The alarming state of chronic disease and health inequities exposed during the COVID-19 pandemic has been a wake-up call for people outside the medical community. There is a growing need for people to commit to making lifestyle changes to help prevent chronic conditions such as type 2 diabetes and heart disease. However, patients are often uncertain of what changes they should make to improve their health and well-being.

A path to lasting lifestyle change

Give your patients the advice they need to set and achieve sustainable health goals. Explore AMA's resources to help patients create healthy habits.

Underlying good health is key to better outcomes among those who do acquire SARS-CoV-2, said Dexter Shurney, MD, president of the American College of Lifestyle Medicine. “That's why we see an increase in severity of COVID among those that are unhealthy and have those comorbidities. The same lifestyle issues that increase chronic disease risk also hamper immunity—everything goes together,” he said.

Dexter Shurney, MD
Dexter Shurney, MD

Here is what Dr. Shurney had to say about what lifestyle changes patients should make to reduce chronic disease and improve their health during the pandemic and beyond.

Discover how the pandemic has shined a spotlight on chronic disease prevention priority.

“A whole food, plant-predominant diet is one of the most important things—it’s important because people tend to forget the power that eating ‘real’ food can have on their health,” said Dr. Shurney. “If your child comes to you and says, ‘I want to eat cake and ice cream three times a day,’ you’d say, ‘No, you can’t do that. That’s not healthy.’

“Yet a lot of us fill our bellies every day with junk food that doesn’t really do our body good. In fact, added sugar and unhealthy fats actually harm our bodies,” he added. “Physicians can help by having better conversations about this and really encourage their patients to do better.

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“Plant-predominant is important since it provides the only source of natural fiber, contains no cholesterol, on average is 64 times higher in antioxidants, and if unprocessed—whole food—is lower in calories,” said Dr. Shurney. “Beyond merely recommending they lose weight, give them a plan.”

Learn about four ways to help patients with chronic disease make dietary changes.

“For physical activity, you should do 150 minutes of moderate exercise a week,” said Dr. Shurney. “But it’s not that you have to do everything to the max. Even if you can just stand up more and not sit as much—even that can be quite beneficial.”

With the COVID-19 pandemic, physical activity has been hard for many to obtain, “but if you can just get out and do a brisk walk, there are a lot of benefits,” said Dr. Shurney. “For patients who are getting up in age, walking is just fine, and it is something most of us can do inside or with a mask outside.”

Discover how patients can start—and stick with—key lifestyle changes.

“The sweet spot is actually seven to eight hours of sleep,” said Dr. Shurney. However, people who get less than seven hours of sleep have higher odds of developing type 2 diabetes.

A potential culprit “in our society right now is blue light—which we get from TV, our cellphones and video screens,” he said. “We need to shut those devices down at least 30 minutes before going to bed because blue light depresses our melatonin levels and we need melatonin to fall asleep.

“We also need to increase our exposure to bright light during our waking hours. Sunlight is the best,” added Dr. Shurney. “What this does is depresses our melatonin during the day and allows for a great rise at night when it’s needed for sleep.”

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“Exercise helps us to relax, so that’s always good,” said Dr. Shurney, adding that “if we get outside, we’re going to get our sun, we’re going to get our exercise and it’s going to relax us. It all works together.”

“The other thing we can do is we can learn how to control our breathing,” he said. By spending “10 minutes on a breathing exercise in the morning and in the afternoon, it will calm us down.”

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Avoiding risky substances like alcohol and smoking can also go a long way. But the approach to getting someone to quit “varies from individual to individual and that’s true for all motivation to effect lifestyle behavior change,” said Dr. Shurney. For smoking, “it’s a matter of trying to frame the conversation so patients believe that they’re going to see not only long-term benefits, but short-term benefits as well, and that they can be successful.”

“We always seem to place smoking in this category of stop today so that 20 years from now you don’t die from lung cancer or COPD [chronic obstructive pulmonary disease]. Twenty years is a long time in the future,” said Dr. Shurney, adding that “we need to show people that there are short-term benefits.”

Learn about the eight things physicians should know about the latest on smoking cessation.

It is even more imperative during the pandemic to maintain positive social connections, especially when stay-at-home orders and physical distancing requirements remain across the country.

“It’s been reported that social isolation and loneliness can be devastating to our health. In fact, loneliness has the negative health effect of smoking up to 15 cigarettes a day,” said Dr. Shurney. “Additionally, it’s important that we gravitate to positive relationships.” 

“If I introduce you to six positive people, you’re going to be the seventh,” he said. “If I introduce you to six negative people, you’ll probably be the seventh. We need to guard ourselves from that.”

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