S6E11 Lifestyle Medicine with Dr Fraser Quin

Overcoming MS  00:01

Welcome to Living Well with MS. This show comes to you from Overcoming MS, the world’s leading multiple sclerosis healthy lifestyle charity, which helps people live a full and healthy life through the Overcoming MS program. We interview a range of experts and people with multiple sclerosis. Please remember, all opinions expressed are their own. Don’t forget to subscribe to Living Well with MS on your favorite podcast platform so you never miss an episode. And now, let’s meet our guest.

 

Dr. Jonathan White  00:35

Hello, everybody, and welcome to the Living Well with MS Podcast. I’m delighted to be here. I’m your temporary host who as you can tell is not Geoff Allix. Dr. Johnny White, medical adviser for the Overcoming MS charity. I’m absolutely delighted today to be joined by Dr. Fraser Quin, who is the Executive Director of the British Society of Lifestyle Medicine, and a good friend of the Overcoming MS Charity, certainly based in the UK. And I personally have known Fraser a couple of years now through our work together. I’m very glad to say that Overcoming MS is a aligned partner to the BSLM. We’ve been at the last two conferences, I’ve been very honored to speak at both of them. And they see a great deal of close tie and link in what we’re trying to do and our ethos and our messaging and our value. So I’m delighted the Fraser’s able to join us today, and thank you so much for agreeing to come along Fraser, welcome to the podcast. So I’m gonna get straight into it for those people. And I can’t imagine anybody in the world of lifestyle modification and medicine who wouldn’t know who you are, Fraser, you’re a big star. Obviously and rightly, but could you maybe just tell us briefly a little bit about yourself and a little about your career to date, if that would be okay.

 

Fraser Quin  01:50

Yeah, thanks, Jonathan. And really delighted to be here and delighted to be working again with Overcoming MS. Yeah, so I should probably come clean right from the start and tell you all that, whilst I am a doctor, I am a PhD Doctor of Economics. So I was appointed over three years ago now by BSLM to take the charity on and grow it in the business sense and allow the board of trustees to oversee the clinical side of the charity. So my role is very much developmental. In BSLM. I guess you could say I’ve had a rounded career mix of academia, I used to be a senior lecturer, private business had my own company, worked for community companies. And also in the third sector. I’ve been a non executive director on several boards and the chair of a national charity in Scotland. So this all brings a wealth of executive experience. And as I like to say, whenever anybody asks me about my career, what this means is simply that I’ve made every mistake in the book. And I’m happy to admit that because you only learn by your mistakes, and the only people that don’t make mistakes are the people that don’t do anything. But what that means is we very much focus on a really positive culture at BSLM. We operate an open honest, inclusive, no blame, no bullying, supportive culture that results in a really happy staff team that we want to work for BSLM and are aligned to BLSM’s mission. So that hopefully gives you a quick whistlestop tour of who I am.

 

Dr. Jonathan White  03:27

Fantastic, thank you. And I can attest to having been at two of the BLM conferences, and the third this year coming up. And it’s without a doubt the most positive and uplifting conference I’ve been to medically and it’s not often you can say that the chat is good, and the food’s even better. But it really is the case. And it embodies all that I love so much about lifestyle medicine. So perhaps you could explain for our audience, and I think a lot of them will know without knowing if that makes sense what lifestyle medicine is because they are doing it for themselves all the time. But but what’s your and BSLS understanding of what lifestyle medicine means Fraser?

 

Fraser Quin  04:02

So I think it’s a useful starting point, I think, is to say what it isn’t because there are a lot of misconceptions out there about lifestyle medicine, and I think many people think it’s it’s complementary medicine, it’s herbalism. It’s the use of crystals, it’s Reiki and so on it and it absolutely isn’t. We don’t criticize anybody for going down that route in their own healthcare. But as an organization, we don’t advocate for it. So lifestyle medicine is an evidence based discipline, which aims support patients to prevent, managing and reverse certain chronic conditions using supportive behavioral change skills and techniques to create and sustain lifestyle changes. So those chronic conditions include things like obesity, cardiovascular disease, type two diabetes, depression, and so on. But the discourse is now moving into areas where previously physicians and clinicians didn’t believe there was a role for lifestyle medicine. So things like dementia and multiple sclerosis. And that’s a really exciting development because lifestyle medicine has a part to play clearly in not just chronic diseases, but also neurological disorders as well. Lifestyle Medicine is based around six pillars. So it focuses on better nutrition, eat more healthfully, stay active and move more. So physical activity, sleep bette, improve social connecti on, not use of harmful substances. So lifestyle medicine is about self care, but it’s about self care supervised by a clinician to support people in their personal journey to make sure that they get the correct information. And a given the appropriate choice is relevant to their health condition. Because you only have to look at the internet, go online, and see some really quite disturbing recommendations around diet, physical activity, type two diabetes, wherever it might be, to know that if we truly want to make sure that people have the correct choices, that lifestyle medicine and our own personal choices around our health should have some clinical supervision at some point.

