DO THIS DAILY To Reduce Inflammation & PREVENT DISEASE Today! | Andrew Weil

it's that kind of food that is at the root of a lot of our cancer coronary artery disease obesity type 2 diabetes hypertension so forth [Music] chronic inflammation is a root cause of disease it's so fascinating for me to be talking to someone like yourself who was way ahead of the game did you know about it before it came into the the sort of common vernacular and what happened there what first caught my attention were articles in the scientific literature in the mid-1980s that made it look as if there were commonalities in the origin of disease entities that i had been taught had nothing to do with each other that coronary artery disease and cancer and neurodegenerative diseases that there might be a common root there in chronic inappropriate inflammation that is a completely new idea and hypothesis and i'd have a good sense of knowing when things are right and that there's going to be evidence to support that so i got onto that idea very early and it excited me because if these broad categories of disease that we had previously thought had nothing in common if in fact they have a common root then there's a common strategy for dealing with them and reducing the risk of them and that is by doing everything you can to contain inappropriate inflammation there's a lot of influences on uh one's inflammatory status some that you can do things about and something you can't you know one that you can do something about is exposure to environmental toxins second-hand tobacco smoke is a major pro-inflammatory agent for example but what particularly caught my attention was the possibility that uh dietary changes could reduce uh inappropriate inflammation and i developed an anti-inflammatory diet with that in mind and and long after i began to uh look at this and begin writing about this i began to see other evidence that mental emotional health was linked here as well and this uh the cytokine hypothesis of depression which is a much more recent idea to me looks much more robust than the serotonin hypothesis of depression which has led to all the use of pharmaceutical antidepressants and the idea that that chronic inflammation and depression are linked are linked that's fascinating to me how do you describe inflammation or chronic inflammation to your patients or your students well i usually say you know we're all we all know inflammation on the surface of the body it's local redness heat swelling and pain at an area that's injured or under attack and that although it can be uncomfortable inflammation is the cornerstone of the body's healing response it's how the body gets more nourishment and more immune activity to an area that that needs it but inflammation is so powerful and it's so potentially destructive that if it persists if it escapes its limits in time and space then it becomes destructive and in the short term it can lead to allergy and autoimmunity but long term it looks as if it increases the risk of a whole diverse range of very serious chronic diseases you know i think that coronary artery disease begins as inflammation in the lining of arteries uh alzheimer's disease clearly begins as inflammation of the brain and that's why anti-inflammatory agents like ibuprofen and turmeric have a preventive effect and cancer is linked here too because anything that increases inflammation also increases cell proliferation the two are totally linked and and when cells proliferate more the risk of malignant transformation is increased so again it's just fascinating that this is so different from what i was taught in medical school in terms of foods and this anti-inflammatory diet that you put together many years ago i wonder if we could sort of talk about what this kind of dietary pattern looks like is it more about the sort of general types of foods you're eating or can we see within that some specific both both and i i developed this by using the mediterranean diet as a template because we have so much scientific evidence for that way of eating being associated with uh you know optimum health and longevity and it's a way of eating that in no way restricts the pleasure of food which i think is extremely important and i tweaked that by adding asian influences to it because i've spent a lot of time in asian countries and there are food specific foods and and uh beverages that i that in particularly in japan uh china uh india that i think are you know very helpful so um the first rule of the atlanta first of all it's not a diet you know it's because diets are things that we go off of so it's an eating plan for life and the the first rule is to stop eating or greatly reduce consumption of refined processed and manufactured foods i mean that's simple it's that that kind of food food being made by somebody else uh that is really at the root of a lot of our uh of these chronic illnesses in in our societies of obesity type 2 diabetes hypertension so forth so the first step is simply to try to eliminate refined processed and manufactured food and then you know next is eating a variety of high quality fresh produce especially vegetables you know fruits yes but fruits are often concentrated sugar sources and i think should be we should be more moderate about that but an array of vegetables with all different colors because those are all protective compounds i think it is good to reduce the amount of animal protein in the diet i don't tell people to become complete vegetarians or you know i myself eat fish and vegetables but i think restricting animal foods is a good idea um increasing the consumption of plant protein in the form of legumes soy protein for example um using olive oil as a major as a main cooking oil and being very careful about the kinds of fats that you consume making sure that you're getting omega-3 fatty acids uh which are strongly anti-inflammatory by eating oily fish or supplements of derived from algae if you don't want to eat fish using spices like turmeric and ginger which are powerful anti-inflammatory agents tea especially green tea which has many helpful antioxidant properties i've developed a uh and eating uh forms of carbohydrate that don't raise blood sugar quickly i'm not anti-carb but i think it's important to distinguish between types of carbohydrates that digest quickly and especially products made from flour and pulverized grains as opposed to truly whole grains that are cracked either entire or cracked in big pieces um and uh i have an anti-inflammatory diet pyramid and at the very top is dark chocolate which i think is a health food and i and consumed in moderation i think is very good for you the first step when you were describing that was remove or eliminate these highly processed foods and it just makes me think of something i i've been sort of contemplating a lot recently andrew which is this this idea that is it more important and i guess the question itself is artificial but it's just uh i guess uh you know thought experiments you know is it more important to exclude these problematic modern highly processed i guess not even foods food like substances or is it more important to i guess we can keep those in but add in some of these so-called you know superfoods or you know your dark chocolate your berries those sort of things i mean how would you look at that sort of conundrum uh i think it is more important to reduce or eliminate the the process stuff me too i think it is really unhealthy and uh on all sorts of levels it's the wrong fats the wrong types of carbohydrates not enough of the protective elements so i guess you could make up for the protective elements by adding some of those other things back but you're not going to take away the damage being done by the you know the unhealthy fats and the unhealthy forms of carbohydrates and the additives how do you you know how do you see these diet wars and and i'm again i'm really interested because you've been across this field for so many years you know something has changed hasn't it in the last i don't know 10 20 years like diet is you know it's prime time now you know everyone's talking about well not everyone not enough people but a lot of people within the health space are talking about diets there are fights going on about vegan versus carnivore versus keto versus low carb and you know i'm interested as to how do you see all that as someone who's been across this for so so long has anything happened to modify your view you know tweak things over time or you know what's been going on there well i've seen a lot of these come and go and i think a lot of the ones that are fashionable at the moment will go uh some of the ones that are popular i think are really unhealthy i think a keto diet is extremely unhealthy unless it's for you know specific use of kids with intractable seizures for example well why do you say that because a lot of people even within the health space are are describing huge benefits from a ketogenic diet and i appreciate that casino can be done many different ways i mean a lot of people can do it with lots and lots of sort of leafy green veg as well to get these phytonutrients but but you know why is it you think it's so unhealthy i think these diets tend to be very unhealthily low in fiber for example i think the restriction of carbohydrates is unhealthy i think it fails to distinguish between better and worse forms of carbohydrate uh i think beans are very healthy forms of carbohydrate whole grains i think are healthy i think keto diet is also very unhealthy for the planet and this is something that we all have to be concerned about today is the the environmental impact of different ways of eating and this is uh you know one of the strong arguments for uh reducing animal protein in a diet especially beef and keto people tend to be eating a lot of meat uh and that i think is one of the great contributors to climate change and we can't afford to do this anymore so for all those reasons i think that's not a good eating plan on an individual level i'm only asking this because i know a lot of people ask this question if there's someone listening to this right now um or or you know watching this on youtube or whatever somehow consuming this information and let's say i don't know three months ago they went on a ketogenic type diet and they're now experiencing they've they've lost weight they've got more energy they've got better skin they've got more focus because this is what you hear a lot right so if something is into that is experiencing that and then they're hearing you someone who they really respect say actually you don't think it's that helpful how would you help that individual kind of make sense of that first of all a general belief i have is that in many cases benefits health benefits that people experience when they change how they eat are really not directly due to the dietary change but rather to the commitment of mental energy to doing something to improve your health you know there's no way to do that experiment but i think it's not easy for people to change how they eat and so to do so represents a great commitment of mental energy and that often initiates a healing response or improves health function of the body so i think any uh beneficial changes that you see following a dietary change have to be assumed to be somewhat and maybe in large part due to that you know if you want to call that a placebo response fine but unless we have controlled experiments to tell how much is due to the actual dietary change it's very hard to tell you asked also about any major changes that i've made in my thinking you know a big one was that i lived through the anti-fat era in the 1970s when we were told that dietary fat was the ultimate culprit and it was causing you know heart disease and all sorts of things and this was the year in which manufacturers made low fat and no fat products and in that period people got fatter and there was really no change in disease patterns and i think that way of thinking has been totally discredited although still if i go to a spa in many countries the food that i'm served is ultra low fat food and people think that's the way you make food healthier is to reduce the fat content and you know that has nothing to do with i think carbohydrates and the nature of carbohydrates are much more relevant there so yes i have seen big changes in and how we're thinking uh and uh you know i expected there were more of them but our center put together over a number of years i think for 15 years we had national nutrition conferences in which we brought together the leading nutrition researchers to present their findings to clinicians and these were extremely well attended conferences and in putting those together one of the things i learned is that in the community of nutrition researchers there's a very high degree of consensus on the big questions we know what are good fats and what are bad fats what are good carbs what are bad carbs but somehow that information does not make it through either the education of clinicians or certainly the general public because people seem to think that it's