Delivering healthy living medicine: all shapes and sizes are needed and welcome

This editorial refers to ‘Technology-based comprehensive cardiac rehabilitation therapy for women in a middle-income setting: a randomized controlled trial’, by H.J. Menezes et al., https://doi.org/10.1093/eurjpc/zwaf147. The primary behavioural components of healthy living (HL) medicine (HLM) are: (i) moving more and sitting less; (ii) consuming a healthy diet; and (iii) not smoking. Maintaining an ideal body habitus for a given age and sex is also a desirable goal—core components of behavioural HLM play an important role in weight loss/maintenance. While appreciation of the value of HL behaviours and HLM in preventing and treating a myriad of chronic health conditions is now commonplace—in particular—its use in the prevention and treatment of cardiovascular disease (CVD) has the greatest supporting body of evidence.1 Cardiac rehabilitation (CR) is perhaps the most recognized and established HLM intervention—patients diagnosed with CVD should be referred to and participate in CR as there is clear evidence on the benefits derived from participation, including increased exercise/functional capacity and quality of life as well as reduced morbidity and mortality. Currently, the most extensively studied and utilized CR model entails 36 in-person sessions over a 12-week period—exercise training, nutritional counselling, education of medication compliance, and stress reduction are core components of CR.2