Lifestyle Medicine to Promote Personal and Planetary Health
Written by Rachelle Murphy, DHSc, OTR/L, DipACLM
Photo by Maarten van den Heuvel on Unsplash
Climate change and environmental degradation have become threats to life on earth as we know it. Once two distinct and separate issues, the intersection between climate and health has become undeniable. Unsustainable human activity is now the driver behind biophysical changes to our planet resulting in dangerous environmental degradation and threatening human health and well-being (Pathak & McKinney, 2021; Myers & Frumkin, 2020). Climate change, unhealthy air quality and pollution, loss of biodiversity, changes in land use and land cover, and depletion of resources such as fresh water and arable land intersect in complex ways to alter how humans eat, drink, recreate, and breathe. These rapidly changing environmental conditions have increased exposure to infectious diseases and natural disasters such as fires, droughts, and extreme weather events (Myers & Frumkin, 2020). Ultimately, these changes affect every aspect of our health and well-being and are amplified even more so for those in vulnerable populations or living with chronic health conditions (Pathak & McKinney, 2021).
Human activity and lifestyle behaviors are driving many of the climate issues we are witnessing. Biodiversity loss is due to deforestation driven by diets high in animal products; air, water, and soil pollution come from industrial plants and manufacturing sites; and we are experiencing higher temperatures due to urbanization and the lack of green spaces. These are just a snapshot of the issues facing our planet that lead to environmental destabilization and contribute to the declining health conditions of its inhabitants (Pathak & McKinney, 2021). Currently, 6 in 10 U.S. adults have one chronic health condition and 4 in 10 U.S. adults have at least two chronic health conditions driving healthcare costs to almost $4 trillion annually (CDC, 2021). These chronic conditions are largely preventable through changes in lifestyle factors and create an opportunity for healthcare professionals to improve client health while also encouraging “climate-friendly” behavior changes that will in turn improve our planet’s health.
Climate Change and Health Risks
The health risks associated with climate change are vast. Unstable weather patterns make it difficult to perform physical activity outdoors. Animal agriculture has led to an increase in vector-borne illnesses and the introduction of dangerous toxins into many foods people consume. Urbanization has resulted in less green space and the disruption of restorative sleep patterns due to rising temperatures, noise, and light pollution. These impacts are especially dangerous for our most vulnerable populations and those living in marginalized communities already suffering from health inequities due to higher exposures of pollution, environmental toxins, food insecurities, and lack of green or safe spaces to be outdoors
Using Lifestyle Medicine in OT to Combat Climate Change & Improve Health
Lifestyle Medicine is an evidence-based approach that utilizes therapeutic intervention from six pillars including nutrition, physical activity, stress management, sleep, social connection, and avoidance of toxins, to reverse and prevent the chronic diseases that plague modern society. Health professionals deliver these interventions to prevent and reverse common conditions such as cardiovascular disease, diabetes, stroke, and cancers. Occupational therapy practitioners are integral in delivering lifestyle interventions with their clients given their training in health behavior change and practice alignment with all six pillars.
Some of the most applicable pillars to occupational therapy practice are shared below. We hope that practitioners will use this knowledge to help achieve healthier practices for their clients and better health for our planet.
Nutrition – The Standard American Diet includes a diet high in processed foods, meat, and dairy. Environmental disruptions have led to the inability of many to meet healthy nutrition guidelines due to poor crop yields and decreased concentrations of needed vitamins in a variety of crops. Lack of healthy and nutritious foods often leads people to seek out ultra-processed foods that lead to heart disease, cancer, strokes, and micronutrient deficiencies. The lifestyle medicine approach to nutrition includes consuming a whole-food, predominantly plant-based diet of fruits, vegetables, legumes, nuts, and seeds. By shifting more people to this type of diet (or at least significantly decreasing the number of animal products consumed regularly), a more sustainable ecological footprint can be achieved, allowing the growing population to be fed while also reducing the burden of chronic disease. Research shows that even shifting to a “flexitarian” diet, where consumption of red meat reduces significantly and intake of fruits, vegetables, legumes, nuts, and seeds increases, the global world could avoid up to 5.9 million deaths (Pathak & McKinney, 2021).
Practical Applications: Occupational therapists often perform meal planning, preparation and cooking activities with their clients during treatment sessions. Introducing more plant-based meals during these sessions and sharing the health benefits of reduced animal product consumption can help improve your client’s health while achieving the added “side effect” of creating a more sustainable food system.