all confusion out there and you know one day they tell us this thing and then tell us another thing is they'll just eat whatever you like and that's not how it is yeah i think that's the big problem with the diet wars that many people who don't feel that strongly get really put off they they see someone they respect say i changed my life on a keto diet they see someone else i respect say i went vegan and i felt amazing and i guess there's a wider problem there i think which is you know i'm interested as to your thoughts on this andrew but i kind of feel we as a society have put a lot of faith maybe too much faith in experts and other people and and it's kind of like well we need to become our own experts right i say to people listen listen to what they're sharing then try it yourself you know yes exactly trust how you feel you know just because your neighbor did this diet and they felt amazing doesn't mean that's the right approach for you i mean how do you see that yeah i feel that way and also i worry that some of these very restrictive ways of eating have a very unhealthy impact on social interaction on ability to enjoy food or to enjoy food together with other people uh you know i just see this happening all the time and and uh people saying you have to eat this way if you don't eat this way you're going to nutritional hell i'm i just i i have no patience for that yeah so food is clearly one of these things where we can tackle inflammation you mentioned avoiding um sort of air pollutants toxins like cigarette smoke is also really important to help reduce inflammation but what are some of the other things that we can do with our lifestyle that can help reduce inflammation well stress has a as an effect on inflammation on inflammatory status and and stress is another uh significant root of many kinds of of health problems i think i would say that learning and practicing methods of neutralizing the harmful effects of stress is right up there with uh nutrition and physical activity and adequate rest and sleep is one of the planks of healthy living i don't think it's possible to live without stress but i think you can learn to manage it and not let it damage the body or mind what are some of your favorite sort of stress reduction practices that you find people get real benefit from well by far my my favorite are breathing techniques i think that learning how to regulate the breath is the most time and cost-effective method of of reducing anxiety of promoting calmness um and i i've been astonished at how little scientific attention has been paid to breath by the way this is something that comes from uh indian culture if you look around the world at places whether it's martial arts or natural childbirth or athletic performance where breathing is stressed and you try to find where this knowledge came from all roads lead to ancient india you know this is a science that developed thousands of years ago in india and has diffused all over the world uh and and uh as i say just astonishing how little scientific research has been done on breath and its ability to change physiology although that finally is changing yeah it really is i mean you have widely popularized the 478 breath um can you tell us what the 478 breath is and you know when did this start coming into your awareness and when did you start talking about it it's a yoga technique so again thousands of years old and uh i learned it from dr fulford uh and i've been practicing it since probably the uh early 1980s and i have taught it i teach it to every patient i come into contact with to all of my students uh sometimes to very large groups of people um it's so time efficient it's just you know the method is simply uh breathing in quietly through your nose to a count of four holding your breath to account for a count of seven and blowing air out forcibly through your mouth to a count of eight and repeating that for four breath cycles when you're first learning it and doing that twice a day religiously and that's all and by simply doing that over time you know over the space of a month or two months you really change the dynamics of the involuntary nervous system decrease sympathetic tone increase parasympathetic tone the relaxation response lowers heart rate lowers blood pressure improves digestion i'm really amazing results and and uh it takes 30 seconds twice a day i mean i love recommendations like that you know very very effective but but free and accessible to everybody which i think is something that i always try and keep at the back of my mind when when talking about health what there's this theme coming up um andrew which is you know i mentioned inflammation before you were becoming aware in the maybe early 80s that there's this kind of root cause of chronic unresolved inflammation that may be behind or at least contributing in a large way to things like hypertension type 2 diabetes heart disease you know depression whatever it's like okay great you also mentioned that you teach the 478 breath to pretty much every single one of your patients so what i really love is this understanding and this idea that there are some basics of health right there are some there are some common commonalities if we focus on the creation of health in the body if we focus on reducing inflammation in the body through hopefully lots of uh you know lifestyle practices we can tackle multiple different diseases even though we're not targeting them specifically and it's you know as you say that 478 breath it sounds like you use that as prevention as prophylaxis but also as treatment when somebody has a problem and i think this is in many ways changing the way that we look at medicine because we have been taught in a certainly i was trained what maybe 30 35 years after you but a very sort of quite a reductionist model we're very good at giving labels to different diseases we we separate off the body into different specialities and that can have value but also we we forget that we want interconnected system and if you change one part of that system you also have a knock-on effect on other parts as well yeah let me give you an example with the 478 breath this is by far the most effective anti-anxiety measure that i've come across it makes the drugs that we use for anxiety to look very pathetic by comparison and i have used that in patients with the most extreme forms of panic disorder uh successfully although in some cases it took some time of regular practice for them to get control of it but the the difference between treating an anxiety attack or panic disorder with a drug like a benzodiazepine and with the 478 breath it's a very stark contrast when people are panicked or in anxiety states the subjective experience usually is of being out of control if you deal with that by giving a a medication you reinforce the false idea that the locus of control is external and over time that method becomes less and less effective and often creates dependence if when a person discovers that they have within them the ability to control an anxiety state by regulation of the breath it's a revelation it's totally empowering and that method becomes more effective with repetition and creates greater independence and greater autonomy it just couldn't be a greater contrast of those two approaches yeah completely agree it's about putting it's just about it's about connecting the patient to what's going on the feeling that they have got some control over otherwise it's yeah i agree it's it's not only the fact that the treatment itself has very few if any side effects right so that's but it's awesome you know it's also about empowerment and i guess that kind of leads on to this term mind body medicine which i've heard you talk about a lot and i think it's worth kind of really trying to understand you know what do you mean when you say mind body medicine you know do you see the mind and body as separate does society see it as separate and you know what does that umbrella term really i think the only way you can separate mind and body is verbally i think they are two poles of the same reality uh and i think the uh the reigning paradigm in western science and medicine simply does not see that you know that we we have a materialistic paradigm in place uh that states that all that is real is that which is physical that which can be touched measured um i guess in medicine taken out and that if you observe a change in a physical system the cause has to be physical non-physical causation of physical events simply is not allowed for in that paradigm and this is why mind-body interactions have been never accorded their proper due why research in that area has been stunted why hypnosis has never been fully accepted as a medical modality for example why we can't make sense of of uh wart cures i mean there's a whole range of things but that that is changing and some of the change has come about with validating placebo responses through brain imaging and showing that there are correlations with you know activity in particular areas of the brain so this makes it accessible to people gradually changing but i would say there's there's a whole range of therapies under the heading mind-body medicine from biofeedback hypnosis visualization and so forth in general these methods are very cost effective time effective even fun for both practitioner and patient and yet they are very underutilized in medicine and they're underutilized because we just don't take this kind of stuff seriously in in my clinical experience i have again and again seen that the the root causes of illness are in the non-physical compartment unless that's dealt with all the physical intervention that you do is not going to solve the problem it's tricky sometimes to present this to patients because many patients are very sensitive to being accused of making up their illness or imagining it that it's all in their head and that's not what is meant by this i i don't it's very difficult to use the term psychosomatic because of that connotation i don't think we've as a profession we've we've got a bit of a bad reputation in the past telling people that their ibs aerosol bowel syndrome is sort of kind of in their head or their fibromyalgia is sort of in their head and i think so there's a lot there's a real defensiveness from people understandably that understandably you know everything is is in both yeah it's uh it's really interesting that isn't it the mind and the body and i guess now we're getting this field of research which i'm interested as to what state this was in in the 60s and 70s but you know the last five ten years we've got the microbiome the gut brain axis lots of research showing this bi-directional communication between body our gut and the mind in our brains and you know were you aware of this uh early on you know what did the research say or did you just intuitively and through your experience know that this was going on i took a course in medical hypnosis at columbia university right after i finished my internship it was one of the most fascinating courses i ever took and certainly made me aware of the research that was out there and it and it totally resonated with my own interests so it's i've paid attention that for a long time i uh have a colleague that i worked with for many years who's on our faculty um who is a teaching member of the american academy of clinical hypnosis and i've sent him many patients and i remember early on him saying to me that he thought that every uh dermatological patient and every gi patient should first go to hypnotherapy before they went to dermatologists or gastroenterologists because those two systems of the body have had the highest ratio of innervation and connection to the mind and i've absolutely found that to be true and another uh experience i had uh shortly after he said that the the leading gastroenterologist in tucson asked me to have dinner with him he's in his 60s and he was very depressed and said that he hoped that i had something that could help him because he said 90 of the patients that he saw had conditions for which his training did not equip them to do anything about i mean that's remarkable um and and i think this is absolutely the way it is and it's not just for gi disorders and terminological disorders it applies to many other things as well and that doesn't mean you should not work on the physical problem but you want to also be working on the non-physical aspect of it but there's two things that come to mind there that that 90 statistic is it's a very striking one what's interesting to me is i would agree with that actually there's that there's um [Music] so much of what we see we don't certainly as medical doctors we don't have tools that work really well for them yeah i feel i don't know what it is about i'm not trying to get too down on my profession at all i'm very proud to be a medical doctor i'm i'm pleased i went through like you that that conventional medical training but i do feel sometimes that there's a there's a certain arrogance within the profession or there's a i don't know what happens at medical school where you go in as a kind of