LMBR1: Sec 1 Intro LS Med p 15-19 Flashcards
Pages 15-19
Since conventional medicine may also include nutrition & physical activity, what makes lifestyle medicine any different ?
Although portions of lifestyle medicine (eg nutrition, physical activity) are included in other fields of medicine, LS medicine is distinct because lifestyle change is prescribed and the FIRST-LINE and MOST IMPORTANT therapy for disease treatment and reversal.
- evidence-based medications and other modalities are used, but only to supplement changes in lifestyle.
BR 15
Does a lifestyle medicine practitioner prescribe medications ?
- evidence-based medications and other modalities are used, but only to supplement changes in lifestyle.
BR 15
6 items
What are the intervention modalities for lifestyle medicine ?
Definition of LS medicine (BR13): Feet, fingers, forks, sleep, stress, love
Feet - regular physical activity
Forks - predominantly WFPB diet
Fingers - avoid risky substances - tobacco, EtOH
Sleep - adequate sleep
Stress - stress management
Love - positive psychology & connectedness
BR 15
In lifestyle medicine, what is meant by ‘disease reversal’ ?
Disease Reversal - DRS (‘doctors’)
D - Diagnostic tests/labs (-)
R - Rx - without current use of any medications
S - Signs/symptoms are not present
(BR-15)
In lifestyle medicine, what is meant by ‘control of a chronic disease’ ?
cONTrOL
L - labs IMPROVED to accepted standard levels but N.O.T. normal
O- optional drugs/medical therapies
BR 15
What is complementary / alternative medicine (CAM)
- an approach to medical care that is not currently considered part of conventional medicine
- uses conventional PLUS complementary/alternative medicine treatments that historically HAVE NOT BEEN WELL RESEARCHED.
BR 16
Is it appropriate to use complementary +/or alternative medicine ?
- evidence-based complementary modalities are appropriate and should be utiilized
- non-evidence-based alternative treatments should be excluded.
What is integrative medicine ?
- addresses patient’s whole person needs (physical, social, emotional, mental, environmental & spiritual) thru a COMBINATION of conventional AND complementary/alternative medicine
- this ‘integration’ is seen by some as a strength, and by others as a weakness.
What is functional medicine ?
- focuses on the physiologic & biochemical functions of the body - cellular metabolism, digestive function, detoxification & control of oxidative stress
- tends to emphasize testing of hormones/metabolites that are not well-proven or generally accepted within evidence-based medicine and is thus still somewhat controversial.
BR 16
Describe mind-body medicine & its modalities
Is it evidence-based ?
- investigates the interactions between the body & mind behaviourly, emotionally, mentally, socially & spiritually
- treats using relaxation, hypnosis, visual imagery, meditation, yoga, biofeedback, spirituality, tai chi etc
- while some mind-body medicine is very solidly evidence-based, other aspects are still unproven.
BR 16
What does preventive medicine include ?
What sort of interventions does it emphasize ?
- includes all aspects of morbidity and mortality prevention for the general public (ie oversees the field of public health)
- emphasizes population-based interventions that include immunizations, screening and protection from bioterrorism.
What is the role of the patient and provider in conventional medicine ?
- pts are recipients of care and other than complying with treatments are not required to make signficiant changes.
- providers are considered responsible for care and outcomes while the patient is a passive reciever of medical services.
BR 16
What is the role of the provider in lifestyle medicine ?
Provider acts as both a medical expert and a coach
BR 15
Name two key elements in improving health behaviours & outcomes ?
(context: role of behavioural determinants of positive health outcomes)
1) A trusting relationship betweeen physician & patient
2) Patient support: multidisciplinary team, loved ones, greater community
BR 17
List the top 10 causes of death in the USA in 2015
(Not in order, BR 17)
1) Heart disease
2) CNS - stroke, Alzheimmer’s
3) Resp - chronic lwr respiratory diseases, influenza/pneumonia
4) Cancer
5) Accidents & self-harm
6) Diabetes
7) Renal - nephritis, nephrotic
3 factors
What factors account for 80% of all premature deaths ?
1) Tobacco use
2) Poor diet
3) Lack of physical activity
(Other- BMI, EtOH)
BR 18
What proportion of people still smoke (USA) ?
1 in 7 still smoke
BR 18
What proportion of people eat a diet low in fruits & vegetables ?
About 3 out of 4
BR 18
What proportion of people don’t get enough physical activity ?
About 4 out of 5 (80%)
BR 18
What proportion of diabetics follow accepted dietary guidelines for saturated fat ?
Only 11%
BR 18 (ref 29)
What proportion of patients with heart diseae continue to smoke ?
8%
BR 18 (ref 30, 31)
What proportion of the variance in health can be explained by DNA sequence (genes) vs epigenetics (environment) ?
When it comes to variance in health status:
- about 10% is from DNA sequence (genes)
~ 70-90% is from epigenetics (gene switches)
BR 18
PNAS 2005 (July 26):102(30):10604-9
What predicts health literacy rates ?
People with higher education have higher health literacy rates
BR 19
What do we see in subjects with low health literacy rates ?
1) Higher rates of hospital admissions & physican visits
2) Less knowledge & poorer managment of serious health conditions (eg HIV, asthma, diabetes)
BR 19
5 conditions
List local environmental conditions which are determinants of health
1) Air pollution
2) Second hand smoke
3) Water supply
4) Food deserts
5) War, famine, earthquakes etc
What role does socioeconomic status have in health ?
Lower SES correlates with poorer health regardless of country studied.
BR 19
What influence does race have on access to health interventions ?
Racial minorities have less access to interventions
BR 19
Which socioeconomic factor best predicts good health ?
Higher education best predicts good health
BR 19
List factors which result in different underlying rates of illness (and thus lead to disparities in health outcomes & health care):
1) Genetic predisposition
2) Local environmental conditions
3) Poorer care
4) Poor lifestyle choices
5) Different care-seeking behaviors
6) Linguistic barriers
7) Lact of trust in health care providers.
BR 19
List 4 broad determinants of health
1) Adverse childhood events
2) Genetic & epigenetic predisposistions
3) Health literacy
4) Local environmental conditions
BR 18-19
Name 4 lifestyle modification services to be provided by health care providers under the first and current National Prevention Strategy (2011)
1) Physicial activity - assessments & counselling
2) Obesity - screening & nutrition counseling
3) EtOH - screening & conselling for excessive use
4) Smoking - cessation services
BR 20
Smoking, BMI, F&V, Exercise
What proportion of patients had healthy levels of 4 key health behaviours ?
BR 18
- only 3% had healhty levels of all four health behaviours:
Non-smoking - 76%
Healthy weight (BMI<25) 40%
Five fruits + veggies/day 23%
Regular physical activity 22%
BR 18