 

Dr. Jonathan White  06:06

Yeah, I couldn’t agree more. I mean, I think the two things that come out of that are, first of all, the vital importance of quality control if you like the fact that there’s someone there to guide you to make sure that the choices that you’re making are ones that are valuable and safe and evidence based but also around the fact that there are pillars. I love that because obviously Overcoming MS we use the term pillars for our messaging as well. And it never well it doesn’t really surprise me at all. Of course it doesn’t the booth evidence base but they are very, very closely and I  think that should be very reassuring thing for those of us who have adopted the Overcoming MS program that there is this organization in the UK and and around the world as we’ll get to that really so closely follows and and advocates on what we’re doing in to suit so thank you for that. As a sort of as a charity itself that the British Society of Lifestyle Medicine, what do you see your sort of primary mission to be Fraser and your goals and achieving that.

 

Fraser Quin  07:02

So I’ll just I’ll read the opening sentence of our mission statement, just trying to get it right “with the knowledge and skills to promote long term successful lifestyle changes. This will support the global movement to bring about change in health and healthcare through creative inspiration, combined with personal development.” So as an organization, we’re really operating at multiple levels to achieve the same. So the biggest development in the last 12 months at BSLM was we launched our core accreditation in January last year, which is the standard lifestyle medicine education for physicians and clinicians in the UK, covers everything from the introduction to lifestyle medicine, the six pillars, socio economic determinants of health, all the way through to supporting behavioral change and the various methods that lifestyle medicine uses to achieve successful outcomes for patients. We also then obviously advocate we lobby, at national level, at regional level, and through our network of members of which we have now 3000, which we’ll come back to in another answer. We have people placed around the UK, all four nations of the UK, who are in a position to advocate on behalf of lifestyle medicine. So we support them with materials and so on. And obviously our annual conference is a scientific conference we’re absolutely science based but also around the practice of lifestyle medicine and almost the art and science of lifestyle medicine. So we achieve our mission through multiple means. But education is going to be crucial for us moving forward because there are so many people are moving into the lifestyle medicine space. And there are some very questionable courses out there, which really do not address accurately what lifestyle medicine is, and seeks to bring in other disciplines which are not science based, and not evidence based, which is actually detrimental to the the practice and definition of lifestyle medicine. So that’s going to be a key focus for us over the next couple of years alongside all the advocacy and the practice of lifestyle medicine in primary care networks, National Health Service Trust as well.

 

Dr. Jonathan White  07:02

I think if healthcare professionals are skeptical about the role of lifestyle medicine and have this conception, which is a misconception of what it is and isn’t, then if there are people out there who are for want of a better phrase charlatans or quacks that only harms all our combined goals. So I I wish you every success with the advocacy and for what it’s worth. I think the accreditation I would love as we’ve spoken before, I’d love to do that if I can find the time in my schedule because I think it’s just a it’s a phenomenal it’s very reassuring, I’ve had to look through all the modules it’s it makes complete sense I think it’s it’s really well designed course and gives you the all the skills that somebody needs to really practice lifestyle medicine really, really well, which can really benefit them as a professional because it’s a joy to do lifestyle medicine, counseling and interventions, I love it. But it’s also phenomenally beneficial to our patients and our clients. And people who listen to our podcast and are involved with the charity outside of the UK, Fraser may have heard of lifestyle medicine. So how does it fit? How does it work together? And since there’s obviously more to the world than just be BSLM, why, why do we slot in fit together and combine with those agencies and other parts of the planet Earth?

