Integrative Healthcare for Optimal Health

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Yet, as we confront the escalating crisis of non-communicable diseases (NCDs), it becomes increasingly clear that conventional approaches alone are no longer sufficient. A new, evidence-based paradigm shift is necessary. Integrative health, which combines conventional medicine with complementary and lifestyle medicine, offers that shift. To assess its effectiveness, we identified and reviewed 14 clinical trials published within the past 5 years in widely read, high-impact factor journals (and their sub-specialty counterparts) – including The New England Journal of Medicine, the Lancet, the BMJ and JAMA. These trials directly compared integrative health interventions with conventional medical treatments across conditions such as insomnia, obesity, age-related disorders, Parkinsonism, and motor neuron disease. The included trials assessed outcomes related to mental health, pain management, and quality of life. Across these studies, we found that integrative health interventions were consistently associated with improved health outcomes. While we acknowledge that stronger evidence is needed, the research findings represent an important step toward exploring a well-balanced, evidence-based approach to integrative health." } { "@context": "http://schema.org", "@type": "BreadcrumbList", "itemListElement": [ { "@type": "ListItem", "position": "1", "item": { "@id": "https://f1000research.com/", "name": "Home" } }, { "@type": "ListItem", "position": "2", "item": { "@id": "https://f1000research.com/browse/articles", "name": "Browse" } }, { "@type": "ListItem", "position": "3", "item": { "@id": "https://f1000research.com/articles/15-257/v1", "name": "Integrative Healthcare for Optimal Health" } } ] } Home Browse Integrative Healthcare for Optimal Health ALL Metrics - Views Downloads Get PDF Get XML Cite How to cite this article Mamtani R, Abraham A, Cheema S et al. Integrative Healthcare for Optimal Health [version 1; peer review: 1 approved with reservations] . F1000Research 2026, 15 :257 ( https://doi.org/10.12688/f1000research.177886.1 ) NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article. Close Copy Citation Details Export Export Citation Sciwheel EndNote Ref. Manager Bibtex ProCite Sente EXPORT Select a format first Track Share ▬ ✚ Opinion Article Integrative Healthcare for Optimal Health [version 1; peer review: 1 approved with reservations] Ravinder Mamtani 1 , Amit Abraham https://orcid.org/0000-0002-9696-8598 1 , Sohaila Cheema 1 , Karima Chaabna 1 , Darshan H Mehta https://orcid.org/0000-0003-0457-4717 2-4 , Javaid Sheikh 5 Ravinder Mamtani 1 , Amit Abraham https://orcid.org/0000-0002-9696-8598 1 , [...] Sohaila Cheema 1 , Karima Chaabna 1 , Darshan H Mehta https://orcid.org/0000-0003-0457-4717 2-4 , Javaid Sheikh 5 PUBLISHED 14 Feb 2026 Author details Author details 1 Institute for Population Health, Weill Cornell Medicine - Qatar, Doha, Qatar 2 Benson-Henry Institute for Mind Body Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA 3 Osher Center for Integrative Health, Brigham and Women's Hospital, Boston, Massachusetts, USA 4 Harvard Medical School, Boston, Massachusetts, USA 5 Office of the Dean, Weill Cornell Medicine - Qatar, Doha, Qatar Ravinder Mamtani Roles: Conceptualization, Data Curation, Formal Analysis, Writing – Original Draft Preparation, Writing – Review & Editing Amit Abraham Roles: Conceptualization, Data Curation, Formal Analysis, Writing – Original Draft Preparation, Writing – Review & Editing Sohaila Cheema Roles: Conceptualization, Data Curation, Formal Analysis, Writing – Original Draft Preparation, Writing – Review & Editing Karima Chaabna Roles: Data Curation, Formal Analysis, Writing – Original Draft Preparation, Writing – Review & Editing Darshan H Mehta Roles: Writing – Original Draft Preparation, Writing – Review & Editing Javaid Sheikh Roles: Conceptualization, Writing – Original Draft Preparation, Writing – Review & Editing OPEN PEER REVIEW DETAILS REVIEWER STATUS This article is included in the Global Public Health gateway. This article is included in the Health Services gateway. Abstract Conventional medicine and public health have collectively improved health and saved the lives of millions. Yet, as we confront the escalating crisis of non-communicable diseases (NCDs), it becomes increasingly clear that conventional approaches alone are no longer sufficient. A new, evidence-based paradigm shift is necessary. Integrative health, which combines conventional medicine with complementary and lifestyle medicine, offers that shift. To assess its effectiveness, we identified and reviewed 14 clinical trials published within the past 5 years in widely read, high-impact factor journals (and their sub-specialty counterparts) – including The New England Journal of Medicine , the Lancet , the BMJ and JAMA. These trials directly compared integrative health interventions with conventional medical treatments across conditions such as insomnia, obesity, age-related disorders, Parkinsonism, and motor neuron disease. The included trials assessed outcomes related to mental health, pain management, and quality of life. Across these studies, we found that integrative health interventions were consistently associated with improved health outcomes. While we acknowledge that stronger evidence is needed, the research findings represent an important step toward exploring a well-balanced, evidence-based approach to integrative health. READ ALL READ LESS Keywords Integrative Health, Integrative Medicine, Complementary medicine, Alternative medicine, Non-communicable disease Corresponding Author(s) Amit Abraham ( [email protected] ) Close Corresponding author: Amit Abraham Competing interests: No competing interests were disclosed. Grant information: The author(s) declared that no grants were involved in supporting this work. Copyright: © 2026 Mamtani R et al . This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. How to cite: Mamtani R, Abraham A, Cheema S et al. Integrative Healthcare for Optimal