open-minded curious individual and you come out or many of us come out quite close-minded thinking we know it all and actually anything that we weren't taught has no value and because you know a real striking moment for me uh andrew was one it was one of my days as a general practitioner you know i moved from specialism into general practice i was getting quite frustrated with just looking at kidneys and i really wanted to see how everything linked together and around one day i'd seen i think close to 50 patients and i was a bit frustrated and before i left the clinic to go home i went through the whole list and i asked myself okay wrong and how many patients have you really really helped today and i honestly thought it was about 20 i thought yeah those 20 i think i've really done something called the other 80 percent you know i've i've referred them somewhere i've given them something to suppress a sensor but i didn't really understand what was going on i knew that they would be back and i thought i can't do this for 34 years like there must be more to this than that right so why is it that it some of us look at that with honesty and transparency go actually we're we're really good at this stuff we're not so good at that stuff and why is it that others kind of almost ignore that and just stay within that system of going no no no no this is the way to do it you know have you got any answers there what goes on there well i consider myself an open-minded skeptic i'm willing to look at anything believe anything but then i need to see uh proof i need to confirm that with my own experience a lot of people that i run into in medicine and science generally i would say are close-minded skeptics which is very different and uh i i think in medicine especially there is a tendency to be suspicious of defensive about any information that comes from unfamiliar sources uh so all of a lot of the ideas of that are out there in the world of alternative medicine you know anything of that sort is just dismissed as as nonsense without even paying attention to it the um the dean of the college of medicine at the university of arizona who gave me the green light to start this center years ago uh jim dolan he was a cardiologist and had had been a psychologist as an undergraduate which is probably accounted for some of his openness to this uh when he retired he said that the achievement he was most proud of in his career was starting the integrative medicine center and he told this said this about uh all the flack that he got for allowing this to happen and he he told a story about the attitudes of people in our profession and i think it's interesting the observation that aspirin uh was an anticoagulant and may have a preventive effect in coronary artery disease was first made i think was in the 1950s by a general practitioner in kansas who noticed that when he he he was taking aspirin notice that when he cut himself shaving that his he bled more than usual so he thought maybe aspirin was responsible this he started giving aspen to some of his friends and confirming this effect and he wrote an article in the journal of general practice saying that aspirin had anticoagulant activities and might be useful as a preventive in coronary artery disease it took something like 30 years for the medical profession to come around to that point of view and a major reason why they didn't was that this had been proposed by a general practitioner and published in a journal that cardiologists didn't read and it was dismissed as an outrageous idea and that's within the profession so imagine when something comes from the world of traditional chinese medicine or the world of herbal medicine you know that that provokes this kind of the same sort of response when you were giving the definition of integrated medicine i think you used the word conventional medicine within it and you just mentioned the phrase traditional chinese medicine and it's an interesting thought isn't it when we we talk about conventional medicine or traditional medicine it's again there's a there's a sort of inbuilt arrogance there it's like well yes it is you know our system of medicine is not that old and if you're gonna call something traditional i think it should be at least a thousand years old yeah exactly it's native american medicine ayurvedic medicine but not what we're doing today as allopathic medicine i mean that only goes back maybe 100 years i mean what is incredible is to see as you said with with breathing but there's a lot of science now coming out isn't there to support what these ancient healing modalities you know traditional chinese medicine indian oyaveta medicine have been talking about for years whether it's a period of time each day without food or you know a period of time every 24 hours where you're not pulling food in whether it's breathing practices whether it's um the fact that different organs have different genetic activity and that that they're more or less active at different parts of the day i remember the guardian newspaper in the uk covered a study maybe two or three years ago which was showing you know it was about the circadian clock and how the liver is more and less active at certain parts of the day other organs are as well and and the kind of conclusion was oh so we can then use different medications at different times in the day and okay that may be one of the conclusions but i was also thinking have traditional chinese medicine and indian medicine not been saying this for thousands of years that there's a different rhythm to different organs at different times of the day and i guess for you as someone who's been preaching this message for a good 50 years you're now seeing a lot more mainstream support in a way that you presumably weren't 40 50 years ago i guess for some of these other modalities not that they need it i guess but it must be quite gratifying to see oh these guys are kind of catching up to what we already knew you know as i say there are ideas in these systems that to me seem so powerful and useful and there's other ideas that that don't seem that way and i i look at all this and i'm very selective in what i take from from other systems one idea that uh i find very powerful from uh chinese medicine i have a another colleague in md in new york who practices what he calls modern chinese medicine and he i once heard him say that if you could summarize all of chinese medical philosophy in one sentence it would be to dispel evil and support the good in in western medicine all of our focus is on dispelling evil you know we identify what we see as agents of disease or causes disease and we blast them with weapons usually pharmaceutical and we really pay no attention to supporting the good which are the intrinsic the intrinsic resistance or defensive functions of the human body and just as a concrete example of this if you look at the way we manage gastroesophageal reflux disease you know we use these very powerful medications that suppress production of stomach acid you know we say that's the problem there's too much acid in the stomach and we stop it with a very powerful drug that's an example of this the dispelling evil philosophy we do nothing to support the defensive function of the body which is how do you make the gastric mucosa more resistant to the erosive action of of stomach acid and there are various ways of doing that there are natural products that do that adjustment of diet i i see so many patients who are put on these medications without any dietary history being taken without any warning of the addictive nature of these drugs the long-term problems that they cause i mean that's that's the unbalanced uh western approach that could really benefit from paying attention to that idea from chinese medical philosophy yeah and the system the modern medical system really feeds that doesn't it because you know she said that i had i had a flashback to i don't know 12 13 years ago i'm going to guess in clinic you know a lot of patients waiting outside this is much more conventional nhs general practice and i can't remember the exact patient but they they'd come in they'd still got these uh gut acid type symptoms they'd already been on i think they started off on a meprazole the proton pump inhibitor yeah then the doctor had changed it wasn't working to lands operazol and then i think i had a protocol which said oh there's a new one called esomeprazole let's try that that's the third line that's recommended by the local hospitals and you just get into this maddening uh vortex where you know no one's understood the root cause of it they've been put on one proton pump inhibitor my understanding is that the early trials on pros and bottom inhibitors only looked at their use for a few weeks three four weeks exactly maximum exactly where it's now and people are on them for ten plus years just on repeat prescriptions and this is a problem that i think is really not appreciated that i've been trying to call people's attention to both my colleagues and patients that when you use these powerful counteractive agents long term you run into a problem i call the homeostatic trap that the body will push back against what you're doing so if you try to block the production of stomach acid with a drug over time the body is going to try to produce more acid so if you lower the dose or stop the medication there's going to be an outpouring of acid much worse than you had to begin with and so people think well then i can't get off these i have to take them and over time you are worsening or prolonging the problem and the same thing happens with depression you give ssri antidepressant drugs to increase serotonin at neural junctions how is the body going to respond to that it's going to try to it will make less serotonin and it will drop serotonin receptors so that if after a year of use you try to get off that or reduce the dose depression is increased uh you know there's there's even a name for this now it's tardive dysphoria which is lingering lingering depression as a result of treatment uh and you see this again and again with so many of our pharmaceutical agents and there's a double problem isn't there andrew there's this problem that the person who initially came to the doctor with these heartburn acid symptoms that were causing them problems at work or that when they went to sleep because we didn't address the root cause then we gave them a pill which may unless we have been really clear that this is a short-term intervention to help your symptoms while we deal with the underlying root cause which is where i think those things can potentially have value sometimes for some patients short-term yeah you know if if we explain that but we disempower the patient they start taking the people think oh i've got a problem that i need this pill to fix and then when they can't get off it yeah it reinforces yeah i i have that problem i i need the pill or i can't function without realizing your body is reacting and this it sounds as though we're talking about rare cases i bet you if you go to any general practice in the uk it's all over the place you'll have hundreds if not thousands of patients at every practice who are in this situation and it's so frustrating because once i run it it is challenging to get them very challenging very challenging and by the way wrong when i was growing up in the 19 1940s 1950s reflux gastric reflux did not exist people had heartburn and they dealt with it mostly by taking calcium carbonate mint flavored calcium carbonate which is relatively safe and i think most people understood that heartburn was your stomach's way of telling you that you'd mistreated it either you ate too much you ate the wrong things but now this has become completely medicalized into this condition you know due to too much stomach acid and you treat it with these powerful medications and then go about your business and as i say almost every patient i see who is in this situation where they're dependent on the drug and can't get off they were started on them without any questions being asked about what they were eating uh were they drinking coffee were they smoking what their stress levels was no no in korean any of that yeah or how stressful their lives were were they were they eating on the move while you know it sounds so basic but there is always there's almost always a way to help people with those symptoms if you take the time to understand what's causing them in the first place and it's you spot on it's this medicalization of symptoms whereas you know it's the body sign it's trying to talk to you and raise raise it's trying to scream at you you got to do something differently right you're not treating me well but instead of listening i guess it's reflexive of just how how busy and stressed out people are now whether it's the doctors in practice whether it's the patients in their busy busy lives that it's almost it kind of feels like it's the perfect storm medicine has got these quick fix solutions for busy people who don't feel they've got the time and energy to make change and then you end up in this really problematic