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Purpose: High-value care is becoming increasingly important as the United States shifts toward a more sustainable health care system. Lifestyle medicine (LM) may be the highest-value model of care. Surprisingly, however, it is taught in a minority of medical schools. In this article, we describe a pilot project of introducing a brief LM course taught within the Mayo Clinic Alix School of Medicine in Arizona. The main purpose of the course was to introduce the students to LM as a specialty practice and to provide students with foundational knowledge of the pillars of LM. Results: Students reported improved personal health habits and increased confidence in LM competencies.

There are over 3.5 million breast cancer survivors living in the United States. Key elements of breast cancer survivorship care include monitoring for disease recurrence, addressing medical and psychosocial consequences of treatment, and educating about lifestyle interventions which decrease risk of recurrence, improve quality of life, and improve outcome. We have developed the PAVING the Path to Wellness Program for Breast Cancer Survivors in order to provide education on evidence-based topics from lifestyle medicine, with the goal to help women adopt healthy habits and improve well-being after cancer treatment. The 12-week program includes all 6 pillars of lifestyle medicine, as well as positive psychology, gratitude, and goal setting work. The PAVING the Path to Wellness Program for Breast Cancer Survivors empowers breast cancer survivors with knowledge regarding evidence-based lifestyle recommendations and helps them achieve an improved sense of well-being following treatment. On completion of the program, participants specifically reported an improvement in attitude and well-being. Next steps involve developing a strategy to offer this program to a larger group of cancer survivors.

Providing a strong foundation in culinary medicine (CM)—including what constitutes a healthy diet and how to find, obtain, and prepare healthy and delicious food—is a cornerstone of educating health professionals to support patients in achieving better health outcomes. The Culinary Medicine Curriculum (CMC), published in collaboration with the American College of Lifestyle Medicine, is the first, comprehensive, open-source guide created to support the implementation of CM at health professional training programs (HPTPs) worldwide. The CMC is modeled after the successful CM elective course for Stanford University School of Medicine students. Key goals of the CMC include presenting healthy food as unapologetically delicious, quick, and inexpensive; translating lessons learned to healthy eating on-the-go; practicing motivational interviewing on healthy dietary behavior changes; and demonstrating how to launch a CM course. The CMC highlights a predominantly whole food, plant-based diet as seen through the lenses of different world flavors and culinary traditions. It was developed, published, and distributed with the aim of expanding CM by reducing barriers to creating CM courses within most types of HPTPs and practice settings. During the first 2 months the CMC was available, it was downloaded 2379 times in 83 countries by a wide variety of health care professionals interested in teaching CM. The global interest in this first, freely available, evidence-based CMC underscores the demand for CM resources. Such resources could prove foundational in expediting development of CM courses and expanding the reach of CM and counseling on dietary behavior changes into patient care.

As new specialties emerge in medicine, certification pathways must be defined and formalized. The Lifestyle Medicine Physician certification, including both experiential and educational pathways, have been in place for several years. Although raising competence across all specialties through the Lifestyle Medicine Physician Diplomates to a foundational level is essential, additional expertise must be attained to be a true Lifestyle Medicine Specialist as outlined by the American Board of Lifestyle Medicine. This column will describe how Loma Linda University Health (LLUH) created a Lifestyle Medicine Specialist Fellowship that meets the educational pathway requirements for the Lifestyle Medicine Specialist certification and how it can be replicated and sustained at other training sites across the nation.

Chronic diseases, previously thought to require decades of risk factors, have become increasingly prevalent in America’s youth. National Health Education Standards have been published since 1995, and yet nearly a fifth of schools fail to follow any state or national health education guidelines. Utilizing the phrase “lifestyle medicine” in childhood would elevate the importance and standardization of the core health guidelines. Several independent pilot programs taught by undergraduate and medical student volunteers have successfully demonstrated lifestyle medicine education models at intermediate and secondary schools. Preliminary feedback demonstrates that student interest in and consideration of behavioral change is possible within this age group. As with any life stage, significant behavior change in youth requires strategic planning of authentic learning practices and culturally competent lessons. We argue for the interdisciplinary development and implementation of community-engaged lifestyle medicine education for intermediate and secondary schools as a promising intervention to address and reverse the chronic disease trend in our youth.

