Abstract
But the true clarion call of the pandemic, and the timely focus of LM2020, is the urgent need to restore health through the implementation of lifestyle medicine at the individual and population levels.
Being this year’s guest editor is a privilege and a challenge given this difficult time, a time especially daunting for the health care community! This edition is meant to capture the essence of the ACLM 2020 Conference, LM2020 Lifestyle Medicine: Health Restored.
While the conference was lifestyle medicine–focused, the COVID-19 (coronavirus disease-2019) pandemic left its RNA all over it. The virus forced us to host the conference virtually, requiring innovative and “out of the box” thinking. Fortunately, the talented and dedicated staff at American College of Lifestyle Medicine succeeded brilliantly.
So too, the virus forced us to innovate and practice medicine differently in 2020. Many of us began using telehealth, in earnest, for example. But the true clarion call of the pandemic, and the timely focus of LM2020, is the urgent need to restore health through the implementation of lifestyle medicine at the individual and population levels.
Those of us who practice lifestyle medicine have long been aware of the deep cracks in our “disease care system”; however, the COVID-19 pandemic made them plain for all to see and applied ever more pressure, pushing the system to its breaking point. It exposed and took advantage of our epidemic levels of chronic disease, allowing the virus to do its worst, discriminating against those who had not had the opportunity to benefit from the power of lifestyle to ameliorate their disease processes. The virus also exposed our social and health care inequities resulting in people of color suffering from COVID-19 disproportionately.
However, for many of us, this was expected. We have known for many years that the American health care system was and is unsustainable and largely ineffective, especially as it pertains to the treatment of chronic disease. This knowledge was the impetus for the promotion of lifestyle medicine as a discipline in the first place. Most of us were not expecting or prepared for a global pandemic. Humans, including physicians, often tend to believe that tomorrow will be much like yesterday. So while a pandemic was forecast by the experts, the timing would have required a crystal ball.
However, we need only look through the lens of history to see how this might occur. History teaches us that epidemics of infectious disease always strike when the conditions are optimal. For example, when a population outgrows its capacity to produce enough food or outgrows its capacity to produce enough healthy food, rather than just calories, or when social inequality or inequity in the food distribution system results in people not getting enough, then the population becomes unhealthy, making it vulnerable to all kinds of disease, communicable and noncommunicable.
Our civilization has created a globalized, industrialized food system with the incentive of producing as many calories as possible, as cheaply as possible. The result has been catastrophic. According to a 2019 Lancet Commission report, Malnutrition in all its forms, including obesity, undernutrition, and other dietary risks, is the leading cause of poor health globally. In the near future, the health effects of climate change will considerably compound these health challenges. Climate change can be considered a pandemic because of its sweeping effects on the health of humans and the natural systems we depend on (ie, planetary health). These three pandemics—obesity, undernutrition, and climate change—represent The Global Syndemic that affects most people in every country and region worldwide.
Lifestyle medicine is one of many critical components needed to address this Global Syndemic. Plant-predominant diets, active transportation, stress management, and social connectedness have the capacity to fortify the immune system against emerging infectious diseases and help people adapt to the physical and psychosocial stressors of climate change all while reducing our collective carbon footprint.
This issue presents novel strategies for implementing lifestyle medicine in practices, education, and health systems, as well as important strategies for dealing with trauma and anxiety. Last, you, the lifestyle medicine community, offer hope by discussing and advocating connections between human and planetary health, along with presenting strategies for pandemic prevention and improving immunity in the face of novel and emerging infectious diseases.
The challenges we face as a civilization and as a species are daunting. Despite this, the dedicated lifestyle medicine practitioners that I have come to know and to count myself as a proud member, fill me with hope for a healthier future for humans, the planet, and all the creatures that we share it with.
It is characteristic for me to end with a quote from Margaret Mead. She said, “Never doubt that a small group of thoughtful, committed citizens can change the world. Indeed, it is the only thing that ever has.” I believe this today more than ever, and I hope you will join me.