Learn how small, sustainable changes in diet, movement, sleep and stress management can help patients prevent and manage chronic conditions.

Published: July 22, 2025

By focusing on small steps, physicians can help patients make meaningful, lasting improvements to lifestyle habits that contribute to chronic disease.

Time constraints and patient resistance can make conversations about activity, diet, stress reduction and other improvements feel secondary.

Even small, incremental lifestyle changes can lead to significant long-term improvements in health outcomes. The Small STEPS, Big IMPACT campaign from the Kentucky Medical Association underscores this concept, encouraging providers to promote patient wellness through practical, achievable interventions.

“We want to educate people on the things they can do within themselves — small steps that can begin to reverse or even prevent chronic disease,” said Evelyn Montgomery Jones, M.D., a dermatologist and president of the Kentucky Medical Association.

She spoke about the campaign on a recent episode of “MedChat,” Norton Healthcare’s continuing medical education podcast.

Why it matters

More than 80% of chronic disease and 40% of cancer are directly linked to lifestyle choices. However, national trends suggest Americans are moving in the wrong direction:

• Healthy lifestyle adherence dropped from 6.8% to 2.7% over the past two decades.
• Polypharmacy has doubled in 20 years, increasing both cost and risk.
• Sedentary behavior is now associated with mortality risk on par with smoking.

Physicians are in a unique position to reverse these trends. Even a brief lifestyle intervention — delivered consistently and compassionately — can make a meaningful difference in a patient’s life.

Small changes that deliver big results

While some patients may resist sweeping overhauls, many are receptive to small adjustments. Evidence-based recommendations include:

Encourage whole, unprocessed foods

Nutritional guidance should focus on simplicity: Eat real food. A diet rich in fruits and vegetables and low in added sugar, sodium and processed ingredients can reduce inflammation and support management of conditions like psoriasis, arthritis and diabetes.

Cut back on sugar-sweetened beverages

Patients may underestimate the impact of what they drink. Replacing just one soda or sugary coffee drink daily with water or fruit-infused alternatives can significantly reduce overall sugar intake. The World Health Organization recommends no more than 25 grams of added sugar per day — a threshold many exceed with a single beverage.

Promote daily movement

Formal gym routines aren’t required. Simply encouraging patients to “de-convenience” their day — taking stairs, parking farther away, walking after meals — can increase physical activity and reduce health risks. Studies show that sitting for four hours daily carries health risks comparable to smoking a pack of cigarettes.

Improve seep and manage stress

Stress and poor sleep are major contributors to chronic disease. Providers can recommend:

• Mindful breathing (six deep breaths in one minute) several times a day
• Screen-free wind-down time before bed
• Setting reminders to move or pause throughout the day

Use positive framing

Language matters. Instead of prescribing deprivation, use empowering terms like “minimize,” “add” or “choose.” For example, recommend minimizing inflammatory foods while increasing nutrient-rich options. This approach fosters patient agency and reduces defensiveness.

Strategies for implementation in clinical practice

Integrating lifestyle counseling into routine care doesn’t require long conversations. Key strategies include:

• Standardize a resource sheet with evidence-based recommendations, such as lists of anti-inflammatory foods, local wellness resources, or trusted websites and podcasts.
• Use teachable moments during visits related to illness, new diagnoses or major life changes, when patients may be more receptive.
• Reinforce the message over time. Repetition is key, especially for behavior change. Even if a patient is not ready at first, continued encouragement increases the chance of adoption.
• Frame medication use as temporary. When possible, explain that lifestyle change can reduce or eliminate the need for certain prescriptions, empowering patients to take ownership of their health.
• Avoid judgmental language. Most patients already feel guilt or shame about behaviors like smoking or poor diet. Use supportive, collaborative language that frames behavior change as a shared goal.

The importance of physician role modeling

Patients are more likely to follow advice when they see their provider embodying the same principles. Physicians should prioritize their own health — not just to reduce burnout, but to serve as credible advocates for lifestyle change. This includes:

• Maintaining their own preventive screenings and primary care visits
• Planning and preparing healthy meals
• Building movement and stress reduction into daily routines

Resources such as the American College of Lifestyle Medicine and SmallStepsKY.org offer tools to help physicians integrate wellness into both personal and professional life.