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Lifestyle Medicine,

Edition 3 Lifestyle, the Environment and Preventive Medicine in Health and Disease

Editors: Edited by Michael Sagner, Garry Egger, MPH PhD MAPS, Andrew Binns and Stephan Rossner

Publication Date: 06 Apr 2017

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Lifestyle Medicine: Lifestyle, the Environment and Preventive Medicine in Health and Disease, Third Edition, is an adjunct approach to health practice that seeks to deal with the more complex modern determinants of chronic diseases—primarily lifestyle and the environments driving such lifestyles—in contrast to the microbial ‘causes’ of infectious disease.

Our lifestyle choices have a profound effect on our health. As we live longer, one thing is clear: many of us will spend time living with injury and chronic illness due to our own choices. Changes in health patterns typically follow shifts in living conditions. Disease patterns have changed worldwide, from infectious to chronic diseases such as obesity, diabetes, and heart disease. This change has been so emphatic—nearly 70% of all presentations to a doctor in modern western societies are now chronic disease related—that medical services are being forced to change to accommodate this.

New chapters in this third edition explain the link between energy intake and expenditure; consider how modern technology are determinants of chronic disease; show how environmental influences, such as endocrine disruptors, influence our health; and summarize recent research on early childhood experiences and chronic disease.

Key Features

Explores the relationship between lifestyle and environmental drivers and the major modern chronic diseases
Outlines the knowledge and skills bases required by health professionals to deal with lifestyle and environmental determinants of chronic disease, as well as the tools and procedures available for doing this
Develops pedagogy for Lifestyle Medicine that will enable it to become a practical adjunct to conventional health and medical practice
Features new chapters explaining the link between energy intake and expenditure, and more

About the author

Edited by Michael Sagner, President, European Society of Lifestyle Medicine, Paris, France; Garry Egger, MPH PhD MAPS, Director, Centre for Health Promotion and Research, Sydney, and Adjunct Professor, Lifestyle Medicine, Lismore campus, Southern Cross University, Australia; Andrew Binns, General practitioner, rural New South Wales, and Adjunct Professor, Division of Health and Applied Sciences , Lismore campus, Southern Cross University, Australia and Stephan Rossner, Professor, Health Behavior Research, Karolinska Institute, Stockholm, and Director, Obesity Unit, Karolinska University Hospital

Section I. Background and Basis for the role of lifestyle factors In chronic disease Prevention and Treatment

Chapter 1. Introduction to the Role of Lifestyle Factors in Medicine

Introduction: What is Lifestyle Medicine?
The Scope of Lifestyle in Medicine
Historical Background
Lifestyle in the Context of Chronic and Acute Disease
Differences Between Traditional/Conventional and the Model of Lifestyle Medicine
The Links That Highlight Lifestyle Factors in Medicine
Who is Best Qualified to Practice Lifestyle Interventions?
The Evidence Base
Frameworks for Lifestyle Changes in Medicine
Summary

Chapter 2. The Epidemiology of Chronic Disease

Introduction: A (Very) Short History of Disease
Lifestyle-Related Causes of Disease
Assessing Risk Factors
Beyond Single Risk Factors
Beyond Risk Factors Altogether
Looking Beyond Immediate Causes of Disease
Proximal Determinants
Medial Determinants
Distal Determinants
Expanding the Concept of Disease and Intervention
The Clinician’s Role in Managing Lifestyle-Related Chronic Diseases

Chapter 3. A “Germ Theory” Equivalent Approach for Lifestyle Medicine

Introduction
Inflammation and Disease
Metaflammation and “Anthropogens”
Chronic Disease and the Germ Theory
Relevance for Public Health and Lifestyle Medicine
Managing Anthropogens
Summary

Chapter 4. A Structure for Lifestyle Medicine

Introduction: the Field of Lifestyle Medicine
Developing the Knowledge Base: the Science of Lifestyle-Related Diseases and Conditions
Summary
Utilizing Skills: the Art of Lifestyle Medicine
Expanding the Range of Tools: the Materials for Lifestyle Medicine
Adopting Procedures: Developing the Actions for Lifestyle Medicine Management
Summary

