Did you know that 80% of chronic disease is preventable and curable with lifestyle change?1 How stressed or depressed you are, how you eat, how you sleep, how you move and if you smoke or drink alcohol are the lifestyle choices that can cause heart disease, diabetes or hypertension. Sound depressing? The flip side is your behaviors can also cure heart disease, diabetes or hypertension and prevent them from invading your body in the first place.2-5
Most people know they need to exercise, eat more vegetables, drink less soda and turn off their phones, but change can be overwhelming and many are skeptical about how much difference any change can really make.
Imagine walking into your doctor’s office to discuss your health and instead of a brief visit, the doctor spends an hour with you. And, what if your physician not only talked about medications but also about the people you love and why you want to be healthy. What if they brought an entire team of specialists in to form a plan to improve your nutrition, sleep, exercise, stress, anxiety or loneliness. Now imagine your physician told you that this entire interdisciplinary care team would stay connected with you to ensure the action plan you created together was enacted. Even more, your Medicare or Medi-Cal health insurance covers this care.
If you are a patient of Hetal Bhakta, MD at Desert Heart Rhythm Cardiology in Palm Springs, you don’t have to imagine. Dr. Bhakta adopted a full lifestyle medicine program to help his patients prevent, reduce damage and even cure heart disease. His patients receive a prescription for lifestyle medicine and a care team that includes a personal health coach, behavioral health specialists, registered dietitians, exercise specialists and connected devices to monitor blood pressure, weight and blood glucose. This team customizes and tailors the program based on individual needs, even providing mental health care.
“Clinical evidence shows that mental health and lifestyle choices are modifiable risk factors for heart disease. I monitor the physical condition and my patient’s emotional health, nutrition, sleep quality and exercise,” stated Dr. Bhakta. “During the pandemic, many patients became more stressed, depressed and isolated. This directly worsened their heart health. Many needed more assistance than I could give them, so I brought in the Nudj Health team to help them make lifestyle changes and achieve health.”
Dr. Bhakta’s extended virtual care team is a partnership with Nudj Health, a lifestyle medicine company that partners with physicians to deliver mental health and lifestyle interventions virtually.
Yuri Sudhakar, CEO and co-founder of Nudj said, “If you have a chronic condition like heart disease, diabetes or cancer, your mental health and behavior choices can be deeply affected. We use an evidence-based model called collaborative care to work with physicians like Dr. Bhakta to treat the whole person and not just the physical disease.”
To study the effects of the lifestyle medicine virtual care, Dr. Bhakta and Nudj Health partnered with the Inland Empire Health Plan, a large Medi-Cal provider in the Coachella Valley. They treated 158 patients, 64 of whom participated in a Nudj Health Lifestyle and home-based blood pressure monitoring program (called Remote Patient Monitoring or RPM) and 94 of whom participated in an RPM-only program.
The patients, many of whom struggle with the high cost of living in the area and have food and housing insecurity, were 48% Spanish-speaking only and had common cardiac conditions such as hypertension, atrial fibrillation and coronary artery disease. Enrollment took place between August and November 2022, the results shared here represent care from August to December 2022.
Compared to the RPM-only program, patients in the Nudj Health Lifestyle + RPM program saw reductions in blood pressure and major improvements in depression, anxiety and insomnia. These results are clinically and statistically significant:
- Blood pressure decreased by 6.98 mm Hg systolic and 3.87 mm Hg diastolic in only four months of treatment, which has been estimated to lower the risk of death by 9% for cardiac-related deaths, 14% for stroke-related deaths and 7% for deaths of any cause.6
- Treatment with the Bhakta-Nudj team allowed 43% of depressed patients, no matter how severe, to experience half as much depression as when they started. Further, many patients found they no longer had any depression.
- For patients experiencing anxiety, 35% decreased their symptoms by at least half. The symptom decrease occurred with patients with mild, moderate and even severe symptoms.
- In people suffering from insomnia, 27% experienced an improvement in sleep by 50%. This improvement was experienced by even the most severe insomniacs.
All this improvement happened rapidly, taking patients, on average, three months to experience a 50% decrease in symptoms, much faster than the typical 21 months needed for symptom improvement in a normal outpatient treatment setting.7
One patient whose life was changed with the Bhakta-Nudj Health coaching was Francisco Garcia Macias, 53. He lives in Palm Springs but commutes to Los Angeles to work. During the pandemic, he contracted COVID and nearly died. He spent three weeks in the ICU and three months in the hospital. Afterwards, he suffered from memory issues, daily pain, weakness and nightmares and was unable to work.
“When I talked to Dr. Bhakta and then met my care manager, it was like a gift from God,” said Macias. “Instead of carne asada every week, it was only once a month. No coffee at night helped me sleep. I started losing weight. The burning sensation in my stomach and my pain improved. I want to have my purpose back. I can almost go back to work. I want to get back in the mix for my wife and my children.”
Dr. Bhakta said, “Treating patients like this and seeing their lives change is why I became a doctor. And now I have the tools and the team to be more effective than I was before.”
Dr. Katie Hill is the Chief Medical Officer of Nudj Health. For more information, visit www.nudjhealth.com.
References: 1) Katz DL, Frates EP, Bonnet JP, Gupta SK, Vartiainen E, Carmona RH. Lifestyle as Medicine: The Case for a True Health Initiative. Am J Health Promot. 2018;32(6):1452-1458. doi:10.1177/0890117117705949; 2) Kelly J, Karlsen M, Steinke G. Type 2 Diabetes Remission and Lifestyle Medicine: A Position Statement From the American College of Lifestyle Medicine. Am J Lifestyle Med. 2020;14(4):406-419. Published 2020 Jun 8. doi:10.1177/1559827620930962; 3) Hasbani NR, Ligthart S, Brown MR, et al. American Heart Association’s Life’s Simple 7: Lifestyle Recommendations, Polygenic Risk, and Lifetime Risk of Coronary Heart Disease. Circulation. 2022;145(11):808-818. doi:10.1161/CIRCULATIONAHA.121.053730; 4) Ornish D, Scherwitz LW, Billings JH, et al. Intensive lifestyle changes for reversal of coronary heart disease [published correction appears in JAMA 1999 Apr 21;281(15):1380]. JAMA. 1998;280(23):2001-2007. doi:10.1001/jama.280.23.2001; 5) Esselstyn CB Jr. Updating a 12-year experience with arrest and reversal therapy for coronary heart disease (an overdue requiem for palliative cardiology). Am J Cardiol. 1999;84(3):339-A8. doi:10.1016/s0002-9149(99)00290-8; 6) Stamler R. Implications of the INTERSALT study. Hypertension. 1991;17(1 Suppl):I16-I20. doi:10.1161/01.hyp.17.1_suppl.i16; 7) www.nudjhealth.com/outcomes