3rd Edition

Lifestyle Medicine, Third Edition

Edited By James M. Rippe Copyright 2019
    1471 Pages 179 B/W Illustrations
    by CRC Press

    The field of lifestyle medicine, which is the study of how daily habits and actions impact on both short- and long-term health and quality of life, continues to expand globally. The scientific and medical literature that supports the success of these lifestyle habits and actions is now overwhelming. Thousands of studies provide evidence that regular physical activity, maintenance of a health body weight, following sound nutritional practices, stress reduction, and other good practices all profoundly impact both health and quality of life.

    Following its predecessors, Lifestyle Medicine, Third Edition, is edited by lifestyle medicine pioneer, cardiologist Dr. James Rippe. This edition has been thoroughly updated and represents the expert opinions of 20 section editors as well as more than 150 expert chapter authors whose knowledge span all aspects of this emerging discipline. Topics cover lifestyle medicine practices including regular physical activity, proper nutrition, and weight management. These principles are applied to the prevention and or treatment of a wide variety of chronic conditions ranging from heart disease and diabetes to cancer, mental health, addiction, and injury prevention.

    This book serves as evidence base for individuals who wish to practice lifestyle medicine or incorporate some of its principles into either general medicine or subspecialty practice. It provides valuable information to healthcare workers in the fields of nutrition, exercise physiology, psychology, behavioral medicine, health promotion, and public policy where lifestyle medicine principles play an ever-increasing role.

    Part I Lifestyle Management and Prevention

    of Cardiovascular Disease

    Chapter 1: The Rationale for Intervention to Reduce

    the Risk of Cardiovascular Disease

    James M. Rippe and Theodore J. Angelopoulos

    Chapter 2: Lifestyle Strategies for Risk Factor

    Reduction, Prevention and Treatment of

    Cardiovascular Disease

    James M. Rippe and Theodore J. Angelopoulos

    Chapter 3: Physical Activity and Fitness in the

    Prevention of Cardiovascular Disease

    Robert F. Zoeller Jr.

    Chapter 4: Clinical Strategies for Managing


    Ulf G. Bronas, Mary Hannan, and Arthur S. Leon

    Chapter 5: Lifestyle Management and Prevention of


    Ulf G. Bronas, Mary Hannan, and Arthur S. Leon

    Part II Nutritional Aspects of Lifestyle Medicineart II: Nutritional Aspects of Life

