American Journal of Lifestyle Medicine最新文献

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.

Introduction: Complementary health (CH) modalities can be used as part of a Lifestyle Medicine (LM) approach to preventing and managing chronic conditions.

Methods: This cross-sectional study used data for respondents to the 2020 (N = 6,715) and 2014/2015 (N = 11,112) cycles of a Northern California health plan member survey to estimate use in 2020 of five CH modalities relevant to LM: vegetarian/vegan diet, mind/body stress management techniques (MBSM), yoga/Pilates, massage therapy, and prayer/spiritual practice. Use was estimated by sex and racial/ethnic group (White, Black, Latino, Asian/PI)) for ages 35-64 and 65-79 years and for adults 35-79 years with diabetes, hypertension, heart disease, fair/poor sleep quality, and chronic stress. CH use in 2020 was compared to 2014/2015.

Results: In 2020, 53% of adults used ≥1 of these CH modalities, including 8.4% vegetarian/vegan diet, 25.8% MBSM, 23.7% prayer/spiritual practice, 16.5% yoga/Pilates, and 17.7% massage. Sex, age group, and racial/ethnic differences were seen in use of most CH modalities, and CH modality use varied by health condition. Significant increases from 2014/2015 to 2020 were seen in use of MBSM and yoga/Pilates, vegetarian/vegan diet, and prayer/spiritual practice.

Conclusion: There is substantial opportunity to increase use of CH modalities within a LM approach to preventing and managing chronic health conditions.

Objective: Present study explored the influence of self-reported health on diff between observable and unobservable health factors.

Method: Data obtained through the 2017-2020 pre-pandemic dataset of the National Health and Nutrition Examination Survey (NHANES). A series of analyses of covariance were conducted with self-reported health as the independent variable, and measures of blood pressure, waist-to-hip ratio, fasting glucose and total cholesterol as dependent variables. Family income served as a covariate.

Results: Results revealed significant differences in self-reported health and blood pressure, waist-to-hip ratio, and fasting glucose. Individuals who rated their health excellent or very good tended to have better health numbers than those who rated their health as fair or poor. No statistically significant difference was found with self-reported health and cholesterol.

Conclusion: It is possible that health numbers that can be observed (or assessed) at home, without a health care professional, may be more aligned with how individuals perceive their own health. Health care professionals may want to further help patients recognize their own health status. The use of wearable technologies may provide added health information resulting in more accurate perception of health. A more accurate perception of a patient's own health may aid health care professionals in further improving patient care.

A call to action from the recently published Doha Declaration, including guiding principles for Lifestyle Medicine integration as an evolution to Lifestyle-First Medicine for global healthcare.