Issue 14 February 2014
Lifestyle Medicine – Optimising sustainable health & wellbeing, while preventing & managing chronic disease In this months newsletter:
Welcome ALMA Mission and Aims Interview with Dr Caroline West CEO Report Lifestyle and Brain Health Website tips Upcoming events From the journals
Welcome to the latest edition of the ALMA newsletter, aimed at keeping you up to date with the latest research, information and resources in the area of lifestyle medicine. The newsletter will also keep you abreast of the work of the association and its committee. In this edition we have our next Q&A profile with ALMA President Dr Caroline West. We hope you enjoy finding out a bit more about our committee members, their interest in lifestyle medicine and what they do outside of ALMA. We have an interesting article from committee member Cam McDonald on the impact of lifestyle on brain health. Our CEO Tanja gives us an update on what has been happening in ALMA in her CEO report. The next ALMA Conference is scheduled for 16th – 18th October 2104 at Brighton Le Sands Novotel in collaboration with ANZOS (Australian New Zealand Obesity Society). As usual we provide a selection of recent lifestyle medicine-related articles from the journals and some upcoming events which may be of interest. If there are other topics or information you would like to see in future editions of this newsletter, then please let us know by emailing firstname.lastname@example.org
About ALMA Mission: To improve knowledge and practical skills of health care practitioners in lifestyle behaviour change within Australia Aims:
Raise awareness of the need and value of lifestyle behaviour
change in the management and prevention of chronic disease
Improve knowledge and skills of practitioners in lifestyle behaviour change
Encourage and engage more health practitioners in the field of lifestyle change
Facilitate improved transfer of information and skills development in effective lifestyle change
Foster research and accreditation in this area Act as an advocate for the development of policies and programs in this area, as an apolitical association.
Issue 14 February 2014
In this issue we again bring you Q&A interviews with our ALMA committee members, providing you with the opportunity to meet them and find out more about their interest and involvement in ALMA. Interview with… Caroline West How long have you been a member of ALMA? I became a member of ALMA from the start. What made you get involved with ALMA/join the committee? I have worked as a GP for 25 years with a focus on prevention. I was always keen to up skill in terms of my knowledge around areas like weight management, nutrition, exercise and mental health . More than a decade ago I started attending Garry Eggers courses on weight management/ lifestyle medicine and from there I began to get involved with teaching and education . Joining ALMA and then getting involved in the committee was a natural progression. What is your role within ALMA? I am currently the President of ALMA. But I have to say the power of ALMA lies in the teamwork from an incredibly motivated committee and our passionate CEO Tanja McLeish. What do you do outside of ALMA? I am a GP and director at East Sydney Doctors which is a large community group practice in Darlinghurst. For many years I have also been involved with the media and write and present for TV programs. I also contribute to columns and blogs as a health writer. I am pretty busy juggling work with my 2 kids and partner. I try to stay pretty active by cycling to work, kayaking, surfing. Music has also been a sanity saver and I am currently in love with my ukuleles and am an enthusiastic "hopeless" player (just ask the participants of the ALMA eduventure walk!) What sparked your interest in lifestyle medicine? For more than 20 years I have had a keen interest in obesity, weight management and prevention. It becomes apparent when you work in this area that this is complicated. It is certainly not as simple as diet and exercise. Environment, culture, mental health, socio-economic determinants all play a role too. In other words, it is a complex lifestyle medical condition. In fact most chronic conditions are complicated and lifestyle medicine helps enormously put these health conditions in a lifestyle framework. I feel a solid knowledge of Lifestyle medicine is vital to all health workers. We are literally facing an overwhelming wave of chronic conditions from diabetes to heart disease to mental health. Lifestyle medicine with its focus on primary care really helps people optimally manage their conditions. What is something new in lifestyle medicine that is taking your interest at the moment? I think the movement towards shared medical appointments is very interesting. The current model of one on one consults may not be economically sustainable into the future . Not only may shared appointment be more affordable for the health system, but it may offer better team management and support from others. Patients may get more out of it, and for the clinicians it provides a different dynamic platform from which they can share care. It's early days, but I think that in 10 years time, there will be a variety of care models available with chronic disease. Your favourite quote? “A person's a person, no matter how small.” ― Dr. Seuss, Horton Hears a Who!
