Lifestyle Medicine

Lifestyle Medicine

Lifestyle, the Environment and Preventive Medicine in Health and Disease

3rd Edition - March 18, 2017

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  • Editors: Michael Sagner, Garry Egger, Andrew Binns, Stephan Rossner
  • Paperback ISBN: 9780128104019
  • eBook ISBN: 9780128104262

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Lifestyle Medicine: Lifestyle, the Environment and Preventive Medicine in Health and Disease, Third Edition, is an adjunct approach to health practice that seeks to deal with the more complex modern determinants of chronic diseases—primarily lifestyle and the environments driving such lifestyles—in contrast to the microbial ‘causes’ of infectious disease. Our lifestyle choices have a profound effect on our health. As we live longer, one thing is clear: many of us will spend time living with injury and chronic illness due to our own choices. Changes in health patterns typically follow shifts in living conditions. Disease patterns have changed worldwide, from infectious to chronic diseases such as obesity, diabetes, and heart disease. This change has been so emphatic—nearly 70% of all presentations to a doctor in modern western societies are now chronic disease related—that medical services are being forced to change to accommodate this. New chapters in this third edition explain the link between energy intake and expenditure; consider how modern technology are determinants of chronic disease; show how environmental influences, such as endocrine disruptors, influence our health; and summarize recent research on early childhood experiences and chronic disease.

Key Features

  • Explores the relationship between lifestyle and environmental drivers and the major modern chronic diseases
  • Outlines the knowledge and skills bases required by health professionals to deal with lifestyle and environmental determinants of chronic disease, as well as the tools and procedures available for doing this
  • Develops pedagogy for Lifestyle Medicine that will enable it to become a practical adjunct to conventional health and medical practice
  • Features new chapters explaining the link between energy intake and expenditure, and more


Clinical endocrinologists, public health practitioners, general practitioners

Table of Contents

  • Section I. Background and Basis for the role of lifestyle factors In chronic disease Prevention and Treatment

    Chapter 1. Introduction to the Role of Lifestyle Factors in Medicine

    • Introduction: What is Lifestyle Medicine?
    • The Scope of Lifestyle in Medicine
    • Historical Background
    • Lifestyle in the Context of Chronic and Acute Disease
    • Differences Between Traditional/Conventional and the Model of Lifestyle Medicine
    • The Links That Highlight Lifestyle Factors in Medicine
    • Who is Best Qualified to Practice Lifestyle Interventions?
    • The Evidence Base
    • Frameworks for Lifestyle Changes in Medicine
    • Summary

    Chapter 2. The Epidemiology of Chronic Disease

    • Introduction: A (Very) Short History of Disease
    • Lifestyle-Related Causes of Disease
    • Assessing Risk Factors
    • Beyond Single Risk Factors
    • Beyond Risk Factors Altogether
    • Looking Beyond Immediate Causes of Disease
    • Proximal Determinants
    • Medial Determinants
    • Distal Determinants
    • Expanding the Concept of Disease and Intervention
    • The Clinician’s Role in Managing Lifestyle-Related Chronic Diseases

    Chapter 3. A “Germ Theory” Equivalent Approach for Lifestyle Medicine

    • Introduction
    • Inflammation and Disease
    • Metaflammation and “Anthropogens”
    • Chronic Disease and the Germ Theory
    • Relevance for Public Health and Lifestyle Medicine
    • Managing Anthropogens
    • Summary

    Chapter 4. A Structure for Lifestyle Medicine

    • Introduction: the Field of Lifestyle Medicine
    • Developing the Knowledge Base: the Science of Lifestyle-Related Diseases and Conditions
    • Summary
    • Utilizing Skills: the Art of Lifestyle Medicine
    • Expanding the Range of Tools: the Materials for Lifestyle Medicine
    • Adopting Procedures: Developing the Actions for Lifestyle Medicine Management
    • Summary

    Chapter 5. Everything You Wanted to Know About Motivation (But Weren’t Intrinsically Motivated Enough to Ask)

