WHAT IS LIFESTYLE MEDICINE?

WebstersDictionary defines…….

Lifestyle as a manner of living that reflects the persons values and attitude. If we were to expand on this definition to include health and diseased states, then we have LIFESTYLE MEDICINE at our fingertips.

Lifestyle Medicine is the use of a whole food, plant-predominant dietary lifestyle, regular physical activity, restorative sleep, stress management, avoidance of risky substances and positive social connection as a primary therapeutic modality for treatment and reversal of chronic disease. It is a refreshing and alternative approach to medicine in treating the causes of chronic preventable diseases with lifestyle interventions which will sooner or later reverse or reduce the disease state itself.

Lifestyle factors like, environmental risks, nutrition deficient diets, sedentary living, smoking, over consumption of alcohol and chronic stress negatively impact our health.

Most people and even doctors dismiss lifestyle factors as a community and public health issue because it is about habits and sometimes even addictions.

Nevertheless, Lifestyle factors are instrumental to the development of certain chronic medical conditions and recently many medical societies jointly published a review on the scientific evidence for lifestyle medicine towards the prevention and treatment of certain chronic medical conditions.

We should incorporate lifestyle medicine to effectively treat diseases so as to achieve the best possible outcome for the community at large. There is strong evidence that this approach works and will further translate to reduced healthcare cost and burden to the governments healthcare budget.

The rise in chronic disease trends and related healthcare spending in the United States and in many other countries like Malaysia is unsustainable. Type 2 diabetes alone is a global pandemic in itself with incalculable consequences.

This being said, there is still hope. The good news is that 80% or more of all healthcare spending in most parts of the developed world are tied to the treatment of conditions rooted in poor lifestyle choices. Chronic diseases and conditions—such as hypertension, heart disease, stroke, type 2 diabetes, obesity, osteoporosis, multiple types of cancer—are among the most common, costly and preventable of all health conditions.

Malaysia is Asia’s fattest country

14 Aug 2018 by Dr Milton Lum

The Institute of Health’s Second Burden of Disease Study for Malaysia in 2012 singled out high blood pressure, smoking, diabetes, high cholesterol and overweight/obesity as the biggest contributors to disability and death. These risk factors are the ingredients for the perfect storm for the Malaysian healthcare system, which is already under stress. The economic costs of obesity are considerable. The total (direct and indirect) costs of obesity of Malaysia are the highest in ASEAN, accounting for 10-19% of national healthcare spending.

Harvard Medical School which is a world acclaimed institution and regarded as the gold standard for quality medical research, education and practice has collaborated with Spaulding Rehabilitation Hospital Network in Massachusetts to form

The Institute of Lifestyle Medicine, USA.

In this Institute, physicians are trained about the importance of advocating exercise

and healthy eating plans into the patient's prescription. The main aim of the Institution is in helping doctors to make patients hHealthier by again, incorporating lifestyle changes and healthy eating.

Eating healthy, is something still very alien to a vast majority of people. With the pressures of work, bosses, family and traffic jams, many of us are not able to cook at home and totally depend on the food industry which feeds us, but does not pay attention to health. The food pyramid that we all grew up w

ith is no longer holding true. The current food pyramid created by Harvard Medical School for Public Health has placed exercise and weight control at the broadest portion of the food pyramid.

So .... What kind of food is healthy and does not make us fat and sick ... ?

Food which is cooked right from scratch, bypassing factories and big gigantic machines. Food without artificial seasonings and preservaties. Food with the correct amount of fibre, unrefined carbohydrates and healthy fats..

-In simple terms ... the food our grandmother used to cook..

The current community wellness programs and public health education techniques that are in place; like dangers of smoking seen on labels of cigarette boxes, reducing the level of sugars in packed food items, fortification of food items with vitamins and minerals, do initiate the necessary curiosity that is required for the public. However, doctors as health educators and preservers have to take it to the next level, so that there is a sense of continuity and participation at different levels.

The recent EPIC study published in the archives of internal medicine studied 23,000 people's adherence to four simple behaviors, that are:

1. Not smoking

2. Exercising 3.5 hours per week

3. Eating a healthy diet of fruits, vegetables, nuts, seed, whole grains and limited amount of red meat

4. Maintaining a healthy weight of BMI < 30

In those adhering to these behavioral patterns, 93% of diabetes, 81% of heart attacks, 50% of strokes and 36% of all cancers were prevented. This study is only one, among a large evidence based documenting, how lifestyle intervention is often more effective in reducing all cost mortality than almost any other medical intervention.

WHY?

Lifestyle factors influence the fundamental biological mechanisms leading to diseased states, by changes in gene expressions that modulate inflammation, oxidative stress and metabolic dysfunction.

Treating the risk factors for diseases like high blood pressure, high blood sugar and high cholesterol like is done currently in most medical clinics…. lNSTEAD OF ACTUALLY FOCUSING ON THE CAUSES OF THE DISEASE, HAS CREATED A GAP IN MANAGEMENTOF CHRONIC DISEASES.

A lot of time, attention and money is spent on diagnosing diseases too late when earlier interventions of lifestyle could have prevented these diseases in the first place. If the disease is diagnosed at an early stage, for example type-2 diabetes, hypertension and obesity related conditions, and the underlying factors in lifestyle are addressed instead of Just prescribing medicines, most of the time the disease can be reversed if there are no internal organ damage and complications.

The lNTERHEART STUDY published in The lancet 2004, followed 30,000 people and found that changing lifestyles could prevent 90% of all heart diseases. The same lifestyle interventions used to prevent and reverse heart disease can prevent and reverse other chronic diseases as well.

In conclusion, healthcare workers like doctors and nurses irrespective of their positions should intergrate lifestyle changes and other dietary interventional practices whenever possible, when dealing with metabolic diseases.

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