and quite toxic situation well this is this is the perfect opportunity for doctors to be teachers and to be able to explain to patients why long-term use of these counteractive pharmaceutical strategies is not wise that it's going to get you into worse trouble uh and may produce bad effects of its own and what the root causes of these things are and what changes you can make you know that's that's what we should be doing and it is very rewarding to do that and to see you know good results yeah you mentioned the placebo effect before and the power of the minds and i've shared on this podcast before that my realization over the past few years has been yes food movement sleep stress super importance they are very very important things to try and help everyone with but actually if you go one step further i really am feeling more and more that it's the mind it's our belief systems up here how we view the world actually determines a lot of those behaviors in the first place and unless we we tackle that yeah we can make big improvements with food and movement and stress but at some point to really get that long-term change we got to tackle what's going on up here and you mentioned the placebo and it's interesting that there's such powerful research behind the placebo but how do we talk about it in medicine it's it's the most derogatory thing in the world when we're talking about trials isn't it it kind of it speaks to how little credence we give or have typically given to the power of our minds yes the the two most common usages of the word placebo i hear in medicine are how do you know that's not just a placebo effect and the most interesting word there is just or we have to rule out the placebo effect you know we should be ruling it in the he placebo responses are pure healing responses from within you know mediated by the mind and that's what we should be trying to make happen more often that is the art of medicine how do you present treatments to patients to get the maximum healing response with the minimum direct physical intervention again something that i began writing about long ago and and talking about and i'm happy to see gradually a a change coming about in that area uh but that word is so charged and so loaded and you know the thinking that placebo responses are imaginary and they're not as important here's a little there's a little uh assignment that i like to give to medical students and also to doctors in training as well is to go into pick up any medical journal at random that reports randomized controlled testing of drugs and look up an article and flip to the back where there's a table summarizing the results in the placebo group there will always be always one or two or a small number of subjects who show all of the changes produced in the experimental group in other words any change that we can produce in the human body with a pharmaceutical agent can be exactly reproduced in at least some individuals some of the time purely by a mind-mediated mechanism to me that is the most important single fact that's come out of this whole era 70 years of randomized uh controlled drug testing and that's what we should be trying to figure out how to take advantage of and make happen more time it's something that doctors who i train ask a lot they say this and i'm assuming you've heard this a lot as well you know dr weil dot chassis you know i understand what you're saying but you know patients don't patients just don't do what i tell them to do and i find that language and that phrasing very telling in and of itself uh what i tell them to do i think is potentially problematic and there's this kind of thing that oh you know i know everything but the patients just don't do what i ask them and one thing i teach um doctors is when i get asked what's the most important thing i've learned in 20 years of seeing patients my answer is always connect first educate second and i always say yeah and also to model behavior for patients as i said this earlier that you have to model you have to embody the changes that you want to see in others so you have to model health for your patient but i'm interesting i totally agree and i what i why i'm so passionate about that is i've realized that until the patient across the table from you has really connected with you made eye contact like really felt hurts i just don't think they're that willing or that engaged to then take the next step whereas if we just rush in to get the solution it just doesn't work that well and then if you take that outside medicine because what is the patient doctor relationship well it's a relationship isn't it so how does it work with your partner or your wife or your children you know who responds well to just being told what to do it's always about feeling seen feeling heard really really having someone validate who you are and how you're feeling before you take that next step and i it's such an obvious thing again we're not taught at a medical school but for me uh dr that is one of the big truths that i've learned from seeing thousands of patients and i'm i'm interested to see your view on that is that something you've come across before would you agree with that or would you modify that i very much agree with that by the way one of the reasons that i like doing the 478 breath with patients is that it establishes a very intimate connection with the patient to breathe with them uh they're not expecting that they're not used to that and i find that facilitates further connection uh also a a practical technique that we teach to the people that we train is motivational interviewing and this is a technique developed recently it's a dialogue that you have with a patient that helps you and the patient identify mental patterns that are obstacles to making changes in behavior and lifestyle and then helping them develop alternative mental patterns that facilitate the changes you want it's a very useful technique and it's something practical that can be taught i mean speaking of hippocrates that you mentioned before a phrase that popped into my mind was it's i think this is hypocrisy it's more useful to know what sort of person has a disease than what type of disease a person has and i think that really that is again something i figured out over over many years of getting frustrated and not being able to help my patients as much as i wanted to i sort of came to that truth that way and that i guess speaks to the power of the mind and how we're all sort of individual um you know you you mentioned the power of the mind sorry yeah go please no you made me think i just had a flash on being in medical school and being told by an attending physician you know go see the gallbladder in room seven yeah that says it all doesn't it says it all yeah am i right in thinking that you've shared a story in the past where i think you had taken some form psychedelic mushroom potentially and whilst you were under its influence you were able to do a yoga pose that you had unable that previously you weren't unable to do or if you could just share that story because i i think that really speaks beautifully to how our mind can get in the way it's a an example of what the potential of these agents is it was actually lsd and i was i think 28 living in the in a rural area in virginia it was a beautiful spring day and i took lsd with a group of friends outside and i had been just starting to practice yoga i had been doing it for i don't know a month or so and one posture that i had a really hard time with is the plow where you lie on your back on the floor and you raise your legs and then try to touch your toes behind your head i got my toes within a foot of the floor and i had horrible pain in my neck and i just got stuck there i couldn't i couldn't do it no matter how much i practiced and i was on the verge of giving up i thought i was too old my body was too stiff uh and then under the on this day when i was under the influence of lsd i felt terrific my body felt really elastic i was you know wonderful i thought gee i ought to try that so i lay down and i was lowering my feet i thought i had about a foot to go and they touched the ground i couldn't believe it and i did it repeatedly i was just so joyful to be able to do that the next day i tried to do it and i got my feet within a foot of the floor and i had excruciating pain in my neck but there was a difference i now knew that it was possible and up to that point i didn't think so and so i kept at it in another couple of weeks i was able to do it if i had not had that experience i think i would have given up so you know i saw a possibility that i did not believe in and that motivated me and i think there's tremendous potential for psychedelics in in medicine not just in psychiatric medicine of showing people that it's possible to experience their bodies in a different way i think that's very applicable to chronic pain for example allergies autoimmunity uh but there's other ways of you know of of getting glimpses of that as well you know one of them is simply meeting a person who's had your illness and is now better and if i can arrange for patients to meet other people who have are well who've had their same illness that's a very powerful way of overriding any negative predictions they've had you mentioned psychedelics and sort of my feeling is that in america at least the things and the interviews and the conversations i consume from america a lot of quite prominent people seem to be talking about the potential value of uh certain psychedelics for certain conditions and i know i think johns hopkins i think lots of prestigious institutions research institutions are now studying this so i wonder you know you're someone who was i think studying marijuana and its effects on health in the 1960s a long time ago maybe one of the first people to do this i wonder if you for any listeners who are naive to this who've never heard about this you're a super well respected doctor you train at harvard medical school could you just outline you know what are psychedelics uh how can they provide utility for people and why have they been demonized for so long well psychedelics are there there are two groups of them chemically there are natural sources of them and they're chemical sources of them these are substances that i think have extremely low potential for toxicity probably lower than any other drugs that we know of they can produce very dramatic psychological effects that are that are quite dependent on sentence setting on people's expectations and on the environment in which they're taken so the most common ones are lsd psilocybin uh masculine which comes from the peyote cactus psilocybin is from mushrooms there is a drug called mdma which is slightly different category marijuana cannabis is not a a psychedelic it's something else but there was a lot of research interest in these in the 1950s uh and and some really wonderful research on them and then uh it all got shut down when uh in the wake of uh of the hippies and and uh timothy leary and uh very restrictive laws were passed against them and only now recently has this uh come about again and it's not just in the in the us although i think we're farther along canada is uh you know well along in making psilocybin available for the treatment of depression and there's actually a lot of activity in the uk with psychedelics as well and in some of continental europe i think this is happening all over and that we're going to see uh very quickly that you know i think we'll see psilocybin made available for the treatment of drug resistant depression and anxiety mdma for uh ptsd which is a huge problem in in america among uh returning war veterans so i think we're going to see these compounds made available for therapeutic use but at the same time there's tremendous interest in the general public in them in the free covid when i was traveling a lot and speaking whatever the subject i was talking about whether it was healthy aging integrative medicine nutrition uh the questions i got were about psychedelics you know where can we have can we make them how can we find guides experiences just tremendous mainstream interest i think two months ago vogue magazine in the us had a cover story on psilocybin you know that that's kind of mainstream interest that's really remarkable wow so you mentioned before when we were talking about um anti-inflammatory diets you mentioned green tea and i know you are a particular fan of green tea in in particular from what i understand it's matcha can you tell me about you know when you became aware of matcha what happened there and why you're so passionate about people drinking more of it uh when i was growing up tea was something drunk by old people and sick people and i drank iced tea heavily sweetened when i was 17 i had a chance to live in japan with japanese families and i really came to love green tea very good and i seen nothing like that in america and i was also introduced at that time to matcha in the japanese tea sermon matches the powdered green tea that's whisked into a froth and consumed in the tea ceremony and i began bringing