6 WAYS LIFESTYLE MEDICINE

TO TAKE CONTROL 1
WHOLE FOOD, PLANT-BASED NUTRITION
Extensive scientific evidence supports the use of a whole-
food, predominantly plant-based diet as an important

OF YOUR strategy in prevention of chronic disease, treatment of

chronic conditions and, in intensive therapeutic doses,
reversal of chronic illness. Such a diet is rich in fiber,

HEALTH antioxidants, and nutrient dense. Choose a variety of

minimally processed vegetables, fruits, whole grains,
legumes, nuts and seeds.

Lifestyle medicine is a medical

specialty that uses therapeutic
2 PHYSICAL ACTIVITY
Regular and consistent physical activity combats the
negative effects of sedentary behavior. It is important
lifestyle interventions as a that adults engage in both general physical activity as
primary modality to treat well as purposeful exercise weekly as part of overall
chronic conditions including, but health and resiliency.
not limited to, cardiovascular
diseases, type 2 diabetes, and
obesity. Lifestyle medicine
certified clinicians are trained
3 STRESS MANAGEMENT
Stress can lead to improved health and productivity -
or it can lead to anxiety, depression, obesity, immune
dysfunction and more. Helping patients recognize
to apply evidence-based, whole- negative stress responses, identify coping mechanisms
person, prescriptive lifestyle and reduction techniques leads to improved wellbeing.
change to treat and, when used
intensively, often reverse such

4
AVOIDANCE OF RISKY SUBSTANCES
conditions. Applying the six Use of tobacco and excessive alcohol consumption have
pillars of lifestyle medicine—a been shown to increase the risk of chronic diseases and
whole-food, plant-predominant death. Treatments often take time, different approaches
eating pattern, physical activity, and many attempts. Patience and support are an
restorative sleep, stress important part of breaking risky substance habits.
management, avoidance of
risky substances and positive
5
RESTORATIVE SLEEP
social connections—also Sleep delays/interruptions have been shown to cause
provides effective prevention for sluggishness, low attention span, decreased sociability,
these conditions. depressed mood, decreased deep sleep, decreased
caloric burn during the day, increased hunger and
decreased feeling of fullness, insulin resistance and
decreased performance. Strive for 7 or more hours per
night for optimal health

6
SOCIAL CONNECTION
Positive social connections and relationships affect our
physical, mental and emotional health. Leveraging the
power of relationships and social networks can help
reinforce healthy behaviors.

www.lifestylemedicine.org
Lifestyle Nutrition
For the treatment, reversal and prevention of lifestyle-related chronic disease,
the American College of Lifestyle Medicine recommends an eating plan based
predominantly on a variety of minimally processed vegetables, fruits, whole
grains, legumes, nuts and seeds.

Eat Plenty Eat Less/Avoid

• Vegetables • Sugary drinks like soda, juice
• Mushrooms cocktails, sweetened coffee and
• Fruits energy drinks
• Legumes • Processed meats like sausage,
• Whole Grains bacon, salami, bologna, deli meat
• Nuts • Processed snacks like crackers,
• Seeds chips, pretzels
• Herbs • Cakes, pastries, sweets
• Spices • Dairy (especially high-fat types with
• Water added salt and/or sugar)
• Red meats
• Poultry Helpful resources:
Food for Thought • Eggs Academy of Nutrition and Dietetics:
eatright.org
Eating Inspiration:
American Heart Association:
Vegetables: Leafy vegetables (kale, spinach, romaine, swiss chard, collard heart.org
greens, cabbage), garlic, onions, peppers (all kinds), leeks, parsnips, potatoes
(all kinds), radishes, turnips, squash, green beans, tomatoes, carrots, corn, peas, American Diabetes Association:
cauliflower, broccoli, cucumbers, eggplant. diabetes.org
Mushrooms: white button, cremini, portabella, shiitake, oyster, beech,
chanterelle, porcini American Institute for Cancer Research:
aicr.org/reduce-your-cancer-risk/diet/
Fruits: Bananas, apples, kiwi, oranges, blackberries, strawberries, raspberries,
blueberries, mango, cantaloupe, watermelon, honeydew, plums, pineapple Full Plate Living from Ardmore Institute of
Legumes: Black beans, kidney beans, pinto beans, garbanzo beans, cannellini Health: fullplateliving.org
beans, lentils, lima beans, broad beans, soybeans
USDA Food Assistance Programs:
Whole Grains: Quinoa, brown rice, oats, barley, wild rice, black rice, whole grain nutrition.gov/topics/food-security-and-
tortillas/pasta/breads, couscous, teff, wheat germ access/food-assistance-programs
Nuts: Almonds, peanuts, pistachios, cashews, brazil nuts, soy nuts, hazelnuts,
walnuts Food Is Medicine Coalition:
fimcoalition.org
Seeds: Chia seed, flax seed, hemp seed, pumpkin seed, sunflower seed
AAFP’s Neighborhood Navigator:
Nutrition Goals aafp.org/family-physician/patient-care/
the-everyone-project/neighborhood-
Setting goals to improve your eating habits is a great way to eat healthier. An ex- navigator.html
ample of a positive nutrition goal is, “I will add 1 cup of berries to breakfast and a
small apple or orange as an afternoon snack at least five days this week.”
Specific - What specific food would you like to add/change?
Measurable - How much or how many will you add or change?
Achievable - Do you have what it takes to follow through?
Realistic - What can you do? (improvement over perfection) lifestylemedicine.org
Time-bound - How often or for how long will you make this change?
© 2023. American College of Lifestyle Medicine.
All rights reserved.
Terms of use: lifestylemedicine.org.
Lifestyle Activity
Moderate Activity Vigorous Activity
• Brisk walking • Hiking
• Heavy cleaning (washing windows, • Jogging
vacuuming, mopping) • Shoveling
• Mowing lawn (power mower) • Carrying heavy loads
• Light bicycling • Bicycling fast
• Recreational badminton • Basketball game
• Tennis doubles • Soccer game
• Tennis singles
*A limitation of labeling activities this way is that it does not consider the fact that some
people have a higher level of fitness than others. It is important to tailor your activity to your
own fitness level.

