June 16, 2024

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“A pill for every ill:” Doctors prescribing pharmaceuticals to treat their patients’ ailments has long been a prevalent attitude within the North American medical community. But the prescription pad is increasingly giving way to “lifestyle medicine” – doctors prescribing changes to patients’ lifestyles, says Dr. Ann Crabtree, an associate professor in the Cumming School of Medicine at the University of Calgary.

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“Lifestyle medicine is having a renaissance. And it’s occurring in social public awareness waves,” she says. While society today generally understands lifestyle as a crucial tenant of good health, that wasn’t always the case.

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The first wave of modern lifestyle medicine was the exercise movement that swept the continent after the Second World War. “Fitness became something important for the general public, not just elite athletes and soldiers,” says Crabtree. The Royal Canadian Air Force (RCAF) developed the 5BX Exercise Plans in the late 1950s, publishing popular books with “basic exercises” for men and women. The 1970s jogging craze was followed by Jane Fonda, leg warmers and ubiquitous aerobics classes, cementing the fitness culture we know today. “The movement continued with fitness videos, exercise classes, gym memberships, personal trainers and special exercise clothing,” she says.

Fitness in the 1970s featured legwarmers and Jane Fonda-style aerobics classes.
Fitness in the 1970s featured legwarmers and Jane Fonda-style aerobics classes. SunMediaArchive

The second wave of lifestyle medicine focused on nutrition. Despite exercising, increasing rates of chronic diseases such as cardiovascular disease, diabetes, obesity and dementia would indicate we can’t eat whatever we want. “What we eat matters. The 1980s and 1990s have been filled with diet recommendations, so many that what one eats has become a new kind of religion,” Crabtree says. “There has been an explosion in nutrition science, a notoriously difficult area to study.” The consensus is people should eat whole foods, mostly plants and limit processed food as much as possible.

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The third wave is about sleep. It challenges the notion that if you exercise and eat well, you can forsake sleep. “It turns out, sleep matters enormously to physical health, mental health and longevity, and using sleeping medication regularly undermines good sleep,” says Crabtree. 2017’s Why We Sleep book by British neuroscientist Matthew Walker heralded the new public interest in sleep as medicine.

The fourth wave of lifestyle medicine looks at relationships, purpose and mental health and is “just getting off the ground,” says Crabtree.  “Our society suffers more from poverty of healthy relationships than from poverty of material goods.” Scientific evidence is rapidly accumulating that family, friends and community significantly impact physical as well as mental health.

The publication of The Good Life, lessons from the world’s longest scientific study of happiness by Harvard researchers in January 2023 is fueling some of this new public awareness.

Crabtree is thrilled to see a growing interest in lifestyle medicine. Over 30 years of clinical practice helping thousands of patients with chronic pain, prescription drug overuse, addiction and chronic disease, she’s developed six pillars of good health: sleep, nutrition, movement, relationships, productivity and mental health.

“There is ample evidence that these six pillars can create health, prevent illness and help treat cardiovascular disease, some cancers and many of the chronic diseases in our society,” she says. The six pillars are not independent and each one affects the others.

“In serious illness when prescription medication is absolutely necessary, at least 50 per cent of the management plan should be lifestyle medicine.  Even in terminal illness lifestyle medicine has the power to increase the quality of life and potentially slow the course of the disease.”

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