Move, Nourish, Recover. Lifestyle Medicine for Better Healthspan & Lifespan with Dr Aisling Farrell.

My name is Dr. Aisling Farrell. I’m a GP with a specialist interest in lifestyle medicine and the service lead for the Lifestyle Medicine clinic in UPMC Swords. Today I’m going to present Move, Nourish, Recover, Lifestyle Medicine for better healthspan and lifespan.

So today we’re going to explore what exactly lifestyle medicine is, how everyday habits can have a profound impact on our health, and I’m going to give you some simple practical steps that you can begin applying in your own daily life.

So, if you’ll indulge me, I’d like to begin with a very short experiment. Now, don’t worry. This isn’t any mind tricks. This is just a fun short experiment to start us off. So if you’re comfortable,
I’d like you to gently close your eyes. Picture yourself standing in your kitchen. In front of you on the table, there’s a wooden chopping board. Resting on it is a fresh, bright yellow lemon alongside a small knife. Now, in your mind, reach out with your right hand and pick up that lemon. Feel the slightly uneven textured skin. And as you hold it up, you can catch a faint, sharp citrus scent beginning to rise. Now, I want you to place it back on the chopping board. Imagine taking the knife and carefully slicing through the lemon. You hear the soft resistance of the skin giving way. The moment it’s cut open, the smell becomes stronger. It’s sharp. It’s zesty and instantly refreshing. You can see the yellow flesh glistening inside with tiny drops forming along the edges. Now, I want you to bring one half of the lemon up towards your mouth. Just imagine taking a big bite into it and taste that burst of intense sourness across your tongue. Now open your eyes. Did you notice that your mouth started to water?

What’s fascinating here is that the lemon isn’t real. Yet many people still have a physical response. That’s because the connection between our brain and body is remarkably powerful. Our thoughts can shape our physical reactions, influence emotions, and ultimately guide our behaviours. And that’s where lifestyle medicine begins.

If a single thought can trigger a measurable bodily response within a couple of seconds, consider the impact of the thoughts, the habits, and behaviours we repeat every single day over months, years, and decades. These patterns shape our health far more than any single event ever could. Lifestyle medicine recognises that many of the key drivers for long-term health, like how we eat, move, and sleep, are rooted in our daily thoughts and choices. So, by understanding and intentionally shaping these patterns, we can harness that same mind-body connection that made us salivate at an imaginary lemon to create lasting improvements in health and well-being.

So, now I’d like to introduce you to my patient, Mark. Mark is a 42-y old man. He works in finance and is married with two small children. His day starts early, but he’s usually rushing to get everyone out the door, so his breakfast is often skipped. He faces an hour commute each way and spends most of his working day sitting at a desk or in meetings. Work is very demanding with tight deadlines and constant emails. So, to keep going, Mark relies on five or six coffees throughout the day. By the time he gets home, he is exhausted and has very little energy left for exercise. His evenings are busy with family responsibilities. So once the children are in bed, Mark likes to unwind with a couple of cans of beer while watching Netflix.
Mark came to see me in clinic. He said, “I’m exhausted all of the time.” He said he had constant fatigue and low energy. He felt overwhelmed by all of the conflicting health advice that he found online. He had quite a strong family history of heart disease and was quite concerned about his future health. He was unsure where to start or what was going to actually work.

So, in the clinic we did a number of investigations. Firstly, during his questionnaire we identified that he had quite low levels of physical activity. He had a high consumption of red meat, minimal fibre intake, and quite high saturated fat intake in his diet. His alcohol intake was above the HSE low-risk alcohol guidelines. And his questionnaire found that he had quite a high stress load. He also was noted to have a significant family history of cardiovascular disease and diabetes.

On his clinical examination, we noted that his blood pressure was elevated. And when we measured around his waist, we noticed his circumference was elevated. His bloods identified high cholesterol levels, particularly his LDL cholesterol, and his blood showed markers that were concerning for pre-diabetes.

