Lifestyle changes can help you live longer with fewer chronic diseases, feel great, and reduce your cancer risk, according to U.S. Air Force Col. (Dr.) Mary Anne Kiel, chair of the Defense Health Agency Primary Care Clinical Community. The practice of lifestyle and performance medicine offers ways to be healthier by enhancing a multitude of areas of your life through six key pillars.
Kiel is a leading DHA proponent of lifestyle and performance medicine, and chairs the U.S. Air Force’s Lifestyle and Performance Medicine Working Group as well.
Clinicians trained in the practice “focus on using the six pillars of lifestyle medicine as the foundation of care for patients,” Kiel said. The six pillars “emphasize complete strategies for improving health, even as we age. Optimizing each of those pillars is critical to maintaining health, reducing our risk of chronic disease, and improving our daily performance.”
This also can be seen through the “lens of readiness and deployability of our service members,” she added.
The six pillars are:
- Whole-food, plant-predominant eating patterns
- Physical activity
- Restorative sleep
- Stress management
- Avoidance of risky substances
- Positive social connections
These are “evidence-based prescriptive therapeutic lifestyle interventions” used as a primary means of treating chronic conditions including, but not limited to, cardiovascular diseases, type 2 diabetes, and obesity, Kiel explained. “They have been shown to improve longevity, decrease morbidity and mortality, and also improve the quality of life in our older years.”
The focus of lifestyle and performance medicine is “optimizing health care system performance and patient outcomes,” Kiel said. “Critical factors include patient experience, reducing costs, improving population health through preventive measures, and the well-being of the health care team,” she explained.
“Our core working group remains Air Force members, but we have gained much support and involvement from members of the other services through our broader coalition of interested membership, which is approaching 350 individuals across all services, as well as the DHA and Department of Veterans Affairs, which are engaged in integrating lifestyle medicine within the Military Health System and VA,” Kiel said.
The U.S. Army has its own functional medicine precepts. The broad-ranging holistic approach, the Health and Holistic Fitness program, encourages service members and their families to engage in healthy behaviors and a lifestyle to promote healthy aging.
The breadth of lifestyle medicine practices is growing within the military as a whole. Already, there are multiple clinics using lifestyle-and-performance-based medicine-immersed approaches in the U.S. Air Force and U.S. Navy, as well as the National Guard and Reserve, that encompass the entire range of providers across many specialties. There are also eight military graduate medical education programs that have adopted the lifestyle medicine residency curriculum.
“Patients are presented with options and educated expertise, but ultimately, they decide what health plan meets their needs,” Kiel said. Not only does this allow for more autonomy for the patient but it can also “result in more buy-in from patients since this becomes their plan and they are vested in it being successful,” she said. “Medical care for the lifestyle medicine patient is therefore characterized by a person-centered approach resulting in an improved state of well-being, and our patients often require fewer medications or procedures long term to combat chronic disease,” Kiel said.
Sleep is One Lifestyle Pillar
“Research on sleep health has shown how critical it is at all ages, but especially when it comes to chronic disease mitigation and reducing risk of dementia and overall morbidity and mortality,” Kiel said.
Improved sleep “can produce almost instantaneous results for improved mental health, pain levels, and risk for infectious disease,” she noted.
A 2021 Pentagon report on the effects of sleep deprivation on readiness in service members found that 64% of service members lack enough sleep compared to 28-37% of civilians. This “significantly increases the risk of accidents in training, operational, and combat environments,” Kiel said.
Good sleep is vital to health and readiness, and sleep and heart health “go hand in hand,” said Dr. Travis Batts, chief of cardiology at Wilford Hall, Lackland Air Force Base, Joint Base-San Antonio, Texas.
“Sleep is a time for our body to repair itself. When our body isn't given adequate time to repair, we keep pressing the same buttons and pushing the same triggers. And before we know it, our body starts to respond in ways that it would during other high stress levels,” Batts explained.
Batts actively incorporates the six pillars of lifestyle medicine into his patient interactions and addresses the sleep issue up front.
“I'm a big advocate of ensuring that my patients … get a long enough time where they're asleep, so that they can reap those benefits and really value the sleep that they get,” Batts said.
He tells his patients that he has some of the same lifestyle issues as they do. “I tell my patients that as much as I'm your physician, I’m my own patient. I have the same lifestyle challenges that you have to get enough sleep,” he said.
A lifestyle medicine appointment often includes a detailed review of a patient’s health history, as well as their daily habits, including things like sleep, environment, what foods they eat and what barriers they have faced in the past.
“A lifestyle medicine approach to health differs from conventional medicine in that it relies heavily on patient engagement and interaction, involves lifestyle prescriptions more often than pharmaceutical prescriptions and focuses on guiding patients towards their short-term and long-term health goals,” Kiel said.
“Even though we have some of the best medicines and best therapies in the world, we can't overcome a poor lifestyle,” Batts said. That’s where patient education comes in. “You don't have to be a cardiologist to promote lifestyle medicine. You can be any type of physician, any provider, any individual.”
Resources
If you would like to learn more about integrating a lifestyle medicine approach for treating your health concerns, talk to your provider.
The Uniformed Services University Consortium for Health and Military Performance has a broad range of resources available to anyone interested in addressing lifestyle challenges. These include: