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Lifestyle Medicine: Nutrition and the Metabolic Syndrome - 1.25 CME Credits

A case-based review referencing nutrition guidelines and lifestyle modification

Start Date: Mar 14, 2019
Duration: ~ 1.25 hours
Price: $49

Course Description

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This course reviews the case of a 54-year-old man who has pre-hypertension, low HDL, high triglycerides, elevated blood glucose, and is abdominally obese. At his first visit to you, this patient, who is new to town, voices concern about his newly diagnosed pre-diabetes as well as his food choices and physical inactivity.

Through the course of seven questions, you will learn how to counsel this patient, and others with similar conditions, using evidence-based approaches consistent with the ACC/AHA and NCEP guidelines about nutrition and behavior management using lifestyle modification techniques. Updated criteria for metabolic syndrome diagnoses from the International Diabetes Federation (IDF) and American Diabetes Association (ADA) criteria for diagnosis of type 2 diabetes using HgA1c will be addressed, as well as discussion of the use of metformin as adjunctive therapy to therapeutic lifestyle changes (TLC).

This course is designed for primary care and specialty physicians, physician assistants, nurse practitioners, and nurses. Participants must pass a pottest with a score of at least 75% to earn CME credit.

What You'll Learn

  • Review important lifestyle modification concepts for sustainable weight control within the areas of nutrition, activity, behavioral health (“mind matters”), environmental (e.g., food and social environments), and accountability (e.g., self-monitoring techniques)
  • Describe the important practical application of a dietary pattern’s average calorie density and its role in metabolic health, especially in terms of type 2 diabetes prevention and weight management
  • Identify the importance of understanding stages of readiness for lifestyle change with respect to how to approach counseling patients who may benefit from such change
  • Identify how to use ancillary specialists to enhance nutritional adherence via feedback, education, and accountability


Elizabeth Peg Frates, MD

Elizabeth Peg Frates, MD Assistant Professor of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital; Faculty Advisor for the Lifestyle Medicine Interest Group, Harvard Medical School

Tom Rifai, MD, FACP

Tom Rifai, MD, FACP Clinical Assistant Professor, Wayne State University School of Medicine; Expert Presenter, Pritikin Intensive Cardiac Rehabilitation program


Lifestyle Medicine: Nutrition and the Metabolic Syndrome is organized as follows:

Precourse Information:
Accreditation and AMA Credit Designation
Disclosure Statement
How to Take This Course
Grading and Certificates

Welcome to Lifestyle Medicine: Nutrition and the Metabolic Syndrome
Case Presentation
Transtheoretical Stages of Change
Metabolic Syndrome
Nutritional Counseling
Resources and Referrals

CME Certificate
CME Posttest
Course Evaluation



The Harvard Medical School is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.


The Harvard Medical School designates this enduring material for a maximum of 1.25 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.


Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 1.25 Medical Knowledge MOC points in the American Board of Internal Medicine’s (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC points.

Every 30 days HMS GCE will upload participant data (name, date of birth, ABIM ID#, MOC points earned) for any learners who have completed this activity directly to their transcript at the ABIM via the ACCME's Program and Activity Reporting System (PARS). Since MOC points earned will be uploaded to your ABIM transcript these points will not appear on your CME certificate. If you do not see your points on your ABIM transcript after 30 days of completing the activity please contact Jillian West at HMS GCE at


Disclosure Policy

Harvard Medical School has long held the standard that its continuing medical education courses be free of commercial bias.

In accord with the disclosure policy of the Medical School as well as standards set forth by the Accreditation Council for Continuing Medical Education (ACCME), course planners, speakers, and content reviewers have been asked to disclose any relevant relationship they, or their spouse or partner, have to companies producing, marketing, re-selling or distributing health care goods or services consumed by, or used on, patients. In addition, faculty have been asked to list any off-label uses of pharmaceuticals and/or devices for investigational or non-FDA approved purposes that they plan to discuss.

Such disclosure is not intended to suggest or condone bias in any presentation, but is elicited to provide the course director and participants with information that might be of potential importance to their evaluation of a given presentation.

Disclosure Statement

The following planners, speakers, and content reviewers, on behalf of themselves and their spouse or partner, have reported financial relationships with an entity producing, marketing, re-selling, or distributing health care goods or services (relevant to the content of the activity) consumed by, or used on, patients:

Name: Elizabeth Pegg Frates, MD
Role: Course Director/Faculty
Company: Wellness Synergy
Relationship: Coach
Company: Curves
Relationship: Scientific Advisory Board

Name: Tom Rifai, MD, FACP
Role: Course Director/Faculty
Company: Reality Meets Science LLC
Relationship: Founder

All other individuals including course directors, planners, reviewers, faculty, staff, etc., who are in a position to control the content of this educational activity have, on behalf of themselves and their spouse or partner, reported no financial relationships related to the content of this activity.


Dr. Tom Rifai is board certified by the American Board of Internal Medicine, a Diplomate of the American Board of Lifestyle Medicine, and former president of the US National Board of Physician Nutrition Specialists. He is one of a select few, along with Drs. Walter Willett and Dean Ornish, chosen for the True Health Initiative’s media response team and is the expert presenter on lessons “Dietary Fats” and “The Biology of Weight Control” for the Medicare-approved Pritikin Intensive Cardiac Rehabilitation program.

Dr. Rifai developed his “5 Keys to Optimal Wellness” lifestyle modification system, which he was invited to speak about at the 2019 Harvard Institute of Lifestyle Medicine conference, and the spirit of which is interspersed in this CME through an eclectic combination of education and experiences, including: a Bachelor of Science in Psychology from Michigan State University (graduating with highest honors); lifestyle medicine and metabolic health-focused internal medicine training at Beaumont Health System; and subsequent extensive clinical leadership experience in lifestyle-based, behavior modification-based programs. He has totaled over 20,000 hours of face-to-face patient time leading multidisciplinary transformational lifestyle change (TLC) programs at institutions including the Beaumont and Henry Ford Health Systems as well as the Pritikin Longevity Center.

Additionally, Dr. Rifai’s personal experience as a recovering binge eater and “comfort food-aholic”, which brought him to the brink of death in 2007, adds invaluable insight when managing patients and health coaching clients. For further background please see

Beth Frates, MD is trained as a physiatrist and a health and wellness coach. Her expertise is in lifestyle medicine, and she works to empower patients to reach their optimal level of wellness by adopting healthy habits. Elected to the Board of Directors of the American College of Lifestyle Medicine (ACLM) in 2016, Dr. Frates is helping to shape the scope of this new specialty.

In October 2018, she co-authored The Lifestyle Medicine: An Introduction to the Power of Healthy Habits. She is an award-winning teacher at Harvard Medical School and developed and taught a college lifestyle medicine curriculum at the Harvard Extension School, which is one of the most popular courses offered at the school. As the director of Wellness Programming at the Stroke Institute for Research and Recovery at Spaulding Rehabilitation Hospital, Dr. Frates has created and implemented a 12-month wellness program for stroke survivors and their caregivers. She is co-author of the book, Life After Stroke: The Guide to Recovering Your Health and Preventing Another Stroke and co-author of three chapters on behavior change in different medical textbooks, as well as multiple journal articles on lifestyle medicine topics including exercise prescription, connection prescription, lifestyle medicine case series, and walking meeting for sustained weight loss. She shared a lifestyle medicine syllabus, which can be downloaded through the ACLM website, in hopes that her work can serve as a template for other instructors and professors hoping to teach a course in lifestyle medicine. For the past nine years, Dr. Frates has been the faculty advisor for the Lifestyle Medicine Interest Group at Harvard Medical School, and she works with the Professionals In Training (PiT) group at ACLM to help create more LMIGs in medical schools and other health care professional training schools. Dr. Frates is passionate about developing programs focused on lifestyle medicine and wellness.

Lifestyle Medicine: Nutrition and the Metabolic Syndrome:
Original Release: 10/14/2010
Most Recent Update: 3/14/2019

End Date: 10/14/2022 (Enrollment ends 9/14/2022)


How long will this course take?

This course should take approximately 1 hour to complete. You do not need to complete it all at once. You may come back as often as you like.

How long will this course be available?

This self-paced course will be available for three years after its start date. Enrollments will close one month prior to the course end date.

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What if I want to learn more about this topic?

HMS Continuing Education holds live topic-focused conferences throughout the year. Please see our course catalog for upcoming events.