 

Fraser Quin  10:28

Yeah, it’s a very good question. And one of the challenges facing the lifestyle medicine community over the last well, since it really since it started, actually, certainly over the last 10 years, has been in identifying and accepting a definition of lifestyle medicine that’s applicable across the world. And that has been achieved. You know, there’s a science based definition based around the Six Pillars of lifestyle medicine. But what is incredibly important is that we recognize cultural differences, regional differences throughout the world. So the practice of lifestyle medicine will be different across the globe. And we have to acknowledge that. What we can’t have, which I think has been the case, in recent years, we can’t have lifestyle medicine as a Western, privileged, worried well based organization that looks only to the wealthy, it has to be something applicable across the globe. And so there have been a number of developments really to achieve this. So BSLM have been a key player in the lifestyle medicine movement globally, since the start, our Chairman Rob Lawson, was was there at the start of the lifestyle medicine movement globally 10 years ago, and has been practicing lifestyle medicine for 25 years. But in 2019, BSLM set up the European Lifestyle Medicine Council, with a view to bringing together lifestyle medicine societies across Europe to make sure that that consensus of lifestyle medicine, the definition was actually acceptable. It was there. And it was applicable in and actually the regional differences even within Europe are absolutely incredible. And there’s some real challenges around that practice in lifestyle medicine, but you know, all positive, not from a detrimental or a negative point of view all positive conversations that take place. And then last year, in February of 2023, BLM convened a meeting of 20 countries from around the world and constituted the World Lifestyle Medicine Organization. It said a democratic organization fully constituted and based in Geneva, and started with the 20 countries, as I said, and we now have 42 countries as members of WLMO, so that organization is growing significantly. Unfortunately, I’m also the executive director of the European Lifestyle Medicine Council and the World Lifestyle Medicine Organization. And whilst that’s hugely enjoyable, it is something that has to change quite soon. So BSLM really does have a global presence, and is intent on establishing the standards of lifestyle medicine, with our partners, with the USA and with Australia, Japan, China, India, and so on and so on. But with mutual respect, so that people can practice lifestyle medicine, as they see fit in their regions, while still acknowledging that some things are non science based, and that will not be endorsed by lifestyle medicine. So that’s that critical friend at times for for some societies around the world, which is required. So it’s a great lifestyle medicine globally is in a really good position. Clearly that there are challenges. It’s far more political than I had anticipated. I have to say there was probably a little bit of naivety on my part around that. There, you know, various organizations around the world want to be seen as leaders, and that’s absolutely fine. But they can’t be the sole leaders of lifestyle medicine, hence the WLMO, a general assembly, which is based on one vote one country, fully democratic, democratically elected leaders, just to push the discourse on around lifestyle medicine. So it really is exciting times for lifestyle medicine globally.

 

Dr. Jonathan White  14:17

Really, really interesting and reassuring. And I love the fact that it is democratic and actually acknowledges those differences. Remember at your conference this year, I was in the same session as a I think it was a general practitioner in Australia who had done a project in type two diabetes with First Nations Aboriginal people. And I could not believe the statistics he was coming out with about things like renal failure and microvascular complications with type two diabetes within that cohort. And he was saying, you know, if we try and impose our typical interventions on them in sort of with inverted commas, the “Western models” of diet and exercise, social connection, it never works, but when you acknowledge their methods of doing these things, and adapted appropriately, the results were absolutely Incredible. And I just thought, wow, this is good stuff. And understandably, that particular gentleman did actually win the prize for that session. I don’t regret that at all. It was fair play. But it really opened my eyes to that, you know, being in a very, the sort of the traditional white middle class, you know, Western way of looking at medicine often, is blinkered and doesn’t serve the people that need the most. And actually, it’s phenomenal to see that. So congratulations on all of that work. I think we’ve already touched on the crossovers between Overcoming MS and the BSLM. And I think there there are obvious for all to see, but the one I would like to point out and just in case you have anything to add to this, because you will know better than I, I think that that sleep quality, and focusing on sleep hygiene is something that’s absolutely vital for everybody, but especially for those with MS. Fatigue is something that is, you know, is so very prevalent amongst our population. And obviously, it interplays with lots of things. But if you sleep badly, you’re more fatigued, which then impacts your sleep, which goes round and round and round in a very vicious cycle. So perhaps of all the pillars, I think our community will know many of them, but perhaps you could just touch very briefly on the sleep side of things.

