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BSLM Newsletter: September 2018
Dear Friends,
Welcome to the September Newsletter.
“I know one thing and that is that I know nothing” said Socrates. Science is knowledge and there is plenty of it out there. But each new ‘knowledge’ comes with yet more questions. This is especially true when you consider the ‘knowledge’ of nutrition. You end up feeling that you know nothing. However, some behave as if they know everything and if you don’t agree with them you must be stupid. It is their evidence that rules. And they know they are right.
BSLM is happy to learn everything, encourage polite discourse and host exchanges of evidence amongst its members. What we stand for is displayed on our website -and we use the words ‘evidence informed’. As a consequence we cannot be labelled as promoting one diet over another. We will follow informed evidence, not the money, as best as we can. The Lifestyle Medicine movement as a whole lives with the pragmatic statement along these lines: Eat real food, as unprocessed as possible, mainly plants and not too much. It excludes nothing because for millennia humans have been adapting to the environment in which they find themselves. It seems that only very recently have we become maladapted to our processed food and obesogenic environment hence the explosion in long term (reversible) lifestyle related diseases. As healthcare workers it behoves us to know about various ‘diets’ and adapt our lifestyle interventions to suit the beliefs, values and mindset of the person in front of us. It is not all about our own beliefs and even less about trying to impose them on others.
As I was cycling along today, reveling in the cool sunshine and slight breeze, I heard a noise and looked to my right to find an inanimate object was keeping pace with me as I climbed. It stayed with me for 20 yards or so and veered off to nestle into a quiet corner. It was a dry leaf wheeling along in the breeze.
Now, it is not a big assumption to make that it was the breeze that was propelling it. But I can’t see the breeze – I can only see its effect. How do I know it was there? Maybe it was an invisible hand?
I know nothing – except that Lifestyle as Medicine has the power to change lives.
Please engage with your Society, help us all to learn and spread your learning into areas that need it with BSLM help. There are educational events being run and planned around the UK, we have a Director of BSLM Learning Academy, which will have an online LM Coaching Certificate course in place mid-2019 and the 2019 LM Diploma Certification exam is open for registrants. Our Undergraduate LM Society is holding its own conference in April 2019 in London and looking for helpers. The BSLM19 conference in Cardiff is open for tickets but the programme is still in evolution and will be special! Meanwhile, the #1change campaign development continues. You will be updated.
Have a great October.
Rob Lawson
Lifestyle Medicine in Africa
by Dr Ifeoma Monye
The world now has more obese than underweight people, spawning an epidemic of chronic lifestyle-related non-communicable diseases (NCDs) even in Africa. Non-communicable diseases are the leading cause of death and disability worldwide, killing 41 million people a year, with African countries experiencing a disproportionately high burden. This means that for every ten deaths in the world annually, seven occur in Africa. Over 80 per cent of these premature deaths occur in low and middle income countries .When this is considered together with the burden of communicable diseases that has long plagued our part of the world, it becomes very clear that Africa as a continent, is sitting on a deadly time bomb of the disastrous consequences of the double disease burden.
A seismic shift now needs to take place in healthcare delivery in Africa, as the system must now move from the current reactive to a pro-active mode of health care delivery, providing a value and outcomes-based system of care. With 80% or more of healthcare spending in Western countries spent on the treatment of conditions rooted in poor lifestyle choices, it’s evident that a focus on the clinical practice of Lifestyle Medicine (LM) is essential. One may argue that in Africa we may not have reached those disturbing numbers yet, the fact remains that we are well on the way, with chronic disease rising in direct correlation to our affluence and “westernisation”.
There is no doubt that the clinicians who are to drive this change must be armed with the knowledge of the core competencies to deliver this change. Medical and nursing curriculae, as well as
other allied fields, presently have very little training, if at all, in Lifestyle Medicine. There is now definite urgency to provide training in Lifestyle Medicine, raising the critical mass of professionals who are knowledgeable and prepared to provide healthcare to the populations, in affordable and accessible ways to prevent, manage and reverse this epidemic in Africa, as there is particularly restricted capacity to accommodate additional disease burden, and little margin for additional brain drain. Few data exist on the readiness of the Africa health workforce to tackle the growing NCD burden, but one thing is certain: there is an obvious need to train health care professionals in Lifestyle Medicine in these resource restricted countries, so that they can help people live healthier, happier and longer lives.
