Dr Lee Ashton

Dr Lee Ashton always knew he wanted to make a difference through nutrition and health research, and couldn’t be more delighted that it’s led him to Newcastle.

Hailing from Manchester in the UK, Lee’s passion for sport naturally directed him towards a career in the field of health. However, it was while studying his undergraduate degree in Sport and Exercise Science that the nutrition subjects captured, and held, his interest. A Masters in Nutrition at Leeds University quickly followed, but Lee’s journey to UON to undertake his PhD was inspired by a connection with a UON leader in the field.

“I’d met Professor Clare Collins at a conference and we’d stayed in touch afterwards,” Lee explains. “She was telling me about all the people who work in the PRC for Physical Activity and Nutrition and I realised that all the papers I were currently reading were written by people at UON. I couldn’t believe that all the people I’d been reading in my literature review were in the one place, so I did everything I could to come here.”

Talking about men’s health

Lee came to UON to undertake his PhD, where he developed and tested a participatory-based healthy lifestyle intervention for men aged 18 – 25 years. The HEYMAN program was devised after input and consultation with more than 340 young men. “We’d seen that young men in particular were neglected in health research,” Lee said. “I’d spoken to some young guys who’d gone along to weight-loss groups but didn’t feel engaged or that it appealed to them.”

Because there are so many pressing health issues across this age group, Lee knew that targeting young men’s health was a priority. “During this time of life there are a lot of transitional changes taking place: moving out of home, finding new groups of friends, settling down and starting a family – and all of these changes are key determinants of health,” Lee says. “There’s a lot of research that shows that behaviours that you create as a young adult are likely to continue through life, so if we’re able to target this group, improve their key health behaviours we can set them on a positive health trajectory for their rest of their life.”

A one-size-fits-all approach to weight loss and wellbeing is unlikely to work for young men. “A review of 244 weight loss programs found that only around 23 per cent of program participants were men, and a lot of them would drop out,” Lee affirms. “So by sitting down with young men in focus groups to find out what they wanted, we could work out what were the motivators and the barriers and address these in the program.”

Like young women, young men were focussed on body image, but with an emphasis on strength and muscle-tone, so as one of the suite of tools on offer the HEYMAN program used High Intensity Interval training (HIIT) to deliver a 10 – 15 minute sessions that offers strength and fitness training anywhere at any time. This also solved another key barrier to fitness: a lack of time to exercise.

Accentuate the positive

Focussing on health benefits, rather than negative aspects was a key issue with the young men, “They didn’t want a facilitator who was constantly talking about the negative aspects of weight and health,” Lee says. “They’d rather relate to the positive aspects.”

The same positive messages applied with alcohol consumption. “None of the participants wanted to be told ‘you have to give up alcohol’ so we tried a health-by-stealth approach which has been successfully used in the SHED-IT program by Dr Myles Young and Professor Philip Morgan, which is more about raising awareness and offering options for specific scenarios. It has to be relevant to their lives or they’re not going to do it.”

The fact that the participants played such a strong role in informing the development and implementation of the program is something that Lee attributes to its success. “There were positive outcomes in a range of areas such as activity and diet – and particularly in relation to junk food,” Lee says. “With many of the men, almost 40 per cent of their diet when starting the program was junk food. But in just three months, they reduced that intake by up to eight per cent. There were also reported improvements in mental health.”

A tight team

The team at UON’s PRC for Physical and Activity and Nutrition offer an enormous scope for collaboration, and Lee was very fortunate to be paired with some of the best for his PhD. “I worked with Professor Clare Collins who’s a nutrition/dietitian expert, Dr Megan Rollo who’s also a nutrition/dietitian researcher but is also an e-health expert, and then Dr Melinda Hutchesson whose focus is on young adults, and Professor Phil Morgan who has expertise in mens’ health and physical activity,” Lee says. “They all had expertise related to my PhD and I was so lucky to have these people to bounce ideas off and to have them help deliver and design the program.”

Lee is motivated by making a difference, and is buoyed by staying in touch with some of his pilot participants. “There were so many late nights and long hours when I was completing my PhD, but, at the end, when you see the guys and see the changes they’ve made, it makes it so worthwhile. You can see the changes in them and it’s great to see them continuing on with the health and fitness changes they’ve made.”

“Cost is a massive barrier to exercise, so we try to make them aware of activities that are available for little-to-no money. You can do high intensity training just using your own body weight, we used an app called Freeletics that the guys can continue to use after our program finishes,” Lee says. “We’re so lucky in Australia as we have free ocean baths for swimming, open parklands to exercise in, and in Newcastle we now have parkruns – a free 5km run for people of all fitness levels,” Lee says.

“One of our HEYMAN sessions involved participation in a local parkrun session and I recently bumped into a guy who told me he’s bought his own fitness tracker and is still doing the parkrun here at Uni every week.”

This pilot program is now informing a larger study that the team are looking to roll out across the country. “We’re now looking at cost-effective approaches such as using e-health to deliver the messages – particularly in rural and remote areas.”

Focussing on translation of research, Lee’s ultimate aim is to see this kind of program rolled out to as many young men as possible, across Australia and in rural areas. “We’re lucky at UON in that we have the Department of Rural Health that enables collaboration on projects across Callahan and Tamworth,” says Lee.

The team in the PRC for PAN is a continual motivation for Lee. “I’ve never worked anywhere like this, everyone always comes together and springs ideas off each other – even though we all come from different areas. When we go to conferences people are envious of what we have. I feel really lucky to have been given this opportunity to come here and to continue to work here after my PhD.”

Taking the local and making it global is the ultimate goal: “When I see the work that Phil’s done with Healthy Dads, Healthy Kids being rolled out in the US and the UK that’s something that I aspire to.”

Giving men the tools they need to live a healthier life isn’t a short-term fix, but Lee firmly believes that educating men about the small changes they can make will help them with their health and wellbeing for the rest of their lives.