 

Fraser Quin  16:08

Sleep is something that typically general practitioners really don’t talk about, and you know, perhaps a throwaway comment. It’s important you get a good night’s sleep. And we all know that. But it’s more complex than that. It’s understanding what impact sleep has on the particular condition for somebody without multiple sclerosis. Sleep can be really debilitating. And I personally have gone through periods of my life when I haven’t been sleeping. And it’s been absolutely crippling. It’s been it’s been making decision making and controlling emotions extremely difficult when you’re in high stress situations. And that’s absolutely exacerbated by multiple sclerosis that’s been demonstrated to through various research projects. And I think this speaks to the important relationship that BSLM has with Overcoming MS for example, in that we can’t be experts in everything. And we’re certainly not experts. In multiple sclerosis, we’ll have members who have an interest in it. And we might even have the odd “expert” in inverted commas in multiple sclerosis. But our organization looks to an organization like Overcoming MS for educational information for guidance around what is and what is important for your members. Members who are who have the MS condition, so that we can in turn guide the whole GP community with within BSLM towards what is of considerable or what is of critical interest to people who have the MS condition. So even by you just flagging up the fact that sleep is one of the most important things to be considered in our patients with MS in this session, actually is really important to get that message back to our members. And I think that then goes one step further. And as you know, Johnny, we’ve talked about this before, at BSLM we’re developing education in a number of areas actually a very large number of areas. But one of the areas that we’re developing education in is in neurological conditions. So we’re doing some work at the moment around dementia and the potential impact of lifestyle medicine interventions in controlling dementia and potentially preventing it in some cases, but the literature is really still out on that. And we would look to yourselves for technical information so that whatever it is we’re passing on to our membership is correct, is science based, is evidence based is based on the work that you’re doing with your members and your patients. So that when people with MS across the country, whoever they are, whether they’re members of Overcoming MS or not present to one of our member GP peas, who is a lifestyle medicine practitioner, they automatically they’re equipped with the knowledge of the condition so that they can actually begin to have conversations around sleep and other things which go beyond the prescription pad which go beyond the Okay, so we know what we have to prescribe you because you have MS. And that’s fine. The BSLM is not anti prescription where appropriate. But it’s really important that GPs are having other conversations with patients around alternative treatments around lifestyle, around sleep, nutrition, physical activity, and so on and so on. So it’s really good to hear you say that sleep is is critical to the treatment and lives of MS patients. And that’s you know, that really exemplifies why the relationship with Overcoming MS is so important to us so that we get the technical information from you to pass to our members.

 

Overcoming MS  19:33

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Dr. Jonathan White  19:50

Absolutely. I like a two way street. It certainly works for both sides of this coin. I think. Unfortunately, it may be a shock for some people to hear. Not every physician or healthcare professional in the world knows about the value of lifestyle medicine. And it can feel a little bit like pushing a huge boulder up a hill sometimes, especially if you are the patient ie not traditionally considered the expert, to advocate for yourself to someone who is by their nature a bit of a skeptic. So maybe perhaps what tips would you have for somebody with MS or maybe another condition that maybe would be a minimal tip to get their team to buy in the lifestyle medicine? How do we do it?

 