Dr Caroline West specializes in Healthy Lifestyle Medicine and is one of Australia’s best known doctors. As a Medical Practitioner /GP she has extensive clinical experience helping clients make healthy changes for life. She is currently the President of the Australian Lifestyle Medicine Association. Caroline is also well known for her work in the media as a TV and print health journalist. She has been a presenter on Beyond Tomorrow, Beyond 2000, Guide to the Good Life, Good Medicine, 60 minutes and George Negus Tonight. Caroline is currently presenting the ALMA Lifestyle Medicine workshops for health professionals around Australia.
Issue 14 February 2014
Issue 14 February 2014
From the CEO Desk – Tanja McLeish NEW ALMA eBook – on ALMA Website The ALMA Eating Plan for People and Planet – a guide for improving health and the environment in the modern world based on recent scientific findings relating to the body’s reaction to certain foods, the plan is focused around a newly discovered form of inflammation (in the arteries and organs of the body) which can lead to long-term chronic like type 2 diabetes, heart disease and cancers.
Tasty sample recipes weekly meal plan and suggestions for other evidence based lifestyle behaviours for good health. Written by Garry Egger with Anja Sussman, Sebely Pal, Joanna McMillan and Shivaun Conn. A workbook of The Australian Lifestyle Medicine Association at a special discount price for our members. Please remember to login into the website to get your special members only price. Visit the ALMA website on www.lifestylemedicine.com.au to purchase your eBook now!!! Amazing Eduventure – Sydney Tall Ships – 1 – 2 November 2014 Come on board for an Eduventure, where you will learn the essential ingredients of Lifestyle Medicine in Module 10: Improving Efficiencies and Outcomes from Better Chronic Disease Management PLUS have an amazing adventure along the way. An experience aboard a Tall Ship allows you to spend the time needed to take in the breathtaking views, the spectacular fragrance of her tar and timbers, listen to the creaks of the ship, taste the salt in the air and enjoy the peace and quiet as the ship glides silently through the water. Come along , join the ALMA team and feel the love and joy that sailing provokes! Contact Tanja to register on 0414726773 or email email@example.com. PLACES ARE LIMITED SO GET IN EARLY!! Registrations CLOSE 29th August 2014!! Register online http://lifestylemedicine.com.au/event/sydney-tall-ships-eduventure/ ALMA Website Has gone LIVE. Part of the security update will be for ALL members to update their passwords. Please reset as per the email you received. Content management is an ongoing process and we apologies for any inconvenience whilst we update the pages over the coming months. We have had some fantastic feedback about the new site already. Your feedback is invaluable and we look forward to hearing from you. NEW LIFESTYLE MEDICINE COURSES Are you a health professional who’d rather be building fences at the top of the cliff than picking up bodies at the bottom? A post graduate-qualification in the world’s first on-line ‘Lifestyle Medicine’ program by world’s leading experts may be what you’re looking for. For more course details and applications click on the link (http://scu.edu.au/coursesin2014/? action=matrix&command=matrix_temp_load&spk_no=301815#award-rules-hdr) and go to part B (specialisations – Lifestyle Medicine) or call Dr Garry Egger on 61 2 99777753 or eMail firstname.lastname@example.org. HOLD THE DATE Date set for next ALMA Conference – 16th – 18th October 2014 – Brighton Le Sands Novotel in collaboration with ANZOS – Australian New Zealand Obesity Society. Social Media Follow us on Twitter - @ALMALifestyle -- JOIN US on Facebook – Australian Lifestyle Medicine Association – soon you will be able to register for events from our facebook page – keep updated on latest events and much, much more. Professor Trims Newsletter – Have you missed one? It’s okay they can be viewed on the ALMA Website under the ‘News & Events’ tab and click on ‘Newsletters’.
