Lifestyle Medicine: An Alternative to Traditional Medicine
By Michael Parkinson, M.D.

Significant and growing scientific evidence shows that the primary determinant of health or disease is not genetics, but rather lifestyle. Heart disease, diabetes, stroke, cancer and a wide variety of other chronic diseases are not only preventable with healthier behaviors – but they can be better managed, and even reversed, through lifestyle improvements.

The connection between lifestyle and health has given rise to a relatively new style of treatment known as lifestyle medicine. Increasingly, it is being seen as an alternative to traditional treatments that are used on chronic diseases.

Lifestyle medicine is a new paradigm that "de-medical-izes" health. It truly addresses the root cause of disease, disability and premature death. What we eat, how we move and how we think are the cornerstones of good health and living a long and productive life. Doctors are beginning to get serious about helping employees and patients to address the root causes of disease – not just treating conditions with pills, tests and procedures.

Defining Lifestyle Medicine
You can define lifestyle medicine as the use of lifestyle interventions in the treatment, management and reversal of disease. Lifestyle interventions, "prescribed" and supported by a health care provider typically consist of:

• Forks: Incorporating more whole, plant-based foods into the diet by reducing or completely eliminating refined and highly processed foods, meat and dairy products.
• Feet: Increasing daily physical activity to at least 30 minutes of aerobic activity such as brisk walking.
• Fingers: Eliminating cigarettes or excess alcohol intake.
• Sleep: Ensuring we obtain adequate and deep sleep every night.
• Stress: Developing healthy coping mechanisms like exercise, meditation or mindfulness for life's inevitable challenges.
• Love: Having and developing a commitment to a purpose, person, or interest which gives meaning to our lives.

Scientific evidence shows that lifestyle interventions can be effective in treating chronic disease, and they can be equally - and often even more effective – than medication. Lifestyle interventions also have the benefit of not having as many risks of unwanted side effects. The cost? None except choices, time, and effort.

Lifestyle medicine does not discourage all medications, however. For instance, when medication can aid in promoting a healthy lifestyle – such as using "the patch" to help quit smoking – it is often recommended.

But, the overall basic tenet of lifestyle medicine is that treating chronic conditions with medication merely treats the symptoms and, therefore, results in poor outcomes and higher healthcare costs. Lifestyle medicine addresses the root cause of the condition, rather than ignoring it.

Lifestyle medicine can both be effective in helping to prevent, but also to treat most chronic diseases. Many diseases affecting multiple organs – like heart disease, kidney disease, hypertension, diabetes, majority of cancers, dementia and other conditions – are due to modern-day processed food diets which are high in added salt, sugars and fats but low in nutrients and micro vitamins. The result can be underlying inflammation which can promote multiple common chronic diseases.

Lifestyle Medicine's Potential
Frankly, we can no longer afford to "medicalize" environmentally and behaviorally caused disease with more treatments, tests and procedures .

At UPMC Health Plan we have taken steps in that direction. For UPMC Health Plan members, physicians now have the option of "prescribing" wellness to their patients to encourage healthy behaviors. That is, instead of issuing a prescription for medication, they can give patients a "prescription" to contact a UPMC Health Plan Health Coach. We have found that this added impetus does make it more likely for someone to contact the health coaches who can get them started on practicing healthy behaviors.

Doctors, who are frustrated often by lack of progress in treating and reversing disease, are beginning to explore this new approach based on sound science. The challenge in the near term is twofold: paying for these services (as opposed to usual medical interventions under "fee for service" reimbursement) and improving the skills of providers to provide them. However, I am confident that with new payment models promoted by the Affordable Care Act (ACA) and with employers' consistent and constructive engagement that we'll begin to see more ways to improve employee and family health.

Dr. Michael Parkinson, Senior Medical Director, UPMC Health Plan, can be reached at parkinsonmw@upmc.edu.

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