that back when i would go to japan and turn people onto it nobody'd ever heard of it in in the states and then sometime in the 1980s i think this was again way ahead of its time i formed a connection with a a japanese company that produced matcha and tried to sell it through my website dr wild.com but it was not the right time for it and then uh it's been quite amazing to me to watch uh how fashionable matcha has become in recent years but i i was concerned that most of the stuff that people were drinking was not good quality because matcha is so finely powdered that it oxidizes very quickly and it loses its bright green color and and good flavor and so i wanted to make really good quality matcha available and i again formed a relationship with another japanese company near kyoto and uh formed a company called matcha.com machikari that's selling this and you know turning a lot of people on to to this i think it's a wonderful product first of all there's a great deal of research on the health benefits of tea in general and green tea in particular a lot due to its antioxidant content matcha is different in that the leaves are grown in a way that increases the content of antioxidants and and it also has a high content of an amino acid called l-theanine that has a calming effect and i think that modifies the effect of caffeine and makes the stimulation of of tea and matcha in particular very different from that of coffee it does not have the jangling effect of of coffee it does not leave you with a crash when the stimulation wears off people say it causes a state of calm alertness um that i think is very desirable so i think it's a good thing much is also beautiful and and delicious and i'm gonna have a bowl of it after we finish talking there's a ritual isn't there in japan as to how this is prepared though and i i i sort of feel like this the matcha tea that you sell when what are people buying they're buying the powder that they then have to find the powder and i don't care what they do with it i mean if they want to use an electric whisk if they want to make a latte out of if they want to sweeten it you know however they want to do it i i like doing it in the traditional way which is using a bamboo whisk in a small amount of hot water unsweetened but you know in in japan now matcha has escaped the tea ceremony ritual uh that's really a kind of old-fashioned thing and and matcha is now consumed mostly by people uh not as part of a ritual although i think um there's a long association of tea in general and matcha in particular with meditation and uh again very different association from uh from that of coffee i think matcha has been associated with contemplation with meditation uh and the ritual of preparing it and when i whisk it in a bowl i find that to be very meditative and relaxing i think what what you're speaking to there is something that again i think is a missing piece in modern life and and even in modern day health promotion which is it's not only what you're doing it's how you're doing it so you know if you're taking five or ten minutes to prepare your green tea you know it's it's it's not just a habit it's it's a ritual it's a time to dedicate to yourself to actually be present with a certain process and and and and you know i mean interested is your view on this but i've been thinking recently that we do science we we look at green tea or we look at the polyphenols in coffee and we go oh this is a great thing and so we in our rush lives we you know we make a quick coffee we slug it down and we go and then we say oh yeah it's got loads of polyphenols and it's really good for me and i kind of feel have we lost something somewhere because for me for example i do drink coffee i've i've limited it i know what works for me but i have it first thing in the morning now i know people will say because i'm an early riser i'm usually up by five people will say it's you know it's probably not with your circadian biology the perfect time to have it however i would argue that you know what that hour hour and a half in the morning before my wife and kids get up is my sacred time for myself and i i make it in a very ritualistic way i i don't slug it down while doing something else i'm paying attention to and i i feel actually for me on balance when you take into account everything that forms a very important part of my day and you know i i feel more and more we're missing this piece when we i hear you i agree with you and i i would extend that to eating in general and one of the things that struck me when i especially when i spent time in italy and in france is how different the attitude is of people toward eating um you know that that in the u.s you are rushed out of restaurants uh it's in a hurry uh there's a lot of concern about you know is this healthy is this not healthy i think in in continental europe especially in france and italy uh there's so much more attention and time given to the enjoyment of food uh to lingering over it to sharing eating in company as a social ritual and i think that has you know as much to do with uh lowered rates of obesity for example as you know the what what people are eating yeah i mean i think there was a study a uk study i think it was the university of birmingham um a few years ago showed that actually if you eat in a rush while distracted so doing something else watching television you eat more at that meal and subsequent meals for the rest of the day right which which again really speaks to what you're saying you know that there are it's not just what you're eating it's how you're eating it's the intention it's what's going on in the mind as you're eating um yeah super interesting so i i feel you've uh you've definitely uh sparked my interest to have some uh matcha tea this weekend what's what's the what's the url i think it's what would that be it's just matcha.com matcha.com fantastic yeah um what about your daily routine i mean you're someone who has been sort of you know really a pioneer in this field and i think a lot of us would be interested to know how do you i mean you know how old are you now i think it's is it i am 79. i mean 79 incredible and looking in tip-top health what do you do on a daily basis because i think it would be quite if you're if you're happy i get up early i i beat you wrong and i got up at 4 20 this morning i tend to get up when the sky starts to get light and that's my best time i uh do some sitting meditation in the morning i have uh two dogs i come down and feed them um i usually have i might have my bowl of matcha and something light to eat and then i take the dogs on a walk i have a garden that i tend to i grow a lot of my own food i try to get walks in or swim every day that's my favorite form of exercise i'm mentally active most in the morning if i'm going to write or do intellectual work i like to do that in the morning and afternoons are more for relaxing reading spending time with friends uh preparing food cooking um you know that's that's my usual day and i i'm usually in bed by usually nine at the latest ten yeah love it so much to think about there um just to sort of close off this conversation dr while i'm interested um you've seen a lot of changes in healthcare over the past 50 years you've seen things come in things go you've seen things take the public interest and leave the public interest if you look at the us healthcare system because i know that's where you're based i know you've traveled the world so you're probably quite familiar i think with other healthcare systems it's very easy for i think many of us to criticize our own healthcare systems other healthcare systems but if you were to look at the us healthcare system yes there are some negatives which you've spoken about before you've spoken on this show you can perhaps recap on what some of those negatives are but are there any positives adverts we can take that round the world we can learn and go oh god america are doing that really really well when it comes to health i'm really interested as to your view on that and you know how other countries need to evolve their health care systems as well well we don't have a health care system in the us we have a disease management system and it's functioning very imperfectly and getting worse by the minute and also we as the richest nation are unable to guarantee basic health care services to all of our citizens that's unconscionable so those are the big black marks i think as a result of the economic collapse of our health care system you know we're spending an outrageous amount of our gross domestic product on health care and have terrible health outcomes that's unsustainable but as a result of that that is what's fueling the integrative medicine movement which is much more developed in the u.s than it is anywhere else if our health care system we're not in such trouble our institutions would not be open to this you know a lot of the people that come to the fellows who come to us to study are sponsored by their institutions by their hospital systems who are paying for their tuition you know this would not be happening if the economics of health care in this country weren't such a mess uh so and i see this happening around the world you know we were not getting any people from the uk until very recently for example or from western europe but as as the economics of healthcare begin to deteriorate everywhere there is openness to integrative medicine and i think that's the great change do people from around the world have to come to america to do that residency or can they do it online it's online we have had you know until covid we had three residential weeks in tucson that were scattered through the the two-year fellowship uh but in the past two years we've done it all online and we may now go back to some uh residential teaching yeah i mean we'll we'll get a link from you we'll put it in the show notes of people and doctors who are interested in that you mentioned universal healthcare of course that's something we do have in the uk we have the national health service which is something this country is very very proud of but something i've been thinking about over the summer is you know i'm on a social media hiatus at the moment for four weeks and it's really the time of year where i really feel i really get to tune into my own thoughts again and what i think rather than being influenced by what i'm reading online each day and i've been thinking about the nhs and of course you know incredible benefits of having something like the national health service you know my own father who had lupus when he was 59 kidneys failed dialysis for 15 years no problem all paid for you know if he was in india or in another country around the world and he couldn't afford dialysis you know i wouldn't have had those 15 years with dad that i had so there's huge benefits but in an era in the 21st century in an area where the majority of our health problems are driven by our collective modern lifestyles i'm really interested is there any downside of having this kind of universal healthcare system whereby we're not really incentivized personally to look after ourselves because actually if you look after yourself you never even need to access the doctor so you're not even getting what you put in i i'm just sort of it's a thought experiment for me at the moment to figure out is there any downside here do you see what i'm getting at yeah but first of all i don't think it's sustainable because in the uk as everywhere now you have an aging population you have epidemics of lifestyle related diseases you have increasing costs of the high-tech interventions which is is what conventional medicine depends on and all of those trends are making health care increasingly unaffordable so the system cannot go on that way and and the issue that you raise that this really does not provide incentives for prevention uh and for people taking responsibility for how they live and managing their disease risks it's all feeding into this so i can't see that this can go on yeah for sure well it's well it's been uh been a real honor uh to speak to you today i could have spoken to you for many more hours and i hope we get the chance to meet at some point in the future when the world opens up um just to finish off then this this podcast is called feel better live more when we feel better in ourselves we get more out of our life you've shared a lot of things today on the show and i wonder if we could just finish off with you sharing some of your most practical most impactful tips that you've seen over 50 years make the most difference in people's lives i think really trust in and pay attention to your body's healing ability because it is your greatest asset you know learn the basic uh facts about nutrition avoid processed manufactured food and really pay attention to breathing and learn how to breathe i mean that's absolutely basic thanks so much for joining us thanks for all your work over the years and i hope we get to meet at some point in the future good i enjoyed it take care thank you take care bye-bye gut bugs the microbiota at the interface