The lifestyle medicine core competencies were developed by a committee of physicians from several medical specialties to provide guidance on the knowledge and skills needed for physicians to provide high quality lifestyle interventions that optimize chronic disease outcomes. These competencies were published in the Journal of the American Medical Association (JAMA) in 2010 and used as the foundation for the first lifestyle medicine course and for the lifestyle medicine board certification examination. In the ensuing years, interest in the field and application has expanded to a variety of health professionals. With evolution of the lifestyle medicine evidence-base, the competencies have been updated. This article sums up the changes in their organization and content. Regular updates are anticipated to align with the ongoing scientific studies and evolution of the field.

In a lifestyle medicine context, competent health coaching requires the development of skills in inquiry. While open inquiry is emphasised, there is a broad range of inquiry types which can elicit narrative responses from a client. In the 1990s, the ‘Question Cube’ was conceptualised as a means of teaching therapy students ways to ask insightful questions. The elements of this model were: type of inquiry, subject and orientation. This article updates the Question Cube model to include the original 3 parameters with the addition of tense and mood. By learning the concepts of inquiry formation, students of health coaching are more able to propose thoughtful and insightful inquiries to their clients.

Although childhood “picky eating” or “fussy eating” or “food neophobia” is well established as a subject of research, commentary, and treatment guidelines, there is very little published research exploring the origins and basis of adult food neophobia, much less its treatment. Existing treatment guidelines for picky eating tend to focus on cognitive behavioral interventions. The consequences of picky eating, although not extensively researched, include inadequate nutrition and weight management difficulties—both significant contributors to the worldwide disease burden. Health coaching has a focus on personal choice, reflection on previous successes and current strengths, as well as identification of a personal health vision and achievable goals. As such, it may play a useful role in supporting behavioral change in adult picky eaters. A structured intervention, rooted in health coaching skills and culinary medicine aimed at supporting such change, is proposed.

While the field of lifestyle medicine has been growing rapidly world-wide over the past two decades in particular, the prevalence of chronic (lifestyle-related) disease is increasing, particularly in developed nations. Lifestyle Medicine approaches are a promising basis for preventing, managing and reversion chronic disease; however, these approaches are based almost exclusively on individual behavioral change. Such changes are best developed and supported with a health-coaching methodology.

The practice of lifestyle medicine and its emphasis on behavioral change continues to grow around the world. Yet much of the burden of disease weighing on healthcare systems from chronic, modifiable conditions remains stubbornly present. From a behavior change perspective, efforts to date have primarily focused on public health messaging and public health campaigns (global approaches) to interventions such as health coaching (individual approaches). There exists an opportunity to consider contextual elements which support behavioral change. The practice of “nudging” behavior in primary care and allied health settings is proposed as a means of responding to these contextual opportunities. Nudging does not assure change; however, it can invite curiosity about change and small behavioral efforts in the direction of a desired change. Furthermore, its nature conserves autonomy and patient choice while inviting a health-creating behavior. As such, when considered and applied in the context of public health and individual treatment options, it creates a consistent milieu in which behavior change is facilitated.