Fraser Quin  20:28

Doctors are still trained to treat symptoms. But they are individual modules, doctors are still not taught much about nutrition beyond, you know, a one or two hour session around the importance of nutrition. So things are changing. But the establishment actually is an issue here. And the demographic of the establishment is an issue because pushback that we get from lifestyle medicine is really from the you know, said this as politely as I can the older doctors, the BSLM membership is really a young membership. They are the newly qualified doctors, the doctors that have been perhaps practicing for up to 20 years, and see the need for a difference. So as the younger generation come through, and the older generation leave, there’s going to be a higher level of uptake of lifestyle medicine, across the National Health Service. This has been really bolstered over the last couple of years, with the RCGP, for example, saying that lifestyle medicine is the future of medicine. A really bold statement, a very dramatic statement, but actually, two years ago RCGP would not acknowledge Lifestyle Medicine at all. So it’s a huge step forward. Likewise, Royal College of Psychiatrists, we’re about to have a one day conference with the Royal College of Psychiatrists about the role of lifestyle medicine, in mental health treatment, obviously. So more and more the Royal Colleges are getting on board with lifestyle medicine, fundamentally, that’s going to have a major impact on the uptake of lifestyle medicine across the NHS, but it is definitely a generational thing no question about that. So if you come across as a patient, and we’ve all been there, we’ve all seen this. If we come across a general practitioner or a nurse practitioner, whoever it might be whoever you see in clinic, that is offering you outcomes that are very narrow, maybe even just one outcome. Do this, do that take this take that. I think it’s incumbent upon us all to push back against that. Now, that is really easier said than done. But actually, we know our own bodies better than anybody we know our own bodies and what works better than anybody. Really interesting. I went to the general, my GP before Christmas with hip pain. And I went several times, saying no, it’s hip pain, he was saying no sciatic nerve, and I know it’s hip pain. So it took me three attempts to get him to send me for a scan and the scan came back and I have arthritis in the hip. So I knew it wasn’t sciatic pain, because I know what that feels like. Now, okay. You know, it’s easy for me to say that I’m a very confident person that I’m actually used to talking to doctors. So it was easy for me to push back, even though I didn’t tell him who I was and what role I had. But we have to enable patients to be able to speak back and part of that is about the patient. But part of that is about the doctor as well. And one of the things we really emphasize in lifestyle medicine, to our members is actually about being that being a friend to patients being open to what the patient is saying and listening part of the lifestyle medicine, behavioral change techniques is about listening techniques about learning how to listen, because again, that’s not trained in medical school. Not always in some in some cases. But if doctors aren’t giving patients choices, then they’re giving patients no choice and that’s not healthy. I think the days have gone, I feel where doctors are saying my patient just wants to be given a pill and they want to go home. They may well be saying that some of them do say that for any number of reasons, but that actually just isn’t acceptable anymore. That’s not doing patients any service whatsoever. We know that we overprescribe in the UK, across the world isn’t there’s no question about an example that I usually cite. And there are multiple examples but you cite the example of statins. Statins, very commonly prescribed drugs and I’ve been offered it in the past and I’ve said no to it. If you want to help seven patients through the use of statins, you have to give it to 100 patients. So you’re prescribing 100 patients and 93 of them It’ll do them no good whatsoever, and potentially will do them harm due to the potential side effects. Now we have to train the GPs not to be going down the route of here’s a tablet off you go come back in three months, and we’ll see how you are. Doctors have to offer offer patients choices. And unfortunately, if they’re not offering choices, and there will still be lots of GPs out there who are not offering choice choices with patients, and your patients as well people, especially with conditions like multiple sclerosis and other conditions absolutely should be challenging doctors for alternatives. I would hope that through membership of organizations like Overcoming MS and organizations, like BSLM that we can empower in some small way patients to know the questions to ask. So is there any evidence that physical activity helps multiple sclerosis? Is there any evidence that in better sleep, sleep patterns and so on? Is there any evidence that a good nutrition pattern, reduced alcohol, whatever it might be helps MS? These are all questions that we actually we should all be asking about all of our conditions, but specifically people with MS. So So part of BSLM’s remit is to facilitate the training for doctors to be more open, but then also provide information for patients on the right questions to ask as well. And that’s something I know that Overcoming MS advocate on. So I would just say that if you’re never offered a choice, you’re not getting the right service from a health practitioner, there should always be choice, we should always have the information to allow us to make those informed choices around medication or lifestyle medicine or whatever it might be. It’s so important. But again, this is going to take time. So that culturally, people feel the general practice is a safe place, and a place where they can ask those questions, because it’s still uncomfortable challenging a doctor, when he says you have this and you should take that it’s very difficult for patients to challenge that none of us are experts, or would say is that we know our bodies, and we should trust our own knowledge of health to be able to put us in a position where we can actually challenge because people with MS, people with type two diabetes, people with cardiovascular disease tend to know more about that condition than the GPs do themselves. I had type two diabetes, I’m now in remission. And each time I visited my GP, I had to educate the doctor on type two diabetes he didn’t have a clue. But again, I was in the fortunate position to be able to competent enough to be able to challenge and to be able to do that. So we need to support patients, as well as doctors to allow that conversation to take place.

 

Dr. Jonathan White  27:58

That answer, I think is the soundbite to this whole episode and actually really brings together so concisely what this is all about. The thing that sticks in my mind is the phrase is you’re talking to skeptics all the time. And actually we myself and one of my fellow facilitators, Yas Neves have done a webinar on our site about this. But I’m very pleased to say we’re doing one for you guys at BSLM in March on this topic. So for those people that may be interested in for healthcare practitioners that may hear this, I would, I would encourage you to define that episode and to look into it because it really is just such an such a huge topic. There’s so many reasons why our system fails patients and why we fail patients. But the thing that I say to many people with MS is that the patients with the best outcomes are the hardest patients for their doctors to work with. Because they ask questions, they find ways to challenge they go away and they find for themselves. And they will be the ones that always always do best not just in MS. But in so many conditions. So so thank you for that. And we’ve touched upon it. But evidence would clearly show neither probably 70 plus percent of chronic diseases are directly linked to our lifestyle. And that number is only going to increase I think with the way that certainly Western populations are living and westernization and all the problems that it causes. Could you tell us briefly just about the number one change campaign that BLM are running? And how that might have a positive impact?

