Lifestyle Medicine in the UK: Going Mainstream?

The release of Dr. Rangan Chatterjee’s book The 4 Pillar Plan, which itself comes on the heels of his massively popular BBC One show Doctor in the House, begs the question: is lifestyle medicine headed for the mainstream?

Is the prospect of an approach to health which emphasises treatment of the root cause – and not the symptoms – altering the paradigm we have become accustomed to here in the UK?

The answer is very possibly, and in this article we aim to outline the reasons why.

Dr. Chatterjee made headlines by claiming that almost 80% of patients he sees as a GP report with conditions which are ‘in some way driven by our collective lifestyles’ – hence the term lifestyle medicine.

Quite why the statement caused headlines might be a mystery to those with their eyes open: it is very clear that what we eat and how we live to a large extent determines our state of health.

Chatterjee is something of a figurehead for a new generation of straight-talking medical doctors here in the UK, though it’s fair to say functional medical doctors in the States have largely led the way in embracing a philosophy centred on nutrition and exercise.

Nonetheless, Chatterjee’s big picture outlook should be applauded – particularly since conditions such as type 2 diabetes, obesity and depression continue to add to our collective pharmaceutical burden.

This burden is not inconsiderable. Indeed, health chiefs have bemoaned that hundreds of thousands of people in England are getting hooked on prescription drugs such as powerful painkillers, antidepressants and sleeping pills.

Chatterjee’s ability to speak to the nation via a prime-time slot on the country’s most-watched TV channel suggests lifestyle medicine may finally be able to pierce the mainstream rather than being confined to the margins under the confused (and often discredited) subheading of ‘alternative medicine’.

Alternative should not be a synonymous for questionable, incidentally. As noted by Public Health England medical director Professor Paul Cosford, ‘We need to make sure people are helped to access alternative treatments.’

Dr. Michael Mosley, a contemporary of Chatterjee, recently spoke up about the shocking lack of nutrition training received by trainee doctors.

Indeed, he claimed to have learned next to nothing about the links between food and health during his own university days.

Have things changed for the better? On the face of it, it wouldn’t appear so. ‘I have a son at medical school and it’s not part of his key curriculum,’ says Mosley.

Lifestyle medicine is rather simply explained: it is the belief that practical lifestyle changes can pay dividends for your overall levels of wellness. These evidence-based lifestyle interventions can include:

• Eating a diet high in healthy fats, vegetables and fruit

• Restricting processed foods

• Factoring exercise into our daily routines

• Prioritising sleep

• Embracing balance

• Looking after our microbiome

According to Dr. Chatterjee, only 10% of our health is determined by our genes; how we live our lives is responsible for the other 90%.

It is a viewpoint shared by an increasing number of naturopathic doctors who question the traditional medical framework: see patient, discuss symptoms, prescribe a pharmaceutical drug to suppress those symptoms and bid the patient adieu.

There are a great many reasons why you might choose to eschew conventional pharmaceutical drugs in favour of natural alternatives.

In 2018, just one example came to light: in a study published in the Journal of the American Medical Association, a link was found between many commonly-prescribed drugs (painkillers, birth control pills, heart medications) and the risk of depression.

The natural outlook is hardly novel: there is a wealth of scientific literature attesting to the health benefits of clean food, regular exercise, sleep and rest, just as there is literature exposing the damning effects of smoking, junk food, high levels of stress and sedentariness.

As much as anything else, lifestyle medicine is a low-cost, easy-to-apply solution to the problems experienced by the increasingly beleaguered NHS. An NHS which spends an astronomical £16 billion a year covering the direct medical costs of diabetes and obesity-related conditions.

Even the chief executive of NHS England concedes that 40% of the medical workload is related to modifiable health risk factors – a conservative estimate if ever there was one!

Although the pharmaceutical companies will fight tooth and nail to protect their interests and maintain the ‘quick fix’ culture, there is a sense that the wind is blowing in the right direction.

Chatterjee’s book The 4 Pillar Plan: How to Relax, Eat, Move and Sleep Your Way to a Longer, Healthier Life has been warmly received; the British Medical Journal is about to launch a journal on the science and politics of nutrition; and Dr Rupy Aujla is leading Britain’s first course in culinary medicine for would-be doctors at Bristol University.

It isn’t the only course: a one-day Prescribing Lifestyle Medicine course has been accredited by the Royal College of General Practitioners (RCGP).

Tutored by a collective comprising Chatterjee, scientific author Michael Ash and Dr. Ayan Panja, it is designed to ‘provide busy GPs, Practice Nurses and Pharmacists with tools to tackle complex presentations with simple yet effective evidence-derived lifestyle medicine interventions.’

At a governmental level changes are also afoot, with the soft drinks sugar tax just one of several anti-obesity policies in the offing.

Public Health England is furthermore pursuing a calorie-cutting initiative, ostensibly compelling food companies to sign up to voluntary targets.

If you wish to better appreciate natural ways to improve your wellbeing, Dr. Chatterjee’s book is a good place to start. Other valuable resources include Dr. Aujla’s The Doctor’s Kitchen, Dr. Malhotra and Donal O’Neill’s The Pioppi Diet, Dr. Mark Hyman’s Food: What the Heck Should I Eat? and Gary Taubes’ The Case Against Sugar.

Lifestyle medicine may not have fully infiltrated the UK mainstream, but it seems likely to be only a matter of time. A preventative medicine strategy that places a focus on nutrition and lifestyle is certainly worth championing, as these factors represent the core of good health.

With any luck we’ll see more university course content being devised in the years ahead, and our costly reliance on pharmaceuticals will be reduced.

Water for Health Ltd began trading in 2007 with the goal of positively affecting the lives of many. We still retain that mission because we believe that proper hydration and nutrition can make a massive difference to people’s health and quality of life. Click here to find out more.