American Journal of Lifestyle Medicine最新文献

Lifestyle-related chronic disease increases in the United States have led to the need for innovative programs targeting dietary choices. Based on growing evidence supporting whole food plant-based (WFPB) nutrition to improve overall health, we devised a one-month WFPB intervention program, Jumpstart Your Health! (JYH), to introduce and encourage adoption of the WFPB dietary lifestyle. This paper investigates its effects on various health indicators associated with cardiovascular and metabolic diseases. Among the total of 150 participants, before and after physical measurements and blood chemistries demonstrate significant (p< 0.05) decreases in weight (-4.2 pounds), cholesterol (-25.3 mg/dl), LDL (-19.0 mg/dl), HDL (-5.6 mg/dl), hemoglobin A1c (-0.2%), and hsCRP (-1.9 mg/L). Among the high-risk participants, we found significant decreases in systolic blood pressure (-10 mmHg), diastolic blood pressure (-8.7 mmHg), weight (-4.3 pounds), cholesterol (-38.8 mg/dl), LDL (-22.7 mg/dl), HDL (-2.8 mg/dl), hemoglobin A1c (-0.2 %), and hsCRP (-2.3 mg/L). We demonstrate that a simple WFPB intervention implemented over one month resulted in significant reductions in physical measurements and blood chemistries that could translate to lowered risk or improvement for obesity, cardiovascular disease, and type-2 diabetes.

Despite decades of research and clinical insights on the importance of physical activity during pregnancy for maternal and infant health, over 75% of pregnant individuals do not meet general physical activity guidelines of 150 minutes of moderate-intensity physical each week. This may be due to several barriers that restrict engagement in physical activity during pregnancy. Without providing individualized facilitators to overcome these respective barriers, physical activity engagement during pregnancy may be severely limited and/or reduced. This literary review presents the challenges specific populations face and strategies to facilitate the inclusion of physical activity as a vital sign (PAVS) during pregnancy to assist individuals to engage in and maintain physical activity throughout pregnancy. Additionally, the Exercise is Medicine's global initiative's ability to assist in implementing PAVS during pregnancy is discussed. We conclude by defining recommendations for routine prenatal care to consider PAVS to aid pregnant individuals in meeting physical activity guidelines.

Alzheimer's disease (AD) disproportionately impacts Black Americans, who are three times more likely to develop AD. While heart-healthy diets have shown potential in reducing AD risk, research on adapted dietary interventions for Black American communities remains limited. This pilot study assessed the feasibility and acceptability of an adapted brain healthy diet intervention (MIND + SOUL) and explored changes in cardiometabolic risk and cognition. Twenty-nine participants completed the 12-week intervention, which included culturally tailored health education, cooking classes, health coaching, and groceries. Feasibility was assessed by attendance and retention rates, while acceptability was measured by two questionnaires. Participants had a mean age of 70.3, with 10.3% male. The intervention demonstrated high feasibility (89.3% retention) and acceptability (mean = 71.9, SD = 8.59), with meaningful improvements in body mass index (estimate = -0.54, P = 0.009), dietary intake (estimate = 28.39, P = 0.042), and executive function (estimate = 3.32, P < 0.001). However, no significant changes in blood-based biomarkers were observed. The MIND + SOUL intervention demonstrated high feasibility and acceptability, improvements in body composition, cognitive function, and dietary behaviors, despite no significant changes in blood-based biomarkers. Findings suggest potential benefits for reducing AD risk factors and promoting healthy aging. Clinical Trials Registry: ClinicalTrials.Gov; NCT05414682.

Objectives: This study identifies the association between patient perception of discharge education/resources and adequate transitions of care (ATOC) (i.e., patient achievement of at least 75% of recommended positive behaviors and activities within 30 days post-stroke hospitalization). Methods: The analysis measured the association between sufficient discharge communication (SDC) (i.e., patient receipt of sufficient diet education, sufficient toxic habit cessation education, if applicable, and scheduled medical follow-up appointment) and ATOC within 30 days post-discharge overall and by race/ethnicity [non-Hispanic White (NHW), non-Hispanic Black (NHB), and Hispanic] in the Transitions of Care Stroke Disparities Study (TCSD-S) (2018-2023). Results: In our sample (N = 1151, Average Age 64+/-14 years, 57% Men, 54% NHW, 24% NHB, 23% Hispanic), 31% overall, as well as 22% of NHW, 43% of NHB, and 41% of Hispanics reported SDC. After covariate adjustment, patients reporting SDC had increased likelihood of accomplishing ATOC when compared to patients not reporting SDC overall (OR = 1.97; 95% CI: 1.42-2.74) and among NHW (OR = 2.76; 95% CI: 1.64-4.64) and NHB (OR = 2.29; 95% CI: 1.16-4.53). The association among Hispanic participants was not statistically significant. Conclusion: Our findings reinforce the importance of providing quality communication to patients to ensure a successful transition of care from hospital to home or rehabilitation facility.

Shame is a common experience for individuals living with chronic diseases related to lifestyle, such as obesity and diabetes. It is often characterized by feelings of stigma and worthlessness, leading many patients to feel judged and unworthy of respect, which can profoundly affect health outcomes and overall quality of life. Despite the severe consequences of shame, therapeutic approaches to address it remain underexplored. This paper highlights the role of Acceptance and Commitment Therapy and Compassion Focused Therapy as effective strategies to mitigate shame, cultivate self-compassion, and, therefore, enhance health outcomes for individuals with chronic lifestyle-related conditions. These therapies have demonstrated positive effects on treatment adherence and self-management among patients with chronic diseases. Therefore, healthcare providers can improve patients' overall well-being by adopting strategies from these therapies, such as using compassionate language that emphasizes empathy, non-judgmental support, and validation, all of which help reduce shame and stigma.

