Most (80%) of what doctors and health professionals see in their clinical practice is related to lifestyle, with nutrition, exercise, sleep and stress playing key roles in major chronic health conditions such as heart disease, diabetes and cancers as well as in women’s health issues such as Polycystic Ovary Syndrome, menopause, bone health and lifestyle cancers amongst many other problems that women face regularly.
In pursuit of physical and mental health and wellbeing, we often think a pill will cure all ills or a screening test will find what’s wrong with us. We hope that a health professional will have the answers. However, is a lot we can do for ourselves, starting with the food we put in our mouths. Other lifestyle factors are also important. While western medicine is invaluable if you have a broken leg, it’s not always so great if you have a lifestyle disease such as PCOS, diabetes, breast cancer and heart disease among others.
What we eat and how we live (stress, sleep, sunshine, environment, infections, exercise) has a great impact on our mental and physical wellbeing.
What is Lifestyle Medicine?
Lifestyle Medicine involves the use of EVIDENCE BASED lifestyle therapeutic approaches for the treatment, reversal and prevention of lifestyle-related chronic disease such as diabetes, heart disease, dementia, obesity, arthritis, hypertension and lifestyle cancers: breast, bowel, prostrate, lung, ovarian and womb cancers.
Lifestyle modifications can help improve many physical and mental health parameters and I see it every day in my practice. With lifestyle medicine, you are in the driving seat and it’s about self-care and self-management and not so much about your doctor.
Lifestyle Medicine is not alternative medicine and runs alongside conventional western medicine. It can often help avoid unnecessary medications and surgery but uses these when really needed.
There are six PILLARS of Lifestyle Medicine:
- Eating a predominantly whole food, plant-based diet
- Regular physical activity
- Adequate sleep
- Stress management
- Avoidance of risky substance use
- Positive social connections
The American College of Lifestyle Medicine (ACLM) in September 2018 released an official position statement on the recommended eating plan
For the treatment, reversal and prevention of lifestyle-related chronic disease, the recommended diet is one ‘’based predominantly on a variety of minimally processed vegetables, fruits, whole grains, legumes, nuts and seeds.’’
Why is lifestyle medicine important in women’s health?
Women’s health issues can be adversely affected by lifestyle factors and these include
- Fertility Issues
- Polycystic Ovarian Syndrome
- Painful Periods
- Heavy Periods
- Weight management
- Cancers of the breast, womb and ovary
- Vaginal Thrush
- Autoimmune conditions such as vulval lichen sclerosus
Women are also affected by common lifestyle diseases and more women die of heart disease than men. Commonest causes of deaths tend to be lifestyle diseases. Genetics only plays 5-10% role in any lifestyle disease. This is good news which means you can alter your destiny through modifying diet and lifestyle factors.
- Heart disease
- Alzheimer’s disease and dementia
- Chronic lower respiratory disease
- Type 2 Diabetes
- Influenza and pneumonia
- Kidney disease
Detailed discussion of the six PILLARS of Lifestyle Medicine:
1. Adopt a mostly WHOLE FOOD PLANT BASED (WFPB) way of eating
Adopting an anti-inflammatory whole food plant based diet (WFPB) early in life helps with both short-term and long-term health. Focus on eating a plant strong diet full of colourful micronutrient and antioxidant rich vegetables, fruits, legumes and intact minimally processed whole grains. To this way of eating, one should add some nuts and seeds and plenty of herbs and spices with water as the drink of choice.
As this way of eating is rich in fibre, it helps promote healthy gut bacteria (healthy gut microbiome) and reduces the incidence of common but serious life threatening diseases such as heart disease and cancer as well as dementia through complex mechanisms.
Soya. Add in 2 portions daily of minimally processed soya such as edamame, tofu, tempeh, miso, natto. Opt for a cup of organic soya milk in your porridge as your choice of plant milk. Soya like quinoa is a complete plant protein and is known to reduce risk of osteoporosis and the risk of breast and prostate cancer, especially if started in childhood. Children should have one portion at least of soya as part of their daily varied plant-based diet.
