Publisher: Sage Publications   (Total: 1166 journals)

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Showing 1 - 200 of 1166 Journals sorted alphabetically
AADE in Practice     Hybrid Journal   (Followers: 6)
Abstracts in Anthropology     Full-text available via subscription   (Followers: 29)
Academic Pathology     Open Access   (Followers: 6)
Accounting History     Hybrid Journal   (Followers: 18, SJR: 0.527, CiteScore: 1)
Acta Radiologica     Hybrid Journal   (Followers: 1, SJR: 0.754, CiteScore: 2)
Acta Radiologica Open     Open Access   (Followers: 2)
Acta Sociologica     Hybrid Journal   (Followers: 39, SJR: 0.939, CiteScore: 2)
Action Research     Hybrid Journal   (Followers: 53, SJR: 0.308, CiteScore: 1)
Active Learning in Higher Education     Hybrid Journal   (Followers: 396, SJR: 1.397, CiteScore: 2)
Adaptive Behavior     Hybrid Journal   (Followers: 9, SJR: 0.288, CiteScore: 1)
Administration & Society     Hybrid Journal   (Followers: 18, SJR: 0.675, CiteScore: 1)
Adoption & Fostering     Hybrid Journal   (Followers: 25, SJR: 0.313, CiteScore: 0)
Adsorption Science & Technology     Open Access   (Followers: 9, SJR: 0.258, CiteScore: 1)
Adult Education Quarterly     Hybrid Journal   (Followers: 260, SJR: 0.566, CiteScore: 2)
Adult Learning     Hybrid Journal   (Followers: 51)
Advances in Dental Research     Hybrid Journal   (Followers: 11, SJR: 1.791, CiteScore: 4)
Advances in Developing Human Resources     Hybrid Journal   (Followers: 35, SJR: 0.614, CiteScore: 2)
Advances in Mechanical Engineering     Open Access   (Followers: 156, SJR: 0.272, CiteScore: 1)
Advances in Methods and Practices in Psychological Science     Full-text available via subscription   (Followers: 20)
Advances in Structural Engineering     Full-text available via subscription   (Followers: 51, SJR: 0.599, CiteScore: 1)
AERA Open     Open Access   (Followers: 14)
Affilia     Hybrid Journal   (Followers: 6, SJR: 0.496, CiteScore: 1)
Africa Spectrum     Open Access   (Followers: 17)
Agrarian South : J. of Political Economy     Hybrid Journal   (Followers: 3)
Air, Soil & Water Research     Open Access   (Followers: 13, SJR: 0.214, CiteScore: 1)
Alexandria : The J. of National and Intl. Library and Information Issues     Full-text available via subscription   (Followers: 68)
Allergy & Rhinology     Open Access   (Followers: 5)
AlterNative : An Intl. J. of Indigenous Peoples     Full-text available via subscription   (Followers: 39, SJR: 0.194, CiteScore: 0)
Alternative Law J.     Hybrid Journal   (Followers: 12, SJR: 0.176, CiteScore: 0)
Alternatives : Global, Local, Political     Hybrid Journal   (Followers: 12, SJR: 0.351, CiteScore: 1)
Alternatives to Laboratory Animals     Full-text available via subscription   (Followers: 11, SJR: 0.297, CiteScore: 1)
American Behavioral Scientist     Hybrid Journal   (Followers: 26, SJR: 0.982, CiteScore: 2)
American Economist     Hybrid Journal   (Followers: 7)
American Educational Research J.     Hybrid Journal   (Followers: 260, SJR: 2.913, CiteScore: 3)
American J. of Alzheimer's Disease and Other Dementias     Hybrid Journal   (Followers: 23, SJR: 0.67, CiteScore: 2)
American J. of Cosmetic Surgery     Hybrid Journal   (Followers: 9)
American J. of Evaluation     Hybrid Journal   (Followers: 18, SJR: 0.646, CiteScore: 2)
American J. of Health Promotion     Hybrid Journal   (Followers: 35, SJR: 0.807, CiteScore: 1)
American J. of Hospice and Palliative Medicine     Hybrid Journal   (Followers: 47, SJR: 0.65, CiteScore: 1)
American J. of Law & Medicine     Full-text available via subscription   (Followers: 12, SJR: 0.204, CiteScore: 1)
American J. of Lifestyle Medicine     Hybrid Journal   (Followers: 7, SJR: 0.431, CiteScore: 1)
American J. of Medical Quality     Hybrid Journal   (Followers: 13, SJR: 0.777, CiteScore: 1)
American J. of Men's Health     Open Access   (Followers: 9, SJR: 0.595, CiteScore: 2)
American J. of Rhinology and Allergy     Hybrid Journal   (Followers: 11, SJR: 0.972, CiteScore: 2)
American J. of Sports Medicine     Hybrid Journal   (Followers: 248, SJR: 3.949, CiteScore: 6)
American Politics Research     Hybrid Journal   (Followers: 36, SJR: 1.313, CiteScore: 1)
American Review of Public Administration     Hybrid Journal   (Followers: 28, SJR: 2.062, CiteScore: 2)
American Sociological Review     Hybrid Journal   (Followers: 357, SJR: 6.333, CiteScore: 6)
American String Teacher     Full-text available via subscription   (Followers: 3)
Analytical Chemistry Insights     Open Access   (Followers: 26, SJR: 0.224, CiteScore: 1)
Angiology     Hybrid Journal   (Followers: 5, SJR: 0.849, CiteScore: 2)
Animation     Hybrid Journal   (Followers: 15, SJR: 0.197, CiteScore: 0)
Annals of Clinical Biochemistry     Hybrid Journal   (Followers: 10, SJR: 0.634, CiteScore: 1)
Annals of Otology, Rhinology & Laryngology     Hybrid Journal   (Followers: 20, SJR: 0.807, CiteScore: 1)
Annals of Pharmacotherapy     Hybrid Journal   (Followers: 59, SJR: 1.096, CiteScore: 2)
Annals of the American Academy of Political and Social Science     Hybrid Journal   (Followers: 51, SJR: 1.225, CiteScore: 3)
Annals of the ICRP     Hybrid Journal   (Followers: 4, SJR: 0.548, CiteScore: 1)
Anthropocene Review     Hybrid Journal   (Followers: 8, SJR: 3.341, CiteScore: 7)
Anthropological Theory     Hybrid Journal   (Followers: 48, SJR: 0.739, CiteScore: 1)
Antitrust Bulletin     Hybrid Journal   (Followers: 14)
Antiviral Chemistry and Chemotherapy     Open Access   (Followers: 2, SJR: 0.635, CiteScore: 2)
Antyajaa : Indian J. of Women and Social Change     Hybrid Journal   (Followers: 1)
Applied Biosafety     Hybrid Journal   (Followers: 1, SJR: 0.131, CiteScore: 0)
Applied Psychological Measurement     Hybrid Journal   (Followers: 21, SJR: 1.17, CiteScore: 1)
Applied Spectroscopy     Full-text available via subscription   (Followers: 27, SJR: 0.489, CiteScore: 2)
Armed Forces & Society     Hybrid Journal   (Followers: 25, SJR: 0.29, CiteScore: 1)
Arthaniti : J. of Economic Theory and Practice     Full-text available via subscription  
Arts and Humanities in Higher Education     Hybrid Journal   (Followers: 49, SJR: 0.305, CiteScore: 1)
Asia Pacific Media Educator     Hybrid Journal   (Followers: 1, SJR: 0.23, CiteScore: 0)
Asia-Pacific J. of Management Research and Innovation     Full-text available via subscription   (Followers: 3)
Asia-Pacific J. of Public Health     Hybrid Journal   (Followers: 15, SJR: 0.558, CiteScore: 1)
Asia-Pacific J. of Rural Development     Hybrid Journal   (Followers: 2)
Asian and Pacific Migration J.     Full-text available via subscription   (Followers: 8, SJR: 0.324, CiteScore: 1)
Asian Cardiovascular and Thoracic Annals     Hybrid Journal   (Followers: 2, SJR: 0.305, CiteScore: 0)
Asian J. of Comparative Politics     Hybrid Journal   (Followers: 5)
Asian J. of Legal Education     Full-text available via subscription   (Followers: 4)
Asian J. of Management Cases     Hybrid Journal   (Followers: 6, SJR: 0.101, CiteScore: 0)
ASN Neuro     Open Access   (Followers: 2, SJR: 1.534, CiteScore: 3)
Assessment     Hybrid Journal   (Followers: 19, SJR: 1.519, CiteScore: 3)
Assessment for Effective Intervention     Hybrid Journal   (Followers: 15, SJR: 0.578, CiteScore: 1)
Australasian J. of Early Childhood     Hybrid Journal   (Followers: 7, SJR: 0.535, CiteScore: 1)
Australasian Psychiatry     Hybrid Journal   (Followers: 18, SJR: 0.433, CiteScore: 1)
Australian & New Zealand J. of Psychiatry     Hybrid Journal   (Followers: 30, SJR: 1.801, CiteScore: 2)
Australian and New Zealand J. of Criminology     Hybrid Journal   (Followers: 545, SJR: 0.612, CiteScore: 1)
Australian J. of Career Development     Hybrid Journal   (Followers: 5)
Australian J. of Education     Hybrid Journal   (Followers: 51, SJR: 0.403, CiteScore: 1)
Australian J. of Management     Hybrid Journal   (Followers: 13, SJR: 0.497, CiteScore: 1)
Autism     Hybrid Journal   (Followers: 356, SJR: 1.739, CiteScore: 4)
Autism & Developmental Language Impairments     Open Access   (Followers: 17)
Avian Biology Research     Hybrid Journal   (Followers: 6, SJR: 0.401, CiteScore: 1)
Behavior Modification     Hybrid Journal   (Followers: 14, SJR: 0.877, CiteScore: 2)
Behavioral and Cognitive Neuroscience Reviews     Hybrid Journal   (Followers: 27)
Behavioral Disorders     Hybrid Journal   (Followers: 1)
Beyond Behavior     Hybrid Journal   (Followers: 2)
Bible Translator     Hybrid Journal   (Followers: 13)
Biblical Theology Bulletin     Hybrid Journal   (Followers: 24, SJR: 0.184, CiteScore: 0)
Big Data & Society     Open Access   (Followers: 55)
Biochemistry Insights     Open Access   (Followers: 7)
Bioinformatics and Biology Insights     Open Access   (Followers: 12, SJR: 1.141, CiteScore: 2)
Biological Research for Nursing     Hybrid Journal   (Followers: 7, SJR: 0.685, CiteScore: 2)
Biomarker Insights     Open Access   (Followers: 1, SJR: 0.81, CiteScore: 2)
Biomarkers in Cancer     Open Access   (Followers: 11)
Biomedical Engineering and Computational Biology     Open Access   (Followers: 14)
Biomedical Informatics Insights     Open Access   (Followers: 8)
Bioscope: South Asian Screen Studies     Hybrid Journal   (Followers: 4, SJR: 0.235, CiteScore: 0)
BMS: Bulletin of Sociological Methodology/Bulletin de Méthodologie Sociologique     Hybrid Journal   (Followers: 4, SJR: 0.226, CiteScore: 0)
Body & Society     Hybrid Journal   (Followers: 29, SJR: 1.531, CiteScore: 3)
Bone and Tissue Regeneration Insights     Open Access   (Followers: 2)
Brain and Neuroscience Advances     Open Access  
Brain Science Advances     Open Access  
Breast Cancer : Basic and Clinical Research     Open Access   (Followers: 12, SJR: 0.823, CiteScore: 2)
British J. of Music Therapy     Hybrid Journal   (Followers: 9)
British J. of Occupational Therapy     Hybrid Journal   (Followers: 253, SJR: 0.323, CiteScore: 1)
British J. of Pain     Hybrid Journal   (Followers: 31, SJR: 0.579, CiteScore: 2)
British J. of Politics and Intl. Relations     Hybrid Journal   (Followers: 39, SJR: 0.91, CiteScore: 2)
British J. of Visual Impairment     Hybrid Journal   (Followers: 14, SJR: 0.337, CiteScore: 1)
British J.ism Review     Hybrid Journal   (Followers: 18)
BRQ Business Review Quarterly     Open Access   (Followers: 1)
Building Acoustics     Hybrid Journal   (Followers: 4, SJR: 0.215, CiteScore: 1)
Building Services Engineering Research & Technology     Hybrid Journal   (Followers: 3, SJR: 0.583, CiteScore: 1)
Bulletin of Science, Technology & Society     Hybrid Journal   (Followers: 9)
Business & Society     Hybrid Journal   (Followers: 15)
Business and Professional Communication Quarterly     Hybrid Journal   (Followers: 9, SJR: 0.348, CiteScore: 1)
Business Information Review     Hybrid Journal   (Followers: 17, SJR: 0.279, CiteScore: 0)
Business Perspectives and Research     Hybrid Journal   (Followers: 3)
Cahiers Élisabéthains     Hybrid Journal   (Followers: 1, SJR: 0.111, CiteScore: 0)
Calcutta Statistical Association Bulletin     Hybrid Journal   (Followers: 1)
California Management Review     Hybrid Journal   (Followers: 37, SJR: 2.209, CiteScore: 4)
Canadian Association of Radiologists J.     Full-text available via subscription   (Followers: 2, SJR: 0.463, CiteScore: 1)
Canadian J. of Kidney Health and Disease     Open Access   (Followers: 8, SJR: 1.007, CiteScore: 2)
Canadian J. of Nursing Research (CJNR)     Hybrid Journal   (Followers: 15)
Canadian J. of Occupational Therapy     Hybrid Journal   (Followers: 167, SJR: 0.626, CiteScore: 1)
Canadian J. of Psychiatry     Hybrid Journal   (Followers: 28, SJR: 1.769, CiteScore: 3)
Canadian J. of School Psychology     Hybrid Journal   (Followers: 12, SJR: 0.266, CiteScore: 1)
Canadian Pharmacists J. / Revue des Pharmaciens du Canada     Hybrid Journal   (Followers: 3, SJR: 0.536, CiteScore: 1)
Cancer Control     Open Access   (Followers: 2)
Cancer Growth and Metastasis     Open Access   (Followers: 1)
Cancer Informatics     Open Access   (Followers: 4, SJR: 0.64, CiteScore: 1)
Capital and Class     Hybrid Journal   (Followers: 10, SJR: 0.282, CiteScore: 1)
Cardiac Cath Lab Director     Full-text available via subscription   (Followers: 1)
Cardiovascular and Thoracic Open     Open Access   (Followers: 1)
Career Development and Transition for Exceptional Individuals     Hybrid Journal   (Followers: 10, SJR: 0.44, CiteScore: 1)
Cartilage     Hybrid Journal   (Followers: 6, SJR: 0.889, CiteScore: 3)
Cell Transplantation     Open Access   (Followers: 5, SJR: 1.023, CiteScore: 3)
Cephalalgia     Hybrid Journal   (Followers: 8, SJR: 1.581, CiteScore: 3)
Cephalalgia Reports     Open Access   (Followers: 4)
Child Language Teaching and Therapy     Hybrid Journal   (Followers: 34, SJR: 0.501, CiteScore: 1)
Child Maltreatment     Hybrid Journal   (Followers: 11, SJR: 1.22, CiteScore: 3)
Child Neurology Open     Open Access   (Followers: 6)
Childhood     Hybrid Journal   (Followers: 19, SJR: 0.894, CiteScore: 2)
Childhood Obesity and Nutrition     Open Access   (Followers: 12)
China Information     Hybrid Journal   (Followers: 9, SJR: 0.767, CiteScore: 2)
China Report     Hybrid Journal   (Followers: 11, SJR: 0.221, CiteScore: 0)
Chinese J. of Sociology     Full-text available via subscription   (Followers: 5)
Christian Education J. : Research on Educational Ministry     Hybrid Journal   (Followers: 1)
Chronic Illness     Hybrid Journal   (Followers: 6, SJR: 0.672, CiteScore: 2)
Chronic Respiratory Disease     Hybrid Journal   (Followers: 12, SJR: 0.808, CiteScore: 2)
Chronic Stress     Open Access  
Citizenship, Social and Economics Education     Full-text available via subscription   (Followers: 6, SJR: 0.145, CiteScore: 0)
Cleft Palate-Craniofacial J.     Hybrid Journal   (Followers: 8, SJR: 0.757, CiteScore: 1)
Clin-Alert     Hybrid Journal   (Followers: 1)
Clinical and Applied Thrombosis/Hemostasis     Open Access   (Followers: 32, SJR: 0.49, CiteScore: 1)
Clinical and Translational Neuroscience     Open Access   (Followers: 1)
Clinical Case Studies     Hybrid Journal   (Followers: 3, SJR: 0.364, CiteScore: 1)
Clinical Child Psychology and Psychiatry     Hybrid Journal   (Followers: 45, SJR: 0.73, CiteScore: 2)
Clinical EEG and Neuroscience     Hybrid Journal   (Followers: 8, SJR: 0.552, CiteScore: 2)
Clinical Ethics     Hybrid Journal   (Followers: 13, SJR: 0.296, CiteScore: 1)
Clinical Medicine Insights : Arthritis and Musculoskeletal Disorders     Open Access   (Followers: 3, SJR: 0.537, CiteScore: 2)
Clinical Medicine Insights : Blood Disorders     Open Access   (Followers: 1, SJR: 0.314, CiteScore: 2)
Clinical Medicine Insights : Cardiology     Open Access   (Followers: 8, SJR: 0.686, CiteScore: 2)
Clinical Medicine Insights : Case Reports     Open Access   (Followers: 1, SJR: 0.283, CiteScore: 1)
Clinical Medicine Insights : Circulatory, Respiratory and Pulmonary Medicine     Open Access   (Followers: 4, SJR: 0.425, CiteScore: 2)
Clinical Medicine Insights : Ear, Nose and Throat     Open Access   (Followers: 2)
Clinical Medicine Insights : Endocrinology and Diabetes     Open Access   (Followers: 33, SJR: 0.63, CiteScore: 2)
Clinical Medicine Insights : Oncology     Open Access   (Followers: 3, SJR: 1.129, CiteScore: 3)
Clinical Medicine Insights : Pediatrics     Open Access   (Followers: 3)
Clinical Medicine Insights : Psychiatry     Open Access   (Followers: 10)
Clinical Medicine Insights : Reproductive Health     Open Access   (Followers: 1, SJR: 0.776, CiteScore: 0)
Clinical Medicine Insights : Therapeutics     Open Access   (Followers: 1, SJR: 0.172, CiteScore: 0)
Clinical Medicine Insights : Trauma and Intensive Medicine     Open Access   (Followers: 4)
Clinical Medicine Insights : Urology     Open Access   (Followers: 3)
Clinical Medicine Insights : Women's Health     Open Access   (Followers: 4)
Clinical Nursing Research     Hybrid Journal   (Followers: 34, SJR: 0.471, CiteScore: 1)
Clinical Pathology     Open Access   (Followers: 5)
Clinical Pediatrics     Hybrid Journal   (Followers: 25, SJR: 0.487, CiteScore: 1)
Clinical Psychological Science     Hybrid Journal   (Followers: 16, SJR: 3.281, CiteScore: 5)
Clinical Rehabilitation     Hybrid Journal   (Followers: 78, SJR: 1.322, CiteScore: 3)
Clinical Risk     Hybrid Journal   (Followers: 5, SJR: 0.133, CiteScore: 0)
Clinical Trials     Hybrid Journal   (Followers: 22, SJR: 2.399, CiteScore: 2)
Clothing and Textiles Research J.     Hybrid Journal   (Followers: 28, SJR: 0.36, CiteScore: 1)
Collections : A J. for Museum and Archives Professionals     Full-text available via subscription   (Followers: 3)
Common Law World Review     Full-text available via subscription   (Followers: 17)
Communication & Sport     Hybrid Journal   (Followers: 8, SJR: 0.385, CiteScore: 1)
Communication and the Public     Hybrid Journal   (Followers: 2)
Communication Disorders Quarterly     Hybrid Journal   (Followers: 15, SJR: 0.458, CiteScore: 1)
Communication Research     Hybrid Journal   (Followers: 24, SJR: 2.171, CiteScore: 3)
Community College Review     Hybrid Journal   (Followers: 8, SJR: 1.451, CiteScore: 1)
Comparative Political Studies     Hybrid Journal   (Followers: 292, SJR: 3.772, CiteScore: 3)
Compensation & Benefits Review     Hybrid Journal   (Followers: 8)
Competition & Change     Hybrid Journal   (Followers: 12, SJR: 0.843, CiteScore: 2)

