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Lifestyle Medicine’s Role in Common Hormonal Disorders: A Case-Based Discussion 生活方式医学在常见荷尔蒙紊乱中的作用:基于病例的讨论
IF 1.9 Q2 Medicine Pub Date : 2024-04-04 DOI: 10.1177/15598276241242012
Mahima Gulati
Hormonal disorders like PCOS (Polycystic Ovary Syndrome), autoimmune thyroid disease (AITD) including Hashimoto’s thyroiditis, male hypogonadism are commonly encountered in clinical practice in the US and worldwide, with rising frequency. These typically affect patients during young or middle age, compared with other common chronic illnesses like type 2 diabetes, hypertension, atherosclerotic cardiovascular disease, where onset may usually be in middle or older age. Multiple studies point to the role of disordered lifestyle health behaviors as contributory to these endocrinopathies, and conversely therapeutic lifestyle changes leading to improvement in signs, symptoms, biochemical markers, and sequelae of these conditions. This article presents 3 different real life case studies of the conditions enlisted above and documents the positive impact of lifestyle improvements on their disease condition. Therapeutic lifestyle behaviors are an extremely useful and important component of management of these familiar endocrinologic disorders, and clinicians need to routinely counsel their patients about healthy lifestyle interventions when treating these common syndromes.
多囊卵巢综合症(PCOS)、自身免疫性甲状腺疾病(AITD)(包括桥本氏甲状腺炎)、男性性腺功能减退症等荷尔蒙紊乱疾病在美国和全球的临床实践中都很常见,而且发病率越来越高。与2型糖尿病、高血压、动脉粥样硬化性心血管疾病等其他常见慢性疾病相比,这些疾病的患者通常在中青年时期发病。多项研究指出,紊乱的生活方式和健康行为是导致这些内分泌疾病的原因,反之,改变生活方式可改善这些疾病的体征、症状、生化指标和后遗症。本文介绍了上述病症的 3 个不同的真实案例研究,并记录了改善生活方式对疾病状况的积极影响。治疗性生活方式行为是治疗这些人们熟悉的内分泌失调症的一个非常有用和重要的组成部分,临床医生在治疗这些常见综合征时,需要对患者进行健康生活方式干预方面的常规咨询。
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引用次数: 0
Empowering Medical Students: Unveiling the Benefits of Nutrition Seminars and Plant-Based Diets in Medical School Education 增强医科学生的能力:揭示营养研讨会和植物膳食在医学院教育中的益处
IF 1.9 Q2 Medicine Pub Date : 2024-04-03 DOI: 10.1177/15598276241242732
Fanny Huang, Deena Sukhon, Jessica R. Cummings, Nikita Lee, Elizabeth Carlson, Michelle Jankowski, Virginia Uhley
Background: Whole-food, plant-based (WFPB) dietary patterns can be used as a lifestyle modification to lower blood pressure and lose weight. This study aimed to observe the effects of WFPB dietary patterns and improve nutrition education in medical school. Methods: Forty-six medical students participated in the four-week Plant Plunge challenge, which consisted of a pre- and post-challenge health screening, weekly nutrition seminars, and the personal challenge to eat more WFPB. Afterward, an anonymous survey was sent to participants to analyze nutrition education quality in medical school. Results: The Wilcoxon Signed Rank test indicated statistically significant improvement in weight and blood pressure (BP) (N = 33). The median (interquartile range) difference in weight from pre- to post- was −.9 (−2.2, .0, P < .0461) pounds, whereas the differences in systolic and diastolic BP were −5.0 (−9.0, −.5, P < .049) and −7.0 (−11.0, −2.0, P < .0037) mmHg, respectively. Participants were significantly more likely to advocate for the integration of nutrition information into the medical school curriculum ( P = .0162). Conclusions: Short-term lifestyle modifications with WFPB dietary patterns help reduce weight and BP. Incorporating nutrition seminars in medical education may improve long-term patient outcomes.
