Six Pillars of Lifestyle Medicine

Overview

Nutrition

Consuming a fiber-filled, nutrient-dense, antioxidant-rich eating pattern based predominantly on a variety of minimally processed vegetables, fruits, whole grains, legumes, nuts and seeds.

Physical Activity

Engaging in regular and consistent physical activity.

Stress Management

Incorporating stress-reducing behaviors may be difficult in modern society but is essential for whole-person health.

Restorative Sleep

Striving for 7-9 hours of high-quality sleep, allowing the body to reset and recover.

Social Connection

Strengthening and maintaining relationships and connections with others that bring meaning and purpose to life.

Avoidance of Risky Substances

Reducing or eliminating the consumption of or exposure to any substances that cause harm through toxicity, addiction, physical damage, or adverse side effects.

Marketing Assets

SPACE

Full Resource Kit

CME/CE

All Pillars:

American Journal of Lifestyle Medicine Articles

Social Media Language for Each Pillar

Whole-Food, Plant-Based Nutrition:

Eating more plant foods is a great way to improve overall health. If you have a chronic disease related to your lifestyle, the American College of Lifestyle Medicine recommends an eating plan that mainly includes a variety of minimally processed vegetables, fruits, whole grains, beans, nuts, and seeds. Setting goals to improve your habits is a great way to eat healthier. An example of a positive nutrition goal is, “I will add 1 cup of berries to breakfast and a small apple or orange as an afternoon snack at least five days this week." #FoodasMedicine

Physical Activity:

Adults aged 18-64 should aim to get 150-300 minutes of moderate exercise or 75-150 minutes of intense exercise each week, along with strength training on at least two days. There are also specific guidelines for older adults, pregnant women, and those with chronic conditions. The more exercise you do, the better, but any amount is better than none. It’s safest to start a new exercise routine with the help of a certified expert like a kinesiologist, exercise physiologist, physical therapist, or personal trainer. Setting a goal is a great way to get started with physical activity. It’s easier to achieve positive goals. An example of a positive activity goal is, “I will walk with a friend or family member for at least 20 minutes after dinner, every weekday for the next two months.”

Stress Management:

Not all stress is bad for us; in fact, some stress can be helpful for completing important projects, studying for an exam, speaking in public, or accomplishing challenging goals. On the other hand, distress or negative stress is the type of stress that can cause short- or long-term anxiety, decreased performance, and lead to poor mental and physical health. Distress can be caused by many factors that differ for everyone. It is important to recognize the things in your life that cause distress, so you can come up with a plan to manage or cope with or view situations differently. Look at events or triggers from a different angle. Consider “Is there another way to look at this situation?” and remember it’s not helpful to focus on what cannot be changed. Try to improve your mood by looking at what is going well in life. Focus on your accomplishments or what you have overcome.

Social Connections:

Social connections and relationships affect our physical, mental and emotional health. Research shows that the single most important predictor of human happiness and long life is having strong social connections. Health-related measures like blood pressure and heart rate improve even with short positive social interactions. Learn more about social connectedness and its potential impact on health and well-being in this article published in the Journal of Family Practice.
Social connections and relationships affect our physical, mental and emotional health. Setting goals is a great way to increase your sense of connection. It’s often easier to achieve positive goals. An example of a positive social connection goal is, “I will increase my feeling of social connectedness by joining a group fitness class that meets for an hour, three nights of the week.” What do you do to strengthen your social connections?

Restorative Sleep:

Sleep is an extremely important part of human health. Negative effects of sleep delays or interruptions include sluggishness, low attention span, decreased sociability, depressed mood, decreased deep sleep, decreased caloric burn during the day, increased hunger and decreased feeling of fullness, insulin resistance and decreased performance. While sleep quantity (getting 7-9 hours of sleep per night) may seem like enough, sleep quality is just as important to your health. According to the Sleep Foundation, sleep quality is defined as how well you are sleeping and is determined by several factors such as:

🔵 How long it takes you to fall asleep

🔵 How often you wake throughout the night

🔵 How much sleep you get every night

🔵 How you feel upon waking in the morning

Positive lifestyle behaviors during the day, such as regular physical activity and adequate hydration, and the establishment of a nighttime routine in the evening can help ensure you are getting quality sleep throughout the night.

