DO THIS To Make Disease DISAPPEAR! | David Perlmutter & Rangan Chaterjee

well dr chatterjee welcome to the program dr mercer thank you so much for having me delighted uh for our viewers we were actually just getting to know each other ahead of the interview and um i i was just again you know talking about your wonderful new book and in the intro you probably didn't hear it but i i talked about how uh once again we're seeing information about the value of our lifestyle choices so how does a guy like you get involved in looking at medicine from this perspective and then ends up writing a book and so much more yeah david that's a great question i mean for me like many other doctors i left medical school thinking that i'd learned all the tools that i needed to get my patients better and for the first few years that was seemingly working okay you know i was working in hospital medicine and acute medicine i was doing all the sort of things that you think you're going to do at medical school running cardiac arrest teams and doing all the stuff on hospice awards but bit by bit i started to get a slight disconnect that i can really see in hindsight i did my exams to be a specialist in nephrology so that's what you know i thought i was going to spend my career doing but for me personally i felt that actually i didn't want to spend my whole career just seeing kidney issues and so i made the rather unusual step to move into general practice um which i've got to say my father who was a conventional md was a bit confused as to why i was leaving uh being a specialist to move to to becoming a generalist but that's the move i made and you know i really love my job as a generalist but what i was finding more and more is that i was suppressing symptoms i was you know putting plasters on people's problems but i wasn't actually getting to the root cause of their problems you know a few years back i think at the end of one day i thought i looked through my clinic list and i thought i've only helped 20 of the people that have walked in today you know for 80 percent i felt yeah i've referred them somewhere maybe certainly for a test maybe giving them a prescription but honestly it was deeply unsatisfying and then for me david if i'm honest the turning point came for me when um my son was six months old so you know my first child my wife had breastfed for six months um you know we're pretty health conscious family we went off on holiday to france um and really it was a very very scary time because what happened is that my son suddenly had a convulsion and he stopped moving his arms went back my wife called out to me i went over i you know i thought he might be choking he had a little bit of a cold that day i tried to turn him over clear his airway nothing was happening and then we rushed to the er and you know you could see that the the doctors the nurses there in france were petrified because this is a six month old boy having a convulsion but as you know david he had no fever you know it's very common for children at that age or i should say it's not uncommon for children or or babies to have a convulsion if they have a fever but he had no fever so he was transferred to a different hospital he had two lumbar punctures we were scared out of our wits didn't know what was going on um and then a few hours later the doctors came back and said you know dr chastisy your son's got a very very low level of calcium so his calcium level his serum calcium um was 0.97 the normal range is 2.2 to 2.6 in that hospital so alarmingly low and then a few hours further to that they came back and said and we've we now know the reason why he was extremely deficient in vitamin d so you know acute medicine fixed him they gave him an intravenous calcium infusion um they gave him his vitamin d but then that was it and um you know for me i you know that the acute problem was dealt with my son was okay but then i started reading i thought you know i had an incredible amount of guilt david if i'm honest because you know as a qualified doctor you know certified in mythology certified in in general practice with my immunology degree i thought how has my son nearly died from a preventable vitamin deficiency and how did i not know anything about that as a doctor and i went on a journey you know i literally became obsessed with reading i started off with vitamin d its effect on the immune system you know my goal david was to get my son back to perfect health as if this had never happened because he had bad skin at the time he had eczema and i was thinking well wait a minute maybe this is the reason why or one of the contributing factors to the to the to his bad skin maybe it's because he's been deficient maybe for the last six months maybe in utero you know i i i i was confused but that drove me on and as i would research david i would find more and more information about the immune system the gut microbiome other nutrients the lifestyle and basically all those principles i started applying with my son to get him better and i've got to tell you now he's nearly eight years old he's thriving he doesn't have any eczema he's you know he's doing great um but then i started upon the same principles with me and my family and we started feeling better and we started feeling great and then i started applying it with my patients and for me it was like the career i always wanted as a doctor i really i could start seeing why my patients were getting sick how i could start to help them bit by bit you know repair what had happened hopefully reverse what happened and start you know getting rid of their diseases sometimes if i could but certainly optimizing their health and you know for me once you know this way of looking at the human body you can't turn back really well it really does present a very stark um dichotomy between focusing on treating disease versus keeping people healthy i mean that really is the divergence that happens in the road and you know truly here in america we talk about our health care plans and the health care bills in congress etc that have nothing to do with health they have only to do with acute treatment of illness and the treatment of chronic illness as well and you know your experience i have to say that probably at least 90 percent of the guests on this program begin because i always ask how did you get you know how does a good guy like you end up doing uh alternative medicine uh something like that and everybody has a personal event in their own lives or in a loved one that really suddenly opened their eyes creates the the epiphany that what they were the how they were perceiving healthcare uh was really very obscure and uh obscured by you know our education it's great that you have the education that you have now you've leveraged that in a very very powerful way and david i would say that you know i think our medical school training is is still very good but it's very good for acute disease and i i the way i see it is that the health landscape of the united states the health landscape of the of the uk has dramatically changed over the last 30 40 50 years and you know this the kind of medicine was still taught in medical school actually i i sort of think probably worked pretty well back then you know we were going to our medical doctor with acute problems they kind of responded pretty well to this one pill for every ill model that we had but we're trying to apply those same principles to what we're seeing today and for me i i've got a record of saying it's like applying 20th century thinking to 21st century problems um and that's fundamentally what has to change you know as part of this journey i was very very lucky in that i got to showcase this style of medicine on um a bbc one documentary series called uh doctor in the house which you know is that there's a few seasons of ad here in the uk and it's gone to 70 different countries around the world and i went to live and stay live alongside families for about four to six weeks and you know these are families with health problems who were already under their gp many of them were already under their specialists as well yet they were still struggling with their health and you know i managed to showcase to 5 million people in the uk each week that you know a condition like type 2 diabetes for example this is back in 2015 could be reversed so and i showed it in 30 days that that was that reversal or you know the technical term now here is to put it in remission we could talk about that later but um you know i managed to show that this is possible in in just a few weeks sometimes but you know throughout the whole series i've had um panic attacks anxiety attacks insomnia fiber you know i got a lady who had pho my algae for years he was under three or four different doctors pain-free in six weeks you know the sort of thing that it was just incredible um you know i feel incredibly lucky that i could showcase to the general public of this country and to many countries around the world that no matter what your condition is doesn't matter what it is by applying some simple changes to four core areas of your lifestyle i think that we can improve things and if we're lucky we might be able to reverse them well it's not that you think that it's reality and the problem is that we are up against a huge medical industrial complex that controls the marketing and the media uh to let people believe otherwise that basically you know eat whatever you want we've got a diabetes pill for