Health [version 1; peer review: 1 approved with reservations] . F1000Research 2026, 15 :257 ( https://doi.org/10.12688/f1000research.177886.1 ) First published: 14 Feb 2026, 15 :257 ( https://doi.org/10.12688/f1000research.177886.1 ) Latest published: 14 Feb 2026, 15 :257 ( https://doi.org/10.12688/f1000research.177886.1 ) 1. Introduction Over the past century, conventional medicine and public health strategies - such as vaccination programs, sanitation, and acute care interventions - have markedly reduced global mortality and morbidity. Nonetheless, the global rise of non-communicable diseases (NCDs), responsible for nearly 70% of deaths and the majority of disability-adjusted life years (DALYs), 1 , 2 reveals the limits of conventional healthcare. While indispensable, conventional approaches often fail to address the multifactorial nature of NCDs, particularly in the absence of patient engagement in self-care. 3 One way to address the rise in NCDs is augmenting conventional medicine with complementary and lifestyle modalities. Complementary medicine encompasses diverse practices not traditionally part of mainstream medical systems, including acupuncture, herbal and dietary supplements, meditation, massage therapy, chiropractic care, yoga, and tai chi. 4 Lifestyle medicine, which overlaps with both conventional and complementary domains, focuses on preventing and managing NCDs through behavioral interventions including nutrition, physical activity, stress reduction, social connectivity, avoidance of harmful substances, and sleep hygiene. 5 These approaches are not only widely used but are also supported by scientific evidence, demonstrating their potential to improve health outcomes. However they often remain unavailable through conventional healthcare practitioners, which may lead individuals to seek alternative healthcare on their own. In this context, integrative healthcare synthesizes conventional medicine with complementary and lifestyle modalities into a unified, evidence-informed framework that aims to optimize health outcomes and enhance patient well-being. 6 Given the multifactorial nature of NCDs, the collective use of conventional, complementary, and lifestyle approaches could achieve greater impact than any of these domains in isolation. This is the central promise of integrative healthcare: an evidence-based, whole-person, and sustainable model of care that addresses the biological, psychological, social, and behavioral dimensions of health ( Figure 1 ). Nonetheless, integrative healthcare remains overlooked as a distinct model for managing NCDs. Figure 1. Integrative Health is an evidence-based, holistic model of healthcare. We argue that the primary challenge facing integrative healthcare for NCDs is not a lack of efficacy, but its marginalization within the mainstream evidence hierarchy. Integrative healthcare is rarely incorporated, despite the fact that existing trials suggest added value over conventional care alone. This commentary illustrates how integrative healthcare currently appears in the literature and outlines key steps toward a research agenda more closely aligned with the realities of integrative healthcare. 2. Evaluating the Value of Integrative Healthcare It is helpful to review the literature in order to assess the clinical impact of integrative healthcare. Over the past five years, only 14 randomized controlled trials comparing integrative interventions with standard conventional care have been published in high-impact, peer-reviewed medical journals ( The New England Journal of Medicine , the Lancet , the BMJ , and JAMA ) ( Table 1 ). These trials spanned diverse settings and involved participants of varying ages, sexes, and educational backgrounds. Across these studies, integrative healthcare approaches were generally more effective than conventional care alone. In patients with various health conditions (including Parkinson’s disease, primary insomnia, and depression), integrative approaches reduced overall symptom severity. Similar added benefits were observed in trials assessing obesity, type 2 diabetes, ageing-associated decline, Crohn’s disease, and pain, where integrative healthcare improved clinical outcomes beyond those achieved with conventional treatment alone. A subset of studies included follow-up beyond six and twelve months, suggesting sustained benefits over time. Table 1. Randomized control trials comparing conventional care and integrative health. Patient symptoms and clinical diagnosis Conventional care Integrative health Outcome and conclusion Reference Motor neuron disease (amyotrophic lateral sclerosis; progressive muscular atrophy; or primary lateral sclerosis) Standard care, including medication for motor neuron disease and related symptoms; treatments such as non-invasive ventilation, physiotherapy, and gastrostomy; and access to other hospital-based and community-based services (such as equipment and adaptations, orthotics, respiratory, gastroenterology, clinical psychology, neuropsychology and counselling, and social care services) N=94 Along with conventional care, participants received Acceptance and Commitment Therapy (a combination of acceptance, mindfulness, motivation, and behavior change techniques to assist engagement in life-enriching activities in the presence of distressing thoughts and feelings) N=95 Integrative health demonstrated clinical effectiveness in maintaining or improving quality of life Gould, 2024 22 Motor symptoms and constipation in patients with Parkinson's disease Levodopa Combination of oral lactulose or rectal glycerin N=83 In addition to conventional care, participants received electroacupuncture. N=83 Integrative health enhanced bowel movements, reducing symptoms of constipation. Improved functional motor activity Li, 2023 23 Quality of sleep in patients with Parkinson's disease Sleep hygiene guidance from sleep clinic physicians with continued use of anti-Parkinson medication and sham acupuncture N=41 In addition to conventional care, participants received acupuncture N=42 Integrative health improved sleep quality