American Journal of Lifestyle Medicine最新文献

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.

[This corrects the article DOI: 10.1177/15598276251337412.].

Background: While physical activity is associated with improved mental health, many medical students fail to meet recommended exercise guidelines. Understanding how exercise relates to wellness indicators in this population may help guide the development of targeted wellness interventions that promote sustainable health behaviors. Objectives: This study aimed to: (1) assess the prevalence and characteristics of physical activity among medical students; (2) examine associations between exercise behaviors and wellness indicators. Methods: A cross-sectional survey was administered to M.D. students at a U.S. medical school. The survey included validated measures to assess exercise habits, burnout, stress, quality of life, social support, and sleep. Statistical analyses included descriptive statistics, t-tests, Fisher's exact tests, and multiple linear regression. Results: Among 82 respondents, only 34.2% met both aerobic and strength training CDC guidelines. These students reported significantly lower stress, higher quality of life, and greater friend support compared to peers who met neither guideline. Individual exercise was associated with lower stress, less burnout, and higher quality of life than group exercise, despite the latter being linked to greater social support. Conclusions: In advocating for interventions that support student wellbeing and the development of sustainable health habits, medical schools can help contribute to long-term student wellness.

Nutrition is a core pillar of Lifestyle Medicine with growing relevance to mental and behavioral health. While traditionally emphasized for cardiometabolic disease prevention, emerging evidence demonstrates that dietary patterns directly influence mood, cognition, stress resilience, and emotional regulation. This article synthesizes current research on biological pathways linking food and mental health-including the gut-brain axis, microbiome diversity, neurotransmitter synthesis, inflammation, and dietary pattern interventions. A diverse and balanced microbiome, adequate intake of omega-3s, B vitamins, and trace minerals, and diets low in inflammatory foods support healthier brain signaling and improved emotional stability. Clinical trials show that Mediterranean and plant-forward diets reduce depressive symptoms, while micronutrient supplementation enhances attention, emotional regulation, and stress response across the lifespan. Nutrition is also a critical but underutilized component of substance use recovery and child and adolescent behavioral health. Cultural food traditions further shape well-being by reinforcing identity, belonging, and resilience. Integrating nutrition screening, counseling, and food-as-medicine interventions into behavioral health care can strengthen treatment outcomes, especially when aligned with culturally informed practices and community needs. Systems-level approaches-including policies addressing food insecurity and produce prescription programs-demonstrate meaningful improvements in mental health. Overall, nutrition represents a powerful, accessible, and culturally resonant strategy to support emotional, cognitive, and behavioral well-being.