Avoid a diet high in trans fats found in junk and ultra processed foods (biscuits/cakes/chocolates/ready meals) as they promote inflammation.
Avoid saturated fats found almost exclusively in animal products (eggs, dairy, fish, chicken and red meat which along with the growth hormone, insulin growth factor, hormones, chemicals, pesticides and antibiotics promote oxidative stress and inflammation in the body, the latter being the base from where most lifestyle diseases arise.
The less processed a food is, the better it is for you. That is why it is best to avoid highly refined foods and stick to fibre rich whole plant foods.
Avoid oils and fruit juices as they tend to be devoid of fibre and as a result do not have the same amount or variety of micronutrients that are so good for our health.
By eating this way, you will not be calorie counting but you will also get more than enough protein, fat and carbohydrates that your body needs as well as all the micronutrients and cancer fighting antioxidants that your body needs.
It is important to aim for 7-9 hours of restful sleep to allow for cell repair, reduction in stress and tiredness as well as reduction in stress hormones such as cortisol. It also improves mood.
- Regular exercise – Yoga, walking, swimming, gym can help with a good night’s sleep.
- A short afternoon nap of less than 30 minutes has been shown to be helpful
- Meditation can reduce stress levels and mood changes.
- Hypnosis may be of help for some women.
- Avoid alcohol as it can cause sleep and mood disturbance.
- Avoid caffeine containing drinks as they can disturb sleep and increase urinary frequency, needing to get up to pass urine more often especially at night.
- Have a cup of camomile tea to relax you.
- Read a book or listen to a podcast or soothing music to relax your mind.
- Avoid bright lights, television, smart phones and tablets as these can all suppress melatonin which has to rise to enable sleep.
- Turn central heating down and layer clothes to avoid overheating.
By identifying and acknowledging triggers, one may be able to better deal with the situation.
With the help of community, having friends, charity work, having a purpose, mindfulness, being grateful, meditation, yoga practice and positive, stress and anxiety can often be reduced. Having gratitude practices can be particularly beneficial.
Move naturally throughout the day, walking, housework, dancing, gardening and go to the gym if you can’t do enough of the rest and have a particularly sedentary job. Regular sustained exercise such as walking, running, swimming, yoga and other low impact exercises have shown to help with overall health. Aerobic exercise can improve psychological health and quality of life (mood, insomnia).
Aim for at least 150 minutes of exercise per week but 300 minutes of exercise per week is ideal. This is approximately 30-60 min of exercise per day.
Add in weight resistance exercises twice a week, working all groups of muscles. Do it under supervision initially if you are a beginner.
Seek medical guidance if you have medical conditions and/or are on medications before undertaking exercise that you are not used to doing.
5. AVOID RISKY BEHAVIOUR
Cigarette smoking and alcohol are both Class 1 carcinogens, which means like processed meat, they are known to cause cancer. There are no safe limits for these risky substances and medical advice should be to avoid them like any other drug or risky substance.
Practising safe sex by using condoms, having the cervical cancer HPV vaccine and using hormonal contraception all help in avoiding sexually transmitted infections, reduce the risk of cervical cancer and the risk of unwanted pregnancies respectively. I recommend both partners to have a STI check at a GUM clinic or with your doctor beforehand.
To lower one’s risk of breast and other lifestyle cancers, it is advisable to
1. Be a normal weight
2. Eat a mostly whole food plant based (WFPB) diet
3. Undertake regular exercise
4. Avoid alcohol and smoking
6. POSITIVE SOCIAL CONNECTIONS
Having a positive social network and talking about your fears can help hugely with improving mental and physical health.
Reach out to friends and family and find ways you can contribute positively to society (helping out a neighbour, community work).
Dr Nitu Bajekal FRCOG Dip IBLM
Consultant Gynaecologist and Women’s Health Expert
Lifestyle Medicine Physician
Updated January 2020