 

Fraser Quin  29:27

Yeah, so #1change is the name of the campaign. And this was really born out of a recognition that and he kind of slightly alludes to the previous question in a sense. You know, if you present at the doctors and you have any number of conditions, you have high blood pressure, wherever it might be and you happen to be obese. You know, it’s not enough for the doctor just to say go away, lose weight, join a gym, stop drinking, do this, you know, that immediately turns people off, and you just shut down because one its was a bout to state it information overload. It’s not an information overload. It’s just a doctor telling a patient, what they need to do. And it’s too much, it’s fine saying, Yeah, of course, you need to lose weight, we all need to lose weight. But you know, how, in my personal circumstances, how do I do that I got a very high stress job, I don’t have much money. So I’m eating probably not particularly healthy, there are all kinds of factors that influence weight loss, type two diabetes, whatever it might be. And it’s just not sufficient to say, Go away, do this, this, this and this. So the #1change campaign was based out of that, acknowledging the fact that behavioral change is very difficult. So it’s saying to people, you can start a lifestyle, journey, lifestyle change by just making one small change? What can you do today, to do that, go for a walk for five minutes today. If you’re sitting at your desk all day in a call center, or wherever it might be every 40 minutes stand up, do a couple of squats, if you can walk for 30 seconds, come back and go back to work. Try and have a couple of days a week where you don’t drink alcohol. So very small things that actually can have meaningful impacts but more importantly, plant the seed plant the idea in somebody’s minds that you actually have to start somewhere. I mean, we have members a couple of GPs that I spoke to a few weeks ago, and one of them was telling me that one of the conversations that they have with a number of their patients is when was the last time you ate a vegetable? They had no fiber in their diet, they had no you know, obviously the the macros and the multivitamins coming from a variety of vegetables. So her #1change was to challenge them to one day a week to eat vegetables. So it can be that big of an issue that’s serious. But in a sense, equally, that simple just to commit to have vegetables once a week in whatever form that you want, it just starts the conversation, and it starts the ball rolling. And if patients can do that, then it becomes a vegetable every two days, it becomes walk 10 minutes, and then 15 minutes, it becomes you know, get a standing desk at work, and then you’re standing all the time. So it’s about creating the atmosphere and the ability to entertain the conversation on because hopefully people even from very small interventions, people can see, feel and see a significant benefit. So for people that drink alcohol, every day of the week, a couple of days off alcohol a week is going to have a positive impact on how they feel there’s no question about that. So it was really just about planting that seed. But you have to do it in context. So you have to do as part of the program. There’s no point in a doctor saying, Oh, what about making a small change in your health? See you in six months, see you in 12 months, it has to be part of an ongoing program. And again, this speaks to the approach of lifestyle medicine, which is having relationships, proper relationships with patients. And that takes time, it takes longer. We know GPs are stressed out with you know, 10 minute consultations and so on. But there are ways around that there are things that can be done at home that I think is convenient online, there are things that can be done in groups, and actually group work and group therapy has been proven beyond doubt to be far more successful than individual interventions beyond just the prescription of drugs, which clearly have their place again. So it’s about creating that discourse. And, but not overloading people with information and with demands that they have to do A, B, C, D, E and F, just try A) walk five minutes a day, or walk five minutes today, see how you feel tomorrow. And then that leads to ongoing support and ongoing conversations. And the most effective, it’s been shown that the most effective programs address one issue in a small way, and then build on it rather than bombard individuals with half a dozen things to do and yeah, stop drinking, stop eating junk food, go to the gym doesn’t happen and everybody knows it doesn’t happen. So it’s just about creating that discourse between doctor and patient about you know, yes, this is difficult. But actually if you try something, perhaps this or perhaps that it’s the start of a journey.

