This document discusses lifestyle medicine and the formation of a lifestyle medicine interest group at UCSF. It provides background on lifestyle medicine, including its focus on using lifestyle interventions like nutrition, exercise, and stress management to treat and manage disease. It summarizes evidence that lifestyle factors account for the majority of chronic disease risk and that lifestyle changes can significantly reduce risks. The interest group aims to help members develop expertise in lifestyle medicine, practice healthy living themselves, and do outreach and coaching to others. Meetings will include discussions, speakers, and health education on various topics related to lifestyle and chronic disease.

1. Lifestyle Medicine
Interest Group at UCSF

2. Thomas Edison once said...

3. Lifestyle
• Inheritance
• Habits
• Your choice
Eat
Move
Sex
Life
Spiritual
Life
Social
Life
Fun
Sleep
Culture
Stress
Work
Family
Values
Study
Creative
Outlets

4. What is Lifestyle Medicine?
• “Lifestyle medicine is the evidence-based practice of
helping individuals and families adopt and sustain healthy
behaviors that affect health and quality of life1.” –ACLM
1. http://www.lifestylemedicine.org/What-is-Lifestyle-Medicine
Four Principles of LM (Dean Ornish):
1. Diet
2. Exercise
3. Relaxation Techniques
4. Social Interactions Stress/Mindfulness

5. Early Death Causes - USA
McGinnis JM, Russo PG, Knickman, JR. Health Affairs, April 2002
(Funding: Robert Wood Johnson Foundation)

6. Obesity – USA
Ogden, et al. NCHS Data Briefs. 219, Nov 2015. CDC
Image: medicalnewstoday.com/categories/fitness-obesity
38%
30%
2000 2014

7. All-cause mortality ages 45-54, USA 1990-2013
• Pain & Opiods
• Lifestyle?
Case, A; Deaton, A. PNAS Early Edition 2015
Poisonings

8. Lifestyle Medicine Applied
• Lifestyle Medicine (LM) is the use of lifestyle
interventions in the treatment and management
of disease.
• Such interventions:
• nutrition
• exercise
• stress management
• smoking cessation
• a variety of other non-drug modalities

9. Hippocrates once said...

10. Evidence
• European Prospective Investigation into Cancer and
Nutrition (EPIC) study, patients who adhered to healthy
dietary principles (low meat consumption and high
intake of fruits, vegetables, and whole-grain bread),
never smoked, were not overweight, and had at least 30
minutes a day of physical activity had a 78% lower
overall risk of developing a chronic disease1.
1. Ford, E. S., Bergmann, M. M., Kroger, J., Schienkiewitz, A., Weikert, C., & Boeing, H. (2009). Healthy living is the best revenge: findings from the European Prospective Investigation
Into Cancer and Nutrition-Potsdam study. Archives of internal medicine, 169(15), 1355.
• 93% reduced risk of
diabetes
• 81% lower risk of
heart attacks
• 50% reduction in risk
of stroke
• 36% overall reduction
in risk of cancer

11. Evidence
• Our genes are a predisposition, but our genes are not our fate.
LM changes your genes—turning on genes that keep you healthy,
and turning off genes that promote heart disease, prostate
cancer, breast cancer, and diabetes—over 500 genes in only
three months1.
• Diet and lifestyle changes may lengthen telomeres. Effects still
significant after 5 years2.
• Lifestyle factors accounted for 90% of the PAR (population
attributed risk) in men and 94% in women for coronary heart
disease (52 country study)3.
1. Ornish, D., Magbanua, M. J. M., Weidner, G., Weinberg, V., Kemp, C., Green, C., ... & Carroll, P. R. (2008). Changes in prostate gene expression in men undergoing an intensive nutrition and lifestyle
intervention. Proceedings of the National Academy of Sciences, 105(24), 8369-8374.
2. Ornish, D., Lin, J., Chan, J. M., Epel, E., Kemp, C., Weidner, G., ... & Blackburn, E. H. (2013). Effect of comprehensive lifestyle changes on telomerase activity and telomere length in men with biopsy-proven
low-risk prostate cancer: 5-year follow-up of a descriptive pilot study. The lancet oncology, 14(11), 1112-1120.
3. Yusuf, S., Hawken, S., Ôunpuu, S., Dans, T., Avezum, A., Lanas, F., ... & INTERHEART Study Investigators. (2004). Effect of potentially modifiable risk factors associated with myocardial infarction in 52
countries (the INTERHEART study): case-control study. The Lancet, 364(9438), 937-952.