The microbiome connects the gut health to the rest of the body's organs, including the skin. The pathophysiology of intestinal dysbiosis leads to the expression "leaky gut." Ongoing speculations are aimed at restoring the gut microbiota via modulating lifestyle habits to prevent and potentially reverse autoimmunity. This review finds the connections between gut dysbiosis and skin conditions. It also collects evidence of some lifestyle pillars that influence the gut microbiome including dietary intakes, exercise, sleep, stress, and toxin exposures. It addresses why maintaining a healthy intestinal microbiome is important for the health of all organs in the human host. More people are affected by gut dysbiosis resulting in pro-inflammatory effects on different organs, like the cutaneous tissue, one of the largest epithelial surfaces. It is essential to take care of the gut health because this is where most of the immune system resides. The connection between the intestinal tract with its microbiota and the cutaneous system with its microbiota seems to be mediated by the immune system of the human host. Therefore, this review enhances the understanding of the research on the gut microbiome, its relationship to skin health, and the interplay between the gut and various autoimmune cutaneous conditions.

There is abundant evidence about the impact of physical activity on health. Many of the clinical guidelines include physical activity as a strong recommendation in treatment plans to optimize health outcomes; however it is necessary to consider the interaction between medications and physical activity. There are certain medical conditions, including cardiovascular disease, diabetes, pain and urinary incontinence that may directly impact physical activity as well as medications for those conditions can affect how a person can be physically active. Having individualized conversations with patients to determine ways to incorporate physical activity into their lives, taking medications into consideration, may lead to healthier outcomes.

Introduction: Healthcare providers play a crucial role in promoting sexual health among older adults, an important yet often neglected aspect of aging well. Although sexuality evolves beyond the reproductive years, it remains a meaningful part of life for many. Despite the natural decline in sexual activity with age, numerous older adults continue to value and engage in fulfilling sexual relationships. Unfortunately, targeted interventions to support later-life sexuality are lacking, creating gaps in care.

Intervention: Sexuality in older adults is influenced by biological, psychological, and social factors. Clinicians should include comprehensive sexual health assessments, including STI screenings, as part of routine care. Providing age-appropriate sexual education and resources helps promote lifelong sexual wellness. Open communication between healthcare providers and patients is vital for addressing sexual concerns, often left unspoken due to stigma or discomfort. Additionally, adopting lifestyle medicine principles-such as balanced nutrition, regular exercise, stress management, and social connection-can enhance sexual health and overall well-being.

Conclusion: Specialized training for healthcare professionals on the unique aspects of older adult sexuality is essential to bridge knowledge gaps. A holistic, evidence-based approach will empower providers to better support the evolving sexual health needs of older adults, improving their quality of life.

The aim of this pilot was to assess the feasibility and acceptability of virtual Narrative Healing Circles (NHC), a new form of Shared Medical Appointments (SMA) among mixed diagnosis population within an urban tertiary academic medical center.

Methods: Multi-method, voluntary recruitment of eligible patients, included referrals, flyers, hospital events page, and patients who participated in an ongoing 7-week integrative oncology SMA series. Two physicians (lifestyle medicine and chaplaincy specialists), both trained in narrative medicine, co-led one-hour long virtual NHC SMAs held every other week for a total of either 4 or 8 sessions. Sessions included a centering meditation, brief check-in, topic introduction, short writing exercise initiated with a written, musical, or visual prompt, followed by time of sharing and listening. Optional electronic pre and post participant surveys were emailed at enrollment (7-questions, response rate 29%) and after 4-8 NHC SMA sessions (12-questions, RR 34%).

Results: Virtual NHC SMA were offered from 2/23/22-8/30/23 with 62 unique participants, 266 total visits. Average age: 57 years (range: 27-84 years). Gender: 85% Female, 15% Male; Ethnicity: 73% White, 16% African American, 6% Asian, 5 % Hispanic. About half lived in underserved areas (Harlem, Bronx, Queens, Brooklyn). Payor mix included 40% Medicare, 60% Commercial insurance. Session attendance: 6 participants (mean); 1-13 (range). The number of sessions attended ranged between 1-28 sessions. Anxiety or fear (89%), depression (61%) and pain (67%) were the top 3 symptoms reported in the pre-survey. After 4-8 sessions, participants reported improvements in anxiety/fear (43%), sadness/depression/hopelessness (33%), irritability/stress (33%), isolation/loneliness (33%). They reported several positive changes: restarting yoga or meditation practice, greater focus on awe, journaling, increased mindfulness, and feeling better equipped to manage stress. 94% reported goals met, 95% would recommend the series to others. The 2 clinician leaders reported increased empathy, personal well-being, and work satisfaction.

Conclusion: Virtual NHC SMA series among mixed diagnosis population is feasible, positively affects patients' agency and well-being, and acceptable to patients and providers. A more formal study design with broader representation of diverse population and assessment of causality such as an RCT with longer follow-up is recommended.

There is abundant evidence about the impact of physical activity on health. Many of the clinical guidelines include physical activity as a strong recommendation in treatment plans to optimize health outcomes; however it is necessary to consider the interaction between medications and physical activity. There are certain medical conditions, including cardiovascular disease, diabetes, pain and urinary incontinence that may directly impact physical activity as well as medications for those conditions can affect how a person can be physically active. Having individualized conversations with patients to determine ways to incorporate physical activity into their lives may lead to healthier outcomes.