The Society for Lifestyle Medicine of Nigeria (previously known as Lifestyle Medicine Practitioners Association of Nigeria) was founded in 2017. Our first international LM conference took place in Abuja, 5-6 August 2017. We organise LM lectures, seminars, community based LM related activities. In 2018, it’s executive has come together with clinicians from other African countries to launch the regional organisation, a Pan-African group, the Africa Lifestyle Medicine Association,(ALMA),with a mandate to help establish societies of Lifestyle Medicine in every country of Africa.
In Africa, our vision is to see a continent where routinely living till 100 years of age is the new norm. We want to ensure that there is quality in these years. We aim to identify and eradicate the cause of lifestyle related diseases, prevent, treat and possibly reverse these diseases using easily accessible, affordable and acceptable methods anchored in the core principles of lifestyle medicine.
This change is possible with the emergence of Lifestyle Medicine in this continent, greatly endowed with natural beauty and an array of fresh fruits and vegetables. A people highly motivated to go back to the core health care concepts that have been in existence for many years, where adjusting nutrition, physical activity, rest and a positive worldview to maximise health is the way to live right now and the path into a healthy future.
Dr Ifeoma Monye
MRCGP,FRCGP,DipBSLM/IBLM
President
Africa Lifestyle Medicine Association
The Diploma in Lifestyle Medicine
Before, During and After
by Dr Sue Smith
So the truth is - I wasn’t expecting it - in fact I had begun to think I was a tad alone. The lone drummer? - being a difficult square peg? - and to be honest, my head hurt from the banging...
The thing was, the job I had so keenly begun training in, now 35 years ago, had lost its lustre. I was certainly not someone to give up easily however - I’d begun the process years before, initially training in Acupuncture, NLP and last year in Health and Wellness coaching and had started to ‘set myself up’ to move on – and then the BSLM happened.
I remember the conversation now - “so... this Lifestyle Medicine thing you mention... what is it exactly? How does it differ from Functional, Integrative and – well - the Conventional?”.
A look up online and one conversation later and I was IN. This was IT... or at least IT was ME! It was what I had always done and was all about… not surprisingly I signed up then and there for the Diploma - well, after family clearance and a good look at what I needed to do…
I went to the conference in June - the first 10 hours required - an inspirational, informative and very professional event - next year already on my timeline.
Then, there was the CPD... I decided, due to time constraint, and the ‘newness’ of the exam, to sign up for the ACPM course. Yes, it was based on American stats [next years will be ‘UK’fied’]. However… the modules were fascinating and a pleasure to learn – the evidence base huge and the confidence kick on learning it all was, for me, monumental.
The main modules were focused on Lifestyle medicine – getting this defined and what takes to create an effective practice. Then there were modules of Physical activity, Nutrition, Sleep, Emotional Health, Coaching, Stress Management and the more negative behaviours of alcohol and nicotine consumption. Each module outlining the evidence and tools needed to deliver and prescribe effectively. What stood out to me was that a lot of this really compelling evidence has been around for YEARS! It’s been there the whole time – just overlayered with pharma quick fixes and time saving solutions, I say no more …
Overall, the learning has provided me with the raw data and confidence, that we can make this the FIRST way for the majority of dis-ease - and the BEST.
The exam was a memorable day – a head packed full of information unsure what was next – and a bit out of practice... A very long and challenging 4 hour MCQ later - very friendly invigilators - the questions varied and standard high, I was done. A short wait and a PASS a few days later, it dawned on me exactly what this all meant… Huge Change!
So, in a healthy nutshell, it was all worth it! I am SO glad to have done it all and learnt so much. Overall was the immense pleasure on becoming part of a group of pioneering graduates, and now one of the Directors locally. A life in lifestyle medicine has become very exciting.
