Lifestyle Med

Lifestyle Medicine, Second EditionK12021
There is no doubt that daily habits and actions exert a profound health impact. The fact that
nutritional practices, level of physical activity, weight management, and other behaviors play
key roles both in the prevention and treatment of most metabolic diseases has been recognized
by their incorporation into virtually every evidence-based medical guideline. Despite this wide-
spread recognition, physicians and other healthcare workers often cannot find a definitive and
comprehensive source of information on all of these areas.
Designed for physicians and other healthcare workers, Lifestyle Medicine, Second Edition
brings together evidence-based research in multiple health-related fields to assist practitioners
both in treating disease and promoting good health. Sections cover nutrition and exercise,
behavioral psychology, public policy, and management of a range of disorders, including
cardiovascular disease, endocrine and metabolic dysfunction, obesity, cancer, immunology and
infectious diseases, pulmonary disorders, and many more.
Lifestyle Medicine Second edition
Lifestyle Medicine SECOND EDITION
SECOND EDITION
CRC Press Taylor & Francis Group 6000 Broken Sound Parkway NW, Suite 300 Boca Raton, FL 33487-2742
© 2013 by Taylor & Francis Group, LLC CRC Press is an imprint of Taylor & Francis Group, an Informa business
No claim to original U.S. Government works Version Date: 20120621
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Dedication
To my dear wife, Stephanie, and our children, Hart, Jaelin, Devon, and Jamie, the wind beneath my wings.
vii © 2010 Taylor & Francis Group, LLC
Contents Preface........................................................................................................................................................................................xix Acknowledgments ....................................................................................................................................................................xxiii Editor ........................................................................................................................................................................................ xxv Contributors ............................................................................................................................................................................xxvii
Part I Lifestyle Management and Prevention of Cardiovascular Disease James M. Rippe, MD
Chapter 1 Rationale for Intervention to Reduce the Risk of Coronary Artery Disease .......................................................... 3
James M. Rippe, MD and Theodore J. Angelopoulos, PhD, MPH
Chapter 2 Lifestyle Strategies for Risk Factor Reduction, Prevention, and Treatment of Coronary Artery Disease ........... 19
Chapter 3 Nutrition Interventions for Cardiovascular Disease: Behavioral and Educational Considerations ...................... 35
Carol E. O’Neil, PhD, MPH, RD and Theresa A. Nicklas, DrPH
Chapter 4 Physical Activity and Fitness in the Prevention of Cardiovascular Disease ......................................................... 49
Robert F. Zoeller, PhD
Chapter 5 Clinical Strategies for Managing Dyslipidemias .................................................................................................. 65
Ulf G. Bronas, PhD, ATC, ATR, FSVM and Arthur S. Leon, MD, MS
Chapter 6 Lifestyle Management and Prevention of Hypertension ....................................................................................... 75
Ulf G. Bronas, PhD, ATC, ATR, FSVM and Arthur S. Leon, MD, MS
Chapter 7 Community Approaches to Reduce the Risks of Cardiovascular Disease ........................................................... 83
Cherise B. Harrington, PhD, MPH, Meridith Eastman, BA, and Laura Linnan, ScD, CHES
Part II Nutritional aspects of Lifestyle Medicine Johanna Dwyer, DSc, RD
Chapter 8 Nutrition 101: The Concept of Nutritional Status and Guides for Nutrient Intakes, Eating Patterns, and Nutrition ....................................................................................................................................................... 103
Johanna Dwyer, DSc, RD
Chapter 9 Healthy People 2020: Highlights in the Nutrition and Weight Status Focus Area ..............................................119
Pamela Starke-Reed, PhD, Crystal McDade-Ngutter, PhD, and Van S. Hubbard, MD, PhD
Chapter 10 Dietary Guidelines for Americans, 2010: National Nutrition Policy ...................................................................131
Rachel Hayes Polon, MPH, RD and Eve Essery Stoody, PhD
Chapter 11 Nutritional Considerations for the Active Adolescent ......................................................................................... 149
Rebecca J. Boulos, MPH and Christina D. Economos, PhD
Chapter 12 Nutrition for the Elite Athlete ............................................................................................................................. 163
Ladd Harris, MS, RD and Katherine Beals, PhD, RD, FACSM, CSSD
Chapter 13 Optimal Nutrition Guidance for Older Adults .................................................................................................... 177
Alice H. Lichtenstein, DSc
Chapter 14 Role of Communication in Changing Nutrition Behaviors to Promote Healthy Lifestyles ................................ 185
Jeanne Goldberg, PhD, RD and Lindsay Peterson, MS, MEd
Part III Physical activity and Fitness Theodore J. Angelopoulos, PhD, MPH
Chapter 15 Physical Fitness Evaluation ................................................................................................................................. 199
Peter F. Kokkinos, PhD and Jonathan Myers, PhD
Chapter 16 Exercise Prescription for Apparently Healthy Individuals and for Special Populations .................................... 209
Paul G. Davis, PhD, RCEP
Part IV Behavioral Psychology Bess Marcus, PhD
Chapter 17 Applying Psychological Theories to Promote Healthy Lifestyles ....................................................................... 223
Sarah E. Linke, PhD, MPH and Dori Pekmezi, PhD
Chapter 18 Cognitive and Behavioral Approaches to Enhancing Exercise Participation ..................................................... 233
Barbara A. Stetson, PhD, John M. Cooper, BA, and Patricia M. Dubbert, PhD
Chapter 19 Behavioral Approaches to Enhancing Smoking Cessation ................................................................................. 245
Joseph T. Ciccolo, PhD, Ernestine G. Jennings, PhD, and Andrew M. Busch, PhD
Chapter 20 Behavioral Approaches to Enhancing Weight Loss and Maintenance ............................................................... 255
Teresa K. King, PhD, Elizabeth E. Lloyd-Richardson, PhD, and Matthew M. Clark, PhD
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Part V Women’s Health Pamela M. Peeke, MD, MPH, FACP
Chapter 21 Women’s Health: Challenges and Opportunities ................................................................................................ 269
Pamela M. Peeke, MD, MPH, FACP
Chapter 22 Menopause ........................................................................................................................................................... 271
Margery Gass, MD, NCMP
Beth Baughman DuPree, MD, FACS
Chapter 24 Osteoporosis ........................................................................................................................................................ 299
Sobia Khan, MD, NCMP, CCD and Holly Thacker, MD, FACP, NCMP, CCD
Chapter 25 Physical Activity and Health in Women ..............................................................................................................313
Shari S. Bassuk, ScD and JoAnn E. Manson, MD, DrPH
Chapter 26 Women’s Body Composition and Lifestyle ..........................................................................................................331
Pamela M. Peeke MD, MPH, FACP
Chapter 27 Health and Wellness Coaching Skills for Lasting Change ................................................................................. 343
Elizabeth Pegg Frates, MD and Margaret Moore, MBA
Part VI Men’s Health Craig Garfield, MD, MAPP
Chapter 28 Perspectives on Men’s Health .............................................................................................................................. 363
Craig Garfield, MD, MAPP
Chapter 29 Addressing Men’s Mental Health through a Strength-Based Approach ............................................................. 369
Anthony Isacco, PhD, Edvina Talovic, MS, Lindsay C. Chromik, MS, and Nicole K. Yallum, MS
Chapter 30 Promoting Nutrition in Men’s Health .................................................................................................................. 383
Brendan Gough, PhD
Chapter 31 Management and Prevention of Urological Diseases in Men ............................................................................. 391
Geoffrey R. Nuss, MD and Christopher M. Gonzalez, MD
Chapter 32 Health Promotion and Risk Reduction in Men ................................................................................................... 405
Lisa Terre, PhD
Part VII Endocrinology and Metabolism Samuel Crockett, MD
Chapter 33 Lifestyle and Insulin Resistance ......................................................................................................................... 421
Samuel Crockett, MD
Chapter 34 Lifestyle Approaches to the Prevention and Treatment of Diabetes ....................................................................431
Marion J. Franz, MS, RD, CDE
Chapter 35 Lifestyle Medicine and the Treatment of Glucose Intolerance ........................................................................... 441
Mary Beth Weber, MPH, PhD, Lisa R. Staimez, MPH, Jennifer Gilligan, MD, PhD, K.M. Venkat Narayan, MD, and Lawrence S. Phillips, MD
Chapter 36 Lifestyle Approaches to the Metabolic Syndrome .............................................................................................. 455
April J. Stull, PhD, RD, Catherine M. Champagne, PhD, RD, and William T. Cefalu, MD
Part VIII Lifestyle Issues in the Prevention and treatment of Cancer Clarence H. Brown, III, MD and Naren Ramakrishna, MD, PhD
Chapter 37 Lifestyle Interventions in the Prevention and Treatment of Cancer.................................................................... 471
Clarence H. Brown, III, MD, Said M. Baidas, MD, Julio J. Hajdenberg, MD, FACP, Omar R. Kayaleh, MD, Gregory K. Pennock, MD, Nikita Shah, MD, and Jennifer E. Tseng, MD
