Chronic Disease Prevention

This introductory course in Lifestyle Medicine is intended for primary-care physicians and other mid- to senior-level healthcare professionals, both in training and in practice. Less than half of the adult population in the United States meet minimum requirements for aerobic exercise 12 x12Carlson SA, Fulton JE, Schoenborn CA, Loustalot F. Trend and Prevalence Estimates based on the 2008 Physical Activity Guidelines for Americans.
Whereas infectious diseases were the primary cause of death in the early 20th century, CVD and cancer have now assumed dominance in mortality (Figure 1). 9 Additionally, obesity and diabetes are inflammatory conditions that not only contribute to CVD and cancer but also serve as profound comorbidities; their shared etiologies promote one another.



According to Kushi et al. 8 , the American Cancer Society nutrition and physical activity guidelines are consistent with those defined by the American Heart Association and purpose the 2010 Dietary Guidelines for Americans, in addition to those established by the American Diabetes Association and the 2008 Physical Activity Guidelines for Americans.

Egger et al. concluded that Lifestyle medicine forms a bridge with public health and health promotion, where the latter is defined as ‘the combination of educational and environmental supports for actions and conditions of living conducive to health'” 10 (The contents in single quotation mark is taken from Greene and Kreuter's material 13 ).
The competence and confidence to diagnose and change unhealthy behaviour is lacking 29 We must improve education and training in the treatment and prevention of lifestyle‐related diseases 30 There needs to be changes in attitudes and perspectives such that practitioners understand therapeutic lifestyle changes to be the most scientifically valid, clinically effective and achievable treatment possible for most common conditions (LRDs) 31 Practitioners need to be taught how to base even 5 to 10 min on lifestyle medicine principles 30 , while we work collectively to establish better delivery mechanisms that reflect the evidence demonstrating more contact time is more effective at producing meaningful lifestyle changes.

Furthermore, compelling evidence is emerging for the role of persistent organic pollutants (POPs), such as polychlorinated biphenyls, dioxins, and pesticides, in chronic diseases such as type 2 diabetes 72 - 75 by impacting beta-cell function 72 , insulin signaling and secretion 73 , and mitochondrial function 74 , as well as in the development of obesity by influencing adipocyte differentiation and neural circuits that control eating behavior (these toxicants have also thus been termed obesogens”) 76 Porta et al. 77 analyzed serum concentrations of 19 POPs in 919 people in Spain and found that more than half of the population studied had concentrations in the top quartile of ≥1 POPs.
Dr. Rekha Mandel , our primary care and lifestyle medicine physician, will address how to prevent and treat illness by replacing unhealthy behaviors with positive ones, such as eating nourishing foods, managing stress, staying physically active, getting plenty of sleep, and developing a strong support system.

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