“We constantly strive to protect endangered species from extinction, while, in fact, it may well be that we ourselves are far closer to extinction.”
Those words were co-authored in The Permanente Journal by more than 20 medical professionals who say lifestyle choices have the power to prevent disease and manage chronic conditions.
Coronado resident Dr. Gina Casian said she began implementing lifestyle medicine in her own life 10 years ago, and is now helping the island community practice good health.
“What actual lifestyle medicine is, I started learning for myself,” said Casian.
The American College of Lifestyle Medicine (ACLM) says lifestyle medicine prevents, treats, and often reverses chronic disease. According to the University of Pittsburgh Medical Center, over 80% of all chronic diseases are lifestyle related.
The ACLM’s six pillars of lifestyle medicine are treatment strategies intended to improve health through nutrition, physical activity, sleep, stress management, social connections and reduced substance abuse.
Casian, 50, has more than 20 years of experience in internal medicine. She became board-certified in lifestyle medicine last December and has been integrating it in her practice as a primary care provider. Today, she provides a holistic healthcare approach at her practice, Choose Healthy, at 171 C Ave.
“My main goal is medical care, and it’s a beautiful fusion with protecting our health, preventing chronic problems, and improving quality of life,” said Casian, who also gives health presentations and hosts Walk with a Doc, a free community walking program.
The Coronado News reached out to Casian to learn more about her practice and insights. Responses have been edited for brevity and clarity.
Q: Tell me about yourself. What motivated you to study and practice medicine?
Casian: I was born and raised in Romania. Medicine is a lifelong passion and interest. I grew up in a family with healthcare providers. My mother used to work as a nurse. I was exposed to the medical environment since I can remember.
When I was 13, my father was diagnosed with lung cancer and it was actually a very rapid deterioration – he passed away in seven months. That was very traumatizing for me because he was my role model. I was his little girl and I could not understand why that happened. I told myself: One day, I’m going to find treatment for cancer. I went to medical school (Ovidius University Faculty of Medicine) and at 25 I came here to the United States. I did my training here in internal medicine and then I still did not find the cure for cancer. But I found many, many answers.
That type of tragedy actually shapes your journey in one way or another, because looking back, I’m thinking, ‘I have everything I have today, and I am where I am today, which I’m very blessed and I’m very happy and fulfilled, for that very negative experience that I wish it didn’t happen.’ But that shaped my journey because this is where I knew I wanted to pursue a medical career and know more about diseases and what happens with the human body.
Q: Can you explain the difference between lifestyle medicine and internal medicine and each of its benefits?
Casian: Internal medicine, it’s a medical specialty and it refers to diagnostic, addressing, treating acute or chronic medical conditions for adults. It’s pretty much treating the disease. Lifestyle medicine, on the other hand, it’s actually preventing and sometimes reversing chronic disease with the six pillars. At Choose Healthy it’s a combination. It’s a beautiful harmonious fusion of both.
Q: How did you decide to focus on the benefits of integrating lifestyle medicine with internal medicine?
Casian: Before we develop a symptom it takes years from changes that happen inside the body at the cellular level. These are changes that happen before we even have pain or a headache or any discomfort. Usually it’s caused by our way of living.
It is actually a challenge and what I embark with my patients. I say ‘I’m here with you. You’re the driver of the car. I’m right here next to you and we go together on your journey. And in six months or a year, you are going to see the change.’ It’s not 100% because nothing is for sure, but I see results. And I see results on the patients that actually have the patience to listen to me and I take the time to learn their story.
I go all the way deep to how they grew up, how they were born, if there were any adverse childhood events. I advise them to try to make peace with their past by self-acceptance, forgiveness, and understanding where they are coming from. And then if possible, try to release that pressure and tension that you’ve been carrying with you all this time. This is life here and now. And then have hope for tomorrow. This is my approach.
Q: What is the importance of each of the six pillars of lifestyle medicine and what do you wish more people knew about them?
Casian: It was something that deeply resonated with me when I came across it. This is a medical specialty and it’s growing so fast. It’s real, it’s natural, it’s our everyday life. There are six pillars, none of them are more important than each other.
Nutrition, it’s not only what we eat. It’s how we eat, what we eat, when we eat, with who we eat. There is a MIND diet that I talk with my patients all the time for brain health. This comes down to mindful eating. There is a big misconception about carbs. Refined sugar is the unhealthy part, but we need carbs for energy. If you cannot do it after all your meals, at least one meal a day, which the best will be dinner, go and walk for 15 minutes.
Exercise is very specific. There is a formula called FITT which refers to frequency, intensity, time, and type of exercise. Sometimes patients need to go lower and allow their body to rest and recover. We create a level of stress when we go too much. And with that comes the cortisol, or the stress hormones, and that will affect goals to lose weight.
It’s a very strong correlation between how we sleep and all the other pillars of lifestyle medicine. It doesn’t matter how much we exercise and how many vegetables we’re going to eat during the day if the night before we didn’t have a good sleep. And then if we didn’t exercise or move our body or if we smoke or had alcohol today, we are not going to have quality sleep tonight. As we age, we care a lot about deep sleep and REM sleep, and those are affected by our unhealthy choices during the day.
Social connection, I’m big about that. I have been doing a Walk with a Doc here on the island since last June. It’s pretty much to get the community together to move, connect with others and with nature. I started just with my family and my best friend and now we have a big group coming every month. When people see each other doing well or making healthy choices, it’s motivational and it’s empowering. So, I believe in the power of community. Every time I look back on these walks, I feel fulfilled.
Health, it’s a whole person. It’s a self-centered whole person and it starts with mental and brain health together. And then it comes with physical health, emotional health, spiritual health, and then social health. It’s a combination of all these aspects. And there is room for growth and learning every day.
Q: Is there a takeaway that you can offer as a piece of advice to the Coronado community?
Casian: The message is in the name of this practice. The choices we make every day have an impact on quality of life now and quality of life later. We have power to choose when it comes about our everyday living and our No. 1 most important valuable asset which is our health. My message to the community is to choose healthy.
To connect with Casian, visit: https://www.choosehealthy.net/.
