Most people are stressed, lack sleep and are overweight and suffer from preventable lifestyle diseases such as heart disease, cancer, stroke and diabetes.
Being overweight or being obese contributes to 50% of adults suffering from hypertension, 10% with diabetes and another 35% with pre-diabetes.
And the costs are inaccessible and increasing, causing the health care system to be overburdened.
But there are new lifestyle “remedies” that are free and that doctors can prescribe for all their patients.
Lifestyle medicine is the clinical application of healthy behaviors to prevent, treat and reverse diseases. More than ever, research highlights that the “pills” that today’s doctor should prescribe for patients are the six domains of lifestyle medicine: plant-based nutrition, regular physical activity, restorative sleep, stress management, reduction or elimination of addiction and positive psychology and social connection.
We are primary care preventive medicine physicians and computational immunologists, both committed to applying cutting edge research to inform the clinical practice of lifestyle medicine. Our findings and recommendations have just been published.
Whole vegetable-based foods
Diets high in fruits, vegetables and whole grains and low in animal products and highly processed foods have been linked to the prevention of many diseases.
These diets also improved health and even reversed common cardiovascular, metabolic, brain, hormonal, kidney and autoimmune diseases, as well as 35% of all cancers.
We believe that future research should include larger studies or new research methods with an emphasis on diet quality. This would include more data on the composition of micronutrients and protein sources in plant foods compared to foods of animal origin – not just the proportion of fat, carbohydrates and proteins.
These tests should include children, as many adult disorders are spread from childhood or in the womb.
Regular physical activity
For decades, the guidelines of general surgeons have emphasized that moderate to vigorous daily aerobic physical activity has immediate and long-term health benefits.
For example, why we age and the rate at which we age – chronological age versus biological age – is determined by several molecular processes that are directly influenced by physical activity.
And now scientists are better understanding the cellular and molecular changes that exercise induces to reduce the risk of disease.
Research priorities for scientists and physicians include gaining a deeper understanding of the type, intensity and frequency of activity, and better insights into the molecular and cellular changes that occur with exercise.
Sleep helps cells, organs and the whole body to function better. Regular uninterrupted sleep of seven hours a night for adults, eight to 10 hours for teenagers and 10 or more for children is necessary for good health.
Although little studied, there is evidence that high-quality sleep can reduce inflammation, immune dysfunction, oxidative stress and epigenetic DNA modification, all associated or causing chronic diseases.
Therefore, research on the biological mechanisms that support sleep-restoring properties can lead to environmental or population and political approaches to better align our natural sleep patterns with the demands of daily life.
While some stress is beneficial, prolonged or extreme stress can overwhelm the brain and the body. Chronic stress increases the risk of cardiovascular disease, irritable bowel disease, obesity, depression, asthma, arthritis, autoimmune diseases, cardiovascular disease, cancer, diabetes, neurological disorders and obesity.
One of the most powerful mechanisms for reducing stress and increasing resilience is to trigger a relaxation response using mind-body and cognitive-behavioral therapies.
More research is needed to gain a better understanding of how these therapies work.
Addiction reduction and elimination
Many social, economic and environmental factors have fueled the national increase in substance abuse in general and, more tragically, the opioid epidemic.
Doctors and researchers are beginning to understand the underlying physiology and psychology of addiction.
However, continued stigma and disjointed or absent access to services remains a challenge. Doctors and scientists need to explore how to predict who is most vulnerable to addiction and find ways to prevent it.
Priority should be given to treatment that incorporates integrated care with a focus on all patient needs.
Positive psychology and social connection
Maintaining a positive attitude through the practice of gratitude and forgiveness has a significant impact on psychological and subjective well-being, which, in turn, is associated with benefits for physical health.
Social connectivity, that is, the quantity and quality of our relationships, has perhaps the most powerful health benefits.
On the other hand, social isolation – such as living alone, having a small social network, participating in few social activities and feeling alone – is associated with higher mortality, greater morbidity, lesser function of the immune system, depression and cognitive decline.
Further studies are needed to discover how an individual’s biology and chemistry change for the better through more social interactions.
The role of inflammation in lifestyle-related diseases
Although inflammation is a healthy and natural way for the body to fight infections, injuries and stress, a lot of inflammation actually promotes or worsens the diseases described above.
The inflammatory response is complex. We have used machine learning and computer modeling to understand, predict, treat and reprogram inflammation – to retain healing elements while minimizing the most chronic harmful ones.
Scientists are discovering new mechanisms that explain how chronic stress can activate and deactivate genes.
Overcoming challenges and barriers
We and others who study lifestyle medicine are now discussing how we can take advantage of all of these approaches to improve clinical studies on the impacts of lifestyle interventions.
At the same time, we and our colleagues realize that there are environmental challenges and barriers that prevent many people from adopting these lifestyle changes.
There are desserts where healthier foods are not available or are cheap. Unsafe neighborhoods, chemicals and harmful substances create constant stress. Poor education, poverty, cultural beliefs and racial and ethnic disparities and discrimination must be addressed in order for all people and patients to appreciate and adopt these six “pills”.