    Chapter 6: The Concept of Nutritional Status and Its


    Johanna Dwyer and Regan L Bailey

    Chapter 7: Dietary Guidelines for Americans,

    2015–2020: National Nutrition Guidelines

    Elizabeth B. Rahavi, Jean M. Altman, and Eve E. Stoody

    Chapter 8: Nutrition and Cardiovascular Disease

    James M. Rippe

    Chapter 9: Optimal Nutrition Guidance for Older Adults

    Alice H. Lichtenstein

    Chapter 10: Effects of an Active Lifestyle on Water

    Balance and Water Requirements

    Gethin H Evans, Ronald J Maughan, and Susan M Shirreffs

    Part III Physical Activity Part III: Physical Activity

    Chapter 11: Implementation of the Exercise


    Rachele M Pojednic, Caroline R Loveland, and Sarah Jones

    Chapter 12: What Physicians Need to Know, Do, and

    Say to Promote Physical Activity

    Mary Kennedy

    Chapter 13: Physical Fitness Evaluation

    Peter Kokkinos and Jonathan Myers

    Chapter 14: Exercise Prescription for Apparently

    Healthy Individuals and for Special Populations

    Paul G. Davis

    Part IV Behavioral Medicine Part IV: Behavioral Medicine

    Chapter 15: Behavior Change

    Elizabeth Pegg Frates and James E. Eubanks

    Chapter 16: Applying Psychological Theories to

    Promote Healthy Lifestyles

    Maryam Gholami, Cassandra Herman, Cole

    Ainsworth, Dori Pekmezi, and Sarah Linke

    Chapter 17: Motivational Interviewing and Lifestyle


    Peter Fifield, Joji Suzuki, Samantha Minski, and

    Jennifer Carty

    Chapter 18: Transtheoretical Model

    James O. Prochaska and Janice Prochaska

    Chapter 19: The Impact of Positive Psychology on

    Behavioral Change and Healthy Lifestyle Choices

    Shelley Carson, Andrea Cook, Stephanie Peabody,

    Sandra Scheinbaum, and Leslie Williamson

    Chapter 20: The Intention–Behavior Gap

    Mark D. Faries and Wesley C. Kephart

    Chapter 21: Cognitive and Behavioral Approaches

    to Enhancing Physical Activity Participation and

    Decreasing Sedentary Behavior

    Barbara A. Stetson and Patricia M. Dubbert

    Chapter 22: Enhancing the Nutrition Prescription

    Using Behavioral Approaches

    Margaret Loeper Vasquez, Jenny Sunghyun Lee,

    Daniel B. Clarke, and P. Michael Stone

    Chapter 23: Behavioral Approaches to Manage Stress

    Elise Loiselle, Darshan Mehta, and Jacqueline Proszynski

    Chapter 24: Health Coaching and Behavior Change

    Karen L. Lawson, Margaret Moore, Matthew M.

    Clark, Sara Link, and Ruth Wolever

    Chapter 25: Digital Health Technology for Behavior


    Jeffrey Krauss, Patricia Zheng, Courtenay Stewart,

    and Mark Berman

    Part V Women’s HealthPart V: Women’ s Health

    Chapter 26: Breast Health: Lifestyle Modification for

    Risk Reduction

    Beth Baughman DuPree and Jodi Hutchinson PA-C

    Chapter 27: Sports and Physical Activity for Women

    and Girls

    Elizabeth Joy

    Part VI Endocrinology and Metabolism art VI: Endocrinology and Metabolism

    Chapter 28: Impact of Lifestyle Medicine on

    Dysglycemia-Based Chronic Disease

    Michael A. Via and Jeffrey I. Mechanick

    Chapter 29: Lifestyle Medicine and the Management

    of Prediabetes

    Karla I. Galaviz, Lisa Staimez, Lawrence S. Phillips,

    and Mary Beth Weber

    Chapter 30: Lifestyle Therapies for the Management

    of Diabetes

    Marion J. Franz

    Chapter 31: Implementing Nutritional Lifestyle

    Treatment Programs in Type 2 Diabetes

    George Guthrie

    Part VII Lifestyle Issues in the Prevention and Treatment of Cancerrt revention and

    Chapter 32: Diet and Cancer Prevention

    Cindy D. Davis and Sharon Ross

    Chapter 33: Lifestyle Approaches Targeting Obesity

    to Reduce Cancer Risk, Progression, and Recurrence

    Debora S. Bruno and Nathan A. Berger

    Chapter 34: Physical Activity and the Prevention and

    Treatment of Cancer

    Case H. Keltner and Heather R. Bowles

    Chapter 35: Nutrition Therapy for the Cancer Patient

    Sandeep (Anu) Kaur and Elaine Trujillo

    Part VIII Obesity and Weight Management art VIII: Obesity and Weight Management

    Chapter 36: Epidemiology of Adult Obesity

    R. Sue Day, Nattinee Jitnarin, Michelle L. Vidoni,

    Christopher Kaipust, and Austin L. Brown

    Chapter 37: Exercise Management for the Obese


    John M. Jakicic, Renee J. Rogers, and Katherine A. Collins

    Chapter 38: Dietary Management of Overweight and


    Nina Crowley, Katherine R. Arlinghaus, and Eileen

    Stellefson Myers

    Chapter 39: Pharmacological Management of the

    Patient with Obesity

    Magdalena Pasarica and Nikhil V. Dhurandhar

    Chapter 40: Surgery for Severe Obesity

    Robert F. Kushner and Lisa M. Neff

    Chapter 41: Adiposity-based Chronic Disease a New

    Diagnostic Term

    Michael A. Via and Jeffrey I. Mechanick

    Chapter 42: Future Directions in Obesity and Weight


    Theodore K. Kyle

    Part IX Immunology and Infection DiseasePart IX: Immunology and Infectious Disease