The tribe is hugely active and impactful, it is an honour to be part of such an inspiring group of people. For me, with a Lifestyle programme on the horizon and a CPD event to be part of in March, things are looking very healthy and well!
2018… The year of the first ever graduates has been a very good one.. and this is just the beginning.
Member Spotlight:
Dr Alex Maxwell
Greetings fellow lifestyle medics! I am honoured to have serendipitously joined as the 500th BSLM member so thank-you very much to Rob Lawson and Joanna Hambridge for inviting me to write a little something about myself, my background and what I am getting up to.
My approach to health has always been along the principles of Lifestyle Medicine. I think I have my family to thank for that; eating wholesome food, exercise and destressing in various ways featured heavily in my childhood, something I will forever be grateful for.
I went to University at St George’s Hospital Medical School from 2006-11 and had a fantastic time. It was during those years that we began to learn about what our body does when it is working properly and when that fabulous homeostasis begins to break down. Gaining one’s medical degree, a bit like passing one’s driving test, is just the beginning of a wonderful and lifelong passion of forever looking to improve at helping people. I think we must never forget what a privilege that is.
An important progression for me as a Medical Student and Junior Doctor was that the classic “Medical model” is quite limited in some important areas. It did not feel right that as a sportsman or athlete I was learning more about Movement, Nutrition and Stress management than as a Medical Student or Doctor! As I developed as a clinician I began to integrate more and more of this understanding into my discussions with my patients. It felt like treating someone “Medically” began to feel superficial in some sense and the lifestyle principles I was beginning to apply were far more in depth, individualised and consequential. They also rarely had negative side effects, excepting possibly DOMS!
I joined General Practice training in Norwich (a fine city!) initially to become a Sports Medic. Through my training I fell in love with General Practice and, in my humble opinion, its unparralleled variety, challenge and flexibility. It was during this training that I became formally aware of BSLM and Lifestyle Medicine as a specialty. As I learnt about it, attended some conferences of varying sorts and gradually integrated even more of its principles into my practice I realised I had found my future career.
I now work in Thornton Heath in South London as a GP at Parchmore Medical Centre. This forward thinking and supportive practice have allowed me to set up regular group consulting courses to teach people about how they can improve their lifestyle. These have been received very well and are incredibly satisfying as a clinician to be a part of! Secondly, I have successfully integrated an activity session to our daily peer review meeting of our referrals. I have kept it varied with each session having a different focus; balance, co-ordination, strength, aerobic and others. They are great fun and really set us up for our afternoon clinic!
We have an amazing operations manager; Brian Dickens, MBE (!). His efforts, more recently towards “Social Prescribing” where we can prescribe or direct people towards non-clinical resources in the community have been nothing short of astonishing. I absolutely believe that Lifestyle Medicine and Social Prescribing are a golden combination and we are very excited to push forward with both of them locally and more widely.
Thank-you again, BSLM, for the opportunity to write this. I look forward to seeing many of you at the conferences throughout the year. Emails welcome!
Member Spotlight:
Dr Alison Sabine
I have been a Consultant Rheumatologist in Birmingham since 2009 and have worked in the NHS for more than 25 years. I trained in Bristol and then worked in Kent and London before moving to the Midlands in 2001.
My interest in Lifestyle medicine has grown from an increasing recognition of the potential for dietary change to modify inflammatory disease and from my own personal experience.
I started to realize that patients often knew more about food and nutrition than myself and colleagues and that blanket advice to eat a ‘healthy balanced diet’ was simply inadequate and often confusing so I set about learning more by studying with the Institute for Integrative Nutrition. This led to a Level 4 Health Coaching qualification and has enabled me to understand the potential role for Health Coaches in the current healthcare setting. I have become an Advisory Board member for the UK Health Coaches Association, which has its inaugural conference this September.
I am also passionate about encouraging people to move more, doing activities they love and have trained as a Nordic Walking Instructor, running Heart of England Nordic Walking while continuing with NHS work.
I see the growing burden of chronic ill health and the impact this is having on people’s lives and I am keen to see a move towards preventative and whole person centred care. We need to challenge the current healthcare paradigm; ill health should not be viewed as the norm and the constant fire-fighting and over-prescribing has to stop. We need to get to the root cause of disease by recognising the person as a whole; mind and body.