Chapter 38 Obesity and Cancer ............................................................................................................................................. 483
Clarence H. Brown, III, MD
Chapter 39 The Role of Physical Activity across the Cancer Survivorship Continuum ....................................................... 491
Catherine M. Sabiston, PhD, Jeff K. Vallance, PhD, and Jennifer Brunet, PhD
Chapter 40 Nutrition and Cancer ........................................................................................................................................... 505
Clarence H. Brown III, MD, Naren Ramakrishna, MD, PhD, Lenore S. Hodges, PhD, RD, CSO, LD/N, and Dawn Napoli, RD, LD/N
Part IX Obesity and Weight Management John P. Foreyt, PhD
Chapter 41 Epidemiology of Adult Obesity ........................................................................................................................... 515
R. Sue Day, PhD, Nattinee Jitnarin, PhD, Austin L. Brown, MPH, and Walker S. Carlos Poston, PhD
Chapter 42 Exercise Management for the Obese Patient ....................................................................................................... 529
John M. Jakicic, PhD, David O. Garcia, MS, and Renee J. Rogers, MS
xiContents
Chapter 43 Dietary Management of the Overweight and Obese Patient ............................................................................... 537
Eileen Stellefson Myers, MPH, RD, LDN, FADA, Raymond A. Plodkowski, MD, Maureen Molini- Blandford, MPH, RD, CSSD, and Sachiko T. St. Jeor, PhD, RD
Chapter 44 Pharmacological Management of the Obese Patient ........................................................................................... 547
Donald Schumacher, MD and Nikhil Dhurandhar, PhD
Chapter 45 Surgery for Severe Obesity.................................................................................................................................. 571
Robert F. Kushner, MD, MS and Lisa M. Neff, MD, MS
Chapter 46 Future Directions in Obesity Research and Treatment ....................................................................................... 583
Risa J. Stein, PhD, Katie Birkenfeld, and Rachel MacPhee
Part X Immunology and Infectious Disease David Nieman, DrPH, FACSM
Chapter 47 Exercise, Inflammation, and Respiratory Infection ............................................................................................ 597
David C. Nieman, DrPH, FACSM
Chapter 48 Chronic Exercise and Immunity: Practical Applications .................................................................................... 605
Paul M. Coen, PhD and Michael G. Flynn, PhD
Chapter 49 HIV Infection: Exercise and Immune Function ...................................................................................................615
Jason R. Jaggers, MS, PhD and Gregory A. Hand, PhD, MPH
Chapter 50 Exercise, Aging, and Immunity .......................................................................................................................... 625
Jeffrey A. Woods, PhD, Brandt D. Pence, PhD, Stephen A. Martin, BS and Marc D. Cook, MS
Part XI Pulmonary Medicine Nicholas A. Smyrnios, MD
Chapter 51 Respiratory Symptoms ........................................................................................................................................ 635
Jeremy B. Richards, MD, MA and Richard M. Schwartzstein, MD
Chapter 52 Chronic Obstructive Pulmonary Disease ............................................................................................................ 651
Crescens M. Pellecchia, DO, MS and J. Mark Madison, MD
Chapter 53 Asthma ................................................................................................................................................................ 659
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Chapter 55 Food Allergy and Anaphylaxis ........................................................................................................................... 689
Michelle E. Conroy, MD
Chapter 56 Influenza .............................................................................................................................................................. 699
Gail Scully, MD, MPH
Ramesh Donepudi, MD, MRCP and Anthony C. Campagna, MD, FCCP
Part XII Sports Medicine and Orthopedics Eric McCarty, MD and Sourav K. Poddar, MD
Chapter 58 Sports Supplements ............................................................................................................................................. 721
Morteza Khodaee, MD, MPH, John Spittler, MD, and Stacy R. Livingwell, MD
Chapter 59 Prevention of Injury ............................................................................................................................................. 729
Bradley J. Sandella, DO and Eugene Hong, MD, CAQSM, FAAFP
Chapter 60 Female Athlete Triad ........................................................................................................................................... 739
Stephanie M Chu, DO and Matthew Leiszler, MD
Chapter 61 The Role of Rehabilitation in Injury Management ............................................................................................. 745
Joy Anderson, PT, ATC, CSCS and Andrea Fetzer, MS, ATC
Chapter 62 Physiology of the Athlete: Bioenergetics, Performance, Physiological Testing, and Monitoring ....................... 757
Iñigo San Millán, PhD
Chapter 63 Evaluation of Acute Sports Injuries in the Adult Athlete ................................................................................... 773
Rebecca Sjostrom, MD, Eric McCarty, MD, Jennifer FitzPatrick, MD, Amy K. MacDougall, MD, and Lucas Rylander, MD
Chapter 64 Concussion in Sport............................................................................................................................................. 789
Kelsey Logan, MD, MPH, FAAPL, FACP and Paul Gubanich, MD, MPH
Chapter 65 Scientific Basis for the Use of Modalities in Sports Medicine ........................................................................... 799
Tara Jo Manal, PT, DPT, OCS, SCS, Anna Shovestul, PT, DPT, OCS, Laura A. Schmitt, PT, DPT, OCS, SCS, ATC, DCE, and Lynn Snyder-Mackler, PT, ScD, FAPTA
xiiiContents
Part XIII Obstetrics and Gynecology Hope A. Ricciotti, MD
Chapter 66 Preconception Care ............................................................................................................................................. 821
Katharyn Meredith Atkins, MD
Chapter 67 Nutrition and Lifestyle for a Healthy Pregnancy ................................................................................................ 831
Hope A. Ricciotti, MD
Kristin Bixel, MD
Chapter 69 Breast-Feeding .................................................................................................................................................... 853
Julia Head, MD, Stephanie-Marie L. Jones, MD, and Marcie K. Richardson, MD
Chapter 70 Contraception ...................................................................................................................................................... 867
Sadia Haider, MD, MPH
Maria Wachendorf Fradinho, MD
Chapter 72 Maintaining a Healthy Pelvic Floor through Childbirth and Menopause .......................................................... 899
Sybil Dessie, MD and Eman Elkadry, MD
Chapter 73 Risk Reduction and Screening for Women’s Cancers ..........................................................................................911
Jo Marie Tran Janco, MD
Chapter 74 Preventing Medical Errors in Obstetrics and Gynecology ................................................................................. 927
Toni Golen, MD
Chapter 75 Nutritional Deficiencies, Diseases, and the Skin ................................................................................................ 939
Christopher Mazur, BS and David H. McDaniel, MD
Chapter 76 Aging and the Skin .............................................................................................................................................. 953
Omer A. Ibrahim, MD, Diana Bolotin, MD, PhD, and Murad Alam, MD, MSCI
Chapter 77 Sun and the Skin ................................................................................................................................................. 965
Amy Y.-Y. Chen, MD and Henry W. Lim, MD
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Chapter 78 Exercise and the Skin .......................................................................................................................................... 977
Brian B. Adams, MD, MPH
Chapter 79 Skin Care ............................................................................................................................................................. 991
Zoe Diana Draelos, MD
Part XV Cardiovascular rehabilitation and Secondary Prevention Kathy Berra, MSN, NP-C, FAACVPR, FAAN and Barry A. Franklin, PhD, FAHA, FACSM, MAACVPR
Chapter 80 Stress Testing for the Coronary Patient: Beyond ST Segment Depression ....................................................... 1005
Eileen M. Hsich, MD, FACC, Benico Barzilai, MD, and Gordon Blackburn, PhD
Chapter 81 Exercise Prescription for the Coronary Artery Disease Patient ........................................................................1017
Peter H. Brubaker, PhD and James H. Ross, MS
Chapter 82 Contemporary Guidelines for Cardiac Rehabilitation ...................................................................................... 1027
Randal J. Thomas, MD, MS
Chapter 83 Benefits and Risks of Exercise for the Coronary Patient .................................................................................. 1037
Barry A. Franklin, PhD, FAHA, FACSM, MAACVPR and Kashish Goel, MD
Chapter 84 Psychosocial Considerations in Coronary Heart Disease: Implication for Cardiac Rehabilitation ...................1053
James A. Blumenthal, PhD and Elizabeth C.D. Gullette, PhD
Chapter 85 Evaluation and Treatment of the Patient with Peripheral Arterial Disease ...................................................... 1067
Kerry J. Stewart, EdD, FAHA, MAACVPR, FACSM
Chapter 86 Impact of Medical Therapy on Cardiovascular Secondary Prevention ............................................................ 1075
Reynaria Nieva, MD, Ahsan Achtchi, DO, Danny J. Eapen, MD, Allen L. Dollar, MD, FACC, FACP, Jefferson Baer, MD, MPH, Kreton Mavromatis, MD, and Laurence S. Sperling, MD, FACC, FACP, FAHA
Chapter 87 Exercise-Based Cardiac Rehabilitation: Outcomes and Expectations ...............................................................1101
Carl J. Lavie, MD, FACC, FACP, FCCP, Richard V. Milani, MD, FACC, FAHA, and Ross A. Arena, PT, PhD, FAHA
Chapter 88 Future of Cardiovascular Disease Prevention and Rehabilitation......................................................................1109
Kathy Berra, MSN, NP-C, FAACVPR, FAAN, Nancy Houston Miller, BSN, FAACVPR, and Shannon Hamilton, BA
Chapter 89 Secondary Prevention: It’s a Family Affair .......................................................................................................1113
Laura L. Hayman, PhD, MSN, Semira Semino-Asaro, MSN, RN, and Eileen M. Stuart-Shor, PhD, ANP
xvContents
Part XVI Lifestyle Components of Pediatric Medicine Thomas W. Rowland, MD
Chapter 90 Pediatric Preventive Medicine: An Introduction ..............................................................................................1123
Thomas W. Rowland, MD
Scott Owens, PhD
Chapter 92 Arterial Function in Children: Effect of Exercise and Lifestyle ......................................................................1141
Bo Fernhall, PhD
Chapter 93 Prevention of Osteoporosis and Bone Fragility: A Pediatric Concern .............................................................1155
Saija Kontulainen, BSc, MSc, PhD and Donald Bailey, MA, MSc, PED
Chapter 94 Identification and Management of Children with Elevated Cholesterol Levels ...............................................1163
Frank R. Greer, MD and Stephen R. Daniels, MD, PhD
Chapter 95 Cardiovascular Risk Factors and Physical Activity in Children ......................................................................1171
Lars Bo Andersen, PhD, Dr Med Sci and Robert G. McMurray, PhD, FACSM
Chapter 96 Prenatal Influences on Future Health ...............................................................................................................1181
Debbie A. Lawlor, MB, ChB, MPH, MSc, PhD, Marie-Jo A. Brion, BA, MSc, PhD, Laura D. Howe, MSc, PhD, and Abigail Fraser, PhD, MPH
Part XVII Family Practice Charles B. Eaton, MD, MS
Chapter 97 Introduction to Family Medicine Section .........................................................................................................1199
Charles B. Eaton, MD, MS
Chapter 98 Office-Based Physical Activity Counseling in Healthy Adults ....................................................................... 1201
Charles B. Eaton, MD, MS, Arnold Goldberg, MD, and Emma Simmons, MD, MPH
Chapter 99 Exercise Prescription for Patients with Chronic Health Problems .................................................................. 1209
Carol Ewing Garber, PhD, RCEP, FACSM, FAHA
Chapter 100 Nutrition Counseling in a Busy Office Practice ...............................................................................................1215
Kim M. Gans, PhD, MPH, LDN, Kelli Drenner, PhD, and Gemma Gorham, MPH
Chapter 101 e-Health Resources to Support Lifestyle Medicine and Management ............................................................ 1227
David K. Ahern, PhD and Judith M. Phalen, MPH
Chapter 102 Pharmacogenomic Tailored Therapy for Smoking Cessation: The Promise of Personalized Medicine ........ 1235
Aditi Mallick, AB and Sean P. David, MD, SM, DPhil
xvi Contents
Part XVIII Lifestyle Medicine in Geriatrics Charlotte A. Tate, PhD
Chapter 103 Lifestyle Medicine and the Older Population: Introductory Framework ........................................................ 1243
Charlotte A. Tate, PhD
Debra J. Rose, PhD
Chapter 105 Role of Physical Activity in Successful Aging ................................................................................................ 1257
Wojtek J. Chodzko-Zajko, PhD and Andiara Schwingel, PhD
Part XIX Epidemiology of Lifestyle-related Diseases Alan C. Utter, PhD, MPH, FACSM
Chapter 106 Epidemiology of Child and Adolescent Obesity ............................................................................................. 1271
Jennifer Utter, PhD, MPH
Chapter 107 Epidemiology and Prevention of Type 2 Diabetes .......................................................................................... 1281
Edward W. Gregg, PhD
Caroline A. Macera, PhD
Scott R. Collier, PhD, FACSM
Part XX Health Promotion Kenneth R. Pelletier, PhD, MD
Chapter 110 Health Promotion in the Workplace ................................................................................................................ 1303
Catherine M. Baase, MD and John White, PhD
Chapter 111 Health Promotion in Health Systems ................................................................................................................1311
Nicolaas P. Pronk, PhD and Thomas E. Kottke, MD, MSPH
Chapter 112 Financial Impact of Worksite Health Management Programs and Quality of the Evidence .......................... 1325
Seth Serxner, PhD, MPH, Daniel Gold, PhD, and Kristin Parker, PhD, MPH
Chapter 113 Future of Health Promotion in the Twenty-First Century ............................................................................... 1337
Dee W. Edington, PhD and Alyssa Schultz, PhD
xviiContents
Part XXI Exercise Psychology Steven J. Petruzzello, PhD
Chapter 114 Taking Stock of Where We Are in Understanding Mind/Body Interactions in the Exercise Domain ............1353
Steven J. Petruzzello, PhD, Tina A. Greenlee, MS, Paula Y.S. Poh, MA, and Megan Nickrent, MS
Chapter 115 Genetic Influences on Regular Exercise Behavior .......................................................................................... 1367
Marleen H.M. de Moor, PhD and Eco J.C. De Geus, PhD
Chapter 116 Influence of Physical Activity on Brain Aging and Cognition: The Role of Cognitive Reserve, Thresholds for Decline, Genetic Influence, and the Investment Hypothesis .................................................. 1379
Maureen K. Kayes, MS and Bradley D. Hatfield, PhD, FACSM, FNAK
Chapter 117 Physical Activity and Anxiety ......................................................................................................................... 1397
Katharina Gaudlitz, MSc, Brigitt-Leila von Lindenberger, MSc, and Andreas Ströhle, MD
Chapter 118 Physical Activity and Depression .................................................................................................................... 1409
Chad D. Rethorst, PhD and Madhukar H. Trivedi, MD
Chapter 119 Redrawing the Model of the Exercising Human in Exercise Prescriptions: From Headless Manikin to a Creature with Feelings ......................................................................................................................................1421
Panteleimon Ekkekakis, PhD, FACSM
Chapter 120 Determinants of Physical Activity: Research to Application ...........................................................................1435
Claudio R. Nigg, PhD, Ryan E. Rhodes, PhD, and Katie R. Amato, BS
Part XXII Injury Prevention David A. Sleet, PhD, FAAHB
Chapter 121 Injuries and Lifestyle Medicine ....................................................................................................................... 1447
David A. Sleet, PhD, FAAHB, Michael F. Ballesteros, PhD, and Grant T. Baldwin, PhD, MPH
Chapter 122 Patient Counseling for Unintentional Injury Prevention ..................................................................................1457
Michael F. Ballesteros, PhD and Andrea Gielen, ScD
Chapter 123 Preventing Traffic Injuries: Strategies That Work ........................................................................................... 1463
Ann M. Dellinger, MPH, PhD and David A. Sleet, PhD, FAAHB
Chapter 124 Child Injury: The Role of Supervision in Prevention .......................................................................................1473
Barbara A. Morrongiello, PhD and Michael R. Corbett, MA
Chapter 125 Preventing Injuries at Home ............................................................................................................................ 1485
Karin A. Mack, PhD and Karen DeSafey Liller, PhD
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Chapter 126 Falls and Fall Injuries among Older Adults ......................................................................................................1495
Judy A. Stevens, MS, MPH, PhD, Grant T. Baldwin, PhD, MPH, Michael F. Ballesteros, PhD, Rita K. Noonan, PhD, and David A. Sleet, PhD, FAAHB
Chapter 127 Preventing Repeat Intimate Partner Violence ................................................................................................. 1507
Samantha Illangasekare, PhD, MPH and Andrea Gielen, ScD
Chapter 128 Sports and Recreation-Related Traumatic Brain Injury ...................................................................................1519
Victor G. Coronado, MD, MPH, Lisa C. McGuire, PhD, Michael R. Lionbarger, MPH, Marlena M. Wald, MPH, MLS, Kelly Sarmiento, MPH, and Julie Gilchrist, MD
Part XXIII Public Policy and Environmental Supports for Lifestyle Medicine Gregory W. Heath, DHSc, MPH, FACSM, FAHA
Chapter 129 Lifestyle Medicine in an Era of Healthcare Reform—2011 .............................................................................1533
Gary B. Wilkerson, EdD, ATC and Gregory W. Heath, DHSc, MPH, FACSM, FAHA
Chapter 130 Policy and Environmental Supports in Promoting Physical Activity and Active Living .................................1539
Gregory W. Heath, DHSc, MPH, FACSM, FAHA and Paul M. Gordon, PhD, MPH, FACSM, FAHA
Chapter 131 Public Policy and Environmental Supports for Healthy Eating ...................................................................... 1545
Zaida Cordero-MacIntyre, PhD, PharmD, MPH, REHS, MS, RD and Alyssa Mompoint, MPH
Chapter 132 Building Strategic Alliances to Promote Healthy Eating and Active Living ...................................................1551
Risa Wilkerson, MA, Elizabeth A. Baker, PhD, MPH, and Matt M. Longjohn, MD, MPH
Chapter 133 Obesity and Health ...........................................................................................................................................1557
xix © 2010 Taylor & Francis Group, LLC
An overwhelming body of scientific and medical literature supports the concept that daily habits and actions exert an enormous influence on short- and long-term health and quality of life. This influence may be either positive or negative. Hundreds, if not thousands, of studies provide evidence that regular physical activity, maintenance of a healthy weight, not smoking cigarettes, and following sound nutritional and other health-promoting practices all profoundly impact health.
Since the publication of the first edition of Lifestyle Medicine (Blackwell Science, 1999), this literature has grown even stronger and more robust. Clearly, the time has come to update and summarize this information in one place and bring it to the attention of physicians and other health care workers with the hope and belief that it will impact on the way they practice medicine. This has been the goal and challenge of the second edition of Lifestyle Medicine.
The strength of the literature supporting the health impact of daily habits and actions is underscored by their incorporation into virtually every evidence-based clinical guideline addressing the prevention and treatment of metabolic diseases. For example, the following guidelines and consensus statements from various prestigious medical organizations all provide significant emphasis on lifestyle medicine principles and practices as key components of the prevention and treatment of disease:
• JNC VII Guidelines for Hypertension, Prevention and Treatment
• NCEP (ATP III) Guidelines for Cholesterol Management
• Institute of Medicine Guidelines for Obesity Management
• Guidelines from the American Heart Association for the Prevention and Management of Coronary Artery Disease
• Guidelines from the American Diabetes Association for the Management of Diabetes
• Dietary Guidelines for Americans 2010 • American Heart Association Nutrition Implement -
ation Guidelines • Guidelines from the American Academy of
Pediatrics for the Prevention and Treatment of Childhood Obesity
• Guidelines from the American Academy of Pediatrics for Heart Disease Risk Factor Reduction in Children
• Guidelines from the American Heart Association and the American Academy of Pediatrics for the Prevention and Treatment of the Metabolic Syndrome
• American Heart Association Strategic Plan for 2020 • Joint Statement from the American Heart
Association and American Cancer Society for the Prevention of Heart Disease and Cancer
Despite the widespread recognition in evidence-based guidelines of the important role lifestyle measures and practices play in the prevention and treatment of metabolic diseases, little progress has been made in improving the habits and actions of the American population. In some instances, risk factors for chronic diseases have actually gone in the oppo- site direction and increased over the last decade. Consider the following:
• More than 70% of the adult population in the United States does not get enough physical activity to result in health benefits.
• Over two-thirds of the adult population in the United States are either overweight or obese (a stag- gering 40% increase over the past 20 years).
• Less than one-third of the adult population gets ade- quate servings of fruits and vegetables and follows other simple, evidence-based nutritional principles related to good health.
• Of the adult population in the United States, 20.6% still smoke cigarettes.
• The prevalence of diabetes in the United States has doubled in the past 20 years.
• The metabolic syndrome is now thought to be present in 25% to 35% of the adult population in the United States.
• Over one-third of the adult population in the United States has high blood pressure.
• Cardiovascular disease, which remains the leading killer of both men and women in the United States resulting in 37% of all mortality each year, has multiple lifestyle factors as underlying risk factors.
• The choice of an inactive lifestyle increases an individual’s risk of developing heart disease as much as smoking a pack of cigarettes per day.
• Obesity is the leading cause of osteoarthritis in women and the second leading cause in men.
• Obesity is the second leading cause of cancer in the United States and is projected to surpass cigarette smoking in the next decade.
Despite these grim statistics, an impressive body of evidence has also emerged regarding how powerful daily practices, when incorporated into a positive lifestyle, can be in
Preface
lowering risk factors and promoting good health. For example, the Nurses’ Health Study demonstrated that 80% of all heart disease and over 91% of all diabetes in women could be eliminated if they would adopt a cluster of positive lifestyle practices, including maintenance of a healthy body weight (BMI of 19–25 kg/m2), regular physical activity (30 min or more on most days), not smoking cigarettes, and following a few simple nutritional practices such as increasing whole grain and consuming more fruits and vegetables. The U.S. Health Professionals Study showed similar dramatic reduc- tions in men from these same positive behaviors. In fact, if individuals adopted only one of these positive behaviors, their risk of developing coronary artery disease would be cut in half.
Furthermore, proper nutrition has been demonstrated to significantly decrease the likelihood of developing diseases—most prominently, obesity, diabetes, and cancer. Physical activity has been repeatedly shown to lower the risk of heart disease and many cancers. Smoking cessation has been clearly associated with increased risk of cancer and chronic obstructive pulmonary disease. The benefits of smoking cessation are profound and occur rapidly.
Even small amounts of weight loss substantially lower the risk of developing chronic disease. For example, in the Diabetes Prevention Program individuals with baseline glucose intolerance, who increased physical activity and lost 5%–7% of their body weight, reduced their risk of developing diabetes by 58%.
In addition to the adverse health consequences of poor lifestyle decisions, these choices also carry a significant eco- nomic burden. Each year, the United States spends more than $6700 for every man, woman, and child on what is essentially “sickness” care. In contrast, virtually every other industrial economy spends considerably less. For example, Greece, which ranks as the 16th largest economy in the world, spends less than $600 annually for every man, woman, and child on health care. Yet, Greece achieves superior outcomes on virtually every recognized international standard of health outcomes than does the United States. Every other industri- alized economy also spends less money per capita than the United States and often achieves superior health outcomes.
Poor lifestyle choices such as lack of physical activity, poor nutritional choices, smoking cigarettes, and failure to maintain a healthy body weight all represent significant risk factors for such costly diseases as diabetes, coronary artery disease, and cancer. Clearly, until we can make a positive impact on lifestyle measures and practices in modern medical care, we will not solve this enormous financial drain on the American economy as well as the toll of human lives. These facts have been recognized in the recent health care reform debate in the United States and are incorporated into the Accountable Care Organization guidelines.
As the literature relating lifestyle practices and habits has grown deeper and more complex, the challenge for physicians and other health care professionals has become even more daunting to keep abreast of this ever-expanding field and incorporate the findings into the modern medical practice.
This challenge is all the more complex since the literature relating to lifestyle and health is spread over a wide variety of disciplines, journals, and textbooks. The need to summarize the evidence behind lifestyle and health into one comprehensive textbook that spans the field of lifestyle medicine has become clearer as the evidence has become deeper and more persuasive. This is what we have attempted to accomplish with the second edition of Lifestyle Medicine.
I was proud to serve as the editor of the first edition of Lifestyle Medicine that was published in 1999. With this initial comprehensive volume, we coined the term “lifestyle medicine,” summarized key findings across multiple disciplines as they existed in the late 1990s, and launched a new emphasis in medicine related to the links between daily behaviors and outcomes. Subsequently, the field of lifestyle medicine has grown dramatically and has matured significantly. There is now an academic, peer-reviewed journal in lifestyle medicine (the American Journal of Lifestyle Medicine, SAGE Publications). Physician competencies have been published based on the recommendations from major medical groups, including the American Medical Association, the American College of Physicians, the American Academy of Pediatrics, the American College of Sports Medicine, the American College of Preventive Medicine, and others.
In addition, an academic medical society has been established for physicians and other health care workers (the American College of Lifestyle Medicine) and an educational track in lifestyle medicine is now offered at the American College of Preventive Medicine’s annual meeting.
While the field of lifestyle medicine is still in its infancy, there is clearly momentum. It is also clear that the academic discipline relating to short- and long-term health consequences of daily habits and actions will be called lifestyle medicine.
A key consideration for incorporating information and counseling concerning lifestyle and health will be broad acceptance of this imperative in the physician community. While most physicians and other health care professionals support the general concept that physical activity, proper nutrition, weight management, not smoking, and other behaviors profoundly impact on health, incorporation of counseling and information in these areas into the daily practice of medicine has lagged. This is extremely unfor- tunate since multiple surveys have demonstrated that physician recommendation is the leading reason why individuals change actions and habits. Moreover, 75% of the adult population in the United States sees a primary care physician at least once a year. The opportunity to underscore the links between lifestyle habits and practices and health outcomes is, therefore, extremely large.
So what is “lifestyle medicine”? We defined lifestyle medicine in the first edition of this reference book as “the integration of lifestyle practices into the modern practice of medicine both to lower the risk factors for chronic disease and/or, if disease is already present, serve as an adjunct in its therapy. Lifestyle medicine brings together sound, scientific evidence in diverse health related fields to assist the clinician
xxiPreface
in the process of not only treating disease, but also promoting good health.” While this definition was put forth over a decade ago, the connections between daily habits and health outlined in this initial formulation remain the fundamental premise behind the field of lifestyle medicine and the organizing principle behind the second edition of our textbook.
With this definition providing the intellectual framework for the textbook, the second edition of Lifestyle Medicine is divided into 23 parts based on key disciplines related to lifestyle medicine. The second edition is approximately 20% longer than the first edition. All chapters have been funda- mentally rewritten or substantially revised and brought up to date with current understandings and references. Many new chapters and several new parts have been added to reflect the modern understandings and enormous changes that have occurred in lifestyle medicine since the publication of the first edition.
The second edition of Lifestyle Medicine opens with Part I on “Lifestyle Management and Prevention of Cardiovascular Disease.” We chose to open the second edition with an in- depth exploration concerning lifestyle and cardiovascular disease for several reasons. First, I am a cardiologist, and as such, my initial interest in lifestyle practices and health related specifically to measures designed to lower the risk of cardiovascular disease. Second, the area of cardiovascular medicine has been a leader in identifying linkages between lifestyle-related risk factors and risk of heart disease. Third, despite very significant progress in multiple areas of cardiovascular disease, it remains the leading killer of both men and women in the United States. Finally, it seemed appro- priate to open the second edition of Lifestyle Medicine with issues in cardiovascular disease, since the American Heart Association has clearly articulated the central role of lifestyle practices and cardiovascular health as a key component in its strategic plan for the year 2020.
Part II on “Nutritional Aspects of Lifestyle Medicine,” underscores the key role that nutrition plays in multiple aspects of health and disease. This part contains in-depth analyses of the clinical implications of the Dietary Guidelines for Americans 2010 as well as an extensive discussion of how to evaluate nutritional status and nutrient intakes. Special populations are the focus of several chapters, including nutrition for the active adolescent, nutrition for elite athletes, and nutrition for older adults. An important new chapter relates to how nutrition principles and behaviors can be communicated to patients to help them achieve healthy lifestyles. Part III on “Physical Activity and Fitness” provides clinically important information on how to evaluate physical fitness and prescribe exercise. In addition, since physical activity and exercise are so key to positive lifestyle measures and health, there are individual chapters on these behaviors scattered throughout the book in disease- or condition-specific sections.
Part IV on “Behavioral Psychology” starts from the premise that most of the issues related to lifestyle medicine involve approaches to changing behavior. This part provides an outstanding, clinically relevant framework for how to apply psychological theories to the promotion of healthy
lifestyles. These theories have been applied in subsequent chapters within this part to approaches for enhancing adher- ence to exercise prescription, smoking cessation, and weight loss and maintenance.
Part V on “Women’s Health” has been expanded and updated to cover important emerging data in this key area. Chapters on breast health, osteoporosis, and physical activity are complemented by new chapters on menopause, osteoporosis, and wellness coaching for women’s lifestyle choices. Part VI on “Men’s Health” is an entirely new part that addresses key considerations for this medically underserved population. Mental health issues, nutrition for men’s health, and management and prevention of urological diseases as well as health promotion and risk reduction specifically geared toward men are welcome, new, and timely contributions to this important area of the book.
A new part on “Endocrinology and Metabolism” (Part VII) provides in-depth discussions of diabetes, glucose intolerance, and the metabolic syndrome as well as the use of lifestyle measures in their prevention and treatment. Part VIII on “Lifestyle Issues in the Prevention and Treatment of Cancer” is another new part that will be highly relevant to every practicing clinician. Such topics as obesity, physical activity, and nutrition and their role in cancer prevention and treatment are discussed in depth as well as their role in cancer survivorship.
Part IX on “Obesity and Weight Management” remains a key part in our textbook. In a sense, obesity represents the quintessential lifestyle disease since nutrition, exercise, pharmacologic management, and surgery all play significant roles. The linkage between the immune system and infectious disease is also an important and often underappreciated area of both research and clinical application. The role of exercise both in immune function, infections, and aging is ably discussed with current understandings from the research literature in Part X on “Immunology and Infectious Disease.”
Part XI on “Pulmonary Medicine” has been totally reworked with updated chapters on asthma and pulmonary rehabilitation and new chapters on indoor air quality and influenza among others. This expanded part will be of great interest to all clinicians.
“Sports Medicine and Orthopedics” (Part XII) occupy prominent places in lifestyle medicine. The greatly expanded part in these areas focuses not only on injury prevention and treatment, but also on rehabilitation and sports supplements. The new chapter on concussions in sports is particularly timely given the recent emphasis on this underdiagnosed condition both in professional and amateur sports.
Part XIII on “Obstetrics and Gynecology” remains a great strength in this textbook with several new chapters and a complete rewriting and updating of all previous chapters. This part adds further depth and clinical relevance to the expanded commitment to women’s health issues found in this edition of Lifestyle Medicine. Part XIV on “Dermatology” is greatly expanded based on new understandings from research with an emphasis on clinical applications. Particularly important are completely revised
xxii Preface
chapters on sun and the skin, exercise and the skin, and over- all approaches to skin care for the active individual.
Part XV on “Cardiovascular Rehabilitation and Secondary Prevention” complements the opening part on “Lifestyle Management and Prevention of Cardiovascular Disease.” Important advances have occurred both in cardiovascular rehabilitation and the secondary prevention of cardiovascular disease. These topics are admirably discussed with modern evidence-based understandings emphasized.
The power of a positive lifestyle clearly extends into the pediatric population. The modern epidemic of pediatric obesity in the United States and the accompanying dramatic increases in both diabetes and metabolic syndrome in the pediatric population are discussed in detail in the Part XVI on “Lifestyle Components of Pediatric Medicine” as are specific guidelines and recommendations for prescribing pediatric exercise and prevention of osteoporosis. An important new chapter on prenatal influences on future health summa- rizes modern understandings of an emerging area about how the earliest influences on risk factors may occur in utero. The chapter on cholesterol management in children provides an evidence-based discussion to what has become a controver- sial topic.
The greatly expanded Part XVII on “Family Practice” provides a comprehensive approach to how busy family practitioners can integrate lifestyle measures and counseling into their daily practice of medicine. Practical advice and recent evidence concerning exercise and nutritional counseling as well as ehealth resources are all discussed in detail. Part XVIII is a new part on “Lifestyle Medicine and Geriatrics” that corrects a significant omission from the first edition of our textbook. The concept of “successful aging” that has gained considerable momentum in the last decade is discussed in detail as are practical strategies for increasing physical activity in the older population.
The greatly expanded Part XIX on “Epidemiology of Lifestyle-Related Diseases” provides a useful framework for the application of epidemiologic principles to both identify and potentially help ameliorate multiple lifestyle-related problems. Part XX on “Health Promotion” has been greatly expanded to include modern understandings of health promotion in the workplace and managed care. This field has grown exponen- tially in the last 15 years. This part concludes with a provoca- tive chapter on the future of health promotion, taking the reader from current successes in health promotion to an expanded role for corporate health promotion in the future of medicine.
The greatly expanded Part XXI on “Exercise Psychology” moves beyond the part on “Exercise and Sport Psychology,” which was contained in the first edition of Lifestyle Medicine. New tools and new approaches to understanding mind–body interactions as well as the genetic influences on behavior are discussed in detail. Physical activity and its relationship to
anxiety and depression are also thoroughly discussed. A new and important chapter on the impact of physical activity on brain aging and cognitive function is a highlight of this part. A new chapter on how psychological issues help determine the level of physical activity provides new insights for how research can impact on practical application.
Part XXII is a new part on “Injury Prevention” that represents another highlight of the second edition. Injuries are a very significant component of lifestyle medicine and also often underappreciated by practicing clinicians. This part, with an internationally prominent group of contributors, organized by the Division of Unintentional Injury Prevention at the Centers for Disease Control and Prevention, provides a broad approach to research in injury prevention and how it is impacting on the practice of lifestyle medicine.
The final part on “Public Policy and Environmental Supports for Lifestyle Medicine” (Part XXIII) reminds us that we do not practice medicine in a vacuum. Public policy issues concerning health care reform and public and environmental supports for physical activity, healthy eating, and obesity prevention all play important roles in the modern practice of medicine.
The work of generating this comprehensive volume in Lifestyle Medicine involved the talent of 25 outstanding part editors who have devoted great energy and talent to the difficult task of organizing and editing parts to be not only sci- entifically accurate but clinically useful. What has emerged from their efforts and those of the over 200 distinguished contributors is a textbook that I hope and believe will be clinically useful to the practicing health care professional while providing state-of-the-art summaries and practical applications of modern scientific and medical understandings related to the interaction between lifestyle practices, modern medicine, and good health. This dual emphasis can only help all of our patients lead happier, healthier, and more produc- tive lives while lowering their risk of developing the chronic diseases that are so endemic in our society.
Over the last 14 years since the publication of the first edition of Lifestyle Medicine, important new information has emerged to provide the scientific links between daily habits and actions and their impact on short- and long-term health and quality of life. The key consideration now will be for those of us in the health care community to apply these understandings to the modern practice of medicine. This is, in my view, the single greatest opportunity that we have to improve health outcomes and lower costs. This is crucial to bringing additional value to the practice of medicine. It is, in essence, both the challenge and opportunity for the future of lifestyle medicine.
James M. Rippe, MD Boston, Massachusetts
xxiii © 2010 Taylor & Francis Group, LLC
Textbook writing and editing are collaborative efforts. Individuals who have contributed to my thinking about the interaction between lifestyle and health over many years are too numerous to acknowledge all by name. I would, how- ever, like to acknowledge a few individuals who have made particularly important contributions to the second edition of Lifestyle Medicine.
First, I would like to thank my long-time editorial director, Elizabeth Grady, who plays a critically important role in all of the major writing and editing projects that emerge from my research organization. The second edition of Lifestyle Medicine is one of over 40 books that Beth has managed, which have been generated through our organization. In addition, she provides editorial direction to two academic journals that I edit and coordinates a variety of other academic endeavors. Beth’s superb organization skills, hard work, and unfailing good humor make these difficult projects possible.
I would also like to thank the 25 section editors who contributed hard work and outstanding editorial skills to ensure scientific accuracy and clinical relevance for each of the sections of this textbook. I am deeply grateful to all of these individuals. A special thanks also to the more than 200 scientists and clinicians who have contributed chapters to this textbook. These individuals, who are experts in the key fields related to lifestyle medicine, have made invaluable contributions to assemble and explain vast amounts of data in this emerging discipline.
I would also like to express appreciation to my office support staff including my executive assistant, Carol Moreau, who seamlessly coordinates my schedule and travel plans to free up the time necessary for such large writing and publish- ing projects. Our office assistant, Deb Adamonis, assists all of us in multiple daily tasks required to expedite diverse projects in our office, while our chief financial officer, Connie Martell, makes sure that processes are in place for all our projects to move forward smoothly.
The research team at Rippe Lifestyle Institute (RLI) has contributed numerous insights and helped clarify my thinking
on a number of aspects of lifestyle medicine. This team is admirably led by Dr. Ted Angelopoulos, who has been a friend and colleague for many years as well as a coauthor and col- laborator on multiple papers, books, and other projects. Josh Lowndes directs the day-to-day processes and work flow of the research team, while Amy Stachnik coordinates the day- to-day interactions with multiple research sponsors and the patient population of Rippe Health Evaluation, our executive health program. Noy Supaswud, our research office manager and my executive assistant in Florida, does a superb job in coordinating this large research team and my work schedule when I am at our research facilities in this location.
I would like to thank the superb editorial team at Taylor & Francis Group/CRC Press: Randy Brehm, senior editor, who was an early and key supporter of this project; Jessica Vakili, who coordinated all aspects of the publication process and pro- vided important day-to-day leadership and invaluable assistance on multiple issues related to manuscripts; and Ira Wolinsky, who was an early and strong supporter of this project. We would also like to thank Richard Tressider, project editor at Taylor & Francis Group/CRC Press. who managed every step of the production process with expertise, patience and knowledge. Arun Kumar Aranganathan of SPi Global managed the editing, design, and typesetting of this book with great skill.
Finally, I am grateful to my family including my loving wife, Stephanie Hart Rippe, and our four beautiful daugh- ters, Hart, Jaelin, Devon, and Jamie, who continue to love and support me through the arduous process of editing major textbooks and journals and the other diverse professional responsibilities I juggle along with family life.
If there are errors or omissions in Lifestyle Medicine, the responsibility is mine. If there is credit due for this project, it belongs to the numerous people who have made substantial contributions along the way.
James M. Rippe, MD Boston, Massachusetts
Acknowledgments
xxv © 2010 Taylor & Francis Group, LLC
James M. Rippe, MD, is a graduate of Harvard College and Harvard Medical School with postgraduate training at Massachusetts General Hospital. He is currently the founder and director of the Rippe Lifestyle Institute (RLI) and professor of biomedical sciences at the University of Central Florida.
Over the past 25 years, Dr. Rippe has established and run RLI, the largest research organization in the world that explores how daily habits and actions impact short- and long- term health and quality of life. RLI has published hundreds
of papers that form the scientific basis for the fields of lifestyle medicine and high-performance health. It also conducts numerous studies every year on physical activity, risk factor reduction, nutrition, and healthy weight management.
A lifelong and avid athlete, Dr. Rippe maintains his per- sonal fitness with a regular walk, jog, swim, and weight training program. He holds a black belt in karate and is an avid wind surfer, skier, and tennis player. He lives outside of Boston with his wife, television news anchor Stephanie Hart, and their four children, Hart, Jaelin, Devon, and Jamie.
Editor
xxvii © 2010 Taylor & Francis Group, LLC
Ahsan Achtchi, DO Chief Medical Resident Grady Memorial Hospital and J. Willis Hurst Internal Medicine
Residency Program Emory University School
of Medicine Atlanta, Georgia
Brian B. Adams, MD, MPH Associate Professor Department of Dermatology University of Cincinnati School
of Medicine and Chief Dermatology Section Veterans Affairs Medical Center Cincinnati, Ohio
David K. Ahern, PhD Director, Health Information
Technology Resource Center for Aligning Forces for Quality
and Director, Program in Behavioral
Informatics and eHealth Harvard Medical School and Assistant Professor of Psychology Department of Psychology Brigham and Women’s Hospital Boston, Massachusetts
Murad Alam, MD, MSCI Professor of Dermatology,
Otolaryngology, Head, Neck, and Surgery
and Director Northwestern University Feinberg
School of Medicine Chicago, Illinois
Katie R. Amato, BS Graduate Research Assistant Department of Public Health
Sciences John A. Burns School of Medicine University of Hawai’i at Mnoa Honolulu, Hawaii
Joy Anderson, PT, ATC, CSCS Physical Therapist, Athletic Trainer CU Sports Physical Therapy and
Rehabilitation University of Colorado Hospital Denver, Colorado
Lars Bo Andersen, PhD, Dr Med Sci Professor, Head of Department Department of Exercise Epidemiology Center for Research in Childhood Health University of Southern Denmark Odense, Denmark
Theodore J. Angelopoulos, PhD, MPH Professor and Director Laboratory of Applied Physiology Program in Physical Therapy Department of Health Professions University of Central Florida Orlando, Florida
Ross A. Arena, PT, PhD, FAHA Director and Professor Physical Therapy Program Department of Orthopaedics and
Rehabilitation Division of Physical Therapy University of New Mexico School of
Medicine Albuquerque, New Mexico
Katharyn Meredith Atkins, MD Clerkship Director Department of Obstetrics and
Gynecology Beth Israel Deaconess Medical Center Harvard Medical School Boston, Massachusetts
Catherine M. Baase, MD Global Director, Health Services The Dow Chemical Company Midland, Michigan
Jefferson Baer, MD, MPH Assistant Professor of Medicine Department of Medicine The Emory Clinic and Director of Preventive Cardiology Emory University Hospital Midtown Atlanta, Georgia
Said M. Baidas, MD Director, Hematologist/Oncology
Fellowship Program Clinical Professor Florida State University Tallahassee, Florida
and
Cancer Center MD Anderson Cancer Center Orlando Orlando, Florida
Donald Bailey, MA, MSc, PED Professor Emeritus College of Kinesiology University of Saskatchewan Saskatoon, Saskatchewan, Canada
and
School of Human Movement Studies University of Queensland Brisbane, Queensland, Australia
Elizabeth A. Baker, PhD, MPH Professor and Chair Behavioral Science and Health
Education Department of Community Health School of Public Health Saint Louis University
and
Co-Director, Doctoral Program Co-Director, Prevention
Research Center Saint Louis University School of Public Health St. Louis, Missouri
Grant T. Baldwin, PhD, MPH Director Division of Unintentional Injury
Prevention National Center for Injury Prevention
and Control Centers for Disease Control and
Prevention Atlanta, Georgia
Michael F. Ballesteros, PhD Senior Scientist/Epidemiologist Center
for Global Health Centers for Disease Control and
Medicine Cleveland Clinic Cleveland, Ohio
Shari S. Bassuk, ScD Epidemiologist Division of Preventive Medicine Brigham and Women’s Hospital Boston, Massachusetts
