PowerPoint PresentationCharity SCIO SC046920
Dr Hazel Hawker.
Declaration of Interest.
*Certified Lifestyle Medicine Physician *GP Appraiser
Lifestyle Medicine
“A 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.”
Global Lifestyle Medicine Alliance 2014
Non-communicable diseases have overtaken infectious diseases
as the biggest killers worldwide.
M Chan WHO Director 2016
July 2019 Green Paper.
healthy physiology
LIFESTYLE the cause and cure of most disease – nourishment, movement,
resilience, connectedness
HIGH RISK foreign, invasive
Hierarchy of drivers (determinants) in modern disease
Distal (Upstream) Medial (Midstream)
Environment Stress Anxiety Dep (mal)Nutrition Obesity CHD
(micro+macro) Insomnia Inactivity Hypertension Diabetes
Physical Depression Technopathology Lipids Stroke
Socio-cultural Iatrogenesis Sun exposure F Blood Glucose Cancers
Political Alcohol Smoking
Social Inequality, Loneliness, Alienation HbA1c COPD
Adverse childhood experiences Infertility
‘cause of the cause’ ‘cause’
Rob Lawson: Adapted from G Egger, Lifestyle Medicine 3rd edition
Components of Lifestyle Medicine
Tools (Aids) What tests/devices/equipment can be used to assist changes towards a healthy lifestyle and/or environment. mHealth - sms, telemetry, ambulatory monitoring, implantable devices, apps, BIA, string
Procedures (Actions) What sequence of steps needs to be taken to establish a course of action to improve unhealthy lifestyles/environments Self-management training, SMAs (Group Consultations)
Clinical Environmental
Procedures - actions
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The Stress Response
immune system
Mitochondrial oxidative stress in obesity: role of the mineralocorti- coid receptor
Journal of Endocrinology Authors: Clara Lefranc 1 , et alVolume 238: Issue 3 Sep 2018
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Nutrition
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Role of the gut microbiota in nutrition and health BMJ 2018; 3 61 doi: https: //doi.org/10. 1136/bmj.k2 179 (Publishe d 13 June 2018)
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Time-restricted feeding (TRF) confines food access to 9–12 hrs during the active phase
TRF is a therapeutic intervention against obesity without calorie restriction
TRF protects against metabolic diseases even when briefly interrupted on weekends
TRF is effective against high-fat, high- fructose, and high sucrose diets
Time restricted eating
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Breaking sitting with standing and light intensity walking effectively improved 24 hr glucose levels and improved insulin sensitivity in individuals with type 2 diabetes to a greater extent than structured exercise. Thus our results suggest that breaking sitting and standing and light-intensity walking may be an alternative to structured exercise to promote glycaemic control in patients type 2 diabetes.
Exercise Snacks
'Exercise snacks' before meals: a novel strategy to improve
glycaemic control in individuals with insulin resistance.
Francois ME1, Baldi JC, Manning PJ, Lucas SJ, Hawley
JA, Williams MJ, Cotter JD.
Author information
Abstract
AIMS/HYPOTHESIS:
The aim of this study was to investigate whether small doses of intense exercise
before each main meal ('exercise snacks') would result in better blood glucose
control than a single bout of prolonged, continuous, moderate-intensity exercise in
individuals with insulin resistance.
Nine individuals completed three exercise interventions in randomised order.
Measures were recorded across 3 days with exercise performed on the middle day,
as either: (1) traditional continuous exercise (CONT), comprising 30 min moderate-
intensity (60% of maximal heart rate [HRmax]) incline walking before dinner; (2)
exercise snacking (ES), consisting of 6 × 1 min intense (90% HRmax) incline
walking intervals 30 min before each meal; or (3) composite exercise snacking
(CES), encompassing 6 × 1 min intervals alternating between walking and
resistance-based exercise, 30 min before meals. Meal timing and composition were
controlled within participants for exercise interventions.
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Walk more and sit less Focus on muscle mass Exercise ‘snacks’ High intensity interval training
Importance of sleep
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Exposure to nature reduce incidents of;
Stroke High blood pressure Raised cholesterol Asthma Heart disease
The health benefits of the great outdoors: A systematic review and meta- analysis of greenspace exposure and health outcomes. Environ Res. 2018 Oct;166:628-637 Twohig-Bennett C, Jones A.
How can we explain these effects?
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Reduce stress Improvement of healthy bacteria “microbiota” Exposure to “fractals” Optimised sun exposure (vitamin D synthesis) Absence of pollutants Reduced noise Opportunity to connect with others Increased chance to move more freely , exercise Temperature regulation
Fractal patterns
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Never ending pattern that repeats itself at different scales Infinitely complex
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EEG Functional MRI scanning Eye tracking
Early research indicates that;
“people are ‘hard-wired’ to respond to a specific form of fractal found in nature, one that reduces stress levels by up to 60%”
https://blogs.uoregon.edu/richardtaylor/2016/ 02/03/human-physiological-responses-to- fractals-in-nature-and-art/
The complete obvious, it seems, takes longer .
Edward R Murrow 1908-1965
Finally, it is accepted as being self-evident Schopenhauer
Now is the time for Lifestyle Medicine.
Let’s put health back into healthcare.
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