Author: Dr Megan Michaux
The BSLM conference theme for 2023 was “People, Places, Planet”. It emphasized the importance of lifestyle medicine as a plan of action going forward to promote health for individuals, communities, and the environment. I was very grateful for the chance to attend the conference via the virtual platform. It was a fabulous foray into learning, feeding my inner nerd and becoming a student again. While the conference does focus on the UK context, including insight into the NHS and their referral structures, a lot of the information is relevant to us, and even more crucially it can inspire us to start bringing lifestyle medicine into the South African context.
First, we were fortunate to hear a talk from Professor Sir Marmot, who is an epidemiologist and has contributed immensely to research around social determinants of health in the UK. The facts and the statistics he presented regarding social deprivation in the UK, and how significantly it influences health, were enlightening. The direct link between social circumstances and many health conditions was clear, in particular obesity. We know that there are far too many people living in poor social circumstances in South Africa, and this is undoubtedly having a similar impact on the health of our population.
From this concerning bigger picture, we moved on to a talk from the energetic and enthusiastic Dr Rangan Chatterjee, who brought us back to the individual. He has been working in this area for many years, and his framework for seeing patients as a lifestyle medicine practitioner is innovative. Dr Chatterjee illustrates how the traditional models that we learn at medical school – we all know that basic template: take a history, examine the patient, make a diagnosis don’t work well with a lifestyle medicine approach. I loved the practicality of his framework, especially the symptom web, which could be a far more suitable way to bring lifestyle medicine into the consultation.
Day 2 started with the warmth of global community, as lifestyle medicine associations from across the world joined the conference. We were privileged to hear how lifestyle medicine is growing all over the world. Speakers were from every continent, including our own African representative, the charismatic and always-dancing Dr Ifeoma Monye from Nigeria. A personal favourite of mine from day 2 was the talk from Professor Sidossis, who is the president of the Mediterranean Lifestyle Medicine Institute. He focussed on the Mediterranean way of life, and he reminded us that the health benefits people often associate with the Mediterranean diet, are likely a result of a much broader lifestyle. This was a reminder that all the pillars matter, and diet in isolation is not enough to create true health.
On Day 3 I signed up for a “side bar session” – something outside of the main discussion room for the day. The talk was about weight management for adults. It was wonderfully interactive, with lots of information, some poll taking and questions, and useful practical suggestions. I was interested to learn that the heritability of obesity sits at 40%-70%, showing a high genetic link. And yet, as the talk highlighted, the stigma people with overweight and obesity experience is terrible, and we need to change the way we think and speak about obesity in healthcare settings and beyond. The discussion was great at illustrating the need to take a patient in context, to see what environmental factors could be at play, and to provide help and support. Our overwhelmed system, much like the overwhelmed NHS, struggles to provide support to these patients. There is so much work that needs to be done to help those with obesity. In our context, I think we could start by making better use of our allied services in those who are able to access them, including dietitians, exercise related services, and psychologists.
Day 3 also brought endocrinologist Professor Mukherjee to the stage, with a focus on using lifestyle interventions for menopause symptoms. Prof Mukherjee was concise, evidence based, and informative. She highlighted how lifestyle medicine can be useful in conjunction with other medical interventions and reminded us that menopause comes with a myriad of difficult symptoms, not the least of which can be cognitive. A practical point was that, while HRT may increase the risk for certain cancers, so might obesity, smoking, and sedentary behaviour. So, in those concerned about cancer risks, lifestyle changes could reduce those risks, improve overall health, reduce menopause symptoms, and potentially mitigate any risk associated with HRT use. This certainly struck me as something worth discussing with a patient with menopause symptoms.
There were so many other talks and side bar sessions on the go at the conference. Unfortunately, one cannot attend them all! I look forward to watching some catch-up sessions, which are recorded and available to attendees afterwards. So many of the sessions I did get to see were insightful and practical, and I learned about gut health, cold water immersion, and nature as a treatment. The link between nature, and how we could use this connection for health is especially close to my heart. I can only imagine the in-person content would be a lot of fun too, and I would’ve been up for some morning yoga, a jogging session, and the cooking demonstrations. For someone considering attending the conference, I think that attending in person would probably be amazing, but there is so much value in attending virtually as well. I found watching from the comfort of my own couch, with a notebook and a cup of coffee in hand, very enjoyable. And we all know travel can be costly, time consuming and difficult for South Africans, so taking the opportunity to use an online platform that allows you to learn from so many intelligent and interesting people will always be worthwhile!
Lifestyle medicine is growing, and the idea of treating patients this way can present so many challenges, not the least of which is getting your patients onboard and willing to put in the work. Learning to prescribe lifestyle changes, just as you would a pain tablet, is something so new and refreshing, it has given me a whole new perspective on health and health conditions. I loved seeing how so many people, of various ages and backgrounds, are enthusiastically supporting the idea of focussing on lifestyle medicine as a way of the future. Educating patients so that they can regain autonomy, take control over their own health, and not only focussing on disease, will be vital in improving our population health. My take home messages from this conference are many, but one speaks louder than the others. It seems to me that lifestyle medicine, if implemented with empathy, with knowledge, and within the context of the individual and the community, has the potential to bring about a complete change in our approach to healthcare, and eventually lead to healthier people, healthier communities, and even a healthier planet.