Lifestyle Medicine

As the lifestyle medicine movement continues to gain traction and strength, it is critically important that lifestyle medicine practitioners base their recommendations on the best available evidence. This review outlines ways of accomplishing that goal. The core concepts behind lifestyle medicine reside in many different bodies of information. These include nutrition, exercise physiology, behavioral medicine, psychology, and many more. Lifestyle medicine practitioners will need to be knowledgeable in all of these areas. A good place to start is with the evidence-based recommendations put out by major national bodies. The Dietary Guidelines for Americans and Physical Activity Guidelines for Americans also provide comprehensive, evidence-based information regarding these 2 critically important modalities. This review also discusses ways that scientific information is often distorted and how conjecture may sometimes be confused with proof. The review concludes with some recommendations for how lifestyle medicine practitioners can ground their recommendations on sound scientific evidence

The art of cardiovascular risk assessment

Cardiovascular disease (CVD) remains the leading cause of death in the United States. Healthcare expenditures have been principally allocated toward treatment of CVD at the end of the health/disease continuum, rather than toward health promotion and disease prevention. A focused effort on both primordial and primary prevention can promote cardiovascular health and reduce the burden of CVD. Risk-factor assessment for predicting atherosclerotic CVD events serves as the foundation of preventive cardiology and has been driven by population-based scoring algorithms based on traditional risk factors. Incorporating individual nontraditional risk factors, biomarkers, and selective use of noninvasive measures may help identify more at-risk patients as well as truly low-risk individuals, allowing for better targeting of treatment intensity. Using a combination of validated population-based atherosclerotic CVD risk-assessment tools, nontraditional risk factors, social health determinants, and novel markers of atherosclerotic disease, we should be able to improve our ability to assess CVD risk. Through scientific evidence, clinical judgment, and discussion between the patient and clinician, we can implement an effective evidence-based strategy to assess and reduce CVD risk