Lifestyle medicine has been around for a long time but finally we are now in a position to have evidence for the lifestyle behaviours we instinctively knew were good for us.
The behaviours that not only have the ability to help us feel better, but those that can turn around chronic illnesses such as diabetes, and those that can prevent illness in the first place. As we become more evidence based in our practices we can start to see how some treatments that we previously reached for may in fact cause more harm than good. With this knowledge it becomes even more crucial that we look to lifestyle measures with none of the side effects or risk factors of medical or surgical interventions when we plan healthcare for the future.
Before we delve into the evidence for the elements of our lifestyle that make a difference to our health there is a need for a disclaimer. Because although we may have the knowledge about what makes us healthier that doesn’t mean it is easy to make the behavioural changes. Various different factors come into play meaning none of us lives the perfect lifestyle. Time is often mentioned as a major reason why we don’t implement the changes but life and motivation also play a part. We may know that a whole food meal will be better for us but when we are on a night shift sometimes the only thing we have access to is convenience food. We may know that regular exercise is good for us but our mood means we struggle to go to work every day, never mind head to the gym.
Knowledge is however the first step in making a change. My advice would be to focus on one thing at a time. Give yourself small goals. Find the easiest win first and then build on it. Often some of the lifestyle changes will automatically lead to the next. Taking regular exercise has been shown to change the foods we crave and reduce our intake rather than increase our intake of unhealthy foods. It is also shown to increase, not decrease our energy levels which in turn may lead us to feeling more like we want to be social. What we also know is that if we make a behavioural change with someone else we are more likely to stick with it and that if we have some accountability and guidance and if we can find something that we enjoy then we are going to be able to sustain these changes and make a more significant difference to our health.
So with that disclaimer in place here is the run through of the 6 pillars of lifestyle medicine.
Evidence points to a Mediterranean diet with a diet of whole foods, including fruits, vegetables, legumes, grains, nuts, fish and lean meat being the best diet for our physical and mental health. Cutting down on processed food, sugar and saturated fats. A great study for showing the effect of nutrition on our mental health is the Supporting the Modification of lifestyle In Lowered Emotional States (SMILES) trial. This Australian study ran a 12 week parallel, single blind RCT comparing outcomes in people with depression. One group was supported to adopt nutritional changes and another group was supported with a befriending service. There was a marked improvement in depression scores in the nutrition group versus the befriending group. Various modes of action are cited. Impact on cardiovascular health, inflammatory and oxidative stress pathways, as well as brain plasticity and the gut microbiota.
Poor sleep impacts on both our physical and mental health, with links to obesity, hypertension, metabolic syndrome, diabetes, cognitive impairment, accidents and breathing disorders. The largest link though is to our mood with over a third of people with chronic insomnia struggling with depression and this is bidirectional. CBT for insomnia is the recommended treatment by NICE for insomnia. (see below for where you can learn this technique yourself).
Movement is great for our minds and bodies and that can be in whatever form works for you. Find something you enjoy and do it often. The recommended minimum for cardiovascular health is 150 minutes a week and for our mental health is 90 minutes. This can be broken down into 5 minute blocks if that is easier for you to fit in around life. This is our passion at Cognitive Sports Therapy so give us a follow on social media or check out our website for advice.
Always easier said than done but being stressed is another thing that impacts our physical and mental health. High levels of Cortisol are not good for us. Specifically in this pillar we are thinking about things like getting out into nature, being mindful, using breathwork or meditation. The lovely stuff that we can often miss out when we are thinking about our priorities. However we know that if we are less stressed we are more focused and more efficient. So skipping that 5 minute meditation may be costing you a lot more than 5 minutes of work time and it is certainly worth prioritising.
Being connected is a great protector of our health, with loneliness being found to be as detrimental for our health as smoking 15 cigarettes a day. Of course we can be around people and still be lonely, so this is about not just being connected to people but also to ourselves. Knowing our thoughts, feelings and emotions. Thinking about switching on a positive mindset through practicing gratitude and helping others. These can all help.
Avoiding substances like alcohol, cigarettes and drugs
We have long known the impact on our health from these substances but sometimes it is good to be reminded. The Nuffield Trust and the Health Foundation found that alcohol related deaths jumped up in 2020 having been stable for many years. The highest proportion of heavy drinkers is aged 24 to 35. This socially acceptable drug isn’t good for our physical or mental health.
These are all big topics in themselves and if you would like to know more then it is worth checking out the Cognitive Sports Therapy YouTube page for our Time to Talk series of videos including one teaching CBTi. If you would like an individual review and plan of your lifestyle then you can access a 20% discount on our Lifestyle Clinic when you mention Wellvet on booking through our website www.cognitivesportstherapy.com.
Dr Claire Gillvray MBChB MRCPsych MRCGP MScSEM DCh
About the Author
Dr Claire Gillvray
Dr Claire Gillvray qualified as a medical doctor in 1999 from Edinburgh University. She is dual trained as a Psychiatrist and General Practitioner and has worked in the NHS and in Private Practice in London, Bristol and Cambridge since then. She has raced for Great Britain and Ireland in triathlon as an age grouper and this led to her choosing to do a MSc in Sports and Exercise Medicine. She founded Cognitive Sports Therapy to help people gain mental strength through use of their mind, body and breath. A truly holistic approach to being healthy and strong. She is a qualified personal trainer and nutritionist and has been an invited speaker at a number of veterinary events due to her interest in the mental health of those within the veterinary profession.