12. Evidence
Adapted from:
Yusuf, S., Hawken, S., Ôunpuu, S., Dans, T., Avezum, A., Lanas, F., ... & INTERHEART Study Investigators. (2004). Effect of potentially modifiable risk factors associated with myocardial
infarction in 52 countries (the INTERHEART study): case-control study. The Lancet, 364(9438), 937-952.

13. Evidence
Adapted from:
Diabetes Prevention Program Research Group. (2002). Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. The New England journal of medicine,
346(6), 393.

14. Evidence
• Can help reduce greenhouse gases, promote more sustainable
environment. Livestock greenhouse gas emissions account for 18-51%
of total emissions1.
• Reduces healthcare costs
1. Herrero, M., Gerber, P., Vellinga, T., Garnett, T., Leip, A., Opio, C., ... & McAllister, T. A. (2011). Livestock and greenhouse gas emissions: The importance of getting the numbers right. Animal Feed Science and
Technology, 166, 779-782.
2. Hersey, J. C., Khavjou, O., Strange, L. B., Atkinson, R. L., Blair, S. N., Campbell, S., ... & Britt, M. (2012). The efficacy and cost-effectiveness of a community weight management intervention: a randomized
controlled trial of the health weight management demonstration. Preventive medicine, 54(1), 42-49.
Table adapted from:
Herman, W. H., Hoerger, T. J., Brandle, M., Hicks, K., Sorensen, S., Zhang, P., ... & Ratner, R. E. (2005). The cost-effectiveness of lifestyle modification or metformin in preventing type 2 diabetes in adults with
impaired glucose tolerance. Annals of Internal medicine, 142(5), 323-332.

15. Prevention & Treatment with
Lifestyle Medicine
• LM is becoming the preferred modality for not only the
prevention but also the treatment of most chronic diseases,
including:
• Type 2 diabetes
• Coronary heart disease
• Hypertension
• Obesity
• Insulin resistance syndrome
• Osteoporosis
• and many types of cancer

16. Why Lifestyle Medicine?
• “ As a nation, more than 75% of our health care spending is
on people with chronic conditions1.” — CDC 2009
• “If the major risk factors from chronic disease were
eliminated, at least 80% of all heart disease, stroke, and type
2 diabetes would be prevented, and more than 40% of
cancer cases would be prevented2.” —WHO
1. CDC. (2009). The Power of Prevention. Retrieved November 10, 2015, from http://www.cdc.gov/chronicdisease/pdf/2009-Power-of-Prevention.pdf
2. World Health Organization. Preventing chronic diseases: a vital investment. Geneva: World Health Organization;
2005. Available from: http://www.who.int/chp/chronic_disease_report/full_report.pdf

17. Value Statement
From the ACLM:
Lifestyle practices and health
habits are among the nation’s
most important health
determinants.
Changing unhealthy behaviors is
foundational to medical care,
disease prevention, and health
promotion.
The physician’s trusted
relationship with the patient, with
the support of the family, an
interdisciplinary team and the
community is the key to improving
health behaviors and outcomes.

18. How Can We Get Started?
“It’s not all or nothing. In all of our studies, we
found that the more people changed their diet
and lifestyle, the more they improved and the
better they felt—at any age. So, if you indulge
yourself one day, just eat healthier the next. If
you don’t have time to exercise one day, do a
little more the next. If you don’t have time to
meditate for an hour, do it for a minute. What
matters most is your overall way of eating and
living.” –Dean Ornish

19. Lifestyle Med Interest Group
1. Develop
Expertise
2. Practice
Healhy Living
3. Outreach &
CoachingYOUR INPUT!
• learn together
• scientific evidence
• address fads
• assemble resources
• larger context • up to you!
• exercise
• sleep
• cooking
• mindfulness
• anything!
• learning workshop
• help real people

20. Meeting Logistics
• Monthly Meetings
 Interactive Discussions
 Speakers
 Health Education
 Goal-Setting
• Potential Topics:
 Nutrition
 Exercise
 Mindfulness
 Social Support
 Relaxation Techniques
 Inspiration
 Health Policy
 Population Health
 Chronic Disease (i.e. diabetes,
hypertension, etc.)
 Ideas???

21. Lifestyle Medicine
Interest Group at UCSF