WIDLIMS Podcast ep #1 – Why Lifestyle Medicine should be mainstream with Dr Rob Lawson

New podcast episode with Dr Rob Lawson from the British Society of Lifestyle Medicine

In this episode, I chat to Dr Rob Lawson (he/him) about...

• what lifestyle medicine is
• lifestyle medicine and Covid-19
• why we should all care about it
• how the current model of teaching in medical school is missing out crucial information to tomorrow’s doctors
• his vision for a lifestyle medicine curriculum – soon reality?

Dr Rob Lawson is a retired GP heavily involved in various lifestyle medicine organisations – you can find out more about him and his work here. The British Society of Lifestyle Medicine website may be accessed here, and they are also on Facebook and Instagram.

Mentioned during the episode

• NASTIE MALODOURS: acronym for social determinants of health
• Dr Rob Lawson’s blog post about Covid-19 and lifestyle
• Dr Rob Lawson interviewing Prof Gary Egger
• Dr Rob Lawson interviewing oncologist Prof Robert Thomas
• Prof Gary Egger’s book about Lifestyle Medicine
• Dr Peter Gøtzsche talking about his book Deadly Medicines and Organised Crime

Lifestyle Medicine – what modern medicine is lacking?

The American College of Lifestyle Medicine defines “lifestyle medicine” it as the following:

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.

ACLM, What is Lifestyle Medicine?

Essentially, lifestyle medicine is about going back to basics, and going back to simpler ways of managing health. There obviously is a role for medications and surgical interventions, but with a healthy lifestyle, it is possible to prevent many diseases in the first instance, and even manage and reverse some chronic disease without needing to take drugs which usually have undesirable side-effects.

The majority of global burden of disease is due to chronic non-communicable diseases. This means diseases which are not transmissible from person to person, as opposed to infectious diseases. Over 60% of deaths across the world are due to such diseases (1). However, there is ample evidence to suggest that it does not have to be like that. If unhealthy habits are what is driving chronic illness, healthy habits could prevent, treat and reverse them.

Typically, people place a lot of emphasis on diet and exercise. However, far more variables shape our health. On an individual level, there is of course social support (or lack of it), stress management skills and relationships – to name a few factors. There also are upstream so-called “psychosocial determinants” of health and disease. Egger et al. organised them according to an acronym: NASTIE MAL ODOURS (2). Some examples of the other factors influencing health outcomes are alienation, environment and social inequity.

These upstream determinants of disease are important, as individuals do not have control over them. They are the direct result of politics and systems of oppression, and the society we live in. So for example, while much research might say that belonging to a minority ethnicity is a risk factor for worse health outcomes, it is in fact the racism itself which is the “risk” causing unfavourable outcomes. Angela Saini writes well on this topic, which is discussed in WIDLIMS episode #3 too, in the context of racism in medicine.

Lifestyle medicine is wonderful as it highlights how it is possible to empower and enrich people’s lives with simple changes. It is important to remember, as Dr Rob Lawson mentions, that lifestyle medicine is not about judgement. “Lifestyle”, he says, has become “a dirty word” in that it sounds as though it is about judging or pigeon-holeing people. That is of course not the case.

I personally believe a lot of good comes out of finding out about the role lifestyle plays in health. Although it is perhaps not possible for everyone to access healthy food, due to living in a food desert for example, or exercise regularly, due to living in unsafe neighbourhoods, or have optimal sleep hygiene, due to working shifts to make money to survive, we ought to inform the public about it, and help make healthy lifestyles as accessible as possible.

In addition to the vast evidence-base for lifestyle medicine, I also would like to point out that there are lots of stories detailing how people have managed to reverse diabetes, cure autoimmune disease and manage endometriosis symptoms – simply by changing their lifestyle!

Unfortunately, medical students are taught little to nothing about this promising way of practicing medicine. That is where organisations such as the BSLM, Nutritank and many more are trying to bridge the gap. I myself had to find out about all of the evidence-base behind lifestyle medicine through a route which I took by chance. That is not how it should be – lifestyle medicine must be mainstream, at the root of everything doctors do!

Other than the British Society of Lifestyle Medicine and Nutritank, the American College of Lifestyle Medicine and Plant-Based Health Professionals UK provide lots of excellent advice, information and support for patients, clinicians and the general public alike on this topic for some further reading.

Some great documentaries to check out would be Forks Over Knives and Code Blue.

Of course, be sure to listen to the podcast episode with Dr Rob Lawson and follow me @widlims for more information. I will be posting and talking about lots more in the field for months to follow!

REFERENCES

1) Sagner, et al. “Lifestyle Medicine Potential for Reversing a World of Chronic Disease Epidemics: from Cell to Community.” International Journal of Clinical Practice, vol. 68, no. 11, 2014, pp. 1289–1292. https://onlinelibrary.wiley.com/doi/pdf/10.1111/ijcp.12509

2) Egger G, Stevens J, Binns A, Morgan B. Psychosocial Determinants of Chronic Disease: Implications for Lifestyle Medicine. Am J Lifestyle Med. 2019;13(6):526-532. Published 2019 May 9. doi:10.1177/1559827619845335 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6796226/