What is Lifestyle Medicine?
CONTEXT
In Portugal, life expectancy ranges from 81.5 years (INE, 2023) to 82.7 years (Eurostat, 2024). This is an extraordinary achievement of medicine, science and technology. But one question remains unanswered: how many of those years are lived in good health, with independence and a good quality of life?
The answer is that the distinction between how long we live and how we live is becoming increasingly crucial as average life expectancy rises. In Portugal, around the last 20 years of life are spent with chronic illness and a loss of independence (physical and/or cognitive).
WHAT IS LIFESTYLE MEDICINE?
Lifestyle Medicine It is a medical approach based on scientific evidence that uses lifestyle-based therapeutic interventions to treat, reverse and prevent chronic diseases such as cardiovascular disease, type 2 diabetes and obesity. Studies show that it can contribute to up to 80% of chronic diseases.
Genetics play a role that is beyond our control, but lifestyle, active prevention and clinical follow-up structured In many cases, they make it possible to delay the onset of chronic illness and maintain an active lifestyle for much longer.
The aim of the Lifestyle and Healthspan Consultation is to help you live longer, in good health, with independence and a good quality of life.
Through the early identification of risk factors and the optimisation of the lifestyle habits that most influence health, we aim to promote true healthy longevity — more years lived with energy, independence and well-being.
Ageing well and staying healthy isn’t down to luck. It’s a choice you make now!
A window decisive
The 30, 40 and 50 years They are a crucial opportunity to prevent illness, maintain independence and improve quality of life in one’s 60s, 70s and 80s… Ultimately, it’s about reaping the rewards of an investment you began making many years ago… the sooner you start, the better the outcome.
At the age of 30, issues relating to sleep, physical and mental performance, and the work-life balance frequently arise.
At the age of 40, a decline in physical fitness, metabolic imbalance and, in women, the first signs of perimenopause can be observed.
At the age of 50, It is time to take a realistic stock of the situation and take action to protect what can still be saved.
And at all other ages, too. Biology doesn’t wait for symptoms to appear. The processes that lead to cardiovascular disease, insulin resistance and functional decline begin decades before any signs appear.
What does it involve? the appointment?
Lifestyle Medicine focuses on providing integrated care for individuals throughout their lives, taking into account all aspects of their well-being: family history, genetic makeup, where you work, your daily routines and timetable, exercise, diet, sleep, stress, hobbies and interpersonal relationships.
Of course, as an internal medicine specialist, accustomed to managing complex chronic conditions, this will also be a focus for optimisation, if the condition is already established.
The first appointment lasts 90 minutes. It is a consultation based on active listening and taking a holistic view of the patient. Before we meet, each patient completes a detailed questionnaire covering their full medical history, medication, sleep, diet, exercise, stress and daily routines, so that the consultation is tailored as closely as possible to the patient’s individual needs.
During the consultation, we assess:
› Cardiovascular risk, with advanced markers in line with the 2026 ACC/AHA guidelines
› Metabolic health: insulin resistance, obesity, type 2 diabetes and metabolic syndrome, from the earliest stages, long before any diagnosis is made. The approach includes lifestyle strategies and, where indicated, medical treatment, including GLP-1-based therapies, with a focus on improving metabolic health and reducing long-term risk.
› Management and optimisation of existing conditions.
› Body composition in addition to weight and BMI, with an assessment of muscle mass and visceral fat.
› Muscle strength (Grip Strength), one of the best predictors of functional ageing.
› The pillars of lifestyle with the greatest long-term impact on health.
› Laboratory tests tailored to the individual’s profile.
We draw up a list of goals and set priorities with each patient. The result is a personalised plan, featuring sustainable and long-lasting changes – an investment in oneself over time.
Medication is prescribed when clinically indicated, as part of an integrated plan.
Use a smartwatch or a one bracelet Is there an app that monitors all these parameters? Let’s look at them during your appointment!
Who is it for? recommended?
- Healthy people who want to grow old in good health and with independence, and this starts from a young age;
- Healthy people who want to check that everything is fine with their health and find out their cardiovascular and metabolic risk;
- People who are healthy but have a family history of high blood pressure, acute myocardial infarction, stroke, type 2 diabetes, increased waist circumference and being overweight, obesity, metabolic syndrome, early-onset dementia, and cancer;
- People who themselves have any of the conditions mentioned above.
The Pillars That Make the Difference
Scientific evidence identifies a set 6 Pillars with a proven impact on the prevention of chronic disease and on the quality of ageing:
› Physical exercise: the intervention with the strongest evidence across multiple dimensions of health simultaneously. It is not about aesthetics. It is about healthy life years.
