Table 12.
Implications of Expert Consensus Statements on Lifestyle Medicine for Primary Care Clinicians.
| Domain | Expert Consensus Statement Summary | Suggestions for Clinicians |
|---|---|---|
| Integrating into primary care (Table 2) | LM addresses the root causes of most chronic diseases, is essential to primary care, and can improve patient outcomes and satisfaction | Understand how LM complements but does not replace traditional allopathic medicine, and how LM differs from other approaches to medical care (functional, integrative, complementary and alternative) |
| Delivery models (Table 3) | Many LM services are feasible in primary care, optimally through a multidisciplinary team led by physicians, NPs, or PAs trained in LM. | Establish teams and use the 5 A’s model (assess, advise, agree, assist, arrange) to engage and empower patients in behavior change through individual counseling (in-person, virtual), shared medical appointments, and convenient non-medical locations a |
| Provider education (Table 4) | LM is a foundational component of all health professional training, education, and continuing education to build the skills and knowledge for effective LM delivery in primary care | Build knowledge and understanding of the 6 LM pillars (Table 1) and techniques to facilitate lifestyle behavior change through CME venues and conference participation with a goal of LM board certification |
| Evidence-base for LM (Table 5) | LM is informed by an established, and rapidly growing, evidence-base of research showing opportunities to improve health outcomes, reduce health care cost, advance planetary health, and promote health equity | Know that LM is an evidence-based specialty; be aware of the large body of existing literature that supports LM efficacy for disease prevention, treatment, and reversal; remain attentive to new LM research, guidelines, and reviews |
| Diagnosis and vital signs (Table 6) | Lifestyle behaviors should be assessed at every patient encounter, ideally with simple, validated screening questions or technologies | Identify and implement pragmatic tools to assess the 6 LM domains (Table 1) to monitor progress in improving health behaviors |
| Treatment (Table 7) | Lifestyle modifications are first-line treatments in managing many chronic diseases, including obesity, type 2 diabetes, cardiovascular diseases, and other conditions impacted by lifestyle | Advocate for a predominantly whole food, plant-based eating pattern while addressing the other pillars of LM (Table 1) through assessment, education, intervention, and behavior change; measure LM treatment success with patient-reported outcome measures, biometrics, and laboratory results |
| Patient, family, and community involvement; shared decision-making (Table 9) | LM encourages patients to actively participate in their care, with support from family, community, and technology for behavior change and maintenance | Learn how to promote positive patient behavior through coaching support; identify technology to support patient health; refer to community programs for health education and promotion |
| Health equity and social determinants (Table 10) | Ensuring that historically marginalized populations have access to LM is a key component of achieving health equity | Recognize that social determinants of health have an impact on behavior choices; make LM recommendations that align with and respect resource availability and cultural background |
CME, continuing medical education; LM, lifestyle medicine.
aNon-medical locations can include schools, neighborhood centers, senior centers, not-for-profit organizations, places of worship, teaching kitchens, and other community venues.