Until April issue ……. Take care of YOU……Cheers Tanja
lifestyle e-news Your ALMA Committee Caroline West - President Joanna McMillan – Vice President Garry Egger – Secretary, Conference Organising Sub-Committee John Stevens – Treasurer David Colquhoun - Conference Organising Sub-Committee Cam McDonald – Newsletter Editor, Conference Organising Sub-Committee Kate Marsh - Newsletter Editor, Conference Organising Sub-Committee
New Website We have gone LIVE with a new website www.lifestylemedicine.com.au Content management will continue as the web pages and benefits to members grow! ON SALE NOW – NEW eBook The ALMA Eating Plan for People and Planet – remember to sign in for the Member discount!
Upcoming Events National Forum - Incentivising a Healthier > Australia - March 6th, Museum of Contemporary Art, Sydney . The forum will be looking at the debate of the 'carrot' versus 'stick' approach when it comes to encouraging healthier behavior to combat rising obesity and chronic disease. http://resources.aia.com.au/index.php/email/e mailWebview?mkt_tok=3RkMM
Issue 14 February 2014
LIVE A LITTLE – Investing time in life beyond medicine will benefit you and your patients! This was the heading on an article written by Dr Caroline West (ALMA President) for the Australian Doctor a while back and now we see the development of GP Wellness modules, meditation and mindfulness strategies being put together to roll out across the general practice network. Caroline is passionate when it comes to Lifestyle Medicine and is keen to support her colleagues to enjoy the balancing act between work and life. Removing barriers on why GPs don’t take holidays such as:
• • • • • •
Inertia – how do you start incorporating breaks into your schedule Concerns about increased workload on colleagues Cost and availability of locums Patient reactions Financial concerns Fears about getting back into a work routine after a break
Sharing 6 good reasons to take a holiday:
1. Rest, relax, recharge. 2. Time to connect with family and friends, shared memories and 3. 4. 5. 6.
experiences can draw you closer. Meet new people. While most doctors meet new people everyday, there is a difference when you are on holiday. You are meeting people without being their doctor, which can be liberating. Adventure, learning new skills. Trying something a little different. Happiness. If you holiday in Australia you can tell yourself you are doing your bit to stimulate the economy.
Taking the time to be mindful of simple daily things and utilising mindfulness based stress reduction can provide many benefits, including:
• • • • • •
Improved immunity Reduced stress, anxiety, depression Increase in empathy Improved sleep Reduction of chronic pain Greater use of positive coping skills such as engagement and prioritising
WANT TO KNOW MORE? HOST YOUR OWN WORKSHOP? To learn more about these workshops, session times and when you can host a workshop in your area please contact Tanja McLeish, CEO on 0414 726 773 or send your request and contact details via email to email@example.com.
Issue 14 February 2014
Is your competition using the internet to steal your customers? It’s amazing to think that only 43% of businesses have a website. Yet over 90% of Australians are online and actively searching. Have you got a proper website? If you were thinking online was only for big business, think again. 1 in 5 Google searches is local. So if you don’t have a serious web presence and people are looking for you, where are they going... your competition of course. So could it get any worse? The answer is Yes. Even if you have a website but don’t have a mobile version, you could be missing out on the 1 in 3 people doing a local search. Now that’s big business to be missing out on. So what can you do about it? Get a web presence and make sure your site is optimized for mobile. The internet should now be your number one marketing channel as it’s the number one way consumers find local businesses. And if you have a website, make sure you’re out ranking your competition for keywords your customers will use to find your business. If they out rank you, then you’re missing out on a lot of business. Mike Sandys is the Managing Director of Oddball Web Solutions. An innovative web design company who build websites that deliver a significant Return-On-Investment. They’re experts in high Google rankings, Adwords and Social Media Management. Checkout their website at http://www.oddballwebsolutions.com.au
Conference: Exercise as Treatment for Chronic Disease-What is the Evidence? 1st May 2014 (Gold Coast, Qld)
Australian Musculoskeletal Network (AMSN) Seminar: Connecting Practice. 15th March, 2014 (Byron Bay)
Exercise is highly effective, but poorly used, treatment for a
The AMSN exists to provide quality inter-professional
number of conditions including cancer fatigue, cardiac
development opportunities for practitioners,
rehabilitation, graded exercise for CFS, osteoarthritis,
researchers and academics engaged in musculo-skeletal care. This
obesity, lower back pain, falls prevention and diabetes.