Physical Activity – In the United States, lack of physical activity is the cause of approximately 1 in 10 premature deaths and only one in three adults currently achieves the recommended weekly amount of physical activity ((Carlson, Adams, Yang, & Fulton, 2018; Tremblay et al., 2010). Climate disasters only contribute to this problem, often leading to a decreased ability to safely engage in outdoor recreation. More often we are experiencing our outdoor activities marred by poor air quality due to pollution, wildfires, or temperature extremes that can lead to health disturbances caused by heat or cold stress on the body.
Practical Applications: Occupational therapists are in a critical position to address the health management of their clients, including physical activity. OTs can encourage engagement in outdoor physical activity, such as walking, gardening, or even nature-based therapy. These practices meet not only the physical needs of the body, but also address areas of emotional health, social connection, and stress management. OTs can encourage the use of walking or biking as forms of transit, which can help to reduce transportation-related greenhouse gas (GHG) emissions in the environment and allow people to meet their physical activity recommendations. Advocating for better infrastructure within one’s community and consulting with city urban planning commissions can encourage more active transport options, increase green spaces, increasing accessibility and improve air quality and safety while positively affecting a person’s overall well-being and health
Sleep – The benefits of getting a good night’s sleep continue to become more evident. Poor sleep quality is linked to conditions like Alzheimer’s disease, cardiovascular disease, diabetes, obesity, reduced immune function, and depression. While it may not be as obvious, climate change can negatively impact a person’s sleep quality in the form of environmental disruptions. Rising temperatures from increased urbanization, as well as noise and light pollution, can all harm restorative sleep patterns.
Practical Applications: Aside from encouraging the 7-9 hours adults need for restorative sleep, occupational therapy practitioners can have their clients engage in activities such as tree planting in urban areas. Increasing the tree canopy in urban areas can directly affect lessening noise and light pollution. It may also aid in normalizing temperatures, thereby creating a more inviting sleep environment. OTs can also recommend using less-polluting energy sources and vehicles with their clients.
Conclusion
The pillars of lifestyle medicine offer occupational therapists easy and effective interventions to meet the health management needs of their clients while improving planetary health as a byproduct. In a society where lifestyle behaviors contribute to 80% of all premature deaths, health professionals from all different specialties must address the detriment that our current way of living is having on the planet and its inhabitants. We must acknowledge the effects climate changes are having on our clients’ abilities to access safe and healthy occupations and to assist our clients with identifying healthier and more sustainable options. We encourage occupational therapy practitioners to empower their clients and colleagues with this knowledge and address planetary health issues through personal lifestyle solutions while advocating for more climate-friendly spaces and actions at the community level.
Resources
Carlson, S. A., Adams, E. K., Yang, Z. & Fulton, J. E. (2018). Percentage of deaths associated with inadequate physical activity in
the United States. Preventative Chronic Disease, 15, E38.
Centers for Disease Control and Prevention (CDC) (2021). About Chronic Diseases. Retrieved from
https://www.cdc.gov/chronicdisease/about/index.htm
Frates, B. (2019). Lifestyle Medicine Handbook: An introduction to the power of healthy habits. Healthy Learning. Monterey, CA.
Myers, S. S., & Frumkin, H. (Eds.). (2020). Planetary health: Protecting nature to protect ourselves. Island Press.
Pathak, N., & McKinney, A. (2021). Planetary health, climate change, and lifestyle medicine: threats and opportunities. American
Journal of Lifestyle Medicine, 15(5), 541–552. https://doi.org/10.1177/15598276211008127
Pathak, N., & Pollard, K. J. (2021). Lifestyle medicine prescriptions for personal and planetary health. The Journal of Climate
Change and Health, 4. https://doi.org/10.1016/j.joclim.2021.100077
Tremblay, M. S., Colley, R. C., Saunders, T. J., Healy, G. N., & Owen, N. (2010). Physiological and health implications of a sedentary
lifestyle. Applied physiology, nutrition, and metabolism = Physiologie appliquee, nutrition et metabolisme, 35(6), 725–740.
https://doi.org/10.1139/H10-079
The blog's author, Rachelle Murphy, DHSc, OTR/L, DipACLM can be reached at rachellemurphyotr@gmail.com.
For more information on Lifestyle Medicine, visit the American College of Lifestyle Medicine: www.lifestylemedicine.org