American Journal of Lifestyle Medicine最新文献

Objective: To evaluate cumulative lifestyle-related chronic diseases and self-reported physical and mental health in low back pain (LBP) patients presenting to physiatrists and spine surgeons, and to assess outcomes following spine surgery in patients with and without lifestyle-related chronic disease(s).

Design: This retrospective study included 4444 patients presenting for evaluation of LBP with physiatrists (n = 3282/4444) or spine surgeons (n = 1162/4444) from 4/1/2019-7/1/2021. Lifestyle-related chronic diseases and PROMIS-10 scores were collected. Length-of-stay (LOS), post-operative events, and persistent post-operative pain within 3 months were collected for surgical patients.

Results: 60.8% (n = 2704/4444) of patients had lifestyle-related chronic diseases; overweight/obesity was most common (56.8% [n = 2131/3755]). Patients evaluated by spine surgeons had more lifestyle-related chronic diseases than those evaluated by physiatrists. Increasing numbers of lifestyle-related chronic disease were associated with lower PROMIS-10 physical and mental health scores (P < .001). For surgical patients, LOS was greater for increasing numbers of lifestyle-related chronic diseases (P = .008). Post-operative events and persistent pain rates were similar in patients with and without lifestyle-related chronic disease.

Conclusion: Lifestyle-related chronic diseases were common in this cohort and more prevalent in patients evaluated by spine surgeons, highlighting the need for pre-surgical health optimization. Future work should prospectively investigate lifestyle metrics, patient-reported outcomes, and post-operative events following standardized lifestyle medicine program implementation.

Background: Multiple studies link dietary patterns to cancer risk and survivorship outcomes with cancer-specific guidelines focusing on fiber and plant-rich, minimally processed diets. Additionally, patients frequently report unmet needs for dietary counselling. There is limited data on oncologists' knowledge and attitudes towards this evidence and whether it influences their clinical practice. Methods: A 25-question survey was distributed to oncology professionals with 150 evaluable responses. The survey assessed respondents' demographics, personal dietary choices, knowledge of dietary guidelines, and practice behaviors. Responses were analyzed using descriptive statistics and Fisher's exact and Pearson's Chi-squared tests. Results: Most respondents considered dietary choices important for cancer risk reduction (77.4%), during treatment (66.7%) and for survivorship (76.6%), with 23.3% referring all patients to a dietitian. Barriers to implementing dietary counselling included lack of time (66.7%) or knowledge (54%), or resources (54.7%) or lack of reimbursement (22%). Oncologists following plant-based dietary patterns were more likely to value dietary counselling, engage in self-directed learning, and perceive diet as relevant throughout the cancer care continuum. Conclusions: Despite established dietary guidance, significant gaps in training and practice persist. Enhancing nutrition education, increasing access to resources, consistent reimbursement of dietitian appointments, and generating robust clinical evidence are essential to support oncologists.

Alzheimer's Disease (AD) and related dementias, encompassing primarily neurodegenerative but also mixed etiologies, represent a mounting public health concern expected to affect over 15 million Americans by 2060. This review synthesizes emerging evidence on how Lifestyle Medicine can meaningfully reduce risk and slow the progression of dementia. While genetic factors contribute to AD, mounting data highlight the central role that modifiable lifestyle factors, including nutrition, physical activity, sleep hygiene, stress management, social and cognitive engagement, and sensory health, play in its pathogenesis and trajectory. Mediterranean-type diets, regular exercise, robust sleep, stress mitigation, and social connectedness are associated with lower dementia risk, while smoking, excess alcohol, and chronic psychological stress elevate risk. Integrative strategies, such as mindfulness meditation and sensor-based digital monitoring, hold promise for individualized prevention and care. Culturally informed, holistic approaches addressing structural barriers and supporting caregivers are critical for equitable dementia prevention. This review presents compelling evidence that Lifestyle Medicine implemented in tandem with emerging technologies offers a scalable, cost-effective, and patient-centered framework for reducing the impact of AD and related dementias while enhancing well-being among patients, families, and communities.