seminar, Connecting Practice, will show how collaboration
Speakers, including our own Professor Garry Egger have been invited to provide the evidence and rationale for the different types of exercise for different clinical conditions, practical tips on the "how to" of different disease-specific exercise regimes, evidence of a variety of clinical conditions where exercise has been found to be most effective and discuss some of the important cognitive, social, and logistical issues that form part of an effective "exercise prescription". More information and registration details can be found at http://www.exerciseastreatment.net.au/
between professions improves practice, client outcomes and your business. Together with some of the best speakers in their fields you will connect and/or re-connect with: new knowledge about the state of your current & future clientele; the use of evidence and research that can improve practice; and specialist clinical skills. As well you will connect with other musculo-skeletal focussed professionals and the services they offer. More information and registration details can be found at http://amsn.com.au/
Issue 14 February 2014
Lifestyle and Brain Health. Cam McDonald Are you combining lifestyle medicine to get the best out of your brain? The old idea that your brain cells disappear never to return after each alcoholic drink, may have served a small purpose in reducing some consumption. However, it gave little hope to those who wanted to unwind the damage caused by a fun 20’s, 30’s experience. The good news from the last 2 decades is that your brain is a busy reproducer of new brain cells, and this phenomenon extends into your 60’s and beyond. This is timely news, as the rate of mental disease including Depression, Anxiety, Bi-polar disease, Alzheimer’s, Dementia and others is rapidly increasing and currently affects 20% (3.2 million) of Australians aged 16 to 85. Evidence supporting lifestyle medicine to reduce this burden have become more substantive in recent years, such that recommendations are becoming more objective and specific. Exercise One of the commonalities to a number of mental conditions is a decrease in the size and function of the hippocampus, a brain region used for memory, focus and attention. Similarly, there seems to be a marked reduction in the production of a critical neurochemical, brain derived neurotrophic factor (BDNF; AKA: Brain Fertiliser). This hormone is responsible for the production, maintenance and survival of baby, old and growing neurons. Not to mention it is extremely anti-inflammatory and produces neuroprotective antioxidants. Aerobic exercise, and to a lesser extent resistance training have been shown to not only reverse the age related wasting of the hippocampus, but has been shown to reverse this process resulting in an INCREASED brain volume in >60 yr olds. The study by Ericksson et al had older guys run on a treadmill for 45 minutes, 3 times/week for 12 months. Compared to control, the hippocampal volume increased 1-2%, compared to a decrease of 1-2% in control. In addition, without any cognitive specific training, visuo-spatial memory (a hippocampus task) improved in the exercise group. Match these findings with the promising data on early cognitive decline and depression, exercise is the wonder drug for brains – prescribe it today! (Check out Exercise is Medicine website for more info on the benefits and prescriptions) Long story short, exercise increases brain function and reverses the effects of ageing in an area specific to mental disease. Nutrition Just like the heart, the brain needs fuel, and it also needs the right building blocks to tackle the challenge of growing and maintaining brain cells. AND, just like the heart, a Mediterranean diet profile is looking like your best bet to enhance cognitive health and prevent age related decline in some measures. Indeed, it has even been shown to be linked to an increase in BDNF and reduced rates of depression. In addition, individual nutrients have raised some interest. Since neurogenesis is the critical element of good cognitive function, nutrients that stimulate and support this growth are going to be key to healthy brains. Omega-3 from fish, krill, calamari!!!, particularly that which is high in DHA have been shown to be important elements in brain growth, and a meta-analysis indicates it’s also pretty handy for depression. Not only does omega-3 improve vasculature as we know from cardiac research, but synaptic membranes consist of up to 40% DHA omega-3 – an essential building block. Other nutrients worth noting include folate, B12 and flavonoids; spices like turmeric and cinnamon also have an effect on brain related optimisation. The combination Recent research is even showing that pairing exercise and omega-3 together may have synergistic effects. Not only from an antiinflammatory perspective, but providing BDNF release for the growth of brain cells, and adding a critical building block (omega-3 DHA) may significantly improve neurogenesis – an interesting idea rather than continually analysing individual modalities!
lifestyle e-news Continued from page 6…. The combination The brain is something you can impact and FEEL today! Heart disease might be 20 years away, longer if you keep up with ALMA, but your meeting with the boss, or new client that you’ve got to nail will be influenced by lifestyle today! Get out there, move, eat good foods and watch your brain improve every day well into your older years. References: 1.
