Lifestyle Medicine

Many common chronic diseases are rooted, at least in part, in lifestyle. Among them are leading causes of death worldwide: heart disease, type 2 diabetes, hypertension, obesity, and certain cancers. Not only do these chronic diseases cause death and disability, they are responsible for 80% of health care costs in the United States.

“Almost all clinical practice guidelines for the top chronic diseases recommend lifestyle changes as the first line of treatment.”

Catherine Collings, MD, FACC, MS, DipABLM
President, American College of Lifestyle Medicine

Lifestyle intervention

By changing your lifestyle, you can often prevent, halt, or reverse these common chronic diseases. This is particularly true if you pursue an intensive, therapeutic lifestyle intervention. 

More than 40 peer-reviewed publications document the effectiveness of LMI’s lifestyle medicine solution in reducing and reversing risk factors related to: 

  • Diabetes
  • Hypertension
  • Obesity
  • Heart disease
  • Other chronic disease

When you join the Pivio community, you embark on a journey to a new lifestyle. You learn how to shift your daily habits to help your body recover and thrive.

Targets for change

Imagine that your lifestyle choices were rated on a scale of 1 to 10, based on how well they sustain your health. A rating of 1 represents a habit that is damaging to your health. A rating of 10 represents an ideal, healthful way of living.

Pivio works by shifting your way of life from the low end of the scale toward the high end, helping you create positive change across the 6 key pillars of lifestyle medicine:

plant-rich eating pattern

Fresh fruits and vegetables, whole grains, and legumes are key to restoring health. Pivio recommends a plant-rich, minimally processed eating pattern.

sleep and rest

7-8 hours a night of restorative sleep is critical for weight control, blood sugar regulation, cardiovascular health, mood, dementia prevention, and keeping your immune system strong.

physical activity

Exercise, even gentle movement like walking, lowers blood pressure, elevates mood, improves circulation, strengthens muscles, boosts immunity, and leads to more restful sleep.

meaningful social connections

Family, friends, and community play a powerful role in maintaining health. Research links social connection with fewer ailments and a longer life.

avoidance of risky substances 

Alcohol, nicotine, caffeine, and drugs can threaten your health, as can environmental toxins and pollutants. It is important to understand and manage the risks. 

Stress Management

It’s no secret that managing stress makes you feel happier. But it also helps you control your weight, reduce risk for heart disease and dementia, reduce muscle tension, get sick less often, and sleep soundly.

Taking aim at disease

Because Pivio is designed to improve overall health, it reduces and reverses risk factors for a wide range of diseases. Upon entering the program, participants complete a health-risk assessment and blood analysis. In 10 weeks, participants repeat the tests. Pivio compares the original and new measurements to identify changes in key biometrics and wellbeing scores.

Many Pivio participants not only reverse disease, but sustain their health improvements for years.

Pivio achieves impressive results in highest risk patients

Average biomarker declines after a 30-day intervention


44.1% decline

Initial level: Above 500mg/dl

Fasting plasma glucose

19.9% decline

Initial level: Above 125mg/dl

Total cholesterol

19.8% decline

Initial level: Above 280mg/dl

LDL cholesterol

16.1% decline

Initial level: Above 190mg/dl

Participants with metabolic syndrome

10.4% decline

Body mass index

3.2% decline

Proven to work

A body of research supports the premise that lifestyle modification is an effective tool to prevent, treat, and reverse disease.


Eating more fruits, vegetables and whole grains can lower risk of death.

Analysis of the Global Burden of Disease study, which spanned 195 countries, noted that “69% of iscshemic heart disease deaths worldwide could be prevented if healthier diets were adopted.”

It also concluded, “More than six million deaths could be avoided by reducing intake of processed foods, sugary beverages, trans and saturated fats, and added salt and sugar, while increasing intake of fish, fruits, vegetables, nuts and whole grains.”   

Eating healthier may reduce the risk of diabetes. 

Those who were in the lifestyle arm of the study had a 58% reduction in the diagnosis of T2DM, far better than the pharmacologic arm using metformin (31%).

Plant-based diets can reduce medication use for chronic conditions. 

“The major benefits for patients who decide to start a plant-based diet are the possibility of reducing the number of medications they take to treat a variety of chronic conditions, lower body weight, decreased risk of cancer, and a reduction in their risk of death from ischemic heart disease.”


Reduces premature death

Moderate-intensity walking at or above 150 minutes a week (30 minutes, 5 times a week) reduced premature death by 20% in older adults. Even walking less than 120 minutes a week is beneficial compared to no walking. 

Improves memory and cuts risk of dementia and Alzheimer’s disease

An analysis of 11 studies found regular exercise can cut the risk of dementia by 30 percent; by 45% for Alzheimer’s disease. 

In another study, exercise training increased volume of the hippocampus — a part of the brain responsible for short-term memory — by 2%, improving memory and effectively reversing age-related loss in volume by 1- 2 years. 

Lowers risk of developing type 2 diabetes

An analysis of 10 studies involving more than 300,000 participants compared risk of developing type 2 diabetes among people who walked briskly for about 2.5 hours a week (about 22 minutes a day, 7 days a week) and those who did little or no walking. Participants who walked had a 31% reduction in risk without accounting for body mass index (BMI) and a 17% reduction when accounting for BMI.


