American Journal of Lifestyle Medicine最新文献

Background: Anabolic-androgenic steroid (AAS) use is rising globally. However, age-related differences in harms and health care access barriers remain underexplored. As such, this study examined age-based differences in AAS-related harms and access to support services. Methods: The sample (N = 1146) comprised men who reported AAS use within the prior 12 months, stratified into 2 age groups (<40 years and ≥40 years). Chi-square analyses were conducted to examine age-related differences in physical health concerns, psychosocial issues, and barriers to health care access. UpSet plots were used to visualise co-occurrence patterns within each domain. Results: Younger men who use AAS were significantly more likely than older men who use AAS to report psychosocial concerns, including anger and depression (all χ ² s > 4.0, all ps < .045). They also reported higher rates of physical concerns, including hair loss and fertility issues (all χ ² s > 6.3, all ps < .012). Access difficulties were also more prevalent among the younger men (χ ² s > 4.0, ps < .046), particularly with pharmacies and hospitals. Conclusions: Younger men who use AAS appear to face greater burden and complexity than older men who use AAS, underscoring the need for targeted harm reduction strategies and improved service engagement pathways tailored to peoples' age.

Non-communicable diseases (NCDs) are the leading cause of illness and death worldwide, and in Qatar, their burden is rising due to rapid urbanization, shifts toward Westernized diets, sedentary lifestyles, and cultural influences. Using data from the Global Burden of Disease Study 2021, this study examined the NCD burden in Qatar, including the burden of cardiovascular diseases, type 2 diabetes, cancer, chronic respiratory diseases, neurological conditions, and mental health disorders attributable to dietary risks, low physical activity, smoking, and high body-mass index (BMI). In 2021, lifestyle-related risk factors were responsible for 64.8% of NCD deaths and 33.2% of DALYs in Qatar. High BMI emerged as the top contributor, accounting for 24.5% of deaths and 13.9% of DALYs, followed by poor diet and smoking. The burden of high BMI-related NCDs increased over the past 30 years, with a 71.4% increase in deaths and a 54.3% rise in DALYs, while the impact of smoking declined. Compared to other Gulf Cooperation Council countries, Qatar had a higher NCD burden, particularly for cardiovascular diseases and diabetes linked to obesity. These findings highlight the need for coordinated public health action, aligned with Qatar's National Health Strategy and the Doha Declaration on Lifestyle Medicine.

Background: Lifestyle medicine (LM) is gaining recognition in medical education. Université Laval, a Francophone university, is the first university in Canada to implement the Lifestyle Medicine Residency Curriculum (LMRC) developed by the American College of Lifestyle Medicine. This study aimed to evaluate the feasibility of implementing LM training for family residents in Quebec City.

Method: Eight mentors adapted the English LMRC to Quebec's healthcare and cultural context while maintaining its core content. In September 2022, 16 family medicine residents participated in the program. Mentors collaborated with program directors to develop French-language materials, contextualize content, and create an online LM platform. Feedback from residents and mentors was collected through surveys, focus groups, and informal discussions to guide continuous improvements.

Results: Fifteen of 16 enrolled residents completed the program. Average attendance at monthly sessions was 70 %, with absences mainly due to night shifts or regional rotation. Resident showed strong engagement, with 100% completing modules asynchronously. Key factors for successful implementation included faculty mentors' and residents' engagement, and French-language materials tailored to the Quebec healthcare system. Challenges included limited French LM resources and a lack of co-located interdisciplinary teams. Strategic solutions involved creating a centralized online platform, protected learning time, aligning the program with existing curricula, and partnerships with community programs.

Conclusion: Implementing LMRC demonstrated the feasibility of integrating LM training into a Francophone family medicine residency. Lessons learned may inform broader adoption in diverse linguistic and cultural settings.

Despite high health care expenditure, the United States reports a steady increase in maternal mortality. Chronic lifestyle diseases that complicate pregnancy can be improved through lifestyle medicine. Though lifestyle medicine is supported across multiple medical disciplines, minimal physician knowledge and time constraints limit its implementation. Group visits are an effective way to promote lifestyle medicine. Two new group visit models that integrate lifestyle medicine into perinatal care are described. Conscious Motherhood (CM) is an 8-week group visit program implemented at an FQHC that focuses on managing chronic conditions diagnosed during pregnancy. The second program is a resident-led listening session following a validated state group visit curriculum that seeks to reduce black infant and maternal morbidity/mortality. Among CM participants, several patients with an elevated BMI lost approximately 10-25 pounds, two were deprescribed long-term antihypertensive medication, and others reported regularization of irregular menses and improvement of fibromyalgia. Eighteen patients and 5 physician trainees participated in the first 18 months of CM. For the state group listening session, attendance averaged 4-5 unique attendees at each session. Group visits centered in lifestyle medicine may help reduce maternal chronic disease, improve perinatal outcomes, and train medical professionals in lifestyle-oriented care.