Guidelines
The recommendation for adults 18-64 years old is to do at least 150-300 Helpful resources:
minutes of moderate intensity or 75-150 minutes of vigorous intensity activity
weekly along with two or more days weekly of strength training. Additional Walk With a Doc:
recommendations are available for older adults, pregnant women as well as walkwithadoc.org
for those diagnosed with chronic diseases. The more physical activity, the more
benefit, but any amount of exercise is better than none. Working with a certified
exercise specialist such as a kinesiologist, exercise physiologist, physical CDC:
therapist, or certified personal trainer is the safest and most reliable way to cdc.gov/physicalactivity
begin an exercise program.
Find a Trainer Near You: usreps.org
Activity Types
Aerobic or endurance activities include running, swimming, biking, hiking, 2019 Physical Activity Guidelines:
playing sports, dancing and brisk walking. health.gov/paguidelines/second-
edition/pdf/Physical_Activity_
Strength or resistance activities include weight lifting, pushing a wheelchair/ Guidelines_2nd_edition.pdf
stroller, kettlebells and body weight exercises such as squats, lunges, pushups,
sit-ups etc.
ACE Exercise Library:
Flexibility activities include stretching and some forms of yoga. acefitness.org

Balance activities include tai chi, qi gong and some forms of yoga. ACSM Resource Library:
Warning/Disclaimer: always talk to your doctor before starting a new activity www.acsm.org/education-
resources/trending-topics-
Activity Goals resources/resource-library
Setting a goal is a great way to get started with physical activity. It’s easier to
achieve positive goals. An example of a positive activity goal is, “I will walk with
a friend or family member for at least 20 minutes after dinner, every weekday
for the next two months.”
Specific - What specific activity would you like to add/change?
Measurable - How much activity, how many sessions?
Achievable- Do you have what it takes to follow through?
lifestylemedicine.org
Relevant - What can you actually do? (know your limits, start small, build)
© 2023. American College of Lifestyle Medicine.
Time-Bound - How frequent or how long will you do the activity? All rights reserved.
Terms of use: lifestylemedicine.org.
Lifestyle Stress Reduction
Stress is unavoidable. How we think about it and how we react to it makes the
difference in how it impacts our self-care and our health. While some medicine
may help to manage stress, there are many things that you can do to help you
manage stress and improve overall health. Partnering with your health care team
can help you determine a plan of action for stress reduction. Ask your healthcare
team about Mindfulness Based Stress Reduction (MBSR).