› Sleep: 7 to 9 hours of restorative sleep. Essential for metabolic, cognitive and emotional health.
› Nutrition: sustainable eating habits, not diets. What works in the long term.
› Stress management: chronic stress accelerates biological ageing and is recognised as a cardiovascular risk factor by European guidelines.
› Social links/connections: relationships and intellectual stimulation are protective factors. Social isolation has an impact on health comparable to that of smoking.
› Elimination of harmful substances: tobacco, alcohol. Very strong evidence.
Habits such as walking by the sea, spending time with friends at the end of the day, and practising good sleep hygiene can have a much greater impact on your health and wellbeing than you might think.
Sustainable changes are those that are made and maintained over time, with a real and lasting impact. This cannot be achieved with expensive supplements or serum therapy, or with programmes that promise magical results in the short term.
Lifespan ≠ Healthspan = Healthy Longevity.
To live better and healthier lives for longer.
Sources:
Portuguese Society of Lifestyle Medicine (SPMEV): www.spmev.org.pt
European Lifestyle Medicine Council: www.europeanlmc.org
Medical Specialists
About
Dr Isa Caçador Agudo / Lifestyle Medicine
DOCTORS' ASSOCIATION: Registration No. 48148, specialist in Internal Medicine.
Dr Isa Caçador Agudo has the support of 18 years’ clinical experience, 10 years as a Specialist in Internal Medicine in the A&E Department, Inpatient Ward, Intensive Care Unit and Outpatient Clinics for Complex Chronic Conditions, Multimorbidity and Polypharmacy.
For years, he worked treating established conditions: heart attacks, heart failure, strokes, kidney failure, diabetes and all their complications. Many lives are saved every day in A&E, but the same patterns keep repeating themselves: the same conditions that could have been prevented.
This experience has changed the way medicine thinks and led it to broaden its focus to what can be done earlier, whilst there is still everything to protect.
Did advanced training in Lifestyle Medicine, Harvard Medical School, Institute of Lifestyle Medicine (2026) and specialist clinical training in Menopause and Perimenopause (2025-2026).
She currently offers consultations in Lifestyle Medicine, Menopause and Perimenopause at LMR and Skin Boutique, in Portuguese, English and Spanish.
She is a member of Portuguese Society of Internal Medicine and Portuguese Society of Lifestyle Medicine.
Frequently Asked Questions about
Lifestyle Medicine Consultation
What is Lifestyle Medicine?
Lifestyle Medicine is a branch of medicine based on scientific evidence that uses interventions relating to diet, physical exercise, sleep, stress management and other lifestyle habits to prevent, treat and, in some cases, reverse chronic diseases.
How can I age more healthily?
The best strategy is early prevention. By optimising diet, physical activity, sleep, stress management and the control of cardiovascular and metabolic risk factors, it is possible to increase the number of years lived in good health and with independence.
What is metabolic health?
Metabolic health refers to the proper functioning of the mechanisms responsible for regulating blood sugar, cholesterol, blood pressure, body composition and energy metabolism. Good metabolic health is associated with a lower risk of diabetes, cardiovascular disease and other chronic conditions.
What is insulin resistance?
Insulin resistance is a common metabolic disorder that can develop many years before the onset of type 2 diabetes. Early detection enables effective preventive measures to be put in place.
At what age should I have this check-up?
The consultation is recommended from the age of 30, but anyone wishing to come earlier is welcome. The processes that lead to chronic illness begin long before any symptoms appear. The aim of the consultation is to promote healthy longevity.
Do I have to be ill to book an appointment?
No. This consultation is for people who feel well and want to stay that way, with a plan based on evidence and tailored to their lifestyle.
However, if you already have an established condition, Dr Isa Caçador Agudo is an experienced specialist in internal medicine and, working alongside you, she will help you make the most of the limitations posed by your condition, assess whether any damage is reversible, and optimise other aspects of your overall health.
Does this consultation include medical treatment?
Yes, when clinically indicated. The approach prioritises sustainable lifestyle changes, but includes pharmacological treatment whenever the risk profile warrants it.
How often are follow-up appointments held?
Tailored to each individual, based on their risk profile and personal goals. Care is provided on an ongoing basis, forming a partnership with the doctor over time and through the different stages of life. The aim is Healthy Longevity, or Healthspan (years of life lived in good health and without dependency).
Is the consultation in Portuguese, English or Spanish?
In all of them. Dr Isa Caçador Agudo conducts consultations in Portuguese, English and Spanish, and also sees international patients and expats in Lisbon and Cascais.
