South Pacific Society of Lifestyle Medicine Conference 2020: Turning the tide on NCDs
Dr Luke Wilson reports back from the inaugural South Pacific Society of Lifestyle Medicine conference in March 2020. Luke was among a high-profile speaker lineup – including an opening address by the President of Fiji himself.
Addendum, 9 April 2019: our thoughts are with our Pacific neighbours who are currently dealing with the terrible impacts of Cyclone Harold on top of the COVID-19 crisis. Our hearts go out to all who are affected and we stand in solidarity with our healthcare colleagues working on the frontlines.
Bula! Last month I was in Pacific Harbour, Fiji for the South Pacific Society of Lifestyle Medicine (SPSLM)’s inaugural conference. Around 100 attendees were present from island nations across the Pacific including Papua New Guinea, Solomon Islands, Vanuatu, Tonga, Samoa, Tuvalu, Kiribati and the Cook Islands, and of course Fiji.
I was fortunate to have been offered the opportunity to speak following a chance encounter with Dr Paul Wood, a fellow GP and lifestyle medicine physician in Auckland last year at the Australasian Society’s own conference. When I found out Dr Wood’s recently established Society was planning a conference, and its timing – starting the day after my birthday – of course I offered my services on the spot. Despite having grown up in New Zealand, technically islands in the Pacific too, and our close connections and short distance from our neighbours, this was my first time visiting the Pacific.
Even though it meant a very early morning start for my transfer to the Pearl Resort venue, I was determined to make registration on time. I had a DFN pull up banner I wanted to get a prime spot for, and also a stack of DFN materials to be distributed to delegates.
But to be perfectly honest I had an ulterior motive for my motivation to arrive early, and am happy to report it was well worth the effort – I was on time to witness His Excellency the President of Fiji, Major-General Jioji Konrote, opening and addressing the conference. President Konrote called for urgent action to deal with chronic disease in the Pacific. I’m told he is vegetarian, and – perhaps unsurprisingly given his military background – is renowned for his physical prowess, encouraging delegates to ‘run’ rather than ‘walk the talk’.
President Konrote graced us with his attendance through the welcome address by SPLSM’s own President, Dr Chester Kuma, which I was pleased from the outset emphasised the role of the transition from ‘Garden foods to processed foods’ to address the heavy burden of non-communicable disease (NCD).
The following presentations provided further sobering detail about the impact and prevalence of diet-related NCDs on the Pacific which is regrettably becoming increasingly dire: some Pacific nations have a prevalence of obesity of up to 80%, and while the global average for diabetes prevalence is 10%, several Pacific nations are over 30%.
After posing with us for our official conference photos President Konrote departed with his cavalcade no doubt back to the more mundane realities of political life, or perhaps for a run. Either way, the challenge has been thrown down by Fiji for DFN to secure the Governor General of Australia at least to open our next conference, if Jacinda Ardern is unavailable.
After our first morning tea break, which included tropical fruit that tasted great, no doubt assisted by the fact that it was locally grown and in season (NZ conference caterers, please take note) we returned to the first of several talks from a presenter who was online rather than in person. Associate Professor Darren Morton, speaking to us presumably from New South Wales, discussed how ‘Evidence Based Medicine’ biases physicians against nutrition. He pointed out that objecting to lifestyle medicine approaches solely due to a lack of evidence from randomised controlled trials is equivalent to avoiding using parachutes for the same reason. This was followed by Professor Garry Egger, again remotely, extolling the benefits of shared medical appointments, before a return to in-person presentation with Stephen Penman of the Australasian Society of Lifestyle Medicine providing a thoughtful and courageous presentation on what Lifestyle Medicine is and is not.
After (a plant-based) lunch, presentations included lifestyle factors impacting eye disease, tobacco control in the South Pacific, and a remarkable testimonial from Dr Margaret Cornelius on her own journey to wellness through lifestyle changes (including, naturally, a whole food plant-based diet). After my early start, nerves about my upcoming and still fairly unpractised presentation caught up with me a bit, so I slipped off to check in to my room and prepare myself a bit prior to the all-important Conference Dinner.