Background. Differences in socioeconomic status contribute to inequalities in lifestyle habits and burden of noncommunicable diseases. We aimed to examine how the effects of a 1-year structured lifestyle education program associate with the participant's educational level and socioeconomic area (SEA) of residence. Methods. One hundred individuals (64% women) with high cardiovascular risk were included. Education level (nonuniversity vs university degree) was self-reported and SEA (low vs high) defined by living in different SEAs. Lifestyle habits and quality of life were self-reported, cardiovascular risk factors and Framingham 10-year cardiovascular disease risk were measured at baseline and after 1 year. Results. Sedentary behavior decreased in both nonuniversity degree and low SEA group over 1 year, with a significantly greater improvement in daily activity behavior in low- compared with high-SEA group. Abdominal obesity decreased significantly more in the nonuniversity compared with the university degree group. Cardiovascular risk and quality of life improved in all groups, however, with greater discrimination when using educational level as the dichotomization variable. Conclusion. The results are clinically and significantly relevant, suggesting that low socioeconomic status measured both as educational level and SEA are no barriers for changing unhealthy lifestyle habits and decreasing cardiovascular risk after participation in a lifestyle program. Livsstilsmottagningen på Karolinska universitetssjukhuset, Solna

Despite a growing interest in lifestyle medicine, students at most medical schools in the United States are not receiving enough nutrition education and training in the principles of lifestyle modification to be effective at applying this knowledge to real-world clinical practice. Moreover, the rising prevalence of chronic lifestyle-related diseases and the increasing deficit of primary care providers is overwhelming the US health care system. The need for primary care physicians is being circumvented by medical students’ diminishing interest in primary care partly due to concerns about salary, prestige, and being too broad in focus. Students may also recognize that the pharmaceutically based management of chronic conditions and supplemental lifestyle recommendations are often fraught with nonadherence, resulting in the progression of disease states. However, some medical schools have incorporated the concepts and practice of lifestyle medicine into their curriculums. This integration has the potential to inspire medical students to choose a primary care specialty, because students become more adept at addressing and treating the root causes of chronic disease. Lifestyle medicine education can empower students interested in primary care to fulfill their initial desires to treat and heal that may have inspired them to want to become doctors in the first place.

Lifestyle medicine domains, despite accounting for more than 78% of chronic disease risk, are infrequently taught as a part of the medical curriculum. Aspects such as nutrition are taught in less than 25% of medical schools, a statistic that continues to decline, and less than 20% of practicing physicians were required to take even a single course in exercise counseling during their medical school training. To combat this lack of training, the American College of Lifestyle Medicine annually awards the Donald A. Pegg scholarship to fund the development of Lifestyle Medicine Interest Groups (LMIGs) across medical schools worldwide. This scholarship was initiated in 2016 and utilizes private funds to support the development and expansion of LMIGs with the aim of increasing awareness of lifestyle medicine among training practitioners. There are four award winners per year. To date there are sixteen Pegg Award winners. This article will showcase the four 2019-2020 Donald A. Pegg award recipients and their impact on the LMIGs at their institutions. Furthermore, it highlights the ingenuity and adaptation of these LMIGs during the COVID-19 pandemic.

