Lifestyle Medicine: The Prescription for Individual, Community, and Planetary Health
By Neha Pathak, MD, FACP, DipABLM
Among the people most at risk from climate change-related heat waves, extreme weather events, and worsened air quality are those with chronic conditions like heart disease, diabetes, and lung diseases.
Already 6 in 10 Americans have at least one chronic disease. And in a vicious cycle, climate change also threatens the very foundation of health and wellbeing -- jeopardizing access to healthy foods and clean air, amplifying stress, and disrupting restorative sleep and social connection – putting more and more people at risk for developing chronic disease in the first place.
Though health professionals train to discuss chronic disease prevention and management, many do not feel prepared to bring the overlapping health risks of the climate crisis into the exam room.
Health professionals in the growing field of lifestyle medicine want to change the practice of medicine, by combating the root of multiple intersecting crises with their prescription pads.
This becomes the opportunity to prescribe whole-food, plant-predominant eating patterns, physical activity, avoidance of toxic exposures, and sleep and stress management strategies such as nature-based therapies to address the chronic health concerns that maybe most relevant to the patient.
Evidence from the Lancet Countdown on health and climate change report and other recent studies show that many of these prescriptions are not just powerful to fight chronic disease but also part health-centered climate solutions. Taken together, these prescriptions can improve health, mitigate climate change and build resilience in the face of unavoidable climate threats as potent side effects.
Multi-solving for Multiple Crises
Poor diets, low in whole grains, vegetables, fruits, nuts, and high in red meat, salt, and processed foods, kill 11 million people a year across the globe every year and the health benefits of whole-food plant based diets are well documented.
In addition to evidence-based health benefits, a shift toward plant-based diets has the potential to make a major dent in the whopping 31% of greenhouse gas (GHG) emissions that come from our global food system. From deforestation, fertilizer use, processing, packaging and transport, not only do the emissions stack up, but so does the pollution of air, water, and soil. It turns out that total GHG emissions to produce animal foods is generally much higher than plant-based food.
Prescriptions for whole-food, plant-based diets address both individual and planetary health crises. Robust evidence presented by the EAT-Lancet commission found that this dietary pattern can save millions of lives and preserve the health of the planet.
A prescription for active transport, meaning walking or bicycling where possible, is another lifestyle medicine “multi-solving” intervention. Sedentary lifestyles kill over 4 million people globally and only 20% of Americans meet physical activity guidelines for strength and aerobic activity while 25 % classify as physically inactive. At the same time, about 29% of GHG emissions come from the US transportation sector. Advising patients to consider taking short car trips off the road, (less than 5 miles round trip) can generate air quality benefits and exercise benefits as well.
Just as health professionals counsel patients to avoid toxic substances tobacco and alcohol, we must extend this counseling to toxic exposures like air pollution -- which is linked to as many as 8 million deaths a year across the globe. This prescription can encourage patients to understand the link between the burning of fossil fuels and burden of chronic disease from conditions like dementia, heart, and lung disease.
When it comes to interventions to enhance restorative sleep, stress management and social connection, lifestyle medicine prescriptions are often interlinked and allow for “multi-solving” for health and climate risks. For example, by prescribing nature-based treatments that encourages protection of local tree canopies, health professionals can address mental and physical health. Individual and community level interventions to improve access to green space can reduce exposure to air-pollution, lower local temperatures during heat waves, and reduce noise and light pollution. This single prescription can address health equity, allow for a safe space for physical activity, improve social cohesion, increase nightly access to restorative sleep, address stress management, and reduce exposure to toxic substances.
With every lifestyle medicine prescription for healthy, plant-based nutrition, physical activity, avoidance of toxic exposures, and nature-based therapy, health professionals are writing a prescription for both individual and planetary health.
Article Details
Lifestyle Medicine Interventions for Personal and Planetary Health: The Urgent Need for Action
Neha Pathak, MD, Kathryn J. Pollard, MS, and Amanda McKinney, MD
First published online May 15, 2022
DOI: 10.1177/15598276221090887
American Journal of Lifestyle Medicine
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