American Journal of Lifestyle Medicine最新文献

The Ottawa Charter for Health Promotion, issued by the World Health Organization in 1986, called for several strategies to promote the public's health. One of the strategies was to create health-promoting health services. Over 35 years have passed since the Ottawa Charter was released, since then, efforts to improve health care have been implemented such as the Patient-Centered Medical Home, the Triple Aim, and the Affordable Care Act, yet little has been done to reorient the cultural and physical environment of health care services to one focused on health promotion. In this perspective, the author offers a compelling description of how one primary care clinic, serving an ethnically and economically diverse population, utilized a settings-based approach to design and implement several health-promoting policies, systems, and environmental strategies. This reorientation of a primary care clinic to one that is health-promoting leveraged the clinical specialty of lifestyle medicine as a cornerstone of the settings-based approach.

Adopting a plant-based diet (PBD) has environmental sustainability benefits and has been shown to improve overall health and quality of life, yet for most people a diet shift towards a plant-based one remains a challenge, due to personal and environmental obstacles. Important independent decisions on self-care and nutritional habits occur in the first year of enrollment for college students. This cross-sectional quantitative study aims to examine the association between health beliefs, motivators, barriers, self-efficacy, and mental health status and following a more PBD in college students. A total of 449 Californian public university and junior college students completed an online survey. A stepwise multiple regression model was used to predict the level of intention to follow a PBD. Self-efficacy (β = 0.28, P < .001), motivators (β = 0.33, P < .001), and barriers (β = -0.19, P < .001) significantly predicted and accounted for 35% of the variance in intention to follow a PBD. The results reveal that greater self-efficacy, higher motivation, and fewer barriers predicted higher intention to follow a PBD. Beliefs did not add significantly to following a PBD.

Purpose: The study was to evaluate the physical condition and mental health of Chinese college student COVID-19 survivors, and to perform severity clustering of physical symptoms. Participants: The study finally included 1912 Chinese college students. Methods: A total of 33 symptoms including general physical symptoms, cardiopulmonary system, digestive system, neurological system, mental health and other symptoms were investigated three months after recovery from COVID-19, and these symptoms are identified using latent class analysis. Results: Three clusters were identified through latent class analysis: 13.2% with severe impairment (cluster 1), 27.2% with mild physical symptoms (cluster 2), and 59.5% with no or mild symptoms (cluster 3). The students who smoked, drank alcohol, did not exercise, or had a history of underlying medical conditions were more likely to have moderate to severe symptoms. Conclusions: Young COVID-19 survivors with a history of underlying diseases and unhealthy habits are more likely to have moderate to severe COVID-19 sequelae. Varying degrees of symptoms should be treated with different rehabilitation plans.

Glucagon-like peptide agonists (GLP-1) are highly effective anti-obesity medications. However, sustained effectiveness is potentially plagued by lack of adherence to the drug and resumption of pre-weight loss behaviors. Side effects are primarily severe gastrointestinal distress but can occasionally be more serious. Health and well-being coaching (HWC) is an important obesity intervention that can be used alongside GLP-1 prescription. HWC is documented to improve medication adherence and promote healthy behavior change. A coach who understands the complexities of rapid weight loss, specifically with GLP-1, can help the patient persist with the treatment. Moreover, the coach can assist in navigating GLP-1 side effects including undesirable loss of skeletal muscle during the weight loss period. A patient-centric and collaborative relationship seem essential to the HWC process. Specific coaching techniques are suggested for working with patients losing weight. The logical, but yet to be tested, expectation is that HWC as an adjuvant intervention to GLP-1 prescription will improve medication adherence and encourage sustained weight loss and health benefits in patients with obesity.

Transition from adherence to habit formation is critical for promoting sustainable dietary changes among older adults. While adherence to health regimens often relies on conscious effort and external motivation, habits are automatic behaviors triggered by consistent cues, reducing the need for ongoing effort. A common misconception is that older adults cannot form new habits due to cognitive decline with age. However, older adults possess valuable strengths, such as strong self-regulation and the ability to delay gratification, that make them well-equipped for habit formation. This commentary outlines how healthcare providers can leverage these strengths of older adults and employ a cue-behavior-reward loop to help them integrate consistent, sustainable dietary changes.

Posttraumatic stress disorder (PTSD) and substance use disorders (SUDs) frequently co-occur, and individuals with co-occurring PTSD and SUD often experience more complex treatment challenges and poorer outcomes compared to those with either condition alone. Integrative treatment approaches that simultaneously address both PTSD and SUD are considered the most effective and include both pharmacological and non-pharmacological strategies. In recent years, complementary interventions have garnered increased attention due to their broad appeal and potential therapeutic benefits in enhancing existing treatments for PTSD and SUD. This review explores the existing literature on the use of nature-based activities, such as hiking, camping, sailing, and surfing in treating individuals with co-occurring PTSD and SUD. Nature-based activities offer promising adjunctive benefits, including the reduction of PTSD symptoms and craving levels. While evidence supports the therapeutic value of nature-based activities, current research remains limited. Further research is needed to better understand their therapeutic role and to refine their implementation in clinical practice.

