Nutrition, Exercise: Medical Schools Boost Teaching of Healthy Behaviors to Fight Chronic Disease

The following is an excerpt from The Wall Street Journal article by Laura Landro, and can be viewed in its entirety by clicking here.

An ounce of prevention may be worth a pound of cure, but medical schools have traditionally given little weight to instruction on how to help patients live healthier lives.

The future could look different as schools and residency training programs have begun to embrace a field known as lifestyle medicine, weaving teaching on nutrition, exercise and other healthy behaviors into the core curriculum of medical education. This new push aims to provide doctors with tools to tackle chronic but often preventable conditions such as heart disease, stroke and diabetes that affect six in ten adults in the U.S.

“Incorporating lifestyle medicine into medical-school curricula can resolve the inadequacies that exist in preparing physicians for the growing challenge of chronic disease,” says Jennifer Trilk, professor of biomedical sciences and director of lifestyle-medicine programs at the University of South Carolina School of Medicine Greenville, which in 2017 became the first medical school in the U.S. to incorporate more than 80 hours of lifestyle-medicine training over four years of undergraduate education.

A number of U.S. medical schools have begun to adopt lifestyle medicine or embed some of it in their programs. Among them are those of Brown University, Harvard University, Stanford University, the University of Oklahoma, historically Black colleges and universities including Morehouse School of Medicine, and schools of osteopathic medicine.

The approach is part of a broader movement to improve health and close gaps on racial disparities in healthcare, as research points to the benefits of healthy behaviors in preventing, treating and even reversing common chronic diseases. A study published in the Journal of the American College of Cardiology last year projected an increasing prevalence of heart disease and diabetes by the year 2060 among Black and Hispanic populations, which have historically had poor access to quality care. The Centers for Disease Control and Prevention cites chronic diseases as leading drivers of the nation’s $4.1 trillion in healthcare costs. And while the U.S. healthcare system has traditionally paid doctors to treat disease rather than prevent it, the opportunity to reduce costs is spurring new reimbursement models from Medicare, private insurers and employer health plans that offer clinicians incentives to prevent disease.

Design and implementation of a clinic-to-community, physical activity health promotion model for healthcare providers

Due to the worldwide burden of noncommunicable disease, the American College of Sports Medicine (ACSM) launched a global health awareness initiative in 2007 called Exercise is Medicine® (EIM®) to create awareness in healthcare providers in promoting physical activity to their patients. To transition awareness into action, Exercise is Medicine Greenville® (EIMG®) launched in 2016 through a first-of-its-kind partnership between a medical school, large healthcare system, and community organization to comprehensively integrate physical activity as a primary prevention strategy into their health system. The EIMG® model connects patients referred by their healthcare provider due to diagnosis of a physical inactivity and/or noncommunicable disease to community partners who provide evidence-based physical activity programs as a population health management strategy. The EIMG® program is inclusive of all patients referred and provides an “open door policy” through the YMCA scholarship fund. Through 2019, 210 patients completed the program (>60% graduation rate). Patients receiving usual care by their healthcare provider decreased body weight (p < 0.001) and systolic blood pressure (p = 0.042). Patients receiving usual care by their healthcare provider who were referred with hypertension decreased body weight (p = 0.001), and both systolic and diastolic blood pressure (p < 0.001). Graduating patients were highly satisfied with the program and program personnel (>4 on a 5-point Likert scale). Aligning healthcare and community partners to implement a clinic-to-community model for patients with noncommunicable disease may be a beneficial population health promotion strategy. Future efforts will be to refine the referral process, scale the model, and continue to inform national health promotion strategies.


Moving Through Cancer

Moving through Cancer (MTC), an initiative of Exercise is Medicine® and the American College of Sports Medicine, has created a beautiful, comprehensive patient booklet on physical activity during and after cancer treatment. The information is based on the latest evidence-based guidelines and was developed by the Moving through Cancer Task Force. Physical activity during and after cancer treatment can result in fewer side effects, faster recovery, and reduced recurrence in some cancers. This booklet is designed for patients, caregivers and providers to both inspire and educate. Please share the link with your colleagues and patients.

Inactivity Linked to Severe COVID-19

Starting March 2020, near the beginning of the pandemic, exercise scientists and clinicians published blogs about the mechanisms by which physical activity could likely reduce harm from COVID-19.

There was strong evidence that physical activity improves immune function, reduces inflammation, prevents and treats most common chronic diseases, decreases the psychological and physiological burden of stress, and improves immune responses to vaccinations among older adults.