 

Dr. Jonathan White  34:43

What I was thinking as you were talking there are two things. The book Atomic Habits by James Clear, I would recommend to anybody listening which is just absolutely amazing. It’s about the benefits of making tiny changes and how they accumulate and combine. The example he often cites is about the Team Sky cycling team back in In the mid 2000s, early 2000s, who used to do things like you know, bringing their own pillows so that the team slept better, bringing their own chef, you know, all of all of these tiny little things, which on their own were almost laughable, but combined together made very powerful, effective changes. And the other thing, couldn’t agree more for some people within our community, they dive in wholeheartedly to our program, and they make all these changes one go, they’re very, very motivated. For others, it takes more time, and it’s more difficult. And that’s absolutely okay. So we have a new initiative called the six months to Overcoming MS Program, which is launched at the start of the year. And I would encourage those who are struggling, or wanting to dip their toe just to check that out on our own channels. And I’m gonna put you on the spot Fraser. When does lifestyle medicine become mainstream? When do you see it happening?

 

Fraser Quin  35:52

Yeah, so it is mainstream. So yeah, no, it is mainstream medicine. And we need to get that message across to people so that people don’t think it’s woowoo. And you’re begging people within the health system. Some think it’s woohoo. So it is mainstream, but it’s not widely adopted within the NHS at this stage. Although evidence suggests there are a hell of a lot of practitioners out there who are delivering lifestyle interventions that wouldn’t necessarily call it or recognize it as lifestyle medicine, but they are, there’s no question about it. So it’s, again, it’s incumbent upon us to be ensuring that people understand what lifestyle medicine is through advocacy and through education. And a perfect example of this actually, that why lifestyle medicine is clearly mainstream, but hasn’t necessarily been fully adopted, is with group consultations, which are shared medical appointments. That’s what they called in other parts of the world group consultations, where people come together. So there’s elements of peer support. But there’s also an element of it because as a clinician present and a physician, so there’s an element of sharing your diagnosis with a wide group, so that people see that they’re not alone. Yes, I have those symptoms. So I can try that I can do this. There’s a huge literature proving that people who attend those courses are more likely to respond to treatment, lifestyle, medicine interventions, and change behaviors than those that simply go off on their own and tried to do this themselves, very often receiving minimal support from the general practice. And that’s not a criticism against general practitioners. I hope I don’t sound as though I’m down on general practitioners, because I’m absolutely not. But the system doesn’t allow people to practice lifestyle medicine. But group consent consultations is a means by which you can treat, treat 10 patients in one go across two hours, two and a half hours, instead of treating people individually, and the peer support element of that has been fundamental in improving the success of that model. So once we and other organizations can get to the point where actually we’re shouting at the top of our lungs about things like this. And that’s not the only tool obviously, the medical establishment has to sit up and listen, they have to find fundings funding for initiatives like this and other lifestyle s and interventions. The reason why we have to do this because it is clearly better for patients. It is more effective. There’s absolutely no question. It’s better for doctors, because they’re in less confrontational, less stressful situations. It’s less risky lifestyle medicines, their lifestyle medicine interventions are less risky than drugs less risky than surgery. And it’s good for the economy. The potential saving in prescription drugs worldwide is phenomenal, let alone in the UK. There’s just no question about that. So once the establishment sits up and acknowledges is this and this has to be done in collaboration with the Royal Colleges, because the Royal Colleges are essentially the the governing bodies of these various organizations the think tanks, pioneers, innovators, if we can get the Royal Colleges on board, and that’s starting to have happen, then we can promote things like group consultations through them, and motivational interviewing through them, listening techniques through them, so that we’re trickling down constantly the message of lifestyle medicine at the grassroots as well as promoting strategically at the higher levels, NHS and UK Government and devolved governments as well. So one of the things that we’re doing with the Royal College of Psychiatry in May it’s a one day conference introducing psychiatry, psychiatrist sorry to lifestyle medicine and the various tools that we use. Now, psychiatrist would claim that they’re doing lifestyle medicine already and they are. There’s a number of things that they’re not doing one of the things that they happen to embrace his group consultations. So that’s the sort of thing we’ll be talking about as well as the six pillars, the definition is making sure there’s a thorough understanding of what it is. But you know, through the various, you know, through the education, through the advocacy through the Royal Colleges, we will expand the scope of lifestyle medicine. But I would argue that it’s already used mainstream because I think to call it otherwise, starts to dip into that realm, of oh it’s whoo hoo, tree hugging and so on maturity absolutely isn’t in place that if I’ve offended anybody, I would quite happily admit, I used to hug trees as well. So I have nothing against tree huggers. But it’s not science. And it’s not lifestyle medicine.

