- Beth Frates, MD FACLM DipABLM is faculty at Harvard Medical School and a pioneer in lifestyle medicine. Dr. Frates wa... moreBeth Frates, MD FACLM DipABLM is faculty at Harvard Medical School and a pioneer in lifestyle medicine. Dr. Frates was voted the President-Elect of the American College of Lifestyle Medicine in August 2020. She is the founder and creator of the first Harvard Medical School Lifestyle Medicine Interest Group. In addition, Dr. Frates is the co-author of one of Book Authority's top 100 best medicine books of all time, The Lifestyle Medicine Handbook.edit
Research Interests: Gerontology and Medicine
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The time is NOW for Lifestyle Medicine. In this review based on a presentation at the American College of Lifestyle Medicine (ACLM) 2021 annual conference, ACLM Current President Cate Collings, MD, Immediate Past-President Dexter Shurney,... more
The time is NOW for Lifestyle Medicine. In this review based on a presentation at the American College of Lifestyle Medicine (ACLM) 2021 annual conference, ACLM Current President Cate Collings, MD, Immediate Past-President Dexter Shurney, MD, and President Elect Beth Frates, MD, share insights on the current state of lifestyle medicine (LM). Interest in LM has greatly advanced in the face of disruptions from the COVID-19 pandemic, expanded educational opportunities in the field, and a rapidly changing healthcare landscape. With growing access to virtual care, advancing technologies, growing emphasis on home-based chronic care, continuing corporate healthcare mergers and acquisitions, and widening adoption of personalized, patient-empowered treatments, the time is ripe for LM interventions to move to the mainstream. As health investments and costs skyrocket, and new players enter the scene, traditional models of payments, reimbursements, and incentives are slowly being upended. Companies and healthcare systems are finally recognizing the scientific evidence and powerful but undervalued potential of LM to accelerate healthy outcomes while controlling costs. Taken together, the lessons from the COVID-19 pandemic, the growth in LM educational opportunities, and the evolving “business of medicine landscape” signal that the time for lifestyle medicine is NOW.
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Research Interests: Gerontology and Medicine
Chronic diseases, previously thought to require decades of risk factors, have become increasingly prevalent in America’s youth. National Health Education Standards have been published since 1995, and yet nearly a fifth of schools fail to... more
Chronic diseases, previously thought to require decades of risk factors, have become increasingly prevalent in America’s youth. National Health Education Standards have been published since 1995, and yet nearly a fifth of schools fail to follow any state or national health education guidelines. Utilizing the phrase “lifestyle medicine” in childhood would elevate the importance and standardization of the core health guidelines. Several independent pilot programs taught by undergraduate and medical student volunteers have successfully demonstrated lifestyle medicine education models at intermediate and secondary schools. Preliminary feedback demonstrates that student interest in and consideration of behavioral change is possible within this age group. As with any life stage, significant behavior change in youth requires strategic planning of authentic learning practices and culturally competent lessons. We argue for the interdisciplinary development and implementation of community-eng...
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A time-honored principle in education is that changes in knowledge, attitudes, and beliefs are precursors to changes in actions or behaviors. Nevertheless, health promotion professionals occasionally hear the bromide that “people know... more
A time-honored principle in education is that changes in knowledge, attitudes, and beliefs are precursors to changes in actions or behaviors. Nevertheless, health promotion professionals occasionally hear the bromide that “people know what they’re supposed to do, they just don’t do it!” What does it mean to know something really well? And when is knowledge influential enough that it affects our very way of being? This editorial introduces a new section for the American Journal of Health Promotion called “Knowing Well, Being Well: Well-being born of understanding” (KWBW). Premiering in this issue of the journal, KWBW will be led by coeditors Drs Sara Johnson and David Katz, two of the most recognized and respected leaders in health promotion. Although today’s health promotion practitioners seem intent on moving “from wellness to well-being,” our discipline is in the nascent stages of reconciling theories of behavior change and pathways to well-being. “Knowing Well, Being Well” will c...
