Part 2: 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
Interventions in LS medicine
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 for clinicians wanting to improve patient health behaviours & outcomes (relatiing to the doctor & the patient) ?
(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
Mn “Know about 3 - 4 - 5 if you want to stay alive”:
- 3/4 insufficient vegetables
- 4/5 in sufficient exercise
What proportion of people don’t get enough physical activity ?
About 4 out of 5 (80%)
BR 18
Mn “Know about 3 - 4 - 5 if you want to stay alive”:
- 3/4 insufficient vegetables
- 4/5 in sufficient exercise
What proportion of diabetics follow accepted dietary guidelines for saturated fat ?
Only 11%
BR 18 (ref 29)
Mn: Gerstein
What proportion of patients with heart disease continue to smoke ?
8%
BR 18 (ref 30, 31)
Mn: Suzanne A on gate w cigarette
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
