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From Stethoscope to Dumbbell: My Journey into Longevity Medicine

The term "longevity medicine" or "longevity science" has gained popularity as a buzzword or trend. However, I want to clarify that I'm not promoting any extravagant tests, gadgets, supplements, or treatments. Instead, I'd like to share my personal understanding of this concept and how my experiences in medicine and fitness have shaped my approach to it.

Despite working full-time as a medical doctor and undertaking additional courses to enhance my knowledge of fitness and nutrition, it's surprising how many people are unaware that I am also a qualified group fitness instructor. My moonlighting job helped me pick up skills, knowledge and experiences in keeping people healthy. An area that medical education and modern medicine is deficient in. This lack of training around nutrition and fitness in medical school was glaringly obvious to me from my 3rd year of undergrad education. I started to question whether medicine is a career for me. Whilst I came from 2 generations of physicians (my grandfather and both my parents), and my passion to make an impact on health, I quickly realised that medical school was all about accurate diagnoses and treatment of diseases. As much as I enjoyed the scientific methods and saw the advances of acute care, I had a constant sense that I was missing something. Especially when chronic diseases related to lifestyle influences is taught as a growing area of burden. And yes smoking and excessive alcohol is part of history taking, but beyond providing the facts of these negative outcomes, I did not feel equipped with the practical skills to change behaviours and I didn’t even begin to understand why merely telling a patient to eat a ‘healthy diet’ and ‘exercise more’ was inadequate in changing the chronic disease trajectory.

I thought I ate a healthy diet and I knew exercising is good for me, and I found a way to enjoy it, so why are we still seeing an increasing number of patients with diabetes, stroke, heart attacks, and obesity-related conditions? I thought that knowledge equates with action, but this is far from reality. Why did people know what they need to do but still didn't do it?

And as I spent some time in the geriatric wards, I began to wonder whether at some point we would all succumb to diseases associated with aging and live the end of our lives as frail, dependent and lonely individuals.

Going back even further, before medical school, physical fitness is not an area of excellence that I or my parents cared much about (despite both being medical doctors). My school, however, encouraged team sports and athletics, to which I quickly found myself lacking compared to my peers. Fortunately, a school friend took me to an aerobics class at her local gym and I immediately got hooked. I still didn't enjoy any team sports, athletics, swimming or gymnastics, but when my favourite hit song played in the step class, and the instructor had some new choreography, it became a fun challenge. This continued throughout my medical training and I tried every kind of choreographed group fitness classes that had music, some I liked more than others.

By the time I was a young doctor, I had my own medical diagnosis, which didn't have a cure, but my specialist at the time told me my fitness habits may have helped with symptoms, so I kept going. But how did someone like me who had a "healthy diet" and exercise regularly develop endometriosis, not unlike some of the patients I saw? Is it bad luck, since I didn’t have a family history of this condition?

Sleep deprivation is a badge of honour in medical training and the profession. Not getting enough sleep meant that you were working hard and there's a culture that it’s completely normal not to sleep well when your mind is constantly ticking with thoughts about work and anxiety about making mistakes. I underestimated how chronic sleep deprivation and stress could impact my body, immunity, and digestive health. Despite healthy eating and exercising, I couldn‘t compensate for how chronic stress and sleep deprivation affected me. On the surface, I looked like the picture of health and on paper, I had healthy behaviours, but poor sleep had a specific impact on me.

My job as a fitness instructor helped me realise that there are inter-individual responses to physical training. Different people responded differently even with the same combination of exercises and frequency. This was also apparent in my clinical practice where I saw how patients on the same diets experienced different outcomes. Despite the uncertainty, what I started to appreciate was that there were nuances to a 'healthy diet', exercise and stress resilience when it came to the individual.

As a member of the health and fitness industry, I had the opportunity to learn about the latest research in health and performance, as well as gain insights into how people can maintain their health rather than waiting until they develop a disease and then recommending lifestyle changes. This perspective has led me to see health maintenance as a proactive approach based on my experience as a fitness professional, in contrast to the reactive approach of treating symptoms and diseases that I have observed as a medical doctor. In fitness, how well you recover determined your performance and ability to adapt to increasing intensity or stress load. The parallel here in medicine is the baseline level of an individual's health determined how well they would recover from an illness, surgical procedure or cope with chronic disease. There was a common theme of resiliency.

The difficulty in being proactive and building resilience lies partly in that healthy behaviours in our modern society often go against the norm of choosing abundant, calorie-dense foods, sedentary lifestyles, and a culture of constant availability. Many of the negative consequences are not immediate but occur insidiously. These modern comforts and conveniences are at odds with our genetic makeup. The increasing prevalence of lifestyle-related chronic diseases is not a new problem, but relying solely on reactive measures such as medication and modern interventions once the disease has taken hold is unlikely to reverse the trend of declining health, diminished quality of life, and rising medical costs. Furthermore, determining what constitutes ideal health for each individual requires moving beyond generalizations based on population-level health trends, while important, do not sufficiently address the individual responses to our modern environment.

The World Health Organization (WHO) defines optimal health as a state of complete physical, mental, and social well-being, and not merely the absence of disease or infirmity. It is a dynamic and holistic concept that encompasses not only the absence of illness but also includes factors such as lifestyle, environment, and social and economic factors that contribute to overall well-being. The WHO recognizes that optimal health is a fundamental right of every human being and that it is essential for sustainable development and the achievement of social and economic progress.

This is where we need to move away from viewing health as binary or merely the absence of disease and towards one that supports a personalised approach.

As optimal health is not currently prioritized in the medical paradigm, it falls upon individuals to take responsibility for advocating for their own well-being. No single health profession, institution, or specialty can claim ownership of this area, as the individual is the ultimate common denominator. This is why I often describe myself as a generalist, applying scientific knowledge and methods to help individuals assess their needs, provide evidence-based solutions, and connect them with properly credentialed professionals who can assist them in receiving the treatments necessary to maintain their health.

You are in the driver's seat and an active participant versus a passive passenger.

As a practitioner of longevity medicine, my role is to bridge the knowledge gap regarding what constitutes optimal health for each individual. While not all of my patients present with symptoms of disease, they all share an interest in achieving and maintaining metabolic, immune, cognitive, and structural health as well as optimal function.

What unites my patients and their concerns is the desire to enhance two critical areas:

1. Increased reserve or resiliency, which involves the ability to bounce back after an injury or event, and

2. A longer health span, which allows for greater enjoyment of life while minimizing suffering, decline, and disease.

While I am not a conventional physician, nutritionist, psychologist, or personal trainer, I have synthesized the knowledge and expertise of these fields in the hope that I can assist individuals in achieving a better quality of life for an extended period of time.

It is my passion and I hope you can share or comment on the information from my blogs with those you believe will benefit, and help me educate and bring more awareness about taking a proactive approach to health and wellbeing.


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