    Chapter 43: Exercise, Inflammation, and Respiratory


    Wesley D. Dudgeon, David C. Nieman, and

    Elizabeth Kelley

    Chapter 44: Chronic Exercise and Immunity

    Melissa M. Markofski, Paul M. Coen, and Michael

    G. Flynn

    Chapter 45: HIV and Exercise

    Jason R. Jaggers and Gregory A. Hand

    Chapter 46: Exercise, Aging, and Immunity

    Jeffrey A. Woods, Yi Sun, and Brandt D. PencePart X: Pulmonary Medicine

    Part X Pulmonary Medicine

    Chapter 47: Respiratory Symptoms

    Jeremy B. Richards and Richard M. Schwartzstein

    Chapter 48: Asthma

    David E. Ciccolella and Gilbert E. D’Alonzo

    Chapter 49: Occupational and Environmental Lung


    Sunkaru Touray, Emil Tigas, and Nicholas S. Smyrnios

    Chapter 50: Venous Thromboembolic Disease

    Joseph Gallant and Ryan Shipe

    Chapter 51: Influenza

    Gail Scully

    Chapter 52: Indoor Air Quality

    Anthony C. Campagna and Dhruv Desai

    Part X Obstetrics and Gynecology

    Chapter 53: Antenatal Care—Nutrition and Lifestyle

    to Improve Conception and Pregnancy Outcomes

    Amanda McKinney

    Chapter 54: Exercise in Pregnancy

    Kristin Bixel and Christie Beck

    Chapter 55: Breast-FeedingJulia Head, Stephanie-Marie L. Jones, Marcie K.

    Richardson, and Angela Grone

    Chapter 56: Contraception

    Karen Carlson and Sadia Haider

    Chapter 57: Prevention, Screening, and Treatment of

    Sexually Transmitted InfectionsKaren Carlson

    Chapter 58: Menstrual Disorders and Menopause

    Amanda McKinney

    Chapter 59: Risk Reduction and Screening for

    Women’s Cancers

    Amanda McKinney and Jo Marie Tran Janco

    Part XII Cardiovascular Rehabilitation and Secondary Prevention

    Chapter 60: Medication Dosing and Adherence in

    Secondary Prevention

    Ozlem Bilen and Nanette K. Wenger

    Chapter 61: Using Digital Health Technology to

    Promote Cardiovascular Disease Risk Reduction in

    Secondary Prevention

    Neil F. Gordon, Richard D. Salmon, Mandy K.

    Salmon, and Prabakar Ponnusamy

    Joel W. Hughes and David Ede

    Chapter 62: Psychosocial Risk Factors as

    Modulators of Cardiovascular Outcomes in

    Secondary Prevention

    Joel W. Hughes and David Ede

    Chapter 63: A Patient’s Perspective on the Keys

    to Longevity 40 Years after Undergoing Coronary

    Artery Bypass Surgery

    Joseph C. Piscatella

    Chapter 64: Lipid Management in Secondary


    Paul D. Thompson and Antonio B. Fernandez

    Chapter 65: Complementary Effects of Lifestyle

    Modification on Cardioprotective Medications in

    Primary/Secondary Prevention

    Xisui Shirley Chen and Philip Greenland

    Chapter 66: Counseling Cardiac Patients to Facilitate

    Behavior Change

    Lola A. Coke, Nancy Houston Miller, and Kathy Berra

    Chapter 67: Extreme Exercise and High Intensity

    Interval Training in Cardiac Rehabilitation

    Barry A. Franklin

    Chapter 68: Counseling Coronary Patients About

    Their Body Weight: Implications Regarding the

    Obesity Paradox

    Sergey Kachur, Carl J. Lavie, and Richard V. Milani

    Chapter 69: Vitamins and Supplements: Evidence

    in the Prevention and Treatment of Cardiovascular


    Jenna M. Holzhausen and Aaron D. Berman

    Chapter 70: Intensive Cardiac Rehabilitation:

    Evolution, Preliminary Outcomes, Considerations,

    and Future Directions

    Jenna Brinks and Amy Fowler

    Chapter 71: Alternative Models to Improve the

    Delivery and Impact of Cardiac Rehabilitation

    Randal J. Thomas, Robert Scales, and Regis Fernandes

    Chapter 72: Primordial/Primary Prevention:

