Lifestyle Medicine - the ABCs

Mon 13 Jun 2022

Last month Dr Charlotte Marriott came and talked to me on “Time to Talk”, our weekly health related live interview that you can catch up on on our YouTube channel. Charlotte is a Consultant Psychiatrist and a Certified Lifestyle Medicine Physician and we were talking about how we can use the principles of lifestyle medicine to help us feel more connected and less alone. Lifestyle medicine has been around forever but we now have the evidence for the lifestyle behaviours we instinctively knew were good for us. These behaviours not only have the ability to help us feel better, but they can also turn around chronic illnesses such as diabetes, and prevent illness in the first place. The Lifestyle Medicine Diploma talks about the 6 pillars of health, nutrition, sleep, physical activity, stress management, connection and avoiding substances. At CST we talk about the ABCs, just because otherwise I will always forget one!

Before we delve into the evidence for the elements of our lifestyle that make a difference to our health there is a need for a disclaimer. Because although we may have the knowledge about what makes us healthier that doesn’t mean it is easy to make the behavioural changes. Various different factors come into play meaning none of us lives the perfect lifestyle. Time is often mentioned as a major reason why we don’t implement the changes but life and motivation also play a part. We may know that a whole food meal will be better for us but when we are on a night shift sometimes the only thing we have access to is convenience food. We may know that regular exercise is good for us but our mood means we struggle to go to work every day, never mind head to the gym.

Awareness and knowledge are the first steps in making a change. My advice would be to focus on one thing at a time. Give yourself small goals. Find the easiest win first and then build on it. Often some of the lifestyle changes will automatically lead to the next. Taking regular exercise has been shown to change the foods we crave and reduce our intake rather than increase our intake of unhealthy foods. It is also shown to increase, not decrease our energy levels which in turn may lead us to feeling more like we want to be social. What we also know is that if we make a behavioural change with someone else we are more likely to stick with it and that if we have some accountability and guidance and if we can find something that we enjoy then we are going to be able to sustain these changes and make a more significant difference to our health.

So with that disclaimer in place here is the run through our ABCs..

A. Avoiding substances like alcohol, cigarettes and drugs, but also other behaviours that we know are detrimental to our mental health. This may be becoming socially isolated, eating junk food, staying up late. The Nuffield Trust and the Health Foundation found that alcohol related deaths jumped up in 2020 having been stable for many years. The highest proportion of heavy drinkers are aged 24 to 35. This socially acceptable drug isn’t good for our physical or mental health. Do you know your perpetuating factors and can you avoid them?

B. Breathe and add to this mindfulness, headspace, meditation. Our heads are buzzing constantly and they need a break. Learning to use breathwork to slow everything down has been shown to lower our blood pressure, reduce our cortisol levels, and improve our mood. Being mindful and living in the present can help with anxiety which is often driven by worry about our past or future. Meditation doesn’t need to mean sitting cross legged and can be done when walking or running.

C. Connection - Being connected is a great protector of our health, with loneliness being found to be as detrimental for our health as smoking 15 cigarettes a day. Of course we can be around people and still be lonely, so this is about not just being connected to people but also to ourselves, the world and nature around us and others. Spending time in nature has been proven to be so good for our physical and mental health and even just looking at images of nature can help.

D. Daily routines with an emphasis on sleep and nutrition - A great study for showing the effect of nutrition on our mental health is the Supporting the Modification of lifestyle In Lowered Emotional States (SMILES) trial. This Australian study ran a 12 week parallel, single blind RCT comparing outcomes in people with depression. One group was supported to adopt nutritional changes and another group was supported with a befriending service. There was a marked improvement in depression scores in the nutrition group versus the befriending group. Various modes of action are cited. Impact on cardiovascular health, inflammatory and oxidative stress pathways, as well as brain plasticity and the gut microbiota. Poor sleep also impacts on both our physical and mental health, with links to obesity, hypertension, metabolic syndrome, diabetes, cognitive impairment, accidents and breathing disorders. The largest link though is to our mood with over a third of people with chronic insomnia struggling with depression and this is bidirectional. CBT for insomnia is the recommended treatment by NICE for insomnia (watch out Time to Talk on our YouTube channel to be taken through this step by step)

E. Exercise is great for our minds and bodies and that can be in whatever form works for you. Find something you enjoy and do it often. The recommended minimum for cardiovascular health is 150 minutes a week and for our mental health is 90 minutes. This can be broken down into 5 minute blocks if that is easier for you to fit in around life. This is our passion at CST so give us a follow on social media or check out our website for advice.

F. Feelings and thoughts. Getting to know your thoughts and feelings is at the heart of Cognitive Behavioural Therapy, one of the most evidence based therapies out there. When we can understand how they impact on our behaviours we can then start to learn how to challenge them and make them more balanced and honest rather than biased and negative. There are lots of ways to do this - keep a journal, self help through books like “Mind over Mood” or with a therapist.

G. Gratitude and positive mindset exercises have been shown to rewire our positive pathways in our brain and can lead in turn to more positive thoughts. Can you think daily about who and what you are grateful for and why? Write it down to really harness its power to help your physical and mental health.

H. Help - like every topic we cover here at CST please always know there is help out there for you and if you are lost or are struggling please ask for help.

These are all big topics in themselves and if you would like to know more then it is worth checking out our YouTube page for our “Time to Talk'' series of videos and in particular my one with Charlotte. Lifestyle medicine really is the future of healthcare and it is for all of us.

Image by Gerd Altmann from Pixabay

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