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Similar Journals
Journal Cover
American Journal of Lifestyle Medicine
Journal Prestige (SJR): 0.431
Citation Impact (citeScore): 1
Number of Followers: 7  
 
  Hybrid Journal Hybrid journal (It can contain Open Access articles)
ISSN (Print) 1559-8276 - ISSN (Online) 1559-8284
Published by Sage Publications Homepage  [1166 journals]
  • Lifestyle Medicine: A Critical Key to Restoring Health

    • Free pre-print version: Loading...

      Authors: James M. Rippe
      Pages: 484 - 486
      Abstract: American Journal of Lifestyle Medicine, Volume 15, Issue 5, Page 484-486, September-October 2021.

      Citation: American Journal of Lifestyle Medicine
      PubDate: 2021-04-22T05:43:08Z
      DOI: 10.1177/15598276211008394
      Issue No: Vol. 15, No. 5 (2021)
       
  • Lifestyle Medicine in a Challenging Year

    • Free pre-print version: Loading...

      Authors: Amanda McKinney
      Pages: 487 - 488
      Abstract: American Journal of Lifestyle Medicine, Volume 15, Issue 5, Page 487-488, September-October 2021.

      Citation: American Journal of Lifestyle Medicine
      PubDate: 2021-04-21T10:20:14Z
      DOI: 10.1177/15598276211008133
      Issue No: Vol. 15, No. 5 (2021)
       
  • Can Approaching Anxiety Like a Habit Lead to Novel Treatments'

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      Authors: Judson A. Brewer, Alexandra Roy
      Pages: 489 - 494
      Abstract: American Journal of Lifestyle Medicine, Volume 15, Issue 5, Page 489-494, September-October 2021.
      Anxiety disorders make up the most prevalent class of mental illnesses. Given the growing prevalence of anxiety in the United States and beyond, there is an urgent clinical need to develop nonpharmacologic treatments that effectively treat and reduce its core symptoms (eg, worry). A leading theory posits that although worrying may be unpleasant, the immediate emotions that are avoided by concentrating on worry are often perceived as more aversive (eg, fear, anger, grief). From a mechanistic perspective, worry is thought to be learned and reinforced in a similar manner to other types of positively and negatively reinforced behaviors: habits. Mindfulness training, a practice that brings awareness to cognitive, affective, and physiological experiences, when delivered in-person via programs such as mindfulness-based stress reduction (MBSR) and mindfulness-based cognitive therapy (MBCT), has demonstrated effectiveness in reducing anxiety, but is difficult to scale in this manner. In this review, we explore novel approaches to using mindfulness training to specifically target the theoretical mechanisms underlying the perpetuation of anxiety (eg, worry as a habit), and the emergence of mobile health platforms (eg, digital therapeutics) as potential vehicles for remote delivery of treatment.
      Citation: American Journal of Lifestyle Medicine
      PubDate: 2021-04-28T04:58:44Z
      DOI: 10.1177/15598276211008144
      Issue No: Vol. 15, No. 5 (2021)
       
  • Nutrition and Medicine: Are They Connected'

    • Free pre-print version: Loading...

      Authors: T. Colin Campbell
      Pages: 495 - 497
      Abstract: American Journal of Lifestyle Medicine, Volume 15, Issue 5, Page 495-497, September-October 2021.

      Citation: American Journal of Lifestyle Medicine
      PubDate: 2021-05-08T10:33:01Z
      DOI: 10.1177/15598276211008376
      Issue No: Vol. 15, No. 5 (2021)
       
  • Primary Pandemic Prevention

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      Authors: Michael Greger
      Pages: 498 - 505
      Abstract: American Journal of Lifestyle Medicine, Volume 15, Issue 5, Page 498-505, September-October 2021.
      Over the last few decades, hundreds of human pathogens have emerged at a rate unprecedented in human history. Emerged from where' Mostly from animals. The AIDS virus is blamed on the butchering of primates in the African bushmeat trade, we created mad cow disease when we turned cows into carnivores and cannibals, and SARS and COVID-19 have been traced back to the exotic wild animal trade. Our last pandemic, swine flu in 2009, arose not from some backwater wet market in Asia, however. It was largely made-in-the-USA on pig production operations in the United States. In this new Age of Emerging Diseases, there are now billions of animals overcrowded and intensively confined in filthy factory farms for viruses to incubate and mutate within. Today’s industrial farming practices have given viruses billions more spins at pandemic roulette. How can we stop the emergence of pandemic viruses in the first place' Whenever possible, treat the cause. The largest and oldest association of public health professionals in the world, the American Public Health Association, has called for a moratorium on factory farming for nearly two decades. Indeed, factory farms are a public health menace. In addition to discontinuing the intensive confinement practices of animal agriculture, we should continue to research, develop, and invest in innovative plant-based and cultivated meat technologies to move away from raising billions of feathered and curly-tailed test tubes for viruses with pandemic potential to mutate within.
      Citation: American Journal of Lifestyle Medicine
      PubDate: 2021-05-03T10:18:44Z
      DOI: 10.1177/15598276211008134
      Issue No: Vol. 15, No. 5 (2021)
       
  • Successful Use of Virtual Shared Medical Appointments for a
           Lifestyle-Based Diabetes Reversal Program

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      Authors: Padmaja Patel
      Pages: 506 - 509
      Abstract: American Journal of Lifestyle Medicine, Volume 15, Issue 5, Page 506-509, September-October 2021.

      Citation: American Journal of Lifestyle Medicine
      PubDate: 2021-04-24T09:15:21Z
      DOI: 10.1177/15598276211008396
      Issue No: Vol. 15, No. 5 (2021)
       
  • Successfully Integrating Lifestyle Medicine Into Health Systems

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      Authors: Padmaja Patel, Marcy Madrid
      Pages: 510 - 513
      Abstract: American Journal of Lifestyle Medicine, Volume 15, Issue 5, Page 510-513, September-October 2021.

      Citation: American Journal of Lifestyle Medicine
      PubDate: 2021-04-29T10:44:36Z
      DOI: 10.1177/15598276211008397
      Issue No: Vol. 15, No. 5 (2021)
       
  • Medical Education Transformation: Lifestyle Medicine in Undergraduate and
           Graduate Medical Education, Fellowship, and Continuing Medical Education

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      Authors: Brenda Rea, Shannon Worthman, Paulina Shetty, Megan Alexander, Jennifer L. Trilk
      Pages: 514 - 525
      Abstract: American Journal of Lifestyle Medicine, Volume 15, Issue 5, Page 514-525, September-October 2021.
      A gaping void of adequate lifestyle medicine (LM) training exists across the medical education continuum. The American College of Lifestyle Medicine’s (ACLM’s) undergraduate medical education (UME) Task Force champions the need for widespread integration of LM curriculum in UME by sharing ideas for catalyzing success, lessons learned, and publishing standards and competencies to facilitate curriculum reform. When it comes to graduate medical education and fellowship, the ACLM and American Board of Lifestyle Medicine have made great strides in filling the void, developing both Educational and Experiential Pathways through which physicians may become certified LM Physicians or LM Specialists (LMSs). The Lifestyle Medicine Residency Curriculum meets the Educational Pathway requirements and prepares resident graduates for the LM Physician board certification. LMS is the second tier of LM certification that demonstrates expertise in disease reversal. The LMS Fellowship is an Educational Pathway intent on American Board of Medical Specialties recognition of LM as a new subspecialty in the near future. Finally, continuing medical education and maintenance of certification equip physicians with LM training to support knowledge, application, and certification in LM.
      Citation: American Journal of Lifestyle Medicine
      PubDate: 2021-04-29T10:44:09Z
      DOI: 10.1177/15598276211006629
      Issue No: Vol. 15, No. 5 (2021)
       
  • Undergraduate Medical Education: Lifestyle Medicine Curriculum
           Implementation Standards

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      Authors: Jennifer L. Trilk, Shannon Worthman, Paulina Shetty, Karen R. Studer, April Wilson, Marianna Wetherill, Lori Whelan, Shipra Bansal, Megan Alexander, Beth Frates, Sylvia Cramer, Brenda Rea
      Pages: 526 - 530
      Abstract: American Journal of Lifestyle Medicine, Volume 15, Issue 5, Page 526-530, September-October 2021.
      Lifestyle medicine (LM) is an emerging specialty that is gaining momentum and support from around the world. The American Medical Association passed a resolution to support incorporating LM curricula in medical schools in 2017. Since then, the American College of Lifestyle Medicine Undergraduate Medical Education Task Force has created a framework for incorporating LM into medical school curricula. This article provides competencies for medical school LM curriculum implementation and illustrates how they relate to the Association of American Medical College’s Core Entrustable Professional Activities and the LM Certification Competencies from the American Board of Lifestyle Medicine. Finally, standards are presented for how medical schools may receive certification for integrating LM into their curriculum and how medical students can work toward becoming board certified in LM through an educational pathway.
      Citation: American Journal of Lifestyle Medicine
      PubDate: 2021-04-28T04:56:29Z
      DOI: 10.1177/15598276211008142
      Issue No: Vol. 15, No. 5 (2021)
       
  • Strategies for Incorporating Lifestyle Medicine in Everyday Hospital
           Practice

