The sequencing of the human genome was meant to crystallize our understanding of the critical roles that genes play in health, but we have discovered the opposite.
Genetics only accounts for about 10% of disease risk, the remaining 90% being due to our lifestyles, behaviours and environment. Deep down, we GPs know this, and see it first hand when it comes to conditions like type 2 diabetes. But a paradigm shift has been going on largely out of sight of doctors looking at the role of lifestyle as medicine.
Now I know what you are thinking. ‘Lifestyle medicine’; it’s a real buzz phrase at the moment, but it is just a bit of stop smoking advice, diet and exercise, right? Actually, there’s a lot more to it. There are reams of literature, which tell us about how food, movement, sleep and rest affect our wellbeing – down to a molecular level.
How does that help us as GPs? When applied carefully just like any intervention, it’s an effective way to tackle, prevent and sometimes reverse non-communicable disease, including autoimmune conditions. Imagine being able to accurately prescribe lifestyle medicine; well, now it’s possible.
This is an intervention that is safe, low cost and easy to apply in practice. Along with increasing numbers of doctors, we have both practised this model of care for many years. As well as patient satisfaction, our own clinical satisfaction has immeasurably improved.
Lifestyle driven chronic conditions are growing and the truth is that many clinical presentations can be managed effectively by using a simple framework – no more complex than a basic consulting model. It’s about thinking more broadly about the patient and prescribing targeted, personalised interventions. It is about joining up the dots in their systems biology, rather than getting carried further downstream with each new or added symptom and feeling the pressure to ‘hold’, prescribe or refer (e.g. migraine headaches, IBS symptoms, aches and pains, tired all the time, brain fog etc).
We both feel strongly that NHS GPs should know about this kind of work and be able to roll it without effort into our impossibly busy days. You can find out more at our one-day RCGP-accredited CPD course ‘Prescribing lifestyle medicine’ next January.
Dr Ayan Panja is a GP in Hertfordshire and Dr Rangan Chatterjee is a GP in Cheshire