Technology has redefined the way patients and providers communicate and obtain health information. The realm of digital health encompasses a diverse set of technologies, including mobile health, health information technology, wearable devices, telehealth and telemedicine, and personalized medicine. These technologies have begun to improve care delivery without the traditional constraints of distance, location, and time. A growing body of evidence supports the use of digital health technology for improving patient education and implementation of skills and behaviors integral to lifestyle medicine. Patient education can now be delivered in standard formats (eg, articles, written messages) as well a wide array of multimedia (video, audio, interactive games, etc), which may be more appropriate for certain topics and learning styles. In addition, patient engagement in their care plays an important role in improving health outcomes. Despite digital health technology development often outpacing its research, there is sufficient evidence to support the use of many current technologies in clinical practice. Digital health tools will continue to grow in their ability to cost-effectively monitor and encourage healthy behaviors at scale, and better methods of evaluation will likely increase clinician confidence in their use.

Significant contributors to rising health care costs are diseases influenced by lifestyle, such as cardiovascular disease, diabetes, and cancer. Unfortunately, American medical education devotes disproportionately little time training future doctors in prevention. Approach. With the support of medical education leadership, medical students collaborated with a faculty advisor at Wake Forest School of Medicine to test the feasibility of a broad-based, student-led lifestyle medicine curriculum. After 3 introductory sessions delivered to an entire medical school class, a smaller pilot series with 16 first-year medical students was held after-hours, featuring experiential learning in nutrition and cooking, physical activity, and sleep. The 8 modules were designed to improve student health, wellness, and knowledge of health behaviors. Feedback. The program was implemented into the first-year medical school class. An unforeseen benefit of the pilot was increased student volunteering in community-based wellness activities and research. Two components of success were the hands-on, experiential modules and being student-led. Details on curriculum development, schedule, and content are provided.

With the majority of patients seen by primary care practitioners suffering from overweight or obesity, an additional certification in obesity medicine provides the critical tools and skillset to expertly address the many chronic health conditions predicated by unhealthy adiposity and excess weight.

The popularity of yoga in the United States and across the globe has been steadily increasing over the past several decades. The interest in yoga as a therapeutic lifestyle tool has also grown within the medical community during this time. However, the wide range of styles available to the public can make it difficult for patients and physicians alike to choose the one that will offer the most benefit. This guide was created to assist physicians in making informed recommendations for patients practicing yoga in the community. When the most suitable style is selected, yoga can be an extremely useful lifestyle tool for patients seeking to improve fitness and develop a mindfulness-based practice.

Lifestyle medicine has the power to reverse the growing burden of chronic disease that now plagues our health care system. The World Health Organization, the Centers for Disease Control and Prevention, and the American College of Lifestyle Medicine have all independently recognized the need for community-centered lifestyle medicine education as a means of empowering individuals to take charge of their own health. Students in undergraduate, medical, and allied health schools may serve as mediators for these conversations. With guidance from faculty lifestyle medicine mentors, these students can operate as peer educators in primary and secondary schools to supplement current health teaching with the core tenants of lifestyle medicine: nutrition, exercise, sleep, mental and social well-being, and substance avoidance as strategies to prevent and treat chronic disease. We present models of two such student-led programs working with middle and high school students in Massachusetts and New Jersey. Both programs have found success by engaging middle and high school students in interactive workshops and by responding to their individual interests and community needs. We share our currently available resources and, moving forward, hope to publish a tested curriculum that students around the country can implement in their communities to promote lifestyle medicine.

The practice of Lifestyle medicine (LM) focuses on helping patients make healthy choices to prevent and treat disease. While such interventions are considered first-line treatment for many diseases, many medical schools have not yet been able to include lifestyle medicine classes in the core curriculum but most are able to offer a parallel curriculum that does not interfere with the schedule of core classes. Lifestyle Medicine Interest Groups (LMIGs) are being created around the country and around the globe. Many students and faculty members are interested in starting and sustaining a LMIG at their schools, but some do not have enough funding or they lack the framework that provides structure to their efforts. To address this situation, the American College of Lifestyle Medicine (ACLM) has encouraged the development of LMIGs, which are student-run organizations that provide a parallel curriculum in LM. To support and strengthen this effort, the ACLM initiated the Donald A. Pegg award to fund four allied health students in founding and augmenting their institution’s LMIGs. The 2016 inaugural winners were James Gardner, P. Elainee Poling, Alyssa Abreu, and Jessie M. Hipple. Their LMIG activities have included events such as nutrition and cooking classes, exercise prescription seminars, group fitness sessions, and patient lifestyle counseling in various clinical settings. Pearls of wisdom for building successful LMIGs include cultivating strong faculty mentorship, marketing the personal benefits to students who attend activities, and collaborating with other student groups.

