1.Physician’s lifestyle counseling knowledge, attitude, and practice: A basis for lifestyle medicine continuing medical education (CME)
Mechelle A. Palma, MD, MMHA, CFP, DPCLM, DipIBLM, FPCLM, FACLM
The Filipino Family Physician 2023;61(1):55-60
Background:
The close association of lifestyle with the pathogenesis of chronic diseases has been established since early times. Lifestyle medicine provides an evidence-based solution to the Non-communicable disease epidemic. However, physicians do not receive adequate training on lifestyle counseling and intervention in both undergraduate education and graduate medical training. Objective: The aim of this study was to examine whether knowledge and attitude regarding lifestyle medicine and the Physicians’ personal lifestyle practices will determine the presence or absence of lifestyle counseling in their medical practice.
Methods:
An online survey questionnaire was formed and spread through the internet. The questionnaire consisted of four parts- demographics, physicians’ personal lifestyle practices, their attitudes, and knowledge about Lifestyle Medicine. Ethical approval was granted.
Results:
Out of 188 respondents, 81.4% were females with mean age ranging between 40-49 years. 49 (26.1%) were residents, 84 (44.7%) were Fellows and the remaining participants were Diplomates. 71.3% and 48.4% of respondents said that they include animal and plant food in their diet. The results regarding attitude and knowledge of the doctors of Lifestyle Medicine were mostly insignificant.
Conclusion
The study doesn’t only provide information about the knowledge gap and lack of counseling skills but also highlights the urgent need for lifestyle medicine education programs for the new trainees as well as practicing physicians.
lifestyle
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continuing education
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nutrition
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medical education
2.Lifestyle medicine
Noel L. Espallardo, MD, MSc, FPAFP ; Nicolas R. Gordo, Jr., MD, MHA, CFP ; Mechelle Acero Palma, MD, CFP
The Filipino Family Physician 2023;61(1):1-1
There is now an epidemiologic shift in the burden of illness from infectious diseases in the last century to lifestyle diseases in the current. Mortality due to lifestyle diseases like diabetes, hypertension and heart disease is now ranked higher than infections. The medical community is now realizing the importance of lifestyle intervention to address the problem. We hope that this issue of our journal focused on lifestyle medicine will help inform our colleagues in family and community practice the necessity and available strategy of lifestyle intervention.
Lifestyle Medicine is the use of evidence-based lifestyle therapeutic approaches, including a whole food, plant-based eating pattern, regular physical activity, restorative sleep, stress management, the avoidance of risky substances, and positive social connection as a primary modality delivered by trained and certified clinicians, to prevent, treat, and often reverse chronic disease.1 It is distinct from other disciplines, such as functional, integrative, complementary, and alternative medicine. Lifestyle medicine focuses on conditions that consume 80% of healthcare visits, hospitalizations, and costs. Hence, it is recommended as the first line and the foundational intervention for non-communicable diseases that address the modifiable lifestyle and behavioral risk factors impacting the disease trajectory, quality of life, and overall health outcomes.2
Despite the advances and increasing availability of medical care, these chronic lifestyle-borne diseases continued to increase exponentially, causing 74% of all deaths globally.2 However, healthcare providers do not receive adequate education, foundational skills, and personal experiential references to efficiently prescribe the recommended lifestyle therapy in primary and specialty care. Thus, lifestyle medicine initiatives align with the quadruple healthcare aims to deliver better patient experience, better outcomes, lower costs, and better clinician satisfaction.3 Through the lifestyle medicine lens and the empowerment of patients, healthcare providers often bring whole health management and disease remission into the scope of care at a lower cost.
Lifestyle is an individual’s choice. The study by Longakit reveals an individual choice of lifestyle practice for wellness elements like physical, social and emotional state. While the study of Alimorong is a an individual’s choice when he or she has health risk like hypertension. Physicians should be able to influence this patient’s choice and there are several strategies available. The case studies of Solijon, Acero and Tan are different strategic methods to promote lifestyle change. The interventions given are usually structured and conducted face-to-face. On the other hand, the studies of Cristobal and Ngo uses digital health interventions to promote lifestyle change.