Yan, 202 24 a Mental disorders (depression, primary insomnia, post-traumatic stress disorder [PTSD], panic disorder, or agoraphobia) Standard outpatient interventions, including psychological (cognitive behavioral therapy, psychoanalysis, systemic therapy) and pharmacological treatments N=201 In addition to conventional care, participants engaged in an exercise program (ImPuls) (evidence-based, moderate-to-vigorous intensity outdoor exercises lasting 30 min, combined with behavioral change techniques targeting motivational and volitional determinants of exercise behavior) N=199 Integrative health demonstrated superior efficacy in reducing global symptom severity Wolf, 2024 25 Insomnia in patients with depression Recommendations to engage in regular exercise, follow a healthy diet, manage stress levels, and continue regular administration of antidepressants, sedatives, or hypnotics N=90 In addition to conventional care, participants received electroacupuncture N=90 Integrative health alleviated insomnia among patients with depression Yin, 2022 26 b Post-operative ileus secondary to resection of colorectal cancer Multimodal analgesia, patient-controlled analgesia plus non-steroidal anti-inflammatory drugs, early oral feeds, and early mobilization N=35 In addition to conventional care, participants received electroacupuncture at one of two different locations on the body N=35 for each group Integrative health enhanced bowel function recovery following post-operative ileus Yang, 2022 27 c Crohn's disease Combination of mesalazine, corticosteroids, azathioprine, or methotrexate N=33 In addition to conventional care, participants received acupuncture N=33 Integrative health induced and maintained remission of active Crohn’s disease, improved intestinal flora, and lowered recurrence rates Bao, 2022 28 Insomnia and pain in patients with chronic spinal pain Best evidence pain management (person-centered care; pain neuroscience education and cognition-targeted exercise therapy) N=62 In addition to conventional care, participants received cognitive behavior therapy (sleep education, self-monitoring of sleep patterns, time-in-bed restriction, stimulus control, sleep hygiene, cognitive restructuring, and relaxation) N=61 Integrative health improved sleep quality and reduced the severity of insomnia, but provided no significant pain relief Malfliet, 2024 29 Pain relief in urolithiasis Diclofenac and sham acupuncture N=40 In addition to conventional care, participants received acupuncture N=40 Integrative health provided fast and substantial pain relief to patients with renal colic compared with sham acupuncture in the emergency setting Tu, 2022 30 a Obesity Low-calorie diet and liraglutide N=49 In addition to conventional care, participants engaged in an exercise routine comprising moderate to vigorous aerobic activity and strength training N=48 Integrative health preserved bone mineral density at clinically important fracture sites during weight loss Jensen, 2024 31 Obesity Liraglutide N=41 Along with conventional care, participants engaged in an exercise routine (150 min/week of moderate-intensity aerobic physical activity, 75 min/week of vigorous-intensity aerobic physical activity, or an equivalent combination of both) N=40 Integrative health improved healthy weight loss maintenance more than liraglutide alone one year after initiation of the trial Lundgren, 2021 32 d Obesity Liraglutide N=49 In addition to conventional care, participants engaged in an exercise routine (150 min/week of moderate-intensity aerobic physical activity, 75 min/week of vigorous-intensity aerobic physical activity, or an equivalent combination of both) N=48 Integrative health promoted healthy weight maintenance after treatment termination compared with obesity pharmacotherapy alone and maintained body weight and composition 2 years after initiation of the trial Jensen, 2024 33 d Type 2 diabetes Standard care (glucose-lowering, lipid-lowering, and blood pressure-lowering medications) N=34 In addition to conventional care, participants received individualized meal plans and structured exercise plans N=64 Integrative health improved physical components of health-related quality of life, while mental components remained unchanged MacDonald, 2021 34 Aging-associated illness Primary health care, including health education flyers and lab test results N=199 In addition to conventional care, participants engaged in a multidomain intervention (physical exercise, cognitive training, nutrition, and disease education) N=199 Integrative health improved the quality of life Lee, 2021 35 a These studies compared the standard of care and sham treatments to integrative health, accounting for placebo effects. b This study had 3 arms: one group received conventional care, one group received conventional care and sham acupuncture and the third group received conventional care and acupuncture. c This study had 3 arms: one group received conventional care, one group received conventional care in addition to electroacupuncture at one site on the body and the third received conventional care with electroacupuncture at another site on the body. d The outcomes reported in these two publications are from the same trial at two different follow-up time points. Beyond clinical outcomes, integrative healthcare emphasizes shared decision-making and patient empowerment. Patients receiving integrative healthcare report higher satisfaction, greater alignment with personal values, and a stronger sense of being heard and respected by their providers. 7 – 10 Integrative healthcare has been associated with reduced polypharmacy, improved adherence to healthy behaviors, and enhanced long-term health outcomes. 11 When appropriately implemented, integrative healthcare can also reduce medical costs and yield improved health outcomes. 12 , 13 These observations pose an important question: if integrative healthcare approaches enhance outcomes and patient experience, why are they not more systematically implemented in NCD management? 