Unlocking the Power of Lifestyle Medicine

Lifestyle Medicine is a global medical discipline that uses well-researched interventions to help people to make and sustain lifestyle changes. These lifestyle changes have been found to not just prevent but treat and even put into remission, some long-term conditions such as Type-2 diabetes, obesity, high blood pressure, depression, anxiety and metabolic liver disease.

A clinician trained to use Lifestyle Medicine doesn’t just give you simplistic advice (most of us know what we need to do but struggle with how to do this), instead they assess in depth all aspects of your life that may be driving your symptoms. For example, we assess your eating patterns, sleep quality, mental wellbeing, any harmful substances you are consuming or being exposed to and how active you are, how connected with nature and whether you are struggling with meaning, purpose or have relationship challenges. This also involves fitness assessments, nutritional status assessments (testing blood sugar, body composition, blood fats and vitamins if needed) and use of wearable data if you use monitoring devices. We can use wearable blood pressure monitors, sleep studies, continuous blood sugar monitoring and more.

We can use wearable blood pressure monitors, sleep studies, continuous blood sugar monitoring and more.

From this assessment we can combine knowledge of your family history, genetic testing if you wish along with your medical history and medications to come up with a supported plan to treat and hopefully reverse some of the drivers of the conditions or symptoms you have.

For some people, if these changes are sustained, they can reduce or stop some long term medicines for example pain medicines, anti-depressants, blood pressure medicines and blood sugar medicines if desired.

Which diseases can be prevented or reversed with lifestyle changes?

Research suggests that heart disease, type 2 diabetes, obesity, some early low-grade cancers (for example prostate cancer), high blood pressure, osteoporosis, depression and dementia can be prevented, treated and in some cases reversed with intensive lifestyle medicine support. Remission (reversal of conditions without medicines) is more likely to be achieved soon after diagnosis of conditions such as Type-2 diabetes and metabolic liver disease and usually only with intensive and sustained lifestyle changes. If you do achieve remission, you still need to keep up with annual NHS checks to ensure the condition doesn’t return and to check that you don’t need to re-start medications.

For conditions such as dementia, intensive lifestyle changes are more likely to slow down rather than reverse memory loss for most people but there have been cases of memory loss reversal in the early stages of what is called “mild cognitive impairment”.  

Who should I see for lifestyle medicine, and how does it fit with my usual GP or hospital doctor care?

There is a lot of noise around wellness in the media. This can be difficult to navigate. Whilst some of this can be based in good quality science, much can be incorrect or over-hyped as this area is poorly regulated unlike medications. For example, there are almost no quality control checks around whether vitamins or mineral supplements contain what they say they do, whether they have contaminants or whether they are effective at improving certain health conditions. Research has shown that some vitamin supplements (calcium for example) can actually be harmful.

We have carefully researched the evidence and companies who produce supplements and can advise you if and where these might help.

Medical training has historically failed to provide sufficient (if any) training of doctors in the role of nutrition, exercise, sleep, stress and so on. The educational charity The British Society of Lifestyle Medicine provides training for clinicians that is up-to-date and based in good quality science.

I helped to set up their Learning Academy, wrote their first foundation course and teach Lifestyle Medicine at Oxford University.

As an NHS GP I know how important it is to keep your own GP up-dated with any medication changes to make sure that your medical team is working together.

Can lifestyle changes really reverse or improve things like Type-2 diabetes, blood pressure, low mood and metabolic liver disease?

Yes, there has been a large randomised controlled trial of a lifestyle intervention for people with Type-2 diabetes in the UK that demonstrated that for a significant proportion of people, remission can be achieved. Randomised controlled trials are the gold-standard type of research that helps to demonstrate that the intervention doesn’t work by chance, is safe and effective. This intervention used low calorie meal replacement with health coaching but other smaller studies have used other dietary approaches. Similarly, there have been trials using nutritional and physical activity interventions for blood pressure reduction, treatment of low mood an metabolic liver disease.

What diet do you recommend is best?

Nutrition science is hugely complex and food plays a greater role in our lives than just influencing our health – it is also an important part of our family and social lives and there are challenges around having time to cook or afford healthy food.

Whilst the science points to healthy eating patterns being based in whole foods with lots of fruit and vegetables there are many different ways to achieve this type of diet – a Mediterranean, low-carb, traditional Asian/Nordic, plant based or vegan. We can support you to get the best out of your preferred dietary pattern.

For some people who want or need quick results, intensive nutritional interventions can be very powerful. These include short term exclusion diets, ketogenic diets and fasting-mimicking diets. These can have profound effects on our metabolic and mental health but are challenging to maintain and have not been well studied over the longer term.  However, I can support you to use these interventions to see rapid impacts that can support longer term changes.

For example, fasting mimicking diets or ketogenic diets can rapidly improve blood sugars and blood pressure as well as have significant impacts on pain, energy and mood that some people find very useful when embarking on lifestyle changes. These types of brief intensive changes can help reset our palate, subdue cravings and set us up for positive change. They do however, need careful support with monitoring of changes particularly if you are taking other medications.

Can you support me if I’m in pain or very unfit?

Yes, absolutely. I have experience supporting people with multiple complex health issues who are often not permitted to join NHS health coaching or lifestyle programmes due to risks. She is able to support you if you are currently unable to exercise, struggling with pain or very low motivation due to depression. For people facing serious difficulties, there can be some low effort interventions that can quickly help before you embark on more significant changes. These can include light therapy (photobiomodulation), evidenced supplements, hot-cold therapies (sauna and cold-plunge), fasting-mimicking diets and so on.

Can lifestyle medicine help with insomnia and sleep problems?

There are very few safe or effective medications for insomnia, however, there are many lifestyle interventions that have been shown to help. Dr Fallows is able to assess  your sleep issues and support with sleep apnoea diagnosis (including sleep assessment referrals), prescribing HRT to improve sleep in the peri-menopause/menopause transition as well as support with supplements and lifestyle interventions.

Are you able to help with alcohol, smoking and drug problems?

We can support smoking and vaping cessation with strategies including the best way to use nicotine replacement, as well as prescriptions for Varenicline and Buproprion.

I am able to help with problematic alcohol use but I don’t offer alcohol detox programmes and can’t support people withdrawing from alcohol.

Prescription drug and recreational drug addiction isn’t something I can treat but I can refer to those who do.