    • Introduction: The Requirements for Change
    • What Is Motivational Interviewing?
    • Why Use Motivational Interviewing Techniques?
    • Motivational Goals and Strategies
    • Barriers and Triggers to Change
    • Motivation at the Public Health Level
    • Some Motivational Tactics
    • Intrinsic Motivation: The End Game
    • Summary

    Chapter 6. Self-Management in Lifestyle Medicine

    • Introduction: Self-care Versus Self-management
    • Components of Self-management
    • Self-care is a Necessary But Not Sufficient Component
    • Evidence of Effectiveness
    • Formats Supporting Self-management
    • Lifestyle Medicine and Self-management
    • Principles of Self-management
    • Being Motivation Focused
    • Being Health Literacy Oriented

    Chapter 7. Overweight and Obesity: The Epidemic’s Underbelly

    • Introduction: Obesity and Ill Health
    • Fat Distribution: Not Only if You’re Fat but Where
    • Dealing With Obesity
    • Is a Calorie Really a Calorie?
    • Changing Energy Balance
    • Trends in Weight Control Management
    • Practical Implications of Physiological Adjustment
    • Current Strategies in Weight Loss
    • Strategies with good supporting evidence
    • Obesity: The “Canary in the Mineshaft”
    • Summary

    Section II. Lifestyle and Environmental Determinants of Chronic disease

    Chapter 8. Nutrition for the Nondietitian

    • Introduction: The Confusion of Nutrition
    • The Science of Nutrition
    • The Concept of (Energy) Volume
    • An Alternative Approach
    • Recent Developments in Nutrient Understanding
    • Specific Dietary Requirements
    • Assessing Food Intake
    • Summary

    Chapter 9. Fluids, Fitness, and Fatness

    • Introduction: Fluids as Energy
    • How Much Fluid is Required?
    • How Much Energy in Fluid is Recommended?
    • Recommended Fluid Intakes
    • Suggested Changes in Beverage Intakes
    • Alcohol
    • Summary

    Chapter 10. Behavioral Aspects of Nutrition

    • Introduction: Eating as a Behavior
    • Hunger and Appetite: Are They the Same?
    • Determinants of Energy Intake
    • Habits
    • Rational Emotive Therapy
    • Summary

    Chapter 11. Physical Activity: Generic Prescription for Health

    • Introduction: Exercise and Evolution
    • Defining Terms
    • Activity Levels, Mortality, Morbidity, and Well-being
    • Types of Fitness: The Five S’s
    • Exercises
    • Muscle Groups for Stretching
    • Progression of Exercise Training
    • Purpose, Meaning, and Physical Activity
    • The Clinician’s Role
    • Summary

    Chapter 12. Physical Activity: Specific Prescription for Disease Management and Rehabilitation

    • Introduction: Specific Exercise Prescription
    • Exercise and Disease Management
    • Genetics and Response to Exercise
    • Exercise and Diabetes
    • Exercise and Heart Disease
    • Exercise and Arthritis
    • Exercise and Hypertension
    • Exercise and Dyslipidemia
    • Exercise, Stress Anxiety, and Depression
    • Other Conditions
    • Summary

    Chapter 13. Stress: Its Role in the S-AD Phenomenon

    • Introduction: “Stress” versus “Strain”
    • What is Stress?
    • Genetics, Resilience, and Hardiness
    • Stages of Stress/Strain
    • The Concepts of Control and Escape
    • An Approach to Dealing With Stress: ACE (Analyze, Change, Evaluate)
    • Change (Escape)
    • Summary

    Chapter 14. Dealing With Worry and Anxiety

    • Introduction: Anxiety as “Feared Helplessness”
    • Health Effects of Anxiety
    • Types of Anxiety Disorders
    • The Extent of the Problem
    • The Role of Lifestyle
    • Diagnosis
    • Worry as a Ubiquitous Characteristic of Anxiety
    • Management
    • Summary

    Chapter 15. Depression

    • Introduction: Depression as a Way of Life
    • What is Depression?
    • Depression and Health
    • Depressive Disorders
    • Risk Factors
    • Diagnosis
    • Management
    • Summary