Self-Management Tips
• Connect with others
• Get involved in activities
• Try different healthy ways to relax (music, exercise, dance, meditation or
yoga)
• Take time for fun, creative activities or hobbies
• Keep a gratitude journal or write about stressful events
• Take care of spiritual needs
• Make time to laugh (comedy, joke books etc)
•
•
Avoid caffeine and alcohol
Try deep breathing techniques
Helpful resources:
• Get a massage
The American Institute of
Stress
Good Stress/Bad Stress www.stress.org
Not all stress is bad for us; in fact some stress can be helpful for completing
important projects, studying for an exam, speaking in public, or accomplishing
challenging goals. On the other hand, distress or negative stress is the type of National Institute of Mental
stress that can cause short- or long-term anxiety, decreased performance and Health:
lead to poor mental and physical health. Distress can be caused by many factors
that differ for everyone. It is important to recognize the things in your life that nimh.nih.gov/health/
cause distress, so you can come up with a plan to manage or cope with or view publications/stress
situations differently.
American Psychological
See Stress Differently Association:
Look at events or triggers from a different angle. Consider “Is there another way apa.org/topics/stress
to look at this situation?” and remember it’s not helpful to focus on what cannot
be changed. Try to improve your mood by looking at what is going well in life.
Focus on your accomplishments or what you have overcome.
Mentalhealth.gov

Headspace (App Store)

Stress Reduction Goals
Setting goals around stress management is a great way to decrease any negative
impact stress may have on your health. It’s often easier to achieve positive goals.
An example of a positive stress management goal is, “I will write about what I am
thankful for at least 10 minutes three times per week.”
Specific - What are you going to do to manage your stress?
Measurable - How much time, how many sessions?
Achievable - Do you have what it takes to follow through?
lifestylemedicine.org
Realistic - What can you actually do? (improvement over perfection)
© 2023. American College of Lifestyle Medicine.
Time-Bound - How frequent? How long will you commit? All rights reserved.
Terms of use: .lifestylemedicine.org.
Avoidance of Risky Substances
It is well known that tobacco use and drinking too much alcohol increases
the risk of many chronic diseases and death, which is why avoiding risky
substances is so important. People who are ready can and do quit smoking;
there are more former smokers in the world now than there are current
smokers. Some treatments work for alcohol abuse, but treatments often
take time, different approaches and many attempts. Giving yourself patience
as well as getting support from others is an important part of reaching your
goals.

Effective Treatment Models

• Counseling
• Individual, group, telephone
• Many quick visits Slips and relapses are normal
• Longer more intense visits and considered part of the
• Medications (anti-relapse) change process. Goal setting,
• Counseling plus medication is more support and persistence is key!
effective
The 2020-2025 Dietary Guidelines
Goals for Avoiding Risky Substances for Americans recommends that
SMART goals guide goal setting to help plan and achieve goals. Setting goals adults of legal drinking age can
around substance use ( tobacco, alcohol, or other drugs) is a great way to start choose not to drink, or to drink in
making changes. An example of a goal is, “I will swap my morning cigarette moderation by limiting intake to 2
with chewing gum at least 5 days this week for the next four weeks. I will ask drinks or less in a day for men or
my partner to help keep me on track and use the free texting service for more 1 drink or less in a day for women,
support.” on days when alcohol is consumed.
Specific - What are you going to do to decrease your substance use?
Measurable - How much will you reduce it by?
Achievable - Do you have what it takes to follow through?
Realistic - What can you actually do? (improvement over perfection)
Measurements:
Time-Bound - How frequent? How long will you commit?
One standard alcoholic drink in US:
12 oz beer
Helpful Resources: 5 oz table wine
National Quit Link: 1-800-Quit-Now Moderation Management 1.5 oz of 80-proof spirits
SmokeFree.gov https://smokefree.gov/ www.moderation.org
Secular Organizations for Sobriety Typical Containers:
nami.org 750 mL wine = 5 drinks
www.sossobriety.org
NIAAA Alcohol Treatment Navigator 750 mL spirits = 18 drinks
alcoholtreatment.niaaa.nih.gov SMART Recovery
www.smartrecovery.org
1 L spirits = 24 drinks
NAADAC Substance Abuse Professionals
www.naadac.org Women for Sobriety
www.womenforsobriety.org
National Association of Social Workers
www.helpstartshere.org Al-Anon Family Groups
www.al-anon.alateen.org
Substance Abuse Treatment Locator
www.findtreatment.samhsa.gov Adult Children of Alcoholics
www.adultchildren.org
Alcoholics Anonymous (AA)
www.psychologytoday.com/us
lifestylemedicine.org
www.aa.org
© 2023. American College of Lifestyle Medicine.
All rights reserved.
Terms of use: lifestylemedicine.org.
Lifestyle Sleep Health
Sleep is an extremely important part of human health. Negative effects
of sleep delays or interruptions include sluggishness, low attention span,
decreased sociability, depressed mood, decreased deep sleep, decreased
caloric burn during the day, increased hunger and decreased feeling
of fullness, insulin resistance and decreased performance. If you are
struggling to sleep, ask your healthcare team whether a sleep study or
Cognitive Behavioral Therapy for insomnia (CBTi) might be needed.

