Free From PainIt's the evidence-based medical specialty that uses lifestyle therapeutic approaches, such as a predominantly whole food, plant-based diet, regular physical activity, adequate sleep, stress management, avoidance of risky substance use, and other non-drug modalities, to prevent, treat, and, oftentimes, reverse non-communicable disease, sometimes referred to as degenerative chronic disease. This important meeting brought together physicians from the American Medical Association, the American College of Physicians, the American Academy of Family Physicians, the American Academy of Pediatrics, and several other specialty societies with the express purpose of developing a set of lifestyle medicine competencies that should be adopted by all primary care physicians.
Since it is common to the point of being considered the norm for people to choose an unhealthy behavior even in the face of negative consequences, all patients dealing with lifestyle-related chronic disease should be encouraged to develop a support system, ideally a small group but minimally an individual.
Several systems and medical delineations have been conceptualized in the past decades (Table 1 ). Personalized microbiome presents a system of medicine which merges technological advances with the traditional foundation of lifestyle through the psychosocial-behavioral interface (Figure 3 ). It would seem that with the advent of personalized medicine and the emergence of diagnostics to assess one's genotype and moment-by-moment biomarkers that dietary and lifestyle recommendations will inevitably become individualized to the patient.
Additionally, the cost per quality-adjusted life-years (QALYs) was much lower for the lifestyle intervention relative to the implementation of metformin therapy (cost per QALY: $1,100 versus $31,300, resp.). Thus, lifestyle costs less and performs better in one of the largest, growing chronic diseases in developed countries, type 2 diabetes.
Recent technological advances - or even older technologies available to low-income populations, such as automated text messages to patients about relevant health behaviors - offer potential low-cost breakthrough opportunities to support lifestyle-related clinical and clinician counseling services beyond the clinical setting.
We are faced with a challenge: on one side, preventive approaches (lifestyle modifications) are generally not recommended or adopted due to multiple etiologies: lack of time, knowledge and skills by primarily medical giver, lack of economic benefits to commercial companies and the biggest challenge of mankind to make a change in oneself behavior, even an unhealthy one.
American Heart Association Strategic Plan for 2020 4 x4Lloyd-Jones DM, Hong Y, Labarthe D, et al. Defining and setting national goals for cardiovascular health promotion and disease reduction: The American heart association's strategic impact goal through 2020 and beyond.