you will gastric band uh your stomach uh we will treat your diabetic neuropathy with an anti-convulsant medication you name it and that is the path to which uh generally people are directed that your choices don't mean anything let's live better through modern chemistry which i submit i've said before is really focusing on the smoke and ignoring the fire and you know the calling it fire is more than metaphorical because it really is fire in the strict definition of the term inflammation in flame uh being the cornerstone of all of these you know chronic degenerative conditions whether we're talking about alzheimer's or coronary heart disease or diabetes or even cancer and the best way to reduce uh inflammation are our lifestyle choices that you sow a wonderfully detailed in your book and i want to get to that relax eat move and sleep how fundamentally these are so important in targeting that process inflammation the cornerstone of pretty much those most common uh dreaded diseases that plague the modern world and i think uh you know a moment ago you were just referring to how in the uk 30 40 years ago the emphasis was possibly a little bit different and i think that what happened is it became more americanized in terms of really the reliance upon uh put through in terms of patience but also the coin of medical commerce being the prescription pad so let's start off with the four pillars of your book in fact that was the original name wasn't it yeah certainly the book has been sort of out in the uk for three months and the name here is the four pillar plan um but the the u.s publisher didn't think that's that sort of name is going to fly in the u.s and you know really they that the u.s publisher has taken the name from my ted talk which is entitled how to make disease disappear which is this whole idea that's you know much of these chronic conditions that we're now we're now seeing have at their roots this you know mismatch really between our genetic heritage and our on our modern lifestyles and i've looked up on that for just a moment two days ago i gave a uh a two hour talk at a group called paleo fx which are uh you know it's an international conference of people who are in this paleo idea that indeed there is this mismatch between our genome and our environment our choices and they're trying to create a lifestyle that emulates what our ancestors had in terms of targeting our genome so how does the recommend how do the recommendations in your book kind of really play upon the notion of epigenetics and the importance of valuing our paleolithic ancestors yeah in a huge way and that's a theme that i keep referring back to throughout the book and you know let's take the relaxed pillar which is the first pillar in the book for example and this is the whole stress piece i feel that you know we're so busy in modern life you know many of us we wake up the first thing we do is grab our phones we're we're looking at our emails we're looking at our social media and that stream of noise will often not finish for us for the entire day and often it's still going on just before we go to bed i've got many patients where that is literally what their daily life is like and if we think about that and we apply an evolutionary lens that would never have happened before we used to have moments of stillness we used to have moments of quiet um we weren't being stimulated continually from the minute we woke up to the minute we went to sleep you know and this whole thing about stress you know as you well know david our our bodies have have you know we've we've evolved this stress response which is very it's a very important stress response stress is not necessarily bad okay stress turns us into the best version of ourselves so if we look back in our hunter-gatherer days what did we need that stress response for you know a lion might be attacking us so we therefore need a stress response we need our cortisol levels to go up we need our adrenaline levels to go up and in that moment we can run faster you know our brain thinks sharper we switch off digestion we pour sugar into our bloodstream to help us do all these things that's great for half an hour or an hour or until that threat has passed and then everything returns back down to normal the problem is those those those things which help us in the short term become problematic if they're not turned off and you know in the in in the ancient world right our stress came from an animal trying to attack us or some something trying to attack us now i feel that our lives are attacking us so we've got you know emails to-do lists we've got multiple things to do at work we've got elderly parents we might be caring for you know two parents who are working trying to juggle tight finances trying to get the kids to school so that you can then rush off to work and i've realized more and more that most of my patients if i'd say the vast majority of my patients are in some ways chronically over-stressed and i've seen that you know a whole variety of different conditions and there's a there's a case study in the book of a lady i had with crohn's disease you know where you know a nasty inflammatory bowel disease that's she wasn't getting better on her immunosuppressant drugs from her gastroenterologist she came to see me we worked a little bit on her diet gave her some supplements and you know things were getting better but then she plateaued it stopped she went away i've not seen her for a few months she comes back into my clinic and she goes like i'm really really frustrated the drugs aren't working you know i'm still needing to use a bathroom about 20 times a day and you know i could hear her speaking and she was like a typical you know a typical patient that i often see a middle-aged woman who you know was it was a fantastic wife you know she did everything for her husband she was a great mother but she had no time for herself you know seven days a week she was doing things for other people and i said you know what i actually feel that your body is overly stressed and i explain to her how stress can also impact the gut it can you know um you know having too much stress can absolutely cause holes to appear in our gut wall you know what we call leaky guts we know that too much stress can alter the balance of gut bugs in you know in our intestine in our large intestine and i said you know what let's try something different what i want you to do is have 15 minutes every morning or once a day where you do something for yourself okay and i said i also want you to find one thing a week that you love something that you really really want to do and she was so skeptical she really was she said is that it i said i said look honestly we made some dietary changes you've hit a plateau i honestly feel that stress is the lever to turn here now for you and again i wrote her out this this prescription this lifestyle prescription if you will on it on a piece of paper she went away she came up four weeks later i said how did you get on she goes well you know just unbelievable i i would have i would drop the kids off to school and i'd go for a 15-minute walk as a routine straight after the school drop-off so that was a new thing for her she also found that the thing that she wanted to do was join a salsa class she'd not done that for years and so she joined a local salsa class and went for about 90 minutes or so once a week and you know at that review appointments we did her msq again her medical symptom questionnaire and her score had come down by 50 percent and the only change i made was her stress levels and this is why i'm really this this is one of the reasons david actually started a book with a relaxed pillar because i think many people who have followed my work in the past may have assumed that i would start off with food but i thought actually you know what i'm going to start with relaxation because stress is that thing that affects all of us because we can't really see it we don't want to prioritize it we don't think about it and and the whole book is about giving people simple practical tools that they can use in their own life and i know they work because these are the things i've learned in 17 years of practice these are what patients have come back to me and said this works for me this doesn't work for me so i've literally put in every tip that i've ever picked up i poured it into that book so there's something in it for everyone well you know aside from the photographs and the illustrations um it you know i mean those contribute to a real readability of your book and i i like the fact that you open with stress and you talk about the 15 minutes of me time i think so many of us feel so dedicated to as you mentioned caring for uh family members uh being parents doing all the things we do that we almost feel guilty for that 15 minutes of as you call it me time but yet i think it's so important and you know to lead in with stress understanding that stress can compromise sleep uh can make you less likely to want to exercise and can lead to making inappropriate food choices so it really is a very very good uh launching point i wanted to get back to um the notion of this inflammatory bowel and just to really you know characterize that is i think it's a bit of a myopic kind of a statement in recognizing uh you know the myriad ways that that is actually a systemic disease can you comment on some of the other things you see in conjunction with what we would routinely think of as