Turning the Tide – Getting back to basics
This is done in a clinical setting - through a doctor’s office or through community oriented programmes.
For many months we have been looking at various aspects of Lifestyle Medicine – particularly addressing the common chronic diseases so often caused by our chosen lifestyles. In the last 17 articles we looked at the common chronic health problems in South Africa and how to specifically address those.
Today and over the next few weeks we are going to look at Lifestyle Medicine – what it is and why it is so important for each of us to understand. Unfortunately it is not an area that most doctors and health workers are formally taught, but hopefully that is changing – certainly in countries like USA , the UK, Europe and Australia. Perhaps the bug will bite in South Africa as well.
What is Lifestyle Medicine?
According to the American College of Lifestyle Medicine (a specialty governing body equivalent to the College of Cardiology or Paediatrics or Orthopaedics), it is the use of lifestyle interventions in the treatment and management of disease, through the application of medical, behaviour, motivation and environmental principles. This is done in a clinical setting – through a doctor’s office or through community oriented programmes. Most conventional medicine relies upon the management by a doctor and his team, but lifestyle includes a large measure of self-care and self-management. Most importantly the management is evidence-based. That means it is not thumb-suck, or snake oil “research”, but is based upon sound science – through peer-reviewed research and experience. Yes it is true that there are many conflicting, especially dietary, messages out there, but the basic core information is unquestioned. Sometimes the media likes to concentrate on controversies. People like to hear good news about their bad habits. But information that is based on large, long term, population studies, and good robust prospective research by some of the best minds, unencumbered by big business interests and sponsorships, is what guides lifestyle medicine teaching.
It is based upon evidence-based lifestyle therapeutic approaches, that incorporate:
A predominantly whole food, plant-based diet,
Regular physical activity,
Avoidance of risky substance use,
Living with purpose
These interventions can certainly prevent, but also oftentimes reverse lifestyle-related chronic disease.
Lifestyle Medicine is a team effort – it includes doctors and nurses, dieticians, physiotherapists and biokineticists, social workers, personal trainers, sports medicine specialists, coaches and counselling psychologists; but also family and friends as participants in the process.
Comparison between Lifestyle Medicine and other fields
Conventional MedicineLifestyle MedicineTreats individual risk factorsTreats lifestyle causes with the goal of primary, secondary and tertiary disease preventionPatient is often a passive recipient of carePatient is an active partner in carePatient is not required to make big changesPatient is required to make substantial transitionsTreatment is often short termTreatment is always long termResponsibility falls mostly on the clinicianResponsibility falls mostly on the patient; emphasis on motivation and adherenceMedication is often the “end” treatment; emphasis is on diagnosis, prescription and disease managementMedication may be needed but as an adjunct to lifestyle change
It is important to know that Lifestyle Medicine practitioners are foremost medical doctors who have been trained in conventional medicine, but have realised that conventional medicine is only one part of patient care. Many have found new meaning and enthusiasm and passion for medicine through helping patients to prevent as well as often reverse their chronic diseases, through addressing the primary causes of their lifestyle diseases.
Here is some good news from the UK about rumours of change in doctor’s training to incorporate Lifestyle Medicine advice.
Here is another UK GP, Dr Gemma Newman, highly experienced in Lifestyle Medicine talking about reversing type 2 diabetes:. She has many much longer YouTube videos in which she relates her own health transformation as well as medical practice renewal once she incorporated the promotion of Lifestyle Medicine.
I am studying an on-line certification course in Lifestyle Medicine Core Competencies produced and run by the American College of Lifestyle Medicine. I will be sharing practical insights gained in my training with relevance to our local scene and the patients I see daily.
To new hope in dealing with the tide of lifestyle diseases.
Dr David Glass – MBChB, FCOG (SA)
Dr David Glass graduated from UCT in 1975. He spent the next 12 years working at a mission hospital in Lesotho, where much of his work involved health education and interventions to improve health, aside from the normal busy clinical work of an under-resourced mission hospital.
He returned to UCT in 1990 to specialise in obstetrics/gynaecology and then moved to the South Coast where he had the privilege of, amongst other things, ushering 7000 babies into the world. He no longer delivers babies but is still very clinically active in gynaecology.
An old passion, preventive health care, has now replaced the obstetrics side of his work. He is eager to share insights he has gathered over the years on how to prevent and reverse so many of the modern scourges of lifestyle – obesity, diabetes, ischaemic heart disease, high blood pressure, arthritis, common cancers, etc.
He is a family man, with a supportive wife, and two grown children, and four beautiful grandchildren. His hobbies include walking, cycling, vegetable gardening, bird-watching, travelling and writing. He is active in community health outreach and deeply involved in church activities. He enjoys teaching and sharing information.