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Research Interests: Mindfulness, Life Style, Treatment Outcome, Medicine, Physical Medicine and Rehabilitation, and 14 moreCounseling, Coaching, Optimism, Humans, Behavior Therapy, Female, Male, Health Coaching, American, Clinical Sciences, Prognosis, Guidance and Counseling Intervention Programs, Sickness Impact Profile, and attitude to health
Understanding the causes and outcomes of stroke is important for stroke survivors and may affect their success in rehabilitation and their risk of recurrent stroke; therefore, this study was performed to assess the knowledge and... more
Understanding the causes and outcomes of stroke is important for stroke survivors and may affect their success in rehabilitation and their risk of recurrent stroke; therefore, this study was performed to assess the knowledge and expectation of functional recovery in stroke patients undergoing acute inpatient rehabilitation. Survey study of 50 consecutive stroke patients undergoing inpatient rehabilitation at a single urban rehabilitation hospital. Forty-six percent of participants were able to correctly identify whether they had sustained a cerebral infarct or hemorrhage. Rehabilitation length of stay was, on average, 1 wk longer than anticipated by patients. Patients overestimated their functional abilities on initial assessment and at discharge compared with staff assessments, with some improvement in accuracy for discharge predictions. Ninety-four percent of participants expected to be discharged home, and most achieved this goal. Although no participant anticipated discharge to a nursing home, 10% of patients were discharged to this location. Knowledge of stroke and its treatment was limited, and expectations for recovery tended to exceed actual accomplishments. There are significant areas of opportunity for enhanced educational efforts for stroke patients undergoing inpatient rehabilitation.
Research Interests: Neurology, Rehabilitation, Health Education, Patient Provider Communication, Medicine, and 15 morePhysical Medicine and Rehabilitation, Physical Therapy, Activities of Daily Living, Humans, Female, Male, Confidence intervals, American, Clinical Sciences, Aged, Middle Aged, Adult, Prognosis, Secondary Prevention of Stroke, and attitude to health
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Research Interests: Psychology and Coaching
To assess whether and how effectively an interactive presentation about lifestyle medicine could impact the knowledge and attitudes of medical students to prepare them for managing chronic conditions in their patients. Chronic diseases... more
To assess whether and how effectively an interactive presentation about lifestyle medicine could impact the knowledge and attitudes of medical students to prepare them for managing chronic conditions in their patients. Chronic diseases are increasingly prevalent and problematic. Although chronic disease management involves lifestyle modification, few physicians are adequately trained in effective motivational interventions. We surveyed first- and second-year Harvard Medical School students in October 2015 before and after a presentation on lifestyle medicine and quantified changes in their knowledge, attitudes/confidence, and skills. Medical students learned the basics of behavioral change after a 1-hour presentation, and their confidence with regard to implementing interventions increased. Median scores of confidence in counseling patients on lifestyle changes improved as did their ability to counsel patients on exercise, nutrition, sleep, stress management, and smoking cessation. After a brief intervention, medical students can learn principles of behavioral management and how to implement the skills with patients suffering from chronic illnesses.
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Lifestyle medicine is a growing field of medicine that addresses key health behaviors, which are the root causes of most premature death, chronic disease, and health care costs. Coaching patients with evidence-based behavior change... more
Lifestyle medicine is a growing field of medicine that addresses key health behaviors, which are the root causes of most premature death, chronic disease, and health care costs. Coaching patients with evidence-based behavior change strategies can help them to make lasting habits in key areas, such as physical activity, healthy eating, improved sleep, cessation of tobacco, forming and maintaining relationships, and stress management. Similarities in philosophy between lifestyle medicine and physical medicine and rehabilitation make them complementary and synergistic in treating the whole patient in their social context.