The star power continued that evening with a dinner address by Dr Jone Hawea of the Pacific Island Food Revolution TV series telling his story. He realised that a new more accessible approach to nutrition education was needed in the Pacific, seeing for example standard public health efforts to combat Coca-Cola’s popularity fail (in fact, in 2018 the soft drink maker tripled its production capacity on the island).
He explained what they were up against alluding to Coca-Cola’s response of ‘Putting one of our [rugby] 7s stars on a billboard promoting Coke’. One of his motivations was to restore pride in traditional foods – Dr Hawea said that when he went to the villages, people would apologise for serving him traditional food. The response to Pacific Island Food Revolution suggests that it has gone a long way towards bringing traditional and healthy food choices back into fashion. It has an enthusiastic following on social media and is now shown in 6 countries across the Pacific, as well as in Australia and New Zealand (so give them a ‘like’ on Facebook and check it out!)
Dr Hawea’s presentation was an appropriate introduction for what followed: a buffet of many traditional favourites, I believe some of which were cooked in a lovo (ground oven). This was the first time I tried dalo (taro), and there were also several other delicious offerings including dishes made from native seaweeds and leaves, alongside some tasty representation of Fijian cuisine’s Indian influence too.
There were a couple of talks scheduled the next morning before mine, but I opted to catch up on some rest and do a few last minute run-throughs of the presentation before I was on at 10.55. After apologising for New Zealand’s recent success at the Vancouver 7s tournament, and hoping to appease the largely Fijian audience by informing them I was wearing my Fiji Rugby shirt in solidarity with their national team, I launched into my presentation, ‘Creating a Lifestyle Intervention for Your Community’.
If you’re interested you can get the main points through reading my article on this topic originally written for ASLM. Just as when I wrote that, I hoped to help inspire the attendees to consider having a go at doing their own program, with a few adjustments as appropriate for their community. The talk was well received and going by the feedback I had from attendees indeed several of them were inspired to consider getting started on something of their own. I also emphasised the environmental benefits of the intervention we chose: a whole food plant-based dietary pattern, bolstered by Jono Drew et al.’s recently published NZ-specific data, and acknowledging that this existential threat to humanity let alone our individual health must guide our healthcare practices and recommendations in the future, especially for the sake of the Pacific.
I had the honour of warming the stage for Associate Professor Wayne Dysinger, past President of the American College of Lifestyle Medicine and Chair of both the American and the International Boards of Lifestyle Medicine. In the first of his several presentations at the conference Dr Dysinger detailed how nutrition specifically could be used to effectively and rapidly reverse type 2 diabetes, which as mentioned earlier in the conference is a particular issue in the Pacific. With changes in diet, he explained, it would be possible for Pacific nations to rapidly eliminate the scourge of [type 2] diabetes almost entirely. After lunch, we learned about strategies for enhancing sleep, helping people adopt new habits, and options for further education and qualification in lifestyle medicine.
The day finished on a high note with a fantastic and inspiring presentation on the Complete Health Improvement Program (CHIP) in Fiji and globally. This program is very well researched and has proven efficacy with published outcome data including in New Zealand and Australia, as well as the United States and Europe. The Fiji team have been collecting data for publication too which is eagerly anticipated (perhaps a presentation at next year’s SPSLM?). Dr Alipate Vakamocea told us that the lab pathologists turned up to his CHIP sessions unannounced because they were so surprised by the results of the tests they had been running that they wanted to find out what was happening. There has also been a Fiji-specific cookbook created which will be published soon. Keep an eye on the Fiji CHIP Facebook page to be alerted when this is released.
