Have you ever fractured a bone, had surgery or damaged yourself on a sharp object? Almost immediately the whole complex process of healing starts, and after a few weeks to months normal function is restored. Of course, sometimes the injuries are so severe you will never regain full function, but even then significant healing can occur. The human body is incredibly complex and its ability to restore normality is remarkable.
When I first went to medical school (50 years ago) we were taught that after a neurological event, such as a stroke or nerve injury, you would not gain further improvement after 18 months. However, this dictum was shown to be flawed since the process of neuroplasticity was discovered. This is the ability of the neural networks in the brain to change through growth and reorganisation – almost like rewiring the circuitry. Therefore, through rehabilitation and patient effort, a great deal of neurological function can be restored.
The organ with the best reputation for healing is the liver. It is said a liver can regrow to a normal size, even after 90% has been removed after injury. But that doesn’t mean we can abuse it indefinitely. Chronic liver disease can be fatal if we continue to subject it to toxins such as excess alcohol and saturated fats.
But what about chronic conditions such as hypertension, type-2 diabetes mellitus, auto-immune diseases (for example, rheumatoid arthritis, ulcerative colitis and lupus), and certain cancers? Is it possible that these conditions may heal if we are able to provide a healthy environment to facilitate the healing process?
Historically, we as a medical profession told our patients that these conditions were progressive, and needed only management to reduce complications. We seldom offered hope of remission or healing.
The fact is that just as a bone, a brain or muscles and skin can heal after an injury so too is it possible for hypertension, atherosclerosis, lupus and even diabetes to go into remission with the provision of a healing environment in many or most cases.
This is where getting back to basics – understanding the lifestyle factors that contributed to all these conditions in the first place,and changing from harmful behaviours to healthful habits – can bring sometimes dramatic results.
Dr Dean Ornish first published research in 1999 in the prestigious Journal of the American Medical Association, demonstrating that intensive lifestyle changes may lead to regression of coronary atherosclerosis in as little as one year. This was unheard of at the time. In participants on the intervention regime angina settled in most patients within weeks, and future coronary events were largely prevented, compared to those following standard coronary care. Repeat angiograms after one year showed partial opening up of constricted arteries, compared to those in standard care where narrowing increased.
Since then, through abundant research the field of Lifestyle Medicine has demonstrated multiple benefits obtained from adopting healthy habits for most chronic diseases. These include regular physical activity, a predominantly plant-rich, whole foods diet, sufficient restful sleep, meaningful social connections, living with purpose, dealing with stress effectively, and avoidance of harmful substances and addictions.
These behaviours do not eliminate the need for pharmacological and surgical therapies, but must be incorporated in any meaningful interventions by all practitioners. Most national guidelines for chronic disease management state that lifestyle behaviour changes are the foundation of care.
In future articles we will discuss how to implement these behaviour changes to obtain the most benefits to our health and well-being.
- This health column is written by Dr Dave Glass, a retired obstetrician/gynaecologist living in Somerset West for just over a year. He is also chairperson of the South African Lifestyle Medicine Association (Salma). With a MBChB, FCOG(SA) and DipIBLM, he has a passion for preventing and addressing the root causes of chronic diseases such as diabetes, heart disease, auto-immune diseases, obesity, dementia and cancer.
