100% satisfaction guarantee Immediately available after payment Both online and in PDF No strings attached
logo-home
Previously searched by you
Previously searched by you
logo
Lifestyle Medicine Exam Questions And Answers Graded A+!!! $10.39
Add to cart
Quickly navigate to
Preview
  2.  
  3. ACLM
  4.  
  5. ACLM

Exam (elaborations)

Lifestyle Medicine Exam Questions And Answers Graded A+!!!
 0 purchase
  • Course
  • ACLM
  • Institution
  • ACLM

Lifestyle Medicine Definition - ANS -the use of lifestyle interventions in the treatment and management of dz -aim: replace medication with lifestyle changes -elements: whole food, plant-based, physical activity, adequate sleep, stress mgmt, avoidance of risky substances -collaborative m...

[Show more]

Preview 4 out of 49  pages

Document information

  • September 12, 2024
  • 49
  • 2024/2025
  • Exam (elaborations)
  • Questions & answers

Subjects

  • lifestyle medicine exam questions and answers grad

Written for

  • ACLM
  • ACLM

Seller

avatar-seller
DocLaura

Reviews received

Content preview

Lifestyle Medicine Exam Questions And
Answers Graded A+!!!
​




Lifestyle Medicine Definition - ANS -the use of lifestyle interventions in the treatment and
management of dz
-aim: replace medication with lifestyle changes
-elements: whole food, plant-based, physical activity, adequate sleep, stress mgmt, avoidance
of risky substances
-collaborative model with patient
-evidenced based
-applies to every patient, every practice

Complementary and Alternative Medicine (CAM) - ANS -used in addition or instead of
standard trx
-practices are not currently considered part of conventional medicine (not evidenced-based)
-may use supplements, spiritual healing
-typically not strong in science

Integrative Medicine - ANS -COMBINES alternative medicine with conventional medicine
-patient centered
-addresses all aspects of health (very comprehensive)
-includes meds and supplements in addition to lifestyle medicine techniques

Functional Medicine - ANS -looking to balance core functional processes (metabolism,
hormones, etc)
-fixes physiological and biochemical functions
-may use supplements and meds

Mind-Body Medicine - ANS -focuses on interactions bw mind and body
-treats dz with methods targeted to the mind (relaxation, hypnosis, imagery, etc)
-major focus on emotional, spiritual, etc
-ex: hypnosis, visual imagery, yoga, etc

Preventive Medicine - ANS -traditional medical approach to prevent health conditions
-immunizations, mammography, etc
-focus in pubic health and population health

6 primary components of LM trx - ANS -healthful eating: whole, plant based diet
-increase physical activity

,-manage stress
-form and maintain relationships
-improve sleep
-tobacco cessation
-

Conventional Medicine - ANS -allopathic medicine
-dz=secondary to exposure to pathogens or environmental fxs or genetic predisposition
-trx: acute and target pathogens or long-term to target risk fx's
-dz-focused approach
-patients are passive recipients of care, not participants
-physician centric
-symptom-targeted treatment
-pt not required to make major changes

Lifestyle medicine approach - ANS -addresses lifestyle related causes of morbidity and
mortality
-trx=lifestyle changes; other adjuvants as needed
-requires effort and commitment from patients
-long term treatment
-patient is active partner in trx
-evidence-based; avoid fads

Dr. Ludwig Johns Hopkins 2005 NEJM study - ANS 2000=first generation to have
decreased life expectancy than prior generation

National Prevention Strategy - ANS -part of ACA passed in 2011
-strategy to change healthcare from sick care to wellness and dz prevention
-coverage for providers to do lifestyle modification: physical activity assessments/counseling;
obesity screening and nutrition; screening and counseling for alcohol use; tobacco cessation

ITLC: Intensive Therapeutic Lifestyle Change - ANS -most intense lifestyle changes (max
dose for induction phase)
-normally used in immersion programs or residential programs
-needed in reversal of advanced/severe conditions (prevention only requires TLC)
-strongest LM evidence come from ITLC studies; efficacy of TLC presumed from these studies
-multi-factorial (not just focused on one aspect of LM)

LM trx intensity - ANS 2 components:
1. intensity of contact hours
2. extent of lifestyle changes made

ITLC maximizes both of these

,Ornish Lifestyle Heart Trial - ANS -1990 with 5 yr results in 1998
-blinded RCT; n=48 adults with CAD
-control; usual care with info about healthy eating and exercise
-intervention: lifestyle program (low fat veg diet, aerobic exercise, smoking cessation, stress
mgmt, group support) with no lipid lowering meds
-f/u: 1 and 5 years
-outcome: CAD stenosis via angiography
-results: 7.9% reduction in stenosis (exp) vs 27.7% increase in stenosis (control); 47% increase
in stenosis in controls not taking lipid lowering meds; 25 cardiac events (exp) vs 45 (control)-RR:
2.47
-CAD regression lasted x 5 yrs in exp group but control had continued progression
-dose-response relationship for adherence and stenosis regression
-82% exp group had regression

