American Journal of Lifestyle Medicine最新文献

Drivers of population-level health in the United States (U.S.) are complex. This analysis refines an ecologic framework of health, employing artificial intelligence modeling to estimate the impact of slavery on present-day, population-level lifespan. This study utilized several U.S. county-level datasets with more than 40 predictive variables representing the ecological framework of health. A non-linear artificial intelligence statistical approach was used to assess the ability of these variables to predict county-level life expectancy, years of life lost and death rate. The R ² values demonstrated that the overall predictive performance of the models for life expectancy, years of life lost and death rates were all very strong, with mean R ² ≥ 0.71 in all 3 prediction models. The number of predictor variables retained in the models ranged from 31 to 46, with measures from each category of the ecological framework of health being retained. The historical prevalence of slavery on a county level was a significant, repetitive interactive term. Unhealthy lifestyle behaviors are a primary driver of chronic disease, ultimately leading to diminished quality of life and lifespan. These health challenges are not insurmountable if the true root causes and forcing factors of health are acknowledged, studied, and addressed.

As Lifestyle Medicine is increasingly recognized as a high-value model of care, clarifying how individual professions may contribute to that value is important. This article explores how pharmacists, as members of interprofessional Lifestyle Medicine teams, use their expertise in pharmacotherapy and patient-centered care to align medications and medication-taking behaviors with lifestyle-driven change. The article calls for a shift toward better documenting and measuring the value pharmacists bring to Lifestyle Medicine, as a necessary step toward more effective, sustainable, and equitable chronic disease care.

The continued burden of lifestyle-related chronic conditions poses a significant public health crisis in the United States. Occupational therapy (OT), with its foundational principles rooted in health promotion and prevention, is uniquely positioned to address this epidemic through the utilization of a complimentary therapeutic approach, lifestyle medicine (LM). This manuscript aims to illustrate OT as a key discipline for implementing LM and to demonstrate the integration of LM principles into OT curricula. By aligning LM principles with the 2023 Accreditation Council for Occupational Therapy Education (ACOTE) standards and using the Occupational Therapy Practice Framework - Fourth Edition (OTPF-4) as a guide, this paper provides a framework for equipping OT educators to prepare entry-level practitioners in addressing health promotion, chronic condition prevention, and health management. The incorporation of LM into OT education promotes a holistic, whole-person approach, in alignment with the origins of the profession and addresses the immediate need for equitable and sustainable health care strategies.

This systematic review assessed whether the "weekend warrior" (WW) pattern of physical activity provides neuroprotective benefits comparable to regularly distributed activity. Data sources PubMed, Embase, Web of Science, and Cochrane Library were searched from inception to December 2024 and updated in April 2025 (PROSPERO CRD42025638102). Eligibility criteria Observational studies reporting dementia, Parkinson's disease, depression, anxiety, psychological distress, or cognitive outcomes in relation to WW vs regular physical activity were included. Two reviewers independently screened studies, extracted data, and assessed risk of bias with ROBINS-E. Twelve studies comprising 614,882 participants met inclusion criteria. Both WW and regular activity were consistently associated with reduced risks of depression (adjusted OR/HR 0.46-0.79), psychological distress (OR ∼0.68), dementia (HR 0.68-0.75), and Parkinson's disease/parkinsonism (HR 0.44-0.69 regular; 0.47-0.58 WW) compared with inactivity. Three studies suggested protective associations with anxiety (OR/HR 0.63-0.77). Cognitive performance was higher among active individuals, with some subgroups (elderly women, sedentary adults) showing slightly greater benefit with WW. No study demonstrated superiority of one activity pattern over the other, and even subthreshold physical activity conveyed measurable protection. Risk of bias was generally low to moderate. Achieving ≥150 minutes of moderate-to-vigorous physical activity weekly, whether condensed into one to two WW sessions or distributed across several days, provides comparable neuroprotective benefits. These findings support flexible, patient-centered exercise recommendations and reinforce that some activity is always better than none.