In the past 20 years, interest in mindfulness and its cultivation through various meditative practices has increased astronomically. This is reflected in the popularity of mindfulness training programs, its ever-widening exposure in popular culture, and in the number of scientific articles published on the topic. With the recent focus on burnout in the medical profession and reports of high levels of anxiety and depression among residents and staff physicians, the potential applications of mindfulness are becoming increasingly apparent in the hospital setting. Mindfulness meditation may be particularly useful for surgeons because they are required to maintain their presence of mind and mental focus in the setting of challenging physical and mental tasks. Furthermore, personality traits such as perfectionism and intensity, which may have facilitated success in the competitive environment of medical school and residency training, may later manifest as intolerance and impatience, contributing to frustration and anger. A mindfulness meditation practice may help reduce the tendency to react to these emotions, yet still allow surgeons to remain motivated to excel. This article provides a definition of mindfulness and describes its introduction to Western culture. The connection of a regular meditation practice to improvements in focus and performance are reviewed. The potential benefits of mindfulness training to a surgical career are discussed, and an approach to introducing mindfulness and meditation to individual surgeons and surgical departments is outlined. We hypothesize that the introduction of department-wide training programs in mindfulness and meditation could benefit surgeons with regard to technical performance, empathy toward patients, academic productivity, and general life and career satisfaction.

Traditional nutrition education in medical school has been inadequate to prepare future physicians to counsel patients on practical dietary changes that can prevent and treat food-related disease. Culinary medicine is being used to address this in a variety of settings, including medical education. The Teaching Kitchen Elective for Medical Students at Stanford University School of Medicine spans 1 academic quarter and combines hands-on cooking of food that is delicious and healthy, correlations with multiple clinical specialties, and role-playing real-life examples of brief dietary counseling with patients to make nutrition education practical and approachable. The course has been run as a quasi-randomized controlled study comparing 3 cohorts of students versus wait-listed controls via precourse and postcourse surveys. Preliminary analysis of the first cohort of students shows significant improvements in attitudes, knowledge, and behaviors around healthy cooking and meal planning for the students compared with controls. Despite these promising preliminary results, more resources are needed to be able to hold the course frequently enough to meet student demand.

It is well established that evidence based clinical nutrition and lifestyle practices play a pivotal role in the prevention, treatment and potential reversal of various common chronic diseases. However, this area of science is under appreciated at all levels of medical education and training. Most medical schools and residency programs do not offer any organized training in nutrition and lifestyle medicine. Given recent data on the rising cost and loss of quality of life secondary to preventable causes, there is an absolute need for a drastic reform of the US medical education system.

While few may argue about the importance of healthy lifestyle choices on the effects of chronic health conditions, many would highlight the challenge that its practical integration poses in daily clinical practice. The field of lifestyle medicine aims to assist individuals and communities to adopt and sustain healthy behaviors. It is a powerful yet often underutilized tool. This article illustrates the importance of joint multidisciplinary efforts in the effective practice of lifestyle medicine. Furthermore it stresses the importance of equipping healthcare providers with the tools and education necessary to deliver consistent, and high quality holistic care.

Current medical education lacks significant training in the principles and practices of lifestyle medicine. In this column, I describe my journey to lifestyle medicine, lifestyle medicine education, and what it is going to take to shift the educational paradigm away from the current model to one that is focused on nutrition and lifestyle behaviors and that is both accessible and effective.

