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RCPCH annual conference

Updated: May 30, 2023

I spent the day today at the virtual Royal College of Paediatrics and Child Health (RCPCH) annual conference. That means I spent the day sitting on the sofa in my pyjamas, but I did get to hear this guy speaking, and he was rather good, so that was interesting.

Lord Victor Adebowale is a cross-bench peer in the House of Lords. He spoke to us about the socioeconomic determinants of health and his own experience of growing up in poverty. He wasn't too specific about what exactly this meant, and he did note certain protective factors in his case (being born with a functioning brain, parents who loved him just enough...), but he did say that the worst thing about growing up in poverty is the absolute knowledge that your life is being controlled by someone else: someone who doesn't know and doesn't care about you.

To be absolutely specific, I grew up on the Heathside and Lethbridge council estate in Lewisham in South-East London, and probably the worst thing I remember about poverty was not owning a puffball skirt. Lord Adebowale said that all of us sitting in the room today (or at home in our pyjamas) should recognise our incredible privilege. I do, and also how incredibly hard I have worked for it. Lord Adebowale is a bit different, and so am I.

Lord Adebowale has co-founded a digital health company (Visionable) and he thinks digital is going to change the world. Commenting on social media, he said that these are 'not so much social platforms as addiction platforms', which is not to decry their benefits.

A speech and language therapist gave a presentation on Augmentative and Alternative Communication (AAC) for children who are unable to speak. In discussing the pros and cons of a low tech and a high tech approach (she, like most parents, preferred high tech), she noted that by the age of six, 85% of children have access to a tablet at home and 40% have their own. She reported that according to Ofcom data (2023), 20% of 3-4 year olds own their own phone and there is now near universal phone ownership by the age 12.

My daughters are 12 and they both own their own phone. We have a 'phone shelf' that I sometimes remember to tell them to put their phones on.

There was also a presentation on 'Upper Limb Robotic Rehabilitation Therapy' at the Children's Trust. This is robot-supported, high intensity movement practice and task-training for children with movement disorders, with integrated motivational gaming technology and virtual reality. It uses the 'Tyromotion Diego Robotic Upper Extremity Rehabilitation Device'. Wow. What a fabulous name! I just wanted an excuse to repeat it really.

And then there was Jeremy Parr, Professor of Neurodisability at Newcastle University and the clinical academic founder of (and a shareholder in) XRTherapeutics. XRTherapeutics makes therapeutic virtual reality experiences for children with a diagnosis of autism who suffer from specific anxieties or phobias. This combines cognitive behavioural therapy (CBT) with the progressive exposure approach so that patients are able to overcome their fears and get back to something resembling their normal life. They are even beginning to be able to simulate smells. The cost per treatment is £5950 and in a randomised controlled trial of 31 patients, 15 showed 'definite improvement'.

Finally, after all of this, Dr Maria Neira, Director of the World Health Organization (WHO) spoke to us from Geneva on the subject of air pollution and climate change. She called on us all to take a leadership role on climate change, highlighting that its effects on health will include extreme weather conditions, natural disasters, the spread of vector-borne infectious diseases, and disruption to the food supply.

Like some of my colleagues I suspect, I was slightly unsettled by the 'you must take action' rhetoric. As a hard-working, conscientious, bicycle-riding (I do own a car, but it is the smallest one I could get) vegan doctor it stung a bit. She was perhaps guilty of preaching to the converted, as it was pointed out that many RCPCH members had cycled all the way to COP26 in Glasgow in 2021 (the 26th UN Climate Change Conference). Someone asked what she thought we could practically do as busy doctors and her answer included cycling, recycling, and this: 'I'm not talking about vegetarian but maybe reducing it a bit'.

It was rather disappointing to hear the Director of the WHO telling people not even to go vegetarian but just to reduce their meat consumption a bit, and going no further than this in recognising the significant contribution of animal agriculture to the problem of climate change, or the harm to health caused by red meat consumption, which in 2015 was classified by the WHO as group 2A: probably carcinogenic to humans (processed red meat was class 1 - definitely carcinogenic to humans).

Well, by the end of it all my head was a bit spinney so I went out for a walk in the woods. I live in Liverpool, but we have a small corridor of trees near my house that, if you don't listen too hard for the sound of traffic on either side, passes quite nicely for an actual wood.

And then I thought this (I know, you have been wondering when I would get to the point and what all of this has to do with food anyway): we can't green our healthcare system, as Dr Neira wants us to, and at the same time implement all these new technologies. This is a bit of a paradox: a contradiction in terms. You can't have your cake and eat it too. It isn't enough to switch over to green energy: we also have to use less energy overall. A lot less energy.

I'm not anti-pharmaceuticals, and I'm not anti-technology either, but what I do believe in, passionately, is food first. If you have a health problem (almost any health problem, unless you have had your leg amputated because that isn't going to grow back however much broccoli you eat), get your diet right first and then see if you need the drugs or the technologies. You probably won't (unless it's an artificial limb. Fair enough).

Okay so 'getting your diet right' in my book means eating a low fat, high raw, plant-based diet for at least a month. Do it and see: get absolutely all of the addictive junk out of your body and take control of your own life. I promise you will find out what I am talking about. If everybody did it almost all of us in that 'room' today would be out of a job.

The low fat, high raw, plant-based diet is a therapeutic intervention absolutely in line with the greening of the NHS. If all we need is 15 out of 31 patients showing a 'definite improvement' to unlock 5 grands-worth of fruits and vegetables per person, well, I think it might just be possible. What we need to do next is get the data. Then we can put a low fat, high raw, plant-based training programme in every NHS trust in the UK.

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