Lifestyle Medicine - Now More Important Than Ever.

Since the Covid 19 pandemic surfaced only a few short months ago, the focus has rightly been on preventing disease transmission through a range of measures from staying at home and social distancing, strict hand hygiene/respiratory etiquette as well as rapid identification of cases and isolation of contacts through massive point in time testing. All occurring against a backdrop of massive disruption to business and normal way of life. 

As economies and societies ‘reopen’ in the coming months, we will all have to adapt to a ‘new normal’ in terms of how we go about our daily lives. This virus hasn’t gone away and a potential vaccine is still some way off. 

In that context it is easy to ignore one important fact. That it is people with underlying chronic health conditions who are most susceptible to becoming ill from Covid-19. Not always but certainly in the vast majority of cases, people being hospitalised with Covid 19 also have obesity, diabetes, heart disease, respiratory issues or other conditions associated with a weakened immune system. 

A recent observational study published in the Journal of the American Medical Association which looked at people hospitalised with Covid 19 in New York found that only six per cent had no underlying health condition and that eighty eight percent of people had at least two. 

This is an important point to make particularly if you are interested in maximising your chances of staying well as time moves on or at least minimising the potential severity of Covid 19 as an illness should you contract it. 

In fact, according to the World Health Organisation, two-thirds of all disease worldwide will soon be the result of lifestyle choices. Currently the leading causes of death in the United States are lifestyle related : poor diet, lack of exercise, obesity, tobacco use and overconsumption of alcohol. Modern society has a tsunami of largely lifestyle related chronic health conditions from diabetes to coronary heart disease and countless others as well as an epidemic of anxiety and mental health conditions. Furthermore while modern medicine in the right place at the right time is invaluable, the simple truth is that pill-only solutions will take us only so far and will not stem the tide. 

The WHO put it well many years ago when they said that health is more than the absence of disease but a state of complete physical mental and relational wellbeing. Your physical health, psychological fitness, emotional wellbeing and relationships are all interconnected to your sense of purpose and the environments you spend your time in. 

Which brings me to the idea of lifestyle as medicine. An idea that has captivated me for years, to rediscover the elements involved in staying healthy - as I like to say ‘living with vitality.’

Ways to not just add years to your life but life to your years.

A healthy lifestylewhich can not only significantly lower your risk of developing many chronic health conditions, but better manage and even potentially reverse them. 

Jim (not his real name) immediately springs to mind as my ‘poster boy’ for lifestyle as medicine. When I met him for the first time last year, it was only the legal requirements of a drivers licence renewal form that had brought him into me at the age of seventy. Basic tests carried out by me revealed diabetes, high blood pressure and raised cholesterol, underpinned by a sedentary lifestyle, high fat, high salt diet with plenty of beer to wash it all down. In his words he drank a ‘slab of beer’ (about twelve cans) most days. Confronted with the consequences of his lifestyle habits for his mortality, he was given two choices - take prescription pills and or make some serious lifestyle changes. To my delight he chose lifestyle changes. 

Even though I had my doubts, he promised he would make real changes as an alternative to medication.

He stopped drinking alcohol, moved essentially to a plant based vegetable rich diet, and bought a home exercise bike to piggy back the habit of exercise with his favourite pastime of watching news and tv. Within six months he had normalised his blood pressure, cholesterol, liver function and reversed his diabetes. All without medication. He looks and feels terrific, and says he hasn’t had as much energy since he was a young man. 

Jim has now turned his attention to other family members as his new found zest for life its making him an advocate for a healthy lifestyle.

The thing is it is never to late to start to take better care of yourself, to embrace this concept of ‘lifestyle as medicine.’

Lifestyle medicine focuses on diet and nutrition, exercise and movement, embracing stress and building great relationships.

Food as Medicine 

Firstly there are thousands of health boosting phytochemicals in fruits, vegetables, fruits, whole grains, and legumes that boost your immune system and support better health. 

Furthermore we now know that the food you eat impacts your microbiome (bugs in your gut) which in turn produce the majority of the body's serotonin - the happiness boosting hormone formerly thought to be produced exclusively in the brain. Which brings new meaning and understanding to the idea of food as medicine and the close connection between body and brain. 

Exercise as Medicine

There is a wealth of data showing a clear and consistent link between taking moderate amounts of exercise and a reduced risk of many chronic health conditions including infectious disease. Simply walking for fifteen to thirty minutes each day can make a big difference to your immune system. 

 Sleep as Medicine

Less than six hours of regular sleep a night can increase your risks of heart attack, diabetes, depression - even long term dementia. Furthermore, sleep deprivation keeps you attuned to a chronic negative stress state, marinating in cortisol (negative stress hormone), which of course is a major cause of inflammation, a weakened immune system as well as playing havoc with your mood, attention span and willpower muscle. Early to bed and early to rise really does make a man healthier, wealthier and wiser. 

Embracing Stress 

In the current climate everyone is feeling extra stressed as a normal part of the ‘fight or flight’ response amidst the Covid 19 pandemic. Furthermore feelings of fear can become self fulfilling as it can weaken the immune system. Learn to embrace stress by focusing on what you can control, mindfulness techniques including slowing your breathing, meditation, actively monitoring your exposure to news and media, spending time in nature and strategies to switch off completely including comedy. 

Accepting the current reality is the starting point to move forward one step, one day at a time. Being able to find meaning, to grow from your experiences is the hallmark of real resilience, a key ingredient in embracing stress. 

Gratitude is a powerful antidote to negative stress and toxic destructive emotions such as envy, resentment and bitterness. It is simply not possible to feel grateful and negative at the same time.

Putting on my medical hat for a moment, an attitude of gratitude is a powerful antidote to needless negativity. Just as it is not possible to feel optimistic and pessimistic at the same time, it’s not possible to feel negative, resentful and grateful at the same time.

When you are feeling negative and stressed the best treatment is a liberal dose of gratitude dispensed regularly. 

Loneliness

Strong relationships are the leading indicator of your wellbeing. As human beings you thrive based on the strength and quality of these human connections. The downside of all this social distancing and disconnection is that many people are feeling lonely. Mother Teresa described loneliness quite aptly as the most terrible poverty. From a health perspective loneliness can be very harmful to your health with numerous studies showing that compared to those with a strong sense of interpersonal connection, love and community, people suffering from loneliness are three to ten times more likely to become ill and die prematurely from almost all causes. 

More connected to others means less ‘me’ and more ‘we.’ Active strategies that enable you to stay connected, even virtually, are the basis for rich, meaningful and flourishing life. 

As we re-emerge into the new reality and learn to adapt to Covid-19, understanding the key role that your lifestyle habits can play in determining your health has never been more relevant and important. After all, health is wealth. While there are no guarantees for any of us, lifestyle as medicine will stack the odds in your favour. 

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