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      Authors: Matthew R. Petersen, Andrew M. Freeman, Marcy Madrid, Monica Aggarwal
      Pages: 531 - 537
      Abstract: American Journal of Lifestyle Medicine, Volume 15, Issue 5, Page 531-537, September-October 2021.
      Cardiovascular disease and its associated risk factors such as hypertension, obesity, and diabetes are contributing to a large portion of morbidity, mortality, and health care costs in the United States. Diet and lifestyle education have been shown to be beneficial in reducing cost, mortality, and morbidity associated with these diseases. However, the lack of implementation of diet and lifestyle tools into clinical practices and into hospital systems leaves much room for improvement. Obstacles such as poor physician education, financial concerns, patient preference, and social resistance to change have made it difficult to promote healthy lifestyle and nutrition practices throughout all aspects of health systems. Some hospital systems and hospital-based clinical practices have had important successes in creating prevention clinic models, implementing plant-based menus in their hospital systems, and incorporating intensive rehabilitation programs that will pave the way for more future change. This review describes the current deficits, obstacles, and innovative strategies for implementing lifestyle medicine into hospital systems.
      Citation: American Journal of Lifestyle Medicine
      PubDate: 2021-04-22T05:46:24Z
      DOI: 10.1177/15598276211006664
      Issue No: Vol. 15, No. 5 (2021)
       
  • Transforming Trauma With Lifestyle Medicine

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      Authors: James S. Gordon, Tatiana Znayenko-Miller
      Pages: 538 - 540
      Abstract: American Journal of Lifestyle Medicine, Volume 15, Issue 5, Page 538-540, September-October 2021.
      A common misconception is that trauma—“injury” to the mind, body, and spirit—comes only to those individuals who have experienced threats of death, sexual violence, or serious injury. The SARS-CoV-2 (COVID-19) and the widespread disruption, anxiety, and stress it has left in its wake have shown us that this is not the case; trauma is universal. Left unaddressed, trauma can have long-term physical and psychological consequences. It appears that the consequences of trauma can also be transmitted from generation to generation through modifications in the DNA of the exposed individual that alter the function of one or more genes. Meditation and other practical, evidence-based mind-body skills can reverse what has been damaged by traumatic events and long-term stress. The Center for Mind-Body Medicine (CMBM), established in 1991, has developed a comprehensive, innovative, and evidence-based model that has been used by diverse populations to heal psychological trauma and promote resilience. Comprehensive, easily available programs of self-care and group support, such as The CMBM’s Mind-Body Skills Group Model, can ensure that children and adults everywhere have the psychological skills they need to address the trauma of the COVID-19 pandemic.
      Citation: American Journal of Lifestyle Medicine
      PubDate: 2021-04-16T04:47:00Z
      DOI: 10.1177/15598276211008123
      Issue No: Vol. 15, No. 5 (2021)
       
  • Planetary Health, Climate Change, and Lifestyle Medicine: Threats and
           Opportunities

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      Authors: Neha Pathak, Amanda McKinney
      Pages: 541 - 552
      Abstract: American Journal of Lifestyle Medicine, Volume 15, Issue 5, Page 541-552, September-October 2021.
      Global environmental degradation and climate change threaten the foundation of human health and well-being. In a confluence of crises, the accelerating pace of climate change and other environmental disruptions pose an additional, preventable danger to a global population that is both aging and carrying a growing burden of noncommunicable diseases (NCDs). Climate change and environmental disruption function as “threat multipliers,” especially for those with NCDs, worsening the potential health impacts on those with suboptimal health. At the same time, these environmental factors threaten the basic pillars of health and prevention, increasing the risk of developing chronic disease. In the face of these threats, the core competencies of lifestyle medicine (LM) present crucial opportunities to mitigate climate change and human health impacts while also allowing individuals and communities to build resilience. LM health professionals are uniquely positioned to coach patients toward climate-healthy behavior changes that heal both people and the planet.
      Citation: American Journal of Lifestyle Medicine
      PubDate: 2021-04-21T10:18:59Z
      DOI: 10.1177/15598276211008127
      Issue No: Vol. 15, No. 5 (2021)
       
  • A Hybrid Value-Based Lifestyle Medicine Practice Model

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      Authors: Wayne S. Dysinger
      Pages: 553 - 554
      Abstract: American Journal of Lifestyle Medicine, Volume 15, Issue 5, Page 553-554, September-October 2021.
      A lifestyle medicine approach to primary care that is value based can provide positive triple aim outcomes and demonstrate market equivalent reimbursement for the practitioner.
      Citation: American Journal of Lifestyle Medicine
      PubDate: 2021-04-22T05:45:00Z
      DOI: 10.1177/15598276211006628
      Issue No: Vol. 15, No. 5 (2021)
       
  • Lifestyle Medicine Prescriptions

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      Authors: Wayne S. Dysinger
      Pages: 555 - 556
      Abstract: American Journal of Lifestyle Medicine, Volume 15, Issue 5, Page 555-556, September-October 2021.
      Lifestyle Medicine prescriptions are a foundational component to the practice of Lifestyle Medicine. With expanding technology, prescriptions are moving from single sheets of paper to customizable ongoing feedback that encourages continuous dialogue and feedback between patient and provider.
      Citation: American Journal of Lifestyle Medicine
      PubDate: 2021-04-16T04:48:33Z
      DOI: 10.1177/15598276211006627
      Issue No: Vol. 15, No. 5 (2021)
       
  • Direct Primary Care: A Successful Financial Model for the Clinical
           Practice of Lifestyle Medicine

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      Authors: Amy R. Mechley
      Pages: 557 - 562
      Abstract: American Journal of Lifestyle Medicine, Volume 15, Issue 5, Page 557-562, September-October 2021.
      Primary care has been shown to significantly decrease the overall cost of a population’s health care while improving the quality of each person’s well-being. Lifestyle medicine (LM) is ideally positioned to be delivered via primary care and has been shown to improve short- and long-term health outcomes of patients and populations. Direct primary care (DPC) represents a viable alternative to the fee-for-service reimbursement model. It has been shown to be economically and financially sustainable. Furthermore, it has the potential to fulfill the Quadruple Aim of health care in the United States. LM practiced in a DPC model has the potential to transform health care delivery. This article will discuss the need for health care systems change, provide an overview of the DPC model, demonstrate a basic understanding of the benefits, and review the steps needed to de-risk the investment of time, money, and resources for our future DPC providers.
      Citation: American Journal of Lifestyle Medicine
      PubDate: 2021-04-15T09:17:18Z
      DOI: 10.1177/15598276211006624
      Issue No: Vol. 15, No. 5 (2021)
       
  • A Powerful Antidote to Physician Burnout: Intensive Healthy Lifestyle and
           Positive Psychology Approaches

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      Authors: Liana Lianov
      Pages: 563 - 566
      Abstract: American Journal of Lifestyle Medicine, Volume 15, Issue 5, Page 563-566, September-October 2021.
      Burnout rates among physicians are rapidly rising. Leaders in the movement to address burnout have made the case that health care workplaces need to foster a culture of well-being, including trusting coworker interactions, collaborative and transparent leadership, work-life balance, flexibility, opportunities for meaningful work and for professional development, and effective 2-way communication. The rationale for focusing on organizational change to prevent burnout has pointed to persistent symptoms of burnout even when individual healthy lifestyle interventions are adopted. However, a case can be made that the lifestyle interventions were not implemented at the level of intensity recommended by the lifestyle medicine evidence-base to secure the desired improvement in physical and mental health when facing significant personal and environmental stressors. The lifestyle medicine community has the ethical mandate to advocate for intensive healthy lifestyle approaches to burnout prevention, in conjunction with organizational supports. By combining comprehensive and intensive lifestyle changes with organizational cultures of well-being, we can more effectively turn the tide of physician burnout.
      Citation: American Journal of Lifestyle Medicine
      PubDate: 2021-04-22T05:43:16Z
      DOI: 10.1177/15598276211006626
      Issue No: Vol. 15, No. 5 (2021)
       
  • Loneliness and Social Isolation as Risk Factors: The Power of Social
           Connection in Prevention

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      Authors: Julianne Holt-Lunstad
      Pages: 567 - 573
      Abstract: American Journal of Lifestyle Medicine, Volume 15, Issue 5, Page 567-573, September-October 2021.
      Social isolation and loneliness were already pressing concerns prior to the pandemic, but recent trends suggest a potential broadening of this public health crisis. Social connections have potent influences on health and longevity, and lacking social connection qualifies as a risk factor for premature mortality. However, social factors are often overlooked in medical and healthcare practice. There is also evidence documenting effects on biomarkers and health-relevant behaviors, as well as more proximal means social connection influences physical health. A recent National Academy of Science consensus committee report provides recommendations for how this evidence can inform medical and healthcare. Clinicians play an important role in assessing, preventing, and mitigating the adverse effects of social isolation and loneliness.
      Citation: American Journal of Lifestyle Medicine
      PubDate: 2021-05-06T12:52:20Z
      DOI: 10.1177/15598276211009454
      Issue No: Vol. 15, No. 5 (2021)
       
  • The Important Role for Physicians as Advocates for Firearm and Road
           Traffic Injury Prevention

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      Authors: Karen D. Liller, Amber Mehmood
      Abstract: American Journal of Lifestyle Medicine, Ahead of Print.
      The purpose of this article is to discuss the important role for physicians in advocating for the prevention of road traffic and firearm injuries. Physicians have shown to be effective advocates for a variety of injuries, and this needs to continue and be enhanced for these injury categories. Road traffic and firearm injuries are among the leading causes of death across the lifespan. The influence and credibility of physicians enhance the messages they provide in advocacy efforts. It is important that physicians educate and counsel patients in a variety of healthcare settings along with joining advocacy efforts of professional associations. Recommendations are provided for advocacy components related to these injuries. Also, it is very important that physicians receive training in medical school and/or residency about injuries and how to successfully advocate for evidence-based injury prevention strategies.
      Citation: American Journal of Lifestyle Medicine
      PubDate: 2021-10-11T12:44:42Z
      DOI: 10.1177/15598276211039458
       
  • Distracted Driving and Driving Patterns in Older Drivers With Glaucoma

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      Authors: Purva Jain, Jonathan T. Unkart, Fabio B. Daga, Linda Hill
      Abstract: American Journal of Lifestyle Medicine, Ahead of Print.
      Limited research exists examining self-perceived vision and driving ability among individuals with glaucoma, and this study assessed the relationship between glaucoma, visual field, and visual acuity with driving capability.137 individuals with glaucoma and 75 healthy controls were asked to evaluate self-rated vision, self-perceived driving ability, and self-perceived distracted driving. Visual acuity and visual field measurements were also obtained. Multivariable linear regressions were run to test each visual measure with driving outcomes.The average age was 72.2 years, 57.3% were male, and 72.5% were White. There were significant associations for a one-point increase in visual field and quality of corrected vision (RR = 1.06; 95% CI = 1.03–1.10), day vision (RR = 1.05; 95% CI = 1.03–1.08), night vision (RR = 1.08; 95% CI = 1.05–1.13), visual acuity score and higher quality of corrected of vision (RR = .41; 95% CI = .22-.77), day vision (RR = .39; 95% CI=.22–.71), and night vision (RR = .41; 95% CI = .18–.94); visual acuity score and ability to drive safely compared to other drivers your age (RR = .53; 95% CI = .29–.96).Individuals with poorer visual acuity and visual fields rate their vision and ability to drive lower than those with better vision, and this information will allow clinicians to understand where to target interventions to enhance safe driving practices.
      Citation: American Journal of Lifestyle Medicine
      PubDate: 2021-09-27T04:35:12Z
      DOI: 10.1177/15598276211042825
       
  • Investigation of Health Behavior on Burnout Scores in Women Physicians who
           Self-Identify as Runners: A Cross-Sectional Survey Study

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      Authors: Hannah Uhlig-Reche, Allison R. Larson, Julie K. Silver, Adam Tenforde, Alisa McQueen, Monica Verduzco-Gutierrez
      Abstract: American Journal of Lifestyle Medicine, Ahead of Print.
      As the proportion of women in the physician workforce increases, burnout in this population warrants further investigation. Exercise is an often-proposed strategy to combat burnout. Evaluating physical activity across a cohort of women physicians can assess associations of health behaviors with burnout. Cross-sectional study of women attending physicians in the United States who are actively engaged in a social media group for runners. An electronic survey comprised of 60 questions covering demographics, health behaviors, and burnout was administered. A healthy lifestyle subgroup (HLS) was defined based on American Heart Association physical activity and nutrition recommendations. We determine the prevalence of burnout and investigate associations between health behavior factors and burnout.Of the 369 included surveys, most respondents were at least six years out from medical training (85.9%) and White (74.5%). Forty-two percent experienced burnout symptoms. Time exercising was significantly associated with fruit/vegetable consumption (P=.00002). There was no significant difference in burnout between the HLS compared to others (P = .37).This group of self-reported physically active women physicians was found to have a lower prevalence of burnout when compared to other women physicians. Exercise and nutrition may be protective against burnout in women physicians but deserve further investigation.
      Citation: American Journal of Lifestyle Medicine
      PubDate: 2021-09-26T04:14:54Z
      DOI: 10.1177/15598276211042573
       
  • A Taste of Virtual Culinary Medicine and Lifestyle Medicine—An Online
           Course for Medical Students

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      Authors: Ginger Poulton, Amanda Antono
      Abstract: American Journal of Lifestyle Medicine, Ahead of Print.
      As medical schools work to train the next generation of providers, including robust content in nutrition education is paramount. The National Academy of Sciences sets the benchmark for 25 hours of nutrition education in medical schools, though many schools do not meet this requirement. Usually, nutrition lectures in medical schools are given in the pre-clinical years and focus on biochemistry and micronutrients. During the COVID-19 pandemic, there was a unique opportunity to quickly develop and implement an elective course for 3rd and 4th year medical students at the University of North Carolina School of Medicine. A course was created in lifestyle medicine and culinary medicine, and all were delivered remotely through Zoom. This course would be simple to replicate at other institutions and was very well received. This article will describe more of the resources, methods, and reactions to this course.
      Citation: American Journal of Lifestyle Medicine
      PubDate: 2021-09-25T02:15:56Z
      DOI: 10.1177/15598276211046558
       
  • Public Awareness of a Plant-Based Diet Following the Release of “Game
           Changers” and “What The Health” Documentaries

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      Authors: Micah Hartwell, Trevor Torgerson, Ryan Essex, Ben Campbell, Danielle Belardo, Matt Vassar
      Abstract: American Journal of Lifestyle Medicine, Ahead of Print.
      Background: Poor diet is a leading cause of premature death and thus diet and lifestyle changes are needed; yet, no consensus exists regarding diets that provide the greatest benefit. One of these diets gaining popularity around the world is a plant-based, vegan diet. Recently, Netflix documentaries What the Health (2017) and The Game Changers (2019) have attempted to improve public awareness of veganism and plant-based diets. Methods: We used Google Trends to obtain data for keywords specific to plant-based diets, veganism, and documentary-specific terms over a time period before and after the release of the Netflix documentaries. We then created a forecasted model for trended search terms using autoregressive integrated moving algorithms and compared the actual trends to the forecast model to determine the effect of the documentaries on each selected term. Results: Search interest for the term “plant-based diet” increased significantly—2.8 times the mean forecasted value for What the Health (t = 12.892, df = 30.012, P < .001) and 2 times the forecasted mean for The Game Changers (t = 19.826, df = 30.118, P < .001). Additionally, following the release of The Game Changers, mean search interest for “plant-based athlete” was 2.8 times higher than the forecasted values. Conclusion: The documentaries What the Health (2017) and The Game Changers (2019) are associated with an increased interest in plant-based diets based on Google search trends, highlighting the need for continued research regarding plant-based diets and their health benefits related to chronic disease.
      Citation: American Journal of Lifestyle Medicine
      PubDate: 2021-09-24T10:06:32Z
      DOI: 10.1177/15598276211044106
       
