By LISA EISENHAUER

A lifestyle medicine program launched in the spring by southeastern Michigan-based Saint Joseph Mercy Health System is a pilot for the system's parent company, Trinity Health.

McDowell

Working as part of a team of seven, Lisa McDowell, director of clinical nutrition and lifestyle medicine, helped develop the program. Its goal, she says, is "to provide support to individuals and teach them to hardwire best practices that optimize their own personal health and potential."

Hillary Stark, a marketing specialist for St. Joseph Mercy Ann Arbor in Michigan, works on a jigsaw puzzle at her home. She says doing puzzles helps ease the stress of a busy life that includes two sets of young twins. Stark learned to prioritize restful sleep as a participant in the lifestyle medicine program being piloted at her hospital.

The team members — five dietitians and two physicians — are certified through the American College of Lifestyle Medicine, a professional society founded in 2004 that provides education, practice support and advocacy.

The lifestyle medicine program includes individual assessments, nutrition therapy and group sessions that are based on six pillars:

• Whole food, plant-predominant diet.
• Regular physical activity.
• Restorative sleep.
• Stress management.
• Avoidance of risky substances.
• Positive social connections.

McDowell says the pillars parallel researchers' findings about the so-called Blue Zones of the world, five regions where residents on average live longer and healthier lives than elsewhere. The findings link the longevity to plant-based diets, physical activity and social connectedness.

"If you look at the American lifestyle, it is so different than these Blue Zone pockets of success," McDowell says. Many people in the U.S. eat meat- and calorie-heavy diets, get too little sleep and exercise, ignore signs of stress and avoid social interaction.

The pillars also reflect the practices McDowell has seen help elite athletes reach their peak performance in her work as a dietitian for both Olympians and the Detroit Red Wings professional hockey team.

"We know that if an athlete is not sleeping well, or if they're dehydrated, or they're not getting the right food, or if they're lonely, or if they're abusing too much alcohol or relying on sleeping pills, they are not going to be their best," she says.

Connecting the dots
The idea for the lifestyle medicine program took root in 2020, McDowell says. She and some of her colleagues noticed that many patients were seeing a variety of providers to address separate health issues. The clinicians wanted to help those patients improve their overall health by making lifestyle changes.

McDowell says sometimes lifestyle choices, rather than traditional medical care, can put patients on the path toward healthy lives.

McDowell's team works with patients to set personal goals to improve their wellness and to figure out how to move toward those goals.

One of the options for patients is the Lifestyle Medicine Intensive Program, an eight-week course of group therapy. Participants start with a private consultation with a dietitian and then engage in weekly group sessions that focus on specific topics such as stress management and the power of social connection. Because of the pandemic, the group sessions for now are virtual.

Cascading benefits
Hillary Stark, a marketing specialist for St. Joseph Mercy Ann Arbor, says she had "zero awareness" of lifestyle medicine until she was assigned to market the program, but she was primed to make some changes to her stressful life as a working mother. This summer she joined a dozen other patients in the program's first group therapy cohort.

In December 2019, Stark had delivered her second set of twins. Her other twosome was just 3. When her maternity leave ended, the pandemic had begun, adding more stress to being a working mother with four very young children.

"It was just like, man, I need a reset," she recalls. "This program with everything that it covers seemed like a really great opportunity that I couldn't pass up."

Based on her individual assessment, Stark's goals include getting more exercise, sticking to a more nutritious diet and finding more time for herself. Over the course of the program, she says she came to appreciate how beneficial getting sufficient sleep is to her overall sense of well-being.

To relax and prepare for sleep, once she puts her children to bed, Stark is spending less time immersed in the apps on her phone and more time doing calming activities that don't involve screen time such as working jigsaw puzzles.

"It's essentially been like a cascade," Stark says. "I'm sleeping better so I'm able to wake up more refreshed, put better focus on what I'm eating. I have more energy throughout the day."

Tough sell for insurers
McDowell says lifestyle medicine follows established practices that have been proven to help keep patients healthier and prevent chronic conditions from worsening. Nevertheless, she notes that it has yet to win over many insurers. "Each insurance varies, but for the most part, what we're finding is there is little reimbursement," she says.

Saint Joseph Mercy is incorporating lifestyle medicine into its programs for colleagues. For example, the system's Nutrition Buddies Program pairs physician residents with kids from the community to learn culinary skills together. The focus on healthy choices also figures into the system's community benefit efforts, which include free community clinics on nutrition.

McDowell is hopeful lifestyle medicine will gain a wider embrace as the field draws more adherents and its benefits are backed up by further research.

"I think that we have to collect data, we have to show outcomes," she says. "I know everybody's different, but I would much rather be empowered with the information to take care of my own health (and avoid preventable chronic illness) than to rely on a medicine or a procedure to try to reverse a disease or treat it."