As leaders in healthcare and the clinical treatment of chronic disease, the American College of Lifestyle Medicine has a responsibility to address certain issues that define our values and impact the field.
The diligent development of authoritative statements on issues and values is essential for inserting lifestyle medicine into decision-making processes.
ACLM’s dietary position:
For the treatment, reversal, and prevention of lifestyle-related chronic disease, ACLM recommends an eating plan based predominantly on a variety of minimally processed vegetables, fruits, whole grains, legumes, nuts, and seeds.
(Note: ACLM supports a dietary spectrum and rather than promoting a “vegan” or “vegetarian” diet, promotes whole-food plant-predominant dietary patterns in alignment with other global and national guidelines and recommendations.
Cara KC, Goldman DM, Kollman BK, Amato SS, Tull MD, Karlsen MC. Commonalities among Dietary Recommendations from 2010 to 2021 Clinical Practice Guidelines: A Meta-Epidemiological Study from the American College of Lifestyle Medicine. Advances in Nutrition. 2023;14(3):500-515. http://doi.org/https://doi.org/10.1016/j.advnut.2023.03.007)
ACLM’s diet-climate position:
ACLM acknowledges that the leading cause of chronic disease and the leading cause of so many of our most pressing global sustainability issues is one and the same: our Western pattern diet. Shifting to a whole food, plant-predominant dietary lifestyle is optimal in order to protect human health and fight disease; this dietary lifestyle pattern is also what is best for the planet, enabling us to preserve our precious natural resources, rein in greenhouse gas emissions, and feed what soon will be over nine billion people on the face of the earth.
ACLM’s obesity position:
Chronic disease clinical guidelines for multiple conditions, including overweight and obesity, promote lifestyle interventions as a first treatment. Patients’ best interests call for a compassionate, evidence-based approach addressing the six lifestyle pillars, as defined by the American College of Lifestyle Medicine (ACLM), to achieve a goal of health restoration. These pillars include 1.) regular physical activity, 2.) whole-food, plant-predominant nutrition, 3.) restorative sleep, 4.) stress management, 5.) positive social connection, and 6.) avoidance of risky substances; also acknowledging each individual’s lived environment and genetic predisposition, as many people live in a home or societal environment that promotes and exacerbates weight gain.
While adequately dosed lifestyle interventions may unilaterally achieve success, obesity is a complex, multifactorial disease wherein patients may require approaches beyond lifestyle alone. However, lifestyle interventions are too often not adequately “dosed” for success. Lifestyle medicine clinicians are trained to prescribe a therapeutic dose of all six pillars. Evidence supports the efficacy of these interventions in addressing the underlying causes of disease, including gut dysbiosis, endothelial dysfunction, oxidative stress, and chronic inflammation.
A comprehensive lifestyle medicine approach prevents and treats many other co-morbidities associated with overweight and obesity, including, but not limited to, hypertension, high cholesterol, heart disease, type 2 diabetes, and arthritis, and a lifestyle medicine approach can also reduce the risk of many types of cancer. Lifestyle medicine must become the foundation of comprehensive treatment, with or without surgery and/or medications as adjunctive therapies. ACLM stands ready to be a resource to help clinicians and patients in treatment of adult and pediatric overweight and obesity.
ACLM’s non-discrimination position:
The American College of Lifestyle Medicine (ACLM) was founded upon and operates on the values of respect, integrity, and trust for all whom we serve.
We are guided by our core values and our vision of lifestyle medicine being the foundation of health and all health care as a service to ALL people.
We are committed to providing a welcoming and inclusive environment for all who are touched by our organization, including, although not limited to, through employment, membership, elected leadership, appointed leadership, volunteer service, strategic partnership, or by engagement with ACLM as a subcontractor, vendor, or client.
In regard to any and all activities of operation, we do not exclude people or treat them differently because of race, color, religion, gender, gender expression, age, national origin, disability, marital status, sexual orientation, or military status. These activities include, but are not limited to, membership application, hiring and firing of staff, nomination and election of leadership, selection of volunteers and vendors, and provision of services.
Type 2 Diabetes Remission and Lifestyle Medicine: A Position Statement From the American College of Lifestyle Medicine
Objectives. The present review represents the position of the American College of Lifestyle Medicine on type 2 diabetes (T2D) and remission treatment. Background. Research now reveals that sufficiently intensive lifestyle interventions can produce remission of T2D with similar success to bariatric surgery, but with substantially fewer untoward side effects. Methods.
A literature review was conducted to examine lifestyle modifications targeting T2D remission, with most studies using a combination of blood glucose markers and treatment history.
Results. There were notable differences in the dosing intensity of lifestyle interventions between therapeutic interventions and subtherapeutic interventions. Studies with therapeutic dosing typically used very low energy diets (600-1100 kcal/day) with a weighted mean remission rate of 49.4%, while studies with subtherapeutic dosing typically used more moderate caloric restrictions (reducing energy intake by 500-600 kcal/day) and the weighted mean remission rate was 6.9%. Conclusions. Remission should be the clinical goal in T2D treatment, using properly dosed intensive lifestyle interventions as a primary component of medical care for T2D patients.
