If I were to tell you that up to 70 percent of all visits to a doctor are now thought to have a predominantly a single cause, what might you guess? Infections? Genetics? Drug-seeking behavior? Heart disease? Cancer? Diabetes? Pain?

As Maxwell Smart, the wise-cracking detective in the old TV series “Get Smart,” used to say, “would you believe …” lifestyle factors contribute to or cause the vast majority of illness requiring medical attention?

In fact, there is even a new field of medicine named Lifestyle Medicine. I just joined the society and am planning to attend an upcoming conference where I hope to learn more about this area.

I hope to learn how better to help my patients work on lifestyle contributors to their health, wellness and illness.

Any longtime readers of this column know that my topics about health often involve things you can do yourself.

How you eat, exercise, manage stress and so forth are major factors in wellness or illness.

During the weekend, I did a unique presentation called “Second Life on Lifestyle Medicine.”

Instead to talking to a lecture hall full of students, I experienced something new to me called HomeTown Science 3D.

This involved a digitalized version of myself — my avatar — dressed in a seersucker suit, and teaching in a parallel universe.

Sounds spooky — this is an innovative project headed by Dr. Cheryl Watson and Ellen Adriance and sponsored by the UTMB Virtual Learning Steering Committee.

They garnered a President’s Cabinet Award last year to develop a new and vibrant method of introducing science and health topics to a broad community of learners.

Their website describes Second Life as an online 3D world where real people meet, using avatars, for innovative education and fun.

If you want to see my avatar and the presentation, it will be available for viewing by the end of this week where previous sessions are already up and running at sandbox.utmb.edu/hometownscience/

default.asp.

For my “Second Life” presentation, I summarized the key points of a book by Australian physicians Dr. Egger and colleagues entitled Lifestyle Medicine. The key domains are:

• Motivation

• Exercise

• Nutrition

• Stress

• Positive psychology

• Anxiety

• Depression

• Addictions

• Sleep

• Sex

• Safety

• Environmental

Of all of these, the most fundamental is motivation. This is because without motivation, nothing changes.

The communication process known as motivational interviewing is central to this process. It involves two basic steps:

1. Make conscious (or create) a discrepancy between where an individual is and where he or she would like to be.

2. Help reduce the ambivalence about getting there.

The stages of change leading to transformation are:

1. Pre-contemplation — no intention to change in the foreseeable future.

2. Contemplation — Aware a problem exists; seriously thinking of changing.

3. Preparation — intending to act in the next month; unsuccessfully acted last year.

4. Action — Modification of behavior, experiences or environment.

5. Maintenance — work to prevent relapse and consolidate gain.

Relapse is frequent, backing up in the stages is not uncommon, and transformation takes time, persistence, and practice.

Lifestyle Medicine expands on the ancient advice given by another Greek philosopher and the founder of modern medicine, Hippocrates. He suggested to keep well, one should simply “avoid too much food, too little toil.”

The updated Lifestyle Medicine recommendations are:

• Don’t smoke

• Don’t eat too much food (or eat or drink too much in general)

• Don’t drink too much alcohol

• Try not to get anxious or depressed

• Get just the right amount of stress.

• Don’t do too many drugs (of all kinds)

• Don’t have unsafe sex

• Eat breakfast

• Keep regularly active

• Sleep well and for long enough

• Do some stretching and strength work every other day

• Wear sunscreen

• Use a moisturizer

• Avoid air conditioning where possible

• Keep the skin well hydrated

• Chew gum

• Floss regularly

Pretty common-sense suggestions, are they not? However, I am not going without air conditioning in Galveston.

Maybe you are striving for a second life of your own, trying to reinvent yourself.

Find one area from the domain list above that you are ready to move from contemplation to action.

Get started. Don’t try to do too much or too little. Forgive yourself if you slip and fall. Just pick up and start again.

In addition to imagining yourself or your avatar as successful, practice experiencing the feelings you will have when you have accomplished the change you desire.

Reflect on Albert Einstein’s quote: “Imagination is everything. It is the preview of life’s coming attractions.”

Maybe your second life is a healthier lifestyle in a parallel universe. Imagine it and feel the change begin.

Dr. Victor S. Sierpina is the WD and Laura Nell Nicholson Family Professor of Integrative Medicine and Professor of Family Medicine at UTMB.

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