of your digestion and the rest of your body are one of the key educators of the immune system and again this is something that's probably exploded in the field of of immunology in the last 10 15 years if you do not so if you take a an experimental animal model where the animals have a reduced or a minimal um collection of good bacteria in their gut their immune system doesn't develop and they're very impaired in how they can respond and heal and even things like you know protection from cancer because our immune system is the main cancer surveillance system so these bugs are helping to educate and teach and mature our immune system and this happens potentially in utero before we're born but predominantly when we enter the world because we go from a relatively sterile there is some evidence that there may be some bugs in the placenta um but we go into this hugely germy world and suddenly our immune system has to cope with that because you know it it's um it's got all these receptors on it to detect pathogens as being problematic so it has to learn to tolerate those because you know most of the bugs around us are safe and harmless and we need them because they're helping us and that's actually how the immune system develops isn't it it is by exposure to the environment around it to the bugs around it to sort of give it that sort of ongoing education so it starts to learn oh i respond to this i don't need to respond to that exactly i often say that you know the immune system is made it's not born there's maybe a percentage in the genetics that we inherit but then it's made it's built throughout our life and it changes throughout our life so that's a lovely idea it's a maine not born we can we can build and we can sort of develop it the way we want to if we give it the right yeah yeah and i i often think about the inputs as a way to shape the immune system and i was trying i was working on a talk the other day and i was trying to make a slide of all the inputs some that we can control some that we can't that are shaping our immune system from birth and then it just became a really busy messy slide because there was too much to put on there but yeah a lot of it happens in childhood and in some ways i find that quite daunting as a mother and you think well you know there's sort of first three years i would say is when you're being colonized by all these good bacteria and there's huge changes going on in the immune system during that time and there's this kind of interaction happening these bacteria they help protect the gut barrier to keep it very nice and and tight and stop any bacteria going into the body because they're only good bacteria if they're in the right location so they're not meant to cross over the gut and enter our body yeah because then they become a problem um but one of the biggest things that they're doing to help our immune system is they're they're eating our foods and i often think your diet's only as good as your microbiota in your gut because they're they're the interface they're eating your food they're helping you to produce these vitamins and minerals from your diet but they're also producing these postbiotics um and people might have heard of prebiotics and probiotics but postbiotics are basically the metabolic waste of the bugs in your gut so they're producing stuff that is their kind of you know waste product of eating your foods like short-sharing fatty acids fatty acids is the classic one i i used to work on these when i lived in switzerland um and looking at how they influence um inflammation in the gut and beyond so short-chained fatty acids are kind of a metabolic byproduct of the the bugs in your gut and they directly bind to the immune cells at that site and they help educate them and teach them to sort of tolerate anything that you're throwing down your mouth because we're not supposed to um react to that because it should be you know benign things that are going in there but they have to help strike that balance that if you did get some kind of food poisoning they also can identify the bad bugs so they help create an environment that's what we call tolerogenic so it's encouraging tolerance of the food that you're eating and there's a very kind of dynamic interaction between these bugs and the immune cells and i'd say what happens in the gut is not just staying there this um influence this sort of tolerogenic influence of things like short-chain fatty acids is also being absorbed into your bloodstream and helping regulate the immune system at distal science from the gut as well it helps makes he regulates yourself doesn't it exactly before there was i think i mean you mentioned the term peacekeeper i think the first time i read that i think it was in a nature paper in 2014 i think i think i think i use that one of my slide decks it's where it calls them our peacekeepers yeah i think for the first time when i saw it in prince which is kind of what they are yeah really and and i i sort of yeah i mean i i really think a lot of people talk about gut health these days but i don't think people understand the immune system's linked it you know they think they've got something separate but i often teach uh doctors about this triad between our diet our uh our gut bugs and our immune system and how they all sort of cross talk oh definitely yeah there's bi-directional communication between you know diets and gut bugs diets and immune system and gut bugs and immune system together it's like this so you know if you if you make certain dietary choices you're going to improve the health of your gut bugs which is going to improve the health of your immune system yes exactly just empowering right because we can do something about that yes exactly and i think as a nation we're not eating enough fiber and also fiber in the uk has a really bad like image problem i think like most people i think come on let's give this some pr yes if i was to ask my husband what he thinks fiverr is he's not in any kind of medical nutrition wellness field he'd um in fact the other day he came home with some crackers that said he's like look they say they've got added fiber and i was like okay because we kind of think of it as being like you know breakfast cereals like cardboard with the big fiber logo on it and um or fiber as being one thing but again it's the diversity different bugs need different forms of fiber and we find it in all the plant-based foods so it's not just the fruits and vegetables nuts and seeds legumes beans pulses and and whole grains and it's about trying to bring in the diversity i think in the last few years there's a publication about the sort of trying to get 30 different plant-based foods into your diet because it's about per week yeah because it's about the diversity but also it's that includes i think lentils and nuts yeah you know and you know i think it's very achievable once people have it in their minds exactly yeah and they're very common in in traditional diets i remember growing up you know my mum would would add lots of different um grains and beans and pulses to spin things out as she put it so that you can make a dish go a lot further yeah wonderful advice um so so far we've said that lots of different colors lots of different diversity of plants is gonna help your gut microbiome it's gonna help your immune system eating less is also something that might be helpful right yeah so this is another field i've just got fascinated with um and that's the immuno metabolism i don't know if you've heard anything about that word you know metabolism two words together yeah and it's only just in the last five years that it's really kind of popped up um and people have started looking at this but metabolism metabolism is basically breaking down of um the major components of our diet so the protein carbohydrate and fats into energy and building blocks that our cells can use and people might hear things about metabolic rate or i've got a good metabolism these kind of things that people say um and you know metabolism and the immune system are really intimately entwined and i don't know why it's taken us so long to figure that out because immune responses are energetically very costly you know it has to be sort of triaging of resources to be like right we're going to fight this infection and turn on all the inflammation turn on all the antibody producing and all those molecules that are being produced and the proliferation of immune cells that takes a lot of resources so it needs energy it needs building blocks is this why we feel tired when with fire skin infection because the body's diverting resource yeah to making all that stuff and you might find that you need to kind of build yourself back up again after you've been uh sick um particularly if you've been sick for quite a long time or if you have an ongoing illness your nutritional needs might be very different from somebody who doesn't have that so in immunometabolism is the field that's trying to understand how metabolism can shape immune responses and vice versa so this happens at the level of the individual immune cell but also can happen in the environment of a tissue and an environment of our whole body and this is something that there's not really any kind of absolute concrete um understanding yet in this area but we know that when an immune cell is fighting an infection it goes through a metabolic switch and it goes from being in this kind of resting state to suddenly sucking up lots more um glucose to fuel uh proliferation the immune cells are making armies of themselves building antibodies requires you know the building blocks of proteins all of this kind of thing is happening and that metabolic switch is known as the warburg effect this is also what's happening to cancer cells but immune cells do this when and it's perfectly normal when they're fighting an infection or fighting any kind of um um problem and then it switched back off and the immune cells go back to normal and there they don't have this huge need for metabolites anymore but what people are starting to to wonder is can the overall environment of a body influence um the metabolic switches inside our immune cells and switch them on aberrantly when they're not needed so we know that um diabetics with poorly controlled blood sugar so they have elevated blood sugar and and their body this creates an environment that causes some of our immune cells like neutrophils to not work so well so it affects so immune cells have nutrient sensing um um switches inside them so they can sense what nutrients are are available and they're taking in that information and then that affects how they can work now what's not known is can we feed someone different um macronutrients proteins carbs or fats and influence how their immune system is working so can you switch unwanted immune responses off or on based on the different macronutrients that your body's metabolizing i think this is where the field of immunology is going to be headed in terms of treating chronic diseases because we know that people with chronic diseases like metabolic syndrome type 2 diabetes heart disease or people who are carrying too much visceral fat that the whole environment of their bodies is metabolically different and this might be causing the immune cells to act abnormally and be become more pro-inflammatory for example wow super interesting yeah a lot of research to come in that area exactly and i think we just don't know enough to say specifics yet but i think that's you know for so long we've been focused on the micronutrients but actually it's the macronutrient so you could adjust someone's diet give them different proportions of protein fat and carb to maybe alter their metabolism and alter immune cells that were going wrong so somebody who had a chronic flat inflammatory disease we could kind of steer that around and incredibly exciting isn't it on the other side of it what you said about eating less um another thing that i bring up in the book because i wanted to get people away from just thinking about you know a vitamin supplement for their immune system is that the immune function is impacted by over nutrition and under nutrition so if you're not eating enough or you're eating too much this is going to send your immune system awry and i should context that by saying if you're doing that consistently and then we have this field of research coming out about fasting and immune function i remember being at conferences decades ago when they were talking about fasting and how it would regenerate um all sorts of parts of the body it was kind of mind-blowing and now we kind of see it more in the mainstream and we have all these kind of forms of different diets and this again is causing metabolic switches in the body that then when you go on to re-feed after someone has had a period without food you get increasing in growth hormone you get production of fresh new immune cells from the bone marrow and the stress of the lack of eating kind of causes some of the older immune cells and ones that might be more likely to malfunction to be deleted so you're kind of replenishing your immune