Read Full Article, here.

Interval training exercise could be a fountain of youth

Looking for a fountain of youth? You may need to search no further than your sneakers.

Exercise, particularly high-intensity interval training, encourages your cells to make more proteins to feed their energy-producing machinery — and this arrests the aging process, according to a new study published Tuesday in the journal Cell Metabolism.

“Any exercise is better than being sedentary,” said Dr. Sreekumaran Nair, senior author of the study and a diabetes researcher at the Mayo Clinic in Rochester, Minnesota. However, Nair noted that high-intensity interval training (HIIT), in particular, is “highly efficient” when it comes to reversing many age-related changes

High intensity interval training involves short bursts of intense aerobic activity within a stretch of more moderate exercise: intermittently sprinting for 30 seconds, for example, in the middle of a moderate-pace jog.

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Commentary: Exercise can be potent medicine

Exercise is better than any medication a doctor can prescribe for chronic disease.

This knowledge should be intuitive to physicians and patients, and yet we have an ever-increasing population who either do not exercise at all or don’t exercise enough. Multiple studies year after year continue to show the detrimental impact that physical inactivity can have on one’s health. In 2012, the prestigious medical journal Lancet released a series of studies that showed physical inactivity was the fourth-leading risk factor attributable to death. If we look at the Upstate, the top two leading causes – heart disease and cancer – have direct relationship to physical activity.

Now, from the heart of the stroke belt, comes a first-in-the-nation coalition that brings together medical school-based research with doctors, community resources and exercise professionals in an audacious partnership to slow the progression of inactivity-related chronic disease.

Greenville Health System (GHS), the University of South Carolina School of Medicine Greenville, the YMCA of Greenville and the American College of Sports Medicine have partnered on an innovative program called Exercise is Medicine Greenville. Its goal is making physical activity a standard in health care – that is, having your doctor talk about and prescribe exercise as part of your treatment plan just as he might prescribe medicine.

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New Greenville program enables exercise prescription, tracking

Lack of exercise is a direct contributor of heart disease, stroke, Type 2 diabetes, stroke and other chronic diseases.

Yet, more than half of adults do not the meet national guidelines for physical activity, said Dr. Jerry Youkey, dean of the University of South Carolina School of Medicine Greenville.

It’s a problem that USC, the Greenville Health System (GHS), the YMCA of Greenville and the American College of Sports Medicine believe they can help change.

They’ve partnered to launch program that, according to Youkey, makes it easier and more affordable for patients to get the exercise and support they need to improve and quality of life.

The new Exercise is Medicine Greenville program prescribes exercise to patients and tracks it “as part of their electronic medical record – as a vital sign comparable to blood pressure or cholesterol – so that the clinician and fitness team has nearly real-time access to exercise progress and can intervene with the patient to get them back on track as needed,” a release from GHS said.

“There’s actually data that shows that patients who get a prescription are more likely to do exercise than if you just tell them to ‘Have a nice day and go get some exercise,’” said GHS president Spence Taylor.

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Exercise: It’s what the doctor ordered

(CNN)On Friday, Weill Cornell Medical College offered a seminar to its second-year medical students, one that’s been offered only once before.

The focus wasn’t cutting-edge pharmacology or modern microbiology but instead, five lecturers exploring different facets of a single topic: “Prescribing the Medicine of Exercise.”
This isn’t as typical as you might think. More than half of the physicians trained in the United States receive no formal education in physical activity, according to a 2015 study. The study authors discovered that most medical colleges do not offer physical activity-related courses, and the rare exceptions are often electives.
The Weill Cornell seminar, a required class for students, is co-directed by Dr. Jordan Metzl and Dr. Marci Goolsby, both sports medicine physicians at the Hospital for Special Surgery in New York with faculty appointments at Cornell. The seminar teaches medical students how to counsel their patients to exercise, one of the most effective forms of preventive medicine.

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GHS, med school, YMCA and international sports medicine leader collaborate on first-in-nation partnership

GREENVILLE, SC – Lack of exercise isn’t just a matter of being a couch potato, it’s frequently a direct contributor to chronic diseases that kill more than 1.7 million Americans every year and cost more than $24 billion in healthcare expenditures.

Now, from the heart of the stroke belt, comes a first-in-nation coalition that brings together medical school-based research with doctors, community resources and exercise professionals in an audacious partnership to slow the progression of chronic disease.