Preserving brain health is essential to maintaining quality of life and cognitive function with age. Exercise plays an essential role. Aerobic exercise such as running and cycling can enhance brain plasticity through increasing gray matter volume in the cerebellum and temporal lobe, as well as the density of connections in the brain's frontal and motor areas via upregulating brain-derived neurotrophic factor (BDNF) and serotonin systems. Anaerobic exercise, such as weightlifting, primarily increases gray matter volume in the basal ganglia and increases the density of connections in the posterior lobe of the cerebellum. In midlife, aerobic exercise can increase white matter integrity and cortical thickness in primary motor and somatosensory areas, while in older age it improves specific markers of cognitive function, such as episodic memory. With regards to neurodegenerative diseases, aerobic exercise has been linked to improved memory performance and reduced hippocampal atrophy in Alzheimer's disease. In Parkinson disease, aerobic exercise has shown to reduce brain atrophy, improve motor function and cognitive control, while anaerobic exercise improves motor performance and information processing. Overall, both aerobic and anaerobic exercises are integral and complementary to preserving brain health through effects on cognitive function and brain structure.

Objective: To identify statements of consensus on integrating lifestyle medicine (LM) into treating major depressive disorder (MDD) in adults to improve quality of care and patient health outcomes. Methods: Experts in MDD, primary care, and behavioral health followed an a priori protocol for developing consensus statements. Using an iterative, online Delphi process, panel members reported levels of agreement, and statements were classified as consensus, near consensus, or no consensus. Results: The panel identified 102 candidate statements addressing: (1) MDD and Lifestyle Risk: Assessment and Treatment, (2) Evaluation, Diagnosis, and Special Populations, (3) Nutrition and Gut Health, (4) Physical Activity, (5) Sleep, (6) Connectedness, (7) Substances and Environmental Factors, (8) Adherence to Treatment and Optimizing Treatment. After 3 iterations of an online Delphi survey, revisions, and removal of duplicative statements, 71 statements met criteria for consensus, 10 for near consensus, and 21 for no consensus. Consensus was reached on key topics that included the importance of lifestyle interventions for treatment and prevention of MDD, strategies for adoption, and benefits for health outcomes and treatment success. Conclusion: Using lifestyle interventions for treating MDD can be strengthened by applying these statements to improve quality of care, inform policy, and identify areas for future research.

Erectile dysfunction (ED) is common and becomes more prevalent with age. The most common form of ED, atherogenic, is considered "the canary in the coal mine" for coronary artery disease, as it is a harbinger of angina and myocardial infarction. Given the smaller size of the penile artery relative to the coronary arteries, atherogenic ED often precedes coronary events by 2-5 years. Diet, exercise, and treatment of sleep apnea have the potential to improve and even reverse arteriogenic erectile dysfunction by, in part, decreasing oxidative stress and inflammation, thereby increasing nitric oxide bioavailability and improving vascular function. The potential for lifestyle changes to improve erectile function may prove uniquely motivating for patients to make such changes.

Background: Sleep is a foundational pillar of health, influenced by numerous genetic, behavioral, lifestyle, and environmental factors. As non-pharmacologic strategies gain prominence, evidence-based approaches are needed to guide clinical practice. Methods: This expert narrative review synthesizes findings from observational studies, randomized trials, meta-analyses, and clinical guidelines, emphasizing the importance of lifestyle and behavioral interventions for sleep enhancement. Topics include sleep hygiene, circadian rhythm regulation, cognitive behavioral therapy for insomnia (CBT-I), exercise, nutrition, substance use, menopause, and consumer sleep technology. Results: Key findings support the importance of circadian alignment through light exposure, sufficient sleep quantity and timing, and behavior modification in sleep health. Exercise and weight management benefit general sleep quality and specific conditions like obstructive sleep apnea. While nutrition shows mixed direct effects on sleep, Mediterranean and low-glycemic diets are associated with fewer insomnia symptoms. CBT-I is a first-line treatment for chronic insomnia. Substances such as alcohol, cannabis, and caffeine exert varied and potentially deleterious effects on sleep regulation. Conclusion: Sleep is critical in health. Multidimensional behavioral interventions offer significant potential for improving both sleep quality and quantity. Clinicians should integrate these low-risk strategies into patient care to address the growing burden of sleep disorders and to promote overall well-being.