system and we start to see in experimental models of autoimmune disease that this is you know highly therapeutic yeah it's fascinating that it's not necessarily just what we're eating it's you know how much or how little it's are we fasting are we not fasting all these kind of different components that all play i guess they will play a role in the signals the body is receiving because i guess that's all that isn't the immune system is trying to interpret the signals you're sort of going okay what does that mean is it is it sort of safe or is it unsaid do i need to take action yes or can i just stay calm i guess everything we do even our thoughts our words our sleep our stress they're all giving a signal in some ways our immune system exactly is do i need to respond or is it okay exactly yeah it is always yeah it's that simple isn't it it's core yes yeah yeah it's it's this decision making that's ongoing and constant it's integrating all these different inputs to decide and i think the thing with the sort of so-called western diets that that you know we talk about as being having a negative impact on our health um it's just it's just really tasty and we just want to eat it all the time it's salty it's sweet it's delicious it's everywhere we can quickly override any lack of hunger cues just to to eat we kind of pathologize being hungry it's like you're not ever allowed to be hungry you have to have 10 snacks in your bag in case you might not be able to reach some food and and then we have millions of incidences of eating across a huge portion of our waking time and part of the research i was involved in several years ago was looking at postprandial inflammation so when we eat there's an inflammation a subtle inflammation that happens in the body and this is quite normal we have plenty of checks and balances in place to keep that in check and actually dietary fiber is one of the best ways to kind of seal that up again and prevent that from happening as is having a period of um time without food in between meals so eating enough and the right things at one meal that you do not need to eat then till the next meal and it's actually quite good for over overall gut health but the whole body health i i i'm sort of super fascinated by this research as well and you know not only do many of us eat too much we eat too often in the day and as you just said there you know that the act of eating is inflammatory yeah so that's a response to eating is that your body will become inflamed as you say nothing to worry about it's sort of that's part of the process but i guess you know and you know i know uh sachin panda's done a lot of look at this professor panda um and i think when when he started his app in 2015 i think it's called my circadian clock i i can't remember the figures off hands but it's something like 20 30 years ago most people were eating three times a day in the u.s i think you can probably infer in the uk as well and then in 2015 when he was measuring and people were impulsing into the app i think the top 10 percent of people were eating 15 times a day and it was a yeah you know so that if we think about that let's say let's say i'm eating 15 times a day and let's say in theory it is all whole food right it's all nice uh health what what is considered yeah you've got to be careful with the language but what is considered sort of helpful foods for our health you do have to ask the question is eating them 15 times a day helpful that's that's like 15 bouts of inflammation whereas if you had the same sort of food over you know it's not a perfect analogy but three times a day over five days you're still getting 15 bouts of inflammation but that's over the whole week yeah as opposed to in just one day and i i really do think societally culturally there's a problem with how much we're being encouraged to eat even healthy foods like you can buy healthy snacks here and healthy snacks there but you're you're sort of inflaming yourself each time and i don't know what what would you make of that yeah no i think that's a real uh issue i think it's not well enough understood in the scientific community to really translate into a kind of clear health message for people but from the research i was involved in and from work like what sachin panda has done and others i definitely think we need to look at the incidence of eating as well as um you know the the stretch of time that we're eating i think some of the studies show that we're spending 18 hours a day eating it's just like the whole time we're awake um and i don't think that we are designed to cope with that on a long-term consistent basis you know going back to the traditional diets i you know my grandparents weren't eating all day every day um because that just wasn't how it was constructed in different cultures or eat in different ways but certainly it's not common to eat all the time and i i want to fuse the tradition with the modern life somehow because i think that's the key that we need we can't go back to times gone by but we can bring bits that we've left behind and kind of integrate it into what we have to work with right now somehow when i i find a very effective and powerful recommendation i use in my patients is to try not to eat for 12 hours and every 24 hours so you know basically eating all your food within a 12-hour window which you know really was the norm for pretty much yeah everyone maybe 30 40 years ago i mean yeah you know we we might stop eating at 8 00 p.m and maybe we wouldn't have breakfast too late i mean i'm not talking about an extreme fast i'm just saying i said i think it's quite i certainly know when i uh managed to stick to that consistently i sleep better i feel more energetic yeah and i think there really is this idea that you know you need time for the body to regenerate a little bit if your gut is constantly having to use up energy to constantly digest food that's going to impact your immune system it's going to impact you know the resource it has for something else yes exactly there's um you know the the gut lining as well there's a kind of um uh it's energetically costly because it's there's a turnover of those cells quite regularly and things like the short-chain fatty acids we mentioned earlier that are produced when our gut bugs digest fiber they are really nurturing to the growth of and repair of the the cells that line the gut barrier and those are kind of the interface cells between what's going on in the guts and what's being put in the bloodstream that could exacerbate that inflammation and we know that certain things like saturated fats high fructose diets fiber poor diets as well as other things like stress and extreme exercise can alter the integrity of that gut barrier and exacerbate this sort of inflammation that you see post-friendly there's a really interesting study that looked at sort of these five major personality types so they are kind of roughly divided into like openness to experience conscientiousness extrovertedness agreeableness and neuroticism so in psychology terms are kind of ways that we can be categorized based on our personality and each of these personality types have specific immunological features and one of the most interesting thing is that um some of them are more likely to be pro-inflammatory and have higher levels of c-reactive protein which is a marker in the blood for for inflammation um and things like being neurotic and um being uh less introverted it can affect the inflammation in our body it's because i guess we're all very different we're all on a sort of spectrum of different personalities but that's evolved from maybe different roles you might play within a community and then what your exposure to different infections might be or your risk of getting injured and things like anger is known to prime the body for um for becoming damaged because maybe anger preceded violence and throughout our evolution we've like okay if you're angry something might happen that might damage you so we need to prime parts of our immune system to prepare for that you mentioned anger and it's something i wrote about i feel question 5 is the importance of forgiveness there is good research on forgiveness a guy called fred luskins done the stanford university i think forgiveness trial or research that i can't remember exactly yeah his research is incredible and i i shared in my last book a story about one of my patients who had high blood pressure and which again you know to to make it relevant to our conversation you know high blood pressure is a chronic non-communicable illness that you know will have chronic inflammation playing a role yeah in some way and you know what she had changed her lifestyle though i was you know i was doing this stuff i try and uh talk about food and movement and sleep you know what it wasn't budging and it was to do with um you know basically her um her husband of many years had cheated on her and they had split up and it was only once she started practicing forgiveness right that her blood pressure started going down it it was incredible and so that's a lot that's an anecdotal story from my clinic but i it really i think it does stand uh firm and consistent with the research that is out there in terms of if you're holding on to resentment and anger that will influence your biology and your immune system exactly and maybe that is culturally what we see dividing different groups and how they deal with illness as well because they may feel marginalized i think social status is also really important i know that in the animal kingdom being lower down the pecking order can be quite stressful for an animal and that can be seen in its its blood chemistry but also for us humans um and i think that's something that we see playing out with the sort of lower socio-economic um uh demographics are worse hit by some of these lifestyle-related diseases yeah they may have more stressful lifestyles and but we always we put it down don't we to oh less access to good food more stress and of course i think those play a role but what if it's also related to stasis as it is the animal kingdom what you know that's something i haven't properly given as much thoughts and it's probably not as common a narrative it's how where do you i guess it's you know in many ways it's do you feel your life has purpose yes yeah you know how do you see your life what's the meaning behind it because that as well in itself has a huge amount of research suggesting it's just you know if you feel your life has meaning and value you tend to have a happier and healthier life yeah i mean another piece of research it came across recently was comparing um samoan individuals to european individuals with um epstein-barr virus which is a virus that almost all of us harbor but when we activate our stress chemistry um this can be actually a sign that the virus uses to allow itself to reactivate and and cause problems and we know in the western culture that being of a lower socio-economic status means that you're more likely to experience spiral reactivation but in the samoan culture um being on a lower socioeconomic status has a totally different impact on the stress chemistry that actually meant it was the people in the higher social economic brackets that were worse affected by latent viral reactivation and this is just you know they use the viral reactivation as a readout an empirical way of measuring the immune system changes but in different cultures you know you and we never think about this in medicine i mean what's that like for you as a scientist and as a lecturer these are the kind of yeah these would be these would be perceived as a kind of softer yes yes aspects of health and science but it's that [Music] exactly we need to bring it together a lot of the data is actually quite old now but i guess it's just been parked there and we have this real kind of biomedical model where we focus in on one cell type and what is that cell doing and it's really reductionist and then we try and piece the jigsaw together and we kind of need to fuse it with the anthropology and be like okay now how do we bring these two fields together because that's the only way we can tackle i think where we're at yeah with our health and you know you sort of you really beautifully bridge it throughout the book all these different components emotions food movement sleep stress yeah you know it's got a nice section on supplements as well which you probably won't be able to get into today um the joy of the table so the joy of the tavola which is an italian phrase for enjoying being at the table and linking what we were talking about earlier with food to emotions you know make your table a joyous place to be because the endorphins from enjoying being at your table with your family your friends or even on your own and just enjoying the meal endorphins can alter the function of our immune cells because they have receptors for those on them so those feel good hormones that actually helps nurture things like the t rags the regulatory t cells so bringing the food together with the emotion and and enjoying that that's so so important