just inflammation of the bowel yeah you mean in terms of symptoms yeah other things that are maybe extra intestinal yeah i mean that's the you know we we talk about something like inflammatory bowel disease as if it is a bowel problem and yes there is a huge amount of inflammation in our guts but one of the themes that i always talk about in all of my work and throughout the book is that the body is interconnected you know you don't just get inflammation in the gut and it just stays in the gut it affects all kinds of different organs around the body because when there's inflammation in the guts lots of immune messengers that we call cytokines gets triggered off and they they take that message of inflammation and they send it to different organ systems so i've got some patients with inflammatory bowel disease who've got mood issues there's depression there's anxiety because we know very clearly now that there is something called the gut brain axis you know these multiple communication pathways between our gut and our brain and i don't think we even know all of them yet i think we're probably going to learn more and more as the next years develop but one of them is the vagus nerve we know that that is one root that the gut can communicate with the brain and the brain can communicate with the guts um we know that actually depending on the health of your gut microbiome you know we can make the the fiber that we eat uh those gut bugs will eat they'll make short chain fatty acids and those short chain fatty acids can almost switch a light on in your brain by sort of connecting with a vagus nerve or they can go around in the bloodstream and get to the brain we know there are multiple sources of that communication so i see those sort of issues i've seen patients with gut problems and inflammatory bowel disease who've got joint pains um you know because all these things are linked i was actually um david just at the weekend i've i've created a brand new course with a colleague of mine called prescribing lifestyle medicine which is the first royal college of gp accredited lifestyle medicine course here in the uk and we ran it for 200 doctors back in january nearly 200 again this weekend in in london and there's this real thirst from both gps general practitioners but also consultant rheumatologists psychiatrists gastroenterologists they're all coming to learn about these principles because um you know because they haven't really you know none of them have been taught them at medical school and they're all starting to realize actually our tools can be a little bit limited for certain conditions but the reason i bring this up david is because i remember one of the cases that i um one of the case studies that i was using to illustrate uh this point about inflammation was a lady with type 2 diabetes extremely overweight lady i think she was about 230 pounds um she her hba1c was i think it was 7.3 and so you know just um i'm sure a lot of your listeners are very well educated but you know five in the us 5.7 i think to 6.5 5 is pre-diabetic and above 6.5 is type 2 diabetes now as well as her type 2 diabetes she had joint pain she was overweight she had a low mood she had all kinds of other problems and the joint pain she'd been see her doctor for for many years and they'd always said this is osteoarthritis you know this is wear and tear on your joints so we made some dietary changes with her about you know primarily around her type 2 diabetes which was a diet very very low in refined and processed carbohydrates you know rich and healthy natural fats but i said to the audience i said guys what's interesting so she started this diet three days later all her joint pain has gone so why is that and you know all kinds of people put their hands up and you know again we've not been taught this concept of inflammation i was saying guys how has she lost this joint pain when she clearly hasn't lost enough weight in three days for this wear and tear joint pain to go and you know these guys this is nearly two hundred dollars they were they were confused by this and i had to explain to them guys this is because what happened when she changed her diet she went to an anti-inflammatory diet and what was causing her joint pain was actually inflammation from her gut and i see this and i'm sure you do david as well all the time when you actually start to switch people's diets and you know to switch them off from a diet that actually causes inflammation to a diet that helps to switch inflammation off it's not just the blood sugar gets better it's not just that the gut problems get better even things like your skin or your joints get better and i know that lady who i presented you know she's a she's a patient of mine from 2015 she's not had any joint pain at all for three years now and and it all went three days after she changed her diets and i found that absolutely incredible well i mean i'm sure the criticism from your colleagues is oh that's an n of one and uh you know could there be placebo effect and it truly is not i mean for our viewers i would refer back to the interview recently with dr sarah hallberg who instituted a ketogenic diet in individuals with type 2 diabetes and just to recap 96 of these individuals were able to discontinue or reduce their insulin and a hundred percent were able to stop their sulfonylurea class drugs average weight loss was 14 of body weight and i mean what you're saying is profound because uh you know the common approach is that you will see the endocrinologist who will tinker with your blood sugar medications you'll see the psychiatrist who's going to put you on an antidepressant the neurologist because of your cognitive slowness the rheumatologist because of your obvious joint pain and maybe a gastroenterologist or surgeon to get your stomach banded and to me it is very reminiscent of the story of the blind men feeling the elephant that you know nobody comes to a consensus this is an entire animal and they each are you know referring only to their specific parts and gee this notion of the body acting as an integrated whole has been how healthcare has been practiced since the dawn of time for humans at least and and now we want to just segregate and really again it i hate to use the word myopic but i'm going to use it because it is very narrow visioned uh in terms of how the body's looked at it is it is myopic because what's remarkable for me david is once once you've opened your eyes up to this way of viewing the human body you can't go back you know once you get it you you sort of look back why did it take me this long to understand that it's quite intuitive and this is what all these other you know medicine has been around in various forms for thousands of years and as you said they've always looked at it in a rounded fashion it's just us in the you know maybe the last hundred years in modern allopathic medicine that we started to get so reductionist and that and i get where that has come from but i think as you know we we made some great strides in the 20th century by taking that reductionist view but i think we've got to recognize how that really has had its limitations and you know i'm it doesn't matter what the condition you mentioned an endocrinologist you remind me of another case study in the book of a lady with menopausal symptoms right this is a lady who was scoring 15 out of 17 on the british menopausal society symptom questionnaire that's a very you know a high severe score of symptoms and her doctor had recommended that she go on hormone replacement therapy um and she didn't want to do that for a variety of reasons she didn't want to go down that road and literally by applying this four pillar approach with her diet initially but primarily with the relaxation pillar with things like um 15 minutes and me time a day five minutes of meditation i'm not talking about 20 30 minutes just five minutes of meditation a day and some magnesium right she went down in six weeks from scoring 15 out of 17 to 2 out of 17 and her life was tolerable and she could easily have been put on hormone replacement therapy and gone down that route and again i'm not necessarily criticizing her had she done that but she didn't want to so as a doctor i need to hear her what what she would like to do and it's just amazing that you know when we talk about diet and we talk about lifestyle david i don't know what it's like in the u.s but here everyone talks about oh you know type 2 diabetes and obesity but actually lifestyle affects everything menopausal symptoms it can affect your joint pain depending on the cause what about mental health problems you know our diet and our lifestyle has a profound impact on our mental health and we've got some great studies now which are really supporting that actually diet diets and we absolutely prioritized with our mental health patients including that smiles trial did you see that from february 2017 in australia that randomized control trial showing that patients with moderate to severe depression the group who went on a modified mediterranean diet versus the group who went on a i think a social support structure for 12 weeks had a statistically significant improvement in there in remission i mean it's absolutely incredible the evidence is overwhelming and it's incredibly frustrating for me that as a profession we're not faster to embrace all that all this new research well that study was actually founded on previous research supportive research that