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Research Interests: Health Promotion, Health Behavior, Mental Health, Medical Education, Health Education, and 15 moreLife Style, Adolescent, Medicine, Curriculum, Self Efficacy, Humans, Psychological Intervention, Lifestyle Medicine, Behavior change, Universities, Alternative Medicine, Wellness Programs, Preventive Healthcare, Healthy Lifestyle, and Specialty
Research Interests: Health Psychology, Geriatrics, Health Behavior, Exercise Physiology, Family Medicine, and 15 moreHealthy Lifestyles, Counseling, Exercise Science, Humans, Internal Medicine, Female, Clinical, Confidence intervals, Exercise, Lifestyle, Health Coaching, Healthy Life style, Clinical Competence, Cross Sectional Studies, and attitude to health
The process of changing eating patterns is one that can be challenging for health providers and patients alike. However, adopting healthy habits around food provides significant benefits for individuals, communities, and health care... more
The process of changing eating patterns is one that can be challenging for health providers and patients alike. However, adopting healthy habits around food provides significant benefits for individuals, communities, and health care systems. The potential rewards of effectively counseling patients about nutrition include improved hemoglobin A1c, decreased blood pressure, improved weight management, increased self-confidence, and increased personal satisfaction. Whenever healthy habits are the subject of a research project, diet is one of the main components of the investigation. For example, the Nurses’ Health Study [1] examined five healthy factors: (1) maintaining a healthy BMI, (2) exercising regularly, (3) eating a healthy diet, (4) not smoking, and (5) drinking alcohol only in moderation.
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In the wake of the COVID-19 pandemic, physician burnout is a more relevant concern than ever. Pre-existing stressors in health care, such as poor work-life balance, perfectionism, and inadequate social support, have been exacerbated by... more
In the wake of the COVID-19 pandemic, physician burnout is a more relevant concern than ever. Pre-existing stressors in health care, such as poor work-life balance, perfectionism, and inadequate social support, have been exacerbated by uncertainty, increased risk exposure, and general anxiety. Burnout places not only physicians, but also patients, systems, and communities at risk. The promotion of physician well-being is critical to sustaining the health care system. Actions to reduce burnout and increase well-being can and should occur on multiple levels. Organizations and leaders must take steps to create a culture of support and respect for health care providers. Such steps may include improved time-off policies, destigmatizing the use of mental health services, and reducing administrative burden. Physician well-being may benefit from action on an individual level as well. The pillars of Lifestyle Medicine provide a framework for engaging in behaviors compatible with overall well...
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Comprehensive lifestyle medicine programs have begun to show efficacy in patients with cerebrovascular disease. The Veterans Affairs (VA) health care system has a large poststroke population and VA rehabilitation departments have... more
Comprehensive lifestyle medicine programs have begun to show efficacy in patients with cerebrovascular disease. The Veterans Affairs (VA) health care system has a large poststroke population and VA rehabilitation departments have significant expertise and resources for promoting healthy lifestyles. A 12-week clinical lifestyle medicine program was therefore implemented for poststroke patients, along with an optional observational study evaluating cardiovascular fitness, function, body composition, vitals, and quality of life before and after the program. Seventeen of 18 clinical patients elected to participate in the study, and 3 later withdrew. The 14 participants improved VO2 max by 1.94 mL O2/min/kg ( P = .001, 95% CI 0.96-2.90). Significant improvements were seen in estimated metabolic equivalents, exercise duration, 6-minute walk test, 30-second sit to stand, grip strength, and balance. Among patients who were hypertensive at baseline, mean decrease in supine systolic blood pre...
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Just as lifestyle medicine is the necessary foundation for true health care reform, lifestyle medicine competencies should be the foundation for health education. Although lifestyle medicine education may benefit a health professional at... more
Just as lifestyle medicine is the necessary foundation for true health care reform, lifestyle medicine competencies should be the foundation for health education. Although lifestyle medicine education may benefit a health professional at any stage in their education or career, evidence-based undergraduate lifestyle medicine education for future health professionals shifts the perspective of health and health care delivery. Educating health preprofessionals in associate, bachelor’s, master’s, and other preprofessional healthcare training programs is of paramount importance due to the interdisciplinary nature of lifestyle medicine. To accomplish this, American College of Lifestyle Medicine (ACLM) members can work collaboratively through committees, projects, and working groups—becoming leadership champions of change. An ACLM Pre-Professional Member Interest Group (LMPP) was created in 2018. LMPP has been working to build a national collaborative effort to amass, create, and distribute...