yeah we haven't had a kitchen for the last four months so we've had no table no joy but we've still been trying to cobble together as a family you know little meals on the floor and it's just you know what i'm so delighted to hear you speak about these things because i think these are things we've missed in health advice yeah it has been too reductionist you know eating at a table with you know your community your tribe has kind of always been a part of human culture yeah and i think in in if you sort of extend the argument that you're making it's kind of like well you could potentially eat the same foods feeling stressed out and lonely yeah and the same food might have a different response if you're eating it with good friends when you're feeling relaxed and calm i'm convinced that you know one thing i've really i've observed clinically maybe for two three years now a lot of people these days are reacting or perceive themselves as reacting to foods yes and i think what's really interesting for me is and i think i really got this in the year preceding me writing the stress solution because i thought well if stress changes your uh your guts and your gi tracts in your digestion significantly as it does well are they actually reacting to the food or are they reacting to the fact that they're eating in a stressed state and i've seen with some patients the same food if they do some sort of what i call a transition between you know action states and eating when they do that for one or two minutes before eating yeah they're no longer reacting to the same foods yeah which you know i think this has even been shown with gluten as the nocebo effect yes which i don't know people say this all the time i go on holiday i can eat the bread it doesn't make me feel bloated but the bread at home must be somehow different maybe it's different but also you're different you're in a different frame of mind when you're on holiday and you're eating and you're chewing your food as you look at the lovely vista and you're just feeling more relaxed and that's affecting your digestion this stuff matters yeah people think you know when i i really don't i hardly pretty much don't drink anymore um but when i did i used to remember that i'd go on a holiday and like you know a glass of red wine would affect my sleep in the uk or you know i feel a bit groggy the next day but i found when i was on holiday i could have a glass or two with dinner i felt nothing yeah i thought this is stress this is like there's no like stress load on my life i'm chilling with my wife and my kids and there's a bee yeah so it's not bothering me but if your life is chronically overly busy you're stressed out the whole time not only are you going to get sick more or potentially you know you're going to be able to not tolerate various things you're going to you're going to you're not going to have to manage those insults as well exactly i call it the food prison you know i see so many people who are so stressed about eating the perfect diet that that's that's just eroding their health you never mind what they're eating being being helpful um but i guess you know you asked me earlier about what i do to manage my stress and i think it's my it's still my learning curve but it's just on my radar now that i'm i'm i'm always experimenting i'm learning how to say no i think having boundaries was one of the biggest things i learned as an adult like why are we not teaching kids this in school and saying that was okay and there's a time and a place for projects if i want to get involved and it it can't be now because that compromises my time as a mother or my time spent with family or my time just you know being on my own or doing the things that nurture my day then i have to say no and let go of that and i guess that's like you know the catharticism of writing or some ways of you know putting a narrative to what's stressing as i has a release to it and that you can feel that you know like a big physiological sigh that your body is making when you're like okay and once the decisions made you move on from it i've said no to that it's sad and i wish i could say yes but i don't think about it the next day when i've moved on and other things are you know it's very freeing actually you know something i struggle with for years and it's i'm getting much better at it but it's it feels good yeah yeah half the time i used to say yes and stuff and then i would just be stressed out why did i say yes i've got to do this i've committed now they've started advertising i'm getting much better at nipping it in the bud yeah source yes but it's taken a lot of work oh yeah i had to learn the hard way yeah um but i started feeling like i was doing everything badly when you start to feel like you're being a bad parent probably i wasn't but in my mind i wasn't doing what i wanted to do and that i think with my kids i just that had to be a firm line that i couldn't ever cross again wow now you mentioned eating and you said um that you know there's some studies that our immune system operates differently if we're eating in company feeling joy feeling happy that reminds me of something else i read in your book about it's something to do with you were giving a list of strategies to people but it was about you know like walking whilst listening to music it was about putting two senses in together could you expand on that yeah that this is it's really interesting actually so this was um data that was generated in the 1980s there's some scientists who were trying to disprove research that come out of russia around that time about conditioning so the classical example of conditioning is pavlov's dogs um most people will be aware of that but there are these experiments they had done where they they had looked to try and condition the immune system and so these scientists were like this this can't be right you know we're going to redo the experiments much more stringently and um see if it is really what it makes out to be can you condition your immune system with various rituals and routines and what they did was they they used an animal model experiment and they gave the the animals a sweet solution to drink and one group got the sweet solution that also had a particular chemical inside it that would modulate antibody responses so they could measure the antibody responses in the blood and see um if that there was an effect happening some kind of readout tangible piece of data that they could observe um so the mice were given these this sugar solution with this chemical for a period of time and after a while when they just gave the sugar solution on its own they got the same effect happening to the immune system so it's kind of like a placebo effect it's like you expect something the most expected this effect to take place in its body on some kind of subconscious level because it was so used to that happening that the the effect happened anyway even without the chemical presence to actually cause the modulation to the immune system and people have been scratching around to try and understand the mechanism and i think the best we've come up with is the placebo effect like it's it's there's some part of us that we don't quite understand that embodies things and when there's a response expected that the biology changes and we can start to pair things together so what you're referring to in the book is like the kind of little stress relieving rituals like you know playing your favorite music whilst you're doing something like taking a nice bath or having a particular scent being in the room while you're doing something else and eventually then you just can play that music and you start to feel the same relaxed feeling that you do when you're in a nice warm bath even without taking the bath yeah you know it makes me think about you know if your home is or has been a stressful place then you know that it kind of works that you may come into that and you your body may start to almost the immune system might sense that and go okay this is a stressful place and react even if nothing stressful happens yes but then you could also flip it and you know i'm a huge fan of ritual and sort of daily practices that even if they only take five minutes they can be very powerful and i think when i hear that i think of a morning routine and i think what if someone you know can design their ideal morning routine let's say let's say it was five ten minutes yeah you know a bit of maybe a minute or two of breathing yeah um you know three or four minutes of some light movement practice yeah and then let's say five minutes of reading a positive book yeah for example i mean that's you know i in the stress season i write about the three m's of the morning we've seen mindfulness movement and mindsets i think you can create one that lasts an hour you can create one last five minutes but the point i'm trying to make is if someone started doing that in the same room let's say they lit a candle yeah in the room did that but even on a day when they're a little bit busy or they haven't quite they can't quite switch off and they just you know sat there with their coffee with the candle on yes maybe that will also condition their immune system the other way and go hey things are okay because he's got the candle on yeah it's quite it's quite powerful well all the sensors kind of integrating so it might be particular scent that you're burning there might be a particular song or playlist that you always play when you're doing those activities for your morning routine and then the morning you wake up and you're just tired and you don't want to do your movements you just want to sit and enjoy a tea but you're in that room with that space and you still may be reaping the benefits of the the meditation and the movement that you would normally do and i think as a human being we just seem to be anchored by routines for me especially becoming a mother it's been it's been hugely important so much so that now i can buffer the lack of routine more because i can circle back to a really strong routine that i've built over time and i think when we went into lockdown this year everything kind of got off kilter and we haven't we're living in a building site basically at the moment so i'm stressing it's stressful the routine is is shock you know each shot has really done a number on us but i think having been someone who needs routine particularly as a bit of a stress head it didn't take long for us to find a new rhythm uh being at home and that's anchoring i think that's i i i love the way you the way you say certain things you said you know we can build a routine like you can build your immune system yeah it's a very empowering words yeah build means we can do that right it doesn't mean it's fixed exactly we've got some agency over that yeah um it's really interesting as you know as i mentioned right at the start this is you know day one in the new studio yeah and gareth who's videoing and sitting there in the corner um we've been talking about you know how do we create a stress-free space that allows a really deep authentic vulnerable conversation to happen yeah and you know it's not quite ready yet you know bringing plants in is one thing you know um we're gonna probably have a candle on or some sort of you know a nice scent yeah you know my my dream is because my this podcast is all about authentic conversation it's not interviews it's conversation i want um someone like you to walk in and within you know i almost want to program it so that people feel calm and they go they want to open up and actually yeah do you know what i mean yeah i think you've done a really good job already but also i think that what you give off as a person really helps so the way people's eyes feel relaxed you know when we're angry we like narrow our eyes or if we're feeling quite negative or stressed and then we pick that up when we're sort of reading the body language and so if somebody has a relaxed disposition that's going to be interpreted by the other person and make them feel at ease as well so and interpreted by our immune systems yes exactly as this is a safe environment it's all about all of those millions of inputs that are going in yeah every minute of every day and our immune systems reading those shaping and responding if you enjoyed that conversation i think you are going to love the one that i had with professor tim spector all about foods it's right there so give it a click and let me know what you think if you snack a couple of hours before a meal your metabolic response to that meal is poorer than if you didn't snack okay just say that again cause i think that's really important

Channel: Dr Rangan Chatterjee

Views: 410,831

Keywords: the4pillarplan, thestresssolution, feelbetterin5, wellness, drchatterjee, feelbetterlivemore, ranganchatterjee, 4pillars, drchatterjee podcast, health tips, nutrition tips, health hacks, live longer, age in reverse, self help, self improvement, self development, personal development, motivation, inspiration, health interview

Id: bcSr7hueQOo

Length: 115min 29sec (6929 seconds)

Published: Wed Sep 15 2021