背景:全食物、植物性(WFPB)膳食模式可作为生活方式的一种调整,用于降低血压和减轻体重。本研究旨在观察 WFPB 饮食模式的效果,并改善医学院的营养教育。研究方法46 名医科学生参加了为期四周的 "植物大跃进 "挑战,其中包括挑战前和挑战后的健康检查、每周一次的营养研讨会以及吃更多 WFPB 的个人挑战。之后,我们向参与者发送了一份匿名调查,以分析医学院的营养教育质量。调查结果显示Wilcoxon Signed Rank 检验表明,体重和血压(BP)的改善具有统计学意义(N = 33)。前后体重差异的中位数(四分位数间距)为-.9(-2.2,.0,P < .0461)磅,而收缩压和舒张压的差异分别为-5.0(-9.0,-.5,P < .049)和-7.0(-11.0,-2.0,P < .0037)毫米汞柱。参与者更倾向于主张将营养信息纳入医学院课程 ( P = .0162)。结论:采用 WFPB 饮食模式进行短期生活方式调整有助于减轻体重和降低血压。在医学教育中纳入营养讲座可改善患者的长期治疗效果。
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引用次数: 0
Prevalence of Vegetarianism and Lifestyle Correlates in a National Study 一项全国性研究中的素食主义流行率和生活方式相关因素
IF 1.9 Q2 Medicine Pub Date : 2024-04-03 DOI: 10.1177/15598276241243296
Shelly S. Bakst, Dolev Karolinsky
Introduction: Vegetarianism in its various forms has gained global recognition in part because of the notion that it is healthier; however, associations between plant-based diets and selected lifestyle practices in Israel have yet to be clarified. Methods: A population-based sample consisting of 1396 Israeli adults was collected via telephone survey, between the years 2013-2014. Differentiation between self-defined and actual vegetarians was initially verified (based on food intake). Next, “actual” vegetarian status was studied in relation to demographics and health behaviors. Results: Approximately 5% (N = 65) of respondents (5.8% Jews and 3.0% Arabs) were “self-defined” vegetarians; but only about half (N = 33) adhered to genuine vegetarian diets. By contrast, nearly 2% (N = 26) of those self-identified as non-vegetarians were “actual” vegetarians; thus, 4.4% (N = 59) of the sample were verified “vegetarians.” And while socio-demographic features did not meaningfully capture differences by vegetarianism status, “actual” vegetarians were significantly more likely than non-vegetarians to be physically active (OR = 1.7), use nutritive supplements (OR = 2.4) and read food product labels (OR = 1.9; all P < .01). Conclusions: Aggregately, “actual” vegetarian participants were more inclined to have healthier lifestyle practices relative to their non-vegetarian counterparts. Forthcoming research using larger samples should however exploit constant assessment measures to validate the link between vegetarianism and health-promoting correlates.
