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We are thrilled to share this book with you. It is the product of more than 50 years of combined research, practice, and teaching on modifiable lifestyle factors affecting human health. We have been struggling in the lab, classroom, clinic, and workplace for years to understand the epidemiology and pathophysiology of some of today's most common diseases (e.g., obesity, type 2 diabetes mellitus, hypertension, and dyslipidemia) and to find nonpharmacological ways to prevent and mitigate these disorders. Our work has contributed a small fraction to the tremendous progress that has been accomplished during the past few decades by many excellent labs, research institutions, and centers around the world, led by brilliant colleagues, investigators, teachers, and clinicians.

We have tried to evaluate, understand, organize, and translate all this knowledge into clinical practice and share it with you. You will be the judge if we have succeeded in this endeavor. Our main goal was not only to provide accurate and trusted knowledge to undergratuate and graduate students but also to make available the tools for current and future clinicians to translate this knowledge into best practices.

Lifestyle factors and the way individuals conduct their lives have recently received great attention, since these factors are modifiable and, therefore, may be subject to considerable intervention and improvement. Many healthy lifestyle choices – such as sensible diets, adequate physical activity, avoiding tobacco use, moderate alcohol intake, good social life, and stress‐reduction – have been associated with lower risks of obesity, insulin resistance, hypertension, dyslipidemia, and other chronic diseases, which are considered the major public health concerns of our time. Therefore, scientific research on the lifestyle factors that may have negative (unhealthy lifestyle) or positive (healthy lifestyle) effects on health has intensified during the past 20 years.

The findings are very encouraging; even small changes toward healthier lifestyle choices can translate into substantial health benefits. The clinical implications are so significant that the first professional organizations to promote lifestyle changes as a primary means to treat diseases were formed. In 2004, the American College of Lifestyle Medicine (ACLM) was formed to provide education and certification to health professionals who want to use lifestyle changes as the foundation of transformed and sustainable health‐care systems. Soon after, many similar organizations were formed around the world (e.g., Lifestyle Medicine Global Alliance, European Lifestyle Medicine Council, European Lifestyle Medicine Organization, British Society of Lifestyle Medicine, Australasian Society of Lifestyle Medicine). According to the ACLM, “Lifestyle Medicine is the use of a whole food, plant‐predominant dietary lifestyle, regular physical activity, restorative sleep, stress management, avoidance of risky substances, and positive social connection as a primary therapeutic modality for treatment and reversal of chronic disease.”

We do not consider ourselves the ultimate authorities in all the scientific areas covered in this book. But this is exactly the main message of our book: metabolic health is a multifaceted entity requiring a multidisciplinary approach. No one can be an expert in all components of lifestyle: diet, physical activity, stress, sleep, substance use and abuse. However, it is crucial for all health‐care professionals who treat patients suffering from chronic diseases to understand the importance of lifestyle choices and help patients to best utilize those choices to their own benefit.

The book is divided into four units to present these complex subjects in a clear and concise manner.

Unit I: Lifestyle Choices and Human Health begins by providing the basic knowledge necessary to introduce students and scientists with diverse backgrounds to this relatively new area of research and practice and the related terminology: healthy lifestyle, wellness, and lifestyle medicine. Next it presents in detail the characteristics and principles of healthy and unhealthy lifestyle choices.

Unit II: Healthy Diets presents the history of how our nutrition habits, the most studied of all lifestyle factors, evolved to what they are today, and discusses the methods scientists have used to evaluate the connections among food, health, and disease. Subsequently, we present several of the world's most important dietary models/patterns, followed by billions of people. Finally, we finish this unit with one of the best‐known and evidence‐based eating patterns, the Mediterranean dietary pattern. One‐day sample meal plans for all dietary models/patterns are presented in Appendix B.

Unit III: From Mediterranean Diet to Mediterranean Lifestyle describes the major milestones in the development of our current understanding of building and maintaining health and well‐being. We can no longer consider diet as the sole determinant of health. We now recognize that other lifestyle factors (physical activity, sleep, stress management, social life, substance use and abuse) are equally important; furthermore, it is the synergistic effect of all these factors that leads to a healthy lifestyle, a life not only with less disease but a state of physical, mental, and social well‐being.

Unit IV: Mediterranean Lifestyle in Clinical Practice presents four case studies, each devoted to one of the prominent features of the metabolic syndrome: obesity, type 2 diabetes mellitus, hypertension, and dyslipidemia. For each case, we present a detailed, step‐by‐step description of the methods a clinician should use to evaluate a patient's lifestyle. Next, we describe general treatment protocols utilizing lifestyle modifications pertinent to the specific disorders. We hope that this section will become a useful tool in the hands of clinicians when managing patients utilizing lifestyle medicine as the first, and possibly most important, line of defense against noncommunicable diseases, before resorting to prescription drugs with possible side effects.

The book has six distinctive features:

1 It is inclusive of all the major lifestyle factors affecting human health.

2 It has a textbook format and can be used for undergraduate and graduate teaching.

3 It uses the unique and evidence‐based perspective of the traditional Mediterranean lifestyle as the gold standard of a healthy lifestyle. A plethora of scientific evidence supports the notion that the traditional Mediterranean diet/lifestyle is one of the healthiest diet/lifestyle patterns. The 2015 Dietary Guidelines for Americans identify the Healthy Mediterranean‐Style Eating Pattern/Lifestyle as probably the healthiest and easiest to follow.

4 The “Take‐Home Messages” at the end of each chapter denote the most important points of the chapter.

5 The “Key Points” throughout the book help the reader focus on important points.

6 Finally, to assist the reader/student in comprehending the presented material, at the end of each chapter we present a list of “Self‐Assessment Questions” with answers provided in Appendix A.

We hope that this book will become a valuable resource to students in medical and health‐related disciplines, and to health professionals such as nutritionists, exercise physiologists, psychologists, addiction specialists, sleep therapists, athletic trainers, physicians, nurses, and other health professionals who are using or considering using lifestyle changes to prevent and treat noncommunicable diseases. The Clinical Cases section provides specific practical tools to assist with everyday practice in the clinic; the materials presented apply to most noncommunicable diseases of today (e.g., cardiovascular disease, autoimmune diseases, stroke, most cancers, chronic kidney disease, osteoarthritis, osteoporosis), not only the specific examples we are presenting.

We are indebted to Christina Katsagoni, PhD; Michael Georgoulis, PhD; Elena Bellou, PhD; Anastasia Diolintzi, PhD; Anastasia Papadimitriou, PhD; Glykeria Psarra, PhD; Amalia Sidossis, MD; and Ioanna Katsaroli, MS. These talented young scientists contributed tremendously to this book by offering ideas regarding book format and content, conducting thorough literature reviews, drafting and editing sections or chapters, and offering constructive criticism throughout the writing of this book. Special thank you to Christina and Michael for their invaluable help during the final stages of book editing. We would not be able to do it without them. Ms. Dafni Kyriakou was quick and effective as always in book formatting. We would also like to thank the Wiley team for their dedication and professionalism: James Watson, Anne Hunt, Tom Marriott, Cheryl Ferguson, P. Sathishwaran, and their colleagues. Finally, we would like to thank Sarah Brown for proofreading our book.

Last but not least, we want to thank our families for their continuous love and support.

LABROS S. SIDOSSIS, PHD Princeton, New Jersey, USA

STEFANOS N. KALES, MD, MPH Cambridge, Massachusetts, USA