Friday 22 February 2019
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Lifestyle Medicine Increasingly Used to Treat Chronic Diseases

Michael D. Parkinson, MD, is senior medical director for UPMC Health Plan, which is part of the UPMC Insurance Services Division. The UPMC Insurance Services Division offers a full range of insurance programs and products and also includes: UPMC WorkPartners, UPMC for Life, UPMC for You, UPMC for Kids, Community Care Behavioral Health, LifeSolutions, EBenefit Solutions, and Askesis Development Group.

A significant and growing body of scientific evidence indicates that the primary determinant of health or disease is not genetics, but, rather, lifestyle. A wide variety of chronic diseases, including heart disease, diabetes, stroke and cancer, are not only preventable with healthier behaviors, but can be better managed and even reversed through lifestyle improvements.

Because of this, a relatively new style of treatment — known as lifestyle medicine — is increasingly being seen as an alternative to traditional treatments used on chronic diseases.

What lifestyle medicine does is “de-medicalize” health, which is needed to address the root cause of disease, disability and premature death. What we eat, how we move, and how we think are the cornerstones of good health and living a long and productive life.

What is Lifestyle Medicine?
Lifestyle medicine is defined as the use of lifestyle interventions in the treatment, management and reversal of disease. Lifestyle interventions, “prescribed” and supported by a health-care provider, typically consist of:

Forks: Incorporating more whole, plant-based foods into our diet. Reducing or completely eliminating refined and highly processed foods, meat and dairy products.

Feet: Increasing daily physical activity to at least 30 minutes of aerobic activity.

Fingers: Eliminating cigarettes or excess alcohol.

Sleep: Ensuring we obtain adequate and deep sleep every night.

Stress: Developing healthy coping mechanisms like exercise, meditation or mindfulness for life’s inevitable challenges.

Love: Having and developing a commitment to a purpose, person or interest that gives meaning to our lives.

How Lifestyle Affects Disease
Many diseases affecting multiple organs — such as heart disease, kidney disease, hypertension, diabetes, a majority of cancers, dementia, and other conditions — are due to diets of modern-day processed foods that are high in added salt, sugars and fats, but, low in nutrients and micro vitamins. The result can be underlying inflammation, which can promote multiple common chronic diseases.

Lifestyle interventions can be effective in treating chronic disease and can be equally and often more effective than medication. And, unlike with medication,there is no risk for unwanted side effects. For the person with the condition, the cost is really just the cost of making choices, devoting time to exercise and exerting the effort to effect lasting behavioral change.

A coordinated worksite wellness program emphasizing healthy behaviors, disease management, aligned policies and supportive environments can reduce total health care and productivity costs. Loss of productivity from absenteeism and presenteeism can be more costly to a company than health-related expenses. Effective workplace wellness programs follow the principles of lifestyle medicine.

We cannot afford to “medicalize” environmentally and behaviorally caused disease with more treatments, tests and procedures. Doctors, frustrated often by a lack of progress in treating and reversing disease, are beginning to explore this new approach based on sound science. The challenge in the near term is twofold: 1) paying for these services (as opposed to usual medical interventions under “fee for service” reimbursement) and, 2) improving the skills of providers to provide them.

I am confident that with new payment models promoted by the Affordable Care Act (ACA) and with employers’ consistent and constructive engagement, we will begin to see more ways to improve employee and family health.

For more information on UPMC WorkPartners Health & Productivity Services, visit