Section 1: Into to LM

Question 1

What is ITLC

Answer 1

• Intensive Therapeutic Lifestyle Change program

Question 2

Examples of ITLC programs

Answer 2

• Pritikin program, Ornish Program, Diehl CHIP

Question 3

What are the core competencies of LM?

Answer 3

Leadership - promote healthy vehaviors, giving presentations, inform politicians about lifestyle changes

Knowledge - effects of lifestyle changes on body

Assessment skills - Assess social, psychological, and biological predispositions of patients’ behaviors resulting to health outcomes, family readiness, willingness and ability to make health behavior changes

Management skills- Use nationally recognized practice guidelines

Office and Community support - practice interdisciplinary team of health care providers and support a team approach

Question 4

80% of premature death are attributed to 3 factors:

Answer 4

• Tobacco use
• Poor diet
• lack of physical activity

Question 5

Determinants of Health:

Answer 5

• Adverse childhood events
• Genetic and epigenetic predispositions
• Health literacy
• Local environmental conditions
• Socioeconomic status

Question 6

Interheart Study

Answer 6

Case control study about Acute Myocardial Infarction (AMI) RISK FACTORS (52 countries)

• Smoking
• Lipids
• Hypertension
• Diabetes
• Obesity
• Diet
• Physical Inacivity
• Alcohol Consumption
• Psychosocial Factors

Question 7

InterSTROKE Study

Answer 7

• Prospective case control study (32 countries)
• 10 Lifestyle risk associated with 90% risk of stroke in men and women of all ages

Question 8

Chicago Heart Association Detetion Project

Answer 8

• Risk of heart disease determined by number of cardiac risk factors a person has

Question 9

Six changes to reduce heart disease risk by 90-95%:

Answer 9

• 50% dec. total cholesterol > 50% risk reduction
• 6mmHg dec. diastolic pressure > 42 reduction stroke risk
• Smoking cessation >50% risk of sudden heart attack
• Maintain ideal body and waist size > 35-55%
• > 150 min. mod. exercise/week > 35-55%
• > 5 servings of fruits and veggies/day > 2–25%

Question 10

Framingham Heart Study

Answer 10

• Risk of atherosclerotic cardiovascular disease in people who were free of CV disease at age of 50:
• 5% vs 69% for men
• 8% vs 50% for women
• Both genders with optimal risk status lived 10 years longer than risk factors after age of 50

Question 11

Nurse Health Study

Answer 11

• Prospective study of 84k women
• Risk of coronary heart disease:
  1. Absence of smoking
  2. MBI <25kg/m2
  3. 30 min/day physical activity
  4. Mod. alcohol consumption (5-30g/day)
  5. Healthy diet score (cereal fiber, marine omega 3, folate)
• If all 5 factors present, 82% lower risk of heart disease

Question 12

Adventist Health Study 2

Answer 12

• Reduced risk of mortality in people in total vegetarian vs non vegetarian
• Vegetarians = lower BMI

Question 13

Lyon Diet Heart Study

Answer 13

• Prevention of heart disease with Mediterranean diet vs American Heart Association Step 1 Diet
• Mediterranean diet > protective effects for 4 years after first heart attack

Question 14

Lifestyle Medicine requires:

Answer 14

• Patient engagement and responsibility
• Treatment are long term
• Provider acts as medical expert and coach
• It saves cost

Question 15

Complementary and Alternative Medicine

Answer 15

• Not port of conventional medicine
• Use only evidence based, non-evidence based should be excluded

Question 16

Integrative Medicine

Answer 16

• Addresses whole person needs + conventional, complementary and alternative medicine

Question 17

Functional Medicine

Answer 17

• Focuses on physiologic and biochemical functions of the body, investigates balance and processes of cellular metabolism
• Emphasizes testing of various hormones and metabolites that are not well proven

Question 18

Mind Body Medicine

Answer 18

• Relaxation, hypnosis, visual imagery, meditation, yoga, spirituality, etc.
• Some are evidence based, some are not.

Question 19

Preventive Medicine

Answer 19

• Includes all aspect of morbidity and mortality prevention for the general public. Oversees public health
• Emphasizes population based interventions like immunizations, screening, and protection from bio-terrorism

Question 20

Conventional Medicine

Answer 20

• Patients are recipient of care, not required to make significant changes
• Provider are responsible for care and outcomes, patient is passive

Question 21

Increased scientific knowledge of the associations between lifestyle choices and chronic disease have not resulted in better lifestyle choices. Lifestyle-related disease has been increasing for decades, and life expectancy is in decline, with the present generation of children expected to live a shorter time than their parents. Life expectancy (expected total years of life) is declining and yet it does exceed health expectancy (expected total years of health).