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Live long and healthy

Leiden University will be 444 years old this year and is still very much alive and kicking. But how can we humans grow old healthily? Hanno Pijl at LUMC is the grand master of lifestyle medicine. He explains how we can all benefit from a sensible - but still enjoyable - lifestyle.

What exactly is lifestyle medicine?

'Lifestyle medicine is adapting living habits as a way of preventing disease. Nutrition plays a role, as do physical activity, sleep, stress, smoking and some toxins. These are largely things that people have under their own control. We're talking about curative care, not about prevention; we work with people who are ill. Diabetes type 2 is the typical example of an illness that can be treated - and even cured - with a more active lifestyle and healthier eating.'

'This branch of medical science is really taking off. The Netherlands Innovation Centre for Lifestyle Medicine (NILG) was set up last July as a partnership between TNO and LUMC.  It immediately attracted a lot of interest from within the Netherlands and internationally. I've got lots of people who want to come and work here as volunteers, patients are interested, and the government, health insurers and pharmaceutical companies are also keen to know more.' 

Why is lifestyle attracting so much interest at the moment?

'That's a good question. We've known for several decades that lifestyle is essential for all non-hereditary chronic conditions, such as heart disease, type 2 diabetes, cancer.  But the way of thinking in medicine hadn't moved on from the 19th century. What it came down to was: for an infectious illness you get pills and accidents are treated by a surgeon.  It took a lot of time before we as docors started to realise that medicines for such conditions as vascular diseases, diabetes and alzheimers don't get to the root of the problem. With these kinds of illnesses, it's all about a person's lifestyle.'

For many people, lifestyle is linked to quality of life. They want their cakes at a party and drink at the weekend. Do people want to hear that they have to reduce these pleasures or cut them out altogether?

'Not all of them do. Many patients come in, sit down and say: doctor, just solve it. As long as they keep thinking that, there's a big problem. At the same time, patients are increasingly telling me that they want to get rid of the pills. You never heard that twenty years ago. The time is ripe for us to give people responsibility for treating their illness. Healthy food  is also getting a lot of attention today.' 

Healthy eating doesn't have such a fun image. How do you convince people to eat healthier?

'You can actually eat much better healthy than unhealthy. If you can find the effort to make the healthy choice, you will discover how delicious that can be, although it takes more effort, and sometimes more money. And I have another sales argument: patients who have started it will almost without exception feel much better. But it's difficult, people have to overcome their resistance.'

Are there ways to help people make the healthier choice?

'Sure, we're developing all kinds of ways. A programme in which we continuously measure the glucose levels of diabetes patients for six months, for example. Meanwhile, we are mapping out which aspects of their lives lead to peaks in sugar. This is how we arrive at individual lifestyle recommendations.

'We are also going to implement a programme in a general practice in the Stevenshof, in our own clinic and in the Haga hospital in which we look at patients holistically. Not only at biological, but also socio-economic and spiritual factors, and even behaviour. Patients have to monitor their nutrition and sleep. TNO has developed a computer-driven tool to help them; it gives them advice on what kind of interventions would be useful.'

Doesn't that kind of holistic approach come up against a lot of scepticism in the hospital?

'For years what we were doing was seen as bordering on quackery. That's totally not the case anymore. When I talk about my work now, most people are enthusiastic. Even the surgeons and the cardiologists, the hardcore boys. Everyone also knows that the Executive Board is fully behind it. We have to let patients do more themselves, also as a way of getting healthcare costs under control.'

In addition to the care sector and the patient, shouldn't society also change? Are you also taking action to against escalators and fast food?

'Making the environment healthier is certainly worthwhile. It's just not where our focus is; we do the care part. But I always say: if we leave everything to healthcare, we're fighting a losing battle. All the temptations we are exposed to are just too difficult for many people. There has to be some kind of movement in society that puts the brakes on it.'

Are we still allowed to have a party, do you think?

'Of course, and cheating occasionally isn't that bad. I'm not entirely without sin myself. But I pay a lot of attention to my food. Almost everything I eat is fresh, and unprocessed. I also cycle to work and try to be as active as possible. '

This article appeared in our alumni magazine Leidraad, winter 2018-2019 edition

Text: Job de Kruiff
Photo: Erik Buis

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