[01.18a] CM - Lifestyle Medicine Assessment and Intervention (Part 1) V2.pdf

Lower in the Philippines vs. global average

How does life expectancy in the Philippines compare to the global average?

Lower in men by more than 6.5 years

How does male life expectancy in the Philippines compare to female life expectancy?

Before age 70

Premature death is defined as mortality occurring before what age?

Males

Which gender experiences significantly higher rates of premature mortality in the Philippines?

Lifestyle-mediated Non-Communicable Diseases

What heavily drives premature mortality among Filipino men?

Ischemic heart diseases

What was the number one leading cause of death in the Philippines from January to November 2025?

19.7%

What percentage of total deaths in the Philippines were caused by ischemic heart diseases in early 2025?

Neoplasms

What is the second leading cause of death in the Philippines?

11.4%

What percentage of total deaths in the Philippines are attributed to neoplasms?

Cerebrovascular diseases

What is the third leading cause of death in the Philippines?

9.8%

What percentage of total deaths are due to cerebrovascular diseases?

Pneumonia

What is the fourth leading cause of death in the Philippines?

Diabetes mellitus

What is the fifth leading cause of death in the Philippines?

6.1%

What percentage of deaths in the Philippines are caused by diabetes mellitus?

Hypertensive diseases

What is the sixth leading cause of death in the Philippines?

Chronic lower respiratory diseases

What is the seventh leading cause of death in the Philippines?

Respiratory Tuberculosis

What is the eighth leading cause of death in the Philippines?

Other heart diseases

What is the ninth leading cause of death in the Philippines?

Remainder of the diseases of the Genitourinary system

What is the tenth leading cause of death in the Philippines?

41 million

According to WHO 2023, how many people do NCDs kill each year?

74%

NCDs account for what percentage of all deaths globally?

42%

What percentage of people die from an NCD before age 70?

86%

What percentage of premature NCD deaths occur in low- and middle-income countries?

Cardiovascular disease

Which lifestyle-related disease causes the most deaths annually at 17.9 million?

9.3 million

How many annual deaths are attributed to cancers globally?

4.1 million

How many annual deaths are attributed to chronic respiratory diseases?

2.0 million

How many annual deaths are caused by diabetes and its complications?

Pneumonia

What used to be the number one cause of death among NCDs worldwide before antibiotics and immunizations?

Unhealthy lifestyles

Nowadays, what is the primary reason people die according to the source?

INTERHEART Study

What study looked at potentially modifiable risk factors associated with myocardial infarction in 52 countries?

Case-control study

What was the study design for the INTERHEART and INTERSTROKE studies?

More than 90%

All nine factors in the INTERHEART study are associated with what percentage of acute myocardial infarction risk?

Smoking

What is the first risk factor identified in the INTERHEART study?

Abnormal cholesterol

What risk factor in INTERHEART is defined by a raised ApoB to ApoA1 ratio?

History of hypertension

What is the third risk factor identified in the INTERHEART study?

Abdominal obesity

What is the fourth risk factor identified in the INTERHEART study?

Psychosocial factors

Stress and isolation are examples of which risk factor in the INTERHEART study?

Type 2 Diabetes

What is the sixth risk factor identified in the INTERHEART study?

Daily consumption of fruits and vegetables

What is the first protective factor in the INTERHEART study?

Regular alcohol consumption in moderation

What is the second protective factor in the INTERHEART study?

1 drink per day

What is the moderate alcohol limit for females in the INTERHEART study?

2 drinks per day

What is the moderate alcohol limit for males in the INTERHEART study?

Regular physical activity

What is the third protective factor identified in the INTERHEART study?

80%

Smoking, healthy weight, blood pressure, and physical activity/diet account for what percentage of heart attack risks?

INTERSTROKE Study

What study looked at risk factors for ischemic and intracerebral hemorrhagic stroke in 22 countries?

90%

Ten risk factors in the INTERSTROKE study are associated with what percentage of stroke risks?

History of hypertension

What is the first risk factor listed for stroke in the INTERSTROKE study?

Current smoking

What is the second risk factor for stroke?

High waist-to-hip ratio

How is obesity measured as a risk factor in the INTERSTROKE study?

