A Health Message So Simple And Effective That Everyone Should Be Doing It
Give a patient a sense of ownership over their health, and you give them hope.
That’s the approach taken by Sean Hashmi, MD, MS, FASN, Regional Director Clinical Nutrition and Weight Management for Kaiser Permanente Southern California, when prescribing treatment for his patients, many of whom have obesity.
Ownership makes patients active participants in their care, not helpless bystanders.
“The best hope in the world is when they feel like they are in the driver’s seat,” Dr. Hashmi said. “The only thing in the world I know that does that is the promise of lifestyle medicine.”
Lifestyle medicine is a medical specialty that uses therapeutic lifestyle interventions as a primary modality to treat chronic conditions including, but not limited to, cardiovascular diseases, type 2 diabetes, and obesity. Lifestyle medicine certified clinicians are trained to apply evidence-based, whole-person, prescriptive lifestyle change to treat and, when used intensively, often reverse such conditions.
Applying the six pillars of lifestyle medicine — a whole-food, plant-predominant eating pattern, physical activity, restorative sleep, stress management, avoidance of risky substances and positive social connections — also provides effective prevention for these conditions. Lifestyle medicine can address up to 80% of chronic diseases.
Dr. Hashmi’s interest in lifestyle medicine grew out of concern for the health of his wife, who suffered from lupus and pulmonary hypertension, among other conditions.
“At one point, we were both certain my wife was going to die,” he said. “I needed to find something. I started to research nutrition and was blown away by how much information there was….There were concepts you could call irrefutable proofs of life that exist, like fruits vegetables, legumes, lentils and all this stuff that is not just feeding your body, but helping to heal your body.”
As he learned more and talked to people passionate about the role of lifestyle behavior in health, he discovered the American College of Lifestyle Medicine, the nation’s medical professional society representing clinicians dedicated to a lifestyle medicine and food-as-medicine–first approach to healthcare. Representing nearly 9,000 physicians and other clinicians, ACLM is the only organization that educates, equips, and supports certification of physicians and other clinicians in lifestyle medicine.
For the treatment, reversal and prevention of lifestyle-related chronic disease, ACLM recommends a whole food eating plan based predominantly on a variety of minimally processed vegetables, fruits, whole grains, legumes, nuts and seeds. In 2021, ACLM published a 10-part series of research white papers on the benefits of a whole food, plant-predominant dietary lifestyle for treatment of chronic conditions. The unique food-as-medicine collection is an evidence-based compilation resource for medical professionals treating patients with chronic diseases.
Dr. Hashmi and his wife incorporated the pillars of lifestyle medicine into their own lives and thrived. Today, his wife is strong, healthy and optimistic. Dr. Hashmi joined ACLM and integrated lifestyle medicine into the care he provided patients, sometimes sharing his personal experiences with lifestyle medicine to inspire and empower them.
“Physicians are designed to be teachers first,” he said. “We’re healers second, but really are teachers first.”
In his practice, Dr. Hashmi performs bariatric surgery that helps limit food consumption and promote weight loss through removal of part of the stomach. A step he takes with patients in the preoperative phase is to “optimize the body” in preparation of surgery.
With Dr. Hashmi’s support, some patients embrace the pillars of lifestyle medicine so wholeheartedly and effectively that they transform their health and never undergo bariatric surgery. They achieve their goals by establishing sustainable healthy habits. For the patient, that achievement is the ultimate act of ownership.
“That is the power of lifestyle medicine,” Dr. Hashmi said. “Reaching them with a message that is so simple, so effective, that everyone should be doing it. And it’s my job, my mission, to carry that message forward.”
As he made changes to his own lifestyle habits, Dr. Turner started talking to a nutritionist colleague at the Mayo Clinic who mentioned ACLM, the nation’s medical professional society representing clinicians dedicated to a lifestyle medicine. ACLM defines lifestyle medicine as the evidence-based use of a predominantly whole food, plant-based diet, physical activity, restorative sleep, social connection, avoidance of risky substances and stress management. ACLM, which represents more than 7,000 physicians and other clinicians, is the only organization that educates, equips, and supports certification of physicians and other clinicians in lifestyle medicine.
Dr. Turner began talking to patients about their lifestyle habits and explaining the evidence that supported how changes could improve their whole health. During clinical rounds, he visited patients with lifestyle-health related books that could benefit their specific health ailment. Resident doctors accompanying him on rounds would say afterward “I’ve never seen anyone do that before. Can you show me the books you’re using?”
For patients who committed to lifestyle behavior changes, the results were at times astonishing. Patients suffering from severe hypertension enjoyed dramatic decreases in blood pressure and, subsequently significantly reduced the antihypertension medication they required. Patients with chronic kidney disease, diabetes or advanced atherosclerotic vascular disease stabilized their kidney function and did not progress to the point of needing dialysis. Patients with a history of kidney stones were able to prevent stone growth and new stone formation.
At times, Dr. Turner took good-natured ribbing from colleagues — “Here comes Turner with his veggies.” But as health care spending soared, the pandemic raised awareness of the risks of chronic lifestyle-related disease and the evidence grew proving the therapeutic power of lifestyle medicine, interest in the field exploded. ACLM, which had 500 members in 2014, has grown to more than 9,000 practicing in the field. Large health systems are increasingly integrating a therapeutic dose of lifestyle medicine into patient care, employee health and their broader communities.
“Interest in lifestyle medicine is growing not just among clinicians and health systems but among patients who are increasingly understanding that they can make a big difference in their health with small lifestyle changes,” said ACLM President Dr. Cate Collings, MD, MS, FACC, DipABLM. “Dr. Turner’s generous gift to ACLM will help more clinicians gain the knowledge and skills to practice lifestyle medicine and partner with their patients take control of their heath.”
The time is now for lifestyle medicine to become the foundation of health and health care, Dr. Turner said. He hopes his gift to ACLM can help build that foundation.
“ACLM has really become my intellectual home,” Dr. Turner said. “I truly believe lifestyle medicine is the most positive thing happening in the medical space. I am excited to do my part to keep that positive momentum going.”
LEARN TO USE FOOD-AS-MEDICINE
The HEAL scholarship was created to provide an avenue for BIPOC healthcare professionals to explore lifestyle medicine as a specialty and help diversify the lifestyle medicine workforce.
ACLM CRT member, Love One Today, an initiative to advance awareness and understanding of the nutrition research on avocado consumption, is empowering lifestyle medicine by providing resources that make it easy for health professionals help patients who want to improve their health and make diet-related lifestyle behavior changes with healthy foods like avocado.
Addressing each patient’s diabetes is more in-depth than a standard diagnosis. Instead, residents and attending physicians educate patients about evidence-based lifestyle medicine that, if prescribed intensively, could reverse their diagnosis.