Katherine Beals, PhD, RD, FACSM, CSSD Associate Professor (Clinical) Division of Nutrition University of Utah Salt Lake City, Utah
Kathy Berra, MSN, NP-C, FAACVPR, FAAN Cardiovascular Nurse Practitioner Stanford Prevention Research
Center Stanford University School of
Medicine Palo Alto, California
Kristin Bixel, MD Clinical Fellow in Obstetrics,
Gynecology and Reproductive Biology
Beth Israel Deaconess Medical Center
Harvard Medical School Boston, Massachusetts
Gordon Blackburn, PhD Associate Staff Preventive Cardiology and
Rehabilitation Cleveland Clinic Cleveland, Ohio
James A. Blumenthal, PhD Professor of Medical Psychology,
Psychology and Neuroscience Department of Psychiatry and
Behavioral Sciences Duke University Medical Center Durham, North Carolina
Diana Bolotin, MD, PhD Assistant Professor of Medicine and Director, Mohs Micrographic Surgery University of Chicago Medical Center Chicago, Illinois
Rebecca J. Boulos, MPH USDA Doctoral Fellow in Obesity John Hancock Research Center on
Physical Activity, Nutrition, and Obesity Prevention
Friedman School of Nutrition Science and Policy
Tufts University Boston, Massachusetts
Marie-Jo A. Brion, BA, MSc, PhD Sir Henry Wellcome Postdoctoral
Fellow School of Social and Community
Medicine University of Bristol MRC Centre
for Casual Analyses Bristol, United Kingdom
Ulf G. Bronas, PhD, ATC, ATR, FSVM Assistant Professor Director SoN Laboratory of Clinical
Physiology University of Minnesota School of
Nursing and Adult and Gerontological Health
Cooperative Center for Gerontological Nursing Minneapolis, Minnesota
Austin L. Brown, MPH Doctoral Student in Epidemiology Division of Epidemiology, Human
Genetics, and Environmental Sciences
Houston, Texas
Clarence H. Brown, III, MD President Emeritus MD Anderson Cancer Center Orlando and Professor of Medicine University of Central Florida College
of Medicine Orlando, Florida
Peter H. Brubaker, PhD Professor Department of Health and Exercise
Science Wake Forest University and Executive Director Healthy Exercise and Lifestyle
Programs Wake Forest University Winston-Salem, North Carolina
Jennifer Brunet, PhD Assistant Professor School of Human Kinetics University of Ottawa Ottawa, Ontario, Canada
Andrew M. Busch, PhD Assistant Professor (Research) Centers for Behavioral and Preventive
Medicine Alpert Medical School The Miriam Hospital Providence, Rhode Island
Anthony C. Campagna, MD, FCCP Program Director Pulmonary and Critical Care Medicine Lahey Clinic Burlington, Massachusetts
and
Center Harvard Medical School Boston, Massachusetts
xxixContributors
William T. Cefalu, MD Office of Associate Executive Director
for Clinical Research and Joint Diabetes, Endocrinology and
Metabolism Program Pennington Biomedical
and
Sciences Center New Orleans, Louisiana
Catherine M. Champagne, PhD, RD Professor Department of Nutritional
Epidemiology Pennington Biomedical
Research Center Louisiana State University System Baton Rouge, Louisiana
Amy Y.-Y. Chen, MD Department of Dermatology Boston University School of Medicine Boston, Massachusetts
Wojtek J. Chodzko-Zajko, PhD Professor and Head Department of
Kinesiology and Community Health
Urbana, Illinois
Sciences Research Department of Psychiatry and
Behavioral Sciences Stanford University School of Medicine Stanford, California
Stephanie M. Chu, DO Assistant Professor Department of Primary Care Sports
Medicine University of Colorado School
of Medicine Denver, Colorado
David Ciccolella, MD Associate Professor, Medicine Section of Pulmonary
and Critical Care Medicine Department of Medicine Temple University School of
Medicine Philadelphia, Pennsylvania
Joseph T. Ciccolo, PhD Assistant Professor (Research) Centers for Behavioral and Preventive
Matthew M. Clark, PhD Professor of Psychology Department of Psychiatry and
Psychology Mayo Clinic Rochester, Minnesota
Paul M. Coen, PhD Assistant Professor of Health and
Physical Activity Department of Health and Physical
Activity School of Education University of Pittsburgh Pittsburgh, Pennsylvania
Scott R. Collier, PhD, FACSM Assistant Professor Department of Health, Leisure and
Exercise Science and Director Vascular Biology and Autonomic
Studies Lab Appalachian State University Boone, North Carolina
Michelle E. Conroy, MD Assistant Professor of Medicine and
Pediatrics Department of Medicine UMass Memorial Medical Center University of Massachusetts Medical
School Worcester, Massachusetts
Marc D. Cook, MS Graduate Student Department of Kinesiology and
Community Health Exercise Physiology and Immunology University of Illinois at
Urbana-Champaign Urbana, Illinois
and Brain Sciences University of Louisville Louisville, Kentucky
Michael R. Corbett, MA Department of Psychology University of Guelph Guelph, Ontario, Canada
Zaida Cordero-MacIntyre, PhD, PharmD, MPH, REHS, MS, RD Associate Professor Nutrition Department and School of Public Health and Center for Health Disparities &
Molecular Medicine School of Medicine Loma Linda University Loma Linda, California
Victor G. Coronado MD, MPH Medical Officer Division of Unintentional Injury
Medicine University of Central Florida College
of Medicine and Medical Director Emeritus, Diabetes
Institute Florida Hospital Orlando, Florida
xxx Contributors
Gilbert E. D’Alonzo, DO Section of Pulmonary and
Critical Care Department of Medicine Temple University School of Medicine Philadelphia, Pennsylvania
Stephen R. Daniels, MD, PhD Professor and Chairman Department of Pediatrics University of Colorado School of
Medicine and Pediatrician-in-Chief and L. Joseph
Butterfield Chair of Pediatrics Children’s Hospital Colorado Aurora, Colorado
Sean P. David, MD, SM, DPhil Clinical Associate Professor Center for Education and Research in
Family and Community Medicine Stanford University School of
Medicine Stanford, California
and
Center for Education and Research in Family and Community Medicine
Alpert Medical School of Brown University
Providence, Rhode Island
Paul G. Davis, PhD, RCEP Associate Professor Department of Kinesiology University of North Carolina at
Greensboro Greensboro, North Carolina
R. Sue Day, PhD Associate Professor of Epidemiology Division of Epidemiology, Human
Genetics, and Environmental Sciences
Healthy Living The University of Texas School of
Public Health Houston, Texas
Eco J.C. De Geus, PhD Professor Department of Biological Psychology VU University Amsterdam and EMGO + Institute for Health and Care
Research VU University Medical Center
Amsterdam Amsterdam, The Netherlands
Ann M. Dellinger, MPH, PhD Epidemiologist Division of Unintentional Injury
Marleen H.M. de Moor, PhD Assistant Professor Department of Biological
Psychology VU University Amsterdam and EMGO+ Institute for Health and Care
Research VU University Medical Center Amsterdam, The Netherlands
Sybil Dessie, MD Chief Resident Department of Obstetrics and
Gynecology Beth Israel Deaconess Medical
and
Division of Urogynecology Mount Auburn Hospital Harvard Medical School Cambridge, Massachusetts
Nikhil Dhurandhar, PhD Associate Professor Infections and Obesity Laboratory Pennington Biomedical
Research Center Louisiana State University Baton Rouge, Louisiana
Allen L. Dollar, MD, FACC, FACP Chief of Cardiology Grady Memorial Hospital and Associate Professor of Medicine Department of Medicine Division of Cardiology and Medical Director for Cardiovascular
Services Emory University School
of Medicine Atlanta, Georgia
Zoe Diana Draelos, MD Consulting Professor Department of Dermatology Duke University School of Medicine Durham, North Carolina
Kelli Drenner, PhD Department of Kinesiology and Health
Science Stephen F. Austin State University Nacogdoches, Texas
Patricia M. Dubbert, PhD Associate Director for Improving
Clinical Care South Central Mental Illness Research,
Education, and Clinical Center and Psychologist Investigator Little Rock Geriatric Research,
Education, and Clinical Center and Professor Department of Psychiatry University of Arkansas for Medical
Sciences Little Rock, Arkansas
Beth Baughman DuPree, MD, FACS Medical Director Breast Health Program Holy Redeemer Health System and Adjunct Assistant Professor of
Surgery University of Pennsylvania Meadowbrook, Pennsylvania
xxxiContributors
Johanna Dwyer, DSc, RD Senior Nutrition Scientist Office of Dietary Supplements National Institute of Health and Professor Department of Medicine and
Community Health School of Medicine Friedman School of Nutrition Science
and Policy and Senior Scientist Jean Mayer/U.S. Department of
Agriculture Human Nutrition Center on Aging
Tufts University and Director Frances Stern Nutrition Center Tufts Medical Center Boston, Massachusetts
and
Office of Dietary Supplements National Institutes of Health Bethesda, Maryland
Danny J. Eapen, MD Cardiology Fellow Division of Cardiology Department of Medicine Emory University Atlanta, Georgia
Meridith Eastman, BA Doctoral Student Department of Health Behavior and
Health Education Gillings School of Public Health The University of North Carolina at
Chapel Hill Chapel Hill, North Carolina