3. Addressing challenges in implementation Despite its promise, the widespread adoption of integrative healthcare faces several barriers. Most healthcare professionals receive limited training in complementary and lifestyle medicine, restricting their ability to implement integrative approaches effectively. 14 , 15 One way to address this would be to foster interdisciplinary collaboration, allowing healthcare professionals from different fields to effectively address patient care. 16 , 17 In this context, developing policies to incentivize education and research in integrative healthcare and implementing culturally-appropriate, evidence-based guidelines can streamline integrative healthcare approaches. 16 – 18 The lack of reimbursement mechanisms for integrative healthcare poses a significant obstacle to access and scalability. A shift away from fee-based service toward value-based care, which links reimbursement to health outcomes and overall patient satisfaction, may result in more widespread adoption of holistic, integrative healthcare. 16 , 19 By prioritizing prevention and resource optimization, integrative healthcare offers a pathway toward more sustainable and equitable health systems. 20 , 21 4. Conclusion Emerging evidence supports the integration of complementary and lifestyle-based interventions into conventional care as a viable strategy for managing chronic disease and enhancing patient outcomes. Findings from recently published high-quality clinical trials presented here show the promise of integrative health. Given the widespread global use of complementary and lifestyle approaches, advancing research in integrative healthcare may support the development of more sustainable, evidence-informed health systems worldwide. Declaration of generative AI and AI-assisted technologies in the writing process During the preparation of this work the author(s) used Microsoft Copilot (Free version) in order to lightly edit the manuscript. After using this tool/service, the authors reviewed and edited the content as needed and take full responsibility for the content of the published article. Data availability The data for this article consists of bibliographic references, which are included in the References section. Acknowledgements We would like to acknowledge Anupama Jithesh, Projects Coordinator, Weill Cornell Medicine-Qatar, for her assistance in retrieving relevant published articles for this commentary. We also thank Philippe Piccardi, Scientific and Education Content Specialist, and Hidenori Miyagawa, Visual Design Specialist, both at Weill Cornell Medicine-Qatar, for their assistance with manuscript editing and visual asset consultation, respectively. References 1. World Health Organization (WHO): Global Health Observatory: Global health estimates: Leading causes of DALYs. (Accessed Apr 28, 2024). Reference Source 2. Global incidence, prevalence, years lived with disability (YLDs), disability-adjusted life-years (DALYs), and healthy life expectancy (HALE) for 371 diseases and injuries in 204 countries and territories and 811 subnational locations, 1990-2021: a systematic analysis for the Global Burden of Disease Study 2021. Lancet. 2024; 403 (10440): 2133–2161. 3. Safer DJ: Overprescribed Medications for US Adults: Four Major Examples. J. Clin. Med. Res. 2019; 11 (9): 617–622. Publisher Full Text 4. World Health Organization (WHO): Traditional, complementary, and integrative medicine. (Accessed May 7, 2025). Reference Source 5. John NA, John J, Tarnikanti M, et al. : Implications of lifestyle medicine in medical practice. J. Family Med. Prim. Care. 2023; 12 (2): 208–212. 6. National Center for Complementary and Integrative Health: Complementary, Alternative, or Integrative Health: What’s In a Name?2021. (Accessed Jan 15, 2025). Reference Source 7. McCaffrey AM, Pugh GF, O’Connor BB: Understanding patient preference for integrative medical care: Results from patient focus groups. J. Gen. Intern. Med. 2007; 22 (11): 1500–1505. 8. Hawkes RE, Cameron E, Cotterill S, et al. : The NHS Diabetes Prevention Programme: an observational study of service delivery and patient experience. BMC Health Serv. Res. 2020; 20 (1): 1098. 9. Klein J, Brauer P, Royall D, et al. : Patient experiences of a lifestyle program for metabolic syndrome offered in family medicine clinics: a mixed methods study. BMC Fam. Pract. 2018; 19 (1): 148. 10. Richardson K, Petukhova R, Hughes S, et al. : The acceptability of lifestyle medicine for the treatment of mental illness: perspectives of people with and without lived experience of mental illness. BMC Public Health. 2024; 24 (1): 171. 11. Srivastava SB: Polypharmacy, Unintended Consequences, and Impact of Lifestyle Medicine. Am. J. Lifestyle Med. 2023; 18 (1): 54–57. 12. Herman PM, Poindexter BL, Witt CM, et al. : Are complementary therapies and integrative care cost-effective? A systematic review of economic evaluations. BMJ Open. 2012; 2 (5): e001046. 13. Sommers E, D’Amico S, Goldstein L, et al. : Integrative Approaches to Pediatric Chronic Pain in an Urban Safety-Net Hospital: Cost Savings, Clinical Benefits, and Safety. J. Integr. Complement. Med. 2022; 28 (5): 445–453. 14. Lippman D, Stump M, Veazey E, et al. : Foundations of Lifestyle Medicine and its Evolution. Mayo Clin. Proc. Innov. Qual. Outcomes. 2024; 8 (1): 97–111. 15. Pan CX, Morrison RS, Ness J, et al. : Complementary and alternative medicine in the management of pain, dyspnea, and nausea and vomiting near the end of Life: A systematic review. J. Pain Symptom Manag. 2000; 20 (5): 374–387. 16. Patel P, Madrid M: Successfully Integrating Lifestyle Medicine Into Health Systems. Am. J. Lifestyle Med. 2021; 15 (5): 510–513. 17. Miller DW, Roseen EJ, Stone JAM, et al. : Incorporating Acupuncture Into American Healthcare: Initiating a Discussion on Implementation Science, the Status of the Field, and Stakeholder Considerations. Glob. Adv. Health Med. 2021; 10 : 21649561211042574. 18. Jonas W, Mehta D: Integrative Care Interest and Offerings Grow. NEJM Catalyst. 4 (9). 