At the beginning of last year, in January 2020, I made a resolution to lead a healthier lifestyle. This included eating better, exercising, sleeping for at least six hours a day and reducing the stress in my life. As part of the resolution, I vowed never to consume anymore carbonated drinks- Coke, Fanta, Sprite etc. Fruit juices would also take a back seat as I planned to consume the recommended 2.5 litres of water per day. I bought a large calibrated water bottle with motivational messages like ‘You can do this!’, ‘Just a little more’ and ‘you dey Kampe! at the 2.5litre mark to inspire me. I also took up walking as a form of exercise, every day, with the aim of reaching ten thousand steps per day.
At the end of the first week, I gave myself a mental pat on the back for pulling through; by week two, my bladder was struggling to keep up with my overly frequent bathroom visits and by week three, I was ‘crying for my mommy’ and cursing the person who discovered exercise.
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Ladies and gentlemen, welcome to Lifestyle medicine. Lifestyle Medicine is the use of evidence-based lifestyle therapeutic intervention—including a whole-food, plant-predominant eating pattern, regular physical activity, restorative sleep, stress management, avoidance of risky substances, and positive social connection—as a primary modality, delivered by clinicians trained and certified in this specialty, to prevent, treat, and often reverse chronic disease.
So, what is all this medical jargon? Let me break it down.
There is no longer any serious doubt that what each of us does in our daily lives profoundly affects our short- and long-term health and quality of life. However, the typical middle class Nigerian wakes up each day and has a carbohydrate rich breakfast and sugar laden beverage. He or she then goes to work and grabs a Coke or Fanta with Gala or another equally greasy, highly salty and oily snack. Lunch is two wraps of swallow with soup, accompanied by another bottle of chilled coke. The weather is too hot to consume anything else anyway. On your way home, depending on your mood and pocket, you munch another snack. Dinner is Rice and if Buharinomics permits, chicken, eaten in front of the TV. Afterall, you need to be up to date with the latest news or series, abi? After a few chores, you hit the bed with a full stomach. Maybe even smoke a cigarette or two. Or a glass of wine or beer. No exercise, not properly hydrated and with a belly full of carbs and sugar.
Hundreds, if not thousands, of studies provide evidence that regular physical activity, maintenance of a healthy weight, not smoking cigarettes, and following sound nutritional and other health promoting practices all profoundly impact health. Therefore, what lifestyle medicine simply means is incorporating healthy habits into our daily lives in order to live a healthier life. It means being intentional about our health. Making that extra effort to exercise, to eat healthier and to quit bad habits like smoking, alcohol and unprotected sex with multiple partners.
Many people and even physicians are surprised to learn that negative lifestyle practices profoundly increase the risk of cancer. Of course, physicians recognize that cigarette smoking is the leading cause of lung and some other cancers. However, the American Institute for Cancer Research and the International Agency for Research on Cancer have concluded that there is sufficient evidence to link human malignancies to excess body fatness. Excess body fat is the second leading cause of preventable cancer, following only cigarette smoking. An inactive lifestyle has also been linked to increased risk of cancer. Do you know that even if you have family history of diabetes, you can delay its onset with exercise? This means that if you are meant to develop diabetes at age 50, with regular exercise you could delay it till you reach 55 or even 60 years. Isn’t that fantastic?
With all of these powerful examples of the profound impact of lifestyle on health, how are we in the medical community doing at helping our patients adopt positive lifestyle habits? Sadly, very poorly. Nigerians have only just woken up to the benefits of living a healthier lifestyle in the last decade. And of course, my Abuja people and Lagosians are in the lead. Every morning and evening, the streets are littered with people- the young and the old, men and women, obese and thin, briskly walking or jogging, with the aim of staying fit. Most have been prescribed exercise by their doctors for their Diabetes or Hypertension, while some are just trying to keep active so as not to fall into the rising statistics of people with non-communicable diseases. They are also a few of my Abuja fine boys and babes who jog with the sole intention of looking ‘cool’ and landing a significant other. I salute your hustle!
However, these people make up a minute percentage of the population. Nigerians are still languishing in the foolish fantasy that being ‘big’ means being rich! And what is success without an accompanying potbelly to prove it? A friend once asked me of a drug to help her grow fat. When I asked her why- she replied that she needed to look the part of a rich man’s wife! Eventually she took the popular drug ‘Sha ka pashe’ and last I heard she was running from doctor to doctor due to uncontrolled hypertension.
The rising increase in the rate of non-communicable diseases or chronic disease is mind blowing. Chronic diseases like Diabetes have more than doubled their number in the US in the last twenty years. Their diet and sedentary lifestyle which we are copying has contributed significantly to rise of chronic diseases like Diabetes, Hypertension and other cardiovascular diseases in Nigeria. Hypertension alone is responsible for up to 20% of mortality in Africa. Yet, we still pour half a bag of salt in our party Jollof rice!
Because of these statistics and more, the Nigerian Medical Association decided to create a Lifestyle Medicine week starting from the 30th of May to the 5th of June, to be celebrated by all state chapters across the nation. The aim is to launch an emphasis on the health-promoting benefits of lifestyle habits and put these habits into practice for our patients and in our daily lives. NMA will be hosting webinars and walks in order to sensitize Nigerians about the importance of living a healthier lifestyle in order to prevent and manage chronic diseases. If we are truly going to practice evidence-based medicine, we (and our country) can no longer afford to ignore the overwhelming evidence that daily habits and actions profoundly impact not only health outcomes but also cost of care.
The sad truth is that with a population of over 180 million, it would be foolish for us to think that government can take of our health. Even wealthy nations like the United states cannot afford it. When you spend the better part of your life smoking three packs a day, coming first in every drinking competition, not hydrating properly and eventually develop kidney failure, how then can you blame government? How many states offer free Dialysis? Na Naija we dey o!
Employing the principles of lifestyle medicine in the daily practice of medicine therefore represents a substantial opportunity to enhance the value equation in medicine by improving outcomes for our patients while simultaneously controlling costs. The time has come to truly practice lifestyle medicine and encourage positive lifestyle decisions for our patients and adopt them in our own lives. Our patients and our country should demand nothing less.
