Prescribing Lifestyle As Medicine – Back to the Basics

Lifestyle medicine is no longer just recommended for disease prevention — it is now being prescribed to also treat chronic diseases. Majority of our healthcare dollars are spent on chronic diseases that are rooted in lifestyle choices.  This is important because we have the power to change the outcome by changing our lifestyle.

What is the Basis of Lifestyle Medicine?
Lifestyle medicine is health oriented, meaning the frame of reference is achieving health and vitality and not just eliminating sickness.  The beauty of practicing this form of medicine is that it can be individualized, such that two patients with a seemingly similar complaint might receive different lifestyle recommendations tailored to their specific case.

Furthermore, this form of medicine goes beyond just temporarily suppressing the symptoms.  Rather lifestyle medicine seeks and addresses the root cause(s) of each patient’s symptoms, which requires that the doctor spend enough time with the patient to educate him or her.  Lifestyle medicine is patient-centered and educational, because for patients to effectively make the necessary changes they need to understand the reasons why.  This type of medicine requires deep and meaningful connection and communication between doctor and patients.

Between optimal health and disease there is a continuum and as dynamic beings we are constantly moving between these two points.  We do not wake up one day suddenly with chronic disease.  In the current healthcare model, often by the time we hear our diagnosis of a chronic disease, things have been going wrong for a long time and we have been experiencing the symptoms of the disease process.  Even then if our labs don’t yet exactly match the defined criteria for the disease we can not be diagnosed and treated.  Lifestyle medicine is yet the strongest measure to prevent chronic disease, as well as to effectively treat it.

A key factor in prescribing lifestyle medicine is treating the person as a whole, as oppose to a collection of individual body parts.  This is vitally important because most people with chronic disease have comorbidities, which means having two or more chronic diseases and conditions simultaneously.  Hence, being treated as a whole, or at least having a team of specialists that effectively communicate on the patient’s case, is crucial for getting to the root cause(s) of the problem and successfully treating him or her.

What Are These Chronic Diseases that we are referring to?
Some examples of common chronic diseases are:

  • High blood pressure
  • Diabetes type 2
  • Arthritis
  • Obesity
  • Depression
  • Alzheimer’s and dementia

What Do We Mean by Lifestyle Medicine?
Lifestyle medicine is the therapeutic use of lifestyle interventions to prevent, treat or even reverse disease.  These lifestyle factors are what we, in Naturopathic Medicine, refer to as determinants of health.  They are the pillars, the foundations, upon which you can build a very solid and sustainable state of health and wellbeing.  I can not overstate the importance of factors, such as exposure to nature and fresh air, quality water and adequate hydration, nutrition, proper functioning of our elimination organs, restful sleep and relaxation of body and mind. By addressing these determinants of health, we can correct for underlying imbalances and deficiencies, creating the optimal environment for our body to heal itself.

The Pillars of Lifestyle Medicine
First and foremost, we need to be looking at these factors through the proper lens.  In each category below, I attempt to explain what the importance of that aspect of lifestyle is and the paradigm shift that is necessary to bring about the realizations that enable us to make the changes.

WATER:  Majority of our body is made up of almost entirely water, but there isn’t enough emphasis even in the health circles on the importance of adequate hydration.  Unlike with food, the maximum time that we can go without water is around a week, and under extreme heat this time can be even less.  Every single living cell in our body needs water for its functioning.  Water acts as a lubricant for our joints, it helps to regulate our body temperature (through sweating and respiration), and it allows us to eliminate waste and toxins from of our bodies.

  • Drink water.  Sounds simple but you’ll be surprised to hear how many of my patients walk around in a chronic state of dehydration.  Or to make matters worse, throughout the day they drink things that dehydrates them further, such as excessive amounts of coffee or caffeinated teas and beverages.  Aim to drink half of your body weight (in pounds) in ounces of water daily.
  • Drink water from a good source.  Yes, the source of your drinking water matters.  The same applies to the water that you bathe in.  Depending on where you live, your tap water might not be the best source of drinking and bath water.  Good quality water and shower filters are one solution to this problem.  Another is sourcing springs nearby, or purchasing water locally.  To find a nearby natural spring check out http://www.findaspring.com/, and make sure that the water is safe for drinking purposes.
  • Drink water from a glass container/bottle as much as possible.  Another good source of non-plastic water bottles are stainless steel ones.  My favorites are wide-neck glass bottles that are easy to wash.