Chronic kidney disease (CKD) is a major public health problem and the prevalence of CKD is substantially higher in older adults. Similarly insufficient sleep and abnormal sleep duration is more common among older adults. However, the relation between sleep duration and CKD has not been widely examined in older adults. We examined the association between long and short sleep duration and CKD in a large, multiethnic sample of older US adults aged ≥60 years (N = 178 268) who participated in the 2022 Behavioral Risk Factor Surveillance System. Sleep duration was categorized into 5 groups: ≤5, 6, 7, 8, and ≥9 h. Main outcome-of-interest was CKD (prevalence = 7.3%). We found both short and long sleep duration to be associated with higher prevalence of CKD. Compared to 7 hours of sleep (referent), the multivariable-adjusted odds ratio (95% confidence interval) of CKD was 1.32 (1.16-1.51) for 6 h of sleep, 1.55 (1.33-1.81) for ≤5 h of sleep, 1.27 (1.12-1.43) for 8 h of sleep, and 1.41 (1.23-1.62) for ≥9 h of sleep. The association was consistently present in subgroup analyses by gender, age, race/ethnicity, and body mass index. In conclusion, both short and long sleep durations are associated with CKD in older adults.

Fibromyalgia is a complex, chronic disorder characterized by widespread musculoskeletal pain, fatigue, sleep disturbances, and cognitive dysfunction. While pharmacologic treatments remain the mainstay of symptom management, their long-term efficacy is limited and often accompanied by undesirable side effects. As a result, there is growing interest in non-pharmacologic interventions, particularly dietary therapies. Emerging literature suggests that whole food plant-based (WFPB) diets, which emphasize fresh fruits, vegetables, legumes, and whole grains while eliminating animal products and processed foods, may reduce systemic inflammation, improve pain thresholds, and enhance overall quality of life in chronic pain populations. Preliminary studies have shown promising associations between plant-based eating patterns and reductions in pain, fatigue, and depressive symptoms in fibromyalgia patients; however, evidence remains limited by small sample sizes, heterogeneous dietary definitions, and varying outcome measures. This literature review synthesizes current evidence on the potential role of WFPB diets in fibromyalgia management, highlights biological mechanisms underlying dietary influence on pain and inflammation, and identifies methodological gaps in the literature. By synthesizing and critically evaluating existing literatures, this review is both an exploratory commentary and a call for further research on the role of WFPB diets in fibromyalgia.

The United States continues to face rising healthcare costs, with Federally Qualified Health Centers (FQHCs) disproportionately affected by the complexity of the populations they serve. Traditional payment models often fail to reflect these realities, limiting value-based care. This article describes a 4-year value-based care pilot at Waianae Coast Comprehensive Health Center, developed with a nonprofit Medicaid health plan and supported by artificial intelligence (AI) and natural language processing (NLP) analytics. The pilot aligned payment with population complexity and total cost of care management using predictive risk and impactability analytics embedded in clinical workflows. By integrating claims data with NLP-derived insights from unstructured clinical notes, the model identified high-risk patients and delivered targeted lifestyle and enabling services, including food-as-medicine interventions. In the first year, services delivered to 884 patients reduced total costs by $806,208 while maintaining access and quality. A produce prescription program generated net savings of $118 per patient per month alongside improvements in hemoglobin A1c. Over 4 years, the approach served more than 3000 patients, generating approximately $4 million in sustained savings. These findings demonstrate that value-based care can succeed in FQHCs when supported by accurate risk adjustment, advanced analytics, and payer-provider collaboration, positioning lifestyle medicine as a cost-effective strategy.

Stroke is a leading cause of mortality and disability, affecting approximately 13.7 million individuals globally each year. It is broadly classified as ischemic or hemorrhagic and often results in cognitive, motor, and emotional impairments. Lifestyle interventions are associated with lower stroke risk and recurrent events, and are core to guideline-based prevention; effect sizes vary by risk factor, adherence, and setting. This review begins with the pathophysiology of stroke, focusing on the roles of sex hormones, genetics, environment, and lifestyle. We then outline how lifestyle interventions can aid in primary and secondary prevention of stroke by targeting modifiable risk factors responsible for approximately 90% of stroke risk, including hypertension, diabetes, high cholesterol, poor diet, sedentary behavior, abdominal obesity, psychological stress, smoking, cardiac causes, and alcohol use. We also discuss clinical implementation, policy strategies, health equity, cost-effectiveness, and future directions. These insights highlight the critical role of lifestyle medicine in stroke prevention, aimed at reducing the global stroke burden.