导言:各种形式的素食主义在全球范围内得到认可,部分原因是素食主义更健康;然而,在以色列,以植物为基础的饮食与特定生活方式之间的关系尚待澄清。研究方法通过电话调查收集了 2013-2014 年间 1396 名以色列成年人的人口样本。首先核实了自我定义的素食者和实际素食者之间的区别(基于食物摄入量)。接下来,研究了 "实际 "素食者身份与人口统计学和健康行为的关系。研究结果约 5%(N = 65)的受访者(5.8% 犹太人和 3.0% 阿拉伯人)是 "自我定义的 "素食者;但只有约一半(N = 33)的受访者坚持真正的素食。相比之下,近 2%(N = 26)自我认定为非素食者的人是 "真正的 "素食者;因此,样本中有 4.4%(N = 59)是经过验证的 "素食者"。虽然社会人口学特征不能有效反映素食者身份的差异,但 "实际 "素食者比非素食者更有可能参加体育锻炼(OR = 1.7)、使用营养补充剂(OR = 2.4)和阅读食品标签(OR = 1.9;均为 P < .01)。结论总体而言,"实际 "素食者比非素食者更倾向于采用更健康的生活方式。不过,即将进行的研究应使用更大的样本,利用恒定的评估措施来验证素食主义与促进健康的相关因素之间的联系。
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引用次数: 0
Auditory Changes in Occupational Health Associated With Metabolic Diseases in Adult Workers 与成年工人代谢疾病相关的职业健康听觉变化
IF 1.9 Q2 Medicine Pub Date : 2024-04-03 DOI: 10.1177/15598276241243277
Francine Varlete Leopoldina Barcelos, Karina Mary de Paiva, Marco José Machado, Patrícia Haas
Introduction: The most common hearing losses in the population are associated with genetic conditions, use of ototoxic substances or medications, infectious diseases, metabolic diseases and chronic ear diseases and the association of exposure to occupational risks or the natural aging process.Objective: Verify the association between hearing loss in workers and metabolic diseases.Method: Retrospective cross-sectional study with analysis of secondary data of subjects exposed to occupational noise and undergoing drug treatment for metabolic disease, attended in two occupational health clinics (C1 and C2) from January 2020 to December 2022, considering the data of reference examinations from the year 2005.Results: Of the n = 97 subjects evaluated, 73.20% were male, exposed to occupational noise (64.90%), with medication use for treating cardiovascular diseases (89.70%). The most recurrent auditory complaint was tinnitus (28.90%), n = 53 subjects presented sensorineural hearing loss with a statistical association between the decline of hearing loss and medications used for metabolic and hormonal regulation.Conclusion: Here was a higher frequency in the use of medications for treating cardiovascular diseases with a risk of triggering or worsening hearing loss in these subjects and greater impairment and decline of hearing thresholds were observed in the results of C2.
导言:人群中最常见的听力损失与遗传条件、使用耳毒性物质或药物、传染病、代谢性疾病和慢性耳病有关,也与暴露于职业风险或自然老化过程有关:验证工人听力损失与代谢性疾病之间的关联:方法:回顾性横断面研究,分析2020年1月至2022年12月期间在两家职业健康诊所(C1和C2)就诊的暴露于职业噪声并因代谢性疾病接受药物治疗的受试者的二手数据,并考虑2005年的参考检查数据:在接受评估的97名受试者中,73.20%为男性,64.90%接触过职业噪声,89.70%服用过治疗心血管疾病的药物。最常见的听觉症状是耳鸣(28.90%),53 名受试者出现感音神经性听力损失,听力损失的下降与代谢和激素调节药物之间存在统计学关联:结论:使用治疗心血管疾病药物的频率较高,有可能引发或加重这些受试者的听力损失,而且在 C2 的结果中观察到听力阈值受损和下降的程度更大。
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引用次数: 0
Use of Treatment and Self-Management Methods: Perspectives and Decisions of Patients With Ulcerative Colitis 使用治疗和自我管理方法:溃疡性结肠炎患者的观点和决定
IF 1.9 Q2 Medicine Pub Date : 2024-04-03 DOI: 10.1177/15598276241243300
Kelli E. DuBois, Christine E. Blake, Caroline Rudisill, Sayward E. Harrison, James R. Hébert
Patients with Ulcerative Colitis (UC) seek a variety of methods to manage the physical and psychosocial burdens of illness on daily life. This study examines how individuals with UC: (1) utilize treatment and self-management methods and (2) make decisions regarding their use of these methods throughout the disease course. Adults living with UC ≥5 years and experienced ≥1 disease flare, participated in individual, semi-structured qualitative interviews. Transcripts were thematically analyzed using a constant comparative approach in NVivo12®. Participants (N = 21) described their decisions to utilize medical, lifestyle, and complementary methods, which were shaped by sources of information, attitudes toward self-management, and personal motivations. The poor quality of life associated with the daily burden of living with UC emerged as a primary motive for exploration and utilization of treatment and management methods. Participants reported primarily utilizing treatment and management methods as reactive responses to flares instead of preventive measures. Results provide insight into patient decision-making and may inform individualized patient care, improve patient–provider communication, and guide interdisciplinary efforts to support self-management among patients with UC. Findings highlight a need for greater focus on promoting preventive self-management lifestyle behaviors to protect against disease activity and progressive impairment.
