Ginnie Graham: Saying goodbye to pills by encouraging lifestyle medicine specialties in health care - Tulsa World

Ginnie Graham: Saying goodbye to pills by encouraging lifestyle medicine specialties in health care - Tulsa World

In recommending weight loss, a doctor pointed to a wall chart with three diet plans and told me to pick one, it didn’t matter which one.

The lack of distinction between choices like all-protein, high-fat, raw food, low-calorie or plants-only struck me as pretty anti-medical and overwhelming as a patient. The diets didn’t work.

Friends had similar concerns when doctors automatically gave drug prescriptions for problems like sleeping or digestion. It seemed like a bandage, not a cure.

The pill-first, one-size-fits-all approach has grown with each passing generation. Yet, more people are battling chronic diseases such as diabetes, heart disease, depression, insomnia and other disorders.

Dr. Lori Whelan — the George Kaiser Family Foundation Chair in emergency medicine at the OU-TU School of Community Medicine and an emergency room physician at Hillcrest Medical Center — has spent a couple of decades stitching up the poor health of Oklahomans. She went searching for a way to do more than mop up messes.

“I went on my own personal health journey researching plant-based diets and the healing power of food,” Whelan said. “In that research, I learned of a national movement and wanted to bring it to our home institution.”

Surprisingly, nutrition is rarely a big part of medical school, if at all.

Students spend months, and eventually years, understanding how pharmaceuticals interact with the body, but not food. The same training gaps are true of sleep, exercise and social connections.

Increasingly, physicians are elevating consideration of these lifestyle factors. This isn’t a hippie, new-age kind of thing. It’s a medical, science-based and holistic approach to health care. It can reverse some disorders and prevent others.

In October 2007, the American Board of Lifestyle Medicine began offering certifications, which are based around the pillars of nutrition, rest, exercise and social connectivity. About 300 physicians nationally are certified in the specialty.

Starting this year, the OU-TU School of Community Medicine becomes one of the nation’s first to offer a curriculum leading to lifestyle medicine certification.

To explain the philosophical shift, Whelan makes a comparison to infectious disease. When an e-coli outbreak occurs, money is spent finding the source, not in simply treating symptoms.

“With a lot of these chronic illnesses, they are food-borne illnesses just like some of these infectious diseases are food-borne illnesses, “ Whelan said. “We are trying to treat them with pills rather than going to the root cause of the problem.

“Many of these chronic diseases can be significantly improved, and in many cases can be completely reversed or cured by the food you are eating.”

Whelan helped introduce the lifestyle medicine curriculum by developing a culinary medicine course two years ago. The voluntary class gave students hands-on cooking lessons in the context of nutrition prescriptions for common diseases.

Each session fills quickly with many students taking multiple classes to learn about the eight “disease states” covered in lifestyle medicine.

For example, a person with heart disease will benefit from a different diet from those with diabetes, allergies, renal disease, arthritis, pregnancy or gastrointestinal disorders.

One size does not fit all people ... or conditions.

“If food is medicine and doctors are experts in medicine, then we need to be experts in food,” Whelan said. “The more we understand what certain nutrients are in each food and how to put those together into a delicious meal, then we are giving ourselves medicine.”

Beginning this year, these classes became manadatory for all OU-TU medical students.

Chef Valarie Carter was hired to develop recipes and teach students.

Because the medical school has a community focus, each recipe must have ingredients found at a local Walmart, meaning accessible and affordable.

Marianna Wetherilll, an assistant professor of health promotion sciences at the OU Hudson College of Public Health and a registered dietician, was a partner with Whelan in bringing lifestyle medicine to the school.

About 80% of U.S. health care costs are rooted in behaviors that can be modified, Wetherill says.

“A growing body of evidence documents how these factors lead to changes at the cellular level to drive and perpetuate chronic disease,” she said. “Through a comprehensive approach that includes lifestyle assessment, counseling and referral partnerships with community health providers, we can better support patients in their own self-healing processes.”

Faculty at the Tulsa-based medical school and public health college are working together to offer the curriculum.

It is funded by the Ardmore Institute of Health, Oxley Foundation and the Hille Foundation.

The Tulsa campus is known for its interdisciplinary work. Officials expect future crossover from areas such as early childhood or Adverse Childhood Experiences.

“For the university, the intended outcome of this initiative is better preparation of its students across multiple health-related disciplines to tackle many of the fundamental drivers of health in our community,” Wetherill said.

Sleep research is just launching at the university and will be part of the curriculum, said Kent Teague, associate dean for research.

“As a bench researcher studying psychoneuroimmunology, I was immediately drawn to the integrative nature of the science woven through the various branches of study within the lifestyle medicine field. All these branches collectively present a tremendous opportunity to transform the health of our community,” he said.

This has revolutionary potential in the way physicians operate their offices. Doctors notoriously have little time but can surround themselves with professionals to help.

“I tell my students they have to prepare their practice or office space,” Whelan said. “It does not have to be the doctor taking all these steps. But you have to have a system in place that allows for easy referrals to the types of programs they need. You set it as a priority in the practice.”

Lifestyle medicine encourages a team approach to meet that goal.

“Patients are given access to physician-supervised, evidence-based treatment options that can be used to reduce or eliminate the need for medications,” Wetherill said. “Many of these lifestyle changes are no-to-low cost and have a low-to-no-risk profile, which is hard to say about many prescription drugs. So, the potential for cost-savings is huge.”

Oklahoma may be the perfect place for the specialty because of our dismal health status.

About 37% of Oklahomans are obese (No. 3 nationally), 33% physically inactive (No. 3), 13% diabetic (No. 8) and 12% smoke (No. 12), according to the United Health Foundation. The state is No. 3 for cardiovascular deaths and No. 6 in cancer deaths.

“The lifestyle medicine curriculum has inspired students to pursue various kinds of patient-care related projects after completion of the course. Also, many students have shared personal changes in their own self-care habits, which is particularly important in protecting against burnout as they embark upon careers that experience high rates of this condition,” Wetherill said.

“If we are talking about the health of communities and really trying to promote health equity, we need to get to a place where providers can speak to all patients, regardless of their walks of life, and support them in making a behavior change.”

2019-09-14 05:00:00Z
https://www.tulsaworld.com/opinion/columnists/ginnie-graham-saying-goodbye-to-pills-by-encouraging-lifestyle-medicine/article_fa1666df-11e2-5ba8-a9d5-b1d4d3c8eb59.html

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