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A lockdown opportunity to bring lifestyle medicine into the mainstream

Shireen Kassam (left) is a Consultant Haematologist and Lifestyle Medicine Physician and founder of Plant-Based Health Professionals UK. @plantbasedhpuk

Laura Freeman (right) is a dual licensed GP, Lifestyle Medicine Physician and Medical Director of Plant-Based Health Onlin

DOI: Dr Kassam and Dr Freeman are both co-founders of Plant Based Health Online.

It may seem an unlikely pairing for a new project – a Consultant Haematologist and a General Practitioner. Yet Laura and I have come via different paths to the same point in our careers where we want to offer patients a different approach to healthcare. For Laura, it started with her own diagnosis of thyroid cancer 5 years ago and the knowledge that she carried a gene that put her at higher risk of other cancers. This led her to investigate the impact of her own lifestyle choices on future risk of chronic illness. For me, it was when I decided to adopt a fully plant-based diet in 2013 that I began to investigate the impact of diet choice on the risk of chronic illness.

Our personal research into these areas led to a level of amazement and wonder at the power of diet and lifestyle for the prevention and even management of chronic illness. To learn that 80% of common chronic illnesses could be eliminated in Western societies by adopting healthy lifestyle habits was astounding to us. With this new knowledge Laura started using the power of lifestyle interventions in her own clinical practice, which at the time was as a family doctor in Canada. The results she saw in her patients were astonishing. For me, I was becoming increasingly frustrated at the level of chronic illness, such as type 2 diabetes and cardiovascular disease, in the patients I was treating for lymphoma. I had limited resources by which to address these issues that would ultimately impact their cancer outcomes. Both Laura and I went on to sit the lifestyle medicine diploma from the international board of lifestyle medicine in 2019 and it was around this time our paths crossed.

I was becoming increasingly frustrated at the level of chronic illness, such as type 2 diabetes and cardiovascular disease.

Laura returned from Canada to Scotland in 2019 and despite qualifying in the UK as a GP and also being licensed in Canada, was unable to easily return onto the UK GP register. This provided her with the impetus to set up her own private lifestyle medicine clinic and start to work with her community to improve their health through a lifestyle first approach. She was the first doctor in the UK to start up regular Walk with a Doc events and to implement the CHIP lifestyle intervention in a community setting. Then the pandemic struck, lockdown was implemented, and these activities had to be put on hold.

The pandemic had highlighted how underlying chronic illnesses were making the UK public vulnerable.

This is where our shared journey begins. We had both been searching for a way to bring lifestyle medicine to a wider audience. The pandemic had highlighted how underlying chronic illnesses were making the UK public vulnerable to the worst effects of COVID-19. Lockdown demonstrated that virtual consultations with healthcare providers had a number of benefits for the provider and the patient. Lifestyle medicine lends itself perfectly to the virtual setting given that its application is in the chronic rather than acute setting. From this the concept of Plant Based Health Online was born. We wanted to bring together a multi-disciplinary team of healthcare providers to deliver a lifestyle medicine service to everyone that needed it.

There were many hurdles to overcome before getting to the point of launch. We were lucky enough to secure donor funding in for this project in June 2020 as our vision was to be a community interest company that puts profits back into improving the health of families and communities. The main task was to get approval from the Care Quality Commission (CQC) as we felt this was essential for adding credibility to the service we are now providing. It provides patients and their NHS healthcare providers with the reassurance that we are providing safe and effective care. This was by no means an easy task and we opted to engage the services of a consultant to guide us through the process, a decision we never regretted. Most of you reading this article will know what this process entails and the policies and procedures that need to be in place prior to the CQC interview process. It is not something we want to repeat in a hurry but suffice to say the hard work was worth it in the end as we gained approval in mid-December. We are pleased to say we are the first online multi-disciplinary lifestyle medicine service with CQC approval.

Whilst working on the CQC approval processes we were getting together our core team which now consists of three GPs (including Laura), a dietitian, a nutritionist and a health coach. They have all been through an onboarding and induction process as with any healthcare provider. We have a GDPR compliant virtual consultation platform called Heydoc, which is also linked to an online pharmacy and laboratory such that the GPs in the practice can offer these services as required. We plan to hold clinical meetings and case discussion as our workload increases so that we can learn from each other’s expertise and experience.

A plant-predominant diet is optimal for human health and is associated with the lowest risk of chronic disease.

Why are we called Plant Based Health Online? Because we wanted to be upfront with patients about our dietary approach. The weight of evidence confirms that a plant-predominant diet is optimal for human health and is associated with the lowest risk of chronic disease. This is the approach has been adopted by the American College of Lifestyle Medicine, which sets international recommendations in this growing field of lifestyle medicine. In practice this means obtaining 85-90% of calories from whole plant foods; fruits, vegetables, whole grains, beans, nuts and seeds. If patients want to be fully plant-based, we will help them achieve this in a healthy way. Not only is this approach healthy for humans but it is now essential for planetary health as we highlighted in our previous article. Without a healthy planet there are no health people and therefore our fate is intertwined with the current climate and ecological crises.

Our fate is intertwined with the current climate and ecological crises.

We opened our virtual doors on January 26th, seven months after first coming up with the idea. We have had a number of inquiries and bookings from just the types of people we were expecting. Those with recently diagnosed illnesses such as heart disease, hypertension, cancer and type 2 diabetes who are seeking a more holistic approach to managing their health. We hope in time that by demonstrating the impact and efficacy of our service that the NHS will be willing to commission this for all patients who are motivated to make lifestyle changes to improve both their physical and mental health. Interestingly we have had a significant number of inquiries from doctors and allied health professionals who want to join our team.