溃疡性结肠炎(UC)患者会寻求各种方法来减轻疾病给日常生活带来的身体和心理负担。本研究探讨了 UC 患者如何:(1)利用治疗和自我管理方法;(2)在整个病程中就使用这些方法做出决定。患有 UC ≥5年且经历过≥1次疾病发作的成年人参加了个人半结构化定性访谈。访谈记录采用 NVivo12® 中的恒定比较法进行主题分析。参与者(N = 21)描述了他们利用医疗、生活方式和辅助方法的决定,这些决定是由信息来源、对自我管理的态度和个人动机决定的。与 UC 日常生活负担相关的生活质量低下是探索和使用治疗与管理方法的主要动机。参与者报告称,他们主要利用治疗和管理方法来应对病情发作,而不是采取预防措施。研究结果提供了对患者决策的深入了解,可为患者的个体化护理提供信息,改善患者与医护人员之间的沟通,并指导跨学科工作以支持 UC 患者的自我管理。研究结果突出表明,有必要更加重视促进预防性自我管理生活方式行为,以防止疾病活动和进行性损伤。
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引用次数: 0
Department of Veterans Affairs Healthcare Provider Perceptions of Confidence Following a Wheelchair/Adaptive Tai Chi Chuan Training 退伍军人事务部医疗服务提供者对轮椅/适应性太极拳培训后信心的看法
IF 1.9 Q2 Medicine Pub Date : 2024-04-01 DOI: 10.1177/15598276241242727
Danielle E. Lauber, Zibin Guo, Elizabeth D. Hathaway
The changing needs of our nation’s military veterans call for a change in the healthcare system delivery models providing their primary sources of care. The VA Healthcare System has incorporated a whole health movement emphasizing individualized approaches to healthcare by encouraging complementary and integrative programs. Wheelchair/Adaptive Tai Chi Chuan (W/A/TCC) is such program offering a transformative opportunity to programmatically enhance veteran healthcare services by enhancing the training of VA healthcare providers. This article explores the impacts of a 7-posture W/A TCC instructional training program for healthcare providers that has been facilitated throughout the VA healthcare system since 2016. The purpose is to better understand the impact this training has on healthcare providers, including Recreational Therapists (RTs). A mixed-methods design exploring participant perspectives showed increased confidence levels following training in several key areas and no statistically significant differences between RTs compared to all other healthcare providers. Meaningful impacts described by participants are explored. Overall discussion focuses on this specific training program’s unique applicability for directly influencing VA healthcare providers and the veterans being served. Overall results offer support for wheelchair/adaptive tai chi chuan training as one strategy that can be utilized to increase the success of holistic veteran healthcare.
