As a young doctor in Soweto, I witnessed first-hand the devastating impact of chronic diseases on my patients. My heart ached each time I prescribed medication, knowing that many of these conditions could be alleviated or even prevented through lifestyle interventions. The statistics for chronic illnesses are scary.
According to the World Health Organisation1, non-communicable diseases (NCDs) kill 41 million people each year, equivalent to 74% of all deaths globally. Each year, 17 million people die from an NCD before age 70; 86% of these premature deaths occur in low- and middle-income countries. These staggering statistics underscore the urgent need for effective interventions to address the global burden of NCDs.
This experience ignited a passion for holistic wellness and led me to explore the power of lifestyle medicine (LM), an evidence-based approach that emphasises the importance of adopting healthy behaviours to prevent and manage diseases. It is grounded in the six pillars of lifestyle medicine2 — nutrition, exercise, healthy relationships, stress management, sleep, and substance avoidance. These pillars form the foundation of a balanced and fulfilling life, and by nurturing them, we can significantly enhance our overall health.
One of the key principles of lifestyle medicine is the concept of harm reduction, a patient centred strategy used in medicine and social policy to minimise harm from hazardous behaviours or practices that cannot be completely avoided or prevented.
This approach recognises that it may not always be feasible to eliminate unhealthy behaviours entirely, but it is possible to minimise their negative consequences. By focusing on gradual improvements and sustainable changes, we can effectively reduce the risks associated with harmful habits.
Lifestyle medicine often advocates for setting realistic, small behavioural goals that focus on progress over perfection. This reduces the likelihood of failure and discouragement, which can be harmful to mental and physical health, as cited in Foundations of Lifestyle Medicine and its Evolution3.
Although LM may be thought of as a newer medical speciality, its principles have roots that extend back for centuries. Hippocrates, an ancient Greek philosopher, and physician often thought of as the father of medicine, famously stated “in order to keep well, one should simply avoid too much food, too little toil”. Around the same time, but several thousand miles to the East, the Chinese philosopher Confucius was also recognising the impact that moderation in diet and alcohol, along with persistent practices of mindfulness and meditation, had on the quality of life.
Nutrition and rediscovering our roots and the power of traditional African diets
Likewise as Africans, we too have a rich heritage of balanced lifestyle living including healthy eating practices that have been passed down through generations. By returning to our roots and embracing traditional African diets, we can tap into a wealth of nutritional wisdom. These diets often emphasise whole, unprocessed foods, plant-based proteins, and healthy fats, which are essential for optimal health.
Walking the talk and integrating movement into daily life
The word exercise sounds laborious and can be intimidating to many people as is the idea of the gym. Our ancestors were accustomed to active lifestyles that involved walking, gardening, and working the land. By incorporating similar activities into our daily routines, we can reap the benefits of regular exercise. If you are working from home, make it a habit to get up every hour to walk around, grab a glass or water or tea, and walk outside. Those 100 or 200 steps add up during the day. If you are at the office, take the stairs and not the lift or park in the furthest parking and walk.
Building healthy relationships and the importance of social connection
Africans have a strong tradition of community and togetherness. By fostering strong social connections and building supportive relationships, we can enhance our emotional and mental well-being. Strengthening and maintaining relationships and connections with others brings meaning and purpose to life. Studies show that isolation is associated with increased mortality.
Community-based activities, social clubs and events can provide opportunities for social interaction and a sense of belonging. Encouraging people to build strong social networks and relationships can mitigate the harm caused by loneliness and isolation, which are linked to various chronic health conditions.
Stress management and finding calm in a chaotic world
Traditional African cultures often emphasised mindfulness and meditation as ways to cope with stress and maintain inner peace. By incorporating these practices into our modern lives, we can develop effective coping mechanisms and reduce the harmful effects of stress. Reframing negative thoughts can reduce the harm caused by chronic stress, which can contribute to various health problems.
Sleep restores and renews the body for optimal health
Adequate sleep is essential for physical and mental health. Prioritising sleep and creating a sleep-conducive environment can help improve our overall well-being. Many of us brag about sleeping less as if it’s a badge of honour to show how hardworking we are but this comes at a cost to our overall wellbeing. Make small, achievable changes in their sleep habits (e.g., setting regular sleep times, reducing screen time before bed) to improve overall sleep quality, reducing harm from sleep deprivation. During sleep, our bodies are working to support healthy brain function and maintain our physical health.
Substance abuse and overcoming addiction and embracing wellness
Many people resort to using vices like substance abuse including drinking, smoking, binge eating or drugs as coping mechanisms because the five pillars of wellness are out of sync. This can have devastating consequences on individuals, families, and communities. By making healthy choices and seeking support when needed, we can break free from addiction and embrace a healthier lifestyle.
For those who struggle with substances like alcohol or tobacco, lifestyle medicine often focuses on reducing intake rather than complete abstinence as a first step. For smokers tobacco harm reduction is key — switching to better alternatives like non-combustible products like oral nicotine and heat not burn products is less harmful than continuing to smoke cigarettes.
Embracing lifestyle medicine is more than a choice — it’s a transformative shift in how we live. By reconnecting with our roots, embracing community, and fostering family structures that support open dialogue and healthy eating, we can fend off chronic diseases, elevate our quality of life, and unlock our full potential. The time to take control of our health is now — let’s seize it, one mindful step at a time.
Dr Mothomang Diaho is Founder and Medical Director of the Lifestyle Clinics Spiral Aloe