Something changed recently in my otolaryngology clinic. I’m board certified in both otolaryngology and lifestyle medicine, and this has prompted the change that has benefitted my patients and transformed my practice.
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October 2022Before I became interested in a more holistic approach to otolaryngology, I had little to offer my patients in the way of medical advice other than reassurance that the “lump” sensation they were feeling wasn’t cancer but instead globus, and a prescription for nasal spray.
But now, I find myself encouraging patients during their appointments to tell me more about the activity levels in their life, their nutritional habits, or the recent stress they’ve been under. Examining their timelines a little more closely has highlighted potential links between globus and a stressful life event, snoring and alcohol consumption, and sinus infections and a change in their workplace.
These in-depth discussions guide the patient to a better understanding of the problem and allow contemplation of a greater variety of treatment options.
The Six Pillars of Lifestyle Medicine
The American College of Lifestyle Medicine (ACLM) was founded in 2004 to advance evidence-based lifestyle medicine to treat, reverse, and prevent noncommunicable chronic disease. Its membership has grown exponentially in the past few years and includes primary care and specialty physicians as well as a host of other healthcare professionals who are united in their desire to transform healthcare. Much of its research focuses heavily on cardiovascular disease, diabetes mellitus, stroke, and cancer. As otolaryngologists, we know these conditions impact our patients both directly and indirectly.
Lifestyle medicine focuses on six different areas, called pillars, to help improve overall health through modifiable lifestyle habits, and the medical literature supports the importance of these practices.
Pillar 1: Nutrition
More than 75% of U.S. adults do not get the recommended daily servings of fruits and vegetables, and over 60% of food consumed in the United States is processed. Plants contain fiber that helps regulate insulin sensitivity, vitamins and minerals that act as cofactors for biochemical pathways, and antioxidants that help reduce cellular damage. Robust data show that the whole-food plant-based strategy promoted by the ACLM supports health and longevity, and emerging research continues to shine a light on common otolaryngology complaints.
Much of [lifestyle medicine] research focuses heavily on cardiovascular disease, diabetes mellitus, stroke, and cancer. As otolaryngologists, we know these conditions impact our patients both directly and indirectly. —Jessica G. Lee, MD
Numerous studies show, for example, that increasing fruit, vegetable, and nut consumption can reduce rhino-conjunctivitis symptoms and wheezing (Allergol Immunopathol (Madr.) 2017;45:417-424; Thorax. 2007;62:677- 683; Public Health Nutr. 2006;9:472-479; Nutrients. 2021;13:728). A recent article in the April 2022 issue of the American Academy of Otolaryngology–Head and Neck Surgery’s Bulletin magazine succinctly compiled the evidence for protective effects of plant-based diets (AAO-HNS Bulletin. 2022;41:32-35). The preventative power of antioxidants has been demonstrated in animal models and smaller patient cohorts (Antioxidants. 2020;9:1076-1097; Ear & Hearing. 2019;41:289-299; Prasad KN, et al. The Case for Using Multiple Antioxidants in Hearing Disorders. The Hearing Review. Accessed June 6, 2008).