Understanding Lifestyle Dissonance: A Neurobiological Narrative to Strengthen Preventive Health Behavior.

BACKGROUND

Noncommunicable diseases are the leading cause of death and disability worldwide, although many of their detrimental health effects can be prevented by lifestyle changes. Despite growing public and individual recognition of the importance of prevention, adherence to recommended measures is limited. We refer to this discrepancy between knowledge and action, specifically in relation to preventive lifestyle behavior, as lifestyle dissonance.

METHODS

This paper presents a narrative synthesis and aims to provide a conceptual framework for communication with patients and the public that includes neurobiological and evolutionary perspectives. It discusses interactions between neural reward systems, executive control mechanisms, and contemporary environmental triggers, including nutrition, exercise, sleep, and stress, as examples of the six pillars of lifestyle medicine.

RESULTS

We propose that lifestyle dissonance can serve as a didactic label in communication with patients and the public to explain the mismatch between evolved neural mechanisms and the modern environment. Rather than a sole failure of willpower, non-adherence to preventive lifestyle measures is partly founded in a conflict within neural circuitry. Patient education regarding the brain's underlying processes and their influence on behavior has the potential to enable individuals to actively redesign their actions, train their reward systems, and thus reinforce healthy behavior.

CONCLUSION

Integrating a narrative on neurobiological mechanisms into public health and clinical practice strategies should thus be aimed at helping bridge the gap between intention and sustainable preventive behavior. This conceptual framework provides a basis for supporting patients and the public in achieving lifestyle goals and improving the effectiveness of preventive measures.

© 2026 The Author(s). European Journal of Neurology published by John Wiley & Sons Ltd on behalf of European Academy of Neurology.