  • Whole-Foods, Plant-Based Diet Perceptions of Medical Trainees Compared to
           Their Patients: A Cross-Sectional Pilot Study

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      Authors: Kara F. Morton, Diana C. Pantalos, Craig Ziegler, Pradip D. Patel
      Abstract: American Journal of Lifestyle Medicine, Ahead of Print.
      Purpose: To evaluate medical trainees’ and patients’ perceptions of the utility of a whole-foods, plant-based (WFPB) diet for chronic disease management. Methods: A cross-sectional study using two original survey tools was implemented. Quantitative and qualitative data were collected from trainees and patients to evaluate perceived motivations and barriers to WFPB diet implementation. Results: Two hundred trainees and 52 patients responded to the surveys. Nearly half (48%) of patients were willing to try a WFPB diet, expressing a desire for additional information and help with its practical application. Over half (53%) of trainees were willing to recommend a WFPB diet to patients but expressed concern about its acceptability and feasibility. Patients perceived significantly more barriers related to personal enjoyment of animal products while trainees perceived more socioeconomic barriers. Conclusion: Poor diet has been identified as the United States’ leading risk factor for mortality from chronic diseases. Plant-predominant diets, such as a WFPB diet, are associated with improved health outcomes and may be an acceptable solution for many patients. WFPB dietary modification could be pursued with a motivational interviewing approach that targets patients’ individual goals. Medical providers should address their own assumptions regarding the dietary changes their patients are willing to make.
      Citation: American Journal of Lifestyle Medicine
      PubDate: 2021-09-01T12:40:00Z
      DOI: 10.1177/15598276211041551
       
  • Health Literacy in Primary Care: Reflections and Suggestions for
           Physicians, Researchers, and Administrators

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      Authors: Anne Sprogell, Allison R. Casola, Amy Cunningham
      Abstract: American Journal of Lifestyle Medicine, Ahead of Print.
      As the healthcare system evolves, it is becoming more complicated for physicians and patients. Patients might have had one doctor in the past, but now are likely to regularly see several specialists along with their primary care physician. Patients can access their health records online, which increases transparency and accountability, but adds more information they have to interpret. This is the concept of health literacy—the ability to obtain, process, and act upon information regarding one’s health. This article will characterize health literacy in primary care and provide three areas that primary care physicians and researchers can direct their focus in order to increase health literacy among patients: community engagement, trainee education, and examination of personal bias.
      Citation: American Journal of Lifestyle Medicine
      PubDate: 2021-09-01T02:39:16Z
      DOI: 10.1177/15598276211041283
       
  • A Qualitative Exploration of Pregnancy Experience With a Nutrient-Dense,
           Plant-Rich Dietary Pattern: A Pilot Study

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      Authors: Allison P. McNelly, Emery R. Eaves, Julia Christine Gardner, Wendy S. Wetzel, Jay T. Sutliffe
      Abstract: American Journal of Lifestyle Medicine, Ahead of Print.
      Introduction: A nutrient-dense, plant-rich diet may be promising as a nutrition intervention for pregnant women for a number of factors. Factors include the possibility of a decreased risk for gestational diabetes, excess weight gain, and preeclampsia. Little is known about the experience of following this type of dietary pattern while pregnant and what barriers are present that should be addressed in a large-scale intervention. Methods: Qualitative interviews were used to understand the personal experience of women who aimed to eat a nutrient-dense plant-rich diet while pregnant. Semi-structured interviews were conducted from June to August 2020. Results: Three main themes regarding a nutrient-dense plant-rich diet emerged. First, family and social influence played an important role. Second, women who had a previous pregnancy felt they had fewer pregnancy symptoms on this diet. Last, the participants may have experienced a reduced milk supply on this dietary plan. Conclusion: Future research should consider family context as a factor in adherence to a nutrient-dense plant-rich dietary pattern, investigate the possible associations between nutrient-dense plant-rich dietary patterns and reduced nausea and vomiting in early pregnancy, and determine whether nutrient-dense, plant-rich dietary patterns contribute to a reduction in milk production for women who experience over-engorgement.
      Citation: American Journal of Lifestyle Medicine
      PubDate: 2021-08-31T07:13:02Z
      DOI: 10.1177/15598276211040454
       
  • Development of Culinary and Self-Care Programs in Diverse Settings:
           Theoretical Considerations and Available Evidence

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      Authors: Dominique Munroe, Miranda A. Moore, Jonathan P. Bonnet, Krystyna Rastorguieva, Jennifer S. Mascaro, Linda W. Craighead, Carla I. Haack, Cassandra L. Quave, Sharon H. Bergquist
      Abstract: American Journal of Lifestyle Medicine, Ahead of Print.
      Culinary-based self-care programs are innovative and increasingly utilized models for catalyzing behavior change and improving health and well-being. The content, duration, and delivery of existing programs vary considerably. Between January and August 2019, we developed a teaching kitchen and self-care curriculum, which was administered as part of a year-long worksite well-being program to employees at an academic healthcare system. The curriculum domains included culinary skills, nutrition, physical activity, yoga, stress management, mindful eating, and ethnobotany. An informal systematic literature search was performed to assemble and evaluate key principles and practices related to self-care domains, learning methodologies, and programmatic design considerations. Here, we provide a qualitative summary of the evidence-informed development of the curriculum intervention.
      Citation: American Journal of Lifestyle Medicine
      PubDate: 2021-08-13T01:50:41Z
      DOI: 10.1177/15598276211031493
       
  • Mitigating Medication-Related Fall Risk Through
           Pharmacist–Prescriber Collaboration

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      Authors: Nicole D. White
      Abstract: American Journal of Lifestyle Medicine, Ahead of Print.
      Medications are known to increase the risk for fall in older adults, and pharmacists can contribute to fall risk prevention through medication therapy management services. STEADI-Rx is an initiative developed to facilitate fall risk reduction through pharmacist–prescriber collaboration. Key components of the STEADI-Rx algorithm are described as well as evidence supporting its integration in practice.
      Citation: American Journal of Lifestyle Medicine
      PubDate: 2021-08-12T04:31:23Z
      DOI: 10.1177/15598276211035361
       
  • Joy in the Workplace: The Mayo Clinic Experience

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      Authors: Elizabeth A. Kelsey
      Abstract: American Journal of Lifestyle Medicine, Ahead of Print.
      The COVID-19 pandemic has changed dynamics in the healthcare setting, through social distancing guidelines and new protocols to promote safety for employees and patients. Although some find themselves more productive in this spread out or virtual environment, the social aspect of the work day has dramatically changed. Staying connected during the day or week comes with additional efforts to seek out opportunities to network and collaborate with colleagues with this work environment shift. Healthcare workers are already at high risk of occupational burnout. In addition, the COVID-19 pandemic has brought additional stressors to individuals outside of their workload compromising a balanced work–life integration. Consequently, personal well-being may become jeopardized due to physical, mental, and social constraints brought on by the pandemic. Mayo Clinic has implemented a joy in the workplace structure to support individual well-being and create space for healthcare workers to be energized in order to put the needs of the patient first and deliver excellent care. Joy at Mayo Clinic contributes to joy in the workplace, reduced burnout, and personal well-being.
      Citation: American Journal of Lifestyle Medicine
      PubDate: 2021-08-06T10:26:25Z
      DOI: 10.1177/15598276211036886
       
  • Effect of Yoga Therapy on Health Outcomes in Women With Polycystic Ovary
           Syndrome: A Systematic Review and Meta-Analysis

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      Authors: Anita Verma, Vikas Upadhyay, Vartika Saxena
      Abstract: American Journal of Lifestyle Medicine, Ahead of Print.
      The purpose of this study was to assess the effect of yoga therapy (YT) on health outcomes of women suffering from polycystic ovary syndrome (PCOS). Interventional studies, with postmenarchal and premenopausal females with PCOS who received YT, with any health outcome reported, were included. Scopus, Cochrane, PubMed, Embase, and Medline databases were electronically searched. Systematic review included 11 experimental studies, representing 515 participants with PCOS, out of which 2 randomized controlled trials (RCTs) were included for meta-analysis. Random effects model was applied using Review Manager Software version 5.4.1 and strength of evidence was assessed using GRADEpro Guideline Development Tool, 2020. Meta-analysis showed that YT may significantly decrease menstrual irregularity (MD −.41, 95% CI −.74 to −.08), clinical hyperandrogenism (MD −.70, 95% CI −1.15 to −.26), fasting blood glucose (MD −.22 mmol/L, 95% CI −.44 to −.01), fasting insulin (MD −28.21 pmol/L, 95% CI −43.79 to −12.63), and homeostatic model assessment-insulin resistance value (MD −.86, 95% CI −1.29 to −.43). Strength of evidence was “low.” In conclusion, YT may have beneficial effects on health outcomes in women suffering from PCOS. However, low strength of evidence suggests need of conducting well-designed RCTs to assess the efficacy of YT for PCOS.
      Citation: American Journal of Lifestyle Medicine
      PubDate: 2021-08-06T03:01:11Z
      DOI: 10.1177/15598276211029221
       
  • A Wrinkle in Measuring Time Use for Cognitive Health: How should We
           Measure Physical Activity, Sedentary Behaviour and Sleep'

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      Authors: Ryan S. Falck, Jennifer C. Davis, Karim M. Khan, Todd C. Handy, Teresa Liu-Ambrose
      Abstract: American Journal of Lifestyle Medicine, Ahead of Print.
      One new case of dementia is detected every 4 seconds and no effective drug therapy exists. Effective behavioural strategies to promote healthy cognitive ageing are thus essential. Three behaviours related to cognitive health which we all engage in daily are physical activity, sedentary behaviour and sleep. These time-use activity behaviours are linked to cognitive health in a complex and dynamic relationship not yet fully elucidated. Understanding how each of these behaviours is related to each other and cognitive health will help determine the most practical and effective lifestyle strategies for promoting healthy cognitive ageing. In this review, we discuss methods and analytical approaches to best investigate how these time-use activity behaviours are related to cognitive health. We highlight four key recommendations for examining these relationships such that researchers should include measures which (1) are psychometrically appropriate; (2) can specifically answer the research question; (3) include objective and subjective estimates of the behaviour and (4) choose an analytical method for modelling the relationships of time-use activity behaviours with cognitive health which is appropriate for their research question.
      Citation: American Journal of Lifestyle Medicine
      PubDate: 2021-07-28T03:01:03Z
      DOI: 10.1177/15598276211031495
       
  • COVID-19: Implications for Physical Activity, Health Disparities, and
           Health Equity

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      Authors: Rebecca Hasson, James F. Sallis, Nailah Coleman, Navin Kaushal, Vincenzo G. Nocera, NiCole Keith
      Abstract: American Journal of Lifestyle Medicine, Ahead of Print.
      Physical activity is one of the most efficacious pathways to promoting mental and physical health, preventing disease, and, most important during the COVID-19 pandemic, bolstering a stronger immune system. Efforts to “flatten the curve” have resulted in the temporary closure of exercise facilities and gyms, suspension of sport activities, and advisories to avoid public recreational spaces. All of these changes have made traditional opportunities to be physically active difficult to access. These changes have also exacerbated existing disparities in access to social and environmental supports for physical activity, potentially contributing to a widening gap in physical activity participation among those at greatest risk for COVID-19. Physical activity can play a special role in reducing the inequitable consequences of COVID-19; however, expansion and better targeting of evidence-informed interventions are needed that address the unique barriers present in communities that have been economically and socially marginalized to achieve health equity in COVID-19 outcomes. This review highlights effective and feasible strategies that provide more equitable access to physical activity programs and spaces across the United States. With a renewed investment in physical activity, this behavior can play a crucial role in improving population health and reducing disparities during the COVID-19 pandemic and beyond.
      Citation: American Journal of Lifestyle Medicine
      PubDate: 2021-07-27T07:50:58Z
      DOI: 10.1177/15598276211029222
       
  • Digital Lifestyle Medicine: Designing, Delivering, and Scaling for Impact

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      Authors: Leanne Mauriello, Kristi Artz
      Abstract: American Journal of Lifestyle Medicine, Ahead of Print.
      Digital Lifestyle Medicine (DLM) is a consumer-centric model of care which elevates the importance of daily behaviors in preventing and reversing chronic disease using virtual and digital modalities to reach patients in the context where lifestyle behaviors occur and empower them to stay well. DLM is health care reimagined, designed to inspire patients to live their best life by enabling skill-building, self-efficacy, and sustainable behavior change supported by peers, scientific-evidence, and a multidisciplinary team of lifestyle medicine (LM) clinicians. Importantly, it requires insights and collaboration from healthcare experts and technology entrepreneurs to provide a profoundly different “user experience” layered with context, relevance, and scalability. Using examples from our DLM practice, we describe how key components of LM practice, including a multidisciplinary care team, behavior change support, health coaching, and peer support, are prime for digital delivery. We conclude by providing preliminary patient outcomes to date, key success factors, and opportunities for enhancement and expansion to inform the adoption and successful implementation of DLM across the collective of LM practice.
      Citation: American Journal of Lifestyle Medicine
      PubDate: 2021-07-27T05:30:56Z
      DOI: 10.1177/15598276211029219
       
  • Knowledge, Attitude, and Practice of Orthopedic Manual Physical Therapists
           Toward Lifestyle Screening and Education: A Descriptive Study

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      Authors: Jillian M. Zollinger, Sozina D. Katuli
      Abstract: American Journal of Lifestyle Medicine, Ahead of Print.
      Introduction. Lifestyle-focused rehabilitation plans need to become part of the standard system of care for the treatment of chronic diseases. To achieve this goal, the KAP of rehabilitation professionals toward lifestyle medicine needs to be understood. This study investigated the niche of orthopedic manual physical therapy and is purposed as a foundational model for continued research. Method. A survey instrument was designed to investigate the KAP of orthopedic manual physical therapists toward lifestyle screening and education. Results. There were 155 participants of which 58.1-72.3% reported frequently talking to their patients about lifestyle topics, while 78.1-80.6% felt highly confident and competent while doing so. Additionally, 92.9-94.8% thought that lifestyle screening and education was important and that physical therapists should be doing it. Participants discussed exercise most frequently with their patients (96.1%) and alcohol the least (12.9%). Participants with advanced degrees (ie, PhD or DSc) had significantly higher Practice (MΔ= −3.755, P = .001) and Knowledge (MΔ= −4.14904, P = .020) ratings than those with entry-level physical therapy degrees. Conclusion. There was strong acceptance of lifestyle screening and education in orthopedic manual physical therapy with an emphasis on exercise. This study provides a foundational basis for continued research.
      Citation: American Journal of Lifestyle Medicine
      PubDate: 2021-07-19T12:12:39Z
      DOI: 10.1177/15598276211028557
       