Working in partnership and encouraging lifestyle change is the future of medicine. Simple lifestyle changes have the power to add up on an individual level and just might also ensure the survival of the NHS, because currently we all know how the pressure on services and staff grow daily.
Together with an organisation called The Good Alliance, I launched the NHS.gifts website on its 70th birthday; an independent movement of UK citizens and residents collaborating to improve their own health. The idea is that small lifestyle changes add up and in doing so, gift the NHS to future generations. It sits well with BSLM’s 1change campaign and I hope together the impact will be to inspire, motivate and offer hope for change.
I’m absolutely delighted to be part of the British Society for Lifestyle Medicine and look forward to meeting like minded members. I truly believe we will see huge shifts in the healthcare system and BSLM will be a major driver of this change. Exciting times ahead!
Member Spotlight:
Dr Fiona Day
I’ve spent over 25 years working in lifestyle medicine. I learned early on that challenging the Professor of Medicine at Edinburgh Medical School in 1993 about why his lecture on hypertension didn’t include anything about salt intake or the use of biofeedback for relaxation didn’t make me very popular! But with an intercalated degree in psychology behind me, I knew that improving mental health and emotional wellbeing would be one of the keys to unlocking the growing burden of non-communicable disease in the population, a theme that has run throughout my career.
I returned to the hospital where I had been a junior doctor to do a locum shift a year later and realised that I knew almost half of the patients on the ward. Having already spent 5 months working in population healthcare in Kaiser Permanente in my medical elective, I knew that this was a sign of a system problem. I looked through some of the patient’s notes, and talked to a few of them, and discovered that there was a revolving door between hospital and community, fuelled by a lack of clear self-empowering interventions for people to implement to regain control of their own health. This was a real ‘moment’ for me in terms of insight into where things were going wrong.
Six months of rehabilitation medicine followed, where my senior colleagues were replicating the Dean Ornish Heart Trials — and were actively taking people off waiting list for coronary bypass surgery following diet, exercise and relaxation programmes — I was amazed and hooked, and concluded that a career in Public Health Medicine was for me. There were no opportunities to try public health before you committed to it as your career, so following inspiration from the Health Education Board for Scotland which was next door to where I was working, I decided to undertake a Masters in Health Promotion and Health Education and specialised in emotional wellbeing. This really opened my eyes to the wider determinants of health and the role that wider society and public policy plays in determining health outcomes, something which I feel is often lacking in the current lifestyle medicine discourse. Improving lifestyles is less about marginal improvements for the affluent and motivated but about significant improvements for vulnerable and marginalised populations whose risk factors cluster together[1] in areas of deprivation.
A few years in health promotion roles learning the ropes of public health, running an exercise referral scheme, training GPs and practice nurses in health coaching interventions, leading healthy lifestyles programmes across the population to reduce heart disease and cancer, and to improve mental health and improve sexual health outcomes. I loved what I was doing and felt I was ready to commit to public health training, and in 2009 I was appointed to my first Consultant post.
I was excited, experienced and finally fully trained to lead large scale health improvement interventions across the system, and I spent a fantastic few years working with an amazing team making real improvements to health and wellbeing outcomes and reducing health inequalities in our populations. Yet inside me the yearning to work on a one-to-one basis was growing; I loved seeing my large staff team grow and develop, I loved mentoring and coaching my registrars, and was increasingly asked to support and develop colleagues in the workplace and across the system. I wanted to use my skills and experience in improving mental health and emotional wellbeing to support leaders in their work and professionals in their careers, and to take all the knowledge and experience from 20 years of leadership in the field of lifestyle medicine and create something new and different where I could add value to tomorrow’s leaders. I retrained as an Executive Coach, Occupational Physician and Mindfulness Based Cognitive Therapy trainer, and while I still work one day a week as a public health consultant, I mainly work with doctors and healthcare professionals to support them in their own careers and leadership roles.