On his functional assessment, then we noted that he had low VO2 max or reduced cardiovascular fitness and his grip strength was also reduced. I asked Mark what his goal was and he said, “I just want the energy to be able to play football with my kids and be around for them as they grow up.”

Mark said that he had tried multiple approaches over the years. He had done walking programs, running plans, diet changes, but always had this fresh start every single Monday. He could never maintain the changes long term, and he felt really frustrated, guilty, and like he was failing. And it wasn’t as if Mark didn’t know what to do.

He already did know what to do. The question here is why is it so hard to actually do these changes consistently? So why does all of this matter now? Well, as you saw in Dr. Gallagher’s presentation, the leading causes of illness and death are chronic conditions like heart disease, respiratory diseases, cancer, and dementia. And the important point is that many of these conditions are strongly influenced by our lifestyle. In medicine, we have become really good at extending our lifespan or how long people are living. But I think today’s biggest health challenge is actually our healthspan.

This is the number of years we actually are living in good health with energy, independence, and quality of life. The goal here simply isn’t to add years to our life. rather it’s about adding life to those years. So, this is where lifestyle medicine comes in. This is an evidence-based approach that uses healthy daily behaviours to prevent, treat, and in some cases even reverse chronic disease. This is not about adding more information. Rather, it’s about turning evidence into consistent real world behaviour change.

It focuses on six pillars that influence almost every chronic disease pathway, including healthy eating, physical activity, sleep, stress management, social connections, and avoiding risky substances.

Now, we already see this working in the real world. Researchers have studied regions of the world where people live longer and healthier lives, and these are known as the blue zones. They include regions all over the world from Italy to Japan and Costa Rica. And what’s striking is that these populations are very different culturally, but they share remarkably similar habits. They tend to move naturally throughout the day. They eat mostly whole foods. They maintain strong family and social connections. And many have a very clear sense of purpose.
These communities don’t just live longer, they tend to live better for longer. And in many ways, lifestyle medicine is the clinical translation of these patterns. So, when we look at the six pillars of lifestyle medicine, I like to simplify it into three main themes. Move, nourish, and recover.

Movement

And movement comes in many different forms. Aerobic activity supports our heart health and our lung health. Strength training protects our muscles and bone and balance and mobility help maintain independence as we age. The benefits from being physically active are almost immediately present. Even a single bout of exercise can improve our mood, reduce our stress, and boost our energy levels. And over time, movement can improve things from our blood sugar control. It reduces our cancer risk and supports cardiovascular health.

VO2 max is a measure of aerobic fitness or how efficiently our body uses oxygen during activity. It’s also one of the strongest predictor of long-term health and longevity.

One of the very earliest examples of this importance comes from the London bus study in the 1950s. This compared bus drivers who spent most of their day sitting with bus conductors who regularly climbed stairs while working. And despite sharing the same environment, the conductors have a significantly lower rate of heart disease than the bus drivers. The message is clear here. Movement matters. Both structured exercise and everyday activity like walking or gardening.

I think a common misconception here is that exercise only counts though if it’s very long or intense. However, small bursts of movement throughout the day can have some real health benefits and these are sometimes called exercise snacks. So, this can be something like a few squats waiting for the kettle to boil or walking during phone calls or even taking the stairs. The key here is consistency and making movement a regular part of your daily life.

When people think about exercise or being physically active, they often think of these cardiovascular areas. But maintaining strength is just as important. As we age, we naturally lose muscle mass and strength. And without intervention, this can affect our balance, our mobility, confidence, and even our independence.

Strength training helps preserve our muscle, maintain our bone health, and reduce fall risk, supporting our quality of life as we get older. The image above illustrates this clearly. This study showed that researchers compared older adults who stayed physically active throughout their life with those who are more sedentary. In the MRI scans that you can see here, muscle appears darker grey while fat tissue appears white. The active 70-year-olds retained muscle mass similar to someone in their 40s. Whereas those who were sedentary by contrast showed mark muscle loss and significantly more fat infiltration within the muscle.