  • What the World Needs Now: Lifestyle Medicine for All Women

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      Authors: Dopke BA, Somers BA, McHugh MD
      Abstract: American Journal of Lifestyle Medicine, Ahead of Print.
      Over the last several centuries, economic progress has allowed millions of women to move from rural subsistence agriculture to urban, more economically prosperous lifestyles. This trend is set to continue, even accelerate in the next century. Due to changes in diet, activity, and lifestyle, non-communicable diseases, such as cancer and heart disease, will continue to rise for women globally. At this time, we are uniquely positioned to anticipate this impact and empower women in both the developed and the developing world to learn from what has worked. Choosing the best approaches to nutrition, exercise, sleep, connectedness, substances, and stress can optimize women’s health span across the globe.
      Citation: American Journal of Lifestyle Medicine
      PubDate: 2021-07-19T05:57:15Z
      DOI: 10.1177/15598276211028101
       
  • Location, Location, Location: Accelerometer Placement Affects Steps-Based
           Physical Activity Outcomes During Pregnancy and Postpartum

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      Authors: Mallory R. Marshall, Alexander H. K. Montoye, Michelle R. Conway, Rebecca A. Schlaff, Karin A. Pfeiffer, James M. Pivarnik
      Abstract: American Journal of Lifestyle Medicine, Ahead of Print.
      As pregnancy progresses, physical changes may affect physical activity (PA) measurement validity. n = 11 pregnant women (30.1 ± 3.8 years) wore ActiGraph GT3X+ accelerometers on the right hip, right ankle, and non-dominant wrist for 3–7 days during the second and third trimesters (21 and 32 weeks, respectively) and 12 weeks postpartum. Data were downloaded into 60-second epochs from which stepping cadence was calculated; repeated-measures analysis of variance was used to determine significant differences among placements. At all time points, the wrist accelerometer measured significantly more daily steps (9930–10 452 steps/d) and faster average stepping cadence (14.5–14.6 steps/min) than either the hip (4972–5944 steps/d, 7.1–8.6 steps/min) or ankle (7161–8205 steps/d, 10.3–11.9 steps/min) placement, while moderate- to vigorous-intensity activity at the wrist (1.2–1.7 min/d) was significantly less than either hip (3.0–5.9 min/d) or ankle (6.1–7.3 min/d). Steps, cadence, and counts were significantly lower for the hip than the ankle at all time points. Kappa calculated for agreement in intensity classification between the various pairwise comparisons ranged from .06 to .41, with Kappa for hip–ankle agreement (.34–.41) significantly higher than for wrist–ankle (.09–.11) or wrist–hip (.06–.16). These data indicate that wrist accelerometer placement during pregnancy likely results in over counting of PA parameters and should be used with caution.
      Citation: American Journal of Lifestyle Medicine
      PubDate: 2021-07-13T10:48:42Z
      DOI: 10.1177/15598276211030472
       
  • Scoring Lifestyle Medicine Goals With FIFA 2022—An Opportunity to
           Strike Big!

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      Authors: Sathyanarayanan Doraiswamy, Sohaila Cheema, Javaid I. Sheikh, Ravinder Mamtani
      Abstract: American Journal of Lifestyle Medicine, Ahead of Print.
      Qatar is one of the few countries in the world with a dedicated national sports day. Qatar believes that sport is one of the best tools to promote a healthy lifestyle to help curb the growing burden of non-communicable diseases (NCDs). With the well-established positive health effects of soccer on cardiovascular, metabolic, and musculoskeletal conditions, the vision of the FIFA World Cup 2022™ hosted by Qatar to use the power of soccer to “open the door of an amazing world experience” is praiseworthy. With NCDs accounting for 70% of deaths in Qatar, there exists a perfect opportunity to promote healthy lifestyles to prevent, treat, and reverse NCDs. We believe that the FIFA World Cup 2022™ presents an opportunity that could contribute to generating valuable evidence on the lifestyle benefits of such large-scale events. This event comes at an opportune moment for countries in the region to make their health systems lifestyle-sensitive. FIFA World Cup 2022™ could just be the tipping point in the region that establishes the role of sports in mitigating the burden of NCDs. With the impact of COVID-19 on persons with pre-existing NCDs, the urgency for addressing the “syndemic” cannot be overemphasized and sport can be the lifestyle medicine.
      Citation: American Journal of Lifestyle Medicine
      PubDate: 2021-07-13T01:43:39Z
      DOI: 10.1177/15598276211026590
       
  • A Retrospective Analysis of Group-Based Boxing Exercise on Measures of
           Physical Mobility in Patients With Parkinson Disease

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      Authors: James W. H. Sonne, Kyle Joslyn, Katherine Reus, Michelle Angulo, Sarah Guettler, Morris C. Beato
      Abstract: American Journal of Lifestyle Medicine, Ahead of Print.
      Objectives: The purpose of this retrospective study is to further the limited body of evidence regarding the effects of a group-based boxing intervention for those with Parkinson’s disease (PD).Design: A retrospective cohort study was performed analyzing data collected on outcome measures at 6-month intervals up to 2 years. Individuals participated in the standardized “Rock Steady Boxing” (RSB) program for up to 24 months. Every 6 months, measures were taken of balance (Fullerton Advanced Balance [FAB] Scale), functional mobility (Timed-Up and Go [TUG]), lower extremity strength (30-second Chair Stand [30CST]), and gait speed (10 Meter Walk Test [10MWT]).Methods: Statistical significance (P < .05) was determined by a two-tailed t test. Data were collected from RSB-affiliated programs at 4 locations across the southeastern United States. Current and/or past participants in RSB with baseline and at least one subsequent outcome measure were included, resulting in 68 participants (54 male, 14 female, and mean age of 71.2 years ± 8.56 standard deviation).Results: Statistically significant improvements in FAB scale, TUG, and 30CST over time were found at both 6- and 12-month time points. Significant changes continued through 18 months for FAB and 30CST. No significant changes in 10MWT were observed; however, a moderate effect size was observed at the 1-year point.Conclusions: Participants with PD were able to achieve statistically significant improvements in standard measures of functional mobility, balance, and strength within the timeline of this study. Limitations include the retrospective nature, an inability to monitor adherence, and lack of control over pharmaceutical or other interventions.
      Citation: American Journal of Lifestyle Medicine
      PubDate: 2021-07-10T02:12:33Z
      DOI: 10.1177/15598276211028144
       
  • “I’m Gonna Hang on to These As Long As I Can”: Examining the
           Perspectives and Knowledge of Oral Health Issues of Older Adults Living
           Independently

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      Authors: Virginia M. Hardgraves, Leah J. Henry, Susan K. Patton
      Abstract: American Journal of Lifestyle Medicine, Ahead of Print.
      Purpose: Advantages of fluoridated water, dental insurance, and greater awareness of preventive oral healthcare allow many adults in today’s aging cohort to maintain their teeth into their advanced years. The purpose of this study was to describe attitudes, expectations, knowledge, and intentions related to oral health issues from the experiences of older adults living independently in a largely rural south central state. Methods: A qualitative analysis guided by behavioral constructs of the Reasoned Action Approach was utilized to conduct semi-structured interviews of a purposeful sample of adults age 65 years and older living independently. Results: Participant data (N = 26) revealed 5 themes: difficulties accessing dental care; active coping; taking care of your mouth as part of overall health; interactions affecting oral health–related quality of life; and supporting roles. Overall, the intention to attain dental care was affected by the perceived need to prioritize many health issues over oral care. An overarching expectation to have affordable basic services available pervaded. Conclusion: The perceptions of participants reflect socioeconomic determinants that could be influenced through improved health literacy education focused on establishing a greater understanding of the oral systemic link especially as it relates to diabetes.
      Citation: American Journal of Lifestyle Medicine
      PubDate: 2021-07-03T04:08:33Z
      DOI: 10.1177/15598276211026842
       
  • Diet in Dermatology: Review of Diet’s Influence on the Conditions of
           Rosacea, Hidradenitis Suppurativa, Herpes Labialis, and Vitiligo

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      Authors: Marielle Jamgochian, Mahin Alamgir, Babar Rao
      Abstract: American Journal of Lifestyle Medicine, Ahead of Print.
      The influence of dietary patterns on cutaneous disease has been an oft-posed question to dermatologists by patients in a clinical setting. Similarly, the popularity of nutritional supplementation with vitamins, minerals, and nutraceutical blends has been increasing. Dermatologists, primary care physicians, and other providers should be familiar with dietary interventions that are evidence-based and those that are more marketable than efficacious. In this review, the modification of diet, including dietary exclusion and dietary supplementation for the treatment of rosacea, hidradenitis suppurativa (HS), herpes labialis, and vitiligo was investigated. Despite abundant anecdotal evidence, the literature search found no high-quality evidence that an elimination diet for rosacea “trigger foods” improved rosacea symptoms though these elimination diets (of hot, spicy, alcohol-containing, or cinnamaldehyde-containing foods) had low risk of harm. There is evidence that zinc supplementation and vitamin D supplementation in deficient patients is helpful for treating HS. For herpes labialis, L-lysine supplementation was found to be effective for prophylaxis but not for decreasing duration of active lesions. For vitiligo, the use of the herb Polypodium leucotomos in conjunction with phototherapy was found to increase repigmentation, as well as vitamin D supplementation in deficient patients.
      Citation: American Journal of Lifestyle Medicine
      PubDate: 2021-07-03T04:01:11Z
      DOI: 10.1177/15598276211026592
       
  • Exercise Behaviors and Beliefs Among Pregnant Women in Rural Communities

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      Authors: Abigail S. L. Stickford, Emma K. Taylor, Danna V. Rodriguez, Sarah Stroup, Danielle L. Nunnery
      Abstract: American Journal of Lifestyle Medicine, Ahead of Print.
      Exercise during pregnancy is safe and beneficial; however, most pregnant women do not meet evidence-based exercise recommendations. Further, data on pregnant women’s physical activity are largely limited to women living in urban environments. Purpose. The purpose of this study is to examine beliefs and behaviors regarding exercise during pregnancy in pregnant and postpartum women living in rural communities. Methods. Surveys were distributed in healthcare settings and via social media to pregnant and postpartum (< 3 months) women living in rural communities. Results. Seventy-five women (28.1 ± 5.4 year) participated. Nearly all believed light (96%) and moderate (89%) intensity exercise are safe to perform during pregnancy, while fewer agreed vigorous intensity (52%) or resistance (40%) exercise is safe. Most (88%) believed women can continue their exercise regimen, and 73% believed that previously inactive women can begin training while pregnant. Only one-third of women met recommendations for cardiorespiratory exercise. The majority (66%) never engaged in vigorous exercise, and most (73%) did not participate in resistance exercise. Conclusion. Pregnant women in rural communities participate in light intensity exercise, but are largely not meeting guidelines for aerobic or resistance training. Knowledge related to safe exercises, particularly resistance training, during pregnancy is limited. Targeted education and programmatic planning are needed in this population regarding exercise guidelines.
      Citation: American Journal of Lifestyle Medicine
      PubDate: 2021-07-03T03:55:38Z
      DOI: 10.1177/15598276211026591
       
  • Applying Psychiatry and Psychology Principles to Lifestyle Approaches for
           Mental and Behavioral Health

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      Authors: Gia Merlo, Alyssa Vela
      Abstract: American Journal of Lifestyle Medicine, Ahead of Print.
      Research suggests that mental health symptoms and disorders are historically underdiagnosed and undertreated, in part due to the siloed nature of medicine. Yet, approximately 50 million American adults experience a mental health disorder. As the field of lifestyle medicine continues to emerge and grow, there is an important opportunity to address mental health from a lifestyle medicine perspective, as well as to ensure that lifestyle medicine can be utilized for all patients, including those with mental health conditions. To effectively address mental health, the field of lifestyle medicine would benefit from understanding and leveraging the decades of science and practice from the fields of psychiatry and psychology, as well as the expertise of psychiatrists and psychologists who are familiar with the science and trained in lifestyle medicine. Incorporating empirical literature from other areas, utilizing well-established conceptual frameworks, and addressing the overlap between lifestyle medicine and mental health early in, and throughout, training and education, are important steps to move toward addressing mental and behavioral health with a lifestyle medicine approach.
      Citation: American Journal of Lifestyle Medicine
      PubDate: 2021-06-24T03:40:34Z
      DOI: 10.1177/15598276211023415
       
  • Culinary Medicine Training in Core Medical School Curriculum Improved
           Medical Student Nutrition Knowledge and Confidence in Providing Nutrition
           Counseling

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      Authors: Christopher R. D’Adamo, Kayli Workman, Christine Barnabic, Norman Retener, Bernadette Siaton, Gabriela Piedrahita, Brandin Bowden, Nicola Norman, Brian M. Berman
      Abstract: American Journal of Lifestyle Medicine, Ahead of Print.
      Background: Elective culinary medicine education has become popular to help fill important gaps in physician nutrition training. The implementation and outcomes among the inaugural cohort of medical students who received culinary medicine training as a required component of medical school curriculum at the University of Maryland School of Medicine are described. Methods: Following a series of elective pilot sessions, culinary medicine training was provided to all first-year medical students in the 2019-2020 academic year. The 3-hour training included evidence-based nutrition lecture, cooking simple recipes, and group discussion of the application to personal and patient care. Pre-/postsession questionnaires assessed nutrition knowledge, skills, and attitudes as well as nutritional counseling confidence. Paired t-tests estimated mean differences in outcomes pre- and posttraining. Qualitative data were subjected to thematic analysis. Results: Overall, 119 of 125 (95.2%) students provided pre- and posttraining outcomes data. All nutritional and patient counseling outcomes improved (P < .05). Themes of being better prepared to address healthy eating barriers in patient care and personal ability to make healthy dietary changes were noted in qualitative analysis. Conclusion: One session of culinary medicine training in core medical student curriculum was feasible and improved medical student nutrition knowledge, skills, and attitudes and confidence in patient nutrition counseling.
      Citation: American Journal of Lifestyle Medicine
      PubDate: 2021-06-21T07:53:01Z
      DOI: 10.1177/15598276211021749
       
  • Plant-Based Diet and IGF-1 Modulation on HER2-Positive Breast Cancer: A
           Lifestyle Medicine Nutrition Approach in Oncology

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      Authors: Laurinda M. F. R. Simões, Nelson A. R. Tavares, Cíntia Ferreira-Pêgo
      Abstract: American Journal of Lifestyle Medicine, Ahead of Print.
      Breast cancer is the second most common type of cancer in women worldwide, where nutritional intervention should be part of a multidisciplinary lifestyle approach in oncology, promoting therapeutic success. Insulin-like growth factor 1 (IGF-1), along with estrogen, can promote the development of neoplastic cells in breast tissue. Cancers that develop under IGF-1 stimulation are often resistant to therapy. This case report describes a 47-year-old woman, body mass index 27.4 kg/m2, with HER2-positive breast cancer, as well as elevated blood glucose, total cholesterol, and low-density lipoprotein cholesterol. Soon after her breast cancer diagnosis, she transitioned from a Western pattern diet (WPD) to a predominantly whole-food, plant-based diet (PWFPBD) for 1035 days, followed by 232 days of PWFPBD plus night fasting for 16 hours per day. IGF-1 decreased 22.38%, glycemia and total cholesterol decreased by −55.06% and −36.00% at the end of the first intervention and went up by 6.25%, and 3.87%, respectively, at the end of the second intervention. A PWFPBD, with or without 16-hour overnight fasting, seems to modulate plasma levels of IGF-1 on a 47-year-old woman diagnosed with breast cancer, type HER2-positive. Future research, should explore the physiologic and pathophysiological mechanisms and clarify whether this dietary strategy, may be clinically useful in preventing HER2-positive breast cancer.
      Citation: American Journal of Lifestyle Medicine
      PubDate: 2021-06-19T09:50:48Z
      DOI: 10.1177/15598276211023048
       