 

Dr. Jonathan White  40:42

Forgive the semantics. I absolutely agree. It’s mainstream, it should be plastered in every consultation room and every GP surgery and clinic across the country in the world. Yes, I think with regards to group consultation, I’ve seen that personally and professionally through our retreats and our Pathways programs. And the power that is locked within that is unbelievable. Our first chief executive Gary McMahon used to say that all the answers are in the room. And they’re not coming from the facilitator, or the leaders on I could not agree more. All those 40 participants, they know everything collectively, and it’s about sharing it. And that is the most rewarding thing as a clinician to see it happening, actually. And it’s easier, I have to do less of the work because the group does the work. And it’s absolutely phenomenal. And I absolutely love it. And I encourage any healthcare professional listening to find a way to become involved in that. I’m close to wrapping up here. Fraser, I’ve got two things. Well, one question to ask you, which is, if you had a crystal ball, and you could look 10 years into the future? What does it look like for lifestyle medicine? Where it where’s it got to? What is it doing?

 

Fraser Quin  41:50

10 years into the future? Well, the trajectories clearly up. And as I’ve already said, you know, there’s various organizations in the UK have a part to play in that. But I think there’s a there’s a global movement that is swelling. And I think we get world organizations like the UN, like the World Health Organization, European organizations, like the European Public Health Alliance, for example, are absolutely on board with lifestyle medicine, have it front and center of health policy globally, and that in 10 years, that will be the case, there’s just there’s absolutely no question about it. All organizations are dipping their feet in the water of lifestyle medicine. And the realization is coming that actually it’s the only solution. I mean, look, you know, researching lifestyle medicine, the Greek philosophers 3000 years ago, were talking about the importance of good food, outdoors, physical activity for mental well being and happiness in life. This is not rocket science. But there’s now an economic element to this that the Greeks probably didn’t consider, which is that lifestyle medicine is less risky, will reduce pharmaceutical bills for all organizations involved in the delivery of healthcare, will reduce the need for litigation, will reduce the need for surgery. So I am absolutely certain that in 10 years time, lifestyle medicine will be front and center in World Health Policy, what that might mean in 15 years time, there might not actually be a need for BSLM, because everybody will be practicing lifestyle medicine. And actually, we can all retire and go and lay on the beach somewhere.

 

Dr. Jonathan White  43:39

Let’s go to the beach. I said that at your conference, actually, someone said, What do I think it’ll look like for us in 10 years? And I said, well, hopefully I’ll be out of a job because there won’t need to be the mainstream. So yeah, let’s, let’s go to an extended retirement. Brilliant idea. Listen, thank you so much for your time. That’s been an amazing, quick tour of lifestyle medicine and the BsLM. And I’m very grateful to you and the organization. If anybody’s interested in wanting to get in touch reach out, find out more, how would they do that?

Fraser Quin  44:08

So go on the BSLM website, there’s a huge amount of information on there. There’s a membership opportunity for the public, which is not expensive that gives you access to all webinars and so on. You’ll see emails on there you know, get in touch with the Office get in touch with me directly. Obviously my details are there as well or through Overcoming MS. And more than happy to help in any way. And I’ll just say Johnny, it’s it’s a delight to work with an organization like Overcoming MS who are so sharing and clearly see the need for collaboration and one of our big words is collaboration and your organization is a joy to work with. And we’re thankful for the expertise that you bring to BSLM

Dr. Jonathan White  44:50

Thank you, Fraser. It goes it goes both ways. Listen, I look forward to seeing you at the next conference and shooting the breeze again and good luck with all your initiatives and taking over the world for lifestyle medicine.

Overcoming MS  45:01

Thank you for listening to this episode of living well with MS. Please check out this episode’s show notes at overcoming ms.org/podcast. You’ll find useful links and bonus information there. Don’t forget to subscribe to the podcast so you never miss an episode. And please rate and review the show to help others find us. This show is made possible by the Overcoming MS community. Our theme music is by Claire and Nev Dean, our host is Geoff Allix. Our videos are edited by Lorna Greenwood, and I’m the producer Regina Beech. Have questions or ideas to share. Email us at podcast at overcoming ms.org We’d love to hear from you. The Living Well with MS podcast is for private non commercial use and exists to educate and inspire our community of listeners. We do not offer medical advice for medical advice please contact your doctor or other licensed healthcare professional