• Define Lifestyle Medicine (LM) and describe the unique role of LM
• Describe the LM core competencies as identified by a national consensus panel
• Understand the importance of LM in treating the nation’s lifestyle disease burden
• Understand the role of behavioral determinants of positive health outcomes
• Cite the scientific evidence that demonstrates the association of risk conditions (from unhealthy behaviors) as key to health outcomes
• Compare and contrast to other fields of health and medicine
• Understand the place and priority of LM in the spectrum of treatment options for chronic (lifestyle-related) diseases
• Understand the efficacy of LM and its impact on disease pathophysiology

• Demonstrate key elements of conducting patient readiness assessment and stage matched responses
• Describe the process of building effective relationships with patients
• Apply motivational interviewing, cognitive behavioral and positive psychology techniques
• Develop a written action plan based on the treatment prescription adjusted for the appropriate stage of change
• Describe strategies for helping patients maintain healthy behaviors
• Cite at least three health behavior change theories and their potential application to practice
• Understand the 5 As and how to incorporate them into the office visit
• Identify two key constructs for effective, sustainable self-management
• Describe process of follow-up for ongoing lifestyle change progress, including building patient self-efficacy
• Demonstrate use of readiness, importance and confidence scales
• List components of relapse prevention planning
• Cite the evidence base for effective coaching that promotes health behavior change and improves health outcomes
• Describe how to create relationships with patients which foster their personal growth
• Describe the role of self-motivation and self-confidence in effective coaching for health behavior change
• Describe the main stages of the coaching process
• List the coaching questions for each stage of change

• List components of the patient history and physical with emphasis on lifestyle risk factors
• Describe screening and diagnostic tests relevant to lifestyle-related diseases
• Describe how to interpret the tests using evidence based national guidelines
• Demonstrate how to screen, diagnose and monitor a lifestyle-related condition (case example)
• Describe strategies for a clinical practice to obtain information about local community resources
• Describe appropriate situations for referring and collaborating with other health professionals, such as dieticians, health educators, fitness trainers, and psychologists
• Describe the key strategies for leveraging the interdisciplinary team to enhance health behavior change interventions
• Describe how planned and group visits can optimize office visits to support lifestyle modification
• Cite strategies for effective office systems and office tools for tracking screening frequency and test results, and proactively prompting follow-up
• List at least three resources available nationally that support healthy lifestyles/lifestyle change
• Describe strategies for a clinical practice to obtain information about local community resources
• Describe how office flow can be designed to assure consistent and up-to-date referrals
• Cite the evidence for collaborative and chronic care models on improved lifestyle outcomes by use of allied health professionals
• Cite examples of team implementation from demonstrated chronic care models
• Describe the chronic care model components and how they can be implemented to support lifestyle modification
• Describe successful primary care and office-based models for lifestyle modification, such as Prescription for Health
• Describe the process for health care service quality improvement with applications for lifestyle interventions, such as Plan-Do-Study-Act (PDSA) cycles

• Cite scientific data supporting that physicians who practice healthy lifestyles are more likely to offer counseling and improve patient outcomes
• Describe strategies for incorporating wellness into clinic, medical office or other health care settings (wellness programs for health providers)
• Conduct personal readiness assessment and develop personal action plan
• Describe how to conduct effective advocacy on behalf of LM directly with patients and their families, as well as policy makers and decision makers within the community

• Understand the dietary guidelines for Americans and why they are important, and the science-base that goes beyond guidelines
• Understand the limitations of the dietary guidelines
• List the food components most Americans get too much of and in which foods they’re found
• List the shortfall nutrients that Americans are failing to sufficiently consume and in which foods they’re found
• Use these criteria to determine which foods are healthiest and which least health-promoting.
• Summarize the major nutrition studies and evidence-base for nutrition prescriptions
• Understand the science behind making nutrition prescriptions
• Demonstrate ability to perform a basic nutrition assessment
• Know how to prescribe nutrition for basic disease processes including inflammation: food patterns / macronutrients, food types / micronutrients, food preparation / oxidation
• Summarize nutrition prescriptions for the most common chronic diseases including hyperlipidemia, diabetes, hypertension, and cancer
• Understand the role of nutrition in preventing and treating chronic diseases, such as cardiovascular disease
• Describe the role of nutrition in preventing, treating and reversing diabetes
• Demonstrate ability to make nutrition prescriptions for health maintenance
• Describe practical strategies for assisting patients to achieve dietary changes
• Cite the prevalence of diabetes and pre-diabetes and the associated cost burden
• Describe consequences of intensive medication management
• Describe the Diabetes Prevention Program and its applications
• Understand the role of nutrition in preventing and treating chronic diseases, such as cardiovascular disease
• Summarize the major nutrition studies and evidence-base for nutrition prescriptions
• List at least five examples of nutrition interventions for diseases
• Describe the pathogenesis of diabetes
• List at least three key epigenetic influencers
• Describe the role of epigenetics
• Summarize key dietary research on the impact of diet on diabetes
• List the major physiologic impacts of plant based diet in the process of diabetes reversal

