Section 1: Introduction to LM Flashcards
What are the lifestyle medicine core competencies as identified by a national consensus panel? (five)
Leadership
Knowledge,
Assessment skills(of patient’s health, lifestyle and readiness to change)
Management skills
Use office/community support
What proportion of premature deaths attributable to health behaviours? What are the health behaviours?
~half (40%) of all premature deaths are attributable to tobacco, alcohol, poor diet, lack of PA
What percentage have healthy levels of all of these: non-smoking, BMI<25, 5+ fruits and veges, adequate PA?
Only 3%
What percentage of medical consultations in primary care are lifestyle related?
80%
What was the Interheart Study?
Standardised case control study about acute MI risk factors – included 52 countries
What did the Interheart Study show about risk factors?
5 risk factors - smoking, lipids, hypertension, diabetes, obesity: makes up 80% attributable risk
9 risk factors made up 90% attributable risk in men and 94% in women: this also included diet, PA, alcohol consumption, psychosocial factors (which was ~33%).
What was the Nurses’ Health Study?
Prospective study that looked at RR of CHD over 14 years in 84000 women
What factors for heart disease did the Nurses’ Health study identify? What was the RR of a CV event if all 5 factors were present? What does this correspond to as population attributable risk?
Identified 5 health factors – having all 5 gave RR of 0.17 of CV event (82%PAR)
* Diet score in upper 40% (intake of cereal fibre, marine omega 3, folate)
* Non smoking
* MVPA >30min/day
* BMI<25
* Moderate alcohol consumption
What did the Lyon Diet Heart Study show?
Showed secondary prevention of CHD using Mediterranean diet – maintained for 4 years post MI
What are the 3 tenets of lifestyle interventions? (ie why are they better than conventional approaches?)
- Lifestyle medicine decreases reliance on medication and therefore reduces medication side effects.
- Lifestyle medicine is often more effective than conventional treatments for chronic disease, positively affecting disease progression.
- Lifestyle medicine offers safer control of some biological markers than some medications.
Describe how effective lifestyle medicine is to treat diabetes?
Asian youth with new type 2 diabetes: intensive lifestyle therapy can achieve reversal or partial remission within 3 months
All types of regular exercise improved HbA1c by 0.8% (comparable to meds)
Plant based diet: >90% of patients relative reduction of HbA1c by 15%, better than most meds, and could decrease or stop meds
Remission is feasible using lifestyle as primary treatment – diet more significant than exercise
Describe how effective lifestyle medicine is to treat CV disease?
*Exercise 26% more effective Than PTCA
*Lifestyle interventions decreased risk of MI with CV disease
*Wholefood plant-based diet lowers risk of cardiac events, and risk of CV disease, via polyphenols impact on endothelium
*Healthy diet and exercise adherence : 48% decreased risk of MI
*Favourable lifestyle (no current smoking or obesity, PA at least once /week. Healthy diet pattern) in those at high risk - 50% lower risk.
*PA significantly decreases CV mortality
What evidence is there that lifestyle interventions affect cancer outcomes?
Intensive lifestyle intervention decrease PSA in prostate Ca
PA decreases risk breast cancer mortality, recurrence
50% reduced breast cancer mortality with fruit/veges and PA
Describe the cost burden for lifestyle-related disease in US?
Cost burden is growing
60% of adults have one chronic disease, and 40% have 2+
42% have obesity
38% prediabetic, 11 % diabetes
2020: 4.1 trillion healthcare spending in US – 90% is on chronic/mental
