Wellness, Weight Loss, and Disease Prevention With the 5 Keys to Healthy Lifestyle Change
Tom Rifai, MD
Rifai T. Wellness, weight loss, and disease prevention with the 5 keys to healthy lifestyle change. Consultant. 2018;58(2):53-57.
Consistent with robust and emerging evidence from randomized controlled trials (RCTs) and observations of populations characterized by longevity,1-3 as well as through thousands of patients’ worth of clinical and personal experience as a physician and recovering overweight binge eater, I have learned how powerful therapeutic lifestyle is as a medicine. Lifestyle can drive, treat, or prevent many of the biggest contributors to premature death and reduced quality of life, particularly in the context of disease epidemics resulting from sedentariness and the standard American diet. For example, type 2 diabetes and atherosclerotic cardiovascular disease (ASCVD) risks could be reduced by as much as 90%, especially in at-risk populations, by adopting a therapeutic lifestyle basis to medical care.4
Since as early as 1993, the top 3 causes of premature death have been related to what is done with forks (unhealthy food), fingers (smoking), and feet (low levels of physical activity), and these 3 factors alone accounted for 80% of premature death in the United States.5 The US Preventive Services Task Force (USPSTF) now recognizes 3 areas of metabolic health for which intensive lifestyle interventions may be effective: cardiometabolic risk (eg, dyslipidemia, hypertension, type 2 diabetes), prediabetes, and obesity.6-8
Therapeutic lifestyle change (TLC), especially in at-risk populations such as the estimated 30.3 million adults with diabetes and the 84.1 million with prediabetes9 and the additional millions with metabolic syndrome and overweight or obesity, has the potential to massively reduce lifestyle-driven metabolic disease-related costs and to markedly reduce lifetime risks for premature death and disability from cardiovascular events, cancers, dementia, chronic kidney disease, osteoporosis, and more, while at the same time improving quality of life with beneficial effects on mood, pain, and function. In short, lifestyle medicine is, or should be, the first line of defense against most modern chronic diseases.
With so many Americans at cardiometabolic risk, it is important that primary care providers identify lifestyle-driven risk factors and prescribe appropriate therapy, primarily lifestyle-based therapy. Addressing risk factors through lifestyle modification early in the continuum of disease risk could substantially improve patients’ quality and quantity of life.