19. American Medical Association: What is value-based care?Jul 30, 2025. Retrieved Dec 15, 2025. Reference Source 20. Pathak N, Pollard KJ, McKinney A: Lifestyle Medicine Interventions for Personal and Planetary Health: The Urgent Need for Action. Am. J. Lifestyle Med. 2022; 16 (5): 589–593. 21. Cramer H: Sustainable Health Care: How Traditional, Complementary, and Integrative Medicine Could Lead the Shift Towards Eco-Friendly Practices. J. Integr. Complement. Med. 2024; 30 (10): 907–909. 22. Gould RL, McDermott CJ, Thompson BJ, et al. : Acceptance and Commitment Therapy plus usual care for improving quality of life in people with motor neuron disease (COMMEND): a multicentre, parallel, randomised controlled trial in the UK. Lancet. 2024; 403 (10442): 2381–2394. 23. Li K, Xu S, Wang R, et al. : Electroacupuncture for motor dysfunction and constipation in patients with Parkinson’s disease: a randomised controlled multi-centre trial. EClinicalMedicine. 2023; 56 : 101814. Publisher Full Text 24. Yan M, Fan J, Liu X, et al. : Acupuncture and Sleep Quality Among Patients With Parkinson Disease: A Randomized Clinical Trial. JAMA Netw. Open. 2024; 7 (6): e2417862-e. Publisher Full Text 25. Wolf S, Seiffer B, Zeibig J-M, et al. : A transdiagnostic group exercise intervention for mental health outpatients in Germany (ImPuls): results of a pragmatic, multisite, block-randomised, phase 3 controlled trial. Lancet Psychiatry. 2024; 11 (6): 417–430. 26. Yin X, Li W, Liang T, et al. : Effect of Electroacupuncture on Insomnia in Patients With Depression: A Randomized Clinical Trial. JAMA Netw. Open. 2022; 5 (7): e2220563. Publisher Full Text 27. Yang J-W, Shao J-K, Wang Y, et al. : Effect of acupuncture on postoperative ileus after laparoscopic elective colorectal surgery: A prospective, randomised, controlled trial. EClinicalMedicine. 2022; 49 : 101472. 28. Bao C, Wu L, Wang D, et al. : Acupuncture improves the symptoms, intestinal microbiota, and inflammation of patients with mild to moderate Crohn’s disease: A randomized controlled trial. EClinicalMedicine. 2022; 45 : 101300. 29. Malfliet A, De Baets L, Bilterys T, et al. : Cognitive Behavioral Therapy for Insomnia in Pain Management for Nonspecific Chronic Spinal Pain: A Randomized Clinical Trial. JAMA Netw. Open. 2024; 7 (8): e2425856-e. Publisher Full Text 30. Tu JF, Cao Y, Wang LQ, et al. : Effect of Adjunctive Acupuncture on Pain Relief Among Emergency Department Patients With Acute Renal Colic Due to Urolithiasis: A Randomized Clinical Trial. JAMA Netw. Open. 2022; 5 (8): e2225735. Publisher Full Text 31. Jensen SBK, Sørensen V, Sandsdal RM, et al. : Bone Health After Exercise Alone, GLP-1 Receptor Agonist Treatment, or Combination Treatment: A Secondary Analysis of a Randomized Clinical Trial. JAMA Netw. Open. 2024; 7 (6): e2416775. Publisher Full Text 32. Lundgren JR, Janus C, Jensen SBK, et al. : Healthy Weight Loss Maintenance with Exercise, Liraglutide, or Both Combined. N. Engl. J. Med. 2021; 384 (18): 1719–1730. 33. Jensen SBK, Blond MB, Sandsdal RM, et al. : Healthy weight loss maintenance with exercise, GLP-1 receptor agonist, or both combined followed by one year without treatment: a post-treatment analysis of a randomised placebo-controlled trial. EClinicalMedicine. 2024; 69 : 102475. 34. MacDonald CS, Nielsen SM, Bjørner J, et al. : One-year intensive lifestyle intervention and improvements in health-related quality of life and mental health in persons with type 2 diabetes: a secondary analysis of the U-TURN randomized controlled trial. BMJ Open Diabetes Res. Care. 2021; 9 (1). Publisher Full Text 35. Lee W-J, Peng L-N, Lin C-H, et al. : Effects of incorporating multidomain interventions into integrated primary care on quality of life: a randomised controlled trial. Lancet Healthy Longev. 2021; 2 (11): e712–e723. Publisher Full Text Comments on this article Comments (0) Version 1 VERSION 1 PUBLISHED 14 Feb 2026 ADD YOUR COMMENT Comment Author details Author details 1 Institute for Population Health, Weill Cornell Medicine - Qatar, Doha, Qatar 2 Benson-Henry Institute for Mind Body Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA 3 Osher Center for Integrative Health, Brigham and Women's Hospital, Boston, Massachusetts, USA 4 Harvard Medical School, Boston, Massachusetts, USA 5 Office of the Dean, Weill Cornell Medicine - Qatar, Doha, Qatar Ravinder Mamtani Roles: Conceptualization, Data Curation, Formal Analysis, Writing – Original Draft Preparation, Writing – Review & Editing Amit Abraham Roles: Conceptualization, Data Curation, Formal Analysis, Writing – Original Draft Preparation, Writing – Review & Editing Sohaila Cheema Roles: Conceptualization, Data Curation, Formal Analysis, Writing – Original Draft Preparation, Writing – Review & Editing Karima Chaabna Roles: Data Curation, Formal Analysis, Writing – Original Draft Preparation, Writing – Review & Editing Darshan H Mehta Roles: Writing – Original Draft Preparation, Writing – Review & Editing Javaid Sheikh Roles: Conceptualization, Writing – Original Draft Preparation, Writing – Review & Editing Competing interests No competing interests were disclosed. Grant information The author(s) declared that no grants were involved in supporting this work. Article Versions (1) version 1 Published: 14 Feb 2026, 15:257 https://doi.org/10.12688/f1000research.177886.1 Copyright © 2026 Mamtani R et al . This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Download Export To Sciwheel Bibtex EndNote ProCite Ref. Manager (RIS) Sente metrics Views Downloads F1000Research - - PubMed Central info_outline Data from PMC are received and updated monthly. - - Citations open_in_new 0 open_in_new 0 open_in_new SEE MORE DETAILS CITE how to cite this article Mamtani R, Abraham A, Cheema S et al. Integrative Healthcare for Optimal Health [version 1; peer review: 1 approved with reservations] . F1000Research 2026, 15 :257 ( https://doi.org/10.12688/f1000research.177886.1 ) NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS track receive updates on this article Track an article to receive email alerts on any updates to this article. TRACK THIS ARTICLE Share Open Peer Review Current Reviewer Status: ? Key to Reviewer Statuses VIEW