New York City Mayor Eric Adams just announced a "Comprehensive Expansion of
Lifestyle Medicine Programming" to be rolled out across the city as a way to offer healthy lifestyle support to those who need it most. This ground-breaking city-wide health initiative will offer team-based support to individuals who need help eating healthier and coping with chronic conditions such as type 2 diabetes, hypertension, and other common health conditions that disproportionately impact Black and brown people and those seeking public health assistance in the five boroughs. It's the most ambitious plan of its kind ever announced by a major US city.

The announcement came just one day after an unflattering Politico story reported that New York's "vegan" Mayor frequents a restaurant in midtown Manhattan where he regularly eats fish. And while most doctors would characterize a dinner of fish and salad or steamed spinach (as the Mayor reportedly orders) as extremely healthy, it is not a strictly vegan choice since vegans don't eat fish or other animal products. Still, it is "mostly plant-based" and extremely healthy.

"This is personal to me," says the Mayor

“Today, New York City is again leading the way with the most comprehensive expansion of lifestyle medicine programming in the nation,” said Mayor Adams. “This is personal to me — a plant-based lifestyle helped save my life, and I’m thrilled that New Yorkers in every zip code will have access to this critical programming. Together, we will stop feeding the health care crisis and ensure all New Yorkers can access the healthy lifestyle they deserve.”

In his book, Healthy At Last, then Brooklyn Borough President Adams told the detailed story of how when he awoke to near-blindness one morning, it sparked a journey toward major lifestyle and dietary changes. He immediately sought medical attention, at which point he learned that he had full-blown diabetes. A plant-based diet helped him lose 40 pounds and reverse his symptoms, to the point where he now no longer requires medication, he wrote.

In sharing his own personal plant-based journey to health, the Mayor has led people to believe that he is vegan. Strict vegans do not eat fish or any animal products. It would be more accurate to instead call the Mayor pescatarian or "mostly plant-based."

A request for comment from the Mayor on his approach elicited this response:

"Let me be clear - Changing to a plant-based diet saved my life, and I aspire to be plant-based 100 percent of the time. I want to be a role model for people who are following or aspire to follow a plant-based diet, but as I said, I am perfectly imperfect and have occasionally eaten fish."

A diet of salad, vegetables, and fish is considered one of the healthier dietary approaches, according to most cardiologists and other medical or nutrition experts, who would love to see Americans adopt a more Mediterranean style diet for the sake of disease prevention, especially heart disease and to lower their lifetime risk of medical conditions such as diabetes or high blood pressure, associated with the Standard American Diet  (SAD) that is high in animal fat, sodium and added sugar and highly processed foods.

The mayor has made it his personal mission to help New Yorkers be healthier, and one way he proposes to do that is by espousing a mostly plant-based diet for people who need to lower their risk of chronic conditions such as pre-diabetes, heart disease, and high blood pressure. The vast expansion of health services he is proposing will place New York City at the leading edge of helping its citizens live healthier, longer, more active lives, according to today's announcement.

New Yorkers will benefit from this ground-breaking healthy lifestyle programming

The program, an expansion of one that was first launched out of a successful diet and lifestyle program at Bellevue, will be "the most comprehensive expansion of lifestyle medicine programming in the U.S." The new expansion "will provide patients living with chronic disease the tools to make healthy lifestyle changes, including providing them access to plant-based diet resources," the announcement read.

The program will expand to serve qualifying NYC Health + Hospitals adult patients in six medical centers: Jacobi, Lincoln, Woodhull, Kings County, and Elmhurst hospitals, as well as Gotham Health, Vanderbilt. The program expansion will be implemented over the coming year.

“This expanded programming won’t only touch the lives of the patients served but will extend to the families and communities of every person served,” said Deputy Mayor for Health and Human Services Anne Williams-Isom. “That mom with type 2 diabetes or that dad with high cholesterol now has new tools to reclaim their health through everyday choices to eat, manage stress, and sleep better, as well as find enhanced social support.

"These programs can change individual lives by treating, preventing, and even reversing common chronic diseases, but will also ripple through to families and communities of those at risk of or living with a chronic disease. I want to thank Dr. McMacken, Dr. Katz, and all the staff doing this cutting-edge work and making a difference in the lives of so many New Yorkers.”

“Even through the pandemic, heart disease remains the leading killer of New Yorkers, with diabetes not too far behind,” said Senior Advisor for Public Health and Incoming Commissioner of Health Dr. Ashwin Vasan. “To move the needle, we will need to invest in both upstream policy reforms and downstream care and supports. Increasing access to dietitians, health coaches, and physicians through innovative approaches, like the Lifestyle Medicine Program, will help more New Yorkers with cardio-metabolic diseases live longer healthier lives. I applaud Mayor Adams and our colleagues at NYC Health + Hospitals for their leadership and for taking a holistic approach to supporting the health of our communities.”

“I have seen the benefits of lifestyle medicine for patients with chronic diseases in my own clinical practice,” said Health Commissioner Dr. Dave A. Chokshi. “As we continue to fight COVID-19, scaling these services will help build a healthier city for all New Yorkers. I applaud NYC Health + Hospitals for expanding this evidence-based program.”

Doctors praise the lifestyle program as groundbreaking

“As a physician, I know that medicine doesn’t always come in the form of a pill. Eating a diet of fruits and vegetables can help prevent and treat chronic illnesses like heart disease - the leading cause of death among New Yorkers - cancer, and type 2 diabetes,” said NYC Health + Hospitals President and CEO Mitchell Katz, MD. “Low-income New Yorkers are much more vulnerable to these diseases and we want to continue offering them an alternative way of eating that works on a limited budget and is accompanied by a network of medical and nutritional professionals. NYC Health + Hospitals is grateful to Mayor Adams for his continued support and innovation as we tackle the problem of chronic illnesses.”