  • Impact of a Whole-Foods, Plant-Based Nutrition Intervention on Patients
           Living with Chronic Disease in an Underserved Community

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      Authors: Shipra Bansal, Meaghan Connolly, Tasha Harder
      Abstract: American Journal of Lifestyle Medicine, Ahead of Print.
      The current study evaluated the impact of a whole-foods, plant-based nutrition intervention on metabolic markers of patients with chronic disease in an underserved community setting. A retrospective analysis of metabolic biomarkers preintervention and postintervention was conducted on 31 patients with metabolic disease who attended an Eating for Life group visit series. Significant decreases were found for body mass index (BMI; −0.66 [−0.91 to −0.40] kg/m2), systolic blood pressure (−12 [−19 to −5] mm Hg), total cholesterol (−20 [−29 to −10] mg/dL), low-density lipoprotein (LDL; −11.6 [−17.5 to −5.5] mg/dL), and high-density lipoprotein (HDL; −3.2 [−5.7 to −0.7] mg/dL, all Ps < .01). In participants with clinically abnormal preintervention data, the mean (95% CI) change significantly decreased for overweight (−0.45 [−0.85 to −0.05]) and obese (−0.76 [−1.13 to −0.39]) BMI, systolic blood pressure (−12 [−19 to −5] mm Hg), total cholesterol −22 [−40 to −4] mg/dL), and LDL (−15.6 [−23.8 to −7.4] mg/dL, all Ps ≤ .03). In conclusion, the Eating for Life model showed significant improvement in BMI, diastolic blood pressure, total cholesterol, and LDL in a federally qualified health center population. Group visits advocating for a whole-foods, plant-based diet may be effective in reducing chronic disease burden in underserved communities.
      Citation: American Journal of Lifestyle Medicine
      PubDate: 2021-06-07T06:27:36Z
      DOI: 10.1177/15598276211018159
       
  • Physical Activity, Stress, and Physically Active Stress Management
           Behaviors Among University Students With Overweight/Obesity

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      Authors: Krista M. Lepping, Caitlin P. Bailey, Meghan N. Mavredes, Jamie M. Faro, Melissa A. Napolitano
      Abstract: American Journal of Lifestyle Medicine, Ahead of Print.
      Student physical activity is associated with lower stress. Research gaps remain regarding the types of stress management behaviors students use and how these behaviors are associated with students’ activity levels. This study examined associations between physical activity and stress management behaviors among students (18-35 years). Students with overweight/obesity (n = 405) attending universities in 2 urban locations enrolled in a randomized controlled trial to promote healthy weight and completed the following baseline measurements: perceived stress, stress management behaviors, accelerometer-measured physical activity, and demographic characteristics. Perceived stress did not differ by physical activity status or race. A greater proportion of students meeting moderate-to-vigorous physical activity guidelines used physically active stress management behaviors compared to those not meeting guidelines (74% vs 56%; P = .006), and students using physically active stress management had lower stress scores (13.1 vs 15.5; P = .003). Among Black and White students only (n = 306), a greater proportion of White students used physically active stress management behaviors compared to Black students (77% vs 62%, P = .013). Results indicate differences in stress management behaviors by student activity level and race. During times of high stress, colleges/universities might support students by promoting stress management and physical activity in tandem, and tailoring messages to student activity levels and demographic characteristics.
      Citation: American Journal of Lifestyle Medicine
      PubDate: 2021-06-03T04:45:17Z
      DOI: 10.1177/15598276211020688
       
  • Comparative Effectiveness of Lifestyle Intervention on Fasting Plasma
           Glucose in Normal Weight Versus Overweight and Obese Adults With
           Prediabetes

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      Authors: Mandy K. Salmon, Neil F. Gordon, Demitri Constantinou, Kevin S. Reid, Brenda S. Wright, Terri L. Kridl, George C. Faircloth
      Abstract: American Journal of Lifestyle Medicine, Ahead of Print.
      Background. It is hypothesized that normal weight individuals develop diabetes through different pathophysiological mechanisms and that methods of prevention may differ in the absence of overweight/obesity. In this study, we compared the effect of lifestyle health coaching (LHC) on fasting plasma glucose (FPG) in normal weight, overweight, and obese US adults with prediabetes. Methods. Subjects were 1358 individuals who completed baseline and follow-up evaluations as part of an LHC program (follow-up = ~6 months). Participants were stratified, based on baseline body mass index (BMI), into normal weight (n = 129), overweight (n = 345), and obese (n = 884) cohorts. LHC included counseling, predominantly via telehealth, on exercise and nutrition. Results. BMI decreased (P < .001) in the overweight and obese participants but was unchanged in the normal weight participants. FPG decreased (P < .001) in all 3 cohorts, and the magnitude of decrease did not differ significantly among cohorts. FPG decreased to
      Citation: American Journal of Lifestyle Medicine
      PubDate: 2021-06-02T09:01:56Z
      DOI: 10.1177/15598276211019012
       
  • Are Future Doctors Prepared to Address Patients’ Nutritional Needs'
           Cooking and Nutritional Knowledge and Habits in Medical Students

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      Authors: Sam Sugimoto, Drew Recker, Elizabeth E. Halvorson, Joseph A. Skelton
      Abstract: American Journal of Lifestyle Medicine, Ahead of Print.
      Background. Many diseases are linked to lifestyle in the United States, yet physicians receive little training in nutrition. Medical students’ prior knowledge of nutrition and cooking is unknown. Objective. To determine incoming medical students’ prior nutrition knowledge, culinary skills, and nutrition habits. Methods. A dual-methods study of first-year medical students. Cross-sectional survey assessing prior knowledge, self-efficacy, and previous education of cooking and nutrition. Interviews of second-year medical students explored cooking and nutrition in greater depth. Results. A total of 142 first-year medical students participated; 16% had taken a nutrition course, with majority (66%) learning outside classroom settings. Students had a mean score of 87% on the Nutritional Knowledge Questionnaire versus comparison group (64.9%). Mean cooking and food skills score were lower than comparison scores. Overall, students did not meet guidelines for fiber, fruit, vegetables, and whole grains. Interviews with second-year students revealed most learned to cook from their families; all believed it important for physicians to have this knowledge. Conclusions. Medical students were knowledgeable about nutrition, but typically self-taught. They were not as confident or skilled in cooking, and mostly learned from their family. They expressed interest in learning more about nutrition and cooking.
      Citation: American Journal of Lifestyle Medicine
      PubDate: 2021-05-27T09:24:05Z
      DOI: 10.1177/15598276211018165
       
  • Lifestyle Medicine and Climate Change: The Role of Providers in Addressing
           a Public Health Challenge

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      Authors: Adam Bernstein, David L. Katz
      Abstract: American Journal of Lifestyle Medicine, Ahead of Print.
      Climate change threatens to undermine efforts to improve human health through lifestyle modification. Lifestyle medicine providers, however, may be well positioned to help patients create new healthful and climate-friendly habits, such as adopting a plant-based diet and limiting or eliminating car travel. Through each provider’s own example and patient engagement efforts, as well as though new technology and the collective action of the American College of Lifestyle Medicine, the broader lifestyle medicine community can play an outsized role in addressing climate change.
      Citation: American Journal of Lifestyle Medicine
      PubDate: 2021-05-26T09:07:39Z
      DOI: 10.1177/15598276211017097
       
  • Diet Quality, Physical Activity, and Weight Changes and Their Association
           With 6-Year Risk of Metabolic Syndrome in Mexican Adults

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      Authors: Marcela Perez-Rodriguez, Juan Osvaldo Talavera, Jorge Salmeron
      Abstract: American Journal of Lifestyle Medicine, Ahead of Print.
      Background. Among lifestyle factors, obesity has been postulated as the most important risk factor for metabolic syndrome (MS). Lifestyle factors such as physical activity (PA), diet quality, and weight management are so closely related, it is not clear if the role of lifestyle factors is exclusively through its effect on weight, or if they contribute independently. Objective. To examine the effect of lifestyle factors such as diet quality, weight change, and leisure time PA on MS occurrence in lean and overweight/obese (OW/OB) adults over a 6-year period. Methods. This was a longitudinal analysis of data from adults participating in the Health Workers Cohort Study. Results. A total of 1046 participants were included; 37.2% of the OW/OB group and 16.2% of the lean participants developed MS. Becoming overweight had a hazard ratio (HR) of 3.06 for developing MS compared with remaining lean (95% CI = 1.98, 4.74). Going from OW/OB to lean was associated with lower risk of MS (HR = 0.41; 95% CI = 0.22, 0.79). Among OW/OB, becoming active was associated with lower risk (HR = 0.63; 95% CI = 0.42, 0.95) in comparison with an inactive pattern; diet quality was not associated with occurrence of MS. Conclusion. Weight change was the most relevant factor predicting MS over a 6-year period.
      Citation: American Journal of Lifestyle Medicine
      PubDate: 2021-05-24T07:41:04Z
      DOI: 10.1177/15598276211017488
       
  • Mental Health in Lifestyle Medicine: A Call to Action

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      Authors: Gia Merlo, Alyssa Vela
      Abstract: American Journal of Lifestyle Medicine, Ahead of Print.
      Mental health symptoms are pervasive, with 1 in 5 American adults experiencing a mental disorder. Poor mental health is associated with a significant global cost burden, from disability to economic impacts. The field of lifestyle medicine, which emphasizes the role of lifestyle factors in the onset and treatment of disease and well-being, is well suited to address mental health. More recently, there has been attention to the need to incorporate mental health into the field of lifestyle medicine and to attend to the bidirectional role of mental health and lifestyle. Thus, there is a critical opportunity for the field of lifestyle medicine to incorporate mental health into each of the foundational pillars (diet, exercise, substance use, psychological well-being/stress, relationships, sleep) while also specifically targeting lifestyle interventions for populations with mental disorders. The current article provides a framework for the role of mental health within lifestyle medicine by addressing the scope of the problem, clarification regarding mental health, and areas of practice (ie, psychiatry), and providing an overview of the relevant mental health literature for each pillar. This article serves as a call to action to explicitly address and include mental health within all aspects of lifestyle medicine research and practice.
      Citation: American Journal of Lifestyle Medicine
      PubDate: 2021-05-21T10:07:48Z
      DOI: 10.1177/15598276211013313
       
  • Accelerated Recovery After Renal Cell Carcinoma and Partial Nephrectomy
           With Lifestyle Modifications

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      Authors: Scott Moore
      Abstract: American Journal of Lifestyle Medicine, Ahead of Print.
      Objective and subjective recovery times following a partial nephrectomy may exceed 1 year if patients adhere to the current Western lifestyle. This case demonstrates the rapid recovery of a 59-year-old female who underwent a robotic partial nephrectomy and utilized lifestyle modifications as an adjunct to the treatment of a Stage T1a clear cell renal cell carcinoma. All 6 pillars of lifestyle medicine are incorporated into this patient’s recovery plan, which successfully reduced her time to recovery after a partial nephrectomy. This case illustrates how modifications in diet, activity, sleep, stress management, social connectedness, and avoidance of risky substances may shorten recovery time after a partial nephrectomy and may serve as an example that providers can prescribe for patients recovering from other surgeries.
      Citation: American Journal of Lifestyle Medicine
      PubDate: 2021-05-19T10:46:35Z
      DOI: 10.1177/15598276211015138
       
  • Motivations Behind Lifestyle Changes

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      Authors: Calder Dorn, Sean Phillips, Sierra Nicol, Holly Russell, Elisabeth Guenther
      Abstract: American Journal of Lifestyle Medicine, Ahead of Print.
      Lifestyle modification has been demonstrated as a powerful tool in combating the morbidity and mortality of disease. Due to lack of training or education not enough physicians are discussing lifestyle changes with patients. The objective of this study was to determine what influenced participants to make lifestyle changes, and if it was a physician, what was said or done to motivate that decision. Inclusion criterion was participants were enrolled in a program dedicated to dietary modifications. One hundred participants were surveyed. Eighty-eight percent were over the age of 50; 78% were female; 92% were White; and 70% had a bachelor’s degree or higher. Sixty-eight percent felt they had not been educated by their health care provider about nutrition; 41% of participants felt information provided was the most impactful statement; 60% of participants noted that their medical diagnosis had a moderate to significant impact on their decision to make a lifestyle change. This study emphasizes that dietary modifications are not being discussed enough to alter the health decisions of patients in the clinical setting. Furthermore, it is paramount physicians take into account patient motivations when discussing lifestyle changes, as well as the role that proper patient education plays in motivating patients to make a change.
      Citation: American Journal of Lifestyle Medicine
      PubDate: 2021-05-19T10:44:15Z
      DOI: 10.1177/15598276211015137
       
  • Dietary Modification for the Restoration of Gut Microbiome and Management
           of Symptoms in Irritable Bowel Syndrome

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      Authors: Andrew Thomas, Annie Thomas, Madeline Butler-Sanchez
      Abstract: American Journal of Lifestyle Medicine, Ahead of Print.
      Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder leading to chronic debilitating issues. A healthy diet plays an integral role in maintaining the gut microbiota equilibrium, thus promoting digestive health. The structure and function of gut microbiota are affected by genetics and environmental factors, such as altered dietary habits, gastroenteritis, stress, increased use of alcohol and drugs, and medication use. Whereas there are various management approaches cited in the literature to manage symptoms of IBS, the purpose of this article is to focus on dietary options that will restore the gut microbiome and help in managing IBS symptoms. Some of the diets that are discussed in this article include a low-FODMAP (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) diet, gluten-free/wheat-free diet, high-fiber diet, dietary and herbal supplements (psyllium, peppermint oil), and probiotics/prebiotics/synbiotics. The clinical practice guidelines recommended by the American College of Gastroenterology outlines evidence-based dietary recommendations for patients with IBS to manage symptoms. Recent advancements in the dietary management of IBS highlighting the use of a patient-centered, personalized nutrition approach along with lifestyle changes, pharmacological therapies, and psychosocial and behavioral interventions are also reviewed and discussed.
      Citation: American Journal of Lifestyle Medicine
      PubDate: 2021-05-10T10:39:59Z
      DOI: 10.1177/15598276211012968
       
  • Cultural Relevancy of Culinary and Nutritional Medicine Interventions: A
           Scoping Review

