
and anxiety, which is increasing worldwide (9).
The economic burden of poor lifestyle choices is
no longer sustainable and is impossible to ignore.
LRDs have been established as a clear threat not only
to human health but also to development and economic
growth (2). Paradoxically, however, it is the latter that are also causal factors in the development
of LRDs (10). At a time when the power of comprehensive
lifestyle changes to prevent and reverse
chronic diseases is becoming well-documented, the
limitations and costs of high-tech medicine are
becoming clearer (11–13).

About ldallara924

Nation Health Federation fighting to protect Health Freedom

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2 Comments on “Lifestyle medicine potential for reversing a world of chronic disease epidemics”

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