National Diabetes Prevention Program (DPP)-Knowler NEJM 2002 - ANS -RCT
-n=>3000 pre-diabetics
-placebo vs metformin (500mg bid) vs lifestyle (>150 min PA/wk to get 5-7% weight loss w/ less
fat, decreased calories + my plate) x 12 mo
-outcome: incidence of T2DM
-table 1: 51 yo, 68% F, 45% minority, BMI 34
-f/u: 2.8 years (shortened bc ethics issue--do lifestyle or metformin)
-results: DM incidence: 11 placebo, 7.8 metformin, 4.8 lifestyle
DM incidence reduction: lifestyle-58%; metformin 31%
-NNT in 3 yrs w/ lifestyle intervention: 6.9
-NNT in 3 yrs w/ metformin: 13.9
-earliest RCT for lifestyle intervention vs meds in PREVENTING chronic dz
-reduced risk of T2DM x 58% and 71% in >=60yo (all ethnicities and genders)
-decreased CVD risk also with decreased BP and cholesterol
-further questions: sustainability of changes and any long-term vascular benefits/mortality
benefits (10 yrs after, participants 1/3 less likely to get T2DM)

Hambrecht Study-Circulation 2004 - ANS -RCT to compare PCI with stenting to exercise
for stable CAD
-f/u: 1 yr
-n=101 males
-outcomes: angina free exercise capacity, myocardial perfusion, cost-effectiveness (avg $ to
improve canadian CVD score x 1), freq of clinical end point (death, stroke, CABG, angioplasty,
worsening angina-->hopsitalization, AMI)
-intervention: 12 mo x exercise x 20 min/day at 70% symptom free HR or PCI w/ stent
-results: higher event free survival (88% to 70%); increased VO2 max (both statistically
significant)
-$7000 vs $3500

Portfolio Diet Study-Jenkens JAMA 2003 - ANS -RCT; n=55

, -intervention: portfolio diet with cholesterol lowing food (plant-sterols, soy protein, viscous fibers
(eggplant/okra), and almonds) or lovastatin 20mg qd + usual diet (below)
-control: usual trx diet (low fat, whole wheat cereal)
-f/u: 1 month
-outcome: LDL reductions
-results: controls 8%, statin 30%, portfolio diet 28%
-outcome: CRP reductions
control 10%, statin 33%, portfolio 28%
-results: no significant difference bw results of statin group and portfolio diet
-reduction in HDL was reported as an adverse event
-FDA now supports foods with high plant sterols as CHD reducing process

Atkins, Ornish, WW and Zone diets for weight loss and HD RR-Dansinger, JAMA - ANS
-RCT-single center
-n=160 overweight/obese 22-72 yo's w/ HTN, DLP, or pre-diabetes
-intervention: atkins (low carb), zone (macronutrient balance), WW (calorie restriction) or Ornish
(low fat)
-f/u 1 yr
-outcomes: weight loss and HD RR
-results: weight loss: atkins-4.6 lbs, zone-7.1 lbs, WW-6.6 lbs, Ornish-7.2 (weight loss amt ass'd
with diet adherence but not type)
-DLP: all reduced LDL/HDL ration x 10%
-HTN: no change
-pre-DM: no change
-adherence ~ 25%
-weight loss ass'd with decrease total/HDL ratio, CRP, insulin (no diff bw diets)

Prostate GEMINAL study-Ornish, 2008 - ANS -prospective cohort; n=30 men w/ low risk
prostate CA
-outcome: gene expression
-intervention: 3 mo comprehensive lifestyle program (<10% calories from fat, whole food plant
diet + 60 min/day stress mgmt+ 30 min/day x 60 days mod aerobic exercise+1hr group
support/wk+soy, fish oil, vita E, selenium, vita C supplements)
-results: improved weight, abd fat, BP, lipids (ss);
gene expression was altered in 500 changes: 450 down-regulated and 50 were turned on (not
all had known fx's)
-limitations: 30% biopsy samples had tumor tissue

Lifestyle changes on telomerase actviity in prostate CA-Ornish, Lancet 2013 - ANS
-descriptive study of long term results of RCT
-n=35 men w/ low grade prostate CA
-f/u: 5 yrs
-intervention: lifestyle changes (diet, activity, stress mgmt, social support)
-outcome: telomere length

The benefits of buying summaries with Stuvia:

Guaranteed quality through customer reviews

Guaranteed quality through customer reviews

Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.

Quick and easy check-out

Quick and easy check-out

You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.

Focus on what matters

Focus on what matters

Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!

Frequently asked questions

What do I get when I buy this document?

You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.

Satisfaction guarantee: how does it work?

Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.

Who am I buying these notes from?

Stuvia is a marketplace, so you are not buying this document from us, but from seller DocLaura. Stuvia facilitates payment to the seller.

Will I be stuck with a subscription?

No, you only buy these notes for $10.39. You're not tied to anything after your purchase.

Can Stuvia be trusted?

4.6 stars on Google & Trustpilot (+1000 reviews)

69978 documents were sold in the last 30 days

Founded in 2010, the go-to place to buy study notes for 15 years now

Start selling
$10.39
  • (0)
Add to cart
Added