Liana S. Lianov

Artificial intelligence (AI) is rapidly transforming health care, offering new opportunities to enhance education, clinical care, and system-level integration. Lifestyle medicine (LM), with its emphasis on behavior change and whole-person care is particularly well positioned to benefit from these advances. This perspective provides an overview of emerging and potential applications of AI across the field, including clinician training and self-directed learning, AI-augmented clinical supervision, patient-facing tools for health behavior change, mental health and emotional well-being, real-time access to scientific evidence, clinical reasoning support, and system-level planning to connect with community resources that address social determinants of health. While these tools offer significant promise to improve scalability, consistency, and personalization of care, they also introduce risks related to data privacy, bias, and overreliance on automated recommendations. Acknowledging recent controversies about AI risks and the rapid evolution of this technology, we propose practical guardrails for clinicians and highlight the importance of leadership engagement to ensure that AI development and its use in the field aligns with the principles of LM and whole-person care. Thoughtful integration of AI with human agency that propels critical thinking has the potential to strengthen, rather than diminish, the human-centered foundations of whole-person care.

Background: Spirituality is a vital, yet sometimes misunderstood component of whole-person care. A growing body of evidence links meaning, purpose, and spirituality (MPS) with improved health outcomes, greater patient satisfaction, and enhanced clinician well-being. In 2024, the American Medical Association (AMA) adopted Resolution 304 (A-24), advocating for the integration of MPS education throughout medical training and continuing education. Despite previous consensus statements and competencies from other professional organizations and accrediting bodies, such as the Association of American Medical Colleges (AAMC), the Liaison Committee on Medical Education (LCME), and the Accreditation Council for Graduate Medical Education (ACGME), MPS-related competencies remain inconsistently embedded within health professions education, including within lifestyle medicine (LM). Objective: To examine competencies, consensus statements and current evidence for spiritual care across various disciplines in order to discern common elements to support the establishment of MPS competencies within lifestyle medicine education and training. Results: The competencies reviewed frame person-centered care through an expanded lens of the human person as biopsychosocial-spiritual. Across disciplines, 5 common categories of competencies emerged, which include: (1) An understanding of whole-person care and broad definitions of spirituality and religion; (2) clinician spiritual self-awareness and self-care, including exploration of potential biases and barriers to patient-centered care; (3) ethical practice, cultural sensitivity, and respect for diversity, including not imposing one’s own personal beliefs (or lack thereof) on the patient; (4) spiritual assessment, communication and care planning skills in patient interactions, including team-based collaboration and referral to spiritual care professionals; (5) clinician therapeutic skills, including compassionate presence, active listening, sensitive communication, motivational interviewing and shared decision-making. Conclusion: Incorporating MPS competencies within LM education aligns with the updated pillar of connectedness, recognizing spirituality as a core driver of lifestyle behavior change. Embedding MPS competencies across the continuum of health professions education represents a timely, evidence-based, and ethically grounded step toward delivering more compassionate, sustainable, and impactful person-centered care.

Background: Understanding the state of the science linking meaning, purpose, and spirituality (MPS) to health outcomes is key to advancing the integration of MPS into lifestyle medicine. Objective: This review aimed to summarize existing research on the use of MPS in lifestyle medicine and healthcare, emphasizing gaps and proposing directions for future research. Methods: A narrative literature review of articles abstracted in PubMed was conducted in conjunction with an in-person summit on MPS and lifestyle medicine in March 2025. This narrative review was organized around the existing science linking MPS to health outcomes, measures of MPS, potential mechanisms accounting for the links between MPS and health outcomes, MPS interventions, potential moderators of the effects, and directions for future research. Results: There are consistent, small to moderate effects that link MPS to increased longevity, improved physical and mental health, and better well-being. Several psychometrically supported measures of MPS exist. Interventions incorporating MPS, especially for populations with advanced illnesses, show promise to improve health and well-being. MPS likely contributes to health through several biopsychosocial pathways. Conclusion: Future work is needed to examine the impact of implementing MPS into lifestyle medicine practice, using rigorous methods, and evaluating its effect on patient outcomes.