Diet risk score

What nutritional factor is listed as a risk for stroke?

Excessive alcohol intake

What alcohol-related behavior is a risk factor for stroke?

Cardiac causes

What cardiovascular risk factor is specific to the stroke study?

Abnormal lipid levels

What lipid-related factor is a risk for stroke?

Regular physical activity

What is the primary protective factor for stroke?

Focused too much on medicine and surgery

What is the problem in current medicine regarding lifestyle intervention?

1948

In what year did the Framingham Heart Study begin?

2000

When did the Framingham study begin involving the genomic level?

Obesity and diabetes

What two conditions did researchers in the Framingham study link to lifestyle practices?

Endometrial cancer

Obesity increases the risk of which cancer by 7x?

4.8x

Obesity increases the risk of adenocarcinoma of the esophagus by how many times?

Implement lifestyle modification first

What is the first step in the JNC 8 algorithm for adults with hypertension?

Smoking cessation

What is the first specific lifestyle change mentioned in the hypertension guidelines?

Controlling blood glucose and lipids

Besides smoking, what two markers should be controlled for hypertension?

18.5-24.9

What is the target BMI for weight reduction to lower blood pressure?

5-20 mmHg per 10 kg weight loss

What is the expected blood pressure reduction for weight reduction?

DASH diet pattern

Which diet pattern consumes fruits, vegetables, and low-fat dairy with reduced saturated fat?

8-14 mmHg

What is the expected blood pressure reduction for the DASH diet?

Regular aerobic exercise

What intervention involves more than 150 minutes of activity per week?

4-9 mmHg

What is the expected blood pressure reduction for physical activity?

Lower salt intake as much as possible

What is the recommendation for sodium intake?

1.5 g/day

What is the specific sodium intake recommendation for maximum BP reduction?

3.8 g/day

What is the recommended maximum intake of sodium chloride?

2-8 mmHg

What is the expected blood pressure reduction for reduced sodium intake?

2-4 mmHg

What is the expected blood pressure reduction for limiting alcohol consumption?

4.7 g/day

What is the daily potassium intake level recommended in the DASH diet?

2-4 mmHg

What is the expected blood pressure reduction for increasing potassium?

50% decrease

What percentage decrease in total cholesterol results in a 50% decrease in heart disease risk?

16% heart disease and 42% stroke

A 6 mmHg decrease in diastolic pressure results in what decreases in disease risk?

50%

Stopping smoking is associated with what percentage reduction in heart disease risk?

35-55%

Maintaining ideal body weight and regular physical activity each reduce heart disease risk by what range?

5 servings per day

How many servings of fruits and vegetables are needed for a 20-25% decrease in heart disease risk?

90-95%

Implementing all six major lifestyle changes decreases heart disease risk by what range?

AACE and ACE

Which organizations provided the Glycemic Control Algorithm?

Lifestyle therapy

What is the first-line treatment for Type 2 DM regardless of HbA1c level?

HbA1c less than 6.5% or greater than 6.5%

Lifestyle therapy is recommended for patients with which HbA1c levels?

Ongoing glucose monitoring

What is recommended alongside lifestyle therapy for diabetic patients?

Older than 45 years old

What age threshold is an established risk factor for Type 2 DM?

Overweight or obese

What weight status is a modifiable risk factor for diabetes?

Gestational diabetes

Having a history of what during pregnancy is a risk factor for diabetes?

PCOS or PMOS

Which ovarian syndromes are risk factors for diabetes?

Processed meats and ultra-processed foods

Besides refined carbohydrates, what food types contribute to diabetes development?

Processed/ultraprocessed food

Which food is proven to be a carcinogen, while burned food is not?

Group 1

In which IARC hazard classification is processed meat placed?

Tobacco smoking, solar radiation, and alcohol

What are three other substances in IARC Group 1 besides processed meat?

Probably carcinogenic to humans

What does the IARC Group 2A classification mean?

Red meat

Which food is classified as Group 2A?

Night shift work

What occupational factor is classified as Group 2A?

Possibly carcinogenic to humans

What does IARC Group 2B classification mean?

Gasoline engine exhaust

What is an example of a Group 2B substance?

Not classifiable

What does IARC Group 3 classification mean?