http://www.amjmed.com/webfiles/images/journals/ajm/AJMJune09King.pdf

ABSTRACT 

BACKGROUND: Lifestyle choices are associated with cardiovascular disease and mortality. The purpose of 

this study was to compare adherence to healthy lifestyle habits in adults between 1988 and 2006. 

METHODS: Analysis of adherence to 5 healthy lifestyle trends (5 fruits and vegetables/day, regular 

exercise 12 times/month, maintaining healthy weight [body mass index 18.5-29.9 kg/m2], moderate 

alcohol consumption [up to 1 drink/day for women, 2/day for men] and not smoking) in the National 

Health and Nutrition Examination Survey 1988-1994 were compared with results from the National Health 

and Nutrition Examination Survey 2001-2006 among adults aged 40-74 years. 

RESULTS: Over the last 18 years, the percent of adults aged 40-74 years with a body mass index 30 kg/m2 

has increased from 28% to 36% (P .05); physical activity 12 times a month or more has decreased from 

53% to 43% (P .05); smoking rates have not changed (26.9% to 26.1%); eating 5 or more fruits and 

vegetables a day has decreased from 42% to 26% (P .05), and moderate alcohol use has increased from 

40% to 51% (P .05). Adherence to all 5 healthy habits has gone from 15% to 8% (P .05). Although 

adherence to a healthy lifestyle was lower among minorities, adherence decreased more among non- 

Hispanic Whites over the period. Individuals with a history of hypertension/diabetes/cardiovascular disease 

were no more likely to be adherent to a healthy lifestyle than people without these conditions. 

CONCLUSIONS: Generally, adherence to a healthy lifestyle pattern has decreased during the last 18 years, 

with decreases documented in 3 of 5 healthy lifestyle habits. These findings have broad implications for 

the future risk of cardiovascular disease in adults. 

© 2009 Elsevier Inc. All rights reserved. 

• The American Journal of Medicine (2009) 122, 528-534 

What is Alternative and Integrative Medicine?

 Rather than focusing on the discussion of the benefits and drawbacks of different modalities such as homeopathy and aromatherapy when compared to the ever changing standard of care through pharmaceuticals and surgery, we can look at the two information processing models that are involved in diagnosis and treatment planning:  Holism and Reductionism.  Both information processing models are equally vital in discerning a correct diagnosis and in developing an effective treatment plan.  

Both models must be used in concert to best navigate a path to optimal health.  And on that path there are many options: pharmacotherapy, nutritional therapy, exercise therapy, aromatherapy and acupuncture to name a few.  When we look at these as options along the path rather than as paths themselves, we are putting the focus on the place where it needs to be:  the patient's needs.  Some patients respond well to pharmacotherapy, some do not, some respond well to aromatherapy, some do not.  The point is that there is a vast array of options for a patient who is seeking optimal health and the patient is the person best qualified to discern what is best for them.  The role of the practitioner is to act as guide and educator to the patient whose life is his own responsibility to care for.

Coming back to the central question that must be effectively addressed by any healthcare provider: why do people choose habits that are detrimental to their health?  This is the core question of addiction, arguably the results of which are the number one public health crisis facing America today.  Addressing this issue requires less of a medical solution than it requires a social solution.  How to we prevent isolation and self-loathing?  This requires a much deeper investigation into our social values and community networks.