American Journal of Lifestyle Medicine

A call to action from the recently published Doha Declaration, including guiding principles for Lifestyle Medicine integration as an evolution to Lifestyle-First Medicine for global healthcare.

Background: Healthy aging is defined as survival to advanced age while retaining autonomy in activities of daily living, high societal participation, and good quality of life. Sarcopenia, insomnia, cognitive impairment, and changes in sensation can be key hinderances to healthy aging, but nutritional supplements may abate their impact. As research advances, an updated review on their efficacy on age-related conditions is warranted. Results: Sarcopenia can be mitigated through proper protein intake, supplements like creatine, and in certain situations Branched-Chain Amino Acids and Vitamin D, in adults over 65. Melatonin supplementation has moderate evidence for improving sleep, while valerian root lacks evidence. Magnesium, tart cherry, and kiwifruits have shown promising impacts on sleep in limited articles. Magnesium, Vitamin D, and B vitamin supplementation have been shown to improve cognition in those with mild cognitive impairment and Alzheimer’s disease but require further study prior to recommendation. The Age-Related Eye Disease Study supplement combination is routinely recommended to reduce risk of progression to advance stages of age-related macular degeneration. Alpha-Lipoic Acid and Folate have been investigated for their roles in mitigating age-related hearing losses. Conclusions: Nutritional supplements and lifestyle changes may mitigate disabilities across multiple domains of age-related illnesses and promote healthy aging.

Background: Age-related hearing loss, also known as hearing loss, is an important and increasingly prevalent public health problem worldwide, as it induces disability and social isolation. Objective: To verify the association between eating habits and hearing loss in the older population. Methods: A cross-sectional study with data analysis of older patients treated in an Outpatient Hearing Health Service accredited to the Unified Health System. Older people aged 60 years and over who attended the Health Service to begin adaptation in the study. The audiological evaluation was performed through Tonal and Vocal Audiometry exams, the auditory rehabilitation process was done using the Individual Sound Amplification Device, and eating habits based on the Dietary Guide for the Brazilian Population. Results: The sample included (n = 654) participants, aged between 60 and 97 years. The type of hearing loss revealed a higher prevalence of sensorineural of moderate degree. Individuals with higher consumption of tea, non-fatty meats, rice, fish, and fruits presented better hearing compared to participants with lower consumption of these types of foods. Conclusion: A higher consumption of foods high in anti-inflammatories and antioxidants may decrease the risk of age-related hearing loss. A higher consumption of foods high in anti-inflammatories and antioxidants may decrease 50% of the risk of age-related hearing loss. The findings also indicate the hypothesis that a pro-inflammatory diet could increase the risk of hearing loss. Antioxidants are believed to counteract the deleterious effects of reactive oxygen species and may be effective in treating diseases related to oxidative stress, including hearing loss.

Transition from adherence to habit formation is critical for promoting sustainable dietary changes among older adults. While adherence to health regimens often relies on conscious effort and external motivation, habits are automatic behaviors triggered by consistent cues, reducing the need for ongoing effort. A common misconception is that older adults cannot form new habits due to cognitive decline with age. However, older adults possess valuable strengths, such as strong self-regulation and the ability to delay gratification, that make them well-equipped for habit formation. This commentary outlines how healthcare providers can leverage these strengths of older adults and employ a cue-behavior-reward loop to help them integrate consistent, sustainable dietary changes.

Aging is a lifelong process, and many chronic diseases and geriatric syndromes are influenced by lifestyle factors. Here, we discuss the benefits of integrating education in geriatrics and lifestyle medicine to not only improve competency of health professions learners in each area, but also so that learners can promote healthy aging in the clinical care of their future patients. We review the current state of geriatrics education, the role of lifestyle medicine in aging, and strategies to bridge the gaps between geriatrics and lifestyle medicine.

Introduction: Healthcare providers play a crucial role in promoting sexual health among older adults, an important yet often neglected aspect of aging well. Although sexuality evolves beyond the reproductive years, it remains a meaningful part of life for many. Despite the natural decline in sexual activity with age, numerous older adults continue to value and engage in fulfilling sexual relationships. Unfortunately, targeted interventions to support later-life sexuality are lacking, creating gaps in care. Intervention: Sexuality in older adults is influenced by biological, psychological, and social factors. Clinicians should include comprehensive sexual health assessments, including STI screenings, as part of routine care. Providing age-appropriate sexual education and resources helps promote lifelong sexual wellness. Open communication between healthcare providers and patients is vital for addressing sexual concerns, often left unspoken due to stigma or discomfort. Additionally, adopting lifestyle medicine principles—such as balanced nutrition, regular exercise, stress management, and social connection—can enhance sexual health and overall well-being. Conclusion: Specialized training for healthcare professionals on the unique aspects of older adult sexuality is essential to bridge knowledge gaps. A holistic, evidence-based approach will empower providers to better support the evolving sexual health needs of older adults, improving their quality of life.

Insomnia is a sleep disorder that affects significant portion of the population. It can result in adverse health outcomes and increased healthcare utilization. The purpose of this review was to identify existing research on the association between insomnia and healthcare utilization. A five-stage scoping review process was conducted guided by the Joanna Briggs Institute process. Data sources searched through 2022 were PubMed, HINARI, Google Scholar and Cochrane, with additional studies identified through hand searching. Descriptive and exploratory analyses were conducted from the findings of the selected studies. After reviewing 124 references, 23 studies were selected. A strong and positive association between insomnia and healthcare utilization and healthcare costs was identified. We also found that insomnia was associated with absenteeism from work, lower work performance ratings, disability, difficulties in daily activities, and life dissatisfaction. An unexpected theme that emerged from the included studies is that there is a large population with persistent insomnia who do not seek help that could benefit from improved management. Findings suggest that identifying and managing insomnia could result in a decrease in healthcare utilization and costs. Further research is needed to determine the most effective methods of identifying and managing insomnia.