demonstrated much higher levels of lps i'll explain in a moment in major depressive disorder in comparison to those who do not and what is lps well lps is when it's found in the blood as a marker of two things it's a marker of gut permeability and it's a marker of inflammation because it it stimulates inflammation so what we're saying then is that depression is really rooted in this process again of inflammation and that this relationship to the gut as demonstrated by the higher level of lps which indicates gut leakiness like you mentioned earlier is in fact very real and what you know mechanistically goes on when you go on a mediterranean diet or other good diet that can help heal the gut lining as the lps level goes down inflammation goes down and it's good for the brain so we see elevated lps in autism in alzheimer's in amyotrophic lateral sclerosis and as i mentioned in major depressive disorder and it can come from nowhere else it comes from the gut exclusively so it really causes us to recognize in in this case a connection then between the brain and the gut that's very very real uh yeah also two diabetes is we're not up on and i think our mission is to say look you're our most well-respected literature is publishing this stuff and why is it invisible to you you should look at it i mean that's what your mission is yeah absolutely and even something like type 2 diabetes there's some really good mechanistic work has been shown that lps might be a triggering one of the root triggers in the development of insulin resistance which then leads to type 2 diabetes so lps is almost like the window to a whole variety of different diseases and that's why in this sort of model of healthcare we always talk about looking at the gut first all right let me just tell our viewers lps is something in the gut it actually is the covering over certain bacteria called gram-negative bacteria that live in the gut so we shouldn't really find it in the bloodstream when we find it in the bloodstream it got there somehow and it means the gut is leaky lps is a powerful initiator of inflammation so going back to what we just heard this relationship then to other things like depression cognitive issues etc points back to the gut and i.e the body as a holistic uh whole um you know you talk about then early on disconnecting from all of these really powerful events that sort of rob us of our connection to who we are and our families etc the phone the the computers the busy lives that we have so disconnecting is very important having that 15 minutes of me time but you also in the book talk about the importance of connected connective uh pursuits being connected to people in our communities being connected to family being connected to other things so what are some of the things that we should try to reconnect to yeah well one of the chat says david in my book is called reclaim your dining table chapter five exactly and it's one of the things that one of the things that led to this was as part of my experience on the this bbc documentary series of going around the country and living with all these different families one thing i realized is well one thing i i noticed was that so many families around the uk and i'm sure it's the same in the us don't sit around a table anymore and and eat it's the sort of thing i wouldn't know in my clinic room because you know it may not come up even if it does come up actually patients may not you know you would see it a different way when you would literally be there day in day out and you see guys you you are eating together it was very common to see you know everyone eats separately somebody's watching television somebody's on a table you know sending uh text messages somebody's scrolling social media while they're reading and i was shocked at how common this is and it was a common thing that i would ask these people to do hey guys can you hold on for just a minute i just got a text no no i'm just kidding but i i i would encourage them to say hey can you for one meal a day sit around a table in company if possible i appreciate everyone lives with other people but for those people i sort of suggest can you do it with your work colleagues at lunch time just one meal a day in company without devices and i can tell you the difference it made with all these families was absolutely profound they not only would they eat less because actually they're they're they're increasing in a bit more yeah they're meeting in a bit more of a mindful fashion but they also started to say you know what i started talk to my wife more and i learned more about her day and i found parents and their children would start to connect a little bit more and and says there's quite a lot of research now on the importance of eating sat down you know in company if possible and i think this is this is incredibly valuable intervention for people to make and i know all this stuff sounds a bit like this is quite soft medicine you know what's what's this md doing talking to me about sitting around a dining table i can tell you i've seen first hand this makes a difference this makes it um so important it's it's it's something that because we've lost that connection in modern life it's a simple way that we can get it back and you know 30 40 years ago every single household in the united kingdom had a dining table right that was the norm but now these things have been you know moved out you know rooms walls have been knocked down to make room for big televisions and you know something that was was a core part of human existence you know eating in company that has just gone from society and i think it's not you know it has multiple consequences for our health the other thing i talk about in terms of this whole idea of connection is the importance of gratitude and i think that's i think that's chapter three and you know about how you can keep a gratitude journal each day and i walk through the science on that but the the game i play at home with my family every day that i'm home for dinner it's a game i actually learned from the strength coach charles poliquin and it goes like this so we sit around a table we're having a meal okay but then what we have to do is we each have to go around and say okay what did i do today to make somebody else happy what did somebody else do today to make me happy and what have i learned today and i could tell you david my initial idea was that this is going to be really really good for my children you know they're going to get a lot of benefit out of this but i pretty soon learned that actually mommy and daddy also get a huge amount of benefit from that as well because we start to have that conversation we learned something about our children about my wife something that i may not have picked up and you know it's just it's just a much warmer experience we finished dinner time feeling really quite relaxed and connected and as we highlighted at the start david yes i'm passionate about nutrition yes i'm passionate about the importance of movements but let's not underestimate how important relaxation is and and how we can sort of buffer all the stresses in the modern worlds and you know one thing that people have fed back to me in the uk since this book has been out is that actually the recommendations i make feel very achievable for people you know i've really tried to set the bar low for people so that they actually feel inspired as they're reading the book to go hey you know what i think i can do that i'm going to try and do that tonight with my family and so these are some of the some of the recommendations i make and and you know you've spoken about this on your on your social media channels before about how social isolation is you know is a health risk superior to smoking you know in fact in terms of its health consequence and so some of these recommendations i make are literally just you know to make some achievable small achievable changes are going to help you feel more connected and less stressed so i'll let our viewers know uh cat out of the bag here that our next next next book so three books out yeah you're planning through your wow this notion of of reconnecting but in a physiological way to the part of the brain that allows you to experience empathy and gratitude and at the same time distance ourselves from the egotistical narcissistic part of the brain that constantly needs stimulation so that we can feel like we have enough so that's what we're working on right now that'll be probably late 2019. um that study that you you just were alluding to of the 10 000 individuals who felt unconnected demonstrated that the risk of illness was in fact triple the risk of smoking so this notion of being unconnected i mean i think the blue zones talked about that that one of the the biggest factors uh that related to the health of individuals living in the various blue zones was yes they had great diets and yes they were physically active but they were connected to their families and communities yeah absolutely and they were you know had low stress levels and they've got good qualities of sleep and that really is about the the whole approach that i've tried to take here is really look at this rounded approach to health in terms of maybe it's not about looking for perfection in any one pillar it's about getting a balance across all four and i i do mention the blue zones in my book because i think you know we can learn a lot from those blue zones you know yes researchers have studied them to