Lack of sleep may increase risk of heart disease, diabetes and depression.  

“As chronic diseases have assumed an increasingly common role in premature death and illness, interest in the role of sleep health in the development and management of chronic diseases has grown. Notably, insufficient sleep has been linked to the development and management of a number of chronic diseases and conditions, including type 2 diabetes, cardiovascular disease, obesity, and depression.”

Getting more sleep can help people live a longer life.

“Diet, exercise, and sleep are three pillars of a healthy life. While improving just one of these lifestyle factors can help people lead longer lives, several recent studies have suggested that improving all three may be a better way to improve both physical and mental health.” 

Sleep deficiency can increase the risk of chronic disease

If you experience continued sleep deprivation, you will develop a condition called sleep deficiency. This is a state in which you cannot make up the many lost hours of sleep. Sleep deficiency increases the risk of obesity, diabetes, cardiovascular disease, depression, and even early death.

Social Connection

Social relationships may reduce Mortality Risk

“50% increased likelihood of survival for participants with stronger social relationships.”

Family support helps reduce BMI. 

“Encouragement of participation with a family member or a “buddy” may be prudent, especially if weight reduction is a key program participation goal.”

Lack of strong relationships is the same as smoking 15 cigarettes a day. 

“Lack of social ties is associated with depression and later-life cognitive decline, as well as with increased mortality. One study, which examined data from more than 309,000 people, found that lack of strong relationships increased the risk of premature death from all causes by 50% — an effect on mortality risk roughly comparable to smoking up to 15 cigarettes a day, and greater than obesity and physical inactivity.”

Risky substances

Smoking cessation reduces anxiety and alcohol use disorder

“Data suggests that smoking cessation is associated with risk reduction for mood/anxiety or alcohol use disorder, even among smokers who have had a pre-existing disorder.”

“Twenty-five chronic disease and condition codes in the International Classification of Disease (ICD)-10 are entirely attributable to alcohol, and alcohol plays a component-risk role in certain cancers, other tumors, neuropsychiatric conditions, and numerous cardiovascular and digestive diseases.”

Smoking and tobacco use increases risk of multiple chronic diseases. 

“Smoking causes cancer, heart disease, stroke, lung diseases, diabetes, and chronic obstructive pulmonary disease (COPD), which includes emphysema and chronic bronchitis. Smoking also increases risk for tuberculosis, certain eye diseases, and problems of the immune system, including rheumatoid arthritis.” 

Stress management

Depression, anxiety, anger, hostility and social isolation can increase cardiovascular risk. 

“Stress from challenging situations and events plays a significant role in cardiovascular symptoms and outcome, particularly heart attack risk. Depression, anxiety, anger, hostility, and social isolation also affect cardiovascular health. Each of these factors heightens your chances of developing heart problems. But emotional issues are often intertwined: people who have one commonly have another.”

Stress management reduce BMI and improve depression.

“In this randomized clinical trial, we evaluated the effect of an 8-week stress management program on weight loss in obese patients vs. age- and BMI-matched control patients who received standard lifestyle instructions. Both groups experienced significant reductions in BMI, perceived stress, level of depression, HLC based on chance, increases in internal and external HLC, as well as positive changes regarding dietary habits, physical activity, daily routine, and social support. The intervention group displayed better results regarding reduction of weight, perceived stress and depression levels.”

Chronic stress puts your health at risk.

“The long-term activation of the stress-response system and the overexposure to cortisol and other stress hormones that follows can disrupt almost all your body’s processes.”

“Within 2 months of going on the program, my cholesterol was halved. My blood pressure was down. In fact, I had to lower my blood pressure pills.”

Mark M.

Intensive lifestyle changes improve cardiac health

The Lifestyle Heart Trial demonstrated that intensive lifestyle changes may lead to regression of coronary atherosclerosis after 1 year.

In this randomized controlled trial, patients with moderate to severe coronary heart disease were randomly divided into two groups. One group adopted intensive lifestyle changes: a 10% fat whole foods vegetarian diet, aerobic exercise, stress management training, smoking cessation, and group psycho-social support. The control group made moderate lifestyle changes. 

After 1 year, results were as follows:Patients adopting intensive lifestyle changes
After 1 year of intensive lifestyle changes
Usual-care control group
After 1 year of moderate lifestyle changes
LDL cholesterol37.2% reduction6% reduction
Frequency of anginal episodes91% reduction165% increase
Average percent diameter stenosisRegressed from 40.0% to 37.8%*

*Change correlated with the degree of lifestyle change.
Progressed from 42.7% to 46.1%

Source: “Intensive Lifestyle Changes for Reversal of Coronary Heart Disease,” Journal of the American Medical Association, Dec. 16, 1998, Vol. 280, No. 23

Knowledge Bank

Lifestyle Medicine experts at LMI share their knowledge to help partners and participants succeed.

Clinical Research

Browse more than 40 peer-reviewed research papers proving that LMI’s lifestyle medicine solution reduces and reverses risk factors related to chronic disease.

Behavioral Science

Pivio’s behavioral science tools integrate Lifestyle Medicine approaches into daily life.


Gain insight about the latest health research and methods that can help employees and patients reclaim their health.


Unfamiliar with lifestyle-medicine terminology? This resource will help you master commonly used terms.