FOOD:  There are countless and at times overwhelming number of resources on diet and nutrition.  My goal is to touch upon and expose you to some simple and basic factors that can have a powerful impact on your health.  Considering food is a source of fuel for the body, providing the proper fuel is crucial for optimally running our engine —  a clean fuel sourced from whole nutritious foods.  But food goes much beyond being just a source of fuel for the body and is also information for our cells.  What we choose to put into our mouth can impact our genetic expression, our mood, our energy, our cognitive and physical performance along with the health of our planet.

  • Eat slow, and chew your food thoroughly.  We spoke about the benefits of this practice in my last article MINDFULNESS PRACTICES — SIMPLE YET POWERFUL.
  • Eat fruits and vegetables with a variety of colors.  These colors indicate the different nutrients these foods contain.  Richly colored fruits and vegetables are packed with rich amounts of antioxidants such as anthocyanin, lycopene, carotenoids, and zeaxanthin, as well as vitamins and minerals.
  • Eat according to the season.  Eating with the season means you are eating plants with higher levels of nutrients that have received adequate amount of nourishment from the sun and soil.  They are fresh and do not have be imported from long distances.  Just like the environment, our bodies go through shifts and changes with the seasons and thus need to be supported accordingly.  Eating with the season supports our body through these times.
  • Eat healthy fats.  We are learning more and more about the role that fats play in our physiology.  But are all fats created equal? The answer is a resounding NO.  AVOID using rancid fats.  Incorporate raw fats from sources like avocados, olives, and nuts and seeds.  Avoid heating fats that are not meant to be used for cooking at high temperatures, such as flaxseed oil or even extra virgin olive oil (especially for high heat cooking).  The best cooking oils are avocado oil and ghee (purified butter) from a grassed source, as well as refined coconut oil.  Purchase oils that are preferably stored in dark glass bottles and keep your oils away from air, light and heat.  I will write more extensively on this very important topic of fats and oils in the future.

MOVEMENT:  And now onto one of my most favorite topics — movement.  I am not just talking about exercise but actually moving our bodies.  Our bodies are naturally designed to be moving in a way to develop a rich and dynamic movement vocabulary.  “The body will become better at whatever you do, or don’t do.  If you don’t move, your body will make you better at not moving.  If you move, your body will allow more movement”.  Ido Portal.

By moving our bodies we come back to them and remind ourselves and the universe that we are still here.  We should move our bodies because we can, because they are designed for movement — complex pattern movements.  This is how our brains develop and how we can ensure longevity.  Lack or absence of movement will lead to our decline.  So, let’s move.  And, let’s feel alive!

  • Move consistently and move more.  Movement is not something that should be restricted to an occasional once a week 1-hour gym visit.  We need consistent movement throughout each and every day.  Use every opportunity throughout the day to sprinkle movement in.  Park the farthest from your destination, take the stairs, do a few squats before actually sitting on your office chair, use the edge of your table to do a few push-ups, do some spine rolls, mobilize your joints, stretch and release the tension in your body.
  • Move in a variety of ways.  Modern day living has negatively changed our postures and movement dynamics, resulting in decreased flexibility in our bodies.  Our bodies are where we live for the entirety of our lives, yet we seldom pay attention to and notice how with passage of time we feel less and less free.  We cannot lift our arms, bend our backs or move our spine without experiencing pain or pulling something and injuring ourselves.  And, we call this the process of aging.  We don’t have to feel imprisoned in our bodies, but for that we have to practice movement in all of its forms.
  • Move for mobility, not just for strength.  For many of us physical activity is still tied to improved physique, mainly weight loss.  As we age what our bodies need the most is preserving our range of motion.  Alongside a diverse movement protocol, bodywork, such as active-release work (ART) and myofascial release, is another great source to help with working through our weak and restricted areas — allowing for more opening.
  • Move with guidance.  Hiring a good, knowledgeable movement coach is not a waste of money, but rather it is a necessity.  Especially if you have adopted a stationary life-style for a long time, learning how to properly move is crucial.  A movement couch can help you move through your restrictions and improve them.  Your body and mind will thank you for this worthy investment.