    Chapter 16. Happiness and Mental Health: The Flip Side of S-AD

    • Introduction
    • Depression and Happiness
    • Lifestyle Medicine and Mental Health Promotion
    • What is (Good) Mental Health?
    • Approaches to Mental Health
    • Positive Psychology?
    • Lives Led
    • Is Positive Psychology the Way for Everybody?
    • Mental Health Promotion, Illness Prevention, and Early Intervention
    • Health Professional Goals in Applying Act-Belong-Commit in the Clinic
    • Summary

    Chapter 17. Technology-Induced Pathology: Watch (This) Space

    • Introduction: the Good and the Bad of Technology
    • The Changing Nature of Health
    • Technology’s “Hormetic” Effect
    • The Future of Researching Technopathology
    • Summary

    Chapter 18. To Sleep, Perchance to … Get Everything Else Right

    • Introduction: The Value of Sleep Research
    • The Reasons for Sleep
    • How Much Sleep Do We Need?
    • Sleep Cycles
    • The Concept of Sleep Debt
    • Fatigue and Excessive Daytime Sleepiness
    • Risk Factors Associated With Poor Sleep
    • Sleep and Lifestyle Interactions
    • What Is Insomnia?
    • The Value of Sleep Diaries in Determining Sleep Patterns
    • Snoring and Obstructive Sleep Apnea
    • Sleep Hygiene
    • Summary

    Chapter 19. Health and the Environment: Clinical Implications for Lifestyle Medicine

    • Introduction: Environmental Influences on Health
    • Defining Environments

    Chapter 20. Meaninglessness, Alienation, and Loss of Culture/Identity (MAL) as Determinants of Chronic Disease

    • Introduction: “MAL” in a Lifestyle Context
    • The Meaning of Meaninglessness
    • Alienation and Estrangement
    • Loss of Culture and Identity
    • Summary
    • The Clinician’s Role

    Chapter 21. Preventing and Managing Injury at the Clinical Level

    • Introduction: Injury Prevention as Public Health
    • The Epidemic of Injury
    • Understanding Injury
    • Injuries From Falls
    • Transportation Injuries
    • Drowning
    • Poisonings
    • Sports Injuries
    • Suicide
    • Summary

    Chapter 22. Rethinking Chronic Pain in a Lifestyle Medicine Context

    • Introduction: A Case Study
    • Types and Extent of Pain
    • Pain: Historical Context
    • Rethinking Chronic Pain: The Need for a New Paradigm
    • “Plasticity” and Chronic Pain
    • Plasticity and Person-Centered Care
    • Plasticity of Systems
    • Practical Therapeutics: Implementing the Principles of Plasticity
    • Summary

    Chapter 23. Understanding Addictions: Tackling Smoking and Hazardous Drinking

    • Introduction: The Different Forms of Addiction
    • Why is Addressing Smoking and Drinking so Challenging?
    • Client Factors
    • Clinician Factors
    • Practice Setting
    • What Works?
    • An Acronym for Treatment: The 5 A’s
    • Raising the Issue
    • Assessment
    • Making Changes
    • Pharmacotherapy
    • What Stimulates Change?

    Chapter 24. Medicines: The Good, The Not So Good, and The Sometimes Overused

    • Introduction: Drugs—Good and Bad
    • Common Side Effects
    • Iatrogenesis and Medicines
    • The Problem of Nonadherence
    • “Deprescription” and Polydrug Use
    • What Can the Clinician Do?
    • Summary

    Chapter 25. Relationships, Social Inequity, and Distal Factors in Lifestyle Medicine: Tackling the Big Determinants

    • Introduction: Causality Revisited
    • Relationships
    • Social Inequality
    • Summary

    Section III. Other issues for Lifestyle medicine

    Chapter 26. Sex and Lifestyle: Not Being Able to Get Enough of a Good Thing Because of a Lifetime of Getting Too Much of a Good Thing

    • Introduction
    • Prevalence of Sexual Problems
    • Causes: General
    • Causes: Specific
    • Management
    • Summary

    Chapter 27. Lifestyle and Oral Health

    • Introduction: Oral Health
    • Lifestyle, Dental Caries, and Tooth Erosion
    • Erosive Factors in the Diet
    • Protective Factors
    • Periodontal Disease and Diabetes
    • Sports and Dental Health
    • Summary

