A NEW PAR ADI GM
Lifestyle medicine Rob Lawson General and Lifestyle Medicine Practitioner; Director and owner of CORE HEALTH
Lifestyle medicine is branch of evidence-based medicine in which comprehensive lifestyle changes (including nutrition, physical activity, stress management, social support and environmental exposures) are used to prevent, treat and reverse the progression of chronic diseases by addressing their underlying causes. An easier explanation is one which my patients understand. Rather than continuing to mop up the overflow from a bathtub, lifestyle medicine is about trying to turn the leaking tap off.
My interest in lifestyle determinants of disease began at least 28 years ago. The penicillin of what is now called lifestyle medicine is represented by the management of stress, nutrition and activity. As an NHS GP, only by setting up a registered charity delivering activity classes around my county for people with long-term conditions, was I able to deliver what I considered to be an essential component of holistic and preventive health care.
Most of the doubling of life expectancy over the last century or so has been due to improved nutrition, housing, hygiene, clean water and sanitation. However, we now face a pandemic of chronic (or lifestyle-related) diseases (LRDs). The major causes of chronic diseases are lifestyle related and if these risk factors were eliminated, at least 80% of all heart disease, stroke and type 2 diabetes and over 40% of cancer would be prevented (WHO 2016).
Chronic metabolic inflammation Pasteur’s germ theory led to cures for infectious diseases. Until now, chronic disease epidemiology has lacked a similar single-cause focus. However, according to Gokhan Hotamisligil at Harvard, a form of low-grade, systemic, and chronic inflammation (metaflammation) underlies many, if not all, chronic diseases. The animal metabolic and immune systems are so essential for survival that these systems evolved a long way back. Consequently these nutrient- and pathogen-sensing systems are highly integrated and their proper functioning is interdependent (Hotamisligil 2006). The failure to co-ordinate this central homeostatic mechanism leads to a cluster of chronic metabolic disorders, particularly obesity, type 2 diabetes and cardiovascular disease.
Anthropogens Garry Egger, Director of the Centre for Health Promotion and Research in Sydney and Professor of Lifestyle
Š Journal of holistic healthcare
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Volume 13 Issue 2 Summer/Autumn 2016
Medicine and Applied Health Promotion at Southern Cross University, has called the main disrupters of this system anthropogens (Egger et al 2015), defining them as man-made environments, their by-products, and/or lifestyles encouraged by these, some of which are detrimental to human health. A broad classification of anthropogens associated with chronic disease can help us focus the practice of lifestyle medicine and could in time shift medical thinking (and our whole culture) towards what needs to be done to bring about real improvement in healthy life expectancy. The anthropogens proposed by Garry Egger et al can be grouped under the acronym NASTIE ODORS. The grouping is reproduced with his permission.
Nutrition (over and under) Excess energy intake, even of healthy foods can be pro-inflammatory and this tendency is made worse in foods that have been refined or processed. The hazards of obesity and the benefits of fat loss are well established. Inadequate and/or over-nutrition account for a significant proportion of risk for chronic conditions like vascular disease, type 2 diabetes and certain cancers. Studies have reported increased risk from excessive amounts of total energy, sugars, salt, alcohol, and (saturated and trans) fats, as well as inadequate levels of fibre, fruit, vegetables and certain nutrients. Levels of processing have been proposed as a general indicator of risk, and there appears to be a clear
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