The highlight however, was another incredible testimonial, this time from Mr Ilaitia Tuinamoala, a CHIP graduate. He explained that before CHIP he was 160kg and his quality of life was really affected by sleep apnoea. He would have difficulty sleeping at night due to snoring, as would his wife, so they slept in different rooms. The need for an extra room meant it was difficult for him to go back to his village, or to stay in hotels. He was falling asleep at his desk at work unknowingly and was worried he would lose his job, and was no longer able to be involved in his church activities due to his health. Since CHIP, his health has improved dramatically and he has gone from a 6XL size to a size M and his waist size has reduced some 20 centimetres, his snoring has disappeared, and his extended family have also enrolled themselves in the program; he has even started a shop selling 100% plant-based foods.
Lectures were interspersed throughout the conference by freestyle Pacific-dance inspired exercise routines to Pacific music (and perhaps slightly more frequently than I would have liked also to Tones & I’s Dance Monkey which seems to be even more popular in Fiji than back home). While I have to admit that my coordination and ability to follow movements has clearly decreased significantly since my kapa haka days, this felt a lot more authentic and natural and enjoyable than the standard conference ‘let’s get up and stretch for 2 minutes since sitting is the new standing’ routine, and I think we all started looking forward to it more and more as the conference progressed and the dance moves became more daring. Notes taken for DFN’s next conference.
On Day 3 biochemist Associate Professor Ross Grant returned to spend the better part of an hour destroying the high fat ‘keto diet’ fad, and later on in the day Dr Lillian Kent proceeded to destroy the remaining ghost of the high fat ‘keto diet’ fad with another excellent lecture focussing on the gut microbiome. Dr Kent is also working on a very exciting sounding program to be deployed mostly in rural areas of the Pacific called ‘Live More Abundantly’ which I’m looking forward to hearing more about at future conferences.
Learn more about the dangers of the keto fad here.
Perhaps the highlight of the third and final day however was the presentation from Dr Walter Vermeulen from Samoa on METI, the Matuaileoo Environment Trust Inc. Dr Vermeulen founded the Trust which exists to provide training and promote capacity building to achieve sustainable living in Samoa through self-reliance, particularly of grassroots communities. As a part of this they provide free healthy living seminars at which attendees learn about the importance of nutrition, are shown healthy recipes to cook and prepare, and are also shown the benefits of a whole food plant-based diet to prevent and reverse chronic illness (they have developed a cookbook with recipes in Samoan and English). I was particularly interested to hear about a four village healthy living project they had completed. This involved various community members working together to promote change and a 3 hour health seminar explaining the causes of the non-communicable disease (NCD) and how to reverse them. This approach was highly successful with 123 of 165 of the villagers reversing their NCD, including 32 out of 36 cases of type 2 diabetes. Fittingly, following the final panel discussion about the practical implications of what we had learned, an honorary Fellowship of the SPSLM was presented to Dr Vermulen.
Dr Kuma’s closing address challenged us, as we returned to our various countries, to take action and use what we had learned to help our communities, and to talk to government and other organisations to get them on board with a lifestyle medicine approach. My 3 days in Pacific Harbour were most enjoyable and educational. Typical of the Fijian hospitality I experienced, there was a very friendly and relaxed atmosphere and I met many new people who were likewise interested in where I was from and what I was working on, and of course DFN and its work in Australia and New Zealand. What I enjoy most about conferences and is most valuable is the time spent exchanging ideas and stories with others with many of the same aspirations and interests. It’s a chance to connect again with and be amongst your ‘tribe’, and also an opportunity to experience the unique customs, cuisine, culture, and community of the location. I hope this isn’t lost and forgotten in the now inevitable transition to more online offerings. Vinaka Fiji and SPSLM for a wonderful event that I won’t be forgetting anytime soon, I’m thoroughly looking forward to visiting again some day!
“Turning the Tide on NCDs – It Starts with Us” was the theme for the inaugural South Pacific Society of Lifestyle Medicine Conference. The 3-day event in March 2020 explored evidence-based strategies to empower health professionals as “change agents” in helping combat the NCD crisis.
Find out more including details about the next conference via spslm.org/conference, and access a number of free educational resources via the SPSLM website, including selected webinars, available at spslm.org/Webinars.