From Daily Health News...

Scientific Basis for Lifestyle Improvement

"Duh" my daughters might say to the news report that a healthful lifestyle is important in the prevention and treatment of disease -- but actually I think it is both interesting and promising that mainstream medical professionals are organizing themselves to press Congress and insurers to pay for preventive medicine, including lifestyle counseling. It's yet more evidence that the tides are beginning to turn toward natural medicine and healthy living and away from costly, risky, symptom-suppressing procedures.

Of course, some insurance plans already reimburse some forms of complementary medical care, and naturopathic physicians have always emphasized natural treatments. But what's news is that in 2004 a group of doctors led by John H. Kelly, Jr., MD, MPH, of Loma Linda University School of Medicine in California, formed the American College of Lifestyle Medicine (ACLM) to inform medical professionals about the importance of a healthful lifestyle in the prevention and treatment of disease.

Now president of the ACLM, Dr. Kelly believes that modern medicine currently focuses too much on acute care and too little on prevention, and we need to turn that around. Once considered fringe notions divorced from mainstream medicine, lifestyle interventions like diet and exercise to promote health and wellness are now getting official attention. There's even research demonstrating that adherence to lifestyle changes improves with more intensive intervention from a patient's medical team.

WHY THIS MATTERS SO MUCH

Unhealthy lifestyle choices have long been acknowledged as primary risk factors for chronic disease -- and health-promoting lifestyle changes are widely viewed as one of the best ways to prevent disease from developing or progressing, which is why I so frequently cover them in articles. But, says Dr. Kelly, lifestyle interventions in which the doctor focuses on how your health habits contribute to your medical issues and "strongly encourages" you to improve them -- perhaps even writing a prescription for exercise, diet or attendance at support groups -- should also be required in acute, episodic care for conditions such as heart attack or stroke... and that's far from the case today. He explained that even though they play a key role in medical treatment of both chronic and acute conditions, interventions such as diet, exercise and emotional counseling tend not to be covered by insurance companies. If they are reimbursed, it's typically only after a serious medical event, such as a heart attack or heart surgery -- not beforehand, when such crises might be prevented altogether.

IS IT ABOUT DOLLARS... OR SENSE?

The problem is that preventive measures don't make money -- for doctors or hospitals. While everyone acknowledges that early intervention is the best and most cost-effective medicine, it's clear that late-stage, acute care services make much more money. For example, some of the most profitable procedures by far for hospitals are heart surgeries, such as coronary bypass surgery. It doesn't make sense to pay tens of thousands of dollars for costly, risky and even controversial cardiovascular surgeries or procedures such as bypass and angioplasty with stents, rather than fund far less expensive treatment and support for patients using proven early interventions, notes Dr. Kelly. Often a healthier diet, regular exercise and stress management can arrest and even reverse cardiovascular disease or diabetes before it reaches a critical point where surgery is being considered -- but this is the way the system works right now. If we were talking about almost any other condition, Dr. Kelly points out, such as Alzheimer's or polio, it would be considered socially unacceptable to delay early treatment until the disease ravaged a person's health and brought him/her near death's door. Besides being wrong, he says, it's also fiscally unwise.

LOOKING TOWARD THE FUTURE

Getting insurance companies to reimburse lifestyle medicine services is a main goal. To that end, Dr. Kelly and the ACLM are trying to raise both awareness and funds to lobby Congress to mandate insurance coverage for lifestyle interventions such as smoking cessation, and require that doctors inform patients about healthy lifestyle changes before prescribing medicines or recommending surgical procedures. As time goes on, a key priority of the organization is to develop and implement evidence-based lifestyle treatment plans for specific diseases, spelling out the details of recommended diet plans, exercise regimens, etc. Eventually, Dr. Kelly expects that lifestyle medicine will become a credentialed medical specialty like obstetrics or surgery or neurology.

In the meantime, we can all benefit from paying more attention to the lifestyle choices we make every day. You've heard it from me before and I'm sure I'll say it again: Health doesn't come from pills or procedures. Don't wait around for your doctor to tell you what you need to do to get healthy -- set your own short-term, manageable goals for lifestyle change. You don't have to forego your favorite treats altogether -- just enjoy them occasionally, rather than regularly. Substitute whole grain cereal for the donuts you've been eating for breakfast. Lace on your sneakers and start walking -- once, twice, aiming for at least five times a week, working your way up to 30 minutes at a clip. And consider including a naturopathic physician, specially trained in preventive medicine and natural treatments, to your medical team.

Each small step in the direction of a healthy lifestyle brings you closer to your goal -- well-being. In a system that has been too long focused on treating sickness rather than promoting health, it's nice to see that some mainstream physicians, like Dr. Kelly, want to put the "health" back in "health care."

Source(s):

John H. Kelly, Jr., MD, MPH, founding president, American College of Lifestyle Medicine, clinical scientist, Diabetes and Wellness Outcomes Research for the Republic of the Marshall Islands, lead researcher of the Lifestyle Research Initiative, in the department of nutrition, School of Public Health, and assistant professor, department of preventive medicine, School of Medicine, Loma Linda University, Loma Linda, California.