Why Lifestyle Medicine

Trying to figure out what kind of doctor you should become? Wondering what specialty you should choose? Then SheMD's Why Specialty Series is perfect for you! We're bringing you female physicians sharing WHY they chose their specialty. Today's post is on why Dr. Mondala chose the field of lifestyle medicine and what the field of lifestyle medicine entails.

My Journey to Lifestyle Medicine

During my pursuit of medicine, I was seeking methods to not only cure disease but also to prevent disease. I was initially drawn to psychology because I found human behavior fascinating and later appreciated that our daily habits can either suppress or elevate health. I valued educating and counseling my patients on healthier ways to eat, move, sleep, and be happy. I was looking for my fit in different medical specialties such as family medicine and psychiatry. Family medicine covers the full spectrum of ages, minor procedures, and introductory aspects of specialty care. I was drawn to the idea to have basic management skills for women’s health and prenatal care. In psychiatry, I appreciate the complex mood disorders, however inpatient psychiatry of active psychosis and suicidal ideations was not for me. In time, I committed to family medicine.

During my family medicine training, I thrived in the variety of rotations and breadth of knowledge I gained. I enjoyed jumping in to perform a cryotherapy, then afterwards draining an abscess. I found value in keeping track of annual screenings for cancer prevention and educating mothers on tummy time and breastfeeding. I found most joy in managing four chronic conditions all at once through nutritional and exercise counseling. As I strongly recommended lifestyle modification, I noticed improvement of hypertension, diabetes, hyperlipidemia, obesity, and reflux. Though this was a challenge due to strong cultural family traditions and perceived financial limitations, I knew this is how I wanted to spend my time with patients. I hoped to understand their barriers to lifestyle modifications and discover any health knowledge gaps. Family Medicine incorporated some of this, however it was not enough. To my surprise, there was an emerging specialty that encompassed my perspectives and values, called Lifestyle Medicine. I found this in my own institution, Loma Linda University. An entire different practice was unraveling before me as I began to dig for the beginnings of lifestyle medicine practices. I went on multiple internet searches on lifestyle medicine, and found the first seeds in the Blue Zones. These blue zones were populations who ate mostly fruits, vegetables, legumes, and whole grains. They also were physically active who either walked miles or farmed daily. They had a strong sense of community and connectivity amongst each other. Interestingly, they were nearly devoid of the common chronic diseases, such as cardiovascular disease, cancer, hypertension, type 2 diabetes, and dyslipidemia. There are five blue zones, and the Adventist Community in Loma Linda represented this healthy long-lived population. These populations were infamous for their centurions, defined by their longevity of a 100 plus years old.

As I learned the lifestyle practice of the Blue Zones, I desired to offer this type of healthcare to my patients. I had a strong stir in my heart and drive to combine family medicine and lifestyle medicine.

What is Lifestyle Medicine?

Lifestyle Medicine is a clinical discipline establish in 2004 by the American College of Lifestyle Medicine (ACLM). The ACLM defines lifestyle medicine as “evidence-based therapeutic approach to prevent, treat and reverse lifestyle-related chronic diseases.” There are 5 pillars of lifestyle medicine that are the main roots of health and wellness: Nutrition, Routine, Physical exercise, Restorative sleep, Stress Management/Emotional Well- being, and Avoidance of risky substance use.

Why Lifestyle Medicine?

1. It is today’s and tomorrow’s medicine.

Nearly 80% of chronic disease is related to lifestyle choices and roughly 80% health care costs are related to chronic diseases. It aligns with the preamble to the Constitution of the World Health Organization from 1946. “Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.”

2. It is foundational to HEALTH.

Lifestyle medicine addresses the root causes of chronic disease by establishing health as a primary goal. Lifestyle modifications are the first line treatment for many chronic diseases.

3. It has paved the way.

Current medical students and residents are now receiving more nutritional focused lectures than in the past. There is a lifestyle medicine curriculum reform taking place to incorporate more dedicated lectures focused on lifestyle medicine principles.

4. Who can become a Lifestyle Medicine Fellow?

Loma Linda University is the first medical establishment to develop a lifestyle medicine fellowship. It welcomes all specialties of medicine.

5. What do I do as a Lifestyle Medicine Physician?

In my specialty clinic, I obtain a unique and comprehensive history of one’s life journey. I consider myself as an educator, a behavioral counselor, a health coach, and a health care partner who empowers one to make lifestyle shifts towards healing and wholeness. I assess health from a lifestyle lens and determine when it is best and safe to eliminate medication use.

Advice for those interested in Lifestyle Medicine

Attend the American College of Lifestyle Medicine Conference to learn the evidence and practice of lifestyle medicine.

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