我国退伍军人不断变化的需求要求医疗保健系统改变为他们提供主要医疗服务的模式。退伍军人医疗保健系统开展了一项整体健康运动,通过鼓励补充和综合计划,强调个性化的医疗保健方法。轮椅/适应性太极拳(W/A/TCC)就是这样一个项目,它通过加强退伍军人医疗保健提供者的培训,为从计划上加强退伍军人医疗保健服务提供了一个变革性的机会。本文探讨了自 2016 年以来在退伍军人医疗保健系统中推广的针对医疗保健提供者的七式 W/A/TCC 指导培训计划的影响。目的是更好地了解该培训对医疗服务提供者(包括康复治疗师)的影响。一项探索参与者观点的混合方法设计显示,在几个关键领域接受培训后,参与者的信心水平有所提高,但与所有其他医疗服务提供者相比,康复治疗师之间并无统计学上的显著差异。还探讨了参与者所描述的有意义的影响。总体讨论集中于这一特定培训计划对退伍军人事务部医疗服务提供者和所服务的退伍军人直接产生影响的独特适用性。总体结果支持将轮椅/适应性太极拳培训作为一种策略,用于提高退伍军人整体医疗保健的成功率。
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引用次数: 0
Implementing Lifestyle Medicine Competencies in Didactic and Clinical Settings for Allied Health Professionals: A Call to Action 在专职医疗人员的教学和临床环境中实施生活方式医学能力:行动呼吁
IF 1.9 Q2 Medicine Pub Date : 2024-04-01 DOI: 10.1177/15598276241240412
Zipporah Brown, Anu M. Räisänen
In this article, we discuss and reflect on the essential components of our concurrent session presentation at the American College of Lifestyle Medicine (ACLM) annual conference LM2023, “Implementing Lifestyle Medicine Competencies in Didactic and Clinical Settings for Allied Health Professionals.” We illustrate the necessity of interdisciplinary lifestyle medicine approaches through a conscious fusion of analysis and storytelling. This review concludes with a call to action empowering the medical community to embrace interdisciplinary lifestyle medicine approaches in effort to increase access to equitable healthcare.
在本文中,我们讨论并反思了我们在美国生活方式医学学院(ACLM)年会 LM2023 "在专职医疗人员的教学和临床环境中实施生活方式医学能力 "的同期会议演讲中的重要组成部分。我们通过有意识地融合分析和故事讲述,说明了跨学科生活方式医学方法的必要性。本综述最后呼吁医学界采取行动,接受跨学科生活方式医学方法,努力增加公平获得医疗保健的机会。
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引用次数: 0
The Social Prescription: Dispensing Wellness Beyond the Medication 社会处方:药物之外的健康配药
IF 1.9 Q2 Medicine Pub Date : 2024-03-23 DOI: 10.1177/15598276241240374
Victoria Stang, Sneha Srivastava
In the realm of healthcare, the significance of social connections cannot be overstated. Beyond the traditional focus on pharmacological interventions and medical procedures, recognizing and nurturing positive social relationships has emerged as a fundamental aspect of lifestyle medicine. This article delves into the multifaceted nature of social connections and their profound impact on health outcomes, particularly in the context of chronic diseases like hypertension, mental health disorders, heart disease, and dementia. Moreover, it explores strategies for healthcare practitioners, with a special emphasis on pharmacists, to foster positive connections with patients, thereby enhancing shared decision-making, self-management, and overall well-being.
在医疗保健领域,社会关系的重要性怎么强调都不为过。除了传统的药物干预和医疗程序之外,认识和培养积极的社会关系已成为生活方式医学的一个基本方面。本文深入探讨了社会关系的多面性及其对健康结果的深远影响,尤其是在高血压、精神疾病、心脏病和痴呆症等慢性疾病方面。此外,文章还探讨了医疗从业人员(尤其是药剂师)与患者建立积极联系的策略,从而加强共同决策、自我管理和整体健康。
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引用次数: 0
Promoting Wellness as a Primordial Prevention Strategy for Achieving Sustainable Public Health in the Post-Covid 19 Era 促进健康是在后科维德 19 时代实现可持续公共卫生的首要预防战略
IF 1.9 Q2 Medicine Pub Date : 2024-03-19 DOI: 10.1177/15598276241240414
Geetha K. Veliah, Padma Venkatsubramanian
The global scenario of a contracted economy over 4% and distraught healthcare systems due to the 2019 pandemic behooves us to redesign our strategies to move towards holistic approaches that allow health and wellbeing to be uniquely viewed within their contexts, promising sustainability. World-over, communities are more aware of the connectedness with nature and the role of positive behaviors. Disproportionate investments go into secondary and tertiary cure in healthcare systems and there is a minimal uptake of primary prevention. Investments in primordial prevention (PP) that can help achieve sustainable health are inadequate. PP is defined as an approach that prevents the risk factors for disease conditions from manifesting through maintenance of good health by embracing healthy environment, diet, and lifestyle behaviors, to function optimally. We propose integration of wellness as a primordial prevention strategy for sustainable public health using the 3 Ps: People, Places, and Policies/Programs. Wellness is holistic and multi-dimensional and is a primordial prevention concept as it focuses on people thriving based on a positive approach to health. The authors point out that the stumbling block in public health is due to unsustainable behavior as a result of misplaced priorities.