    Implications and Challenges for Families and Children

    Laura L. Hayman and James Muchira

    ParPart XIII: Lifestyle Components of Pediatric Medicine

    Part XIII Lifestyle Components of Pediatric Medicine

    Chapter 73: Pediatric Lifestyle Medicine

    Jonathan R. Miller, Richard Boles, and Stephen R. Daniels

    Chapter 74: Life Course Approach to Prevention of

    Chronic Disease

    Katherine A. Sauder and Dana Dabelea

    Chapter 75: Cardiovascular Risk and Physical

    Activity in Children

    Lars Bo Andersen and Robert G. Murray

    Chapter 76: Cardiovascular Risk and Diet in Children

    Jessica L. Hildebrandt and Sarah C. Couch

    Chapter 77: Sleep and Obesity Prevention in

    Children and Adolescents

    Jill Landsbaugh Kaar and Stacey L. Simon

    Chapter 78: Childhood Obesity

    Jaime Moore and Matthew Allen Haemer

    Chapter 79: Identification and Management of

    Children with Dyslipidemia

    Julie A. Brothers and Stephen R. Daniels

    Chapter 80: Diagnosis, Management, and Treatment

    of Systemic Hypertension in Youth, Updates from

    the 2017 American Academy of Pediatrics Clinical

    Practice Guideline

    Carissa M. Baker-Smith and Samuel Gidding

    Chapter 81: Prevention of Osteoporosis in Children

    and Adolescents

    Heidi J. Kalkwarf

    Part XIV: The Practice of Lifestyle Medicine

    Parrt XIV The Practice of Lifestyle Medicine

    Chapter 82: Definition of Lifestyle Medicine

    George Guthrie

    Chapter 83: Health Provider Core Competencies in

    Lifestyle Medicine

    Liana Lianov

    Chapter 84: Lifestyle Medicine Clinical Processes

    Ingrid Edshteyn

    Chapter 85: Sleep as Medicine and Lifestyle

    Medicine for Optimal Sleep

    Virginia F. Gurley

    Chapter 86: Emotional Health and Stress


    Neil Nedley and Francisco E Ramirez

    Chapter 87: High-intensity Therapeutic Lifestyle


    John Kelly

    Chapter 88: Physician Health Practices and Lifestyle


    Erica Frank and Debora Holmesrt XV: Cardiovascular Rehabilitation

    and Secondary Prevention

    Part XV Substance Abuse and Addiction

    Chapter 89: Introduction to Addiction Section

    Joji Suzuki, Elizabeth Pegg Frates, and Irena Matanovic

    Chapter 90: History of Alcohol and Opioid Use and

    Treatment in the United States

    Sanchit Maruti and Steven A. Adelman

    Chapter 91: Behavioral Approaches to Enhancing

    Smoking Cessation

    Joseph T. Ciccolo, Nicholas J. SantaBarbara, and

    Andrew M. Busch

    Chapter 92: Alcohol Use Disorders: Diagnosis and


    Chwen-Yuen Angie Chen and Sara C. Slatkin

    Chapter 93: Diagnosis and Treatment of Opioid Use


    Joseph R. Volpicelli

    Chapter 94: Cannabis Use Disorder and Treatment

    Christina Aivadyan and Deborah Hasin

    Chapter 95: Smartphone-Based Technologies in

    Addiction Treatment

    Emily Wu and John Torous

    Chapter 96: Psychosocial Interventions for

    Treatment of Substance Use Disorders

    Saria El Haddad Medicine in Geriatrics

    Part XVI Lifestyle Medicine in Geriatrics

    Chapter 97: Lifestyle Medicine and the Older

    Population: Introductory Framework

    Arthur S. Leon and Charlotte A. Tate

    Chapter 98: Reducing Aging-associated Risk of


    Arthur S. Leon

    Chapter 99: Aging-Associated Cognitive Decline and

    its Attenuation by Lifestyle

    Arthur S. Leon

    Chapter 100: Aging Successfully: Predictors and


    Debra J. Rose,

    Chapter 101: Role of Physical Activity in the Health

    and Wellbeing of Older Adults

    Andiara Schwingel and Wojtek J. Chodzko-Zajko XVII: Health Promotion

    Part XVII Health Promotion

    Chapter 102: Health Promotion Introduction

    By Dee Edington

    Chapter 103: Health Promotion: History and

    Emerging Trends

    M. Parkinson

    Chapter 104: The Employer’s Role in Lifestyle


    Dexter Shurney

    Chapter 105: Why, How, and What in Leveraging the

    Value of Health

    Ron Loeppke

    Chapter 106: International Health & Lifestyle

    Wayne N. Burton

    Chapter 107: The Community as a Catalyst for

    Healthier Behaviors

    Jane Ellery and Peter Ellery

    Chapter 108: Motivation as Medicine

    Jennifer S. Pitts

    Chapter 109: Future Directions of Health Promotion:

    Role of the Physician

    Alyssa B. SchultzPart XVIII: Exercise Psychology

    Part XVIII Exercise Psychology

    Chapter 110: My, How Those Seedlings Have

    Grown: An Update on Mind/Body Interactions in the

    Exercise Domain

    Steven J. Petruzzello, Allyson G. Box, and Dakota G.