look for the perfect diet but i don't think that's it with the blue zones i think it's the combination of things that they do about it everybody's trying to emulate the diet in crete or wherever or wherever it was that they felt had you know okinawa or wherever it was that they felt they had uh great health they forget about the other factors yeah and you know here in the west we are uh you know we're chronically underslept we're over stressed we don't move enough we're eating a lot of sugary processed junk foods and we're disconnected okay and then we try and compare oh you know there's those those blue zones are eating this way and yet we're not tackling the stress levels we're not tackling the lack of sleep and we're trying to make those sort of generalizations and actually i sort of speculate in the book that could it be you know because we we talk about you know people are talking about carbs a lot these days and we look at those okinawan communities where they're having you know an 80 high carbohydrate diet and sort of kind of trying to figure out well how can that be that they could have such a high carb diet certainly from the research i've read yet not get type 2 diabetes not have insulin resistance not to have alzheimer's and i i sort of hypothesized that could it be in the context of a the carbs that they're having are local they're they're what i call cellular carbs are very nourishing to the gut microbiome they're not the acellular sort of grain type carbs that we know can spike blood sugar it can have and some of them can have a detrimental impact on our uh on our gut microbiome and our health but i think it's something more than that i think it's also the fats that actually that they're drilled in on all the other pillars as well so i often speculate that could it be what why does the low-carb diet or what is called a low-carb diet they're low in refined processed carbohydrates why does that have such a powerful excuse me sorry on so many patients in the western world and i think it's because in the context of our environment which is a lack of sleep too much stress not moving enough in that context it seems to have quite a powerful and unique growth so again you can't look at that in isolation i'm often asked that question oh they eat a lot of rice and how come they don't have these problems well the reality is they are getting these problems now if if you look at what's happening current currently versus looking back 20 years which is where many of these statistics are derived um getting back to the sugar part you talk about denormalizing sugar which was a great uh great terminology so what do you mean by that yeah you know sugar's become like the big villain around the world right it's it's and i don't disagree with some of that but i was thinking about this you know as humans we've always craved know sugar or honey or sweet things right so i was thinking well what is it what is it what is going on that has made sugar the problem and or one of the problems and i think it's the fact that it's become so normal so that's why the chapter's called denormalized sugar right it's about saying look if you want a sugary treat now and again right like they often do in the blue zones right for example i'm not necessarily saying you shouldn't do that if that's what you want to do but don't kid yourself that you're not having sugar every day with your breakfast cereal with your sandwich for lunch with your ready-made pasta for dinner don't kid yourself that actually you're not having sugar and so the whole idea of denormalizing sugar is to help teach people to start looking at food ingredients try and find out where sugar is lurking and i don't mind look if you if you in the 21st century want to avoid sugar for the rest of your life you can have a hard time right because it's everywhere and you are going to be tempted you know everywhere you go once you step outside your front door you're going to be tempted by it i said well people think it's okay to eat stevia for example what are your thoughts on stevia yeah i i'm not convinced if i'm honest with you i'm you know i don't it's not something i've really covered in the book i don't sort of um i don't positively recommend it i'm sort of concerned with a lot of with with stevia with various sweeteners i'm concerned that there may be a negative impact on our gut microbiomes and so i'm i sort of i i've not really covered that in a great amount of detail in the book but i don't particularly advise that with my patients if i'm honest you do mention agave i didn't answer agave yeah i'm not the point is is that i'm not people crave sweet things right so if you're used to having sugar day in day out okay they think that you know i need sugar but often it's that they've just uh trained their taste buds to need sugar so you know when i used to drink when i first started drinking tea okay i used to take two spoons of sugar in it right this is years ago and then when i when i gave it up the first time i had it it was disgusting right i couldn't stand it but then three weeks later i was at work and i think i picked up the wrong one and it was somebody else's that had sugar in it i nearly spat it out i couldn't stand it and that's how quickly our taste buds um can adapt so i try to take a bit of quite a moderate approach in the book to sort of say hey guys look i get it if you want a bit of sugar and you find it too hard to completely cut it out so get it out of your house get it out of your cupboards and that's a theme that i talk about throughout my approach and throughout this book is control the environment that you can control like if you bring in those sugary treats to your house and you think you're not going to have them you are kidding yourself because you can willpower it for a week maybe for two weeks but you will come back one day you'll be stressed out you'll be tired and and you you will crack and i remember you know just it was literally a few weeks ago i came back from work i was tired i was stressed i've not slept well the night before i was watching some i can't remember what i was i think was watching something with my wife and i thought yeah i really fancy something sweet really really wants something and i started looking in the cupboards and there was nothing there you know there was nuts there there was health foods and you know what i call this an itchy mouth you know so so much of the time we actually think we're hungry or we're craving that something sweet but if you ain't got it there the feeling passes and it goes away and so a big theme for me is control the environment that you can control because once you walk out your front door it is very very hard for for many people to make those healthy choices we're uh we're going to close soon but i want to talk about you know everybody has kind of their um unique area of body that they like to exercise because they get a lot of bang for the buck in terms of uh how good it is for them we recently interviewed dr frank lippman and he was talking all about squats and you talk quite a bit about glutes the importance of strengthening your glutes i think you had some back issues yeah and you found that strengthening your glutes was very helpful for that so why the emphasis on the glutes and that's a great i know there's no segway from sugar to glutes but it is i love it i love it quick fire it's unsaid so yeah you're right with many of these things you know our personal experiences start to dictate that the way that we practice and so i had you know 10 10 years of debilitating back pain you know i'm a tall guy i'm you know six foot six and a half um and you know i used to be a competitive squash player had to give everything up and i did what most people do i went to physios i went to the doctors i went to the spinal surgeon i had an mri scan i did all these things and and nothing was helping you know i'd sometimes get a bit of short-term relief but then the problem would come back and then i found somebody called gary ward who you know really thinks about the musculoskeletal system in the same way that you or i would think about the human body he's always looking what's the root cause of this problem is the back problem really a back problem or is it it's the back taking the strain because other parts of the body aren't functioning properly and for me it came down to my glutes my right foot wasn't working properly and that had an impact up the chain to my right glutes and as soon as i started to teach my glutes how to fire properly my back pain just vanished and i've seen the same thing with some of my patients not everyone knew there's many different causes of backache have you been able to get back to squash yeah i'm back playing squash i'm back skiing moguls and back to everything now and i i will even move furniture around my house and my friends can't believe that because back in my 20s i would nowhere near go any of that but i know that the root cause of my problem has been addressed so i actually have no fear now that my back is going to go but you we we started off the conversation you were chatting about when you were at paleo fx and this whole mismatch of the the the you know the the uh our genetic the issue now because of the way we live our lives now we're sat down a lot we're slumped over on phones and computers and laptops okay our brains are very smart our brains no longer need to switch our glute muscles on for much of for much of our day so it bypasses