I think the encouraging news here is that strength training does not have to mean lifting heavy weights in the gym all the time. This can include resistance band exercises, body weight movements, things like Pilates, gardening, any activity really that challenges your muscles regularly.

Strength is about much more than building muscle. It helps us to continue doing the everyday activities that matter. Whether that’s climbing stairs, carrying groceries, or playing with our grandchildren as we age.

So, a simple test that we can try at home right now is the sit-to-stand test. So, what I’d like you to do in your chairs is cross your arms and put your hands on your shoulders. I want you now to stand up from your chair without using your hands. Were you able to do it? This may seem very straightforward, but it provides a very useful indication of lower body strength, balance, and functional fitness.

So, knowing movement is important is not the same as having a plan that actually fits into your life. Exercise is important for Mark, my patient, to reach his goals, but it was also important to improve his health markers.

As a reminder, his goal was to have energy to play football with his children and be around for them as they grow up. For Mark, we agreed on two priorities in regards to activity.

Number one was to increase his daily steps to 5,000 a day and to track this on his phone. And number two was to add two at home body weight workouts of 30 minutes each.

Nutrition

The next scene we’re going to move on to is nourish. Every day we make dozens of food choices and over time those choices become patterns and those patterns shape our health. Food influences everything from our energy levels, our mood, blood sugar control, our gut health and cardiovascular risk.

One of the most researched eating patterns in the world is the Mediterranean diet. This pattern has been consistently linked with lower risk of heart disease, stroke, diabetes, and cognitive decline. It’s rich in plant-based foods, whole grains, healthy fats like extra virgin olive oil. It’s moderate in fish, eggs, and poultry, and low in foods like red meat or ultra processed foods high in sugar. Importantly, this is not about strict rules or perfect eating. Rather, it’s about a long-term pattern of mostly whole plant-based foods.

I think so much dietary advice nowadays focuses on what we should cut out. And that really creates a mindset of restriction and that some foods are bad.

In my opinion, I think one of the simplest and most effective nutrition strategies is to switch the focus to foods that you can add. So, examples would be maybe adding chia seeds to our breakfast or maybe adding beans, vegetables or fish more regularly. I think these small additions gradually improve the overall quality of the diet without feeling restrictive.

So, we’re going to go back to Mark and what did we do for him? He often skipped breakfast and reached for coffee and sugary snacks around 11:00. He felt time starved in the morning and meal prepping had worked for him in the past. So, we agreed to perhaps prepare overnight oats in the evening for a source of complex carbs and including chia seeds and flax seeds for fibre, omega-3s, and Greek yogurt for protein. We also agreed to include more oily fish like salmon twice a week.

The final theme is recovery. In today’s modern world, we often focus on activity, productivity, and doing more. But health is also built during recovery. This theme includes everything from stress management, sleep, avoiding harmful substances, and social connection.

So, I’m going to bring you back to the lemon from earlier. We saw how our thoughts alone can create physical responses. The same is true for stress.

The body doesn’t only respond to actual threats. It also re reacts to perceived ones. So, notifications, work pressures, or even imagining a difficult conversation can be enough to activate that stress response, increasing our heart rate, causing muscle tension and issues with sleep. And in the longer term, this can have significant negative implications for our mental and our physical health.

Mark had very high stress scores. We discussed a very simple tool that he could use during the day, anytime that he felt like he was becoming stressed, and I’d like to share it with you now.
It’s called the Physiological Sigh, and it’s quite simple. What we’re going to do is firstly take a deep inhale through your nose. Once you’re almost completely there, take a second short inhale through the nose on top. Then slowly and fully exhale through the mouth. Did you notice your shoulders start to drop?

Many people will feel their body relax almost immediately. You can repeat this a few times anytime you need it. It’s one of the fastest ways we have to control the nervous system and it’s a tool that is always available to you whenever you need it.

Sleep

The second area we’ll look at in recovery is sleep. This is one of the most powerful recovery tools we have.

