A lifestyle medicine program at New York City-based NYC Health + Hospitals is helping patients with chronic disease feel healthier and achieve measurable clinical improvements through nutrition, exercise and behavioral support.
Over a monthslong period, the lifestyle medicine program includes one-on-one visits with a medical provider, dietitian, and health coach for personalized coaching, group visits designed as shared medical appointments, fitness classes and other support for lifestyle changes. Afterward, the programs offer ongoing services to participants, such as monthly support groups.
While the program has recorded several clinical outcome improvements, Michelle McMacken, MD, executive director of nutrition and lifestyle medicine at the 11-hospital system, said she feels the most fulfillment in seeing patients feel healthier.
“The thing that’s the most rewarding is actually when a patient sits in front of me and tells me, ‘I feel so much better. I feel like I have a new understanding of … how I want to live my life in a way that will support me now and in the future,'” Dr. McMacken said in a March 16 episode of the “Clinical Leadership Podcast.”
The system piloted the lifestyle medicine program in 2019 at NYC Health + Hospitals/Bellevue — the oldest hospital in the U.S., which began as a six-bed infirmary in 1736 and now operates 1,215 beds, according to the system’s website.
The pilot included a small group of medical providers, a registered dietitian and a certified health coach who worked with patients with cardiometabolic disease and other health concerns related to excess weight to implement evidence-based lifestyle changes. Interventions include a healthy, plant-based diet, physical activity, sleep health, stress reduction, avoidance of substance use and enhanced social connections.
“I think the pillar that many people forget about completely is the pillar of connectedness, which sounds a little touchy-feely, but it’s really [important]. We know loneliness is a huge risk factor for mortality,” said Dr. McMacken, who is board certified in internal medicine and lifestyle medicine.
The pilot recorded significant reductions in hemoglobin A1C and weight, as well as improvements in cholesterol, blood pressure and patient satisfaction — prompting NYC Health + Hospitals to scale the program.
“Putting that all together, the evidence is very, very powerful that we cannot just help prevent all of these common chronic conditions, but we can actually significantly improve them,” Dr. McMacken said. “That’s our passion, and that’s our mission.”
Today, the program spans all five boroughs of New York City and has more than 75 staff members. The interdisciplinary team includes physicians, nurse practitioners, dietitians and health coaches, as well as community health workers, program coordinators, psychologists and a fitness instructor.
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