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Healthy ageing? Shift the focus from the individual to the population

David van Bodegom, Professor of Vitality in an Ageing Population, will give his inaugural lecture on 11 November, also titled Vitality in an Ageing Population. According to Van Bodegom the key to healthy ageing is the lived environment. In the fight against lifestyle-related conditions, he therefore advocates changing our lived environment instead of making individuals feel guilty. Van Bodegom’s chair was established by the Leyden Academy on Vitality and Ageing.

‘Type 2 diabetes, obesity and cardiovascular diseases. These ageing diseases are an enormous problem in the Netherlands when a healthy lifestyle can help prevent or cure them,’ says David van Bodegom. But, he adds, in a lived environment where we sit for hours at the office and have access to unhealthy food at any time of day, healthy behaviour is difficult to maintain. ‘It’s the environment that makes us ill, and that is what we have to address.’

Office fruit

Van Bodegom uses a personal example to illustrate how our environment guides our choices. ‘Since there’s been a bowl of apples next to the coffee machine at work, I’ve been eating loads more of them. Not because I want to but simply because they are there. If we change our environment, our behaviour follows automatically. This makes it more fun and sustainable to maintain a healthy lifestyle.’

Long way to go

The healthcare system isn’t yet equipped for this, says Van Bodegom. ‘It’s easier to prescribe medicine in the current system than to talk to the patient about a healthy lifestyle.’ Fortunately, change is afoot. ‘I’ve noticed that lifestyle is increasingly important to young doctors and medical students in particular. They look further than the consulting room.’ The prevention agreement [an agreement between the government and 70 other parties on improving the population’s health, ed.] and the inclusion of combined lifestyle interventions in the basic health insurance package are also steps in the right direction, says Van Bodegom. ‘But we still have a long way to go.’

Exercise together

To improve the health of elderly people, Van Bodegom and some colleagues started Vitality Clubs. These are groups of elderly people who exercise together a few times a week, completely on their own initiative and without professional support therefore. ‘The clubs are a roaring success. Participants come for their health but keep coming for the company. This shows that the social aspect is more important. The elderly people coach one another to stay healthy.’ Van Bodegom wants to research whether this form of peer coaching also works for people with type 2 diabetes. The Bij de Kwekerij lifestyle programme was recently launched to find out. ‘We are going to research whether an alternative referral route like this can deliver health benefits and can relieve the burden on the healthcare system in a lasting way.’

Health gains

Van Bodegom wants to spend the next few years working with his colleagues to further advance lifestyle medicine. His main message for his audience is that many more health gains stand to be made in the elderly. ‘To achieve this we need to shift our focus from the individual to the population.’

Van Bodegom’s inaugural lecture can be followed via a livestream on 11 November at 16.00.

Source: LUMC. 

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