Abstract
‘. . . all of us who believe so strongly in the power of daily habits and practices are going to have to put in an enormous amount of “work” to turn this dream into a reality.’
Once again, we at the American Journal of Lifestyle Medicine (AJLM) are pleased to devote an entire issue of the AJLM to the Proceedings of the National Meeting of the American College of Lifestyle Medicine, which was held from October 19 to 22, 2014, in San Diego, California.
The conference opened with an Expert Panel Discussion, which I had the pleasure of moderating. Based on what I saw at the meeting, I am pleased to report that lifestyle medicine continues to grow and thrive! Attendance at the ACLM conference doubled compared to the previous year and is anticipated to, once again, double in 2015. The energy and passion among participants was palpable.
I want to recount an episode that happened to me during the conference which I believe summarizes a critical juncture in the lifestyle medicine movement. As I was walking toward the fitness center at the conference hotel, a gentleman came up behind me and stated, “I love the quotation on the back of your T-shirt.” Here is the story of the quotation. All 4 of my daughters have been involved in high-level competitive swim programs. Thus, my wife and I have had the opportunity to go numerous swim meets over many years. Oftentimes, we see quotations on T-shirts that inspire us. This particular one stated, “Without a dream there is no reason to work. Without work there is no reason to dream.” We put this quote on T-shirts for all 4 of our daughters and also on T-shirts for my wife and me. I thanked the gentleman for his kind words; however, on the way over to the fitness center, as I thought about it, I recognized that the idea emblazoned on the back of my T-shirt in a sense defines where we are in the lifestyle medicine movement.
It was clear from the enthusiastic participation from the audience at the conference that many more health care professionals are beginning to understand the “dream” of lifestyle medicine and bring great passion to it. This provides a very important, perhaps even indispensable, foundation for the movement going forward. However, we are now at a juncture where it is clear that all of us who believe so strongly in the power of daily habits and practices are going to have to put in an enormous amount of “work” to turn this dream into a reality.
In the opening panel discussion, I asked the panel of esteemed experts to address 2 critical questions. The first question was, “What is evidence-based lifestyle medicine and why is it important?” The second question was, “How can lifestyle medicine specialists best be utilized in treating lifestyle disease?” The answers to these questions, of course, are related to each other and the view points of the panelists were both thoughtful and diverse. Their comments can be read in detail in the opening article of this issue of AJLM.
It is clear, however, from the different perspectives of the panelists that evidence on the efficacy of lifestyle medicine will be critically important in establishing this movement within American health care. On the other hand, the evidence may be somewhat different than what mainstream medicine has typically regarded as convincing, such as results from randomized controlled trials. Nonetheless, the evidence of the deleterious effects of poor lifestyle choices surrounds us every day ranging from low levels of physical activity, high prevalence of overweight and obesity, poor nutritional habits, and use of tobacco products.
These incontrovertible facts have already been incorporated in the evidence-based guidelines for virtually every major professional organization in health care ranging from the American Heart Association, American Diabetes Association, and even the recommendations from the American Cancer Society. A key consideration will be how lifestyle medicine experts can help both the health care profession and the public at large actually implement positive lifestyle measures in every person’s life. This is clearly a “dream” worth “working” for.
The second question, relating to the role of lifestyle medicine specialists in treating lifestyle-related disorders, is complicated. It could be argued that we need to train every medical professional in lifestyle medicine. On the other hand, several of the panelists argued that the complexity of the field mandates a cadre of individuals who are specifically trained and recognized as “specialists” in the emerging field of lifestyle medicine.
My own view is that it does not have to be an “either–or” question. I am both a cardiologist and a lifestyle medicine specialist. I think we can and should have both individuals who are specifically trained in lifestyle medicine and others who bring these concepts into other branches of medicine. We must encourage every physician to become knowledgeable in the benefits of positive lifestyle decisions, practices, and habits while, at the same time, recognizing that some individuals will specialize in this area and lead the movement.
In addition to the Expert Panel Discussion in this issue of AJLM, we have selected articles based on a number of other presentations from the conference. These range from issues related to disease reversal and the role of plant-based diets to application of lifestyle medicine principles, to healthy pregnancy, lifestyle medicine education, population-based lifestyle medicine, and establishing the lifestyle medicine practice of the future. I believe our readers will find these diverse articles thought-provoking and inspiring.
I would also like to specifically acknowledge and commend the outstanding work done by this issue’s Guest Editor, Dr Mark Faries. He put in a substantial effort to select and coordinate the articles found in this issue. Without his excellent work, this issue would not have been possible.
We at the American Journal of Lifestyle Medicine remain committed to providing evidence that will help lifestyle medicine practitioners lead the way in this important area. Moreover, my research laboratory, Rippe Lifestyle Institute, is committed to the hard work that will assist in this process. This year I had the pleasure of editing my most recent book for the public Preventing and Reversing Heart Disease for Dummies, 1 and next year, my team and I at Rippe Lifestyle Institute will be publishing a textbook titled Nutrition in Lifestyle Medicine. 2 My Research Director, Dr Ted Angelopoulos, and I also wrote a review article titled “Lifestyle Strategies for Cardiovascular Risk Reduction” for Current Atherosclerosis Reports. 3 These were preceded in 2012 when we published the Encyclopedia of Lifestyle Medicine and Health 4 and in 2013 with the second edition of my Lifestyle Medicine textbook. 5 Both of these larger efforts were designed to span the field of lifestyle medicine and provide a solid evidence base for the field.
It is also clear that cardiology is moving briskly into the area of lifestyle medicine. Indeed, the council of the American Heart Association that I sit on has changed its name from “The Council on Nutrition, Physical Activity, and Metabolism” to the “Council on Lifestyle and Cardiometabolic Health.” 6
When it comes to hard work, we at AJLM are committed not only to “talking the talk” but also joining the American College of Lifestyle Medicine in “walking the walk!”
I closed the lifestyle medicine Expert Panel Discussion with a quote from the famous sociologist Margaret Meade, who stated, “Never doubt that a small group of thoughtful, committed citizens can change the world. Indeed, it is the only thing that ever has.” 7 While the number of health care professionals specifically dedicated to lifestyle medicine remains relatively small, the challenge is great, and I truly believe that this small group of thoughtful, committed individuals has the potential to change the world. So let us proceed with passion and commitment but never forget that “Without a dream there is no reason to work. With work, there is no reason to dream.” Let us continue to dream and work together!