Lifestyle Medicine emphasizes evidence-based lifestyle changes to address chronic conditions Yet, concerns have emerged regarding its ability to address broader social determinants of health (SDoH). This study examines how family physicians' perceptions of SDoH relate to their use of lifestyle medicine competencies. This cross-sectional survey was administered to 5770 family physicians. Participants rated the importance of LM core competencies and the impact of community conditions on patient health. Data analysis involved descriptive statistics, factor analysis, regression models, and t-tests. This study encompassed 447 responses. The findings revealed that while respondents recognized the effect of certain SDoH, such as access to unhealthy food (89%), alcohol (86%), and tobacco (83%), they showed less awareness of factors like racism and discrimination (53%), and access to parks (56%) or education (60%). Gender and the level of social deprivation in their area were significant factors influencing respondents' perception of SDoH impact. Additionally, those who valued and used lifestyle medicine core competencies were more likely to acknowledge the influence of SDoH on patient health. Our findings suggest that comprehensive education on SDoH, especially with a focus on community aspects, is crucial across all levels of medical training to address this gap and ensure equitable care.

Lifestyle physical activity (LPA) interventions emphasize small bouts of movement that can be flexibly integrated into one's everyday routine. Despite research illustrating benefits for LPA on health outcomes, few LPA interventions and measurement tools have been developed and tested. The purpose of this study was to present a novel LPA self-report scale, including its content, scoring, and internal consistency reliability, and summarize its intervention responsiveness. The LPA scale was administered in a pilot randomized controlled trial that tested a 12-week LPA + Fitbit intervention against a health education (HE) control (matched to LPA + Fitbit on contact time) in a sample of 50 women with depression in alcohol treatment. The LPA scale includes 22 items covering five domains relevant to LPA. Results demonstrated good internal consistency reliability for the total score (ω = 0.84) but poor-to-acceptable internal consistency reliability for the domain scores (ω range: 0.43-0.80). Participants randomized to the LPA + Fitbit intervention had significantly greater improvements in the LPA total score and two domain scores compared to HE participants. Overall, results demonstrate good internal consistency reliability and intervention responsiveness of the LPA scale total score. A larger, more comprehensive psychometric evaluation is needed for validation of this scale.

Introduction: Polypharmacy-defined as taking numerous medications that may not be clinically necessary-is becoming a significant concern among the older adult population. This study examined the associations between lifestyle behaviors and the number of prescribed medications in older adults (75 years and older) living in the counties of San Bernardino and Riverside.

Methods: This study employed a cross-sectional survey to assess lifestyle behaviors and medication use in 611 older adults aged 75 or over. Bivariate correlation and linear regression analyses were used to assess potential relationships between lifestyle behaviors and the number of prescribed medications.

Results: Fruit consumption (P = 0.005), mild physical activity per week (P < .001), and lifestyle index (P = 0.003) had a highly significant inverse association with the number of prescribed medications. Fat consumption had a direct positive relationship with the number of prescribed medications (P = 0.02).

Conclusion: Higher fat intake was directly linked to an increased need for medications, while regular physical activity, a higher fruit intake, and a healthy overall lifestyle were all associated with a lower likelihood of polypharmacy. Future research can explore the mechanisms linking these behaviors with medication usage.

Introduction: Rheumatoid arthritis (RA), a debilitating autoimmune disease, affects approximately 78 million people globally. RA is often managed solely by rheumatology providers, but an interdisciplinary approach to RA may be the key to improving health equity and outcomes. An interdisciplinary model is an important step towards this goal. The Biopsychosocial Model of Disease Experience in RA (BDRA) is a conceptual approach that considers individual disease determinants in interdisciplinary research and care.

Objective: To introduce and critique the evidence-based, interdisciplinary BDRA.

Methods: Engel's Biopsychosocial Model of Health (BMH) and the Revised Symptom Management Conceptual Model (RSMCM) were blended in the BDRA. A literature search of articles published prior to December 2021 was completed using "disease exacerbation," "disease improvement," and "disease activity" in RA. Results were categorized as biological, psychological, and social determinants of disease activity in RA. These biopsychosocial factors alter biological function and result in the individual RA experience. Model development and critique were completed using guidelines established by Walker and Avant.

Conclusion: The BDRA is a visual depiction of RA biopsychosocial factors, disease activity, and individual experience. This model can guide interdisciplinary research and patient care, in efforts to improve RA health equity and rates of sustained remission.