Chapter 5. Everything You Wanted to Know About Motivation (But Weren’t Intrinsically Motivated Enough to Ask)

Introduction: The Requirements for Change
What Is Motivational Interviewing?
Why Use Motivational Interviewing Techniques?
Motivational Goals and Strategies
Barriers and Triggers to Change
Motivation at the Public Health Level
Some Motivational Tactics
Intrinsic Motivation: The End Game
Summary

Chapter 6. Self-Management in Lifestyle Medicine

Introduction: Self-care Versus Self-management
Components of Self-management
Self-care is a Necessary But Not Sufficient Component
Evidence of Effectiveness
Formats Supporting Self-management
Lifestyle Medicine and Self-management
Principles of Self-management
Being Motivation Focused
Being Health Literacy Oriented

Chapter 7. Overweight and Obesity: The Epidemic’s Underbelly

Introduction: Obesity and Ill Health
Fat Distribution: Not Only if You’re Fat but Where
Dealing With Obesity
Is a Calorie Really a Calorie?
Changing Energy Balance
Trends in Weight Control Management
Practical Implications of Physiological Adjustment
Current Strategies in Weight Loss
Strategies with good supporting evidence
Obesity: The “Canary in the Mineshaft”
Summary

Section II. Lifestyle and Environmental Determinants of Chronic disease

Chapter 8. Nutrition for the Nondietitian

Introduction: The Confusion of Nutrition
The Science of Nutrition
The Concept of (Energy) Volume
An Alternative Approach
Recent Developments in Nutrient Understanding
Specific Dietary Requirements
Assessing Food Intake
Summary

Chapter 9. Fluids, Fitness, and Fatness

Introduction: Fluids as Energy
How Much Fluid is Required?
How Much Energy in Fluid is Recommended?
Recommended Fluid Intakes
Suggested Changes in Beverage Intakes
Alcohol
Summary

Chapter 10. Behavioral Aspects of Nutrition

Introduction: Eating as a Behavior
Hunger and Appetite: Are They the Same?
Determinants of Energy Intake
Habits
Rational Emotive Therapy
Summary

Chapter 11. Physical Activity: Generic Prescription for Health

Introduction: Exercise and Evolution
Defining Terms
Activity Levels, Mortality, Morbidity, and Well-being
Types of Fitness: The Five S’s
Exercises
Muscle Groups for Stretching
Progression of Exercise Training
Purpose, Meaning, and Physical Activity
The Clinician’s Role
Summary

Chapter 12. Physical Activity: Specific Prescription for Disease Management and Rehabilitation

Introduction: Specific Exercise Prescription
Exercise and Disease Management
Genetics and Response to Exercise
Exercise and Diabetes
Exercise and Heart Disease
Exercise and Arthritis
Exercise and Hypertension
Exercise and Dyslipidemia
Exercise, Stress Anxiety, and Depression
Other Conditions
Summary

Chapter 13. Stress: Its Role in the S-AD Phenomenon

Introduction: “Stress” versus “Strain”
What is Stress?
Genetics, Resilience, and Hardiness
Stages of Stress/Strain
The Concepts of Control and Escape
An Approach to Dealing With Stress: ACE (Analyze, Change, Evaluate)
Change (Escape)
Summary

Chapter 14. Dealing With Worry and Anxiety

Introduction: Anxiety as “Feared Helplessness”
Health Effects of Anxiety
Types of Anxiety Disorders
The Extent of the Problem
The Role of Lifestyle
Diagnosis
Worry as a Ubiquitous Characteristic of Anxiety
Management
Summary

Chapter 15. Depression

Introduction: Depression as a Way of Life
What is Depression?
Depression and Health
Depressive Disorders
Risk Factors
Diagnosis
Management
Summary

Chapter 16. Happiness and Mental Health: The Flip Side of S-AD

Introduction
Depression and Happiness
Lifestyle Medicine and Mental Health Promotion
What is (Good) Mental Health?
Approaches to Mental Health
Positive Psychology?
Lives Led
Is Positive Psychology the Way for Everybody?
Mental Health Promotion, Illness Prevention, and Early Intervention
Health Professional Goals in Applying Act-Belong-Commit in the Clinic
Summary