Greenville Health System (GHS), the University of South Carolina School of Medicine Greenville, the YMCA of Greenville and the American College of Sports Medicine have partnered on this innovative program. The Exercise is Medicine Greenville program goes beyond prescribing exercise to also tracking it as part of the patient’s electronic medical record – as a vital sign comparable to blood pressure or cholesterol – so that the clinician and fitness team has nearly real-time access to exercise progress and can intervene with the patient to get them back on track as needed.

“We’re trying to change the whole culture of not only how healthcare professionals view exercise but also how they can use exercise as a first line of prevention and treatment for their patients’ fitness and health. Getting enough exercise each week shouldn’t be seen simply as a nice option or luxury if people have time; we need to make it a priority and better help patients truly understand the scientific health benefit that we see as researchers and doctors,” said Jennifer Trilk, Ph.D., director of the Human Performance Lab at the USC School of Medicine Greenville and a national leader in exercise and lifestyle medicine.

The Greenville med school was one of the first institutions in the nation to lead that charge; clinical exercise physiology is already required teaching in all four years of the Greenville med school’s curriculum as a way to educate future physicians on the health benefits of exercise.

“Lifestyle behaviors – and, in particular, exercise – produce healthy heart and metabolic effects in the body which improve patient health, independent of significant weight loss,” said Trilk. “Many people struggle with body weight, and significant weight loss sometimes takes months and even years to achieve. The good news is that effects of exercise on the patient who has low back pain, diabetes, high cholesterol, high blood pressure or early cardiovascular disease occurs much more quickly. These sometimes less-obvious but vital improvements can be reinforced in the doctor/patient relationship as a measurable success while the patient-doctor team continue to work together to decrease the patient’s body weight over time.”

Patient Patricia Manley called the pilot program a “blessing in disguise.”

“If I wasn’t offered the opportunity to be in the program, I don’t think I would be here today,” said Manley. “I think I would be laid back in a bed somewhere. So, when the pilot program was offered to me, I had to take that chance. I knew life wasn’t going to be easy if I didn’t try to do something different. Trying something different changed my life. I want to keep at it until I can’t keep at it anymore.”

Manley, who has chronic kidney disease, has found that exercise has improved her kidney function as well as glucose and cholesterol levels. She’s also lost 26 pounds. Before the program, she had times when she would spend three days in bed because she just didn’t feel like getting up and being active. Now, she has days when she wants to spend the entire day at the YMCA, she said.

Through GHS’ Epic-based patient electronic record, clinicians are prompted to ask how much exercise patients get each week. Anyone getting less than the U.S. Physical Activity Guidelines recommendation of 150 minutes/week of moderate-intensity exercise would be targeted to receive physician-based counseling along with detailed health tutorials developed as part of the program. Patients at-risk or already with chronic conditions such as hypertension, high cholesterol, diabetes and obesity, as well as chronic musculoskeletal issues like chronic low back pain, can be referred into the specially-developed 12-week exercise and support program.

Exercise is Medicine Greenville’s lofty goal has already drawn praise from U.S. Surgeon General Regina Benjamin, who called prevention “imperative” as more American families struggle to deal with chronic diseases like diabetes, hypertension and strokes.

“Much of the illness and early death related to these chronic diseases can be prevented by increased physical activity,” said Benjamin, who served as the 18th U.S. Surgeon General. “This is an innovative approach that, through a prescription and then a tested referral-feedback process, links the medical profession with physical activity

professionals and community resources. I commend these organizations for their vision and leadership.”

The just-launched program is currently limited to four GHS practices: the Center for Family Medicine, the Internal Medicine Clinic, Mountain View Family Medicine in Greer and Cypress Internal Medicine in Greer. Approximately 70 patients have already been referred into the program, with expansion to other GHS practices planned.

“As a physician who practices Lifestyle and Sports Medicine, the Exercise is Medicine Greenville program has been one of the best programs I have had patients participate in,” said GHS’ Bobby Masocol, MD, who has referred patients into both a pilot program and the just-launched program. “I always tell patients that exercise is better than any medication that I can prescribe. To have a program that is sustainable, helps patients long-term and supports physicians is something that health care needs. The patients that I have sent through the program have improved their depression, lost weight and were able to get off some of their medications. I’m grateful to have a resource like this.”

