Lifestyle Medicine: Prescription for a Healthier Future

We’re all used to getting a prescription for medication, telling us the dosage and how often to take it, or a handout for physical therapy exercises, including how many reps and how often. But how about a prescription for a good night’s sleep? Or for a healthy diet?

This is part of something called “Lifestyle Medicine,” a holistic approach to health and wellbeing that’s just what the doctor ordered—whether you are recovering from illness or injury, living with chronic illness, or simply want to remain on the path to good health. Lifestyle Medicine attends to six elements, which together address whole-patient health: nutrition, physical activity, stress management, substance avoidance, restorative sleep and social connection.

“We dose medication, we dose therapy—with specific exercises, how many, how often and for how long. We should really apply that same philosophy to these six pillars,” says Dr. Andrew Abdou, DO, an attending physician on Burke Rehabilitation Hospital’s comprehensive stroke team who is also certified by the American College of Lifestyle Medicine. “Diet is a part of rehabilitation. We want to help the patient rehabilitate how they sleep, deal with stress, avoid harmful behaviors and keep up their social relationships.”

The Power of the Prescription

To give these factors the attention they deserve and to give patients actionable information, Dr. Abdou literally writes out prescriptions for sleep hygiene, for example, or better nutrition. “I take my prescription pad, write out a nutrition or a sleep plan, go over it in detail, and give it to the patient to take home. This gives people something tangible to do. We’re not just saying, eat better and get more exercise. We’re addressing behavioral change—outlining specific ways to make effective change.”

A prescription for restorative sleep might include:

• Keep an intentional and consistent bedtime
• Avoid screens for about an hour before bedtime
• Don’t eat too close to bedtime
• Don’t get into bed early
• Keep the room cool
• Consider using white noise (on your smart phone or a machine)

A prescription for nutrition depends on the patient’s specific health conditions. He might start with this “prescription”: add an extra cup of vegetables to each meal, three times a day, for two weeks. Or look to “eat the rainbow,” meaning choose fruits and vegetables of different colors to diversify your nutritional intake.

Dr. Abdou recalls a recent nutrition prescription he wrote for a patient who had had a stroke, was contending with diabetes, hypertension and chronic pain. “She has these impairments and just wants to know what she can actually do. When she looks at a nutrition label at the grocery store, what is she looking for?”

The prescription: Choose “slow carbs” (vegetables, whole grains, legumes) over fast carbs (white bread, white rice, cookies and cakes). The healthiest foods—fruits and vegetables—don’t have labels. But for those that do, Dr. Abdou offers tips and tricks, such as this formula for decoding nutrition labels: Locate the measurement for fiber and multiply it by 3. The resulting number should be higher than the number for carbohydrates. If it’s not, look for alternatives, such as chickpea pasta over white flour pasta.

“When we formalize and structure it like that, the physician and the patient are more attuned to addressing these issues specifically and consistently,” says Dr. Abdou. “And, in my experience, patients are more compliant with making the necessary changes.”

Smart Goals, Smarter Choices

As with the rest of the rehabilitation journey for Burke patients, Dr. Abdou says a big part of Lifestyle Medicine includes being guided by the patient’s own goals. He specifies that the care team seeks to identify “smart goals”—ones that are specific, measurable, achievable and time-bound. The team then works with the patient and caregivers to outline steps to meet those goals, uncover any barriers they may face at home, and address how to overcome those barriers.

Dr. Abdou, who specializes in electrodiagnostics and neurorehabilitation medicine, says the six pillars are particularly relevant in his work with stroke patients. “A lot of these lifestyle elements go hand in hand with the disease process,” he explains. “Nutrition, sleep, stress—this is all going to have a role in things that directly impact cardiac risk, whether it be blood pressure management, blood sugar management, obesity, or other factors.”

But he emphasizes that everyone, himself included, would benefit from taking the comprehensive approach to health that Lifestyle Medicine introduces. “It's really for all ages and all levels of health, for health care workers as well as patients.”