Background: Rates of burnout and job dissatisfaction remain high among clinicians. While health care organizational changes are needed to promote their well-being, individual factors must also be supported. A key factor for health behavior change and well-being includes meaning, purpose and spirituality (MPS), among other lifestyle factors. Yet, clinician well-being programs are often lacking explicit support for MPS. Objective and Approach: To develop a synthesis of the evidence behind MPS in clinician well-being and report on the discussions of experts from a national summit on MPS on integrating MPS into clinician well-being programs. Findings: Addressing MPS as a key element of a comprehensive healthy lifestyle is vital for healthcare professionals and essential in targeted interventions to improve physical health and mental well-being, decrease burn out, and boost life satisfaction. Researchers and experts in MPS and in lifestyle medicine emphasize the essential role of MPS in well-being. Integrating MPS into daily life and fostering relationships that cultivate a sense of mattering in the workplace promote resilience and intrinsic motivation, help professionals reconnect with their purpose, ultimately advancing positive behavior and health across all career stages. Organizations can enhance well-being programs and foster well-being culture in the workplace that honors MPS. While research on clinician well-being has evolved, gaps remain in replicability, scalability and best practices of MPS interventions. Future studies should explore synergies between individual resources and systemic challenges to support MPS well-being factors. Conclusion: Further research and integration of MPS in clinician well-being programs is necessary in providing comprehensive approaches that address individual, as well as organizational and systemic factors.

Background: Meaning, purpose, and spirituality (MPS) are central to human experience and closely linked to health behaviors, well-being, and clinical outcomes. Despite strong evidence and growing policy support, MPS remains underutilized in routine care. It is vital to the practice of whole-person lifestyle medicine (WPLM), where sustained behavior change depends on deeply held motivations. Objective: To synthesize current evidence and expert consensus from a national MPS summit and translate it into practical guidance for integrating MPS into WPLM clinical practice. Approach: We summarize evidence for MPS as a driver of health, review definitions, and propose clinically feasible workflows, interprofessional team roles, and implementation tools (e.g., HOPE Note/PHI, FICA, HOPE, CLEAR). We outline community partnerships, documentation practices, and referral pathways, and address policy and payment environments that enable scalable, equitable adoption. Findings: MPS-informed care strengthens therapeutic alliance, resilience, adherence, and patient satisfaction; aligns lifestyle goals with “what matters” to the patient; and fits naturally within team-based, whole-person models. Brief structured or conversational assessments can be embedded in intake, follow-up, and transitions, while documentation and huddles propagate insights across teams. Group medical visits and links to community programs extend continuity and belonging. Payment alignment (e.g., group visits, coaching, value-based models) and fit-for-purpose metrics are pivotal for scale. The six-pillar framework of lifestyle medicine (LM) has not previously included spirituality, but recent revisions now allow for initial integration of MPS and progress toward a more complete WPLM. Conclusions: Integrating MPS is not an optional add-on but a foundational component of quality WPLM practice. Clinicians can begin with small, repeatable steps—brief inquiry, purposeful documentation, warm referrals—while systems pursue policy, payment, and measurement alignment. Implications for Practice and Research: Priorities include establishing standardized, functionally accurate definitions; incorporating MPS components into clinical LM frameworks; conducting implementation studies across settings and populations; developing acceptable accountability metrics; and evaluating effects on clinician well-being.

Positive social connection is a key factor for healthy longevity and improving emotional, mental, and physical well-being. Robust cohort studies show how relationships represent a foundational human need, reduce morbidity, and increase longevity. This chapter provides recommendations for how lifestyle medicine practitioners and health teams can help individuals identify their social needs and increase the quantity and quality of positive interactions. The integration of positive psychology interventions into health behavior change and treatment plans can increase high-quality connections. Also, positive interpersonal processes, such as expressing gratitude, can be prescribed, serving as independent health-protective factors. Healthy lifestyles increase positive emotions, further reinforcing healthy behaviors. Systematic reviews and case studies about the powerful impact of social connection in clinical care are highlighted here. Through these clinical approaches, practitioners can promote positive health. Positive health is an emerging area that leverages person-centered whole health care with a focus on healthy living and the positive influences in an individual’s life, including social connection. Such practices can promote flourishing and growth in the face of adversity. The field of lifestyle medicine is best positioned to advance this positive health approach as foundational to effective high-quality clinical care.

