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Lifestyle Medicine: It’s a grassroots effort

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“You can actually be meticulous with your diet and still be absolutely miserable. And
you can be a highly active person and still not be full of the
joy of living.
The bigger goal here is what I would refer to as wellbeing.”

Dr Darren Morton

Sydney based Lifestyle Medicine expert, Professor Darren Morton, discovered early in his professional career that there was a lot more to health than what many of his colleagues were initially taught to believe. His own journey started from a physical exercise background but the road soon took a turn.

“I was trained as a physical education and maths teacher. Very quickly though, I went on to further my studies in human physiology which focuses on how we humans are put together and how we work.”

He always had a special interest in exercise physiology and was very passionate about encouraging people to move more and live more actively. But, then, “I had this epiphany over 20 years ago now.”

“It dawned on me that my key interest was helping people to live healthier so they could be happier. In so doing, people feel more empowered to make the contribution they’re meant to make in the world.”

For Dr Darren, as he is more commonly addressed by those involved with him, Lifestyle Medicine was a natural progression. He’s still very passionate about exercise and views it as one of the pillars of good health but there are several others as well. “Clearly nutrition—what you eat and what you don’t eat—is a really important part of that,” he says.

For 30 years Dr Darren has been based at Sydney’s Avondale University where he is the Director of the Lifestyle Medicine and Health Research Centre. It’s all been a natural progression but, when asked why many other doctors don’t make the same broad connection, he says it’s easy to become quite sceptical.

Conspiring forces

“There are forces that conspire against this and some of them are quite sinister. At the heart of it a lot of people get taken along with that momentum and there’s just a lack of awareness of the alternatives,” he says.

“I think, for example, when we look at medical doctors, what they are trained in is not a lifestyle paradigm. And, you can sort of understand how it happens.

“Modern medicine earned its stripes in a time when infectious diseases were the biggest burden of disease. We developed some really clever technologies, such as antibiotics and other medicines, that were very effective in dealing with infectious diseases. But we’ve become very reliant upon those medications and pills as the medical approach became predicated on them.

“One of my good friends and mentors, Dr Hans Diehl, says for every ill there’s a pill, and for every pill, there’s a bill. Hence. you can understand how the whole economic wheel starts to revolve around pharmacology.

“As chronic diseases have taken over in the past few decades as the main cause of mortality and morbidity, modern medicine has endeavoured to apply that same paradigm that worked for infectious diseases—pills and medications. Of course, there are medications that have some value for the management of chronic disease, but we have failed to see the glaringly obvious – that chronic diseases are lifestyle-related illnesses. Hence, the best treatment for chronic disease is lifestyle modification—we need to treat the cause.

“That is what lies at the heart of Lifestyle Medicine—to look upstream at the cause of chronic disease and treat them. Any approach to the management and treatment of chronic disease that does not prioritise lifestyle modification is founded on an erroneous paradigm.

Nutrition research

“One of my concerns with nutrition research is that it has become so reductionistic. Researchers are always on the hunt for some magic ingredient in foods. It is not enough to observe that blueberries are health-giving, researchers want to discover if there is a magic ingredient in blueberries that can be extracted and marketed as the next great panacea and cure-all for all ills.

“But the truth is that there is no one magic ingredient in blueberries, there are a myriad of nutrients in blueberries that work synergistically to make them so life-giving. The simple takeaway is blueberries are good for us and we should eat them.

These days, Dr Morton says, most of his time is focused on mental health and wellbeing.

“The reason I have taken so much interest in that area is because we talk about behaviour change and we try and get people to eat healthier and lose weight and the like, but people often don’t do that because they’re not in a good place emotionally.

“It’s really hard to follow through on healthy lifestyle behaviours if your mental health is suffering. Indeed, there is a reciprocal relationship between how you feel and how you behave, and how you behave and how you feel.

