How this program can help your patients
How this program can help your patients
We know that lifestyle is the leading determinant in the development and progression of chronic disease but that simply telling patients to eat less and exercise more seldom works. In clinical practice, most of us do not have the time to give extensive lifestyle advice nor the training to coach patients to make the recommended lifestyle changes. The 10-week lifestyle medicine program closes this gap with an evidence-based program that covers each of the domains of lifestyle medicine: nutrition, exercise, stress management, sleep, substance use, and social connectedness. We provide lifestyle education that supports your clinical care.
Who is the program for?
The program will suit people who:
- Have heart disease or type 2 diabetes
- Want to lose weight in a way that is sustainable
- Want to learn how to have the best chance of preventing heart disease, diabetes, cancer and dementia
- Want to improve their health and well-being – to look and feel better, have more energy and sleep better
- Want to make significant lifestyle changes with the guidance of qualified health professionals
- Enjoy the social connection of learning how to improve your health in a group environment
Why lifestyle medicine?
Chronic diseases, caused primarily by lifestyle and environmental factors, now account for most of our healthcare costs. Lifestyle medicine is a branch of evidence-based medicine in which comprehensive lifestyle changes (including nutrition, physical activity, sleep, stress management, addictions, social support) are used to prevent, treat and reverse the progression of chronic diseases by addressing their underlying causes. Lifestyle medicine programs provide the education and support that patients need to make meaningful and sustainable health behaviour changes.
Evidence for lifestyle medicine
Lifestyle Medicine is an evidence-based lifestyle therapeutic approach. Evidence for lifestyle medicine comes from population health studies, cohort studies, intervention studies and laboratory research yielding biologically plausible associations – and is supported by a small number of high quality randomised controlled trials.
of Australians have at least one chronic disease
of Australians report multiple risk factors for chronic disease
of Australians aged 18 and over are overweight or obese
- The Lifestyle Heart Trial (1990) was a randomised controlled trial which demonstrated regression of coronary artery disease in the majority of subjects in the intervention group versus disease progression in the standard treatment controls. (1) The Ornish Program is now a multi-centre program with sufficient evidence of its cost-effectiveness to receive a (US Medicare) health insurance rebate for the treatment of coronary heart disease. Our program is similar to the Ornish Program.
- A follow up study (1998) demonstrated that 85% of the intervention group had regression of atherosclerosis and a 400% improvement in blood flow in coronary arteries. 90% of participants had reductions in chest pain in the first month. (2)
- Esselstyn et al (2014) – 198 patients with CAD supported to go on a low fat plant based diet. Of the 177 patients who were adherent the incidence of adverse cardiac outcomes over the following 3.7 years was 0.6%. Of the non-adherent participants, the adverse incident rate was 62%. (3)
- The BROAD Study (2017) – A randomised controlled trial using ad libitum whole food plant based eating led to greater weight loss at 6 and 12 months than any other published research. (4)
A key factor in the cost-effectiveness of lifestyle medicine programs is the more efficient use of the health professionals’ time in the group education setting.