HIDE Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Version 1 VERSION 1 PUBLISHED 14 Feb 2026 Views 0 Cite How to cite this report: Armano L and Racz A. Reviewer Report For: Integrative Healthcare for Optimal Health [version 1; peer review: 1 approved with reservations] . F1000Research 2026, 15 :257 ( https://doi.org/10.5256/f1000research.196190.r464948 ) The direct URL for this report is: https://f1000research.com/articles/15-257/v1#referee-response-464948 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 11 Mar 2026 Ljerka Armano , UHC Sisters of Mercy, Zagreb, Croatia Aleksandar Racz , University of Rijeka, Rijeka, Croatia Approved with Reservations VIEWS 0 https://doi.org/10.5256/f1000research.196190.r464948 Summary of the Article The manuscript entitled “Integrative Healthcare for Optimal Health” presents an opinion-based analysis advocating for the integration of conventional medicine, complementary medicine, and lifestyle medicine into a unified model of healthcare aimed at addressing the growing ... Continue reading READ ALL Summary of the Article The manuscript entitled “Integrative Healthcare for Optimal Health” presents an opinion-based analysis advocating for the integration of conventional medicine, complementary medicine, and lifestyle medicine into a unified model of healthcare aimed at addressing the growing global burden of non-communicable diseases (NCDs). The authors argue that although conventional medical approaches have significantly improved life expectancy and reduced mortality over the past century, they are insufficient to adequately address the multifactorial etiology of chronic diseases. As a response, the authors propose integrative healthcare as an evidence-informed model that combines pharmacological and clinical interventions with behavioral, lifestyle, and complementary therapeutic approaches. To illustrate the potential effectiveness of integrative healthcare, the authors identify and summarize fourteen randomized controlled trials published in high-impact journals over the past five years. These trials examine integrative interventions in conditions such as Parkinson’s disease, obesity, insomnia, Crohn’s disease, chronic pain, and type 2 diabetes. According to the authors, the overall pattern of results suggests that integrative approaches often lead to improved health outcomes, particularly in quality of life, symptom management, and patient engagement. Beyond clinical outcomes, the manuscript highlights the conceptual and systemic barriers that prevent wider implementation of integrative healthcare. These include insufficient training among healthcare professionals, lack of reimbursement mechanisms, and the persistence of traditional hierarchies of medical evidence that marginalize complementary approaches. The authors conclude that expanding research, policy support, and interdisciplinary collaboration could enable integrative healthcare to become an important component of sustainable healthcare systems worldwide. Overall, the manuscript addresses a timely and important topic, particularly in light of the increasing prevalence of chronic diseases and the growing interest in holistic and patient-centered care models. The manuscript raises an important and relevant issue in contemporary healthcare. The discussion is well structured and highlights the potential role of integrative healthcare in addressing complex chronic conditions that are poorly managed by purely biomedical approaches. The article successfully emphasizes the importance of patient engagement, lifestyle interventions, and multidisciplinary care. However, although the manuscript provides an interesting perspective, several aspects require further clarification and strengthening in order to meet the standards expected for a scientifically rigorous indexing. The current version reads primarily as a conceptual commentary supported by selective examples , rather than as a systematic evaluation of evidence. Greater methodological transparency and a more balanced critical appraisal of the literature would significantly strengthen the manuscript. Major Issues While the manuscript addresses an important and timely topic, several major issues should be addressed in order to strengthen the scientific credibility and analytical clarity of the article. First, the manuscript lacks sufficient methodological transparency regarding the identification and selection of the clinical trials used to support the argument. The authors state that fourteen randomized controlled trials published in high-impact journals during the past five years were reviewed to illustrate the value of integrative healthcare. However, the manuscript does not describe how these studies were identified, which databases were searched, what search strategy was employed, or which inclusion and exclusion criteria were applied. Without this information, it remains unclear whether the selected studies represent a systematic overview of the available evidence or a more selective narrative sample of favorable findings. Even though the article is presented as an opinion piece rather than a formal systematic review, providing at least a brief description of the literature identification process would considerably improve transparency and allow readers to better understand the evidentiary basis for the authors’ conclusions. Second, the conceptual definition of “integrative healthcare” requires further clarification. The manuscript groups together a wide variety of interventions including acupuncture, exercise programs, cognitive behavioral therapy, dietary interventions, and other lifestyle approaches under a single conceptual umbrella. While these approaches may indeed contribute to integrative models of care, they represent heterogeneous therapeutic strategies with different mechanisms of action, evidence bases, and levels of clinical acceptance. The current presentation risks oversimplifying these differences and may create ambiguity regarding what exactly constitutes integrative healthcare in clinical practice. A clearer conceptual framework distinguishing