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  2. Keyword: Holistic Health
The Six Pillars of Lifestyle Medicine in Managing Noncommunicable Diseases – The Gaps in Current Guidelines
ABC
Review Article

The Six Pillars of Lifestyle Medicine in Managing Noncommunicable Diseases – The Gaps in Current Guidelines

Rafaella Rogatto de Faria et al. Sergio Freitas de Siqueira Francisco Aguerre Haddad Gustavo Del Monte Silva … Caio Vitale Spaggiari Martino Martinelli Filho

Abstract

Background:

Noncommunicable diseases (NCDs), also known as chronic diseases that are long-lasting, are considered the major cause of death and disability worldwide, and the six pillars of lifestyle medicine (nutrition, exercise, toxic control, stress management, restorative sleep, and social connection) play an important role in a holistic management of their prevention and treatment. In addition, medical guidelines are the most accepted documents with recommendations to manage NCDs.

Objective:

The present study aims to analyze the lack of lifestyle pillars concerning the major Brazilian medical guidelines for NCDs and identify evidence in the literature that could justify their inclusion in the documents.

Method:

Brazilian guidelines were selected according to the most relevant causes of death in Brazil, given by the Mortality Information System, published by the Brazilian Ministry of Health in 2019. Journals were screened in the PUBMED library according to the disease and non-mentioned pillars of lifestyle.

Results:

Relevant causes of deaths in Brazil are acute myocardial infarction (AMI), diabetes mellitus (DM), and chronic obstructive pulmonary diseases (COPD). Six guidelines related to these NCDs were identified, and all address aspects of lifestyle, but only one, regarding cardiovascular prevention, highlights all six pillars. Despite this, a literature search involving over 50 articles showed that there is evidence that all the pillars can help control each of these NCDs.

Conclusion:

Rarely are the six pillars of lifestyle contemplated in Brazilian guidelines for AMI, DM, and COPD. The literature review identified evidence of all lifestyle pillars to offer a holistic approach for the management and prevention of NCDs.

  • Holistic Health
  • Life Style
  • Noncommunicable Diseases
  • Practice Guideline
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Creative Commons Attribution (CC BY) Creative Commons license
08/01/2024 DOI: 10.36660/abc.20230408 Views 1
Quality of life and clinical indicators in heart failure: a multivariate analysis
ABC
Artigo Original

Quality of life and clinical indicators in heart failure: a multivariate analysis

Jefferson Jovelino Amaral dos Santos et al. Jony Erwin Andreola Plewka Paulo Roberto Slud Brofman

BACKGROUND: In Heart Failure (HF), special attention must be given not only to objective or isolated aspects, but also to the patient’s health self-perceptions. Subjective aspects can help healthcare providers understand and better treat HF. OBJECTIVE: The objective of this study was to evaluate the simultaneous effects of clinical indicators of HF on the Quality-of-Life (QOL). METHODS: We investigated, through a multivariate analysis, the QOL of 101 Brazilian HF outpatients using the Minnesota Living with Heart Failure Questionnaire (including subscales) and its correlation to clinical and physiological variables such as age, ethnicity, gender, echocardiogram parameters, body mass index, mean blood pressure at rest, time since diagnosis, Functional Classification according to the NYHA, functional capacity by a Specific Activity Scale, comorbidities, Framingham Score of Cardiac Risk (CR), Lung Function Test (spirometry) and Body Composition. RESULTS: QOL showed significant univariate correlations to the echocardiogram: ejection fraction (p=0.0415), left ventricular diastolic diameter (LVDD) (p=0.004), left ventricular systolic diameter (LVSD) (p=0.0001); comorbidities (p=0.002) and Lung Function Test: Forced Vital Capacity (FVC) (p<0.0001), Forced Expiratory Volume in the 1st second (FEV1) (p<0.0001) and Maximal Voluntary Ventilation (MVV) (p=0.001). In the multivariate analysis, the backward stepwise protocol detected important simultaneous influent variables (r²=0.60): gender (0.000178), ethnicity (p<0.00001), LVSD (P<0.00001), CR (p=0.000002), FVC (p=0.002027), FEV1 (p<0.00001) and MVV (p=0.00001). CONCLUSION: Gender, ethnicity, LVSD, CR, FVC, FEV1 and MVV are independent predictors of HF patients' QOL. Simultaneously, they are responsible for about 60% of the QOL variance. Biopsychosocial aspects could contribute to patient and health professional expectations and treatment results.

