Lifestyle Medicine Approach


Written by: Dr. Simon Poole


Major Principles of Lifestyle Medicine

Health and wellness are inextricably linked to the way we live our lives.

Although in recent years we have often come to rely on drugs and medical interventions to treat illness and disease, it has long been understood that the maintenance of a state of good health is dependent to a very large extent on our lifestyle choices. Peoples of ancient cultures were well aware of this relationship and we can read descriptions of lifestyle medicine in early works of philosophy and religion.

Modern lifestyle medicine is broadly defined as an evidence based approach to the advancement of health and wellbeing through promoting the prevention of avoidable lifestyle-related diseases.

“The application of environmental, behavioural, medical and motivational principles to the management (including self care and self-management) of lifestyle-related health problems in a clinical and/or public health setting”1

Health professionals are increasingly advocating the principles of lifestyle medicine as epidemiologists predict a dramatic rise in the burden of chronic illnesses including cardiovascular disease, cancers, hypertension, strokes and obesity. In recognition of this, The World Health Organisation in 2005 called for investment in health promotion to stem the rise in premature deaths and avoid unnecessary disability due to chronic diseases.2

Lifestyle measures which can be advocated with evidence to support healthier lives include good nutrition, physical activity, stress reduction, rest, smoking cessation, and avoidance of alcohol abuse


Wellness is a term which was used in the World Health Organisation’s 1948 Constitution which described health as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.” The pursuit of wellness is regarded as being an active and dynamic process of making choices to achieve the goal of a healthy and fulfilling life. Wellness is not confined to a physical state, but also refers to mind and spirit. Promoting wellness deserves the same scientific rigour as the founding principles of evidence-based lifestyle medicine.

Wellness is dependent on good nutrition but is also supported by regular physical activity, engagement in family and community life, stress reduction and a sense of purpose. The word “diet” is derived from the Greek word “diaita” which means “way of life”. It is useful to think of a diet in this much more holistic way as a means to achieve wellness, rather than as a restrictive way of eating designed to lose weight.


The evidence supporting the benefits of lifestyle choices is well established. More than 90 percent of type 2 diabetes, 80 percent of cardiovascular disease, 70 percent of stroke, and 70 percent of colon cancer cases are potentially preventable by a combination of non-smoking, avoidance of being overweight, moderate physical activity, healthy diet, and moderate alcohol consumption.3

In particular, a Mediterranean style diet rich in Extra Virgin Olive Oil has been shown to be exactly the sort of diet which can provide these benefits.

The Mediterranean Diet was first described by Professor Ancel Keys in research showing lower rates of mortality in communities that adhered to a traditional diet rich in extra virgin olive oil, vegetables, fruit and nuts, wholegrains and legumes with moderate consumption of alcohol and low amounts of red meat.4

The Lyon Heart study demonstrated significantly better outcomes for people with heart disease who adopted a Mediterranean style diet, and the large Greek EPIC study showed further evidence for reduced mortality with higher Mediterranean Diet adherence scores.5,6

Research now demonstrates reduced risk of many diseases including cardiovascular disease, cancers, dementia, parkinsons disease, diabetes and obesity as well as overall mortality with the Mediterranean Diet.7–47

The diet is now widely recommended as a healthy eating pattern. The 2015 US Dietary Guidelines Advisory Committee specifically cited it as a diet of choice and it is advised by governments and public health bodies across the world.48

Extra Virgin Olive Oil and olives contain numerous compounds which have been shown to have powerful antioxidant and anti-inflammatory effects. As an individual component inseparable from the Mediterranean Diet, higher consumption of Extra Virgin Olive Oil has been associated with, a reduction in risk of stroke by as much as 73% and with a 26% and 44% reduction in overall mortality and cardiovascular mortality respectively.49,50

First published in 2013, the Predimed study (Prevención con Dieta Mediterránea), a high quality randomised controlled study compared a Mediterranean Diet supplemented with Extra Virgin Olive Oil with a low-fat diet. The results were compelling, revealing a thirty percent reduction in cardiovascular disease and stroke and the trial was stopped after seven years for ethical reasons when the advantages of the Mediterranean Diet oil became clear. The low fat cohort was recommended to adopt the more healthy Mediterranean diet supplemented with Extra Virgin Olive Oil. Further subset data are emerging showing benefits for other conditions.51

The European Food Safety Authority has recognised the significance of the compound hydroxytyrosol and its derivatives in the protection of LDL cholesterol from oxidative stress, a process considered to be fundamental to the development of symptomatic cardiovascular disease. This has resulted in the acceptance that Extra Virgin Olive Oils with a certain quantity of these compounds are able to carry a specific health claim.52 This claim is: ‘Olive oil polyphenols contribute to the protection of blood lipids from oxidative stress’. Note: The claim may be used only for olive oil which contains at least 5 mg of hydroxytyrosol and its derivatives (e.g. oleuropein complex and tyrosol) per 20 g of olive oil. In order to bear the claim information shall be given to the consumer that the beneficial effect is obtained with a daily intake of 20 g of olive oil.52




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