Knowledge, perception and adherence to lifestyle medicine pillars : a cross-sectional study among Lebanese adults.

Abstract

Background: The six pillars of lifestyle medicine (LM) (nutrition, physical activity, stress management, quality sleep, social relationships and addiction cessation) improve behaviours that play a causal role in the occurrence of chronic diseases and medical deterioration among adults. LM has shown a positive impact on health outcomes for the last few decades. Therefore, it is highly encouraged to implement it in primary care practice in Lebanon and the Middle East for the prevention and treatment of non-communicable chronic diseases (NCDs). To our knowledge, no study has been performed on the Lebanese population's knowledge, perception, and adherence regarding the six pillars of LM in primary care clinics.

Objectives: The objectives of this study are to assess the knowledge and perception of LM’s pillars in a sample of Lebanese adults, to examine whether LM’s pillars are being addressed by PCPs during medical visits and, finally, to evaluate the adherence to LM’s pillars among Lebanese adults and the determining factors.

Methods: This cross-sectional study was conducted using a self-administered online questionnaire on a convenience sample of 263 Lebanese adults. The online questionnaire, developed by researchers for this study, included 21 questions on lifestyle behaviours related to adherence to the six pillars of LM and 16 questions inquired knowledge and perception, plus whether their PCPs provided any advice about the six pillars of LM. Univariate and Bivariate analysis through IBM SPSS 25 software was performed to investigate the stated objectives. Chi-Square test and Independent Sample T-test were used to analyse the stated objectives.

Results: A sample of Lebanese adults [N=263, 90% CI], 75.7% female, with mean age of 36.06 ± 11.27 years were surveyed in this study. The results indicated that participants with lower BMI and no children were more likely to adhere to physical activity, sleep quantity, social connections, and stress management recommendations. Adherence to physical activity was also significantly associated with a family history of chronic disease and BMI. In addition, females demonstrated better commitment to not smoking and getting sufficient sleeping hours compared to males. Sleeping hours were negatively affected by older age (P-value<0.001), employment, and marriage. Furthermore, married adults reported feeling socially isolated more often than other participants. Our findings also revealed that over 70% of PCPs advised or inquired about their patients' nutrition and physical activity habits. The pillar least discussed in PCPs' clinics, according to the participants, was social connection (N=27%). A significant association was found between PCPs' intervention and adherence to sleeping hours as well as avoidance of smoking.

Conclusion: Adherence to the six pillars may be influenced by various demographic factors, and further larger studies are needed to gain a better understanding of these associations. On the other hand, despite most of the six pillars being discussed in clinics, there is still room for improvement in Lebanese clinical preventive practice.

Keywords: Adherence, Knowledge Lebanese adults, Lifestyle medicine, Perception, Primary care practice, Non-communicable chronic diseases.