Charles B. Eaton, MD, MS Professor Department of Family Medicine and
Epidemiology and Director Center for Primary Care and
Prevention Alpert Medical School of Brown
University Memorial Hospital of Rhode Island Pawtucket, Rhode Island
Christina D. Economos, PhD Associate Director John Hancock Research Center on
Physical Activity, Nutrition, and Obesity Prevention
and Associate Professor Friedman School of Nutrition Science
and Policy Tufts University Boston, Massachusetts
Dee W. Edington, PhD Director Health Management Research
Center University of Michigan Ann Arbor, Michigan
Panteleimon Ekkekakis, PhD, FACSM Associate Professor Department of Kinesiology Iowa State University Ames, Iowa
Eman Elkadry, MD Fellowship Director Division of Urogynecology Female
Pelvic Medicine and Reconstructive Surgery
Mount Auburn Hospital Harvard Medical School Cambridge, Massachusetts
and
Eve Essery Stoody, PhD Center for Nutrition Policy and
Promotion U.S. Department of Agriculture Alexandria, Virginia
Bo Fernhall, PhD Dean and Professor College of Applied Health
Sciences University of Illinois Chicago, Illinois
Andrea Fetzer, MS, ATC Certified Athletic Trainer CU Sports Medicine University of Colorado Hospital Denver, Colorado
Jennifer FitzPatrick, MD University of Colorado Boulder, Colorado
Michael G. Flynn, PhD Professor and Department Chair Department of Health and
Human Performance College of Charleston Charleston, South Carolina
John P. Foreyt, PhD Professor Department of Medicine Baylor College of Medicine Research
Center and Director Behavioral Medicine Research
Center Houston, Texas
Maria Wachendorf Fradinho, MD Clinical Fellow Department of Obstetrics and
Marion J. Franz, MS, RD, CDE Nutrition and Health Consultant Nutrition Concepts by Franz, Inc. Minneapolis, Minnesota
Abigail Fraser, PhD, MPH MRC Research Fellow MRC Centre for Casual Analysis
in Translation Epidemiology (CAiTE)
xxxii Contributors
Elizabeth Pegg Frates, MD Assistant Clinical Professor Department of Physical Medicine and
Rehabilitation Harvard Medical School and Director of Medical Student
Education Spaulding Rehabilitation Hospital Institute of Lifestyle Medicine Wellesley, Massachusetts
Barry A. Franklin, PhD, FAHA, FACSM, MAACVPR Director Preventive Cardiology and
Rehabilitation Beaumont Health Center William Beaumont Hospital Royal Oak, Michigan
and
Kim M. Gans, PhD, MPH, LDN Professor Department of Behavioral
and Social Sciences and Director Institute for Community Health
Promotion Brown University Providence, Rhode Island
Carol Ewing Garber, PhD, RCEP, FACSM, FAHA Associate Professor Program in Movement Sciences Department of Biobehavioral Sciences Teachers College Columbia University New York, New York
David O. Garcia, MS Physical Activity and Weight
Management Research Center Department of Health and Physical
Activity University of Pittsburgh Pittsburgh, Pennsylvania
Craig Garfield, MD, MAPP Assistant Professor Department of Pediatrics and Department of Medical Social Sciences Northwestern University Chicago, Illinois
Margery Gass, MD, NCMP Executive Director The North American Menopause
Society and Consultant Cleveland Clinic Center for Specialized
Women’s Health and Clinical Professor Case Western Reserve University
School of Medicine Mayfield Heights, Ohio
Katharina Gaudlitz, MSc Department of Psychiatry and
Psychotherapy Charité—Universitätsmedizin Berlin Berlin, Germany
Andrea Gielen, ScD Professor and Director Johns Hopkins Center for Injury
Research and Policy Baltimore, Maryland
Julie Gilchrist, MD Medical Epidemiologist Division of Unintentional Injury
Kashish Goel, MD Internal Medicine Resident Department of Internal Medicine Detroit Medical Center Wayne State University School of
Medicine Detroit, Michigan
Arnold Goldberg, MD Faculty Associate Department of Family Medicine Lehigh Valley Health Network Allentown, Pennsylvania
Jeanne Goldberg, PhD, RD Professor of Nutrition Friedman School of Nutrition Science
and Policy Boston, Massachusetts
Christopher M. Gonzalez, MD Professor in Urology Northwestern Memorial Hospital Northwestern Medical Faculty
Foundation Chicago, Illinois
Paul M. Gordon, Ph.D., MPH, FACSM, FAHA Associate Professor and Director Laboratory for Physical Activity and Exercise Intervention Research University of Michigan Ann Arbor, Michigan
Gemma Gorham, MPH Project Director Institute for Community Health
Promotion Brown University Providence, Rhode Island
Brendan Gough, PhD Professor of Social Psychology Division of Psychology School of Social Sciences Nottingham Trent University Nottingham, United Kingdom
xxxiiiContributors
Tina A. Greenlee, MS Graduate Teaching Assistant Department of Kinesiology and
Community Health College of Applied Health Sciences University of Illinois at
Urbana–Champaign Urbana, Illinois
Frank R. Greer, MD Professor Department of Pediatrics School of Medicine and Public Health University of Wisconsin and Wisconsin Perinatal Center Meriter Hospital Madison, Wisconsin
Edward W. Gregg, PhD Chief, Epidemiology and
Statistics Branch Division of Diabetes Translation Centers for Disease Control and
Medicine Department of Internal Medicine,
Sports Medicine OSU Athletics The Ohio State University Columbus, Ohio
Elizabeth C.D. Gullette, PhD Senior Faculty Center for Creative Leadership Greensboro, North Carolina
Sadia Haider, MD, MPH Assistant Professor Section of Family Planning Department of Obstetrics and
Gynecology University of Illinois
Medical Center Chicago, Illinois
Julio J. Hajdenberg, MD, FACP Chairman Department of Medical Oncology and
Hematology MD Anderson Cancer Center Orlando Orlando, Florida
Shannon Hamilton, BA Senior Undergraduate Student School of Public Health University of California, Berkeley Berkeley, California
Gregory A. Hand, PhD, MPH Professor Associate Dean for Research and
Practice Arnold School of Public Health University of South Carolina Columbia, South Carolina
Cherise B. Harrington, PhD, MPH Assistant Professor Department of Prevention and
Community Health School of Public Health and Health
Services The George Washington University Washington, District of Columbia
Ladd Harris, MS, RD Athletes’ Performance Phoenix, Arizona
Bradley D. Hatfield, PhD, FACSM, FNAK Professor and Chair Neural and Cognitive Sciences
Program Department of Kinesiology School of Public Health University of Maryland College Park, Maryland
Laura L. Hayman, PhD, MSN Associate Dean for Research Professor of Nursing College of Nursing and Health Sciences and Associate Vice-Provost for
Research University of Massachusetts
Julia Head, MD Clinical Fellow Department of Obstetrics and
Gynecology, and Reproductive Biology Beth Israel Deaconess Medical Center Harvard Medical School Boston, Massachusetts
Gregory W. Heath, DHSc, MPH, FACSM, FAHA Assistant Provost for Research and
Engagement Guerry Professor of Health and Human
Performance and Professor of Medicine
University of Tennessee at Chattanooga and UT College of Medicine, Chattanooga
Chattanooga, Tennessee
Lenore S. Hodges, PhD, RD, CSO, LD/N Outpatient Oncology Dietitian Center for Nutrition Therapy MD Anderson Cancer Center
Orlando Orlando, Florida
Eugene Hong, MD, CAQSM, FAAFP Hamot and Sturgis Endowed Chair Professor Department of Family, Community and
Preventive Medicine Drexel University College of
Medicine Philadelphia, Pennsylvania
Laura D. Howe, MSc, PhD Research Fellow School of Social and Community
Medicine University of Bristol Bristol, United Kingdom
Eileen M. Hsich, MD, FACC Director Heart Failure and Transplantation Cardiovascular Medicine Cleveland Clinic Cleveland, Ohio
Van S. Hubbard, MD, PhD Director Division of Nutrition Research
Coordination National Institutes of Health Bethesda, Maryland
Omer A. Ibrahim, MD Yale School of Medicine New Haven, Connecticut
xxxiv Contributors
Samantha Illangasekare, PhD, MPH Postdoctoral Research Fellow Department of Health, Behavior and
Society Johns Hopkins Bloomberg School of
Public Health Baltimore, Maryland
Psychology Chatham University Pittsburgh, Pennsylvania
Jo Marie Tran Janco, MD Clinical Fellow Department of Obstetrics, Gynecology,
and Reproductive Biology Beth Israel Deaconess
Medical Center Harvard Medical School Boston, Massachusetts
Jason R. Jaggers, MS, PhD Research Associate Department of Exercise Science Arnold School of Public Health University of South Carolina Columbia, South Carolina
John M. Jakicic, PhD Chair and Professor Department of Health and Physical
Activity and Director Physical Activity and Weight
Management Research Center University of Pittsburgh Pittsburgh, Pennsylvania
Ernestine G. Jennings, PhD Assistant Professor (Research) Centers for Behavioral and Preventive
Nattinee Jitnarin, PhD Postdoctoral Fellow National Development and Research
Institutes, Inc. Institute for Biobehavioral Health
Research Leawood, Kansas
and Reproductive Biology Beth Israel Deaconess
Medical Center Harvard Medical School Boston, Massachusetts
Omar R. K

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