CHAPTER 1
Introduction to Lifestyle Medicine

Introduction

Lifestyle Medicine is a new and evolving speciality in Medicine. It is a distinct speciality aimed at treating the root cause of most chronic diseases using the strongest evidence-based modalities available. Current approaches to medicine and health care offer inadequate solutions to the problems we face. Lifestyle Medicine seeks to address these issues to improve the health and wellbeing of individuals and societies. This chapter covers the definition of Lifestyle Medicine and provides some questions to test candidates understanding of the difference between Lifestyle Medicine and other disciplines such as Conventional, Complementary, and Alternative medicine (CAM), and Integrative and Functional Medicine, to mention but a few.

1. Lifestyle Medicine is best defined by which of the following?
   1. A branch of alternative medicine
   2. A new field of medicine where lifestyle interventions are effective in the prevention, treatment and, rarely, reversal of diseases
   3. Evidence-based use of whole food, plant-based dietary lifestyle, regular physical activity, restorative sleep, stress management, avoidance of toxic substances such as tobacco and alcohol and supportive social connections for a healthy life
   4. The application of medical, behavioural, motivational, and environmental principles in the management of lifestyle-related health problems in a non-clinical setting
2. Lifestyle Medicine is most appropriately described in which of the following ways?
   1. The integration of lifestyle practices into conventional medicine to lower the risk for chronic disease
   2. The integration of lifestyle practices into conventional medicine to eliminate conventional medical practice
   3. The integration of lifestyle practices in the form of complementary therapy
   4. The integration of lifestyle practices in the form of alternative therapy
3. Which of the following best describes the practice of Lifestyle Medicine?
   1. A practice that does not include medications
   2. A practice that involves environmental and dietary interventions
   3. A practice where medications, rather than behaviour change, form a significant part of the management
   4. A practice where self-management is not an essential component
4. Which of the following is a major component of Lifestyle Medicine?
   1. Cessation of all medications
   2. Ozone therapy
   3. Physical activity
   4. Use of supplements
5. Which of the following best describes a key component of the practice of Lifestyle Medicine?
   1. Emphasis on diagnostic laboratory tests
   2. Emphasis on vitamin supplements
   3. Pharmaceuticals as first line of treatment
   4. Use of whole food plant-based nutrition
6. Which of the following best describes the place of coaching in Lifestyle Medicine?
   1. It is not an essential component in Lifestyle Medicine
   2. It has not been found to be effective in depression management
   3. It can be used to improve personal lifestyle choices regarding weight management and physical activity or sleep
   4. The coach prescribes the best management for the patient
7. Which of the following most closely describes the best practice in Lifestyle Medicine?
   1. Emotional wellness plays a minimal role
   2. Nutrition must follow a named diet to yield lasting results
   3. Medication remains the mainstay of management
   4. Sleep prescription is an important pillar in the management of many chronic diseases
8. Which of the following is most distinctive of Lifestyle Medicine practice?
   1. It places emphasis on behavioural change
   2. It places emphasis on non-behavioural interventions
   3. It requires a multi-professional team
   4. The doctor is the only important clinician in the team
9. Which of the following most appropriately describes a Lifestyle Medicine setting?
   1. Inpatient surgical care centre
   2. Primary, secondary, or tertiary care clinics that incorporate group consultations in the management of their patients
   3. Super-specialist diagnostic centre
   4. Tertiary consultant-delivered service
10. Which of the following best describes primary care-shared medical appointments (a form of group consultation) in Lifestyle Medicine?
    1. Patients often complain of confidentiality issues
    2. Research has shown that patients do not like this approach compared to conventional single-person appointment
    3. Shared medical appointments offer time and space to empower patients to self-manage
    4. These are not an ideal approach for behavioural change
11. The most compelling evidence for the effectiveness of therapeutic lifestyle change comes from which of the following?
    1. Studies of annual therapeutic lifestyle change clinic visit programs
    2. Studies of intensive therapeutic lifestyle change programs
    3. Studies of monthly therapeutic lifestyle change clinic visit programs
    4. Studies of non-intensive therapeutic lifestyle change programs
12. Which of these most appropriately explains the difference between Lifestyle Medicine and other types of practice?
    1. It is distinctly different from all the other categories of medicine
    2. It is the same as Alternative Medicine
    3. It is the same as Complementary Medicine
    4. It is the same as Functional Medicine
13. In understanding Lifestyle Medicine and Integrative Medicine, which of the following best explains their relationship?
    1. Both are patient-centred and involve personalized care
    2. Both place the same emphasis on behavioural change
    3. They are exactly the same
    4. They do not have any common components
14. In understanding Lifestyle Medicine and Functional Medicine, which of these is the most appropriate statement?
    1. Both place emphasis on vitamin supplements
    2. Both are forms of Alternative Medicine
    3. Functional Medicine is concerned with interactions between the environment, gastrointestinal, endocrine, and immune systems to create individualized care
    4. They do not have anything in common
15. Concerning Lifestyle Medicine and Conventional Medicine, which of these statements best describes the differences?
    1. Both place the same emphasis on behavioural intervention
    2. Conventional Medicine places emphasis on restoring function by addressing the root cause through individualized treatment
    3. Lifestyle Medicine, unlike Conventional Medicine, emphasizes cellular metabolism and control of oxidative stress
    4. Unlike Lifestyle Medicine, in Conventional Medicine, apart from complying with the prescribed medications or surgery, patients are not required to make significant changes
16. In the therapeutic approaches used in Lifestyle Medicine, which of these therapeutic interventions has been most appropriately represented?
    1. Cognitive Behavioural Therapy is seldom used
    2. Group consultations have been found to be effective
    3. Lifestyle Medicine approaches have not been found to be effective in the management of communicable diseases
    4. Motivational counselling is more effective than medications in severe depression
17. Comparing Lifestyle Medicine and Preventive Medicine, which of these best compares their approaches?
    1. Lifestyle Medicine practice is the same as Preventive Medicine in approach
    2. Medication is the 'end' in both fields of Medicine
    3. Personalized care is a key feature in both the fields of Medicine
    4. Preventive Medicine, unlike Lifestyle Medicine, emphasizes population-based interventions
18. Which of the following is a key process in health coaching for behavioural change in Lifestyle Medicine?
    1. Assessing the client's readiness for change
    2. Changing the lifestyle of the client
    3. Enforcing behavioural change in the client
    4. Setting goals for the client
19. Which of the following is the most appropriate behaviour change technique for the behaviour change process?
    1. In all stages, use motivational interviewing
    2. In all stages, use positive psychology
    3. In the early stages, use cognitive behavioural therapy
    4. In the later stages, use motivational interviewing
20. Which of the following best reflects physician competencies for prescribing Lifestyle Medicine?
    1. Ideally, physicians will role-model and practice healthy personal behaviours
    2. Physician helps patients sustain healthy lifestyle practices with no need to refer to other specialities
    3. Physician's engagement with patients has not been shown to improve patient outcome
    4. The healthcare provider should avoid engagement with the patient
21. In Physician Competencies in Lifestyle Medicine, which of the following best explains the important processes involved in the assessment of a patient?
    1. Assessment of the employer's readiness and willingness is more important than family readiness and willingness
    2. Assessment of environmental factors is the most important aspect
    3. Assessment of family readiness and willingness is more important than the client's readiness and willingness
    4. Assessment of social,...