• Describe the relationship between physical activity (PA) and health
• Develop an exercise prescription
• Describe the major evidence for the physical activity components (aerobic, strength, flexibility, and balance)
• Define physical activity and exercise
• List the components of exercise
• Describe the US Physical Activity Guidelines for Americans (PAGA)
• Understand the role of personal behavior and role modeling
• Understand the use of METS in assessing fitness
• Describe the impact of exercise on weight
• Identify the minimum and maximum levels of exercise
• Describe the major evidence for the physical activity components (aerobic, strength, flexibility, and balance)
• List key physical activity assessment tools
• Describe how to collaborate with your patients to promote physical activity change
• Identify resources for sustainable behavior change
• List the components of writing the Exercise Prescription
• Describe the treatment of disease with exercise as compared with medication
• List evidence-based PA recommendations for: healthy older adults, pregnancy, obesity, heart disease, diabetes, cancer, disability, and stroke

• Use screening tools for stress, depression and anxiety
• Understand relationship between emotional distress and poor health
• Describe provider role in facilitating patients’ emotional wellness
• Point indicators in lieu of indications for referral to a mental health professional
• Understand depression as a comorbidity for diabetes and coronary artery disease
• Demonstrate ability to manage depression and anxiety in patients with comorbidities
• Describe the components of emotional wellness self-management
• Understand the role of positive psychology and its use in lifestyle medicine
• Understand the nature of stress and identify manageable elements of pathogenic stress reactions
• Report how mindfulness-based stress reduction contributes to medicine and healthcare
• Report how skills of mindfulness-based stress reduction (MBSR) can help patients intervene in stress reactions and better care for themselves.
• Describe the integral and essential elements of MBSR
• List conclusions from salient research in MBSR
• Describe mindfulness skills that enable presence, clarity and curiosity in the clinical encounter
• Identify the benefits of physician empathy, attunement and resonance in the clinical encounter

• Understand sleep’s role in health and chronic disease
• Identify lifestyle-based activity, dietary, environmental and coping behaviors that can improve sleep health
• Identify at least two lifestyle adjustments related to light exposure and meal composition and timing that support improved sleep
• Identify key factors that differentiate patient subpopulations with insufficient or poor quality sleep
• Understand the role of light exposure and endogenous melatonin in sleep health
• Identify 2-3 lifestyle adjustments related to light exposure that support improved sleep
• Identify 1-2 lifestyle adjustments related to meal composition and timing that support improved sleep

• The health effects of tobacco use
• The health benefits of tobacco cessation
• Effective, evidence-based tobacco cessation/treatment options
• Recommendations from the USPHS Tobacco Cessation Guideline
• The 5 As model as a guide for tobacco cessation and other substance use brief interventions
• Effective interventions to assist users willing to quit tobacco
• The importance of behavior therapy with pharmacotherapy for tobacco cessation
• Assistance for users who are currently unwilling to quit tobacco
• Diagnostic criteria for substance use disorders
• Screening patients for substance use and addressing any related health effects
• Brief interventions and referrals to specialists when appropriate

Positive Psychology and Behavior Change

• Apply positive psychology in motivational interviewing and health behavior change counseling
• Describe how positive psychology and emotional well-beings support achieving and sustaining healthy behaviors

Life Meaning/Purpose

• Compare and contrast eudaimonia and hedonia
• Explain how eudaimonia relates to physical health and including longevity

Connectedness/Social/Relationships

• Describe how connectedness and social networks effect emotional well being, physical health and longevity
• State the effect social media has on one’s emotional well-being

Healthy Lifestyle Behaviors and Emotional Well-Being

• Describe the science of how a plant-based diet impacts emotional well-being
• Explain how physical activity effects emotional well-being
• Describe the role sleep plays in emotional well-being
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