“The aim of medicine is to prevent disease and prolong life;
the ideal of medicine is to eliminate the need of a physician.”
William James Mayo
Living with a chronic medical illness isn’t something any of us plan for. You might have heart disease in the family, or high blood pressure or depression but if you’re fit and well, you’re probably hoping it won’t affect you. Which means when or if that diagnosis is made, especially if you don’t have any symptoms or know the outlook could be bleak, it can be difficult to accept.
“What if I’m told my illness means I can no longer do my job?”
“Will I become incapacitated and have to rely on others to look after me?”
“What impact will my poor health have on the rest of the family?”
If you have a chronic medical illness, you’re not alone.
50% (1:2) Australians have at least one chronic health condition
60% (3:5) Australians over the age of 65 have more than one
What are we talking about here?
According to the Dept of Health, the biggest group are those living with mental and behavioural conditions – 4.8 million Australians (20.1%) of the population.
Then there are those living with back problems, arthritis, asthma, diabetes, heart, stroke and vascular disease, osteoporosis, chronic obstructive pulmonary disease, cancer, and kidney disease.
And around 80% of ALL heart disease, stroke and type two diabetes and 40% of cancers is preventable.
What if, you could reduce your risk of developing a chronic medical condition?
What if, addressing your lifestyle could enable you to modify or even reverse your existing chronic medical condition?
Many of our chronic medical conditions are associated with a higher risk of anxiety or depression. Just ask anyone living with chronic pain how that makes them feel.
That’s why looking for ways to alleviate the risk and burden of chronic medical disease at a physical and mental level is essential.
The good news is, it’s often possible.
There are four key factors making us sick. Namely, poor diet, physical inactivity, smoking and excessive alcohol consumption.
Let’s look at the fastest growing non-communicable chronic disease on the planet, type two diabetes.
The percentage increase in diagnosis of type two diabetes has increased by 104% from 1990.
In 2017 an analysis of the dietary health risks across 195 countries as part of the Global Burden of Disease Study confirmed that we’re eating insufficient amounts of healthy foods and too much of the unhealthy stuff. No surprises there.
Improving diet could potentially prevent
one in five deaths globally.
Many of the patients I looked after with type two diabetes were really worried about the associated potential complications such as heart disease, kidney, or eye problems.
Some dealt with it with denial. Some developed anxiety and some resigned themselves to enduring a shorter, more health-challenged life.
Having diabetes doubles your risk for depression.
Lifestyle Medicine is all about using scientific evidence to prevent illness and disease and to modify its progression.
With the state of our mental health in crisis as a society, doesn’t it make sense to address potentially preventable disease by implementing what we already know works and can bring about substantial improvement in an individual’s physical AND mental wellbeing?
So where does mental wellbeing fit into the picture?
Research into the relationship between stress and diabetes, suggests that stressful experiences might affect the onset and/or the metabolic control of diabetes. Moreover, those predisposed to develop diabetes may be triggered by exposure to stressful life events.
This is because prolonged chronic stress leads to higher levels of cortisol production that is associated with increased insulin resistance.
The relationship between diabetes and depression is bi-directional. Having type two diabetes is associated with a higher risk of anxiety and depression which can lead to poorer medical compliance to diabetic management, decreased quality of life and increased mortality.
Having depression can predispose those at risk to developing type two diabetes.
Addressing stress and any associated mood disorders including anxiety or depression using a variety of techniques including relaxation practice, breathing exercises, meditation, exercise, and nutritional support is vital to better diabetic control, improved quality of life and overall state of health.
Reversing chronic medical disease.
One of the most exciting findings over the last couple of years has been the understanding that pre-diabetes and early type two diabetes can often be reversed or modified with the effect lasting up to 10 years, simply by modifying the diet and losing body fat.
Research by Professor Roy Taylor from the University of Newcastle UK found that Type 2 diabetes is caused by excess fat in the pancreas and liver and that losing even 1 gram of fat from the pancreas can restart the normal production of insulin.
The key is to get rid of the fat and then by keeping your weight in the healthy range keep diabetes at bay.
What does remission look like?
It’s about having long-term blood sugar readings (HbA1c) below 6.5% without the need for any medication.
How much weight do you need to lose? That will depend partly on your starting point, but even modest weight loss will bring about improvement. Achieving a 15kg loss has the potential to lead to reversal in 86% of the time.
Initial findings from the DiRECT trial in the UK showed that achieving weight loss saw almost 46% of the participants go into remission from diabetes and able to come off their medication.
Twenty-four percent managed to achieve at least 15 kgs weight loss. At the two year mark, 70% of those remained in remission. The key being to keep the weight off.
If you’re keen to find out more about type two diabetes reversal, I was fortunate enough to be invited to watch the first of a three-part series put together by Artemis films that will be screened from October 13th, 2021, on SBS. In this series Dr Michael Mosley and exercise physiologist Ray Kelly work with 8 participants with pre-diabetes or type two diabetes to show how achieving rapid weight loss can bring about significant positive improvement not just for their physical health but for their mental well-being as well.
We are neither just a body nor a mind, we are whole beings. Addressing any chronic medical illness requires a holistic approach that examines all facets of lifestyle and wellbeing.
It’s time to reimagine the concept of health and do more to prevent illness by empowering individuals to know how to stay healthy and to act early, to modify or reverse the disease process. While not everything can be reversed at least we are heading in the right direction.
Mental Health Reimagined is an international online summit for health professionals bringing together a diverse range of experts to outline the evidence-base and application of lifestyle intervention in the treatment of mood disorders.
If you’re a medical doctor or specialist, allied health practitioner, public health professional, or another health professional who has a role in mental health care, join me in attending Mental Health Reimagined on Saturday 6 November to explore the opportunities and challenges of lifestyle intervention for those presenting with mental illness, and learn how to support your patients using key elements of Lifestyle Medicine (promoting physical activity, reducing alcohol consumption, stopping smoking, improving sleep and reducing stress).
When: Online on Saturday, 6th November 2021
Register at: bit.ly/mentalhealthreimagined
Dr Jenny Brockis is a medical practitioner and board-certified lifestyle medicine physician, keynote speaker and best-selling author. Her new book Thriving Mind: How to Cultivate a Good Life (Wiley) is now available for purchase
If psychological safety, resilience and mental wellbeing is something you’d like to find out more about, please contact me to set up a time for a chat.