This chapter reviews the relationship between physical activity, positive emotions, and positive psychology interventions with highlights from the scientific literature. Clinical coaching applications of the PERMA (Positive emotions, Engagement, Relationships, Meaning, and Accomplishment) model and other practical techniques are presented for leveraging positive psychology to promote physical activity, emotional wellbeing and positive health. Many individuals struggle to meet the recommended levels of physical activity due to barriers such as lack of time, motivation, and resources. Practicing lifestyle medicine from the inside out, which weaves positive psychology approaches into physical activity prescriptions and coaching can help overcome barriers and increase activity levels with resultant powerful mental and physical health benefits. Paying attention to positive emotions experienced during a physical activity enhances the experience and reinforces the desire to continue or increase the activity (as described in the upward spiral theory of lifestyle change). Moreover, engaging in positive psychology interventions, such as gratitude journaling and self-compassion, and leveraging personal strengths can promote resilience and positive emotions increasing one's energy level and creative problem-solving to address lack of time and resource barriers – as framed in the broaden and build theory. Hence the integration of and emphasis on positive psychology and positive health principles is essential to successful outcomes of the physical activity pillar of lifestyle medicine for health and wellbeing.

Robust empirical evidence supports social connection, a fundamental human need, as the key health factor for healthy longevity. Applications of the PERMA (Positive emotion, Engagement, Relationships, Meaning, and Accomplishment) model and other positive psychology interventions (PPIs) and strategies can increase high-quality, positive social connections that are associated with improved emotional, mental and physical wellbeing. Examples of these positive psychology techniques include positive interpersonal processes, such as shared laughter and expressions of gratitude and compassion for one another. The healthcare settings can apply the techniques during clinical visits and in prescriptions for self-care to help individuals lead healthier, longer and more fulfilling lives.

Lifestyle Medicine From the Inside Out: Using Positive Psychology in Healthy Lifestyles for Positive Health summarizes the principles, science, and practice of how positive psychology can be integrated into lifestyle medicine for positive health in health care and self-care. This integration builds physical health and well-being, buffers against adversity, and promotes personal growth after traumatic experiences. By intertwining healthy habits and positive psychology-based activities, including personal strengths and what is meaningful to each person, individuals can truly thrive. Such an approach is what the authors refer to as practicing "lifestyle medicine from the inside out." Co-authored by the lead developer of the original lifestyle medicine competencies, this book suggests positive health expansions for each competency, outlines specific questions that drive personal reflection for change and positive clinical interactions, and describes the step-by-step approach in case studies. Such innovative clinical practice that connects with what matters most to individuals is foundational to care. In a rapidly changing and increasingly challenging world, health professionals in a wide variety of roles practicing in lifestyle medicine, primary care, and across medical specialties, patients, and all individuals can benefit from the insights and practical tips outlined in this book to achieve and maintain flourishing.

This chapter reviews the science and practical clinical applications of the PERMA (Positive emotions, Engagement, Relationships, Meaning and Accomplishment) framework and other positive psychology techniques to promote healthy eating and how healthy eating increases emotional wellbeing. By leveraging the patient's positive experiences associated with healthy eating, identifying strengths and values related to healthy eating, and using positive psychology interventions (PPIs) to increase positive emotions that boost problem-solving, individuals can develop positive healthy eating habits. As healthy eating routines are built, positive emotions can be increased in an upward spiral of healthy eating changes. This practice approach shows much promise; however further research is needed to explore the effectiveness in health care settings for different medical conditions and patient populations.