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The 2019 Addendum, in conjunction with the original health and wellness coaching (HWC) Compendium, organizes HWC literature with the aim of assisting researchers while providing a resource for practitioners. The 2019 Addendum to the HWC... more
The 2019 Addendum, in conjunction with the original health and wellness coaching (HWC) Compendium, organizes HWC literature with the aim of assisting researchers while providing a resource for practitioners. The 2019 Addendum to the HWC Compendium extends the initial work by adding HWC-related literature published in the past 2 years. The 2019 Addendum divides articles retrieved into 8 categories, including a new miscellaneous section complementing categories examining HWC effects on cancer, cholesterol, diabetes, heart disease, hypertension, obesity, and wellness. The 2019 Addendum again provides in-depth information about the nature, quality, and results from each article in a detailed spreadsheet provided as an electronic appendix. The 2019 Addendum contributes another 104 peer-reviewed coaching-related articles to the HWC Compendium. This most recent research again describes HWC as a favorable intervention with treatment potential in all categories, though only 3 new cancer arti...
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Student-led Lifestyle Medicine Interest Groups (LMIGs) empower the next generation of healthcare professionals to tackle the pandemic of lifestyle-related chronic diseases and provide important pathways to increasing the visibility of... more
Student-led Lifestyle Medicine Interest Groups (LMIGs) empower the next generation of healthcare professionals to tackle the pandemic of lifestyle-related chronic diseases and provide important pathways to increasing the visibility of Lifestyle Medicine (LM) in health professions schools. Each year, the Donald A. Pegg Student Leadership Award offers four allied health students a seed grant to start or support LMIGs at their schools as well as financial assistance to attend the annual American College of Lifestyle Medicine (ACLM) conference. The 2017 student winners were Paresh Jaini, Albert Barrera, Alyssa Greenwell, and Alicja Baska. With the support of the Pegg Award, the awardees and their faculty advisors have made great strides in LM at their institutions in the areas of research, community outreach, student education, and global networking. Their LMIG activities have included students presenting research at national conferences, initiating a chapter of the national organizatio...
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Health and wellness coaching (HWC) for lifestyle behavior change is emerging as a practice, role, and profession, in diverse health care, employee wellness, and community settings. Health care professionals apply HWC as a behavior change... more
Health and wellness coaching (HWC) for lifestyle behavior change is emerging as a practice, role, and profession, in diverse health care, employee wellness, and community settings. Health care professionals apply HWC as a behavior change methodology for the prevention and treatment of diabetes, hypertension, hyperlipidemia, heart disease, cancer, and other chronic disorders. The purpose of this systematic review was to provide a comprehensive and organized compendium of HWC literature. To date, extant HWC literature remains scattered with no meaningful summary accessible. Lack of comprehensive summary stems from lack of consensus on HWC definition and standards. We applied a recently proposed, standardized definition of HWC to determine compendium inclusion criteria for peer-reviewed, data-based literature from relevant search engines (ie, PubMed, PsychInfo, and CINAHL). A systematic review process was executed and ultimately yielded 219 articles meeting HWC inclusion criteria. Of t...
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Research Interests: Positive Psychology, Obesity, Medicine, Healthy Lifestyles, Coaching, and 14 moreOverweight, Weight Loss, Case Study, Lifestyle Medicine, Lifestyle, Health Coaching, Alternative Medicine, Body Mass Index, Weight, Case reports, Weight Management, Lifestyle and health, BMJ Case Reports, and Motivation Psychology
The process of changing eating patterns is one that can be challenging for health providers and patients alike. However, adopting healthy habits around food provides significant benefits for individuals, communities, and health care... more
The process of changing eating patterns is one that can be challenging for health providers and patients alike. However, adopting healthy habits around food provides significant benefits for individuals, communities, and health care systems. The potential rewards of effectively counseling patients about nutrition include improved hemoglobin A1c, decreased blood pressure, improved weight management, increased self-confidence, and increased personal satisfaction. Whenever healthy habits are the subject of a research project, diet is one of the main components of the investigation. For example, the Nurses’ Health Study [1] examined five healthy factors: (1) maintaining a healthy BMI, (2) exercising regularly, (3) eating a healthy diet, (4) not smoking, and (5) drinking alcohol only in moderation.
