Lifestyle medicine for all: Healthy food comes first – Harvard Health Blog
“Lifestyle medicine is for the rich, isn’t it?” a colleague asked me several years ago, questioning my involvement in this relatively new area of medicine that guides people towards healthy habits. This has been a common misconception, to be sure.
But across the United States, a revitalized brand of health activism aims to bring lifestyle medicine to a wider range of people. This is supported by a new effort from the American College of Lifestyle Medicine to engage the communities most affected by chronic disease.
The first pillar of a healthy lifestyle: food is medicine
Lifestyle medicine is an evidence-based practice that helps people adopt and maintain healthy behaviors such as improving diet, increasing activity, managing stress, sleeping, moderating alcohol consumption and smoking cessation. Large studies show that such habits can extend our lives by well over a decade. Plus, these habits can even keep those extra years free from diseases like diabetes, heart disease, strokes, and cancer.
A plant-based diet – that is, a diet high in vegetables, fruits, beans and legumes, nuts and seeds, and whole grains – can reduce inflammation, as well as the risk of many chronic diseases such as diabetes, heart disease, stroke, and cancer. Simply put, food is medicine. Some doctors provide this information to patients as part of their regular medical care.
But many people do not have easy access to healthy plant foods. Especially now, they can suffer from severe financial limitations, unemployment and unstable housing. Or they may live in a “food desert,” where grocery choices are severely limited, or worse, a “food swamp”, an area where fast food and junk food are more available than anything else. Living in a food swamp puts people at a higher risk of being overweight or obese.
Ways to help change the equation
Helping patients access healthy plant foods is of critical importance. And some doctors and academic medical centers are taking steps to bring healthy foods to underserved communities.
Pantry. Dr. Jacob Mirsky is a physician at Massachusetts General Hospital and Co-Director of the Healthy Lifestyle Program in the Department of Medicine. He works in an underserved community north of Boston, where he runs his clinic’s new herbal pantry. When prescribing a predominantly plant-based diet for his patients, he is also able to provide the plants. He sees this work as activism and an effective way to fight inequalities while taking care of his patients.
Plant-based pantries and food prescription programs have been well received by communities. One of these programs in a low-income rural area of Texas provided 30 pounds of fresh produce to households identified as food insecure – meaning they didn’t have enough food to eat – every two weeks for six months. Participants described the program as essential in helping them feed their families, and 99% said they consumed all or most of the food received.
Education and support. Dr. Michelle McMacken is Assistant Professor of Medicine at the Grossman School of Medicine at New York University and Director of the Herbal Lifestyle Medicine Program at NYC Health and Bellevue Hospital. She strives to make lifestyle medicine services accessible to as many patients as possible, regardless of their socioeconomic status.
“I believe everyone deserves access to lifestyle medicine, especially the most at risk and vulnerable patients who could benefit the most,” she said. “The majority of my patients – including those who face significant socioeconomic challenges – want to know what they can do to be healthier. We are working together to determine how they can benefit from lifestyle medicine in their own situation. “
Despite difficult circumstances, she has seen patients achieve health transformations including weight loss and improved cholesterol and blood sugar levels.
Programs that educate people about the power of plant foods can have a huge impact. A study of 32 Latinx people with type 2 diabetes living in a medically underserved area of California offered a five-week program that introduced participants to the power of plant foods. The drop in blood sugar continued even six months after this program ended.
Connecting people and food. The Family Van is a long-standing Harvard Medical School-backed mHealth program that provides free education, resources, and some clinical services to anyone, regardless of insurance status. Much of what they do is help people access nutritional support through SNAP (Supplemental Nutrition Assistance Program) and locate sources of low cost products like The Fresh Truck. and The Daily Table. They will also provide grocery gift cards as well as healthy eating tips. The Family Van has been collecting data such as body mass index, blood pressure, blood sugar and mineral for more than a decade, and has published several papers showing that such interventions work.
Programs like these are essential and wonderful, but there is still a long way to go. In our Healthy Living Program at Massachusetts General Hospital, we hope to establish the practice of a healthy lifestyle as the standard of care for preventing and treating chronic disease for all of our patients. To do this, we develop practical and precise methods to assess clinically important factors of diet and lifestyle during the physical examination of each patient. At the same time, we are investigating evidence-based approaches to helping people eat and live healthier, including our plant-based pantry, health coaching, and web-based group training courses. . We hope that in the future, each of our patients will have access to the quality information, resources and support they need to live their healthiest lives.
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