Luke Lemke
Columbus Medical Center
Lifestyle Medicine
in the Workplace
Overview
 What
is Lifestyle Medicine(LM)?
 Why is it important?
 What is the role of lifestyle change in preventing and the
treatment of disease?
 How can we implement lifestyle changes in our lives and
the world around us?
 The use of our "Fingers, Feet, Forks, Stress, Sleep and Love"
 How can we create our own "Blue Zones"?
" Be the Change You wish to see in the World"
Mahatma Gandhi
Definition of Lifestyle Medicine
Lifestyle Medicine is the therapeutic use of evidencedbased lifestyle interventions to treat and prevent lifestyle
related diseases in a clinical setting. It empowers
individulals with the knowledge and life skills to make
effective changes that address the underlying cause of
disease.
"American College of Lifestyle Medicine" 2009
“If we give every individual the right
amount of nourishment and exercise, not
too little and not too much, we have found
the safest way to health.”
Hippocrates
Why is Lifestyle Medicine So Important?
Leading Causes of Death in the US 2013
1.
2.
3.
4.
5.
6.
7.
8.
9.
Heart disease 611,105
Cancer 584,881
Chronic lower respiratory diseases 149,205
Accidents 130,557
Stroke(cerebrovascular diseases) 128,978
Alzheimer’s disease 84,767
Diabetes 75,578
Influenza and Pneumonia 56,978
Suicide 41,149
*CDC Vital statistics 2013
Actual Causes of Death
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Tobacco 435,000
Poor diet and physical inactivity 400,000
Alcohol consumption 85,000
Microbial agents 75,000
Toxic agents 55,000
Motor vehicle accidents 43,000
Firearms 29,000
*Mokdad, Actual causes of Death in the U.S. 2000 and 2004
80% of All deaths are caused by our LIFESTYLES
Chronic Disease
is not the CAUSE
Genetics are not always the cause.
Our LIFESTYLES are the CAUSE!
Diseases are many times the effects
of our Lifestyle choices.
Behavioral Determinants
 Virtually
ALL of the top 10 leading causes of death in US adults
are moderately to STRONGLY influenced by lifestyle patterns
and behavioral factors
BEHAVIOR
DISEASE
Tobacco Use
Heart Disease
Physical Activity
Stroke
Diet
Cancers
Preventive Services
Diabetes
*adapted from LM Advocacy presentation: ACOLM website; www.lifestylemedicine.org
UPSTREAMIST
 We
must start to look "Upstream" at the behaviors that are
causing our disease.
What is the role of lifestyle change in
preventing and treating disease?
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Smoking
-only 44% of smokers were advised to quit in the last year
-only 25% were offered assistance
Diet and Nutrition
-only 25% of pre-diabetics reported receiving dietary advice
-only 1 in 12 diabetics were adhering to the ADA dietary recommendation
Exercise and Activity
-only 1 in 3 patients indicated they received advice to increase their activity.
Weight Loss
-only 2 of 5 obese patients were advised and counseled to lose weight, even
when they
conditions made worse by their weight.

Important Lifestyle Questions to Ask

I am within 5 pounds of my ideal body weight
I exercise 30 minutes or more most days of the week
I eat a plant based, whole food diet with 5 fruits/vegetables
most days
I don’t use tobacco products
I have 2 or fewer alcoholic drinks per day
Do I get 7-8 hours of sleep most nights