that the problem is when you bypass it it also means that when people try and get up and go and do glute exercises in the gym for example often they're not firing their glutes even though they're trying to and so i i created with gary these four key exercises that i do every day myself they take about three minutes i do them every morning as my coffee is brewing for four minutes i just knock out those four exercises um that are detailed in the book and there's a free video there on my website so people can watch it even without getting the book if they want to but they're incredibly beneficial for people and they help you you can't actually do those exercises without switching your glutes on the design in such a way that your glute has to fire whilst you're doing it and i know for me it really helps me feel that in the start at the start of the day you know if you think about it you know would you build um you know a jenga sort of tower on shaky foundations would you build lego on shaky foundations no you wouldn't but yet our glutes are you know a foundation that what i call a cornerstone muscle in our body if our glutes are off many other things start going off and so i'd like to start the day with a very quick two three minute workouts where yeah i wouldn't even call it a workout it's just a series of movements to fire up my glutes and i find that i move a lot better throughout the day and i can tell you david that people who bought the book in the uk so many people are tweeting me or on instagram they're getting hold of me saying oh my god this is really helping me get rid of my back pain and you know as you know you've written multiple books david i'm a huge fan of your books this is the first book for me and it's just an incredible feeling as an author to get feedback from people that something that you've written they are finding so incredibly useful for a whole variety of different problems and you know i feel very very lucky yeah you know it's a very uh it's a feeling of gratitude that you would get these uh emails or people are posting on social media that they learned something from your book and it was life-changing for them in this case you know whether it's a diet change or strengthening and mobilizing their glutes i would say for me the back pain was coming from the piriformis muscle and i just went on youtube and looked at piriformis which is spelled p why isn't it yeah piriformis muscle and um stretched out my piriformis and my back pain for years that i had had that kept me from playing racquetball uh went away and it was you know sometimes it's just the dynamics of your movement especially for me as a runner that contributes to these imbalances like you say that uh yeah you know and then that's just once it's one suggestion you know that i make and you know one point before we close out it just would just like say clarify i think what's um what what the approach i've taken in my book catamaran disease disappear is is that there's four key areas of health that we have control over that have the most impact on the way that we feel and in each pillar i've given people five ch there's five chapters and each chapter is a recommendation not a prescription you know i'm not telling people what to do i'm making suggestions for them and i i'm not expecting people to do all 20. i say very openly most of my patients need to do about three in each pillar roughly which is a total score of 12. and i'm trying to give people options so if there's a chapter in there like a recommendation that people don't like you know what don't do it i'm good with that you know choose a chapter that you do like that actually you feel motivated and inspired to think yeah i can fit that in in the context of my my own life and i i think that's the that's the approach i'm taking more and more now in my clinic with my patients approach i've taken in the book and i'm i'm finding that a lot of people are really resonating with it because it's taking the pressure off they don't have to be perfect in any one pillar they just need to choose a couple two or three in each one that they can build into their life yeah and that's very encouraging for people to want to do more and you know even in terms of exercise you know i wouldn't insist that an individual immediately go out and walk a mile or if you know if they couldn't do that well half a mile you can't do that look go out your front door walk to the mailbox and come back that's where we'll start but uh i think that you know getting making progress and feeling encouraged by implementing any of your suggestions will amplify the desire to really flesh out the program yeah absolutely and one of my favorites on that is i've got something called a five minute kitchen workout which is a strength workout and that came literally came about from my patients who i would talk to about sarcopenia and strength and how important it is and i'd say you know we need to really work on resistance training and they'd come back four weeks later i said you know how's it going did you manage to get to the gym you know darker works too busy i can't afford the gym it's not my way back from work and i thought okay you know what as a doctor i need to come up with better advice i need to come up with advice that actually they feel is relevant and applicable in their lifestyle and in that moment was born this five minute kitchen workout that i you know i've got 20 year old patients doing i've got 70 year old patients doing it and i say guys i just want from you five minutes twice a week can you give me that and they all say yes and what happens is because they start doing it and they feel good suddenly those five minutes twice a week becomes 10 minutes six times a week very very quickly so from doing zero strength training within weeks they're already up to an hour strength training it's just by it's just by trying to personalize the recommendations for those individuals i'm i'm not against the gym if you love going to the gym that's great but many people just won't go well they can't afford it and i'm saying you can do a great strength workout in your kitchen without spending any money without buying any equipment you could do it in your own clothes without even getting changed it's trying to just lower that bar to entry and one thing i'm really proud of david is that pretty much every single recommendation in this book is free right the only one you can have an argument with me on or a discussion is is it easy to eat an unprocessed diet in the 21st century or is it is it more expensive to and you know i would argue that actually it can be done on a budget but certainly the other 19 recommendations there is you know they're all free of charge so that means they're accessible and available to a ceo of a top company and they but just as applicable to a single mother who's on benefits they can all apply these principles and that was one of my guiding thoughts throughout this book was how can i make health accessible for every single person who reads this book and certainly i i hope i've gone some way in achieving that well i think you have and i think that all of our viewers will um have appreciated your passion and your compassion uh and uh you know i think that it comes from at its core a sense of gratitude and doing your best to give back and you know the word doctor means teacher so as the teacher you are now writing books and doing television you're really getting a very very important message out to you know people that you'll never have contact with and yet you know rest assured you're making a big change so i commend you for that i've been a medical doctor now for you know almost 20 years i can tell you that the bulk of what i see i'd say probably 80 percent of what i see is in some way driven by our collective modern lifestyles and when we change our lifestyles in the in the right way i have seen so many of these so-called diseases disappear that's what i managed to demonstrate on my bbc show that's been shown now in 70 countries around the world i've shown things like type 2 diabetes you know vanished within 30 days a change that has proved sustainable two or three years later panic attacks anxiety gone down by 70 80 in just six weeks by making these changes chronic back pain for 30 years right once we started addressing the cause completely gone okay and and the list goes on i realized that no matter who they were no matter what the name of their disease was you know what when you make simple changes in four key areas to your lifestyle it is amazing how many of those symptoms just start to vanish you've said that this is the first generation being born now that has a shorter life expectancy than the generation before them which is pretty terrifying yeah you know in the united states and i think in the uk now as well the current generation that are being born you know have got a lower life expectancy than any previous generation before them or certainly in the in our recent history and that's pretty worrying actually you know i've got two young kids at home myself and that makes me worry is what sort of world are they being born into you know are are there now issues with health that are going to mean they're going to be less well-off than the generation before them and i think this this really sort of plays into why there's such disillusionments at the moment with the way medicine is practiced in the 20th century right even 30 40 years ago the bulk of what we were