During sleep, it’s actually a highly active state in which the body repairs tissues, supports memory formation, and strengthens the immune system. Poor sleep, on the other hand, is linked with things like diabetes, mood-related disorders, and an increased risk of cognitive diseases. Yet, for many people, switching off at night can be really difficult. Mark reported issues with his sleep, particularly when he was stressed. He told me that he just felt his mind was busy all the time.

This is a really common issue, and it can just feel like having a dozen browser tabs open at once. A tab for tasks, for worries, for ideas or different conversations. And a simple strategy is to close those tabs before bed. Take out a pen and paper and write everything down for five minutes before bed.

Everything that’s going on in those tabs, what needs to be done, what you’re worried about, anything that’s on your mind. This helps signal to the brain that it doesn’t need to keep holding on to it overnight. It can make it much easier to switch off. And I’d ask you now, what is keeping your tabs open at night?

Another part of recovery here is reducing harmful exposures. Smoking remains one of the strongest risk factors for cancer, heart disease, and lung disease. Alcohol increases our risk of liver disease, cancers, and mood disorders. And I think even reviewing nowadays our time spent on the internet or even scrolling social media as this can have a detrimental effect on our mental health. I think the encouraging message here is that even small reductions can improve our health.

We decided to look at Mark’s alcohol consumption. He liked to unwind with a can of beer watching Netflix. When we looked at his average consumption over the course of the week, it was approximately 14 cans of beer. We decided to look at the calorie content of beer he was drinking and the units it contained. On average, he was consuming approximately 160 calories per can of beer, which equated to just over 2,200 calories per week. Each can of beer had approximately 1.5 units, which equated to about 21 units per week.

Mark was unaware that this was over the HSE low alcohol intake guidance and this is 17 standard drinks per week for a man and 11 for a woman. We decided to look at the zero-alcohol version and the difference in calorie content over the course of the week.

If he switched to a zero or alcohol-free can of beer, this was 70 calories per can or 980 calories over the course of the week with no units of alcohol. This led to a over 1,200 calories reduction over the course of the week. Mark decided that he was going to switch to zero alcohol on weeknights while still enjoying an alcoholic beer at the weekend.

Social Connection

And the final theme or area in our recovery theme is social connection. This is one of the most overlooked aspects of health. Long-term studies have shown that strong relationships are associated with better physical health, better mental health, and a longer life. So, having looked at those three themes, why is change much harder than it looks?

I think behaviour change is hard, not just because people don’t know what to do, but often because they feel overwhelmed when it comes to change, competing priorities, and a significant lack of support.

People do much better when they have clear priorities, personalised guidance, and they’re accountable. This involves a proper interpretation of their health results and a realistic plan that fits into their life.

I want to bring you back to Mark and his three-month progress.

When we looked at his behaviour changes, he had incorporated the step count into his day and it was now on an average of 6,000 steps per day. He was also starting to play football with his children at the weekend and was attending his children’s football matches. He had reduced his alcohol intake by 50% and had introduced breakfast every single day. He had a 3kg weight loss. His waist circumference had reduced. His blood pressure markers had improved and significantly improvements in his cholesterol and blood sugar control over that 3-month period. He himself felt better. He reported that he had improved energy levels and felt quite motivated and encouraged by the objective improvements. and he remains engaged in ongoing behavioural change. His goals now are to complete a 5K run and increase up his grip strength by incorporating more strength-based workouts. I think the most common mistake we see is trying to change everything at once.

We’ve all had New Year’s resolutions that faded quickly, and Mark is an example of this. Big changes often lead to overwhelm and inconsistency. Small habits on the other hand are much more likely to stick. I want you to think small, achievable, and repeatable.

And as we finish, I want you to choose just one thing. Not 10, not a full life overhaul. Just one small habit. Maybe it’s a 10-minute walk. Maybe adding a protein source to your breakfast or writing down your thoughts before bed. The goal here is a habit that you can repeat for years.

So, as you leave today, I want you to remember three words. move, nourish, and recover. It’s never too late to make healthier changes to improve our lives.

