Prioritized Research for the Prevention, Treatment, and Reversal of Chronic Disease: Recommendations From the Lifestyle Medicine Research Summit

Abstract

Declining life expectancy and increasing all-cause mortality in the United States have been associated with unhealthy behaviors, socioecological factors, and preventable disease. A growing body of basic science, clinical research, and population health evidence points to the benefits of healthy behaviors, environments and policies to maintain health and prevent, treat, and reverse the root causes of common chronic diseases. Similarly, innovations in research methodologies, standards of evidence, emergence of unique study cohorts, and breakthroughs in data analytics and modeling create new possibilities for producing biomedical knowledge and clinical translation. To understand these advances and inform future directions research, The Lifestyle Medicine Research Summit was convened at the University of Pittsburgh on December 4–5, 2019. The Summit's goal was to review current status and define research priorities in the six core areas of lifestyle medicine: plant-predominant nutrition, physical activity, sleep, stress, addictive behaviors, and positive psychology/social connection. Forty invited subject matter experts (1) reviewed existing knowledge and gaps relating lifestyle behaviors to common chronic diseases, such as cardiovascular disease, diabetes, many cancers, inflammatory- and immune-related disorders and other conditions; and (2) discussed the potential for applying cutting-edge molecular, cellular, epigenetic and emerging science knowledge and computational methodologies, research designs, and study cohorts to accelerate clinical applications across all six domains of lifestyle medicine. Notably, federal health agencies, such as the Department of Defense and Veterans Administration have begun to adopt “whole-person health and performance” models that address these lifestyle and environmental root causes of chronic disease and associated morbidity, mortality, and cost. Recommendations strongly support leveraging emerging research methodologies, systems biology, and computational modeling in order to accelerate effective clinical and population solutions to improve health and reduce societal costs. New and alternative hierarchies of evidence are also be needed in order to assess the quality of evidence and develop evidence-based guidelines on lifestyle medicine. Children and underserved populations were identified as prioritized groups to study. The COVID-19 pandemic, which disproportionately impacts people with chronic diseases that are amenable to effective lifestyle medicine interventions, makes the Summit's findings and recommendations for future research particularly timely and relevant.

Lifestyle Medicine and Economics: A Proposal for Research Priorities Informed by a Case Series of Disease Reversal

“…With respect to health and patient experience, the outcomes in the four cases presented are far superior to the typical prognosis of these chronic conditions, which often involves increasing medical regimes and polypharmacy, increased side effects, and no prospect of health restoration. The results of this case series are consistent with previous and emerging research demonstrating that ITLC is effective in delivering significant health benefits [66], including weight loss [41,67], improvements in blood glucose among patients with T2D [68][69][70], regression of atherosclerosis [30,71,72], and even remission of autoimmune disease [73]. Beyond the dramatic physical health benefits, it is also clear that these patients have experienced increased levels of happiness and improved quality of life.…”

Lifestyle medicine pillars as predictors of psychological flourishing

“…It will be crucial to examine links between standard Western, vegetarian, pescatarian, flexitarian, lacto-ovo and vegan diets and flourishing. In addition, given the positive impact of healthy behaviors linked to the LM pillars, on aging (both chronological and epigenetic) (Vodovotz et al, 2020), future research should explore the links between PPI and LM in this field.…”

Natural Compounds as Promising Adjuvant Agents in The Treatment of Gliomas

“…Due to the poor results of current treatment strategies, it is critical to improve treatment outcome [ 31 ]. Lifestyle medicine is dependent upon lifestyle factors (such as physical activity, the environment, and diet) together with general health maintenance aiming to reduce the risk factors related to chronic diseases [ 32 ]. An essential component of lifestyle medicine is natural food compounds.…”