As I write, the United Nations is currently reviewing progress towards preventing and controlling non-communicable diseases which account for 71% of worldwide deaths[2]. There is a long way to go.
[1] https://www.kingsfund.org.uk/publications/tackling-multiple-unhealthy-risk-factors
Event Preview:
Applied Lifestyle Medicine
by Dr John Sykes
27th October 2018
Royal College of General Practitioners, London
How do we apply lifestyle medicine in our daily practice and how do we relay this information to our patients and wider society?
Accredited by the Royal College of General Practitioners, join us as we learn from the experts on how to apply nutrition, physical activity, mindfulness and sleep hygiene as methods to manage common medical complaints, to prevent and treat chronic conditions, all in realistic and achievable time frames.
We have an incredible line up of speakers including Nick Littlehales, Dr Zoe Williams, Dr Nicola Guess, Jillian Lavendar, Dr John Sykes, Dr Tim Anstiss, Mr George Ampat and Alan Flanagan with a range of exercise breaks in the day led by Darryl Edwards and Bradley Scanes. We promise a day of evidence based talks, practical case based discussions, group workshops led by BSLM directors and much more, allowing you to take away practical tools to apply in your daily workplace.
Open to all healthcare professionals and with 6 CPD points, a chance to learn from the experts and an opportunity to connect with like-minded individuals, why would you not come?
For any queries, please email thevisionarymedic@gmail.com.
We hope to see you soon!
Introducing KCL LifeMed Society!
Dear BSLM colleagues,
To spread the word of the increasing relevance of lifestyle medicine, we decided a few months ago to start a lifestyle medicine society at Kings College London. Over the last few months we have worked tirelessly, planning and developing ideas on how to develop the society, with the limited resources at our disposal. We are very pleased to announce that we officially launched KCL LifeMed Society at the welcome fair for new students at KCL. In order to increase traction, the stall at the event, without using the generic sugar-laden snacks as incentive we decided to do something different. We created a box full of the sugary treats that are usually given out at welcome events and used this for a competition in which students were asked to guess the number of calories the box contained. We negotiated two one-month gym memberships with the University gym as an incentive for students to guess
correctly. We also reached out to the London BSLM network for support and Dr Alex Maxwell kindly reached out with an offer to support us in person at the event. Over the two days we engaged with new students on the importance of lifestyle medicine and how it is incorporating not only about our physical wellbeing, but also our mental wellbeing. With the help of Dr Alex Maxwell, we were able to smash our initial target of 50 sign-ups by obtaining over 100 sign-ups over the two days! Results like this have emboldened us that there is an interest from students about lifestyle medicine and that we can use our society as a platform to engage and educate future doctors on how they can use lifestyle medicine for themselves and their future patients. Moving forward, we will be reaching to those students already at the medical school, as well as other health-related courses such as physiotherapy,
nursing, nutrition & dietetics. We have exciting plans for future events and initiatives, which we will surely keep you updated on. We would really welcome any support or suggestions from the BSLM, you can contact us at LifeMedSoc@gmail.com. You can also follow our progress at Facebook, Instagram and Twitter using the @kclLifeMed handle. Please also share our details throughout your own network.
Abe Bashir
Co-President & Co-Founder of KCL LifeMed Society
Community Events
There are many great community events coming up in the next year. Here are just a few from the BSLM events page:
21 October 2018
Lifestyle Medicine 2018
Indianapolis, Indiana, USA
Event Details +
The American College of Lifestyle Medicine produces an annual CME accredited conference—the nation’s premier medical education event exclusively focused on lifestyle in medicine and lifestyle as medicine…
27 October 2018
Applied Lifestyle Medicine
London
Event Details +
How do we apply lifestyle medicine in our daily practice and how do we relay this information to our patients and wider society? Accredited by the Royal College of General Practitioners…
10 November 2018
1st European Lifestyle Medicine Conference
Geneva, Switzerland
Event Details +
The European Lifestyle Medicine Organization (ELMO) is a scientific, medical organization based in Geneva (Switzerland) dedicated to research, prevention and treatment of chronic diseases and lifestyle related diseases...
Submit events that you'd like to see included on the BSLM events page