seeing as doctors the bulk of what was coming in and people what people were complaining of were what we call acute problems they responded very well to the sort of pharmaceutical model the the one pill for every ill model so let's say you have a pneumonia for example okay this one modern medicine is brilliant so a pneumonia the overgrowth of a bug in your lung right you're coming to see the doctor the doctor says yeah this is the issue right i'm gonna give you a pill to get rid of that bug and then within a week within two weeks you know your problem's gone right the model of medicine we have now responds you know what was set up in that era what we're seeing today in the 21st century is chronic disease whether it's type 2 diabetes okay which is like a modern epidemic whether it's mental health problems right in the uk like one in four people in any given year are gonna have a mental health problem um whether it's alzheimer's disease which you know as we're living longer people are now worrying you know as i get older you know how am i gonna be am i gonna be able to function am i gonna be able to talk to my family or i'm gonna start losing my brain health and my memory um so these sort of conditions require a different approach and that's why life expectancy is going down because we're we're not really well equipped to tackle these problems because these problems don't respond to a one pill for every real model you've got to change multiple things right you've got to understand and a lot of people still don't understand including a lot of the profession that these are conditions there may be a genetic tendency right you may have a genetic predisposition that is not your destiny though it doesn't mean you're going to get that condition right we know there's a the field is called epigenetics which is basically this whole idea that you know you're born with some genes but your environments how you live your life that shapes and that determines whether those genes are switched on if they're switched off how those genes are expressed and that's a big shift actually and that's exciting because that means that we've in a huge part we've got control over what happens to us i think that's incredibly exciting so we need to start teaching our children we need to teach our doctors we need to educate the public we need to change the ethos in schools in institutions to so helping us foster a community where health is absolutely valued at the top because if it isn't right we're going to struggle in our lives so you know i've watched many of your your your videos tom and um you know when we talk about trying to make a difference trying to live a meaningful and purposeful life right health is an ingredient of that when we feel better we live more so much of the time the problems people are telling me about that the disagreements are having the family disharmony they're having often it's because they don't feel good right they're putting the wrong things into their body whether it's food they're not sleeping enough that's changing their hormones that's making them moody that's causing them to have tension with their children with their partner with their work colleagues and it all starts to add up and i've realized that often my training has taught me to suppress that downstream symptom right with a pill without actually going upstream and figuring out what's causing this in the first place and the approach i try and take on my tv show with my patients with my book it's really about saying we've over complicated health right i want to simplify it and we've overly focused on one area so obviously everyone talks about food when we talk about health and food's important right but it's not the only thing there are there are other factors that i would say are equally important that even if you'd asked me five years ago i wouldn't have known that you know five six years ago i thought it was all about food right but i've changed my mind now you might be better off saying your diet is good enough maybe the fact that you're on netflix or youtube till 1am every night and you're only sleeping five hours a night actually if you go to bed one hour earlier you will find you get more bang for your buck than trying to cut out a little bit more sugar in your diet yeah one of the most interesting things about your approach is this whole notion of lifestyle over diet as in it's it's more important than that and i thought whoa that's pretty radical and five years ago i would have said the same thing i was at the height of building quest nutrition all i i thought the answer to everything was what you were eating a hundred percent meat right yeah and then my wife ends up having this catastrophic problem with her microbiome and it came on like that it went from no sense of we have a problem to our life got put on hold for a year because she just couldn't eat and she was malnutrition it was it really actually got scary at one point and i thought my wife's diet is perfect so clearly there's something going on here that i don't fully understand part of it was my definition of perfect was totally screwed up and then the other part was that there are so many other lifestyle factors talk about this notion of the threshold effect which i think is so important for people to understand yeah it's this idea that we've all got our personal threshold okay so the way i explain it if you were in my clinic with me right now and i pretty much go through this with every patient i say well let's say you were born in perfect health here right we've got this sort of personal we've got a threshold right so we can deal with multiple insults up to a point so that could be you know poor diet the fact that we don't move very much we might have had a relationship breakup which is a stress on our body we may have a job we don't like right it's all building us building up building up getting closer to our threshold that's when they get sick right what i mean by that is often a patient will come in to see me and they'll say you know doc i was fine everything's going fine and then you know i changed my job i don't like my new boss and then you know they they come down with an autoimmune illness right but when you go into their history you see things were not fine at all they you know we're very resilient as humans we can deal with lots of stresses right but something is like the straw that breaks the camel's back and and you can sort of you can find the last stressor that tips you up that pushes you over right but when you've gone over your threshold often it's not a case anymore of taking off that last stressor right often you have to go back to basics and build from scratch again it's like you know if we were juggling balls i have to say you know in your life when things get busy you can juggle one ball two balls three balls four balls and then someone chucks a fifth one in and what happens everything falls down and you know we we we always look for what's that one thing that it is can i give you a case story right right this is um a very typical patient of mine but this is a it was a guy in his 50s i think he's 52 year old guy right he's got type 2 diabetes now he's a successful businessman he's go go go all the time right he's you know working hard working weekends he's always on his email right and he got diagnosed with type 2 diabetes so he saw on tv in the uk he saw my bbc show the first series and he saw what i did with that type 2 diabetic patient so he uh drastically reduced the refined and processed carbs in his diet okay and then he'd read some other blogs and he really got obsessed with low carb and he was getting some changes right his blood sugar was coming down but then it plateaued and he was getting frustrated because he kept reading more and more blogs he kept lowering his carb intake and and he just wasn't getting anywhere so he you know he ends up on my waiting list he comes in to see me and i remember going through everything with him and i thought to myself this is not a dietary issue anymore right because he didn't realize like many people don't that your stress levels contribute to your blood sugar levels your sleep quality contributes to your blood sugar levels it's not just your diet even their diet is something we can we get it you know we eat a bit of sugar that's going to put the sugar up in our blood we get that but we don't get right and there's some really good studies on this that if you only sleep four to five hours a night for six nights okay you are 40 percent less good at managing your blood sugar right you become pre-diabetic after five to six days just from the leg just from a lack of sleep it's incredible when you start understanding that you think well of course we need a more balanced holistic approach to helping these people so this this chap so what i did with him i said look your diet is brill okay arguably it's too good arguably you're you're almost you're trying too hard now and it's stressing you out i said it's sleep and stress for you so i talk about these four pillars right i talk about food movement sleep and relaxation that it's not about perfection in any one pillar but it's about balance across all four this approach takes the pressure off people it's not about the perfect diet or the perfect gym routine it's about making sure your dog is good enough making sure you're moving enough making sure you're doing something for your sleep and something for your stress levels it's it's an approach