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Lifestyle medicine group sessions present a promising approach to clinical care. Based on decades of work in shared medical appointments and group visits for diabetes and other chronic conditions, a lifestyle medicine group session has... more
Lifestyle medicine group sessions present a promising approach to clinical care. Based on decades of work in shared medical appointments and group visits for diabetes and other chronic conditions, a lifestyle medicine group session has the potential to provide a fresh and rewarding way of interacting with patients that fuels the practitioner and feeds patients’ needs to spend time with the lifestyle medicine practitioner, connect with him or her, connect with others, learn the latest recommendations regarding healthy habits, practice these behaviors, and discuss their obstacles, motivations, and strategies for healthy living. The lifestyle medicine group session discussed in this article is a combination of group coaching, education, and group support.
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Lifestyle medicine has the power to reverse the growing burden of chronic disease that now plagues our health care system. The World Health Organization, the Centers for Disease Control and Prevention, and the American College of... more
Lifestyle medicine has the power to reverse the growing burden of chronic disease that now plagues our health care system. The World Health Organization, the Centers for Disease Control and Prevention, and the American College of Lifestyle Medicine have all independently recognized the need for community-centered lifestyle medicine education as a means of empowering individuals to take charge of their own health. Students in undergraduate, medical, and allied health schools may serve as mediators for these conversations. With guidance from faculty lifestyle medicine mentors, these students can operate as peer educators in primary and secondary schools to supplement current health teaching with the core tenants of lifestyle medicine: nutrition, exercise, sleep, mental and social well-being, and substance avoidance as strategies to prevent and treat chronic disease. We present models of two such student-led programs working with middle and high school students in Massachusetts and New...
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A high percentage of patients seen in primary care clinics partake in excessive alcohol consumption. It leads to numerous health problems and remains one of the leading risk factors for chronic disease. Despite the health concerns,... more
A high percentage of patients seen in primary care clinics partake in excessive alcohol consumption. It leads to numerous health problems and remains one of the leading risk factors for chronic disease. Despite the health concerns, screening for and intervening in patients’ alcohol misuse has yet to become standard practice in many primary care settings. There is well-established empirical evidence that brief doctor-patient interactions reduce alcohol consumption among excessive drinkers in primary care settings. This article draws on randomized controlled trials and literature on screening techniques, motivational interviewing, the transtheoretical model of behavior change, and medication-assisted treatments to enhance brief intervention methodology. Through this review, evidence-based practical strategies are presented to primary care doctors that reduce alcohol consumption in patients screened as problem drinkers. Referral information for those individuals with severe drinking pr...
Research Interests: Primary Care, Addiction, Drugs And Addiction, Primary Health Care, Family Medicine, and 15 moreMedicine, Healthy Lifestyles, Motivational Interviewing, Internal Medicine, Alcoholism, Healthy Aging, Psychological Intervention, Lifestyle, Health Coaching, Healthy Life style, Lifestyle and health, Family and Community Medicine, Hospitalist, Alcohol Addiction, and Brief Intervention
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Social connection is a pillar of lifestyle medicine. Humans are wired to connect, and this connection affects our health. From psychological theories to recent research, there is significant evidence that social support and feeling... more
Social connection is a pillar of lifestyle medicine. Humans are wired to connect, and this connection affects our health. From psychological theories to recent research, there is significant evidence that social support and feeling connected can help people maintain a healthy body mass index, control blood sugars, improve cancer survival, decrease cardiovascular mortality, decrease depressive symptoms, mitigate posttraumatic stress disorder symptoms, and improve overall mental health. The opposite of connection, social isolation, has a negative effect on health and can increase depressive symptoms as well as mortality. Counseling patients on increasing social connections, prescribing connection, and inquiring about quantity and quality of social interactions at routine visits are ways that lifestyle medicine specialists can use connection to help patients to add not only years to their life but also health and well-being to those years.
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Laughter is a normal and natural physiologic response to certain stimuli with widely acknowledged psychological benefits. However, current research is beginning to show that laughter may also have serious positive physiological effects... more
Laughter is a normal and natural physiologic response to certain stimuli with widely acknowledged psychological benefits. However, current research is beginning to show that laughter may also have serious positive physiological effects for those who engage in it on a regular basis. Providers who prescribe laughter to their patients in a structured way may be able to use these natural, free, and easily distributable positive benefits. This article reviews the current medical understanding of laughter’s physiologic effects and makes a recommendation for how physicians might best harness this natural modality for their patients.