SLEEP:  Sleep is perhaps the most undervalued aspect of health.  We see it as a waste of time or something for lazy people.  Some of us even feel guilty for getting a full night of restful sleep.  I personally have gone through most of my life not giving myself the permission to get enough sleep.  I would constantly cut from my sleep to stretch my day and do more, but I have learned that no amount of supplementation, exercise, and good diet can make up for chronic sleep deprivation.  Our bodies heal and regenerate during sleep.  It’s during a deep and restful night of sleep that our brains get to process the waste and detoxify.  Sleep is crucial for brain health, for proper functioning of our immune system, for preventing excess release of stress hormones, for regulating our blood sugar levels and energy and much more.  Sound sleep is pivotal to both mental and physical wellbeing.

  • Sleep better using morning light exposure.  A good night’s sleep begins with how you start your day.  Exposing yourself to natural sun light during the day is extremely beneficial.  Natural sun light or day-time blue light exposure will increase the production of the hormone serotonin, which independently plays a role in regulating your sleep-wake cycle.  Serotonin is also the precursor to melatonin — your sleep hormone.  Serotonin is used by the pineal gland to produce melatonin.  Hence, natural light exposure can also enhance your melatonin levels.
  • Sleep away from technology and adopt a bedtime routine.  Shut off your technology 60-90 minutes prior to your bed time and adopt a bedtime routine.  Being exposed to the blue wavelength light right up until bedtime (although important during the day) can interfere with sleep.  It lessens the amount of melatonin being produced.  By being attached to your devices all day long and into the night, we continue to be stressed and anxious and consequently more alert when in fact you should be relaxing.  Having a bedtime routine that involves shutting off phones and computers 60-90mins prior to bed, using red light or candle light, taking a warm bath, listening to relaxing music, and creating a dark and cool sleep environment are critical to good quality sleep.  Dr. Chatterjee has a very valid point when he said: children have nighttime routines and that’s wildly accepted.  What makes us think that as adults we do not need a nighttime routine?
  • Sleep deeper using regular physical activity and movement practices.  There is scientific evidence showing that incorporating physical activity can be a very effective non-pharmaceutical alternative for better sleep.  Physical activity can help to reduce stress, manage anxiety and improve mood — all of which are vital in improving both sleep quality and duration.  Specifically morning and early afternoon exercise can also help in resetting the sleep-wake cycle.
  • Sleep at a relatively consistent time every night.  Pick a bedtime that you can stick to as closely as possible throughout the week.  Sleeping on a regular schedule will help you maintain your body’s internal clock, which in turn will help you fall asleep and wake up more easily.  A regular bedtime schedule will enhance both duration and quality of your sleep.

RELAXATION:  During the past two articles we have discussed biofeedback and mindfulness practices.  Although I would not consider biofeedback and mindfulness as merely relaxation techniques, one of their benefits is relaxation

  • Decompress through embracing mediation and simplicity.  What do we do when we are in a state of overwhelm?  We try to simplify our lives.  What if we could make this a regular practice and do it more often?  Take a few minutes every day to focus on breathing and inviting more ease into your life.
  • Decompress through introducing more play and creativity into your life.  Creativity comes from a state of calm.  We can not readily tap into our creative side when we are in a state of fight or flight.  Play also brings us close to our true nature, because when we play we engage in activities that brings us back to our bodies and out of our heads.  We begin to experience another side of ourselves and often lose track of time.  This is a crucial reset for our nervous system and mind.
  • Decompress through keeping a gratitude journal.  This is one of my favorites.  Either by keeping a journal (what I recommend) or giving yourself several minutes daily to feel and name the things that make you smile and you are grateful for.  This takes only a few minutes and it’s simple yet very powerful in shifting your perspective.
  • Decompress through taking walks in nature.  You can make this be your morning walk where you expose yourself to the natural light or even add in an evening walk after dinner.

When we begin to feel better from small, albeit powerful changes in these areas, we can appreciate how very important they are to our health and how invaluable our health is.

What Is the Alternative?

Maintaining health is an investment — one of the most important investments each of us can make.  The alternative to practicing and implementing these healthy lifestyle choices is higher risk medicine.  Prescription drugs, needing multiple drugs to mask the side-effects of each other, and invasive procedures like surgery are examples of the conventional approach to today’s chronic diseases.  Sadly none of these approaches though truly address the root causes of disease.

Resources

  • Dr. Rangan Chatterjee’s book titled: The 4 Pillar Plan, is another great resource for discussing these determinants of health in more depth.
  • I use the app f.lux on my computer to avoid blue-light exposure in the evening after sunset.

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