Chapter 17. Technology-Induced Pathology: Watch (This) Space

Introduction: the Good and the Bad of Technology
The Changing Nature of Health
Technology’s “Hormetic” Effect
The Future of Researching Technopathology
Summary

Chapter 18. To Sleep, Perchance to … Get Everything Else Right

Introduction: The Value of Sleep Research
The Reasons for Sleep
How Much Sleep Do We Need?
Sleep Cycles
The Concept of Sleep Debt
Fatigue and Excessive Daytime Sleepiness
Risk Factors Associated With Poor Sleep
Sleep and Lifestyle Interactions
What Is Insomnia?
The Value of Sleep Diaries in Determining Sleep Patterns
Snoring and Obstructive Sleep Apnea
Sleep Hygiene
Summary

Chapter 19. Health and the Environment: Clinical Implications for Lifestyle Medicine

Introduction: Environmental Influences on Health
Defining Environments

Chapter 20. Meaninglessness, Alienation, and Loss of Culture/Identity (MAL) as Determinants of Chronic Disease

Introduction: “MAL” in a Lifestyle Context
The Meaning of Meaninglessness
Alienation and Estrangement
Loss of Culture and Identity
Summary
The Clinician’s Role

Chapter 21. Preventing and Managing Injury at the Clinical Level

Introduction: Injury Prevention as Public Health
The Epidemic of Injury
Understanding Injury
Injuries From Falls
Transportation Injuries
Drowning
Poisonings
Sports Injuries
Suicide
Summary

Chapter 22. Rethinking Chronic Pain in a Lifestyle Medicine Context

Introduction: A Case Study
Types and Extent of Pain
Pain: Historical Context
Rethinking Chronic Pain: The Need for a New Paradigm
“Plasticity” and Chronic Pain
Plasticity and Person-Centered Care
Plasticity of Systems
Practical Therapeutics: Implementing the Principles of Plasticity
Summary

Chapter 23. Understanding Addictions: Tackling Smoking and Hazardous Drinking

Introduction: The Different Forms of Addiction
Why is Addressing Smoking and Drinking so Challenging?
Client Factors
Clinician Factors
Practice Setting
What Works?
An Acronym for Treatment: The 5 A’s
Raising the Issue
Assessment
Making Changes
Pharmacotherapy
What Stimulates Change?

Chapter 24. Medicines: The Good, The Not So Good, and The Sometimes Overused

Introduction: Drugs—Good and Bad
Common Side Effects
Iatrogenesis and Medicines
The Problem of Nonadherence
“Deprescription” and Polydrug Use
What Can the Clinician Do?
Summary

Chapter 25. Relationships, Social Inequity, and Distal Factors in Lifestyle Medicine: Tackling the Big Determinants

Introduction: Causality Revisited
Relationships
Social Inequality
Summary

Section III. Other issues for Lifestyle medicine

Chapter 26. Sex and Lifestyle: Not Being Able to Get Enough of a Good Thing Because of a Lifetime of Getting Too Much of a Good Thing

Introduction
Prevalence of Sexual Problems
Causes: General
Causes: Specific
Management
Summary

Chapter 27. Lifestyle and Oral Health

Introduction: Oral Health
Lifestyle, Dental Caries, and Tooth Erosion
Erosive Factors in the Diet
Protective Factors
Periodontal Disease and Diabetes
Sports and Dental Health
Summary

Chapter 28. Lifestyle and Environmental Influences on Skin

Introduction: The Skin as an Organ
Why Skin in Lifestyle Medicine?
Summary

Chapter 29. Lifestyle-Related Aspects of Gastrointestinal Health

Introduction: Exposing the Gut
The Top End: Reflux and Dyspepsia
The Middle Bit: Irritable Bowel
The Bottom End: Constipation and Diarrhea
Exercise: Good and Bad News
Summary

Section IV. The Future of Health

Chapter 30. The Next Chapter: The Future of Health Care and Lifestyle Interventions

Introduction
Health Care Systems and Society at Large Must Focus on Proactive Prevention
The Quality of Care Case
The Economic Case
Embracing Predictive Medicine
Personalizing Lifestyle Interventions
Medicine Will Become More Participatory
Conclusions

ISBN: 9780128104019

Page Count: 484

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