Integrating lifestyle medicine in clinical care

Abstract

This thesis explores the integration of lifestyle medicine in clinical care in different ways. We underscore the importance of a healthy lifestyle in improving the prognosis in infection diseases such as COVID-19. Furthermore, we test practical examples to improve preventive medicine in and around hospitals. We show that pressuring healthcare professionals does not lead to increased referrals to smoking cessation counselling. On the other hand, using de Stopcoach, an app to support smokers in their quit attempt, in combination with smoking cessation counselling, is associated with a higher success rate. Notably, this effect is also sustained in people with lower socioeconomic position. Regarding diet, we show that hospitals dietary policies are far from perfect. We develop a questionnaire to ask after intention to eat healthy, and we provide a simple and effective way to help hospitalized patients choose healthier options from a set menu. Lastly, we develop the Diabetes Box, a healthcare pathway supported with an app and wearables, that aims to provide people with diabetes with insight into their glucose regulation. Subsequently, we offer personal guidance to improve health behavior regarding sleep, stress, diet and exercise.