13 March 2024

Lifestyle medicine is an innovative approach to healthcare that emphasises the role of daily habits and behaviours in the prevention, treatment, and management of chronic diseases.

By addressing the lifestyle factors that contribute to chronic health conditions, lifestyle medicine can reduce the burden on healthcare systems and improve the quality of life for individuals. Moreover, lifestyle medicine empowers patients to take control of their health. It provides them with the tools and knowledge to make sustainable lifestyle changes that can have a lasting impact on their well-being.  

What is lifestyle medicine?

Lifestyle medicine focuses on six primary areas: nutrition, physical activity, stress management, sleep, social connections, and avoidance of risky substances. Unlike traditional medicine, which often focuses on treating symptoms with medication or surgery, lifestyle medicine seeks to address the root causes of chronic diseases. 

Integrating lifestyle medicine in clinical practice 

Dr Ajaz serves as a specialty doctor in hepatology at the Institute of Liver Studies, King’s College Hospital NHS Foundation Trust (NHS FT), and is a certified lifestyle medicine physician. Her approach to treating patients with Metabolic-Associated Steatohepatitis Liver Disease (MASLD) uniquely integrates principles of lifestyle medicine. Holding a PhD in Diabetes, Endocrinology, and Metabolism from King's College London, Dr Ajaz leverages her extensive research and clinical expertise to pioneer advancements in this field. Here are a few examples highlighting her innovative use of lifestyle medicine: 

New Horizons: The MASLD clinic's journey to lifestyle enlightenment 

Dr Ajaz conducted a clinical audit to assess the impact of lifestyle medicine on patient outcomes within the Liver MASLD clinic, where lifestyle advice was integrated into patient consultations. Over a 12-month period, patients who received this comprehensive care were followed up to gauge the effectiveness of the intervention. Remarkably, 84% of these patients achieved an average weight loss of 5.3%. This modest reduction in weight was associated with notable improvements in clinical parameters, underscoring the significant health benefits of lifestyle modifications. 

Formation of the patient support group for MASLD-LIVFIT 

In her clinic, Dr Ajaz initiated an online survey to understand patient preferences for support mechanisms that could aid in managing MASLD. Feedback from the patients led to the formation of the first interactive patient support group for MASLD at King’s College Hospital NHS FT - LIVFIT in June 2019. This group organises meetings every two months and invite experts in the field of lifestyle medicine. Till now the invitees have included nutritionists, world renowned physical activity experts, culinary experts, experts on stress management, liver consultants, osteopaths, experts on obesity related sleep disorders etc.  

Members of this group have also become research champions and leaders in patient and public involvement and engagement (PPIE), aiding in the initiation of new studies. They have presented at international forums. 

Assessing gaps in awareness and interest in lifestyle medicine for chronic metabolic diseases 

In collaboration with Lambeth diabetes team, Dr Ajaz conducted a service evaluation project in which she screened a high-risk diabetes group for undiagnosed MASLD. Those who agreed to participate were provided with structured questionnaires on diet, physical activity, and MASLD knowledge. Data showed that 54% of the subject had fatty liver and 26% had liver fibrosis in this multi-ethnic high-risk group. Overall, the average BMI was 32kg/m2 but only 48% of patients considered themselves to be ‘overweight’. A staggering 99% of the study group expressed a keen interest in receiving more detailed guidance and a multidisciplinary approach from healthcare professionals regarding lifestyle modification.  

Charting the course for health: Vision for ‘lifestyle hubs’ 

Dr Ajaz has been advocating for the creation of ‘lifestyle hubs’ in both community and hospital settings. Drawing inspiration from the Multi-disciplinary Clinic (MDC) model, these hubs are to transform the healthcare experience, making it more holistic, efficient, and tailored to individual needs. By championing ‘lifestyle hubs’, Dr Ajaz envisions a future where patient-physician communication is significantly enhanced, leading to deeper understanding and better health outcomes.  

The time is now 

Lifestyle medicine offers a path forward, one that is sustainable, effective, and aligned with the needs of the population. As we look to the future, the question is not whether the NHS can afford to integrate lifestyle medicine, but whether it can afford not to. The time to revamp healthcare is now, with lifestyle medicine leading the way towards a healthier, more resilient society. 

*Dr Saima Ajaz (BSc, MBBS, MPhil, PhD, Dip IBLM/BSLM), Speciality Doctor Hepatology and Lifestyle Medicine Physician, Institute of liver studies, King’s College Hospital NHS FT, and Honorary Senior Clinical Lecturer, School of Immunology and Microbial sciences, King’s College London. 

What to find out more?  Join Dr Camille Hirons and Dr Saima Ajaz, at the King’s Health Partners Primary Care Webinar on Wednesday 20 March, 1pm-2pm.  Register here.