BSLM25 – Highlights for Children and Young People (CYP)

As the dust settles from another fantastic BSLM conference, I wanted to reflect on the most pertinent CYP highlights (25% of our population but 100% of our future!).

With a gaggle of excitable paediatricians including RCPCH president, Prof Steve Turner present (from left to right, Dr Chetana Kallappa, Prof Nick Makwana, Dr Seb Gray (me), Prof Steve Turner), there seemed to be a huge buzz about engaging and collaborating with the paediatric specialist interest group and as we’re in our own infancy, it’s a great opportunity to shape what we do moving forward. If interested in nurturing our development, please contact office@bslm.org.uk

Nurses & AHP’s: The Burning Platform in CYP Health

Prof Ranger reminded us of nurses being the unsung heroes of healthcare (and I’d put allied health professionals in the same waterlogged boat). Under-valued, under-paid and overworked with nursing students reporting burnout before they even qualify. We now have one school nurse on average for every nine schools. Imagine what difference could be made if every school had its own nurse – early help, mental health support, promotion of healthy lifestyle, proper prevention.

Working with CYP should be joyful. I’ve previously written about finding Joy in Work here and we’ve also looked at wellbeing and burnout as part of Paediatrics 2040. The deep-dive Wellbeing report was primarily for paediatric doctors but hugely relevant to other doctor groups, nurses and AHPs. You can’t pour from an empty cup and compassionate self-care is an essential baseline to deliver compassionate care.

Obesity: It’s Complicated

Dr Jen Unwin spoke about food addiction in young people with a surprising 15% of food addicts not being overweight at all. Food addicts are 7-times more likely to develop type 2 diabetes. Should we be using the Yale Food Addiction Scale and CRAVED questionnaires to spot the signs earlier and offer support? It’s not just about willpower, it’s brain chemistry.
Prof Oliver Mytton reminds us that little things add up. Walking to school might look small but stringing marginal gains together doesn’t just work for British cycling, it can create a healthier nation. Sarah Le Brocq brought the vital lived experience voice advising caution with the word “lifestyle” – for some, this can be an accusatory, trigger word. Prof Louisa Ellis also reminds us that your “best weight” might not be your “ideal weight” – health needs to be personalised. We need to ditch the blame game and focus on support that really works.

Movement is Medicine

Matthew Waugh highlighted that moving your body helps your mind, especially in young people, showcasing some incredible work with mental health patients. Sir Muir Gray, in between throwing his arch enemy, “the chair”, off the stage, encouraged us all to walk more. Lyndsey Barrett showed how health can link with leisure industry to create opportunities for kids who’d potentially be left out. Starting with the person rather than the policy – less tick-boxes, more footballs, dance classes and skateboards. As the BMA state, “The best forms of exercise are those that fit into everyday life”.

Vaping: The New Smoke Signal

Dr Jo Inchley triggered an audible gasp with some stats about vaping. 1 in 3 adolescents have vaped; 1 in 5 have done so in the last month. Wheels are in motion for this becoming one of the biggest lifestyle challenges for us to combat. Lots of unknowns long-term but lots of growing evidence of direct harm, passive harm and gateway to cigarette smoking. Advocating for CYP when faced with public health measures like “swap to stop” remains challenging. Harm reduction justification for adult smokers shouldn’t come at the cost of harm increase for CYP and we haven’t got that balance right yet. For more of the risks, see our blog here and our latest publication about support CYP with vaping cessation here.

Systems, Not Silos

“Systems thinking” was another buzz phrase of the conference. Lifestyle medicine is about prevention, so we need schools, families and communities to be at the heart of the solution. Our health system isn’t currently focussed on health; it’s an illness system and so to truly align with the NHS 10 year-plan shift to prevention, systematic changes and integration are fundamental as outlined brilliantly by Dr Rupa Joshi. The shift from hospital to community is also a huge challenge – robbing Peter to pay Paul when Peter’s already broke and Paul’s already too busy doesn’t add up and we truly need to step back and work together to manifest intentions.

Climate, Nature & Future-Proofing Health

CYP won’t just inherit our healthcare mess, they’ll inherit our planet too. Speakers like Rachel Stancliffe and Prof Derek Clements-Croome linked the climate emergency directly to health. Should we add a seventh pillar to lifestyle medicine for nature? Sometimes the best prescription isn’t a pill, it’s a park.

My Take Home Messages:

1. Support the supporters. Nurses, AHPs, teachers, and everyone else who works with CYP all seem to be struggling and at risk of burning out. We need to nurture and look after each other; if we burn out, CYP lose out.

2. Make it personal. One size does not fit all. Whether it’s finding a physical activity, making healthy food choices, relaxation methods, social preferences, everyone is different and a personalised approach to health will be the winner.

3. Think big picture. Breaking down silos and working across the system to create environments where healthy lifestyle is the default rather than the golden apple only afforded to the affluent.

Our CYP deserve a health system that doesn’t just focus on surviving but truly enable them to thrive and be the best version of themselves. We need to embrace challenges (huge fan of Dr Margaret McCartney!) and always show compassion as Prof Sir Al Aynsley-Green will continue to remind us. The enthusiasm and energy from the BSLM members can act as a catalyst for improved child health and I look forward to growing the movement together.