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      Authors: Seiichi Villalona, Vanessa Ortiz, Wilfrido J. Castillo, Sonia Garcia Laumbach
      Abstract: American Journal of Lifestyle Medicine, Ahead of Print.
      Background. Taking into account the disproportionate impacts of disease burden from chronic conditions by racial and ethnic group, this scoping review sought to examine the extent to which nutritional interventions incorporated culturally relevant topics into their design and analyses. Methods. A literature search of 5 databases was conducted for any peer-reviewed studies on nutritional and culinary medicine interventions published between 2000 and 2019. Results. Studies were divided into 2 categories, medical education interventions (n = 12) and clinical/community interventions (n = 20). The majority of medical education interventions were not culturally tailored and focused on obesity/weight management within the Northeast and Southeast United States. In contrast, clinical/community interventions were primarily culturally tailored for Latinos/Hispanics and African American/Black populations residing in the Northeast and diagnosed with prediabetes/diabetes mellitus or hypertension/cardiovascular disease. Conclusions. This review identified an existent gap and need for inclusive studies that consider the culturally relevant topics into the design and implementation of nutritional intervention studies. Studies within medical education appeared to be the area where these changes can be most beneficial. There may be some value among clinic and communal-based studies in stratifying heterogeneous subgroups because of the missed cultural nuances missed when grouping larger racial cohorts.
      Citation: American Journal of Lifestyle Medicine
      PubDate: 2021-05-03T10:09:52Z
      DOI: 10.1177/15598276211006342
       
  • Fitness Policies Within the Fire Service: A Pilot Investigation of
           Exercise Adherence on Fitness Outcomes Among Rural Firefighters

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      Authors: Bridget F. Melton, Greg Ryan, Ronald L. Snarr, Macy Weeks, Emily Langford, Marissa Villafuerte
      Abstract: American Journal of Lifestyle Medicine, Ahead of Print.
      The purpose of this study was to investigate the adherence to departmental fitness policies and to evaluate the impact of on-duty firefighters’ adherence to fitness outcomes. This cross-sectional designed study utilized a convenience sample of 40 career firefighters from one department in rural southeast Georgia. Onsite gym attendance logs were recorded during a 10-month period. Firefighters were classified as lowest (0-16 sessions), low (17-30 sessions), moderate (31-44 sessions), or high (45+ sessions) adherence for analyses based on gym attendance. The fitness outcomes were retrieved from required annual fitness testing, including measurements of muscular strength (1RMest leg press and 1RMest bench press), muscular endurance (pushup), muscle power (vertical jump), cardiovascular fitness (submaximal treadmill), mobility (functional movement screen), and flexibility (shoulder elevation). Only 12.5% (n = 5) of firefighters complied with the department’s fitness policy of a minimum 75% adherence rate. Furthermore, there were significant differences (P ≤ .05) between various muscular strength, endurance, and flexibility between adherence rates. This study indicated that firefighters that complied more with the fitness policies were more physically fit than those that did not. Considerations should be made to promote and enforce departmental fitness policies to ensure that firefighters can physically perform their responsibilities.
      Citation: American Journal of Lifestyle Medicine
      PubDate: 2021-04-30T06:47:23Z
      DOI: 10.1177/15598276211011586
       
  • Lifestyle Medicine at the University of Central Florida College of
           Medicine

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      Authors: Léonie Dupuis, Denise Kay, Magdalena Pasarica, Daniel Topping, Carla Gonzalez, Sharon Wasserstrom
      Abstract: American Journal of Lifestyle Medicine, Ahead of Print.
      From 2009 to present-day, the University of Central Florida College of Medicine has progressively incorporated lifestyle medicine into its curriculum thanks to a variety of student and faculty-led efforts. These efforts include extracurricular learning opportunities through a student-run Lifestyle Medicine Interest Group, curriculum-based didactics through University of Central Florida faculty members’ integration of lifestyle medicine in preexisting sessions, and clinical experiences for students provided by a American Board for Lifestyle Medicine certified practitioner.
      Citation: American Journal of Lifestyle Medicine
      PubDate: 2021-04-28T04:53:36Z
      DOI: 10.1177/15598276211011055
       
  • The Great Recession and Physical Activity of Young Adults

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      Authors: Shamma Adeeb Alam, Bijetri Bose
      Abstract: American Journal of Lifestyle Medicine, Ahead of Print.
      Objective. Since physical inactivity has been identified as a pandemic and a public health priority, it is crucial to understand the role of adverse economic shocks on physical activity. In this study, we examine the impact of job losses during the U.S. Great Recession from January 2008 to June 2009 on the likelihood of physical activities of young adults. Methods. We use individual fixed effects estimation on a nationally representative longitudinal data from 2005 to 2015, the Panel Study of Income Dynamics (PSID), to examine the impact of job losses of young adults, their spouses, and their parents on physical exercise of young adults aged 18 to 27 years. Results. Own job losses during the Great Recession led to a decrease in the likelihood of physical exercise among young adults. However, job losses of parents and partners had no effect on the likelihood of young adults’ physical exercise. Conclusion. Our findings indicate a negative impact of the recession on physical activity of young adults and highlights the need for policymakers to consider the impact of major economic downturns on the physical activity of young adults.
      Citation: American Journal of Lifestyle Medicine
      PubDate: 2021-04-24T09:17:08Z
      DOI: 10.1177/15598276211008400
       
  • Introducing Lifestyle Medicine Within the Mayo Clinic Alix School of
           Medicine in Arizona

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      Authors: Jennifer M. Drost, Pauline H. Lucas, David C. Patchett, Melissa R. Hatley, Daniel C. Johnson, Robert Scales
      Abstract: American Journal of Lifestyle Medicine, Ahead of Print.
      Purpose: High-value care is becoming increasingly important as the United States shifts toward a more sustainable health care system. Lifestyle medicine (LM) may be the highest-value model of care. Surprisingly, however, it is taught in a minority of medical schools. In this article, we describe a pilot project of introducing a brief LM course taught within the Mayo Clinic Alix School of Medicine in Arizona. The main purpose of the course was to introduce the students to LM as a specialty practice and to provide students with foundational knowledge of the pillars of LM. Results: Students reported improved personal health habits and increased confidence in LM competencies.
      Citation: American Journal of Lifestyle Medicine
      PubDate: 2021-04-22T05:42:45Z
      DOI: 10.1177/15598276211007824
       
  • Jumpstarting Health With a 15-Day Whole-Food Plant-Based Program

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      Authors: Susan M. Friedman, Carol Hee Barnett, Robert Franki, Bruce Pollock, Beth Garver, Ted D. Barnett
      Abstract: American Journal of Lifestyle Medicine, Ahead of Print.
      The 15-day Jumpstart was developed as an evidence-based, affordable, standardized, replicable, and scalable program, designed to demonstrate quickly to patients that changing what they eat can improve their health. The program was designed using the principles of the self-determination theory of motivation and personality. Patients were instructed to eat an Esselstyn-compliant, whole-food plant-based diet consisting of vegetables, fruits, whole grains, and legumes. Of the 389 participants in the program from September 2018 to February 2020, average weight loss was 5.8 pounds (7.3 for those whose body mass index was >30), average systolic blood pressure drop was 6.8 points (16.8 points for those with systolic blood pressure >140), average drop in cholesterol was 26 points (44 points for those with a cholesterol >200), average drop in low-density lipoprotein was 19 points (33 points for those with a low-density lipoprotein >100), and average drop in fasting blood sugar was 5.1 points (28.4 points for those starting in the diabetic range); P value was
      Citation: American Journal of Lifestyle Medicine
      PubDate: 2021-04-08T11:23:25Z
      DOI: 10.1177/15598276211006349
       
  • Medical Student Perception of Lifestyle Medicine and Willingness to Engage
           in Lifestyle Counseling: A Pilot Study of Allopathic and Osteopathic
           Medical Students

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      Authors: Jenny Sunghyun Lee, Imam M. Xierali, Paresh Atu Jaini, Zaiba Jetpuri, Frank Papa
      Abstract: American Journal of Lifestyle Medicine, Ahead of Print.
      Introduction. This study assessed medical students’ perception of lifestyle medicine and readiness to engage in lifestyle counseling. Methods. All medical students in one allopathic and one osteopathic medical school received a survey involving items designed to measure their awareness and interest in lifestyle medicine, perception of physicians serving as lifestyle role models for patients, and intent to practice lifestyle counseling. Results. Two hundred and eight-nine subjects (145 allopathic and 144 osteopathic students) responded to the survey. A total of 24.1% of responding allopathic students had heard about lifestyle medicine compared with 53.9% of responding osteopathic students (P < .01). A total of 90.5% of allopathic students rated their current knowledge of lifestyle medicine as inadequate or poor compared with 78.7% of osteopathic students (P < .01). Ninety-two percent of all respondents wanted to learn more about lifestyle medicine, while 95.2% believed they would provide more effective counseling if they were trained sufficiently to serve as a healthy lifestyle role model for their patients. Conclusions. Both cohorts favored learning more about lifestyle medicine and believed physicians should provide lifestyle counseling to patients with chronic diseases. Given these findings, and the demonstrated benefits of lifestyle medicine–based health care, the authors suggest that training in lifestyle medicine be increased in undergraduate medical education.
      Citation: American Journal of Lifestyle Medicine
      PubDate: 2021-04-05T07:35:25Z
      DOI: 10.1177/15598276211004449
       
  • Preliminary Evidence of Children’s Weight Gain From 5 Months of Home
           Quarantine During the COVID-19 Pandemic

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      Authors: Keith Brazendale, Jeanette Garcia, Ethan T. Hunt, Michael Blankenship, Daniel Eisenstein, Ana Leon
      Abstract: American Journal of Lifestyle Medicine, Ahead of Print.
      Purpose. Preventive measures to curtail the spread of the Coronavirus Disease 2019 (COVID-19)—such as home quarantine, closure of schools/programs—are necessary, yet the impact of these restrictions on children’s weight status is unknown. The purpose of this case report was to investigate changes in children’s body mass index (BMI) and zBMI during COVID-19 quarantine. Methods. Children had their heights and weights recorded early March 2020 (pre-COVID-19) and 5 months later (early August 2020). Paired sample t tests examined changes in BMI and zBMI from baseline to follow-up. Results. Twenty-nine children (62% female; mean age 9.3 years; 27.5% with overweight or obesity) provided height and weight data at both time points. There was a significant difference in pre-COVID-19 BMI (mean [M] = 20.1, standard deviation [SD] = 6.0) and follow-up BMI (M = 20.7, SD = 6.4); t(57) = −3.8, P < .001, and pre-COVID-19 zBMI (M = 0.8, SD = 0.9) and follow-up zBMI (M = 0.9, SD = 0.9); t(57) = -3.1, P = .003. Five of the 29 children moved from normal weight to overweight (n = 4) or obese (n = 1) during 5 months of quarantine. Conclusions. Preliminary evidence shows most children increased their BMI and zBMI values from pre-COVID-19 assessment to the follow-up assessment, 5 months later. These initial findings identify potential incidental negative health consequences of children as a result of COVID-19 preventative measures such as home quarantine.
      Citation: American Journal of Lifestyle Medicine
      PubDate: 2021-04-03T07:39:05Z
      DOI: 10.1177/15598276211006657
       
  • Adverse Childhood Experiences as “Upstream” Determinants of
           Lifestyle-Related Chronic Disease: A Scoping Perspective

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      Authors: Garry Egger, Andrew Binns, Bob Morgan, John Stevens
      Abstract: American Journal of Lifestyle Medicine, Ahead of Print.
      We have previously proposed a list of determinants (causes) of modern lifestyle-related chronic disorders, which provides a structure for the emerging discipline of lifestyle medicine. This consists of lifestyle factors with a common immune biomarker (metaflammation) that interact in a systems fashion linked with chronic disease outcomes. We considered this to be a work in progress and later added 3 psychosocial determinants into the causal mix: meaninglessness, alienation, and loss of culture and identity (MAL). Here, we propose adverse childhood experiences (ACEs) as deeper, or even more distal, disease drivers that may act directly or indirectly through MAL to influence later chronic disease. The links with metaflammation and the need for recognition of these embedded scars in the management of lifestyle-related health problems is discussed.
      Citation: American Journal of Lifestyle Medicine
      PubDate: 2021-04-02T09:02:13Z
      DOI: 10.1177/15598276211001292
       
  • Effectiveness of Tai Chi for Health Promotion of Older Adults: A Scoping
           Review of Meta-Analyses

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      Authors: Fei-Chi Yang, Aishwarya B. Desai, Pelareh Esfahani, Tatiana V. Sokolovskaya, Doreen J. Bartlett
      Abstract: American Journal of Lifestyle Medicine, Ahead of Print.
      Background. Tai Chi is a form of exercise that is accessible to people from different socioeconomic backgrounds, making it a potentially valuable activity for health promotion of older adults. Purpose. The objective of this scoping review was to summarize the current knowledge about the effectiveness of Tai Chi for older adults across a range of general health outcomes from published, peer reviewed, unique meta-analyses. Methods. Meta-analyses were retrieved from Medline, Embase, AMED, CINAHL, SPORTDiscus, PsychINFO, Web of Science, PubMed Health, and the Cochrane Library from database inception to late August 2019. Multistage deduplication and screening processes identified eligible full-length meta-analyses. Two people independently appraised 27 meta-analyses based on the GRADE system and organized results into 3 appendices subsequently collated into heterogeneous, statistically significant, and statistically insignificant tables. Results. “High” and “moderate” quality evidence extracted from these meta-analyses demonstrated that practicing Tai Chi can significantly improve balance, cardiorespiratory fitness, cognition, mobility, proprioception, sleep, and strength; reduce the incidence of falls and nonfatal stroke; and decrease stroke risk factors. Conclusions. Health care providers can now recommend Tai Chi with high level of certainty for health promotion of older adults across a range of general health outcomes for improvement of overall well-being.
      Citation: American Journal of Lifestyle Medicine
      PubDate: 2021-03-24T11:25:02Z
      DOI: 10.1177/15598276211001291
       
  • The Role of Disordered Eating in Type 2 Diabetes: A Pilot Study

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      Authors: Alyssa M. Vela, Brooke Palmer, Virginia Gil-Rivas, Fary Cachelin
      Abstract: American Journal of Lifestyle Medicine, Ahead of Print.
      Rates of type 2 diabetes mellitus continue to rise around the world, largely due to lifestyle factors such as poor diet, overeating, and lack of physical activity. Diet and eating is often the most challenging aspect of management and, when disordered, has been associated with increased risk for diabetes-related complications. Thus, there is a clear need for accessible and evidence-based interventions that address the complex lifestyle behaviors that influence diabetes management. The current study sought to assess the efficacy and acceptability of a pilot lifestyle intervention for women with type 2 diabetes and disordered eating. The intervention followed a cognitive behavioral therapy guided-self-help (CBTgsh) model and included several pillars of lifestyle medicine, including: diet, exercise, stress, and relationships. Ten women completed the 12-week intervention that provided social support, encouraged physical activity, and addressed eating behaviors and cognitions. Results indicate the lifestyle intervention was a feasible treatment for disordered eating behaviors among women with type 2 diabetes and was also associated with improved diabetes-related quality of life. The intervention was also acceptable to participants who reported satisfaction with the program. The current CBTgsh lifestyle intervention is a promising treatment option to reduce disordered eating and improve diabetes management.
      Citation: American Journal of Lifestyle Medicine
      PubDate: 2021-03-23T09:49:04Z
      DOI: 10.1177/15598276211002459
       