Avoidance of Risky Substances:

It is well known that tobacco use and drinking too much alcohol increases the risk of many chronic diseases, and even death. Avoidance of risky substances is crucial for sustained health. Setting SMART goals for avoiding, or quitting, substances like cigarettes and alcohol is a great way to begin making positive changes to your lifestyle. Don't forget to give yourself patience as well. Support from others is another important part of reaching these goals. #lifestylemedicine #lifestylemedicinetips #bepresent

Marketing Language for Each Pillar

Whole-Food, Plant-Based Nutrition:

While there is a wide spectrum of dietary patterns, diets that include an abundance of whole and minimally processed plant foods are preferable.1

Extensive scientific evidence supports the use of a whole-food, predominantly plant-based eating pattern as an important strategy in the prevention of chronic disease,2 treatment of chronic conditions and,3 in intensive therapeutic doses, reversal of chronic illness.4

A primarily whole-food, plant-based eating pattern promotes overall health by increasing the intake of minimally processed, nutrient-dense, fiber-rich, antioxidant-rich foods and beverages and decreasing intake of saturated and trans fats, refined carbohydrates, processed oils, added sugars, sodium, and chemical contaminants.5

By its nature, this eating pattern also lowers calories. For the treatment, reversal and prevention of lifestyle-related chronic disease, ACLM promotes6 eating a variety of minimally processed vegetables, fruits, whole grains, beans, legumes, nuts and seeds.

American College of Lifestyle Medicine. Food as Medicine Jumpstart American College of Lifestyle Medicine Lifestylemedicine.org. 2021. Accessed September 13, 2022.
Dinu M, Abbate R, Gensini GF, Casini A, Sofi F. Vegetarian, vegan diets and multiple health outcomes: A systematic review with meta-analysis of observational studies. Critical Reviews in Food Science and Nutrition. 2017;57(17):3640-3649. http://doi.org/10.1080/10408398.2016.1138447
Remde A, DeTurk SN, Almardini A, Steiner L, Wojda T. Plant-predominant eating patterns – how effective are they for treating obesity and related cardiometabolic health outcomes? – a systematic review. Nutrition Reviews. 2021;80(5):1094-1104. http://doi.org/10.1093/nutrit/nuab060
Esselstyn CB, Jr., Gendy G, Doyle J, Golubic M, Roizen MF. A way to reverse CAD? J Fam Pract. 2014;63(7):356-364b.
American College of Lifestyle Medicine. The Benefits of Plant-Based Nutrition. American College of Lifestyle Medicine. Lifestylemedicine.org. 2021. Accessed September 12, 2022. https://lifestyle-medicine.foleon.com/wfpb-nutrition/diet-quality/
American College of Lifestyle Medicine. American College of Lifestyle Medicine Announces Dietary Lifestyle Position Statement for Treatment and Potential Reversal of Disease. PR web. prweb.com. September 12, 2022. Accessed September 12, 2022. https://www.prweb.com/releases/american_college_of_lifestyle_medicine_announces_dietary_lifestyle_position_statement_for_treatment_and_potential_reversal_of_disease/prweb15786205.htm

Physical Activity:

Although any amount of physical activity is better than none, it is important that adults engage in both general physical activity that offsets the negative effects of a sedentary lifestyle as well as purposeful exercise for targeted health outcomes as part of their weekly physical activity.

ACLM supports the personalization of exercise/activity for each individual to maximize the benefit with minimal risk, especially for injury. Clinically experienced and certified exercise specialists in the fields of kinesiology, exercise physiology, physical therapy, or personal training should be included in lifestyle medicine team models of care, especially for those starting a new exercise program or want help in designing a safe and effective program.

General physical activity can burn calories and is important in combating the negative effects of sedentary behavior; however, purposeful exercise improves cardiorespiratory and strength fitness and leads to substantial health benefits. These health benefits include reduction of blood pressure, weight, and risk of osteoporosis and dementia; prevention of and improved survival from several different cancers; and improvement in insulin resistance (a key factor in metabolic syndrome, diabetes, polycystic ovary syndrome and several other cardiometabolic disorders).

Exercise prescriptions should be tailored and focused on treatment and reversal of an individual health risks or disease conditions.

ACLM supports the World Health Organization (WHO) recommendations7 that adults 18-64 years old perform 150 to 300 minutes of moderate intensity aerobic physical activity, 75 to 150 minutes of vigorous intensity aerobic physical activity, or a combination of both weekly, as well as age-specific recommendations for other stages of life.

ACLM also supports the ACSM recommendation that adults 18-64 years old do muscle-strengthening activities of moderate or greater intensity that involve all major muscle groups two to three days per week.8

7. World Health Organization. Physical activity. World Health Organization. Who.org. November 26, 2020. Accessed September 12, 2022. https://www.who.int/news-room/fact-sheets/detail/physical-activity
8. Michael RE. Resistance Training for Health and Fitness. American College of Sports Medicine. Prescriptiontogetactive.com/. 2013. Accessed September 13, 2022. https://www.prescriptiontogetactive.com/static/pdfs/resistance-training-ACSM.pdf

Stress Management:

The chronic stress of modern society has made it more difficult to practice healthy lifestyle habits and can exacerbate health issues such as cardiovascular disease, insulin resistance, sleep deprivation, depression, anxiety, weight gain, etc.

