“The groundwork for all happiness is good health.” – Leigh Hunt
The first time I realized that most of the medicines that we as doctors were prescribing were acting as band-aids were during my internship. Having completed my basic medical training, I was now seeing patients in different departments with a variety of complaints. I noticed that many patients with chronic diseases were usually treated for their symptoms. Of course, there were medicines prescribed to lower blood sugar levels in the case of diabetes, lower cholesterol levels in those with elevated cholesterol levels, and immunosuppressants and steroids for autoimmune diseases. But these medicines did not target the underlying cause. If one stopped taking them, the problems would come right back. Another thing that disturbed me was the fact that the condition of many patients continued to worsen with time despite taking the medicines prescribed. They also had to deal with the side-effects of these medicines.
There are various hypotheses for the pathogenesis of autoimmune diseases but the accepted hypothesis keeps evolving with new research as does the treatment. Often, the treatment does not change much because of the time it takes for a new drug to go from the pre-clinical phase to being approved for use in patients.
I also noticed that my knowledge of nutrition and lifestyle factors like sleep, stress, and relationships was very limited. My medical training had not given me much knowledge on them. Another striking phenomenon that I noticed was that every other young woman I met, told me how they or someone they knew had been recently diagnosed with polycystic ovary syndrome (PCOS). Similarly, every other friend or colleague would mention how their parent or aunt or uncle had recently been diagnosed with either diabetes or hypertension. These were people in their early 50s.
This was something that could be attributed to the increasing consumption of fast food from franchises of global fast-food brands that were opening rapidly all across the country. Another factor was the increasing adaptation of sedentary lifestyles. In contrast, people belonging to the generation of our grandparents were relatively healthy in comparison to their children i.e. our parents, aunts and uncles; and grandchildren.
The dietary and lifestyle advice that we were giving patients was limited to telling them to eat healthily, eat more vegetables and fruits and avoid junk food. For exercise, we would tell them to exercise for 45 minutes to an hour daily. No specific dietary advice tailored to the patient’s needs was given in most cases. We often asked them to reduce stress but did not specify how. This was mainly due to time constraints during consultations and also due to limited knowledge.
In the meantime, I completed my Pathology residency but this reality of how we were not focusing on treating the cause of the disease in most cases, always remained at the back of my mind. I was unaware that a branch of medicine called Lifestyle medicine had come up and focused on exactly the things that I sought to address. Lifestyle medicine centers on a whole-food, plant-based diet; physical activity; adequate rest and recovery; stress management, and social connection to not only promote health but also to treat and reverse disease. I started reading all the research papers on how lifestyle changes could be used to treat disease. I read any book that I could get my hands on that focused on using food and changes in lifestyle and the environment as medicine. A few years back, I started a blog to try and create awareness about how our diet and lifestyle choices affect our health. The focus of that blog was on PCOS and diabetes. I was unable to maintain it due to time constraints and eventually closed it down.
I started afresh this year with another blog (https://healthootopia.com/) which aims to provide knowledge to people about various diseases, how we can make better lifestyle choices to improve our health and address the underlying cause of chronic disease through food, sleep, proper physical activity, managing stress and building and maintaining fulfilling relationships. I now incorporate a lot of dietary and lifestyle changes in my treatment plans for my patients in addition to the necessary medication.
The best part of lifestyle medicine is that it is truly patient-centered. It puts the ball in the patients’ court to fully take ownership of their health. Lifestyle medicine is not a cure-all and not a replacement for all medications or procedures. However, it can bring us a lot closer to the triple aim of improved health, reduced costs, and improved patient satisfaction. My aim is to empower people to manage their health on their own with proper guidance. People need to realize that long-lasting changes can be brought about by making these small but necessary changes. They need to realize that they have all the power they need to become the best versions of themselves and lead healthy and happy lives.
Dr. Smrita Singh, MBBS, DNB
Dr.Smrita Singh is originally from Assam, India. She obtained her medical degree from Gauhati Medical College in Guwahati, Assam, India. She completed her residency training in the Department of Pathology at Kidwai Memorial Institute of Oncology, Bangalore, India. She loves supporting and empowering people about their health. She especially enjoys working with young men and women as they establish their healthcare goals and needs.
In her spare time, Dr. Singh enjoys traveling, cooking, reading, writing, and spending time outdoors. She is conversant in English, Hindi, and Assamese.