Lifestyle Medicine 2016: Emerging Opportunities and Continuing Challenges

‘. . . the health of people and the planet alike may be more intertwined than previously imagined.’

The annual American College of Lifestyle Medicine (ACLM) national conference is a unique event that invites health care professionals of all disciplines to gather, spread ideas, and learn about innovative strategies to promote health. The theme of the 2016 national conference, “Healthy People. Healthy Planet,” brought environmental experts from around the world who shared the profound impact that lifestyle choices have on the Earth.

The daily work of most conference attendees focuses predominantly on human health, but evidence presented at the conference suggests that the health of people, and the planet alike, may be more intertwined than previously imagined. Presentations such as “Food Choice and Sustainability: Tipping Point Realities” by Dr Richard Oppenlander, “Cultivating a Better Food System” by Danielle Nierenberg, and “Lifestyle Medicine Through a Planetary Health Lens” by Dr Samuel Myers offered insight regarding the current state of the food system. However, they also created a sense of urgency concerning mainstream agricultural practices and the damage that is being done to the environment. Although there may be differing opinions on the minutia of an optimal diet, without fresh water or an inhabitable planet, those details quickly become meaningless. Thankfully, what appears to be a healthy diet for humans may also be the healthiest diet for the planet as well. ¹

In addition to the special theme this past year, the ACLM conference included popular workshops providing hands-on learning opportunities, a keynote presentation describing the North Karelia project, discussions on the evolving business of lifestyle medicine (LM), and updates on a variety of LM topics.

The workshops this year focused on providing evidence-based LM services in one’s own practice. Topics included Culinary Medicine, Medical Fitness, Behavior Change, and Group Visits. Each workshop was interactive, engaging, educational, and able to provide useful take-home ideas for LM services that could be offered to patients immediately.

While the composition of one’s diet has a large impact on health, the Culinary Medicine workshop highlighted the less discussed role of cooking on health. The hands-on experience gave attendees a chance to hone their own chef skills while preparing a healthy dish to share. In addition to the health benefits that plant-based foods can offer, evidence suggests that there is an inverse correlation between cooking and mortality. ²

Analogously, the Medical Fitness workshop sought to address a void in the physical activity continuum—the gap between acute rehabilitation following an injury and the ability to work out without any restriction. The Medical Fitness focus is on balancing flexibility and strength to correct any imbalances that might exist. Many patients with chronic disease can benefit from this type of exercise program. Opportunities to partner with fitness experts who can help these patients become or remain active will become increasingly more available in the future.

Last, the Group Visit workshop afforded participants the opportunity to create a personalized group visit blueprint. The workshop discussed how group visits can work in any financial model (ie, insurance, capitated, self-pay, hybrid, etc) and can be offered in multiple formats (ie, didactic, discussion, video, online, etc). While there are many variables to consider, group visits appear to be an excellent medium to deliver reimbursable LM services to patients. While this journal issue captures many of the themes from the conference, the live workshops are areas where the hands-on experience is needed in order to appreciate the full effect of these sessions.

Following the pre-conference workshops, this year’s opening keynote speaker was Dr Erkki Vartiainen, the Director of Department at the National Institute for Health and Welfare in Finland. He shared the extraordinary tale of the North Karelia Project that was started in 1972. This project is arguably the largest community LM research project in existence. The project was a multilevel LM overhaul led by the Finnish government that focused on reducing sodium intake and replacing saturated fat with unsaturated fat. It resulted in an astonishing ~80% reduction in cardiovascular disease mortality, ³ with those statistics still maintained 40 years later. ⁴

Another topic that attracted much attention this year was the business of LM. Many professionals are passionate about creating LM practices, but reimbursement for LM services has remained a challenge. The conference this year was filled with presentations, including “The Art and Science of Healthcare Entrepreneurship” by Dr Sami Bég, “Navigating the Crossroads of Value Based Care” by Dr Liana Lianov, and “How to Create a Successful LM Practice” by Dr Marc Braman. The emphasis of these presentations was on innovative LM business approaches and effective reimbursement strategies. Topics discussed included how to bill using traditional insurance, the opportunities available by utilizing direct primary care, the concept of concierge medicine, and the benefits and drawbacks of cash practices. The shift in the current health care environment toward patient outcomes and value-based care will further increase the adoption of LM principles into everyday practice. Many health networks, insurance companies, and corporations have started to realize the economic impact that LM can have. The ACLM Healthcare Transformation Summit showcased two leading health care systems that have adopted LM into their routine operations: NCH Healthcare System and Lee Memorial Health System.

The ACLM conference also offered an array of up-to-date, evidence-based talks on everything from behavior change to the intestinal microbiome. A collection of some of the most noteworthy topics have been turned into state-of-the art reviews and can be found in this issue. The outgoing president, Dr David Katz, gave his final address to the ACLM at the conference as well. His contributions have been invaluable to the growth and recognition of this college. It is reassuring to know that he will remain on the board as the past president for another few years. We also had the chance to welcome the incoming president of the ACLM, Dr George Guthrie. He was one of the founding members of the college and will bring tremendous wisdom, insight, and leadership moving forward.

The 2016 national ACLM conference was an unforgettable experience. I have never been to a more inspired gathering of individuals. LM goes far beyond disease prevention and health promotion. In addition to treating and reversing disease, it is an integral part of the solution against all that ails us and the planet as well.