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Lifestyle Medicine is a new and evolving speciality in Medicine. It is a distinct speciality aimed at treating the root cause of most chronic diseases using the strongest evidence‐based modalities available. Current approaches to medicine and health care offer inadequate solutions to the problems we face. Lifestyle Medicine seeks to address these issues to improve the health and wellbeing of individuals and societies. This chapter covers the definition of Lifestyle Medicine and provides some questions to test candidates understanding of the difference between Lifestyle Medicine and other disciplines such as Conventional, Complementary, and Alternative medicine (CAM), and Integrative and Functional Medicine, to mention but a few.

1 Lifestyle Medicine is best defined by which of the following?A branch of alternative medicineA new field of medicine where lifestyle interventions are effective in the prevention, treatment and, rarely, reversal of diseasesEvidence‐based use of whole food, plant‐based dietary lifestyle, regular physical activity, restorative sleep, stress management, avoidance of toxic substances such as tobacco and alcohol and supportive social connections for a healthy lifeThe application of medical, behavioural, motivational, and environmental principles in the management of lifestyle‐related health problems in a non‐clinical setting

2 Lifestyle Medicine is most appropriately described in which of the following ways?The integration of lifestyle practices into conventional medicine to lower the risk for chronic diseaseThe integration of lifestyle practices into conventional medicine to eliminate conventional medical practiceThe integration of lifestyle practices in the form of complementary therapyThe integration of lifestyle practices in the form of alternative therapy

3 Which of the following best describes the practice of Lifestyle Medicine?A practice that does not include medicationsA practice that involves environmental and dietary interventionsA practice where medications, rather than behaviour change, form a significant part of the managementA practice where self‐management is not an essential component

4 Which of the following is a major component of Lifestyle Medicine?Cessation of all medicationsOzone therapyPhysical activityUse of supplements

5 Which of the following best describes a key component of the practice of Lifestyle Medicine?Emphasis on diagnostic laboratory testsEmphasis on vitamin supplementsPharmaceuticals as first line of treatmentUse of whole food plant‐based nutrition

6 Which of the following best describes the place of coaching in Lifestyle Medicine?It is not an essential component in Lifestyle MedicineIt has not been found to be effective in depression managementIt can be used to improve personal lifestyle choices regarding weight management and physical activity or sleepThe coach prescribes the best management for the patient

7 Which of the following most closely describes the best practice in Lifestyle Medicine?Emotional wellness plays a minimal roleNutrition must follow a named diet to yield lasting resultsMedication remains the mainstay of managementSleep prescription is an important pillar in the management of many chronic diseases

8 Which of the following is most distinctive of Lifestyle Medicine practice?It places emphasis on behavioural changeIt places emphasis on non‐behavioural interventionsIt requires a multi‐professional teamThe doctor is the only important clinician in the team

9 Which of the following most appropriately describes a Lifestyle Medicine setting?Inpatient surgical care centrePrimary, secondary, or tertiary care clinics that incorporate group consultations in the management of their patientsSuper‐specialist diagnostic centreTertiary consultant‐delivered service

10 Which of the following best describes primary care‐shared medical appointments (a form of group consultation) in Lifestyle Medicine?Patients often complain of confidentiality issuesResearch has shown that patients do not like this approach compared to conventional single‐person appointmentShared medical appointments offer time and space to empower patients to self‐manageThese are not an ideal approach for behavioural change

11 The most compelling evidence for the effectiveness of therapeutic lifestyle change comes from which of the following?Studies of annual therapeutic lifestyle change clinic visit programsStudies of intensive therapeutic lifestyle change programsStudies of monthly therapeutic lifestyle change clinic visit programsStudies of non‐intensive therapeutic lifestyle change programs

12 Which of these most appropriately explains the difference between Lifestyle Medicine and other types of practice?It is distinctly different from all the other categories of medicineIt is the same as Alternative MedicineIt is the same as Complementary MedicineIt is the same as Functional Medicine

13 In understanding Lifestyle Medicine and Integrative Medicine, which of the following best explains their relationship?Both are patient‐centred and involve personalized careBoth place the same emphasis on behavioural change They are exactly the sameThey do not have any common components