Objectives: The purpose of this study is to use the National Health Interview Service (NHIS) database to assess the impact of socioeconomic factors on fall risk in older adults in the US. Methods: The NHIS database was retrospectively analyzed to assess several variables related to falls and resulting injuries in older adults. The database covered the period from 2000 to 2018. Results: Our study identified several correlations that have not been previously reported in the literature. Welfare recipiency was associated with more injuries from falls (aOR = 18.8, 95% CI: 1.9-185.6, P = .01), while US citizenship was associated with a lower risk of falls in older adults in the US (aOR = .4, 95% CI: .2-.9, P = .02). Discussion: These findings highlight the importance of evaluating patients for social determinants of health (SDOH) in both the inpatient and outpatient setting. Based on this data, we believe SDOH should be incorporated into fall risk assessments.

Less than a quarter of the 116 million adults with hypertension in the United States have blood pressure (BP) lower than the guideline-recommended goal of 130/80 mmHg. There is a critical need for novel interventions that integrate evidence-based recommendations—such as lifestyle medicine and home BP monitoring (HBPM)—into clinical care. In this study, we tested the hypothesis that a four-part, primary care physician-led Virtual Group Visit (VGV) series combining lifestyle medicine, Health and Wellness Coaching (HWC), and HBPM could lead to a reduction in BP and antihypertensive medications. There was a decrease in systolic (β = −.108 mmHg per day; P = .046) and diastolic (β = −.058 mmHg per day; P = .026) BP. Thirteen of the 22 patients (59%) who started the VGV series on medications had at least one medication dosage reduced or discontinued during the VGV series, and 8 of the 18 patients (44%) who finished the VGV series on medications had at least one medication dosage reduced or discontinued in the 180 days after the VGV series. This pilot study demonstrates for the first time that lifestyle medicine VGVs, coupled with HWC and HBPM, are associated with improved BP control and medication deprescribing.

Resistance training (RT) is a form of exercise that provides numerous health benefits. One barrier to participation may be the technical demands associated with some exercises. While recommendations for RT, including the number of repetitions, sets, rest, and training loads are established, recommendations for exercise selection have not been addressed. We used a Delphi-type method in three iterative surveys. In the first survey, 17 experts rated the technical complexity of 77 different strength training exercises as having low, moderate, or high technical demands. A second survey was generated based on the first, such that exercises receiving a majority high complexity vote were removed. In the second survey, experts rated the remaining exercises as either appropriate or too advanced for a novice. Exercises were deemed appropriate if 70% agreement was reached. Lastly, experts rated exercises as being appropriate for adults over the age of 60. Experts agreed that 41 different exercises were appropriate for novices and that 32 of the exercises were appropriate for novice adults over the age of 60. Our findings provide recommendations for program design to compliment already established recommendations for RT of repetitions, sets, rest periods, and training loads.

Similar to other medical professions, the field of physical therapy is transitioning from a reactive to proactive model of care. This holistic approach to practice largely includes physical activity but also includes the often-overlooked field of nutrition. The purpose of this research study was to assess the knowledge, attitudes, and beliefs of nutrition in physical therapy students. Subjects included current students and recent graduates of doctoral physical therapy programs (N = 151). A cross-sectional mixed methods survey was disseminated to Doctor of Physical Therapy (DPT) students. The survey consisted of 49 questions including demographic information, a nutrition knowledge test (NKT), and questions about attitudes and beliefs regarding nutrition. The mean NKT score of this sample was15.09 ± 3.33 out of 28 total points. Only 19.2% of total respondents agreed or strongly agreed with feeling comfortable counseling clients and only 2.6% agreed or strongly agreed that their nutrition courses adequately provided them with the proper tools to educate clients on nutrition. However, 60.2% of respondents agreed or strongly agreed that an introductory nutrition course should be a requirement of any DPT education. Findings demonstrate a gap in knowledge of nutrition among physical therapy students.

A systematic review and meta-analysis investigated randomized clinical trials (RCTs) of mindfulness-based interventions (MBIs) targeting lifestyle behaviors commonly associated with brain health in adults. Data sources included Ovid Medline, Ovid PsycINFO, CINAHL [EBSCO], Embase, Cochrane Library [Ovid], Web of Science, and https://ClinicalTrials.gov. Studies were screened using Covidence 2.0. A total of 79 published RCTs of MBIs for adults (18+, patient and non-patient populations) targeting one or more lifestyle behavior (physical activity, sleep, diet, alcohol use, tobacco cessation, and social and mental activities) met eligibility criteria. MBIs were associated with reduced sleep disturbance (40/54 RCTs; 3537 participants; SMD = −.53; 95% CI = −.74 to −.32; I ² = 78%), increased physical activity (9/17 RCTs analyzed; 685 participants; SMD = .72; 95% CI = .04 to 1.40; I ² = 89%), improved tobacco cessation (8/12 RCTs; 1234 participants; OR = 2.11; 95% CI = 1.12 to 3.97; I ² = 55%), and lowered alcohol use (4/6 RCTs; 261 participants; SMD = −.39; 95% CI = −.45 to −.32; I ² = 0%). This review found moderate to high-quality evidence for MBIs targeting sleep, physical activity, alcohol use, and tobacco cessation. Heterogeneity for these outcomes and insufficient data to analyze diet, mental activities, and cognitive functioning limit our ability to draw definitive conclusions about the effects of MBIs on brain health.