complementary medicine, lifestyle medicine, and multidisciplinary conventional care would help strengthen the analytical coherence of the manuscript. Third, the discussion of the evidence base would benefit from a more balanced and critical appraisal of the cited studies. The manuscript predominantly highlights positive findings from the selected trials, emphasizing improvements in quality of life, symptom reduction, and patient engagement. However, little attention is given to potential methodological limitations that may influence the interpretation of these results. Issues such as small sample sizes, heterogeneity of patient populations, placebo effects in interventions such as acupuncture, and varying follow-up periods may affect the robustness and generalizability of the reported outcomes. A more critical reflection on these aspects would not weaken the authors’ argument but rather demonstrate a more rigorous and balanced scientific approach. Finally, some of the conclusions presented in the manuscript appear somewhat broader than the evidence provided fully supports. The trials summarized in the manuscript address diverse clinical conditions and employ different intervention types, making it difficult to draw general conclusions about the overall effectiveness of integrative healthcare as a unified healthcare model. While the evidence presented suggests promising potential, caution should be exercised when extrapolating these findings to healthcare systems more broadly. Moderating the language of some conclusions and emphasizing the need for further high-quality research would enhance the scientific credibility of the article and align the interpretation more closely with the available evidence. Addressing these issues would substantially improve the methodological transparency, conceptual clarity, and analytical balance of the manuscript, thereby strengthening its contribution to the discussion on the role of integrative healthcare in contemporary medicine. Is the topic of the opinion article discussed accurately in the context of the current literature? Partly Are all factual statements correct and adequately supported by citations? Partly Are arguments sufficiently supported by evidence from the published literature? Partly Are the conclusions drawn balanced and justified on the basis of the presented arguments? Partly Competing Interests: No competing interests were disclosed. Reviewer Expertise: Clinical medicine, public health, CAm, oncology, hospital infections, Neurosurgery, nursing We confirm that we have read this submission and believe that we have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however we have significant reservations, as outlined above. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Armano L and Racz A. Reviewer Report For: Integrative Healthcare for Optimal Health [version 1; peer review: 1 approved with reservations] . F1000Research 2026, 15 :257 ( https://doi.org/10.5256/f1000research.196190.r464948 ) The direct URL for this report is: https://f1000research.com/articles/15-257/v1#referee-response-464948 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Respond or Comment COMMENT ON THIS REPORT Comments on this article Comments (0) Version 1 VERSION 1 PUBLISHED 14 Feb 2026 ADD YOUR COMMENT Comment keyboard_arrow_left keyboard_arrow_right Open Peer Review Reviewer Status info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Reviewer Reports Invited Reviewers 1 Version 1 14 Feb 26 read Ljerka Armano , UHC Sisters of Mercy, Zagreb, Croatia Aleksandar Racz , University of Rijeka, Rijeka, Croatia Comments on this article All Comments (0) Add a comment Sign up for content alerts Sign Up You are now signed up to receive this alert Browse by related subjects keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2026 Armano L et al. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 11 Mar 2026 | for Version 1 Ljerka Armano , UHC Sisters of Mercy, Zagreb, Croatia Aleksandar Racz , University of Rijeka, Rijeka, Croatia 0 Views copyright © 2026 Armano L et al. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (0) Approved With Reservations info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Summary of the Article The manuscript entitled “Integrative Healthcare for Optimal Health” presents an opinion-based analysis advocating for the integration of conventional medicine, complementary medicine, and lifestyle medicine into a unified model of healthcare aimed at addressing the growing global burden of non-communicable diseases (NCDs). The authors argue that although conventional medical approaches have significantly improved life expectancy and reduced mortality over the past century, they are insufficient to adequately address the multifactorial etiology of chronic diseases. As a response, the authors propose integrative healthcare as an evidence-informed model that combines pharmacological and clinical interventions with behavioral, lifestyle, and complementary therapeutic approaches. To illustrate the potential effectiveness of integrative healthcare, the authors identify and summarize fourteen randomized controlled trials published in high-impact journals over the past five years. These trials examine integrative interventions in conditions such as Parkinson’s disease, obesity, insomnia, Crohn’s disease, chronic pain, and type 2 diabetes. According to the authors, the overall pattern of results suggests that integrative approaches often lead to improved health outcomes, particularly in quality of life, symptom management, and patient engagement. Beyond clinical outcomes, the manuscript highlights the conceptual and systemic barriers that prevent wider implementation of integrative healthcare. These include insufficient training among healthcare professionals, lack of reimbursement mechanisms, and the persistence of traditional hierarchies of medical evidence that marginalize complementary approaches. The authors conclude that expanding research, policy support, and interdisciplinary collaboration could enable integrative healthcare to become an important component