Sleep Disrupters
• Too much food or drink close to sleep time
• Blue light from phone/computer/television screen
• Caffeine and alcohol use
• Stress/anxiety/worry
• Certain noises/sounds
• Temperature (too hot or too cold)
• Lack of daytime sunlight exposure Helpful resources:
• Medications and medical conditions
• Bed partner and/or pets
Sleepeducation.org
Tips for Better Sleep
American Society of
• Use bed for sleep only Sleep Medicine
• Establish regular sleep schedule (same sleep and wake times)
• Minimize/eliminate bedroom noise and lights
• Increase daytime exposure to sunlight Recommendations
• Move at least every hour during the day
• Eliminate nighttime caffeine and limit daytime caffeine for Optimal Sleep
• Avoid alcohol within 3 hours of bedtime
Infants 4 months to 12 months:
• Avoid high-sodium foods close to bedtime
12 to 16 hours per 24 hours
• Eliminate/limit after-dinner and late-night snacking
• Maintain a healthy BMI Children 1 to 2 years of age:
• Stay hydrated during the day 11 to 14 hours per 24 hours
• Use Cognitive behavioral therapy for treatment of insomnia (including naps)
• Increase exercise to 150 minutes of moderate intensity per week Children 3 to 5 years of age:
• Include more whole food plant-based dietary choices
10 to 13 hours per 24 hours
• Increase medication techniques
(including naps)

Sleep Management Goals Children 6 to 12 years of age:

9 to 12 hours per 24 hours
Setting goals around sleep health is a great way to increase your sleep quality. Teenagers 13 to 18 years of age:
It’s often easier to achieve positive goals. An example of a positive sleep goal 8 to 10 hours per 24 hours
is, “I will begin a new bedtime routine of shutting off the television and instead,
reading a book for at least 30 minutes before bed, four nights this week.” Adults:
7-9 hours of sleep per 24 hours
Specific - What are you going to do to improve your sleep quality/quantity?
Measurable - How much time, how many sessions?
Achievable - Do you have what it takes to follow through?
Realistic - What can you actually do? (improvement over perfection)
Time-bound - How frequent? How long will you commit?
lifestylemedicine.org
© 2023. American College of Lifestyle Medicine.
All rights reserved.
Terms of use: lifestylemedicine.org.
Lifestyle Social Connections
Social connections and relationships affect our physical, mental and
emotional health. Research shows that the single most important
predictor of human happiness and long life is having strong social
connections. Health-related measures like blood pressure and heart rate
improve even with short positive social interactions. Below are some tips
that may help you create and keep important connections in your life.

Forming New Social Connections

• Volunteer; helping others improves health, increases happiness and
allows you to meet new people
• Connect with a community resource center to find local options
• Find online or community groups of those who share the same
interests– meetup.com or Facebook groups are a great place to
look
• Join a religious or spiritual group
• Help at a local animal shelter or adopt a pet to connect with other
animal lovers
• Go to a local sports event, music performance, lecture or art display
• Help organize community events by joining a steering committee or
board
Helpful resources:
• Attend community celebrations like parades or walks
• Take a course at your local library or community college meetup.com
• Ask your employer for ways to increase social connections at work

TIP: Look for social opportunities that improve other areas of health such purposebuiltfamilies.com
as activity groups or healthy cooking classes.

Social Media and

Strengthen Social Connections Depression
• Take more care to quickly connect with people you see a lot during the week While technology can improve
• When possible, stay positive while connecting with others social connectedness in
• Share new experiences some cases, research finds
• Make and spend time with others that those who use social
• Be there for those who need you
media the most are at a
• Be flexible, supportive and excited about what others are doing in their lives
higher risk for depression.
Be mindful of how you use
Social Connection Goals technology to support social
connections in your life.
Setting goals is a great way to increase your sense of connection. It’s often
easier to achieve positive goals. An example of a positive social connection
goal is, “I will increase my feeling of social connectedness by joining a group
fitness class that meets for an hour, three nights of the week.”
Specific - What are you going to do to improve feelings of connectedness?
Measurable - How much time, how many sessions?
Achievable - Do you have what it takes to follow through?
Relevant - What can you actually do? (improvement over perfection) lifestylemedicine.org
Time-bound - How frequent? How long will you commit? © 2023. American College of Lifestyle Medicine.
All rights reserved.
Terms of use: lifestylemedicine.org.