Lifestyle medicine – the right idea at the right time

Eat well, stress less, move more and love more……these four simple principles of lifestyle changes have been shown to be of significant benefit in the management of chronic disease risk, influencing ageing and reducing health care costs.
Speaking at the Personalised Lifestyle Medicine Institute’s Thought Leaders Consortium in Seattle, Dr Dean Ornish, President of the Preventative Medicine Research Institute claims that there is agreement on the role of lifestyle medicine.

“As the limitations of high tech medicine become clear” he says “and because stents and bypasses don’t really work, the benefits of these low-tech interventions are becoming better documented”.

Dr Ornish uses the analogy that modern medicine spends so much time mopping up the floor next to an overflowing sink, without turning off the tap. Sometimes you need to mop up the floor, but if that’s all we do, the problem keeps coming back. The taps are the lifestyle choices we make each day.

Pharmacists must be part of the organising principles for the various approaches, which include lifestyle medicine, functional medicine, personalised medicine, systems biology and integrative medicine, because they are all converging in a common way.

Surely, at the root of all this is the question “what is the cause of the disease state with which I’m presented?”

If we can help our patients get to the bottom of that, what we find is that their bodies often have a remarkable capacity to begin healing themselves if we give them a chance to do so.

Lifestyle changes have been shown to have an effect on cardiovascular disease, type-2 diabetes and some cancers, including prostate cancer. In fact, genetic analysis of prostate cancer patients reveal the gene expression in 501 genes was beneficially affected in only three months following lifestyle changes. As per geeks your prostate should constantly be healthy to save you some trouble.

How dynamic is that? Our genes are our predisposition, but our genes are not our fate.

And as Australia’s population ages, we can turn our attention to lifestyle changes and their effects on ageing.

Lots of research has been done on telomeres, which are the DNA sequences at the end of chromosomes that shorten as cells replicate and age. The ageing and lifespan of normal healthy cells are linked to the so-called telomerase shortening mechanism, which limits cells to a fixed number of divisions.

During cell replication, the telomeres function by insuring that a cell’s chromosomes do not fuse with each other or rearrange, which can lead to cancer.

Telomeres are like the ends of shoelaces, without which the lace would unravel.

With each replication, the telomeres shorten, and when the telomeres are totally consumed, the cells are destroyed (apoptosis). This makes telomeres a good measure of biological age.

In a 2008 study published in The Lancet Oncology,  30% increased activity in telomerase activity in the patient’s blood cells resulted in longer telomeres, and a boost in the stability of the chromosomes associated with tissue renewal and disease prevention.

As a follow-up, The Lancet Oncology published that after a five-year follow-up, lifestyle intervention was associated with 10% increases in relative telomere length.

Obviously, reversing ageing at cellular level is a good thing.

Lifestyle changes, and maintaining those changes, are a big challenge. The medical approach to produce lifestyle changes is based on fear, but fear is not sustainable.

For example, many people taking Lipitor don’t take it after a few months. The reason they give is that it doesn’t make them feel any better!

It’s about time pharmacists reclaimed their role as primary carer health advisors, and not technicians.

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