“Applying a whole-of-health approach is absolutely critical to the pursuit of total wellbeing. For example, whole-food plant-based eating is a fantastic pathway to health and happiness—there is so much science that demonstrates this—but you can be meticulous with your diet and still be absolutely miserable. Similarly, you can be a highly active person and still not be full of the joy of living.

“To me, wellbeing is much more than just what we eat and how we move. Well-being is about feeling good and feeling good about life. In truth, eating well and moving well are pathways to feeling better, but to feel better about life we have to take that deeper dive into spiritual questions. Of course, that means different things for different people, but at the heart of it what people need, I believe, is a sense of why.

Looking for purpose

“People are looking for meaning, they’re looking for purpose. They need to know that they matter and that this life matters. During Covid, many people encountered an existential crisis. Modern living is so busy nowadays, but Covid was a time when many of us were forced to slow down, which gave us time to reflect on bigger existential questions.

“My experience is that that needs to be part of the dialogue. It needs to be part of what we address when we look at wholistic wellbeing. Eating healthy, moving well and getting good rest are really important pillars of good health, but without addressing what makes life really worth living we don’t set ourselves up for the fullest expression of what wellbeing might be and can be.”

Do you think the health system would be improved if people took better care of themselves?

“This is foundational to Lifestyle Medicine which teaches that we are in the driving seat of our health and wellbeing. The current healthcare system applies an ‘expert’ model whereby the doctor is the expert, they tell us what to do and we’re meant to do it (and of course, we don’t for the most part). Essentially, our health is in their charge and their control.

“But nothing could be further from the truth. Our decisions and behaviours make a huge contribution to our health and wellbeing.

“Look at the information coming out of some of the large European studies like EPIC (European Prospective Investigation into Cancer). We know that just four basic lifestyle choices—eating a healthy diet, being active, controlling your body weight and not smoking—reduces your risk of heart attack by 80 per cent, type 2 diabetes by over 90 per cent and stroke by 50 per cent.

“This is huge! There are no medicines that can do that. Lifestyle is incredibly powerful and effective.

“Now it’s easy to recite statistics but imagine, if through proper education and the right kind of support, people were empowered to make better lifestyle choices resulting in 8 out of 10 fatal heart attacks not occurring, or 9 out of 10 cases of type 2 diabetes not occurring. That would change the entire healthcare landscape. We need to get better at understanding that people can take charge of their health and provide them with the support to do so. People need to know that there is hope.

“What I love about Lifestyle Medicine is that it is helpful for not only preventing chronic conditions, it can also be effective for managing, treating and even reversing them.

“In 2018, the Lancet published a paper saying that through therapeutic lifestyle change up to 50 per cent of diabetes can be reversed – even for people who have had type 2 diabetes for a number of years. This is a game-changer.

Fast growing discipline

“Lifestyle Medicine is one of the fastest growing disciplines in health care around the world, but it still has so far to go. It will get there eventually but it’s just going to take time. That paradigm shift will occur bit by bit.”

Dr Morton says critical support for Lifestyle Medicine is coming from the grassroots.

“It’s so powerful when you have credible sources,” he says, “people who say, ‘this is what it has done for me’. That connects with people.

“When it comes to behaviour change, credible sources are far more influential than incredible sources. For example, when a dietitian who is a little overweight themselves and struggles with their weight says to a client, I used to be a size 20 and it has been hard but I am now a size 14 and if I can do it, so can you, it is very compelling. They are relatable and credible, even more so than someone who is very lean and tries to counsel them on weight loss (i.e. an ‘incredible source’).

“When it comes to Lifestyle Medicine, we can all be part of it. We are all on a wellness journey and we all have a story to tell. Sharing stories, especially of personal transformation, is incredibly powerful for helping other people to embrace that same journey.”

Peter Barclay
Peter Barclay
Has a professional background in journalism, photography and design. He is a passionate Kiwi traveler and an ardent evangelist for protecting all the good things New Zealand is best known for. With his wife Catherine is also the co-owner of Wholefoodliving.

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