The human brain remains one of the greatest challenges for modern medicine, yet it is one of the most integral and sometimes overlooked aspects of medicine. The human brain consists of roughly 100 billion neurons, 100 trillion neuronal connections and consumes about 20–25% of the body’s energy. Emerging evidence highlights that insufficient or inadequate nutrition is linked to an increased risk of brain health, mental health, and psychological functioning compromise. A core component of this relationship includes the intricate dynamics of the brain-gut-microbiota (BGM) system, which is a progressively recognized factor in the sphere of mental/brain health. The bidirectional relationship between the brain, gut, and gut microbiota along the BGM system not only affects nutrient absorption and utilization, but also it exerts substantial influence on cognitive processes, mood regulation, neuroplasticity, and other indices of mental/brain health. Neuroplasticity is the brain’s capacity for adaptation and neural regeneration in response to stimuli. Understanding neuroplasticity and considering interventions that enhance the remarkable ability of the brain to change through experience constitutes a burgeoning area of research that has substantial potential for improving well-being, resilience, and overall brain health through optimal nutrition and lifestyle interventions. The nexus of lifestyle interventions and both academic and clinical perspectives of nutritional neuroscience emerges as a potent tool to enhance patient outcomes, proactively mitigate mental/brain health challenges, and improve the management and treatment of existing mental/brain health conditions by championing health-promoting dietary patterns, rectifying nutritional deficiencies, and seamlessly integrating nutrition-centered strategies into clinical care.

Mental health symptoms are pervasive, with 1 in 5 American adults experiencing a mental disorder. Poor mental health is associated with a significant global cost burden, from disability to economic impacts. The field of lifestyle medicine, which emphasizes the role of lifestyle factors in the onset and treatment of disease and well-being, is well suited to address mental health. More recently, there has been attention to the need to incorporate mental health into the field of lifestyle medicine and to attend to the bidirectional role of mental health and lifestyle. Thus, there is a critical opportunity for the field of lifestyle medicine to incorporate mental health into each of the foundational pillars (diet, exercise, substance use, psychological well-being/stress, relationships, sleep) while also specifically targeting lifestyle interventions for populations with mental disorders. The current article provides a framework for the role of mental health within lifestyle medicine by addressing the scope of the problem, clarification regarding mental health, and areas of practice (ie, psychiatry), and providing an overview of the relevant mental health literature for each pillar. This article serves as a call to action to explicitly address and include mental health within all aspects of lifestyle medicine research and practice.

Physician burnout, as described in North America, is a multidimensional work-related syndrome that includes emotional exhaustion, depersonalization, and a low sense of accomplishment from work. More than 50% of physicians were reporting symptoms of burnout prior to the COVID-19 pandemic. This silent epidemic of burnout is bound to become less silent as the pandemic continues. Lifestyle medicine is an evidence-based discipline that describes how daily habits and health practices can affect overall health and well-being of individuals. Lifestyle Medicine can potentially play a significant role in preventing and ameliorating physician burnout. This article explores the burnout process, including the historical context, international definitions, symptoms, and imprecision of the clinical diagnosis. The systemic etiological issues are discussed, and the psychological underpinnings are explored, including physicians’ personal vulnerabilities contributing to burnout. The stress response and lifestyle medicine’s role in healthy coping are described. A prevention model for risk factor reduction is proposed, focusing on primordial, primary, secondary, and tertiary prevention. Lifestyle medicine clinicians’ role in prevention, treatment, and advocacy to ameliorate the potential for burnout is discussed along with specific recommendations.

The field of Lifestyle Psychiatry aims to prevent, treat, and sometimes reverse chronic physical and mental health conditions through evidence-based interventions. The foundational pillars of this field are physical activity & exercise, nutrition, restorative sleep, stress management, toxic exposure reduction, and connectedness. Connection has been defined as “feeling part of something larger than yourself, feeling close to another person or group, feeling welcomed, and understood.” Within Lifestyle Psychiatry, however, we emphasize that connectedness encompasses not only our relationships with other individuals but also our connection to ourselves and with the world at large. We have identified these three relationships as three core or pivotal needs. Similarly, we have expanded our previous model of connectedness to include six domains: (1) Happiness, (2) Purpose in Life & Meaning-Making, (3) Empathy & Compassion, (4) Social Connection & Community, (5) Nature, and (6) Spirituality & Religion. In this paper, we present psychological and scientific data supporting the necessity of the six domains of connectedness. By combining the six domains with the three core needs, practitioners of lifestyle psychiatry can develop impactful and sustainable interventions that promote connectedness, decrease negative health outcomes, and promote psychological growth through increasing resilience, emotional development, and the ability to be alone without loneliness.

The incidence of substance use and behavioral addictions continues to increase throughout the world. The Global Burden of Disease Study shows a growing impact in disability-adjusted life years due to substance use. Substance use impacts families, communities, health care, and legal systems; yet, the vast majority of individuals with substance use disorders do not seek treatment. Within the United States, new legislation has attempted to increase the availability of buprenorphine, but the impact of substance use continues. Although medications and group support therapy have been the mainstay of treatment for substance use, lifestyle medicine offers a valuable adjunct therapy that may help strengthen substance use recovery through healthy neuroplastic changes.

The field of psychiatry has evolved over the past 2500 years. Between dynamic psychotherapy and psychopharmacology, lifestyle psychiatry holds a different space. This approach capitalizes on the lifestyle medicine movement, as it promotes change within 6 domains of activity. Apart from incorporating these lifestyle pillars as adjunctive therapy for either psychodynamic therapy or psychotropic medication regimens, lifestyle psychiatry is on the frontier similar to the other growing fields of precision psychiatry, advanced learning in psychiatry, psychedelics in psychiatry, digital mental health, and psychiatric genetics. Any disruption into the historical practice of psychiatry, particularly with the prescription of medications, can be met with scrutiny. We encourage the field of psychiatry to keep an open mind as our field continues to evolve. What makes lifestyle psychiatry particularly powerful and unique in its ability to assess and evaluate internal and external factors that contribute to individual behaviors, and may impact the ability to incorporate healthy lifestyle actions. Internal factors include: emotional regulation, internalized trauma, cognitive factors, and personality traits. On the other hand, external factors include environmental barriers and work-related burnout.