Only 8% of ALL Americans can say yes to all of these.
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How can we implement Lifestyle change
in our lives and the world around us?
 Feet
 Forks
 Fingers
 Sleep
 Stress
 Love
“I am not a product of my circumstances. I
am a product of my decisions”
Stephen
Covey
How can we use our “feet”
The role of exercise in Lifestyle Medicine.
How we can use our “feet” in Lifestyle
Medicine
 Consensus
recommendation for 150 minutes per week of
moderately intense exercise(not just work activity)
 The health benefits of exercise apply to all ages, social
groups, and diseases.
 Benefits of even small increases in exercise are seen in
the prevention and treatment of nearly all chronic
diseases.
 Wellcoaches. My certainty is greater, than your doubt.
 Exercise IS Medicine!!!- ACSM
How can we use our “feet” in Lifestyle
Medicine
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ABC for fitness(Activity Bursts in the Classroom). Free program for
school age kids to increase the exercise.
ABE for fitness in Adults(Activity Burst Everywhere). Free online video
series that shows how to take 3-8 minute bursts of exercise that will
help reach the 30 minutes a day.
“Exercise is Medicine” certified providers to design programs that are
specific and obtainable.
Digital Technology. Help to motivate people to get to their daily
goal.
Incentivize people to be active, not just on how much they weight.
Coaches using Motivational interviewing skills, not “fear” based ones.
How we can use our “forks”
The role of diet in Lifestyle Medicine.
How we can use our “forks” in Lifestyle
Medicine
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2015 USDA/HHS-US Dietary Guidelines. Final draft is due out in
Fall.
Plant based, whole food diet, less sugar, less refined carbs
Increased intake of fruits, vegetables, legumes, and whole
grains and nuts.
Increased intake of dietary fiber. Men 45-55g/day, Women 5565g/day.
Decreased intake of processed foods, refined sugars,
saturated fats and cholesterol, (but loosening the restrictions)
Avoid the “bad food, good food” model.
“Eat what you Love and Love what you eat.” Michelle May
How we can use our “forks (cont.)
 Nuval
scoring system. Rates foods on their health benefits
from 0(unhealthy) to 100(healthy).
 Food dairies such as “My Fitness Pal”, “Lose it”. Very
helpful for long term adherence.
 Incentivize people to eat healthier food, by giving them
more bang for their buck. Make healthier food less
expensive.
How we can use our “fingers”, or
not.
The role of smoking cessation in Lifestyle Medicine.
Smoking Cessation in Lifestyle Medicine
 “don’t
ask, don’t treat”. Ask even if they is no perceived
readiness to quit
 Tobacco use cessation counseling
 Tobacco use medications ex. Chantix, bupropion,
 About 46% of smokers reported that they Healthcare
provider had advised them to quit, only 25% were offered
assistance
How we can use our “Pillows”
The role of sleep in Lifestyle Medicine.
The role of Sleep in Chronic Disease
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Adult needs 7-8 hours of sleep per night. However, more than
40% of adults report getting less than 7 hours of sleep in 24
hours.
Adolescents need more than 9 hours per night. Again almost
70% reported less than that on average weeknight.
Insufficient sleep is associated with CVD, diabetes, HTN, obesity
and depression.
Drowsy driving contributed to 100,000 MVA’s and 15,000
deaths in 2008.
The role of Sleep in Chronic Disease
Suggested strategies for improving sleep initiation and
maintenance.
-consistency in bedtime and rising.
-maintaining an appropriate sleep environment.
-avoid the “screens”.
-avoid the large meal or intense exercise before
bed.
•
Role of Stress in Lifestyle Medicine
Take time to breathe
Role of Stress Reduction in Lifestyle
 Yoga
 Mindful
Meditation
 Eliciting the “Relaxation Response” Dr. Herbert Benson
 Progressive muscle relaxation
 Coaching-using certified Wellcoaches.
 Estimated $200 billion annually is lost due to absenteeism,
subpar performance, tardiness, and workers’
compensation claims due to stress.
What is the role of Love in Lifestyle
Medicine.
How does our Social Interconnectivity affect our Health?
“The best and most beautiful things in
the world cannot be seen or even
touched – they are felt with the heart.”
Helen Keller
How can we use our Social connections
to improve our health
 Time
spent with family and friends may be the greatest
predictor of our longevity.
 Our “support groups” help us avoid the loneliness and
isolation that contributes to depression and anxiety.
 The #1 class of drugs prescribed over the last 20 years are
antidepressants.
 We Treat our time with friends and family as a luxury after
the “important” stuff, it is the “IMPORTANT” stuff.
Creating our “Blue Zone”
“Lifestyle is the Medicine, and culture is the
spoon” Dr. David Katz
How we can create our own “Blue
Zones” The 9 keys to long healthy, happy
life.
 Get
moving.
 Eat only until you are full. “Eat food, not too much, mostly
plants”. Michael Pollan
 Plant based diet ( and beans and nuts!).
 Drink red wine ( in moderation!!).
 Develop a personal mission statement ( find your
purpose).
Your “Blue Zones” (cont.)
 Take
time to de-stress.
 Just Go! Belong. Be a part of a spiritual community.
 Family First!
 Surround yourself with likeminded(healthy) people.
Summary
 Chronic
diseases are not the cause of our healthcare
crisis in our world. Our lifestyle choices are!
 We can in fact nurture nature. Our genes are not our
destiny.
 This is a gradual process, any changes we make to be
healthier will benefit us. Small incremental lifestyle
changes will bring Big results if given time.
“That man is a success who has lived
well, laughed often, and loved much.”
 Robert
Louis Stevenson
Email: lemkeluke@gmail.com
References
 American
College of Lifestyle Medicine
 Institute of Lifestyle Medicine
 The Blue Zones by Dan Buettner
 Disease Proof by David Katz
 Nutritionfacts.org-Dr. Michael Greger
 Lifestyle Medicine-Evidence Review: American College
of Preventative Medicine. June 30, 2009
QUESTIONS?