Climbing the Eiger at 60?

“You’ve got to be kidding!” said my friend Jeannie about my plan to climb the Eiger over the Mittellegi ridge. Or maybe she thought that I was mad. After all, I have suffered from severe Spondyloarthritis and moderately severe Inflammatory Bowel Disease for decades.

However, the medication I take has a huge positive effect on my quality of life and makes such a mad plan thinkable. But there is a big difference between feeling ok, with bearable pain and being able to manage to get through the day, and feeling really, really fit and strong and confident. And that is the change in the last two years since I became aware of the power of “lifestyle medicine”.

Changes in my lifestyle have transformed my life and made it possible for me – a 60 year old woman with chronic illness – to climb the Eiger. I want to share my experience. Maybe my learnings will be useful for others. But please remember, I’m not a doctor and this is not medical advice. Everybody is different. Try things out, get professional support if you can, and observe carefully what works for you!

If you get to the end of this blog there is a slide show of the Eiger tour!

What is lifestyle medicine?

According the American College of Lifestyle Medicine, it uses evidence-based practice to help people adopt and sustain healthy behaviour that affects health and quality of life. Some Lifestyle health factors are now well-established: don’t smoke; keep your weight under control; exercise regularly. But the benefits of taking these lifestyle changes even further don’t seem to be recommended by most doctors. Perhaps they aren’t proven enough, or not well-known, or not believed in. For whatever reasons, these are all things that I have found out more or less for myself.

Lifestyle medicine focuses on sleep, nutrition, exercise, and stress reduction.

Sleep

Worries, overwork or medication have all affected my ability to get a good night’s sleep in recent years. Many people know what a problem insomnia can be, how lack of regular sleep can affect wellbeing, and how great it is to get a good night’s sleep. One source of support has been Dr. Guy Meadows and his approach called ACT (Acceptance and Commitment Therapy). In the Sleep School he teaches how to overcome insomnia through observation and acceptance. This often works for me. Trying to control my fears and worries in this way fits with my approach to stress reduction through meditation and mindfulness (see below).

The most important factor affecting my sleep, however, is nutrition, which I will explain in more detail.

Nutrition

I have been paying close attention for some time to what I eat, and I reported my experiences in an earlier blog entitled Am I really what I eat? I continue to follow the recommendations I received from nutritionists, and I eat a Mediterranean diet with lots of fruit and vegetables. Now I can’t imagine eating any other way. It’s delicious!

But what about eating less or less often? My first thoughts and impressions about fasting were A new F-word: FASTING – love or hate? Since I started intermittent fasting in August 2019, I believe it has had a huge impact on my wellbeing!

A lot has been written about nutrition as a factor in controlling inflammatory diseases, but what I have discovered in the last 6 months or so is that when I eat is just as important as what I eat. Intermittent fasting has made a real difference to my sensitive gut, and I believe that reducing gut irritation or even inflammation in my gut affects my overall wellbeing and may even have helped to reduce inflammation in my back and joints. For over 6 months, I have generally eaten my last meal by 6 PM and fasted for 16 hours, which means I drink an herbal tea in the morning and then sometime after 10 o’clock I have a delicious breakfast with coffee, fruit, wholegrain cereal and yoghurt.

Dr. Satchidananda Panda of the Salk Institute of Biological Sciences in California researches the circadian rhythm and how this cycle of functions that repeats over 24 hours affects our performance, mood and general health. The best-known example is the sleep cycle. Dr. Panda believes that the benefit of sleep for the brain in the circadian rhythm is only the tip of the iceberg. Other organs have a circadian rhythm and also need time to rest and recover, such as the digestive system. The circadian clock could even mediate the immune system. He has extensively tested the benefits of fasting over the last 20 years and believes that every cell in our body has its own circadian clock. Every hormone, every neurotransmitter, every gene in our body has times when it works best, and times when it needs to rest, repair and reset. The circadian clock is not only linked to sleeping, but also to eating and exercising. Therefore, it is important not only to sleep at the right time, but also to eat at the right time.

He achieved his first results with mice that were fed a fixed “western” diet. One group was only allowed to eat within a limited time window of 8 hours. The other group was allowed to eat exactly the same amount of food, but without time restrictions. After a few weeks, the mice that fasted 16 hours a day were much leaner, more energetic and generally healthier than the mice that could eat or snack all day. Over the last 5 years, he has expanded his research to thousands of human volunteers who monitor their eating habits. The results suggest that similar results can improve people’s wellbeing. In addition to weight loss, improved mood and better sleep, study participants report other benefits such as reduced joint pain and inflammation. Dr. Panda explains his work in the BBC podcast Don’t tell me the score.

This seems completely plausible to me, because the effect of intermittent fasting on my digestion and thus on my overall wellbeing in recent months has been nothing less than dramatic. By fasting, I give my digestive system a break, during which it doesn’t have to digest new food and can rest and regenerate. I can feel how much more relaxed my gut is, how much better I can sleep and how energised I am. For someone who has suffered from leaky gut and chronic inflammation for decades, this is a real gift for me.

If you understand the science (which I unfortunately am not trained in), then this work is summarised here: Mattson MP, Allison DB, Fontana L, Harvie M, Longo VD, Malaisse WJ, Mosley M, Notterpek L, Ravussin E, Scheer FA, Seyfried TN, Varady KA, Panda S. Meal frequency and timing in health and disease. Proc Natl Acad Sci U S A. 2014 Nov 25;111(47):16647-53. doi: 10.1073/pnas.1413965111. Epub 2014 Nov 17. PMID: 25404320; PMCID: PMC4250148.

Getting fit

To keep my mood up during lockdown, I made a plan “5 tips for managing your day” that included daily exercise. I used an online fitness programme with a huge range of options, from stretching and yoga to Pilates and PIIT (professional intensive interval training!). It was amazing how this made me fitter every morning over several months than I could ever have imagined, even though I never left my own house by much, let alone went into the mountains.

Stress reduction

The key to stress reduction for me is a few minutes of mindfulness or meditation before I start the day. Collecting my thoughts and intentions by journaling also helps. If you are interested in this topic, I reflected on stress reduction in an earlier blog, Lockdown.

Putting it all together to climb the Eiger!

All these practices help with disease management and improve my wellbeing. It is a gradual process. It took months for lifestyle changes to translate into improved wellbeing. Discoveries were a process of trial and error. No clinician advised me to adopt these practices. I had to look through the available material and decide for myself what is quackery and what is responsible advice. If I’m not sure about a theory, I check whether the author of the recommendations was willing to subject their ideas to scrutiny by publishing them. If there are no recent publications on PubMed, I am sceptical that the work is serious and discard it.

Much more research needs to be done to provide evidence-based, generally accepted recommendations for the benefit of all patients. The Spondylitis Association of America recently published an excellent article on Lifestyle healthcare, with references to follow up if you need more information. The article contains general guidance and could be helpful for anyone affected by a musculoskeletal condition. I believe these areas would be given a much higher priority if health research were more focused on patients’ wellbeing, rather than being driven by commercial considerations or personal ambitions.

Vor allem glaube ich, dass ich ohne all diese Lebensstiländerungen niemals, niemals den Eiger im Alter von 60 Jahren hätte besteigen können!

Here is the Eiger tour in pictures – enjoy!