The 12-week group intervention includes twice-weekly exercise routines targeted to each patient’s chronic disease or lack of physical activity as well as face-to-face and technology engagement to progressively build positive lifestyle behavioral changes that will help the patient accomplish, maintain and sustain their chronic disease self-management. The program is available at the GHS Life Center, Caine Halter Family YMCA Downtown, Eastside Family YMCA in Taylors, GHS Family YMCA in Simpsonville and George I. Theisen Family YMCA in Travelers Rest. Specially-trained fitness professionals, who’ve received training beyond the standard level now found in the industry, work closely with the referred patients to provide individualized exercise plans and on-going behavioral and emotional support. The exercise program is targeted to unique issues faced by the patient with chronic disease – for example, patients with hypertension may receive a cardio-metabolic routine that focuses on aerobic exercise while a patient with chronic back pain or osteoporosis may receive a musculoskeletal routine that focuses on strength/mobility issues.

The cost of the program is $199, but the YMCA offers scholarships to those with demonstrated financial need that are referred into the program. Upon completion of the program, participants are encouraged to continue exercising to help ensure that the new practices become ingrained habits.

“Due to the rising epidemic of obesity and related diseases within our community, the YMCA and its partners have adopted Exercise Is Medicine Greenville as a key way of offering solutions to those patients ready to take control of their health,” said Scot Baddley, president of the YMCA of Greenville. “We see firsthand the life-changing transformation that these patients have made and are continuing to make – and it is

incredible. We are grateful to have the opportunity to work with our partners to establish physical activity intervention as a new standard in health care.”

“As part of a national, charitable, non-profit association that’s focused on youth development, healthy living and social responsibility, we are also proud to help remove economic barriers to participation so that no one is denied access due to ability to pay,” said Baddley.

The American College of Sports Medicine launched the Exercise is Medicine Solution and the professional credential, which med school researchers then augmented for Greenville by providing in-depth training ranging from behavioral health support to detailed analyses on the cumulative effect of these diseases on the body.

“Exercise is Medicine is committed to the belief that physical activity is integral to patient health and improved treatment outcomes,” said Adrian Hutber, Ph.D., vice president for Exercise is Medicine. “Greenville Health System is a real pioneer in health care by implementing the EIM Solution. We applaud the commitments of the system and the community to improving the health of residents.”

“Creating accountability, motivation and appropriate follow-up for lifestyle interventions is the key to making Exercise is Medicine a cornerstone of preventive medicine and chronic disease management,” said Hutber. “The combined efforts of our partnership will enable us to provide better outcomes, reduce healthcare costs and enhance the quality of life for all.”

About Greenville Health System

Greenville Health System (GHS) — an academic health system that is the largest not-for-profit healthcare delivery system in South Carolina — is committed to medical excellence through research, patient care and education. GHS offers patients an innovative network of clinical integration, expertise and technologies through its eight medical campuses, tertiary medical center, research and education facilities, community hospitals, physician practices and numerous specialty services throughout the Upstate. The 1,358-bed system is home to 15 medical residency and fellowship programs. Visit for more information.

About University of South Carolina School of Medicine Greenville

The University of South Carolina School of Medicine Greenville is a partnership between the state’s largest university, the University of South Carolina (USC), and one of the largest health systems in the Southeast, the Greenville Health System (GHS). Located near GHS’ flagship tertiary hospital Greenville Memorial Hospital, the medical school graduated its first physician class in spring 2016. This “different school of thought” is dedicated to providing exceptional training for new physicians in transforming healthcare delivery. Learn more at

About the YMCA of Greenville

The YMCA of Greenville is, and always will be, dedicated to building healthy, confident, connected and secure children, adults, families and communities. With a focus on youth development, healthy living and social responsibility, the Y nurtures the potential of every youth and teen, improves Greenville’s health

and well-being and provides opportunities to give back and support neighbors. Begun in 1876, the YMCA of Greenville serves more than 70,000 people annually through programs that include Afterschool, Resident Camp and Day Camp, Aquatics, Youth and Adult Sports, and Health and Wellness. Programs are offered through four family branches, as well as the Verdae YMCA, Y Camp Greenville, Judson Community Center, the Program Center – GHS and the Hollingsworth Outdoor Center. The Y is also home to Y Teen Services and the SC Youth in Government program. For more information about the YMCA of Greenville, visit, or call (864) 412-0288.