    Chapter 28. Lifestyle and Environmental Influences on Skin

    • Introduction: The Skin as an Organ
    • Why Skin in Lifestyle Medicine?
    • Summary

    Chapter 29. Lifestyle-Related Aspects of Gastrointestinal Health

    • Introduction: Exposing the Gut
    • The Top End: Reflux and Dyspepsia
    • The Middle Bit: Irritable Bowel
    • The Bottom End: Constipation and Diarrhea
    • Exercise: Good and Bad News
    • Summary

    Section IV. The Future of Health

    Chapter 30. The Next Chapter: The Future of Health Care and Lifestyle Interventions

    • Introduction
    • Health Care Systems and Society at Large Must Focus on Proactive Prevention
    • The Quality of Care Case
    • The Economic Case
    • Embracing Predictive Medicine
    • Personalizing Lifestyle Interventions
    • Medicine Will Become More Participatory
    • Conclusions

Product details

  • No. of pages: 484
  • Language: English
  • Copyright: © Academic Press 2017
  • Published: March 18, 2017
  • Imprint: Academic Press
  • Paperback ISBN: 9780128104019
  • eBook ISBN: 9780128104262

About the Editors

Michael Sagner

Michael Sagner, MD is a medical doctor specializing in sports medicine and preventive medicine. He is also a certified fitness trainer and certified sports nutritionist. He is founding head of several international projects focused on clinical chronic disease and risk factor treatment and prevention. Michael Sagner is actively involved in scientific research in the field of preventive medicine and has developed the ‘cell to community’ approach, which aims at connecting basic research, clinical medicine and public health to address chronic diseases. His research interests are the underlying mechanisms and causes of chronic diseases and interdisciplinary approaches in clinical treatment. His research considers the complex interactions within the human body in light of a patient's lifestyle, genomics and environment.

Affiliations and Expertise

President, European Society of Lifestyle Medicine, Paris, France

Garry Egger

Professor Garry Egger AM MPH PhD is the Director of the Centre for Health Promotion and Research in Sydney and Adjunct Professor in Lifestyle Medicine at Southern Cross University in Northern NSW, Australia. He has worked in clinical and public health since 1972 and has been a consultant to the World Health Organization, industry, and several government organisations, as well as being involved in medical and allied health education. He is the author of thirty books, over two hundred peer reviewed scientific articles, over a thousand popular press articles and has made numerous media appearances.

Affiliations and Expertise

Director, Centre for Health Promotion and Research, Sydney, and Adjunct Professor, Lifestyle Medicine, Lismore campus, Southern Cross University, Australia

Andrew Binns

Dr Andrew Binns AM BSc MBBS DRCOG DA FACRRM is a general practitioner in Lismore in rural NSW, Australia. He has a special interest in lifestyle medicine and its relevance to primary care. He is Adjunct Professor with the Division of Health and Applied Sciences, Lismore Campus, Southern Cross University. He is also medical editor of GP Speak, a bi-monthly magazine for the Northern Rivers General Practice Network.

Affiliations and Expertise

General practitioner, rural New South Wales, and Adjunct Professor, Division of Health and Applied Sciences , Lismore campus, Southern Cross University, Australia

Stephan Rossner

Professor Stephan Rossner MD PhD was Professor of Health Behavior Research at the Karolinska Institute in Stockholm and Director of the Obesity Unit at the Karolinska University Hospital. He has worked with international obesity-related matters for more than twenty years and served as the Secretary, Vice-President, and President of the International Association for the Study of Obesity (IASO). He has published more than 500 scientific articles on nutrition and lifestyle-related matters, written more than twenty books for the lay press, appeared repeatedly in media, and promoted health as a stand-up comedian in ‘science theatre’.

Affiliations and Expertise

Professor, Health Behavior Research, Karolinska Institute, Stockholm, and Director, Obesity Unit, Karolinska University Hospital

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  • Rob L. Mon May 14 2018

    Lifestyle Medicine - 3rd edition

    This is a comprehensive text covering lifestyle - and not restricted to what many people understand by 'lifestyle'. By covering the determinants of lifestyle related diseases we can begin to apply solutions to man-made problems.