In this plenary lecture, I will first emphasize that the current epidemic of chronic societal diseases results from the exposition of a large and growing segment of our population to a “toxic” environment not compatible with healthy behaviors. This obesogenic environment has tremendous socio-economic consequences all over the world since the WHO has reported that 60% of all deaths result from noncommunicable chronic diseases that are largely attributed to four behaviors: smoking, excessive alcohol consumption, poor nutritional habits and lack of physical activity. Despite the fact that such behaviors are recognized as critical for health, studies have shown that only a few physicians assess nutritional quality and level of physical activity in clinical practice.
During my talk, I will review some of the work conducted in my laboratory over the last 30 years which led me to propose that four key “lifestyle vital signs” should be assessed and targeted in clinical practice as they are powerful predictors of various health outcomes: waist circumference as a marker of abdominal obesity, cardiorespiratory fitness, nutritional quality and level of physical activity. Our intervention studies conducted in the context of primary prevention have documented the remarkable benefits on health of assessing the above four “lifestyle vital signs” to target upstream behaviors (nutritional quality and physical activity) and their related outcomes (waist circumference and cardiorespiratory fitness). In an area where the potential of personalized medicine is explored, I will propose that the time for preventive lifestyle medicine has come. Innovative models should be developed so that patients managed in primary care have access to programs based on these simple principles.