Oklahoma has a high rate of chronic disease in comparison to other states in the U.S., currently ranking among the top five worst states for heart disease, chronic lower respiratory disease, cancer, diabetes, and maternal mortality. The purpose of this study was to evaluate the lifestyle medicine (LM) program at a local hospital system in Tulsa, Oklahoma, a health system that serves a patient population with notable health disparities. This mixed-methods evaluation assessed patient data from a representative sample of 63 patients across six distinct cohorts. Quantitative data included pre/post biometric data and pre/post-self-efficacy assessment. SPSS (V29) was used to analyze all quantitative data via descriptive statistics and paired t-tests. Qualitative data were gathered via interviews and focus groups; all interviews were audio-recorded and transcribed verbatim. MAXQDA was used to analyze qualitative data. Results reveal significant weight loss and significant increases in knowledge, self-efficacy, and health behavior change among patients. The findings of this study support the recommendation that Oklahomans should have increased access to LM interventions in hopes of experiencing significant shifts in improved health outcomes and reduced chronic disease risk factors for individuals and at the community level when such interventions are implemented at scale.

Background: Lifestyle behaviors are a potential adjunctive treatment for depression in emerging adults (18-25 years), but the combination of behaviors associated with depression remains unclear. Methods: 2,019 emerging adults from the National Health and Nutrition Examination Survey between 2011 and 2018 were selected. Latent class analysis (LCA) identified patterns of lifestyle behaviors (diet [Dietary Inflammatory Index], sleep [quantity/quality], physical activity, sedentary behavior, substance use [alcohol/smoking]). Multiple logistic regression examined associations between lifestyle patterns and depression. Results: LCA identified 6 male classes and 5 female classes. Compared to the Healthy reference group, males in the Poor Sleep Sedentary Drinkers (aOR [95% CI]: 4.40 [1.10, 17.55], P = 0.032) and Pro-inflammatory Diet (PID) Smokers Drinkers (aOR [95% CI]: 6.11 [1.94, 19.25], P = 0.002) groups and females in the PID Smokers Drinkers (aOR [95% CI]: 4.96 [2.07, 11.89], P < 0.001), Trouble Sleeping (aOR [95% CI]: 6.65 [2.17, 20.33], P < 0.001), and PID Sedentary (aOR [95% CI]: 4.74 [1.37, 16.35], P = 0.012) groups had increased odds of depression. Conclusions: We found unique sex-specific lifestyle patterns associated with depression (males: diet, sleep [quantity/quality], sedentary behavior, substance use; females: sleep quality). Lifestyle behaviors should be comprehensively targeted to prevent and treat depression in emerging adults.

Brain health is profoundly influenced by lifestyle factors, offering promising avenues for the prevention and mitigation of various brain health issues, including age-related cognitive decline. This review examines evidence on how key lifestyle modifications, including diet, exercise, sleep, stress management, social engagement, exposure to toxic environmental factors, risky behaviors, and cognitive training, affect brain health. Historical background is provided, but original articles published within the past 6 years that discuss lifestyle medicine are the focus of this review. The main topics covered are how Mediterranean, Nordic, and vegetarian diets support cognitive resilience, how physical exercise (aerobic and anaerobic) enhances neuroplasticity, and explain sleep's role in metabolic clearance. In contrast, persistent stress leads to hippocampal atrophy, and toxic environmental exposures and head injury increase dementia risk. Other lifestyle modifications, such as meditation and social support, can mitigate these impacts. Cognitive reserve, built through lifelong learning and social interaction, provides resilience against neurodegeneration. While these strategies on their own hold value, personalized multimodal interventions have proven to be the most effective approach for promoting overall brain health and attenuating age-related cognitive decline.