Lifestyle Medicine and Nutrition
Core concepts
Lifestyle medicine is the first-line treatment for many chronic conditions. The pillars: nutrition, physical activity, sleep, stress management, avoidance of risky substances, and social connection. Know the exercise prescription: 150 minutes/week of moderate or 75 minutes/week of vigorous aerobic activity plus muscle-strengthening twice weekly.
Nutrition counseling should be practical and non-judgmental. The Mediterranean-style pattern is supported for cardiovascular risk, and reducing ultra-processed foods and added sugars is high-yield. Weight management: even 5–10% weight loss improves metabolic markers. Motivational interviewing - open questions, affirmations, reflections, summaries - is the counseling skill the exam rewards over lecturing.
Behavior change models: the transtheoretical (stages of change) model (precontemplation, contemplation, preparation, action, maintenance) guides the right intervention at the right stage. For a precontemplator, the answer is often to build rapport and raise awareness, not to hand out a plan. The 5 A's (Ask, Advise, Assess, Assist, Arrange) structure tobacco counseling; pharmacotherapy (varenicline, NRT, bupropion) plus counseling is most effective.
Traps
- Lecturing a precontemplator - mismatched intervention.
- Recommending supplements over food-based change without deficiency.
- Forgetting sleep and stress as modifiable risk factors.
- Overlooking alcohol as a source of calories and risk.
Rule of thumb
Match the intervention to the stage of change: precontemplation → build awareness; contemplation → explore ambivalence; preparation → set a specific plan; action → support and problem-solve.