In the United States, women face greater risks of death in pregnancy and childbirth than women in other wealthy countries. This is influenced by preventable conditions like hypertension, substance use disorders, and diabetes mellitus. The risk is greater for women from diverse, low-income communities. Lifestyle medicine (LM) can help prevent and reverse the effects of chronic diseases. LM Physicians can reduce the occurrence of preventable diseases by counseling patients to make choices to improve their health outcomes. Access to LM is often a challenge for low-resource populations. This article outlines an intervention in 1 low-resource county, San Bernardino, where a full-time Patient Navigator (PN) assisted at a Federally Qualified Health Care Centre (FQHC) to improve patient engagement with women's health clinics through appointment scheduling, reminders, and rescheduling to virtual appointments as needed. Throughout an 18-month period, the women's clinic saw a 4-fold increase in appointments with help from the PN, who followed up with no-shows, offered phone consultations, and was key in problem-solving barriers to care. The clinics were scaled and included the addition of residents who could participate in LM training supervised by a LM Physician, gaining insight into needs among low-resourced communities. This demonstrates a scalable model for increasing access to LM interventions for women in low-resourced communities, as well as allowing trainee clinical experiences in priority populations.

Lifestyle-related factors and obesity contribute significantly to the burden of chronic disease. In response, Loma Linda University Health (LLUH) implemented the Lifestyle Medicine Residency Curriculum (LMRC) and launched a lifestyle and obesity medicine (LOM) consultation clinic within its family medicine (FM) residency program. The LOM clinic was embedded within a Federally Qualified Health Center (FQHC) affiliated with LLUH. It expanded from a biweekly half-day clinic to a weekly half-day model with 21 appointment slots per session to achieve financial sustainability. Key stakeholders were engaged across the FQHC and LLUH obesity medicine teams. In June 2024, senior residents were surveyed to evaluate educational impact and perceived value of the clinic experience. Quality improvement efforts established electronic referrals, standardized assessments, documentation templates, and a scheduling system to streamline operations. Ongoing challenges included non-unified nutrition messaging, social and psychological barriers to behavior change, and systems-level constraints related to staffing, education, space, and access. The LOM clinic model demonstrates operational scalability and sustainability within a residency-based FQHC setting. Early outcomes suggest it enhances resident engagement, supports patient-centered chronic disease management, and may serve as a replicable framework for other institutions integrating lifestyle medicine into primary care training and underserved settings.

Background: Physician burnout, recognized in ICD-11 as an occupational phenomenon from chronic workplace stress, remains under-addressed in residency training. Lifestyle medicine (LM) provides practical tools at individual and system levels, though applications for residents are not well documented. Objective: To describe LM interventions across 3 levels at 1 academic center: (A) institution-wide well-being programming, (B) program-level systems changes with retention outcomes, and (C) an individual Plan of Action for Resilience (PAR) with resident well-being scores. Methods: Approaches were consolidated into one framework. (A) Chief wellness residents and coordinators characterized well-being activities across 34 programs; (B) on-time graduation, late graduation, and attrition rates were compared before and after systems changes including LM education and protected time; (C) residents completed the Mayo Clinic Resident & Fellow Well-Being Index (RF-WBI) with PAR at baseline and 6-12 months, matched anonymously. Results: (A) All programs reported at least one LM pillar, most often social connection, stress management, and physical activity. (B) On-time graduation improved from 47% to 77% and attrition declined from 35% to 10% (χ² P < .03). C) PAR participants had lower RF-WBI distress scores (mean 1.2 vs 2.9, P < .004). Conclusions: LM interventions across levels were feasible and associated with improved well-being and program outcomes.

Background: Lifestyle medicine (LM) has been shown to reverse chronic diseases, yet data is limited on the application of LM interventions in low-resource countries. Methods: This practice-based implementation report evaluated the impact of individual and group LM interventions on chronic disease reversal in 15 patients followed longitudinally at a medical clinic in Malawi. Results: LM interventions led to the reversal of an average of 1.4 chronic diseases per patient based on legacy criteria used by the American Board of Lifestyle Medicine. Conclusion: These findings support the use of LM interventions for chronic disease reversal in a global health setting with limited resources. Future studies may explore enhanced health data tracking as well as expanding LM initiatives in similar environments.

Lifestyle medicine (LM) interventions are underutilized in underserved communities. This study describes a LM intervention at a resident-led free clinic in San Bernardino, California. Objectives were to quantify changes in LM screening and counseling as well as patient-reported behavior changes. We conducted a retrospective review of 2013-2015 clinic data, examining visit types, LM screening and counseling rates, and patient-reported behaviors (weekly exercise, daily produce intake, and smoking). Descriptive statistics and chi square tests were used to quantify and compare categories of clinic utilization, including encounters, screening, and counseling between time points. Paired t tests were used to assess clinical measures such as glucose, blood pressure, and BMI, and independent t tests were used to assess patient behaviors sucha as exercise and eating habits. In 2015 vs 2014, screening increased for exercise (80% vs 13%, P < .0001), nutrition (75% vs 6%, P < .001), and smoking (86% vs 24%, P < .0001). Reported smoking decreased (60% vs 44%, P < .01), while exercise days rose insignificantly (3.3 vs 2.5, P > .05). From early to late 2015, LM counseling increased (13% vs 47%, P < .05) alongside higher produce consumption (2.3 vs 3.2 servings/day, P < .05). Integrating LM systems changes with resident and community engagement was feasible and associated with improved LM counseling and patient behaviors in a free clinic setting.