14 In understanding Lifestyle Medicine and Functional Medicine, which of these is the most appropriate statement?Both place emphasis on vitamin supplementsBoth are forms of Alternative MedicineFunctional Medicine is concerned with interactions between the environment, gastrointestinal, endocrine, and immune systems to create individualized careThey do not have anything in common

15 Concerning Lifestyle Medicine and Conventional Medicine, which of these statements best describes the differences?Both place the same emphasis on behavioural interventionConventional Medicine places emphasis on restoring function by addressing the root cause through individualized treatmentLifestyle Medicine, unlike Conventional Medicine, emphasizes cellular metabolism and control of oxidative stressUnlike Lifestyle Medicine, in Conventional Medicine, apart from complying with the prescribed medications or surgery, patients are not required to make significant changes

16 In the therapeutic approaches used in Lifestyle Medicine, which of these therapeutic interventions has been most appropriately represented?Cognitive Behavioural Therapy is seldom usedGroup consultations have been found to be effectiveLifestyle Medicine approaches have not been found to be effective in the management of communicable diseasesMotivational counselling is more effective than medications in severe depression

17 Comparing Lifestyle Medicine and Preventive Medicine, which of these best compares their approaches?Lifestyle Medicine practice is the same as Preventive Medicine in approachMedication is the ‘end’ in both fields of MedicinePersonalized care is a key feature in both the fields of MedicinePreventive Medicine, unlike Lifestyle Medicine, emphasizes population‐based interventions

18 Which of the following is a key process in health coaching for behavioural change in Lifestyle Medicine?Assessing the client’s readiness for changeChanging the lifestyle of the client Enforcing behavioural change in the clientSetting goals for the client

19 Which of the following is the most appropriate behaviour change technique for the behaviour change process?In all stages, use motivational interviewingIn all stages, use positive psychologyIn the early stages, use cognitive behavioural therapyIn the later stages, use motivational interviewing

20 Which of the following best reflects physician competencies for prescribing Lifestyle Medicine?Ideally, physicians will role‐model and practice healthy personal behavioursPhysician helps patients sustain healthy lifestyle practices with no need to refer to other specialitiesPhysician’s engagement with patients has not been shown to improve patient outcomeThe healthcare provider should avoid engagement with the patient

21 In Physician Competencies in Lifestyle Medicine, which of the following best explains the important processes involved in the assessment of a patient?Assessment of the employer’s readiness and willingness is more important than family readiness and willingnessAssessment of environmental factors is the most important aspectAssessment of family readiness and willingness is more important than the client’s readiness and willingnessAssessment of social, psychological, and biological predispositions and the desired health outcome is very important

22 Health coaching in Lifestyle Medicine is more likely to succeed in which of the following situations?Readiness of the patients and their community to make a health behaviour changeReadiness of the patients and their employer to make health behaviour changeReadiness of the patients and their family to make health behaviour changeReadiness of the patients and members of their support group to make a health behaviour change

23 Which of the following best describes the intensity component of the Lifestyle Medicine treatment intensity program?Amount of contact hours during the programAmount of days spent on the program Amount of physical activities on the programAmount of whole food plant‐based options in the program

24 A 58‐year‐old man, diagnosed with Type 2 Diabetes 20 years ago, recently moves into the area and registers as a new patient in the primary care clinic. His BMI is 40. He has dyslipidaemia, severe left hip pain, and is desperate to have Lifestyle Medicine interventions for his condition. For the past five years, his treatment consists of Soluble Insulin, Metformin, and Atorvastatin. Based on the current evidence, which of the following will be the most effective option of therapeutic lifestyle intervention treatment for him now?Intensive therapeutic lifestyle change treatmentIntensive therapeutic lifestyle change treatment followed by therapeutic lifestyle changeNon‐intensive therapeutic lifestyle change treatmentNon‐intensive therapeutic lifestyle change treatment followed by therapeutic lifestyle change

25 In the scientific foundation of the Healthy Doctor = Healthy Patient project (Frank et al. 2013), which of the following most accurately represents the findings in this study?Counselling patients makes a difference in patients’ habits and in their healthNorth American physicians tend to live just as long as their peersPhysicians live longer than their contemporaries because they have access to better medical carePhysicians with poor health habits are more likely to advise their patients about preventive habits