全球经济萎缩超过 4%,医疗保健系统因 2019 年大流行病而陷入困境,在这种情况下,我们有必要重新设计我们的战略,转而采用整体方法,让人们在各自的环境中独特地看待健康和福祉,从而实现可持续发展。世界各地的社区都更加意识到人与自然的联系以及积极行为的作用。在医疗保健系统中,对二级和三级治疗的投资不成比例,而对一级预防的投资却微乎其微。有助于实现可持续健康的初级预防(PP)投资不足。初级预防的定义是,通过健康的环境、饮食和生活方式,保持良好的健康状况,防止疾病风险因素显现,从而发挥最佳功能。我们建议将健康作为可持续公共卫生的基本预防战略,采用 3P:人、场所和政策/计划。健康是整体的、多维的,是一个基本的预防概念,因为它关注的是人们在积极的健康方式基础上的茁壮成长。作者指出,公共卫生的绊脚石是由于优先事项错位造成的不可持续的行为。
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引用次数: 0
Lifestyle Medicine and Japan’s Longevity Miracle 生活方式医学与日本的长寿奇迹
IF 1.9 Q2 Medicine Pub Date : 2024-03-19 DOI: 10.1177/15598276241234012
Tamami Shirai, Kazuyo Tsushita
With Japan’s economic growth, its life expectancy increased from 1965, and since 1980, Japan has become one of the longest-lived countries in the world. Strong government-led initiatives such as low-cost health insurance, widely distributed health screenings, a new law to prevent non-communicable diseases established in 1956, Shokuiku (Japanese culinary education), and stress-measuring systems in the workplace contributed to the population’s longevity. In addition to these public initiatives, Japan has benefited from evolving lifestyle practices over its long history. These include Washoku (Japanese traditional food), which utilizes the complex interaction of individual nutrients unique to Japan as well as numerous metabolically active compounds, the interrelation of Japan’s population levels with its plant-dominant diet, a mindful culture connected with nature, and the principle of hara-hachi-bu (Confucianism-based caloric restriction habit; “eat until 80% full”), and so on. In 2002, Japan took the remarkable action of stipulating by law that citizens must deepen their interest in and understanding of the importance of healthy lifestyle habits, be aware of their own health status, and strive to improve their health throughout their lives. Today, to protect its future, Japan must face a new challenge: a population that is declining and is the world’s fastest-aging.
随着日本经济的增长,日本人的预期寿命从 1965 年开始延长,自 1980 年以来,日本已成为世界上最长寿的国家之一。政府主导的低成本医疗保险、广泛分布的健康检查、1956 年制定的预防非传染性疾病的新法律、Shokuiku(日本烹饪教育)以及工作场所的压力测量系统等强有力的举措为人口的长寿做出了贡献。除了这些公共举措外,日本还得益于其悠久历史中不断发展的生活方式。这包括利用日本特有的各种营养素和大量代谢活性化合物的复杂相互作用的 "和食"(日本传统食品)、日本人口数量与以植物为主的饮食之间的相互关系、与自然相连的心智文化、原八不原则(基于儒家思想的热量限制习惯;"吃到八成饱")等等。2002 年,日本采取了一项了不起的行动,即通过法律规定公民必须加深对健康生活习惯重要性的兴趣和理解,了解自己的健康状况,并在一生中努力提高自己的健康水平。今天,为了保护自己的未来,日本必须面对新的挑战:人口正在减少,是世界上老龄化速度最快的国家。
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引用次数: 0
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American Journal of Lifestyle Medicine
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