The importance of lifestyle for overall health and well-being cannot be overstated. By Centers for Disease Control and Prevention estimates, nearly 80% of many chronic conditions such as heart disease and type 2 diabetes are preventable through the adoption of healthier lifestyles. Yet, while preventable, these common illnesses account for the majority of the rising US health care costs. For nearly a century, Cummins Inc, a large global employer headquartered in Columbus, Indiana, that designs, manufactures, distributes, and services diesel and natural gas engines and related technologies, has demonstrated a penchant for innovation. However, in the area of health improvement, the company believed it could do better and decided to address the prime factor—lifestyle—the root cause of the growing problem of chronic disease for its employees and their families. This report offers a glimpse into Cummins’ forward-thinking strategy and their early efforts to combat preventable chronic disease through lifestyle and lifestyle medicine.

Lifestyle medicine (LM) is now recognized as a first-line treatment and disease reversal program for many chronic diseases. More providers are encouraged to prescribe lifestyle treatments, yet lack of training, inadequate time, and poor reimbursement hinder many physicians from actually following through, and few LM specialists are available for counsel or referral. With great strides in resolving these dilemmas, the American College of Lifestyle Medicine has created standards and competencies, and the American Board of Lifestyle Medicine will be holding its first exam for certification in LM in October 2017. Still no residency or fellowship program exists to train providers to become LM specialists. This article describes one physician’s journey through an unaccredited fellowship in lifestyle medicine at Black Hills Health and Education Center under Dr John Kelly, founding president of the American College of Lifestyle Medicine. Highlighting the differences of her lifestyle medicine training from her prior primary care and preventive medicine training, the author advocates for the formation of an accredited LM training program in intensive lifestyle medicine interventions.

NextGenU.org now uniquely offers a free, accredited, globally-available online training in Lifestyle Medicine. Courses such as Lifestyle Medicine for Primary Care Physicians, Prevention and Treatment of Alcohol Use Disorders/Tobacco Use, Substance Use Disorder Screening, Public Health Nutrition, and more are competency-based and include knowledge transfer, a web-based global peer community of practice, and local, skills-based mentorships. Trainings use existing, expert-created resources from governments, universities, and medical specialty societies thus ensuring their quality and simultaneously making them free of costs, advertisement, and geographic barriers. To offer free credits for these courses, NextGenU.org partners with universities and professional societies. NextGenU.org ’s comprehensive Lifestyle Medicine Curriculum will launch in early 2017.

Student-led Lifestyle Medicine Interest Groups (LMIGs) empower the next generation of healthcare professionals to tackle the pandemic of lifestyle-related chronic diseases and provide important pathways to increasing the visibility of Lifestyle Medicine (LM) in health professions schools. Each year, the Donald A. Pegg Student Leadership Award offers four allied health students a seed grant to start or support LMIGs at their schools as well as financial assistance to attend the annual American College of Lifestyle Medicine (ACLM) conference. The 2017 student winners were Paresh Jaini, Albert Barrera, Alyssa Greenwell, and Alicja Baska. With the support of the Pegg Award, the awardees and their faculty advisors have made great strides in LM at their institutions in the areas of research, community outreach, student education, and global networking. Their LMIG activities have included students presenting research at national conferences, initiating a chapter of the national organization Walk with a Doc, hosting educational lectures on LM principles, sponsoring plant-based cooking sessions, facilitating stress management workshops, and hosting a national-level LM congress in Europe. Through the ACLM, the Pegg Award generates an atmosphere of growth for LMIGs, fostering the expansion, vision, and integration of LM into the education of health professions students worldwide.

Stanford Medical School has created a class in lifestyle medicine that any student in the university can attend for credit. It is based on the foundational principles of lifestyle medicine and also informs students about topics such as Chinese medicine, naturopathic medicine, and wearable devices. The popularity of the course at Stanford speaks to the growing interest in the field of lifestyle medicine for medical students, undergraduate students, business students, and even engineers.