  • Distinct Protocols of Physical Exercise May Improve Different Aspects of
           Well-being in Women With Polycystic Ovary Syndrome

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      Authors: Gislaine Satyko Kogure, Lúcia Alves da Silva Lara, Victor Barbosa Ribeiro, Iris Palma Lopes, Maria Célia Mendes, Sérgio Kodato, Rui Alberto Ferriani, Cristiana Libardi Miranda Furtado, Rosana Maria dos Reis
      Abstract: American Journal of Lifestyle Medicine, Ahead of Print.
      The purpose of this study to assess the effects of different protocols of physical exercise on the domains of the quality of life (QoL), sexual function, anxiety, and depression scores in women with polycystic ovary syndrome (PCOS). Data of 112 women with PCOS were extracted from 2 trials with different protocols of physical exercise: continuous aerobic training (ContinuousAT, n = 23), intermittent aerobic training (IntermittentAT, n = 22), and progressive resistance training (ResistanceT, n = 43) alongside a control group (CG, n = 24). Volunteers who completed self-report questionnaires—Female Sexual Function Index (FSFI), the Hospital Anxiety and Depression Scale (HADS), and the MOS 36-Item Short-Form Health Survey (SF-36) for QoL—preprotocol and postprotocol of physical exercise were included. Within groups, from baseline to week 16, all ContinuousAT, IntermittentAT, and ResistanceT protocols promoted improvements in multiple FSFI domains and HADS scores. However, ResistanceT did not improve the QoL aspects. Between groups, from other physical training protocols, the IntermittentAT was most effective for QoL and FSFI domains as well as HADS scores. It is concluded that all interventions were effective and improved indicators of sexual function, anxiety, and depression. When comparing protocols, interval training with high-intensity stimuli and active recovery was more effective.
      Citation: American Journal of Lifestyle Medicine
      PubDate: 2021-03-23T09:47:09Z
      DOI: 10.1177/15598276211001330
       
  • Improved Walk Test Performance and Blood Pressure Responses in Men and
           Women Completing Cardiac Rehabilitation: Implications Regarding Exercise
           Trainability

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      Authors: Felipe Araya-Ramírez, José Moncada-Jiménez, Peter W. Grandjean, Barry A. Franklin
      Abstract: American Journal of Lifestyle Medicine, Ahead of Print.
      Purpose. To evaluate changes in walk test performance and blood pressure (BP) responses following a 12-week exercise-based outpatient cardiac rehabilitation (CR) program. Methods. Six-Minute Walk Test (6MWT) and resting systolic BP (SBP), diastolic BP (DBP), post-6MWT heart rate (HR), and post-6MWT BPs were measured before and after CR in 311 (237 men,74 women) patients. Using age as a covariate, 2 by 2 (Gender × Measurement) ANCOVAs were used to determine differences in 6MWT performance and hemodynamic variables. Results. After adjusting for age, men covered a greater 6MWT distance than women; pre-CR versus post-CR program values are as follows: men, 429.3 ± 94.6 versus 557.6 ± 90.7 m, P ≤ .001; women, 374.9 ± 100.7 versus 483.2 ± 82.9 m, P ≤ .001. Both genders reduced resting DBP following the CR program (men: 67.2 ± 9.8 vs 65.6 ± 8.5 mm Hg, P = .034; women: 69.2 ± 10.7 vs 65.0 ± 8.0 mm Hg, P = .001) and increased HR following the 6MWT after the CR program (men: 97.7 ± 16.8 vs 112.7 ± 21.3 bpm, P ≤ .001; women: 100.7 ± 20.8 vs 110.2 ± 22.0 bpm, P ≤ .001). Similarly, SBP increased immediately following the 6MWT (122.8 ± 18.5 vs 133.6 ± 20.7 mm Hg; P ≤ .001) in men but not in women. Conclusion. The present findings indicate similar relative improvements in 6MWT performance and BP responses in adherent men and women following an exercise-based CR program.
      Citation: American Journal of Lifestyle Medicine
      PubDate: 2021-02-23T06:17:02Z
      DOI: 10.1177/1559827621995129
       
  • Oral Health: Opportunities for Lifestyle Medicine Highlighted by the
           SARS-CoV-2 Pandemic

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      Authors: Wayne N. Burton, Paull C. Gossett, Alyssa Schultz
      Abstract: American Journal of Lifestyle Medicine, Ahead of Print.
      A significant amount of illness has origins in oral microorganisms. The current SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) pandemic has reduced the general population’s access to and use of routine and nonemergency dental care. This creates a dangerous situation in which oral bacteria, fungi, and viruses may remain unchecked and allowed to flourish, which in turn increases risks for several systemic diseases as well as negative outcomes for pregnancies and surgical patients. This situation presents opportunities for health maintenance and disease prevention by individuals as well as for dental health professionals to use anti-infective treatments and procedures. Lifestyle medicine professionals have a chance to encourage behaviors that individuals can undertake to promote good oral health outside of the dentist’s office as well as shaping public perceptions about and reinforcing the importance of resuming dental visits as governmental restrictions allow.
      Citation: American Journal of Lifestyle Medicine
      PubDate: 2021-02-19T09:47:45Z
      DOI: 10.1177/1559827621993012
       
  • I Read It Online: Understanding How Undergraduate Students Assess the
           Accuracy of Online Sources of Health Information

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      Authors: Anthony Dissen, Qudratullah Qadiri, Charles J. Middleton
      Abstract: American Journal of Lifestyle Medicine, Ahead of Print.
      Online sources of health information are a significant means by which the public educates itself about health and wellness. The purpose of this study is to investigate how undergraduate students evaluate and assess health-related websites for accuracy, as well as the self-reported factors used in identifying whether a website is an accurate source of information. One hundred and fifty-seven students participated by reviewing a series of 10 health-related websites and indicated whether they believed the website to be an accurate source of health information. Students completed an open-ended question to self-report how they made this determination. Results indicate that students were not able to accurately distinguish between credible sources of web-based health information and those sources that were previously categorized as not being credible sources. Analysis of self-reported qualitative feedback gave rise to 6 factors used to determine the accuracy of the websites reviewed. While students report using these factors, and these factors are consistent with previous research, this does not appear then to be translating to successful determination of a source’s accuracy. Educating students in proper fact-checking and evaluation skills may be warranted to develop a generation of individuals who can be said to have better health literacy.
      Citation: American Journal of Lifestyle Medicine
      PubDate: 2021-02-19T09:47:25Z
      DOI: 10.1177/1559827621990574
       
  • Exercise and Cardiovascular Disease Risk Factors in Children and
           Adolescents With Obesity: A Systematic Review With Meta-Analysis of
           Randomized Controlled Trials

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      Authors: George A. Kelley, Kristi S. Kelley, Russell R. Pate
      Abstract: American Journal of Lifestyle Medicine, Ahead of Print.
      The purpose of this study was to examine the effects of exercise on cardiovascular disease (CVD) risk factors in children and adolescents with obesity. Randomized controlled trials (RCTs) of exercise ≥4 weeks in children and adolescents with obesity were included if one or more CVD risk factors were included as an outcome. Studies were retrieved by searching 7 electronic databases, cross-referencing, and expert review. Data were pooled using the inverse-variance heterogeneity (IVhet) model and strength of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) instrument. Thirty-nine studies representing 1548 participants (847 exercise, 701 control) met the inclusion criteria. Aerobic exercise improved 10 of 12 (83.3%) outcomes (P < .05 for all) while combined aerobic and strength training improved 5 of 8 (62.5%) outcomes (P < .05 for all). The strength of evidence ranged from “very low” to “moderate.” It was concluded that aerobic exercise, as well as combined aerobic and strength training, is associated with improvements in multiple CVD risk factors among children and adolescents with obesity. However, the generally low strength of evidence suggests a need for future well-designed and conducted RCTs on the effects of exercise, especially strength training, in children and adolescents with obesity.
      Citation: American Journal of Lifestyle Medicine
      PubDate: 2021-02-19T09:47:15Z
      DOI: 10.1177/1559827620988839
       
  • Kindness as a Stress Reduction–Health Promotion Intervention: A Review
           of the Psychobiology of Caring

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      Authors: David A. Fryburg
      Abstract: American Journal of Lifestyle Medicine, Ahead of Print.
      Chronic stress is a ubiquitous problem shouldered by many people worldwide. Although the stressors are myriad (eg, loneliness, finances, health, discrimination), the corporal response to them either causes or exacerbates mental and physical illness, including depression, anxiety, and cardiovascular disease. Identifying efficient ways to help people buffer their response and promote resilience and wellness is critical to improving overall health. Positive interpersonal connection is a proven way to promote resilience and happiness. It is associated with decreased mortality and markers of better health. Kindness and caring are prosocial behaviors that build positive interpersonal connections and can uplift both the giver and receiver. Simply seeing kindness and caring activates the neuropsychology of kindness, elevating the viewer and promoting generosity, interpersonal connection, and inclusion. That augmenting positive emotions, enhancing interpersonal connection, and inducing prosocial behavior change are possible through seeing kindness opens the opportunity to bolster resilience in higher stress settings like health care. In a recent study, watching kindness media in a health care setting rapidly increased self-reported feelings of happiness, calm, gratitude, and being inspired. Viewers were significantly more generous. Providing staff and patients with a nonjudgmental lift to enhance caring interactions through kindnesses media can be an important, low-cost adjunct to improving the healthcare environment.
      Citation: American Journal of Lifestyle Medicine
      PubDate: 2021-01-30T06:41:47Z
      DOI: 10.1177/1559827620988268
       
  • Pediatric Sports-Related Concussion: An Approach to Care

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      Authors: Olivia E. Podolak, Kristy B. Arbogast, Christina L. Master, David Sleet, Matthew F. Grady
      Abstract: American Journal of Lifestyle Medicine, Ahead of Print.
      Sports-related concussion (SRC) is a common sports injury in children and adolescents. With the vast amount of youth sports participation, an increase in awareness of concussion and evidence that the injury can lead to consequences for school, sports and overall quality of life, it has become increasingly important to properly diagnose and manage concussion. SRC in the student athlete is a unique and complex injury, and it is important to highlight the differences in the management of child and adolescent concussion compared with adults. This review focuses on the importance of developing a multimodal systematic approach to diagnosing and managing pediatric sports-related concussion, from the sidelines through recovery.
      Citation: American Journal of Lifestyle Medicine
      PubDate: 2021-01-22T05:10:27Z
      DOI: 10.1177/1559827620984995
       
  • Comprehensive Lifestyle Medicine Program Improves Fitness, Function, and
           Blood Pressure in Poststroke Veteran Cohort: A Pilot Study

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      Authors: Jeffrey Krauss, Elizabeth Frates, Mira Parekh, John Chan, B. Jenny Kiratli, Jonathan Myers
      Abstract: American Journal of Lifestyle Medicine, Ahead of Print.
      Comprehensive lifestyle medicine programs have begun to show efficacy in patients with cerebrovascular disease. The Veterans Affairs (VA) health care system has a large poststroke population and VA rehabilitation departments have significant expertise and resources for promoting healthy lifestyles. A 12-week clinical lifestyle medicine program was therefore implemented for poststroke patients, along with an optional observational study evaluating cardiovascular fitness, function, body composition, vitals, and quality of life before and after the program. Seventeen of 18 clinical patients elected to participate in the study, and 3 later withdrew. The 14 participants improved VO2 max by 1.94 mL O2/min/kg (P = .001, 95% CI 0.96-2.90). Significant improvements were seen in estimated metabolic equivalents, exercise duration, 6-minute walk test, 30-second sit to stand, grip strength, and balance. Among patients who were hypertensive at baseline, mean decrease in supine systolic blood pressure (SBP) was −9.70 mm Hg (n = 10, P = .005, 95% CI −15.7 to −3.7) and standing SBP was −11.09 mm Hg (n = 11, P = .009, 95% CI −18.7 to −3.48). There were no significant improvements in laboratory measures or body composition. Participant satisfaction was high. These findings corroborate recent literature suggesting that lifestyle programs improve stroke recovery and reduce recurrence risk.
      Citation: American Journal of Lifestyle Medicine
      PubDate: 2021-01-16T10:01:19Z
      DOI: 10.1177/1559827620988659
       
  • A Place for Plant-Based Nutrition in US Medical School Curriculum: A
           Survey-Based Study

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      Authors: Kara F. Morton, Diana C. Pantalos, Craig Ziegler, Pradip D. Patel
      Abstract: American Journal of Lifestyle Medicine, Ahead of Print.
      Purpose. To evaluate medical students’ and family medicine residents’ perceptions of their current degree of nutrition training in general and regarding a whole-foods, plant-based (WFPB) diet. Methods. An original survey instrument was administered to medical students and family medicine residents. Quantitative and qualitative data were collected to evaluate perceptions of nutrition education in medical training, a WFPB diet, and ideas for nutrition-focused curricular reform. Results. Of the 668 trainees surveyed, 200 responded (response rate = 30%). Of these, 22% agreed that they received sufficient nutrition education in medical school and 41% agreed that a WFPB diet should be a focus. Respondents with personal experiences with a plant-based diet were more willing to recommend it to future patients. Common ideas for curricular reform were instruction on a WFPB diet along with other healthy dietary patterns, patient counseling, a dedicated nutrition course, and electives. Conclusions. Nutrition education in US medical training needs improvement to address the growing burden of obesity-related chronic disease. Proper nutrition and lifestyle modification should therefore play a larger role in the education of future physicians. A focus on plant-predominant diets, such as the WFPB diet, may be an acceptable and effective addition to current medical school curriculum, and deserves further study.
      Citation: American Journal of Lifestyle Medicine
      PubDate: 2021-01-16T09:59:45Z
      DOI: 10.1177/1559827620988677
       
  • The Effects of a Nutrition Education Program on Dietary Intake and
           Biomarkers in HIV+ Adults

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      Authors: Jillian Poles, Eduard Tiozzo, Janet Konefal, Allan Rodriguez, Judi M. Woolger, John E. Lewis
      Abstract: American Journal of Lifestyle Medicine, Ahead of Print.
      Background. People living with HIV (PLWH) have increased risk of cardiovascular disease (CVD). Dietary behavior modification may assist in the treatment of CVD, but the optimal dose of nutrition education is unknown. The current aim was to determine if a weekly 1-hour nutrition education program would improve multiple outcomes among PLWH. Methods. Participants (n = 62) were assessed on dietary intake, serum biomarkers, and physical characteristics at baseline and 3 months, and percent change was calculated. Participants were grouped into 3 attendance categories of the classes: none, fair, or good. Analyses of covariance were performed on the outcomes. Results. Calories, protein, fat, saturated fat, carbohydrate, sugar, added sugar, and glycemic load were significantly different (all P values
      Citation: American Journal of Lifestyle Medicine
      PubDate: 2021-01-15T10:21:15Z
      DOI: 10.1177/1559827620986790
       
 
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