Adherence to a Mediterranean diet, cognitive decline, and risk of dementia. JAMA : the journal of the
American Medical Association 2009, 302(6):638-648. 5.
Cosiales P, Martí A: The effect of the Mediterranean diet on plasma brain-derived neurotrophic factor (BDNF) levels: the PREDIMED-NAVARRA randomized trial. Nutritional neuroscience 2011, 14(5):195-201.
Campbell S, Macqueen G: The role of the depression. Journal of psychiatry & neuroscience :
Erickson KI, Voss MW, Prakash RS, Basak C, Szabo A, Chaddock L, Kim JS, Heo S, Alves H, White SM et al:
cohort studies. J Hum Nutr Diet 2013, 26(1):56-70.
and improves memory. Proceedings of the
From the Journals Poter et al. Obesity and physical frailty in older adults: a scooping review of lifestyle intervention trials. J Am Med Dir Assoc. 2014 Jan 17 [Epub ahead of print] Wolever et al. A systematic review of the literature on health and wellness coaching: defining a key behavioural intervention in healthcare. Glob Adv Health Med. 2013 Jul;2(4):38-57. Martinez-Gonzalez et al. The major European dietary patterns and metabolic syndrome. Rev Endocr Metab Disord. 2013 Sep: 14(3):265-71 Hutfless et al. Strategies to prevent weight gain in adults: a systematic review. Am J Prev Med. 2013 Dec;45(6) Strath et al. Guide to the assessment of physical activity: clinical and research applications: a scientific statement from the American heart association. American heart association physical activity committee of the council on lifestyle and cardiometabolic health and cardiovascular, exercise, cardiac rehabilitation and prevention committee of the council on clinical cardiology and council circulation. 2013 Nov 12;128(20):2259-79 .
Sanhueza C, Ryan L, Foxcroft DR: Diet and the risk of unipolar depression in adults: systematic review of
Exercise training increases size of hippocampus
National Academy of Sciences 2011, 108(7):30173022
Sanchez-Villegas A, Martínez-González MA: Diet, a new target to prevent depression? BMC medicine 2013,
JPN 2004, 29(6):417-426. 3.
Sánchez-Villegas A, Galbete C, Martinez-González MA, Martinez JA, Razquin C, Salas-Salvadó J, Estruch R, Buil-
hippocampus in the pathophysiology of major
Féart C, Samieri C, Rondeau V, Amieva H, Portet F, Dartigues J-F, Scarmeas N, Barberger-Gateau P:
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Gomez-Pinilla F: Brain foods: the effects of nutrients on brain function Nat Rev Neurosci 2008, 9(568-578).
Hoelscher et al. Position of the academy of nutrition and dietetics: interventions for the prevention and treatment of pediatric overweight and obesity. J Acad Nutr Diet. 2013 Oct;113(10): 137594 Vegting et al. Internet programs targeting multiple lifestyle interventions in primary and secondary care are not superior to usual care alone in improving cardiovascular risk profile: A systematic review. Eur J Intern Med. 2014 Jan;25(1):73-81 Peter et al. Genetic modifiers of cardiorespiratory fitness response to lifestyle intervention. Look AHEAD Research Group. Med Sci Sports Exercise. 2014 Feb;46(2):302-11. Fleming et al. Low-glycaemic index diets in the management of blood lipids: a systematic review and meta-analysis. Fam Pract. 2013 Oct;30(5):485-91 Showell et al. A systematic review of home-based childhood obesity prevention studies. Pediatrics. 2013 Jul;132(1) . Cotter et al. Internet interventions to support lifestyle modification for diabetes management: a systematic review of the evidence. J Diabetes Complication. 2013 Dec 11 [Epub ahead of print]
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