“The expansion of our lifestyle medicine services to New Yorkers throughout the five boroughs will be a powerful tool in addressing the burden of type 2 diabetes, hypertension, and other common chronic conditions, with benefits that could positively impact entire family units and those closest around them,” said Michelle McMacken, MD, executive director, Nutrition and Lifestyle Medicine at NYC Health + Hospitals. “We continue to be grateful to all of our advocates and partners who have made our existing lifestyle medicine services a success and this necessary expansion a reality.”

Health and food policy will go hand in hand for New Yorkers

“Today's announcement that H+H's lifestyle medicine services are now available in all five boroughs is an exciting step forward for our city," said Kate MacKenzie, executive director, Mayor's Office of Food Policy. "Healthy food is essential for a healthy life, and this expansion couldn't come at a better time for New Yorkers. I am grateful to Mayor Adams for his passion and commitment to helping all New Yorkers make positive lifestyle changes and to Dr. McMacken and the team at H+H for executing on that vision."

In 2019, with the advocacy of then-Brooklyn Borough President Adams, the Bellevue Plant-Based Lifestyle Medicine Programamong the first of its kind in a safety-net health care setting — was launched. The program takes an interdisciplinary approach to reduce patients' cardiometabolic risk, where a team of physicians, dietitians, and health coaches support patients in making evidence-based lifestyle changes, including adopting a healthy plant-based diet, increasing physical activity, improving sleep habits, reducing stress, avoiding risky substances, and providing social support. The program has received national attention and there has been a high demand for services, including self-referrals from more than 850 New York City residents.

Each of the sites that will be receiving the expanded lifestyle medicine services will be equipped with a full-time dietitian and health coach, as well as physician teams. Participants will be referred by their health care providers or can self-refer. Eligibility criteria for participants include heart disease, hypertension, type 2 diabetes, prediabetes, and/or health concerns related to obesity.

Patients who enroll in one of the programs will receive a full medical evaluation by a team physician, with special attention to current lifestyle behaviors and social needs. They will also meet individually with a dietitian and a health coach and will participate in group education on topics including nutrition, physical activity, sleep, stress reduction, and other lifestyle pillars. The lifestyle medicine team will individualize the behavior change approach for each patient, considering cultural traditions, socioeconomic circumstances, family situations, and other key factors.

In addition to expanding access to lifestyle medicine services, NYC Health + Hospitals will partner with the American College of Lifestyle Medicine to help provide additional lifestyle medicine training to care teams, as well as with Plant-Powered Metro New York to offer cooking demonstrations to patients at the Kings County Hospital site.

“We are thrilled to partner with NYC Health + Hospitals to support its patient community with culturally-mindful education and skill-building for healthy eating,” said Lianna Levine Reisner, president and network director, Plant-Powered Metro New York. “Throughout the city, people from all walks of life are being inspired by the power of food for health. They want to learn how to incorporate more fruits, vegetables, and other healthy plant foods onto their plates and into their daily routines. It's a great step forward to have the investment of the public health care system in life-changing programs and services that prioritize evidence-based nutrition and lifestyle.”

NYC Health + Hospitals’ expansion of lifestyle medicine services builds on its commitment to put healthy eating and other beneficial lifestyle habits at the forefront of patients’ care. In 2019, the system launched Meatless Mondays at all 11 of its acute care hospitals. The program was launched in an effort to provide a broader range of healthy, appealing meal options to inpatients and introduce them to the benefits of plant-based nutrition so that they could make important lifestyle decisions that would lead to living their healthiest lives.

A holistic approach to lifestyle disease

"As a lifelong vegetarian, I know that lifestyle choices have a direct impact on health. I'm excited that NYC Health + Hospitals will expand their lifestyle medicine program to Elmhurst Hospital so that our community can access the life-saving expertise of physicians, dieticians, and health coaches," said New York City Councilmember Shekar Krishnan.

“NYC Health + Hospitals is leading the way in offering health care services that affect patients’ everyday lifestyle habits,” said New York City Councilmember Julie Menin. “Proper and effective nutritional guides and services are most important for our vulnerable populations, like those with chronic conditions. Expanding the reach of these services citywide provides access to dietary resources that individualizes its patients and offers an equitable approach for contemporary lifestyle needs.”

Medical experts applaud the initiative

"A healthy lifestyle is the cornerstone of any person's wellbeing,” said New York City Councilmember Chi Osse. “It is wonderful to see the city taking these steps to elevate this important component of health care, as well as to know that this program will be carried out in a culturally-mindful manner."

"Today we face not just a pandemic of COVID-19, but also a pandemic of cardiovascular disease —which scientific literature demonstrates could be dramatically improved with the nutrition and lifestyle behaviors that Dr. McMacken has championed for years,” said ​Kim Allan Williams, Sr., M.D., James B. Herrick professor and chief, Division of Cardiology, Rush University Medical Center; past-president, American College of Cardiology. “I applaud Mayor Adams, Dr. Katz, and Dr. McMacken for supporting the expansion of lifestyle medicine programs across NYC Health + Hospitals. This is timely if we expect to improve outcomes, extend lives, reduce health care costs and sustain the planet.”

"We applaud the expansion of this powerful Lifestyle Medicine program throughout the NYC Health + Hospitals system,” said Robert Ostfeld, MD, MSc., director, Preventive Cardiology, Montefiore Health System. “In our aligned Cardiac Wellness Program at Montefiore, we encourage patients to embrace a plant-based diet with the goal of preventing disease and improving cardiovascular risk. In our experience, such interventions can lead to profound health benefits. This NYC Health + Hospitals initiative is an inspiration to health care systems worldwide, a boon for New Yorkers, and we are proud to share a similar vision.”

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