Brian Asbill, MD, cardiologist at Asheville Cardiology Associates and Mission Heart, became the first person in the world to become certified in Lifestyle Medicine. Who better than to answer some questions about it?
What is lifestyle medicine?
Lifestyle medicine is the evidence-based practice of helping individuals adopt and sustain healthy behaviors that affect health and quality of life. It does so by focusing on the root causes of disease, such as diet, exercise, sleep and stress.
How long have you formally practiced lifestyle medicine?
I was surprised to find at the initial board certification exam October 2018 that I was the first person in the world to register for the exam and thus have certificate #00001!
What type of training does the lifestyle medicine specialist receive?
There are different types of certification for physicians, nurses, dietitians or PhDs offered through the American Board of Lifestyle Medicine, all requiring 30 total hours of Continuing Medical Education (CME) plus 10 hours of in-person CME. Then, of course, the provider must study for and pass the certification exam.
How does lifestyle medicine differ from primary care?
Lifestyle medicine practitioners focus on things like nutrition, exercise, tobacco cessation, stress management, sleep and relationships as the foundation of good health. This method stresses these modifications over pills and procedures as preventive measures whenever possible. Primary care involves initial care for a patient, and then coordination of their comprehensive care. I believe strongly that comprehensive care should incorporate the principles that are foundational to lifestyle medicine. Therefore, primary care is really the ideal environment for introducing patients to these principles. Lifestyle medicine is a tool that can be used by primary care physicians, specialists and other allied health professionals, and we should all be well-versed in how to incorporate its principles so that we all are supporting our patients in a more comprehensive way.
What types of conditions and problems can be treated through lifestyle medicine?
About 75-80 percent of chronic disease is related to poor lifestyle choices, and 75-80 percent of the cost of healthcare in this country is for the treatment of chronic disease. Those patients who benefit most from a lifestyle-focused treatment plan are those with several lifestyle medicine-rated diseases, including obesity, hypertension, diabetes, high cholesterol and cardiovascular disease. People are often surprised to find that a lifestyle-focused treatment plan is effective in treatment of conditions like early-stage dementia, certain cancers, some autoimmune disorders, arthritis and erectile dysfunction.
What kind of results have you seen in patients?
I have seen some truly life-changing results in patients! My patients who have been treated with a number of different medications for their blood pressure, cholesterol and blood sugar, for example, have lost weight and seen dramatic improvements in all of these metrics. Many, if not most, of them have been able to reduce their need for multiple medications, and some of them have been able to discontinue their medications altogether.
What motivated you to pursue lifestyle medicine?
I was drawn to lifestyle medicine because so many of my patients had the same collection of chronic diseases that ultimately lead to cardiovascular disease. Cardiovascular disease is the leading cause of death in the United States. Those chronic diseases associated with it include obesity, diabetes, hypertension, dyslipidemia and tobacco abuse.
Brian Asbill, MD, is a cardiologist at Asheville Cardiology Associates and Mission Heart.