    Chapter 111: Genetic Influences on Regular Exercise


    Matthijs D. van der Zee, Nienke Schutte, and

    Marleen H.M. de Moor

    Chapter 112: The Influence of Physical Activity on

    Brain Aging and Cognition: The Role of Cognitive

    Reserve, Thresholds for Decline, Genetic Influence,

    and the Investment Hypothesis

    Maureen K. Kayes and Bradley D. Hatfield

    Chapter 113: Physical Activity and Anxiety

    Katharina Gaudlitz, Brigitt-Leila von Lindenberger,

    and Andreas Ströhle

    Part XIX Injury Prevention

    Chapter 114: Physical Activity and Depression

    Kayla N. Fair and Chad D. RethorstPartXIX: Injury Prevention

    Chapter 115: Injuries and Lifestyle Medicine

    David A. Sleet

    Chapter 116: Traffic Injury Prevention: Strategies

    That Work

    Ann Dellinger, David A. Sleet, and Merissa A. Yellman

    Chapter 117: Review and Implementation of the CDC

    Guideline for Prescribing Opioids for Chronic Pain

    LeShaundra Cordier and Helen Kingery

    Chapter 118: Improving the Care of Young Patients

    with Mild Traumatic Brain Injury: CDC’s Evidence-

    Based Pediatric Mild TBI Guideline

    Kelly Sarmiento, Angela Lumba-Brown, Matthew

    Breiding, Wayne Gordon, David Paulk, Kenneth

    Vitale, and David Sleet

    Chapter 119: Older Adult Falls: Epidemiology and

    Effective Injury Prevention Strategies

    Ann Dellinger, David A. Sleet, and Jeanne Nichols

    Chapter 120: Prevention of Suicidal Behavior

    Alex E. Crosby, Deborah M. Stone, and Kristin Holland

    Chapter 121: Unintentional Injuries to Disabled

    Persons: An Unrecognized Yet Preventable Problem

    Louis Hugo Francescutti, David Sleet, Linda Hill,

    and Henry Xiang XX


    Part XX Public Policy and Environmental Supports for Lifestyle Medicine

    Chapter 122: Lifestyle Medicine in an Era of

    Healthcare Reform— Seven Years of Healthcare

    Disruption: 2010– 2017

    Aaron F. Hajart, Sandra Weisser, Gary B. Wilkerson,

    and Gregory W. Heath

    Chapter 123: Policy and Environmental Supports for

    Physical Activity and Active Living

    Elizabeth A. Dodson and Gregory W. Heath

    Chapter 124: Policy and Environmental Supports for

    Healthy Eating

    Charlene Schmidt, Emily Maddux, and Elizabeth


    Chapter 125: Building Strategic Alliances to Promote

    Healthy Eating and Active Living

    Risa Wilkerson, Elizabeth A. Baker, Matt M.

    Longjohn, Kara Hamilton, Shewanee Howard-

    Baptiste, and Hahn Kori

    Chapter 126: Obesity and Health: For Lifestyle Medicine,

    Third Edition

    By James M. Rippe and Theodore J. Angelopoulos


    James Rippe, MD, is a graduate of Harvard College and Harvard Medical School with post graduate training at Massachusetts General Hospital. He is currently the Founder and Director of the Rippe Lifestyle Institute and Professor of Biomedical Sciences at the University of Central Florida.

    Over the past 25 years, Dr. Rippe has established and run the largest research organization in the world exploring how daily habits and actions impact short and long-term health and quality of life. This organization, Rippe Lifestyle Institute (RLI), has published hundreds of papers that form the scientific basis for the fields of lifestyle medicine and high performance health. RLI also conducts numerous studies every year on nutrition and healthy weight management. One recent research interest of the RLI team has been the metabolism and health effects of sugars.

    A lifelong and avid athlete, Dr. Rippe maintains his personal fitness with a regular walking, jogging, swimming, 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.