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In this video, Elizabeth Simkus, DNP, FNP-C, of the Rush University Prevention Center in Chicago, offers tips on how healthcare providers can address positive lifestyle changes with patients, and what lies ahead for preventive healthcare.

The following is a transcript of her remarks:

It's difficult, a lot of times, to change habits or to make lifestyle changes. So one of the main things that I will do with patients is identify the 'why' -- why it is important to them to make lifestyle changes in order to address [them].

Some people will say 'Well, I'm prediabetic, or I'm diabetic, and I saw my grandma or my mom or whomever go through that disease and have complications related to that, and I don't want to go down that road.' Or I'll have people who say 'I want to live long enough to see my children graduate from college, or my grandkids grow up.' When someone has a personal motivating factor, or a reason why it's important to them, then it's easier -- because we're human and we're not going to be perfect -- but when we have that background 'why' in the back of our minds, it's going to be easier to stay on track, or to get back on track when we fall off.

So that can be really helpful when people are making a lifestyle change or changing a habit. The other one is, I'll work a lot with patients on just mindfulness or presence and being aware of what you're doing. Sometimes some of these habits, related to candy or related to food or whatever the habit that we're trying to change is that it's an automatic thing that we reach for when we're either stressed or we're sad or we're tired, and so bringing awareness to the habit, and identifying areas or tweaks that we can make in order to break the habit, then that can be a way to implement change and be able to change that habit for the better.

A lot of times when my patients leave my office, I want them to feel empowered; to know that just small changes in a variety of different areas in their lifestyle can make a big difference on their health. So again, small tweaks and changes in diet, maybe cutting out the sugar-sweetened beverages, the soda, the juice, the Gatorade, and adding in more water; putting in more fruits and vegetables. We can still eat the foods that we're accustomed to or that culturally, what we like to eat, but if we can tweak and modify in order to improve the nutritional density and reduce the caloric density -- if there's an issue with weight management -- then that can make a big difference.

Focusing on physical activity. Some people think 'Well, I'm not going to go to the gym. It's just not realistic for me.' Then that's fine. We're going to work with you and what is in your lifestyle, even if we split it up to where you do 10-minute walks three times a day, or we build up to doing 30 minutes a day, most days of the week, of moderate physical activity or cardiovascular physical activity like brisk walking or bike riding, and then adding in some strengths training, which I feel like is commonly missed or not thought about as much. But as we age, we tend to lose lean muscle mass, and then that can put us more at risk for developing diabetes or other chronic conditions. Plus, in the elderly population, we want to keep our strength and mobility and prevent falls. So for physical activity, small tweaks and changes.

Our sleep, making sure we're addressing any disordered sleeping, like sleep apnea or insomnia, or being able to meet those minimum recommendations of 7 hours a night of good quality sleep is going to help with our overall health-related goals.

Stress kind of wreaks havoc on our bodies as well. It's not that we're going to be able to remove stress from our life, that's not realistic, but if we can manage it more effectively through journaling, meditation, listening to music, exercise, prayer, or whatever it is that works for those patients. If we can manage the stress that we're going through better, that's going to impact our physical health in a positive way as well.

And then lastly, our mood and our social connectedness and family and community, those too, there's a lot of evidence that [connectedness] plays into our overall physical and mental health. So kind of approaching it from all of the different angles and making those small tweaks and changes can really have a positive impact on somebody's quality of life.

You think of that quote that people say: 'An ounce of prevention is worth a pound of cure.' It's so true. I wish -- and we're starting to change in healthcare -- but I feel like our healthcare system is very reactive. We're great at saving someone from a heart attack, or you rehabbing them after a stroke or something like that. But focusing on prevention is key in being able to improve the health of our entire country.

When we're able to focus on prevention instead of reacting and trying to cure something with medication -- almost just putting a Band-aid on it -- but [we're] getting at the root cause of a lot of these chronic conditions, which can be addressed through lifestyle... I'm very excited about the opportunity of growth for lifestyle medicine.

If you look at the guidelines, some of the standards of care in diabetes from the or the guidelines, the first-line treatment is lifestyle, and yet our healthcare system in the current model fee-for-service and with the number of patients and short visits that a lot of primary care providers get, it's not possible for them to focus on lifestyle as much as we do in lifestyle medicine.

So I'm really excited about the opportunity to grow the field and to be able to provide that preventive health, healthcare for our patients and for the population.

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