If you’d like support in making lifestyle changes to improve your health, our Lifestyle Medicine Clinic in UPMC Swords is now accepting new patients. You can contact us using the email below or visit our website to learn more. I’d like to thank you all very much for your time today.

That’s a great question. Thank you so much. So yeah, high blood pressure is quite a common condition in Ireland and knowing how to manage it is really important. I think, from a dietary perspective, one of the most effective approaches for managing high blood pressure is a Mediterranean-style diet.

So, when we’re looking at that, we’re mostly looking at whole-based foods. So, that would be like plenty of fruit and vegetables, lots of whole grains. So, like brown rice, brown pasta, that kind of thing. And our healthy fats. So, that would be looking at options.

So, for example, our extra-virgin olive oil, avocados, nuts, and seeds. And particularly for people who are living with hypertension or high blood pressure, having a look at our salt intake is important here.

So, making sure we’re not adding salt to food and being mindful of how much salt we’re taking as well.

All right, that’s again quite a common question, really. So, menopause and bone health is a really important topic to look at. Oestrogen has a protective effect on our bones and our cardiovascular system. And during the perimenopausal and menopausal stages of life, our oestrogen levels start to decline. And that can mean our bone mineral density starts to decline, increasing our risk of developing conditions such as osteopenia and osteoporosis. Also, during that time, our muscle mass can decline by about 5 to 10% each decade. So, exercise can help look at both of those areas.

From a bone health and a muscular point of view, we want to focus on strength training. So, the aim here would be maybe two to three sessions of strength training per week. Now it doesn’t have to be in the gym.

And I think this is my big point this evening that strength training can be, for example, done at home with body weight exercise, resistance band, Pilates, it doesn’t really matter, but as long as you are consistent with it and trying to do it regularly during the week, it will be my big take-home point tonight.

The other area, then, I think, from an exercise point of view, is cardiovascular health. It’s important that we don’t forget that as well. So, that would be things like the aerobic exercise I talk about.

So, running, swimming, cycling and aiming for about 30 minutes five times a week, and that doesn’t need to be a full 30-minute session. We could break that into like our exercise snack. So doing five-minute walking, you know, during the day, some cycling in the evening time, but we’re trying to hit that overall mark over the course of the week.

That’s an important question. Particularly, lifestyle medicine, this whole concept is quite new in Ireland. I compare it to the analogy of a banker and a financial adviser. So, going for a health screening is like going to the bank; you’re getting a snapshot of exactly where your health is right now. So, like going in and getting a bank statement, you know exactly what is in the pot, which gives the snapshot of what our blood pressure is, our cholesterol levels are, etc. And those markers come in to do a lifestyle medicine consultation; it’s kind of like going to your financial advisor. We’re looking at where you’re at right now and what your goals are for the future, and helping you put together a plan for the short and long term to help achieve those goals. So, I hope that analogy made sense.

The resting heart rate is the heart rate, or your resting heart rate, which is the number of times your heart beats every single minute when you’re at rest. And in general, a lower resting heart rate reflects better cardiovascular fitness and a more efficient heart rate.

When we’re looking at that and ways to reduce or improve resting heart rate, we’re looking at all the basics here. So, sleep is really important here and making sure that we’re adequately recovered. So, high-quality sleep of about seven to eight hours per night, if we can.

Managing our stress, and that’s a really important one here, that you know a very high resting heart rate can indicate that the body is under not just physical stress, but also mental stress as well.

So, keeping an eye on our stress and regular physical activity.

So not always just that really high intensity exercise but even just some gentle cardiovascular exercise like walking can be helpful.

So we can definitely see improvements in your bone mineral density. And that would be a lot of things that we’ve spoken about already, like your strength training is really important here.

Having a look at some dietary changes here. So, making sure your calcium intake is nice and high and looking at your Vitamin D consumption and all of those things together can help improve your bone mineral density.

However, if you have been diagnosed with Osteopenia or Osteoporosis, it is really important to talk to your doctor about any medications that may be required to help.