  • Heart Failure
  • Holistic Health
  • multivariate analysis
  • Quality of life
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Creative Commons Attribution (CC BY) Creative Commons license
13/10/2009 DOI: 10.1590/S0066-782X2009000800015 Views 1

How to cite this article

EndNote RIS

Electronic Document Format (Vancouver)

Faria RR, Siqueira SF, Haddad FA, Silva GDM, Spaggiari CV, Martinelli Filho M. The Six Pillars of Lifestyle Medicine in Managing Noncommunicable Diseases – The Gaps in Current Guidelines. Arquivos Brasileiros de Cardiologia 2024;120(12):e20230408.

Electronic Document Format (ABNT)

Faria, Rafaella Rogatto de; Siqueira, Sergio Freitas de; Haddad, Francisco Aguerre; Silva, Gustavo Del Monte; Spaggiari, Caio Vitale; Martinelli Filho, Martino. The Six Pillars of Lifestyle Medicine in Managing Noncommunicable Diseases – The Gaps in Current Guidelines. Arquivos Brasileiros de Cardiologia, v. 120, n. 12, e20230408, Jan. 2024.

Electronic Document Format (APA)

Faria, R. R. , Siqueira, S. F. , Haddad, F. A., Silva, G. D. M., Spaggiari, C. V., & Martinelli Filho, M. (2024). The Six Pillars of Lifestyle Medicine in Managing Noncommunicable Diseases – The Gaps in Current Guidelines. Arquivos Brasileiros de Cardiologia, 120(12), e20230408.

Electronic Document Format (ISO)

Faria, Rafaella Rogatto de and Siqueira, Sergio Freitas de and Haddad, Francisco Aguerre and Silva, Gustavo Del Monte and Spaggiari, Caio Vitale and Martinelli Filho, Martino. The Six Pillars of Lifestyle Medicine in Managing Noncommunicable Diseases – The Gaps in Current Guidelines. Arquivos Brasileiros de Cardiologia [online]. 2024, vol. 120, n. 12, [cited 2026-10-14], e20230408. Available from: <https://journals.cardiol.br/en/article/the-six-pillars-of-lifestyle-medicine-in-managing-noncommunicable-diseases-the-gaps-in-current-guidelines/>. ISSN 0066-782X

EndNote RIS

Electronic Document Format (Vancouver)

Santos JJA, Plewka JEA, Brofman PRS. Quality of life and clinical indicators in heart failure: a multivariate analysis. Arquivos Brasileiros de Cardiologia 2009;93(2):159-66.

Electronic Document Format (ABNT)

Santos, Jefferson Jovelino Amaral dos; Plewka, Jony Erwin Andreola; Brofman, Paulo Roberto Slud. Quality of life and clinical indicators in heart failure: a multivariate analysis. Arquivos Brasileiros de Cardiologia, v. 93, n. 2, p. 159-166, Oct. 2009.

Electronic Document Format (APA)

Santos, J. J. A. , Plewka, J. E. A., & Brofman, P. R. S. (2009). Quality of life and clinical indicators in heart failure: a multivariate analysis. Arquivos Brasileiros de Cardiologia, 93(2), 159-166.

Electronic Document Format (ISO)

Santos, Jefferson Jovelino Amaral dos and Plewka, Jony Erwin Andreola and Brofman, Paulo Roberto Slud. Quality of life and clinical indicators in heart failure: a multivariate analysis. Arquivos Brasileiros de Cardiologia [online]. 2009, vol. 93, n. 2, [cited 2026-10-14], pp. 159-166. Available from: <https://journals.cardiol.br/article/quality-of-life-and-clinical-indicators-in-heart-failure-a-multivariate-analysis/>. ISSN 0066-782X

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