Chronic stress can cause poorer overall quality of life, decreased job and school performance, and lead to mental and physical health issues.13

Communities of color are disproportionally affected by stress caused by bias and discrimination in addition to the social determinants or drivers of health,14 which are the conditions in the places where people live, learn, work, and play.14

Stress management is an important component of care in working towards whole-person health.12

There are many things that can help manage stress and improve overall health. ACLM suggests partnering with an interdisciplinary healthcare team to determine a plan of action for helping patients reduce their stress levels.

Such things as planning ahead, budgeting, leaving earlier from work, and being proactive tend to reduce preventable stress.

12. American Psychological Association. APA Professional Practice Guidelines. American Psychological Association. Apa.org. January 2010. Updated April 2021. Accessed September 12, 2022. https://www.apa.org/practice/guidelines
13. American Psychological Association. Stress effects on the body. American Psychological Association. Apa.org. November 1, 2018. Accessed September 12, 2022. https://www.apa.org/topics/stress/body
14. Jones SCT, Anderson RE, Gaskin-Wasson AL, Sawyer BA, Applewhite K, Metzger IW. From "crib to coffin": Navigating coping from racism-related stress throughout the lifespan of Black Americans. Am J Orthopsychiatry. 2020;90(2):267-282. http://doi.org/10.1037/ort0000430

Social Connections:

Research shows that having social connection is a key factor in human happiness and quality longevity.21, 22

Social connections and relationships affect our physical, mental and emotional health,23 including prevention of dementia in older age.24

In addition, people are more likely to adopt the health behaviors of others in their immediate social networks, including alcohol consumption,25 exercise,26 and diet.27

Leveraging the power of social connections and social networks can help reinforce healthy behaviors.28

21. Trudel-Fitzgerald C, Zevon ES, Kawachi I, Tucker-Seeley RD, Grodstein F, Kubzansky LD. The Prospective Association of Social Integration With Life Span and Exceptional Longevity in Women. J Gerontol B Psychol Sci Soc Sci. 2020;75(10):2132-2141. http://doi.org/10.1093/geronb/gbz116
22. Helliwell JF LR, Sachs J, De Neve J-E, eds,. 2020,. World Happiness Report 2020 Sustainable Solutions Network.
23. Holt-Lunstad J. Social Connection as a Public Health Issue: The Evidence and a Systemic Framework for Prioritizing the “Social” in Social Determinants of Health. Annual Review of Public Health. 2022;43(1):193-213. http://doi.org/10.1146/annurev-publhealth-052020-110732
24.Fratiglioni L, Marseglia A, Dekhtyar S. Ageing without dementia: can stimulating psychosocial and lifestyle experiences make a difference? Lancet Neurol. 2020;19(6):533-543. http://doi.org/10.1016/s1474-4422(20)30039-9
25. Rosenquist JN MJ, Fowler J, Christakis N. The Spread of Alcohol Consumption Behavior in a Large Social Network. Annals of Internal Medicine. 2010;152(7):426-433. http://doi.org/10.7326/0003-4819-152-7-201004060-00007 %m 20368648
26. Patterson MS, Amo CE, Prochnow T, Heinrich KM. Exploring social networks relative to various types of exercise self-efficacy within CrossFit participants. International Journal of Sport and Exercise Psychology. 2021:1-20. http://doi.org/10.1080/1612197X.2021.1987961
27. Gudzune KA, Peyton J, Pollack CE, et al. Perceived Diet and Exercise Behaviors Among Social Network Members With Personal Lifestyle Habits of Public Housing Residents. Health Education & Behavior. 2018;45(5):808-816. http://doi.org/10.1177/1090198118757985
28. Valente TW, Pitts SR. An Appraisal of Social Network Theory and Analysis as Applied to Public Health: Challenges and Opportunities. Annual Review of Public Health. 2017;38(1):103-118. http://doi.org/10.1146/annurev-publhealth-031816-044528

Restorative Sleep:

ACLM believes sleep is a critical aspect of human health and is the foundation upon which other lifestyle therapies, such as diet and exercise, are improved.

Sleep delays/interruptions have been shown to cause sluggishness, low attention span, decreased sociability, depressed mood, decreased caloric burn during the day, increased hunger, and decreased performance.

Risky Substance Avoidance:

Risky substances like alcohol, tobacco, and other drugs dramatically increase the risk and exacerbate the ill effects of chronic diseases and death. Other risky behaviors and exposures can negatively impact mental and physical health. Addressing these behaviors with evidence-based approaches is an essential element of health restoration.