About The American College of Sports Medicine

The American College of Sports Medicine is the largest sports medicine and exercise science organization in the world. More than 50,000 international, national and regional members and certified professionals are dedicated to advancing and integrating scientific research to provide educational and practical applications of exercise science and sports medicine. For more information, visit

Industry Giants Announce Unprecedented Marriage Between Health Care and Fitness; Potential Impact for Millions

Newswise — (Indianapolis)- To jointly address the rapid progression of chronic diseases and skyrocketing health care costs, Exercise is Medicine®(EIM), a global health initiative managed by the American College of Sports Medicine (ACSM), along with the American Council on Exercise (ACE) and the Medical Fitness Association (MFA) today announced a new collaboration called the Exercise is Medicine Solution. The partnership and the EIM Solution will bring together health care systems, clinicians, fitness professionals and community resources to affect positive health outcomes and reduce health care costs. The announcement was made at the National Press Club in Washington D.C. and included a keynote by 18th U.S. Surgeon General Regina Benjamin, M.D.

“Prevention is an imperative,” said Benjamin, “as more American families struggle to deal with chronic diseases, such as diabetes, hypertension and strokes. Much of the illness and early death related to these chronic diseases can be prevented by increased physical activity. The EIM Solution is an innovative approach that, through a prescription, links the medical profession with physical activity professionals and community resources. I commend these organizations for their vision and leadership.”

The EIM Solution’s multipronged approach has never been implemented in the US and will include physical activity counseling, as well as prescription and referral strategies, particularly those linking health care and community-based resources. Ultimately, the goal is to achieve global targets for the reduction of inactivity, related morbidity and mortality, and health care costs.

ACSM’s Exercise is Medicine initiative was launched in 2008 and has grown rapidly into 43 countries. Thousands of physicians and exercise professionals have been trained and millions of patients have been impacted around the world. “We are grateful for all we’ve accomplished in the first eight years,” said Adrian Hutber, vice president of Exercise is Medicine. “The EIM Solution marks the beginning of the next phase in our strategy, which is to engage major health systems and communities and work together to improve health and combat chronic diseases by promoting physical activity and fitness.”

As part of today’s announcement, the new partners also introduced the Greenville Health System (South Carolina), which is among the 20 largest health systems in the US., as the first to fully adopt the EIM Solution. Components adopted by GHS include:

•Incorporating Exercise is Medicine as required teaching into all four years of curriculum to educate future physicians on the health benefits of exercise.
•Incorporating physical activity as a vital sign in their EPIC Electronic Medical Record (EMR)
•Using EIM Your Prescription for Health patient education material in the EPIC EMR
•Employing a full-time EIM Coordinator to take patient referrals and work with them to refer to either Greenville Healthcare System Medical Fitness Center or one of the Greenville community Y locations
•Onboarding Coordinator at the Y will receive all patient referrals, meet with them for onboarding and assign them to an EIM group physical activity class

“The EIM initiative and solution align perfectly with GHS’ vision to transform health care for the benefit of the people and communities we serve,” said Sean Bryan, M.D., chair of the Department of Family Medicine at GHS. Dr. Bryan also quoted Adam Sher, M.D., a GHS internal medicine physician in Greer, SC who said, “We are all very excited to welcome our new partnership with Exercise is Medicine. We think that the EIM Solution will bring great opportunity for lifestyle change and improved health and happiness to our patients and our staff. I believe that the Exercise is Medicine program is going to play a major new role in improving lifestyle, health, and happiness in our patients and their families.”

An often missing component of physician-prescribed treatment plans has been the involvement of health and fitness professionals. As part of the EIM Solution, physicians can refer their patients to qualified exercise professionals who hold the EIM Professional Credential. “Fitness professionals are uniquely qualified to help people on a journey of lifestyle change, particularly those with specific training and accredited certifications in health coaching, said ACE Chief Science Officer Cedric Bryant, PhD. “As one of the largest certifying bodies in the United States, ACE will work with ACSM and MFA to reinforce standards for well-qualified health and fitness professionals that will solidify trust between the medical and fitness communities, for the benefit of patients and consumers.”

According to Bob Boone, president and CEO of the Medical Fitness Association, the partnership with ACSM and ACE provides the infrastructure to help the EIM Solution succeed. “We’re bringing together the researchers, professional credentialing bodies and the medically integrated facilities that provide the basic platform to make EIM work,” said Boone. “Creating accountability, motivation and appropriate follow-up for lifestyle interventions is the key to making Exercise is Medicine a cornerstone of preventive medicine and chronic disease management. The combined efforts of our partnership will enable us to provide even more measurable, value-based care and outcomes that will drive improvements in population health – delivered one person at a time.”

The partnership between ACSM, ACE and MFA represents nearly half of the fitness professional industry in the U.S. As part of ACSM’s phase two strategy, the collaboration will continue the work of expanding the EIM program into other regional health systems. For more about the Exercise is Medicine Program, visit the website