Ceud Mile Failte — A Hundred Thousand Welcomes
2018 BSLM Conference Introduction Speech
by Dr Rob Lawson
On behalf of BSLM trustees and Directors, welcome to Edinburgh, Scotland’s capital city. I’m not saying that to annoy our Glasgow visitors, by the way. It is a certain fact in an uncertain world. A bit like the fact that Lifestyle Medicine, practiced with humility, is a certainty in that uncertain world called Medicine.Something else that is very certain is the honour of having you all here today.
We are travellers from all over the world, all sharing the same vision and eager to learn from each other. A warm welcome to you all. Present from UK, Europe including Croatia, Middle East, Africa, Australia, USA.
I noticed that the back of the conference programme has a picture of an 18th century Scot, Adam Smith, philosopher, economist and part of the ‘enlightenment’ era. He referred to the ‘invisible hand’ contributing to the equilibrium of supply and demand in a capitalist economy. Given the dys-equilibrium between a finite supply available to the NHS and the demands on it from our increasingly disease-burdened population, I wonder if Lifestyle Medicine can be that ‘invisible hand’ which restores equilibrium and provides enlightenment. We should make it so.
Now to get a little serious.
Why do we need Lifestyle Medicine? Margaret Chan was WHO Director-General in February 2017and she acknowledged that there are grand challenges for the next decade in terms of global health policy and programs.
- The globalized marketing of unhealthy products, has opened wide the entry point, for the rise of lifestyle-related chronic conditions
- Non-communicable diseases have overtaken infectious diseases as the biggest killers worldwide.
- This is a unique time in history, where economic progress, improved living conditions, and greater purchasing power are actually increasing diseases instead of reducing them.
- Social media have become a new voice with considerable force, yet few safeguards govern the accuracy of its content. The proliferation of front groups and lobbies, protecting commodities that harm health, has created arguments that further muddle public thinking and challenge the authority of evidence.
- The Oxford Dictionary of the English Language chose “post-truth” as its word of the year for 2016. In a post-truth, post-fact world, views that appeal to emotions and personal beliefs are more influential than objective evidence-based facts.
- And she posed this question: What does this mean for public trust in the evidence produced by science, medicine, and public health?
- So this is the climate in which we find ourselves, and which we have brought upon ourselves. In no small part thanks to us Scots who invented the television, the telephone, the refrigerator and the couch potato. And we have no choice but to face up this, to think differently, to create change and to recreate health and wellbeing.
So what is Lifestyle Medicine? Let me read the Lifestyle Medicine Global Alliance definition:
“A branch of evidence-based medicine in which comprehensive lifestyle changes, including nutrition, physical activity, stress management, social support and environmental exposures, are used to prevent, treat and reverse the progression of chronic diseases by addressing their underlying causes.”
As Lifestyle Medicine practitioners we stand like stretched elastic bands, drawing together conventional medicine and public health. We understand that by ignoring the causes, or upstream determinants, of lifestyle-related disease, we are rather missing the point. So I anticipate during today we will be hearing something about Lifestyle Medicine Science, the knowledge and evidence underpinning it; the art or skills required to modify health behaviour, such as motivational interviewing; the tools to add to your Lifestyle Medicine toolbox, such as mobile health and de-prescribing; and the procedures of Lifestyle Medicine, including Group Consultations.
These are the evidence-based determinants of lifestyle-related disease. It is easy to remember. Joining up the first letter of each determinant spells out
NASTIE MAL ODOURS. Professor Egger’s doing. They are largely man-made causes of metabolic inflammation. And as they are man-made they must be man un-made. And we must resolve to unmake them to achieve sustained improvements in health and wellbeing.
Lifestyle Medicine is about all of that, but other words come to mind: self-management, shared decisions, iatrogenesis, overdiagnosis, behavioural change, multi-disciplinary teamwork, community assets, green spaces, microbiome, biodiversity, social connectedness, the built environment, deprivation. All of these matter – a lot.
So where are we going with Lifestyle Medicine? We really need to be looking ahead.
We need to be looking ahead and upwards to see the new horizon and head towards it with optimism.
The red line is the world in crisis, increasing chronic disease and struggling health systems. The lights in the NHS are being kept on – just.
Meanwhile, the blue line represents innovations attempting to move away from crisis towards Horizon 2 but creating disruption along the way.
Lifestyle Medicine is the green line. Transformative innovation, clear thinking, solid evidence and eyes firmly fixed on a viable and better world.
OK, there will be turbulence and there will be disruptors along the way. But we must not be put off. The fact that today, in the 21st century, in this country, a 5 year old son will have a lesser healthy life expectancy than his father is a betrayal of a generation — and we must act now.
Now is the time for change.
Now is the time to make a difference.
We can do this – the Lifestyle Medicine way. #1change at a time.
So please get behind the #1change campaign being launched later today
Now is the time, with gratitude, to hear our excellent speakers.
Thank you and enjoy your day.