5 Practical Tips to Manage Chronic Disease Through Lifestyle Changes

Exercise more, eat better, reduce stress — we all know the benefits of healthy habits, but with a job (or two), family and social demands, good habits are often difficult to fit into your schedule.

Chronic conditions like diabetes, high blood pressure and cardiovascular disease are on the rise and lead the nation in causes of death. Avneet Nagra, PA, a board-certified physician assistant with MUSC Health – Columbia, focuses her practice on chronic disease management and preventative medicine and says patients can make simple changes to manage these conditions.

"My role is not just medication management. I guide and support patients as they make diet and lifestyle improvements," says Nagra. Understanding how daily choices impact chronic disease and overall wellness is key. "During my time with patients, we go in-depth on wellness, with very specific questions about diet, exercise, lifestyle, stress factors and more."

Disease Management: Here are 5 Lifestyle Tips for Improving Chronic Disease

Find your reason: Why do you want to live a long, healthy life?

Nagra says her first step is getting a good idea of a patient's motivation and willingness to make lifestyle changes. "We all know we should eat less fast food, go to the gym, walk — choices we can make that will have benefits," says Nagra. "I do a lot of counseling to help patients understand the importance of lifestyle changes, how these relate to the management of their chronic disease, and to ensure they'll follow through." She then helps patients make a plan that builds on small goals.

Some patients are motivated to take fewer or no medications. "We're offering ways to combat the chronic conditions and maintain a healthy lifestyle so they can reduce or stop taking medicines for these conditions," says Nagra.

Small improvements in blood pressure, cholesterol or diabetes numbers can be very motivating for patients. "I tell them to have patience," Nagra explains. "Chronic diseases are chronic for a reason— they do not happen overnight. Therefore, improving chronic conditions also does not happen overnight. Any change they make, whether big or small, is leading them to healthier outcomes," she says.

Eat healthy portions and snacks

Portion control is a big consideration, and so is snacking, says Nagra. "When people think of improving their diet, they usually think only about meals, not about snacking."

When she meets with patients, she asks very specific questions. "I ask them to describe yesterday's meals, what they ate and how much. Did they do any late-night snacking? We then make a plan to fit small dietary changes into their day-to-day routine. I teach them about appropriate portions, healthy meals they can make the night before, how to choose healthy snacks."

Overall, lifestyle and dietary changes are more important than following popular fad diets. Nagra says connecting to a dietician is key in making sure patients understand how to take control of their own health.

Make your movements and exercises intentional

It's a misconception that any physical activity counts, says Nagra. Most exercise and movement at work is not really exercise. "I tell my patients, 10,000 steps a day at work does not count. Exercise is not just about moving or steps — it's about getting the heart rate to a certain level that increases metabolism, actively burns calories and fat and creates muscle mass. It needs to be intentional. Exercise needs to connect your mind to your body, so you are focused on working those muscle groups."

Getting at least 150 minutes of moderate-intensity, intentional activity a week can help improve diabetes, hypertension, obesity and cholesterol levels as well as reduce stress. "Having a partner to exercise with, who will hold you accountable, is a great way to stay committed. Patients enrolled in programs such as E2M and Noom have shown great success," she says.

Address your stress

The stress hormone cortisol plays a role in chronic disease and its progression. "High levels of cortisol can also cause you to gain weight. The body retains fat because it's going into survival mode from the stress. That weight gets stored in the gut, which is a health concern," says Nagra.

Focusing on stress management can be multidirectional and help improve your immune function, chronic pain, cardiovascular disease and mental health. Lack of sleep, a big contributor to stress, is rarely addressed. Regular and good quality sleep (at least six to eight hours) reduces stress hormones and helps prevent weight gain.

Focus on your mental health, too

Having and managing a chronic disease often creates a significant mental health burden for patients. Sometimes a patient is not able to manage their chronic condition.

"Poor mental health can affect a patient's motivation and ability to make healthy changes or improvements," says Nagra. Treatments to address stress, anxiety and depression — such as cognitive behavioral therapy — can be successful in improving chronic diseases.

"It's all connected like a circle. At MUSC Health, we design a plan from many perspectives because it's about whole health. It all ties in together. The changes we strive for are specific to the way the patient lives, so they have a visual of how they can fit into it. That's where the success lies."

Get help from many sources

This approach often requires multiple specialties, says Nagra. Patients at MUSC benefit from a team of specialists and providers who work in concert. A dietitian or nutritionist helps with meal planning and advice on healthy alternatives and ingredients. A psychologist helps patients address mental health barriers. Routine follow-ups provide feedback and allow for modifications. Having strong, positive social connections and support at home, work and within the community also play a large role in a patient's overall health and well-being.

"We give patients the resources they need to make the plan work and ensure they have everything they need to build the most successful way of life for them."

Nagra is based at MUSC Health Primary Care Laurel St. Medical Pavilion. To make an appointment, call 803-227-5320 or log into MyChart.