Section 1: Into to LM Flashcards
What is ITLC
- Intensive Therapeutic Lifestyle Change program
Examples of ITLC programs
- Pritikin program, Ornish Program, Diehl CHIP
What are the core competencies of LM?
Leadership - promote healthy vehaviors, giving presentations, inform politicians about lifestyle changes
Knowledge - effects of lifestyle changes on body
Assessment skills - Assess social, psychological, and biological predispositions of patients’ behaviors resulting to health outcomes, family readiness, willingness and ability to make health behavior changes
Management skills- Use nationally recognized practice guidelines
Office and Community support - practice interdisciplinary team of health care providers and support a team approach
80% of premature death are attributed to 3 factors:
- Tobacco use
- Poor diet
- lack of physical activity
Determinants of Health:
- Adverse childhood events
- Genetic and epigenetic predispositions
- Health literacy
- Local environmental conditions
- Socioeconomic status
Interheart Study
Case control study about Acute Myocardial Infarction (AMI) RISK FACTORS (52 countries)
- Smoking
- Lipids
- Hypertension
- Diabetes
- Obesity
- Diet
- Physical Inacivity
- Alcohol Consumption
- Psychosocial Factors
InterSTROKE Study
- Prospective case control study (32 countries)
- 10 Lifestyle risk associated with 90% risk of stroke in men and women of all ages
Chicago Heart Association Detetion Project
- Risk of heart disease determined by number of cardiac risk factors a person has
Six changes to reduce heart disease risk by 90-95%:
- 50% dec. total cholesterol > 50% risk reduction
- 6mmHg dec. diastolic pressure > 42 reduction stroke risk
- Smoking cessation >50% risk of sudden heart attack
- Maintain ideal body and waist size > 35-55%
- > 150 min. mod. exercise/week > 35-55%
- > 5 servings of fruits and veggies/day > 2–25%
Framingham Heart Study
- Risk of atherosclerotic cardiovascular disease in people who were free of CV disease at age of 50:
- 5% vs 69% for men
- 8% vs 50% for women
- Both genders with optimal risk status lived 10 years longer than risk factors after age of 50
Nurse Health Study
- Prospective study of 84k women
- Risk of coronary heart disease:
1. Absence of smoking
2. MBI <25kg/m2
3. 30 min/day physical activity
4. Mod. alcohol consumption (5-30g/day)
5. Healthy diet score (cereal fiber, marine omega 3, folate) - If all 5 factors present, 82% lower risk of heart disease
Adventist Health Study 2
- Reduced risk of mortality in people in total vegetarian vs non vegetarian
- Vegetarians = lower BMI
Lyon Diet Heart Study
- Prevention of heart disease with Mediterranean diet vs American Heart Association Step 1 Diet
- Mediterranean diet > protective effects for 4 years after first heart attack
Lifestyle Medicine requires:
- Patient engagement and responsibility
- Treatment are long term
- Provider acts as medical expert and coach
- It saves cost
Complementary and Alternative Medicine
- Not port of conventional medicine
- Use only evidence based, non-evidence based should be excluded
Integrative Medicine
- Addresses whole person needs + conventional, complementary and alternative medicine
Functional Medicine
- Focuses on physiologic and biochemical functions of the body, investigates balance and processes of cellular metabolism
- Emphasizes testing of various hormones and metabolites that are not well proven
Mind Body Medicine
- Relaxation, hypnosis, visual imagery, meditation, yoga, spirituality, etc.
- Some are evidence based, some are not.
Preventive Medicine
- Includes all aspect of morbidity and mortality prevention for the general public. Oversees public health
- Emphasizes population based interventions like immunizations, screening, and protection from bio-terrorism
Conventional Medicine
- Patients are recipient of care, not required to make significant changes
- Provider are responsible for care and outcomes, patient is passive
Increased scientific knowledge of the associations between lifestyle choices and chronic disease have not resulted in better lifestyle choices. Lifestyle-related disease has been increasing for decades, and life expectancy is in decline, with the present generation of children expected to live a shorter time than their parents. Life expectancy (expected total years of life) is declining and yet it does exceed health expectancy (expected total years of health).