We know that although healthy habits require commitment, evidence-based lifestyle medicine works very well in the real world – for those young or old, healthy or chronically ill. We also know that it offers a refreshing shift in practice for doctors and allied healthcare professionals alike. So, as we move forward in 2021, we are eager to both showcase the success of our patients and highlight the power of optimal nutrition and sustainable healthcare.

Featured photo by Drahomir Posteby-Mach on Unsplash

37 Comments

  1. What a great initiative. Let’s hope the NHS sees the value of lifestyle medicine and makes this service accessible to all.

    • Very very interesting article and makes me very happy to hear about the development of this aspect of medical help, which is so important in our life.

  2. This is a game changing health service and one which provides evidence-based diet and lifestyle advice to enable patients to regain control of their health and to feel empowered to continue. There has never been more of a need for lifestyle medicine than the current climate.

  3. Great initiative!
    It is time for the general public to be educated in evidence based lifestyle medicine. GPs are best placed to spread the message to their patients. I believe this is already happening!

  4. A much needed service, good for human health and planetary health! Lifestyle medicine has much to contribute to improving quality of life for everyone! All GPs should become involved in promoting and practicing Lifestyle medicine and all schools should teach the subject. Thank you for a great article!

  5. What an excellent initiative! Advocating lifestyle medicine is not only important but also very much needed right now. I hope it becomes mainstream. Thank you!

  6. How wonderful! This is such an essential service that we need now more than ever. Shocking that 80% of common chronic illnesses could be eliminated by adopting healthy lifestyle habits. I hope the NHS realises how important this is and helps make it accessible to everyone. Good luck!

  7. What an amazing and trailblazing service to provide true benefit in addressing the root causes of our current epidemic of chronic disease and help people to lead healthy and vital lives. Wishing this amazing team great success.

  8. This is such an amazing initiative! This needs to be heard by everybody. Thank you BJGP and PBHO for putting this out there!

    • This is a radical enterprise which arrives at a crucial time for both personal and environmental health. It should be fully endorsed. Wishing you every success in all your endeavours.

  9. Thank you for taking the plunge and bringing this incredible service to life. I love how you link human health with the health of the environment, this aspect is so often missing in healthcare debates. Plant-based health is the future.

  10. A valuable service that is currently missing from our reactive healthcare system. Thank you for starting this initiative and using an approach that can tackle the root cause of many chronic diseases that stem from poor quality diet and lifestyle habits. This will no doubt help many, many patients regain their health and transform lives.

  11. This is a much needed initiative! Finding true evidence based health care in a world of sick care. So many people are going to be able to make real long term lifestyle and positive health changes with the help of this wonderful offering. Congratulations! Thank you for all you are doing.

  12. What an exciting time for you both professionally, and for the medical profession as a whole. Best of luck, and as a psychiatrist I would be fascinated to understand more re best ways to support behaviour change for your patients

  13. Such a great resource and initiative. I’ve seen first hand how switching to a plant based diet has been beneficial to myself (and the world!) and I’m excited to add in the other aspects of lifestyle medicine to my life. Will be following this with interest!

  14. A new and obviously successful approach to prophylaxis and treatment of chronic lifestyle illness. Hope this is universally adopted. I shall look forward to seeing its progress.

  15. With healthcare at breaking point, there has never been a more pressing need for an overhaul of how chronic illnesses are both managed and prevented. You’re doing a wonderful job in arming medical professionals and patients with a different approach entirely, backed by compelling evidence. I wish you every success.

  16. What a trailblazing and important project! Great to read about all the progress you’ve already made – thanks to your hard work and expertise. Well done and I hope the NHS gets on board with this soon…

  17. Such important work. I love the holistic approach backed by evidence and science !! The best of both worlds. Amazing endeavour and I will be following along the journey !

  18. Your passion and commitment to helping your patients be better is nothing short of inspiring. I love the EBM approach as much as the compassion and ingenuity in your venture.

    I look forward to see all that you two will achieve!

  19. Great initiative. I hope to see this exciting endeavour go from strength to strength and ultimately be taken onboard by the NHS

  20. There is a vital need for this amazing facility for both personal health and that of the planet. Your dedication to drive this forward is inspirational. I am sure this project will achieve the success it clearly deserves.

  21. Finally an accessible, professional and CQC registered platform to heal people and planet. Going to the root cause of poor outcomes for patients with Covid too.

  22. At last a real step forward to finding solutions for chronic illness caused by diet and lifestyle.
    Wishing much success to all involved in this.

  23. Lifestyle medicine must be the medicine of the future. More and more evidence is seen everyday for the benefits of a plant based diet, for prevention and treatment of a wide array of conditions that cause so much suffering and cost so much to society. Which conditions? The ones we see in the clinic every day! Hypertension, diabetes, ischaemic heart disease, autoimmune disease including inflammatory bowel disease, skin conditions, early stages of cognitive impairment, chronic kidney disease and so many more. A plant based diet is promoted by the American College of Lifestyle Medicine, the body which is responsible for the Lifestyle Medicine curriculum and the internal examination for certification. While not all patients may be ready to adopt beneficial lifestyle changes, it is our responsibility as physicians to become knowledgable enough to offer the choice, and even to lead the way by our own personal health choices.

    • Great CQC approved initiative!
      As an NHS GP practicing Lifestyle Medicine, I hope to see more GPs and AHPs incorporate this in the daily practice and this is the way forward to help our patients and to have a healthy planet!

  24. An excellent initiative ! Congratulations on seeing your hard work come to fruition. If only all patients has access to comprehensive supported lifestyle intervention programmes such as this; I could twiddle my thumbs 80% of the day ! 😉

  25. What an inspiration! I truly believe this will become mainstream medicine and we will one day look back at our reactive approach to I’ll health. Huge kudos to you both for progressing this movement.

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