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Health in Modern Times

I turn 42 this month and after 18 years of working, seeing patients from literally every aspect of the wide London demographic, I have started to understand what ‘health’ actually means and involves. Over the past 12 months, the COVID19 pandemic has caused so much pain and loss. I have seen mental health deteriorate, patients die, families bereft and in shreds. For me it has triggered a deeper thinking about what ‘health’ is and what it needs to be in the modern age.

I am a General Practitioner and also a Lifestyle Medicine Physician. Lifestyle Medicine is an emerging speciality which helps people to make & sustain changes in their health and quality of life by using evidence-based changes to diet, physical activity, sleep, stress and substance use.

In a growing number of studies these changes have been found to prevent, reduce or even reverse a number of chronic diseases such as hypertension, diabetes, and obesity. It has also been found to help improve problems such as joint pains, poor sleep and stress.

Through my ongoing learning via patient care and analysing high quality trial evidence, as well as national and international data on how diseases are emerging and health is being shaped, it is clear that our day-to-day choices are deeply impactful to our health.

What issues do we face?

In America, national data has shown that for the first time EVER, there is a generation of men and women that have a lower predicted life expectancy compared to the generation above. The burden of chronic disease is rapidly increasing, and these difficult and life-shortening illnesses are often caused at least in part by our lifestyles.

A clear but shocking illustration of this was in the INTERHEART study that spanned 52 countries, which analysed patients attending hospital with their first heart attacks and found that the top five risk factors shared by 80% of this group were smoking, hypertension, diabetes, obesity & diet.

But it’s in my genes

Our genetics are important; they determine our propensity for certain illnesses. It is now becoming apparent however, that they don’t determine our destiny. The DNA is our genetic material but we have a number of gene switches that sit alongside this genetic material, which can modify gene expression. These epigenetic switches are really quite powerful. A healthy lifestyle, with good nutrition, regular physical activity, adequate and good quality sleep, maintaining emotional health and reducing stress, avoiding smoking and alcohol excess, can help switch off a genetic likelihood for things like obesity, diabetes, high blood pressure and even inflammatory conditions of the joints.

So what does this mean for me?

Most people take ‘getting healthier’ as a challenge. They look for interventions such as a new diet or an exercise plan that are typically far from their day to day baseline. They hope that once engaged in these new regimes, it will bring about immeasurable change. Whilst it may work and sometimes even cause dramatic change, those extreme changes are often not sustainable. Those behaviours are not maintained and patients slip back into previous habits and the health improvements often stop. With this can come a sense of failure.

I think ‘getting healthier’ shouldn’t be dramatic but instead should be sustainable, and this requires acceptable, specific and achievable changes. It is this that moves us from feeling restricted to feeling empowered.

If you are keen to become a healthier you, I would urge you to go back to and reflect on the six pillars that support your lifestyle - nutrition, physical activity, sleep, emotional health, stress, smoking and alcohol.

London GP & Lifestyle Physician

To find out more, and to pick up practical lifestyle related health tips, follow on Instagram @thelondonlifestyledoc.

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