While the studies on lifestyle interventions presented in this issue are not robust evidence like randomized trials, these are experiences by local physicians with their patients. These experience may be a good enough basis to increase awareness and provide training for family and community physicians on lifestyle medicine, as advocated by the study of Palma.
3.“Lifestyle Redo” managing dyslipidemia as risk factor for cardiovascular disease in adults through lifestyle intervention
Harris E. Acero, RMT, MMHA ; Mary Jane Botabara Yap, RN, MPH, DrPH ; Mechelle A. Palma, MD, MMHA, CFP, DPCLM, DipIBLM, FPCLM, FACLM
The Filipino Family Physician 2023;61(1):21-26
Background:
Cardiovascular disease (CVD) is a leading cause of death around the world including the Philippines. Dyslipidemia and lifestyle have been considered as important modifiable risk factors. Experts in the Philippines have recommended that among individuals with dyslipidemia, lifestyle modification should be advised regardless of their present condition or risk profile. However, a key limitation of the most recent guidelines is the lack of studies on lifestyle interventions involving Filipinos.
Objective:
This study aimed to provide preliminary evidence for the use of a lifestyle medicine intervention program in the management of dyslipidemia as risk factor for cardiovascular disease.
Methods:
This study employed a mixed method of quantitative and qualitative research designs. The tools used were selfadministered questionnaires, collecting and examining documents. Measures to improve validity in qualitative studies have also been employed such as respondent validation and rival explanation. Triangulation with the findings from the other qualitative methodologies was also employed. Ethical approval was granted.
Results:
The first part of the study has a total of 66 participants who underwent a lifestyle intervention program in a single clinic, comprising of 26 male and 40 female subjects were selected through convenient sampling method. Around 50% of the participants were 40-59 years old, 42.4% were 30-39 years old, and only 7.6% were 60-89 years old. The knowledge of the respondents had an overall mean of 7.73 (SD=1.16) which is interpreted as high knowledge. The attitude of the respondents had a mean of 3.58 (SD=0.50) which is interpreted as very positive. The respondents also had a good lifestyle practice with overall mean of 2.76 (SD=0.49). The second part of the study consisted of eight participants with 3 males and 5 females who were chosen through purposive sampling. All participants experienced reduction of their LDL-C and total cholesterol levels after the 12-week lifestyle intervention. Two participants had increased triglyceride levels. The select group also showed reduction in the blood glucose levels and body mass index.
Conclusion
This study revealed that participants had good knowledge and attitude regarding cardiovascular diseases and its risk factors. Yet, there is still a high number of those who do not efficiently practice healthy lifestyle and diet. Additional information should be extracted to establish the dietary intake of participants which contributed to the increase in triglyceride levels of some select participants.
lifestyle
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ischemic heart disease
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dyslipidemia
4.Coping with coal: Exploring the experience of communities near a coalfired power plant utilizing descriptive phenomenological approach
Mary Jane Botabara-Yap ; Marife Villamiel ; Zenaida D. Willison ; Mechelle A. Palma
Philippine Journal of Health Research and Development 2021;25(1):15-23
Background:
Coal is the largest source of energy on earth and is used to supply electricity in many countries. Unfortunately, as much as it helps light up some communities, coal-fired power plants are also the world's biggest industrial polluters.
Objectives:
This study investigated the environment and health conditions of the community before, and 20 years after the construction of the coal. It explored the perception of the respondents on the presence of a coal-fired power plant in their community, and determined strategies that can help protect the community against the coal-fired power plant.
Methodology:
It utilized descriptive phenomenological design using in-depth interviews through snowball
sampling. Data were analysed through Colaizzi method and was guided by the health belief model which
claims that change can occur if self-efficacy is built in.
Results:
Three themes emerged from the analysis: (1) realization of the deterioration of the environment and the residents' health, (2) awareness on the interplay between economic gain, politics, and impact on health and environment, and (3) recognizing the need for increased community empowerment on health and environment.
Conclusion
The presence of a coal-fired power plant in the community brings about negative changes in health and environment. Sustainable efforts to combat such negative effects are needed, and community residents in the vicinity of the power plant need to be empowered to conduct check-and-balance for their own health and environmental safety.
Health
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Environmental Pollutants