Our program places a strong emphasis on nutrition, and our approach is plant-predominant, whole foods. This is not controversial, it’s the approach taken by the American College of Lifestyle Medicine, the Ornish Program and the Complete Health Improvement Program (CHIP). The CHIP program has helped tens of thousands of participants across North America and has had over 40 peer-reviewed papers published demonstrating the effectiveness of this approach – e.g. Morton, D. et al. 2014. (5)
- The Multicenter Lifestyle Demonstration Project demonstrated that almost 80% of patients who were eligible for bypass surgery or angioplasty were able to safely avoid it by changing lifestyle. (6)
- There is evidence that lifestyle medicine programs can be cost effective: A Geisinger Health (US) pilot study of a lifestyle medicine approach decreased mean healthcare costs by 80% (from $240,000/member/year to $48,000/member/year.) (7)
- The Nurses Health Study showed that animal protein intake was associated with higher premature mortality from all causes. Plant protein was associated with lower mortality. (8)
- The Adventist Health Study 2 observed a dose response relationship for animal product consumption and diabetes prevalence suggesting that any step in the plant-based direction was beneficial. (9)
- A pooled analysis of 11 prospective studies of 364,696 people found that a 5% reduction in saturated fat (mainly found in animal foods) led to a 25% reduction in deaths from heart disease. (10)
- Levine et al. demonstrated that diets high in animal protein were associated with a 75% increase in total mortality, a 400% increase in cancer risk, a 500% increase in diabetes and higher IGF-1 levels. (11)
- Evidence for the benefits of plant-predominant whole food nutrition extends to many other conditions including low grade prostate cancer (Ornish 2005). (12)
- The Physicians Health Study found that those eating the standard Western diet had a 250% higher risk of prostate cancer-related death and a 67% higher risk of all cause mortality, whereas those eating a mostly whole food plant based diet had a 36% lower risk of all cause mortality. (13)
- The EAT Lancet Commission supports a plant-predominant diet for human and planetary health. (14)
We will support patients with any step they choose to take towards an optimal diet – the evidence shows that it’s not all or none.
- Ornish, D. et al. Can lifestyle changes reverse coronary heart disease? The Lancet 336: 8708, 129-133. 1990.
- Ornish, D. et al. Intensive lifestyle changes for reversal of coronary heart disease. JAMA. 280923), 2001-7. 1998.
- Esselstyn, C. et al. A way to reverse CAD? J Fam Pract. Jul:63(7), 356-364b. 2014.
- Wright, N. et al. The BROAD study: A randomised controlled trial using a whole food plant-based diet in the community for obesity, ischaemic heart disease or diabetes. Nutrition and diabetes, 7, e256. 2017.
- Morton, D. et al. The Complete Health Improvement Program (CHIP): History, Evaluation, and Outcomes. Am J Lifestyle Med. 2014;10(1):64-73.
- Ornish D. Avoiding revascularization with lifestyle changes: The Multicenter Lifestyle Demonstration Project. Am J Cardiol. 1998;82(10B):72T-6T.
- Geisinger Health: www.geisinger.org/health-and-wellness
- Song M, et al. Association of animal and plant protein intake with all-cause and cause-specific mortality. JAMA Intern Med. August 1, 2016.
- Orlich, M. and Fraser, G. Vegetarian diets in the Adventist Health Study 2: a review of initial published findings. Am J Clin Nutr 2014: Jul; 100(1); 353S-358S.
- Jakobsen, MU, Willett W, et al. Major types of dietary fat and risk of coronary heart disease: a pooled analysis of 11 cohort studies. Am J Clin Nutr 2009: 1425-32
- Levine ME et al. Low protein intake is associated with a major reduction in IGF-1, cancer, and overall mortality in the 65 and younger but not older population. Cell Metab. 19, 407-417, March 4, 2014
- Ornish, D. et al. Intensive lifestyle changes may affect the progression of prostate cancer. J. Urol. Sep;174(3);1065-9; discussion 1069-70. 2005.
- Yang M. et al. Dietary patterns after prostate cancer diagnosis in relation to disease-specific and total mortality. Cancer Prevention Research, June 2015 DOI: 10.1158/1940-6207.
- EAT-Lancet Commission on Food, Planet, Health: https://eatforum.org/eat-lancet-commission/
“FROM FEAR OF DISEASE TO JOY OF LIVING!
Lifestyle medicine programs are intended to facilitate long term change. Long term adherence is surprisingly good (85-90% – www.ornish.com) according to data from the Ornish, McDougall and other programs. Participants often find that they feel so much better on a healthier diet and lifestyle that their motivation is reframed from fear of disease to joy of living which is far more sustainable.
Resources for practitioners
The Plantrician Project plantricianproject.org
Nutrition Facts website (Dr Michael Greger) www.nutritionfacts.org
Moving Medicine Forward Master Class – 12 x 2hr sessions www.plantpurecommunities.org
Australian resource (Dr Malcolm Mackay and Jenny Cameron): www.wholefoodsplantbasedhealth.com.au