of sustainable healthcare systems worldwide. Overall, the manuscript addresses a timely and important topic, particularly in light of the increasing prevalence of chronic diseases and the growing interest in holistic and patient-centered care models. The manuscript raises an important and relevant issue in contemporary healthcare. The discussion is well structured and highlights the potential role of integrative healthcare in addressing complex chronic conditions that are poorly managed by purely biomedical approaches. The article successfully emphasizes the importance of patient engagement, lifestyle interventions, and multidisciplinary care. However, although the manuscript provides an interesting perspective, several aspects require further clarification and strengthening in order to meet the standards expected for a scientifically rigorous indexing. The current version reads primarily as a conceptual commentary supported by selective examples , rather than as a systematic evaluation of evidence. Greater methodological transparency and a more balanced critical appraisal of the literature would significantly strengthen the manuscript. Major Issues While the manuscript addresses an important and timely topic, several major issues should be addressed in order to strengthen the scientific credibility and analytical clarity of the article. First, the manuscript lacks sufficient methodological transparency regarding the identification and selection of the clinical trials used to support the argument. The authors state that fourteen randomized controlled trials published in high-impact journals during the past five years were reviewed to illustrate the value of integrative healthcare. However, the manuscript does not describe how these studies were identified, which databases were searched, what search strategy was employed, or which inclusion and exclusion criteria were applied. Without this information, it remains unclear whether the selected studies represent a systematic overview of the available evidence or a more selective narrative sample of favorable findings. Even though the article is presented as an opinion piece rather than a formal systematic review, providing at least a brief description of the literature identification process would considerably improve transparency and allow readers to better understand the evidentiary basis for the authors’ conclusions. Second, the conceptual definition of “integrative healthcare” requires further clarification. The manuscript groups together a wide variety of interventions including acupuncture, exercise programs, cognitive behavioral therapy, dietary interventions, and other lifestyle approaches under a single conceptual umbrella. While these approaches may indeed contribute to integrative models of care, they represent heterogeneous therapeutic strategies with different mechanisms of action, evidence bases, and levels of clinical acceptance. The current presentation risks oversimplifying these differences and may create ambiguity regarding what exactly constitutes integrative healthcare in clinical practice. A clearer conceptual framework distinguishing complementary medicine, lifestyle medicine, and multidisciplinary conventional care would help strengthen the analytical coherence of the manuscript. Third, the discussion of the evidence base would benefit from a more balanced and critical appraisal of the cited studies. The manuscript predominantly highlights positive findings from the selected trials, emphasizing improvements in quality of life, symptom reduction, and patient engagement. However, little attention is given to potential methodological limitations that may influence the interpretation of these results. Issues such as small sample sizes, heterogeneity of patient populations, placebo effects in interventions such as acupuncture, and varying follow-up periods may affect the robustness and generalizability of the reported outcomes. A more critical reflection on these aspects would not weaken the authors’ argument but rather demonstrate a more rigorous and balanced scientific approach. Finally, some of the conclusions presented in the manuscript appear somewhat broader than the evidence provided fully supports. The trials summarized in the manuscript address diverse clinical conditions and employ different intervention types, making it difficult to draw general conclusions about the overall effectiveness of integrative healthcare as a unified healthcare model. While the evidence presented suggests promising potential, caution should be exercised when extrapolating these findings to healthcare systems more broadly. Moderating the language of some conclusions and emphasizing the need for further high-quality research would enhance the scientific credibility of the article and align the interpretation more closely with the available evidence. Addressing these issues would substantially improve the methodological transparency, conceptual clarity, and analytical balance of the manuscript, thereby strengthening its contribution to the discussion on the role of integrative healthcare in contemporary medicine. Is the topic of the opinion article discussed accurately in the context of the current literature? Partly Are all factual statements correct and adequately supported by citations? Partly Are arguments sufficiently supported by evidence from the published literature? Partly Are the conclusions drawn balanced and justified on the basis of the presented arguments? Partly Competing Interests No competing interests were disclosed. Reviewer Expertise Clinical medicine, public health, CAm, oncology, hospital infections, Neurosurgery, nursing We confirm that we have read this submission and believe that we have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however we have significant reservations, as outlined above. reply Respond to this report Responses (0) Armano L and Racz A. Peer Review Report For: Integrative Healthcare for Optimal Health [version 1; peer review: 1 approved with reservations] . 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