that works in the short term but it's also going to be working six months down the line 12 months down the line so this this chat with diabetes with type 2 diabetes we came up with a with a system i said look ideally you'd have a 90 minute switch off before bed where you don't look at work emails you don't go on your computer because i can't do that 90 minutes no way that's all right what about 30 minutes so he goes okay so we started with 30 minutes okay we also we agreed in the consultation i spoke to him about meditation okay he was a bit skeptical on meditation i said okay look hear me out here i'll tell you what let's get an app right so we downloaded an app in the clinic right i said okay this is free down like this all i want you to do is commit to five minutes a day that's it okay so all we agreed on was 30 minutes before bed he'd switch off his computer and his tech and his work emails and he'd do five minutes meditation per day with the zap okay that was it and he starts somebody comes back in four weeks and he's like okay i'm already starting to feel better you know he's sleeping better he feels less anxious and stressed the whole time said that was my way in then we got to increase it so it was an hour in the evening okay it was uh he only stuck to five minutes meditation but we then introduced something that i call the three four five breath when you breathe in for three you hold for four and breathe out for five and he did that a few times throughout the week and bit by bit he started to introduce these practices he increased his carbons hey because i said you're being too aggressive you don't need to be that aggressive with your carbs okay six months later the guy's blood sugar is no longer in the type 2 diabetic range okay so he puts his carbs up he improves his sleep he gets the stress levels down and his blood sugar starts to come down and that's why i'm so passionate tom that when we take this rounded 360 degree approach to health not only does it yield fantastic results okay but it's just it feels more accessible it feels more achievable for people um i've got countless more case studies like that but that that's i think rather counter-intuitive because you know five six years ago i had i was using that what is called a low-carb approach a lot with my patients um and again i'm not a huge fan of the term low carb i think the beauty the beautiful thing about it is that it it simplifies the concept so you know so clearly that people get it um but i think you know we have unfairly demonized fats for 30 40 years i i worry we're gonna do the same uh with another food group in the same way and i think you know ultimately you look at these blue zones around the world these areas around the world where people are have got high rates of longevity they're living to a ripe old age in good health and you look at what they're doing and i find it really interesting because a lot of a lot of them are having high carb diets like in okinawa in japan they're having an 80 carbohydrate diet but the carbs are not the refined and processed carbs that we're having here in the west right there they're local sweet potatoes right which is very nourishing you mentioned the gut microbiome sweet potatoes and those sort of colorful vegetables are fantastic for our gut health absolutely fantastic and i actually think that's what holds all the diets around the world which work well right i think the commonality is not the carb content or the fat concept the commonality is they're all a local minimally processed food that nourishes our microbiome that's what i think is the unifying factor and and the other thing i think when we look at these blue zones like okinawa and we try and figure out well why are they why are they doing so well we're trying to figure out what is it in their diet that's the magic but it ain't just the diet it's the whole lifestyle right these guys have low stress levels they sleep well right they're physically active every day they prioritize community right that's why those guys are healthy right it's not just the one thing and i think why is it that this low-carb approach seems to have such a fantastically beneficial role for so many people in the west well i think what's going on here in the west we are physically inactive we are under slapped we're over stressed we're having highly processed food okay maybe it's an and all those things make you insulin resistant which is what actually leads to type 2 diabetes and it's behind a lot of cases of obesity maybe it's in this environment in our highly stressed out under western environment maybe it's in this environment that that low-carb approach has such a beneficial role maybe those guys they stay under their threshold in a different way they don't need to be as aggressive with their carbs let's say because they're you know they're getting all that sleep they're getting their stress levels down i think food is much more than fat versus carbs but good health is much more than food right wow that's really strong yeah i've always been interested as a doctor as to what works in real life right i love the research papers i love the science but i'm more interested in how do you convert that into real life action for that person sitting in front of me and i can tell you one of one of my um one of the most popular things from this book is what i call the five minute kitchen workouts and this this again came out of a need that i saw from my patients right so you know strength training is very much undervalued in society you know when we talk about activity and movement and exercise right we're always talking about you know walking more or you know doing more cardio and there's nothing wrong with that necessarily but we neglect strength and once we hit 30 right once we get above the age of 30 we can lose three to five percent of our muscle mass every decade we can be even more above the age of 50 and you know your muscle mass independently predicts your mortality it's one of the strongest factors to determine how well you're going to be when you get older so i was seeing all the research on this about five or six years ago i remember patients were coming in and i say to them okay guys uh you know strength training is really important you know i want you to work out for about 30 40 minutes three times a week you know maybe get to the gym if you can and i thought okay right i've told them i told them about the research i come back six weeks later i said hey guys how are you getting on hey doc you know it's been busy you know the gym's a bit expensive it's not on the way back from work i've not really done it much i thought okay i'm clearly not giving them advice in a way that they feel is practical for them that they feel they can do in the context of their lives i've got to do something better and in that in that moment in my consultation room that five minute kitchen workout was born i said all right i'll tell you what let's forget about the gym let's forget about gym memberships forget about buying equipment i'm going to show you a workout you can do right here right now in your kitchen i've got 20 year old patients doing i've got 70 year old patients doing it you can modify it for any ability level and you know i find that by setting the bar low with people right and they achieve that they feel good about themselves they start to do more it's about simple approaches that work in real life yeah the science is all in there but the science interests me but it doesn't dictate what i do i've got to convert that into what's going to really help my patients real life people with busy jobs with busy lives right who want to be healthy i want to talk about the show for a second because being with people living with them for four to six weeks and getting in there what are you seeing that are patterns of um i'll call it bad behavior but i don't mean that in like the moral sense i just mean it has an unintended consequence um that they may not even realize and then what are some of the fixes that are these simple things so like in the movement pillar you've got that something simple they can do in the kitchen but what are things that you see over and over and over that people do wrong that have a really simple fix so i'll tell you a few things yeah food was food was a big one there's no question you know when you open people's cupboards you open their drawers and you see what's in there you see the naughty drawers and you see the stuff that's in there and then you also not only look at what's in there which is basically all the highly processed food it's all the sugary treats that live inside the house right but it's then as you're looking there you see the family dynamic you see like the wife oh you know that's not mine that's he always brings that and i tell him not to bring that in because no no the husband's like no that's not the case at all i bring these in because you like them right you see that in every house so there's obviously this dynamic that um you know who's responsible for it you know everyone's putting the blame without realizing it on other people it's not me it's you know i'm doing it for the family so i find that quite interesting so one of the fixes there is to control the environment you can control right if you're trying to make healthy let's say food choices right don't keep that stuff in your house right so i say to them when you walk outside your front door these days you are having to exercise your willpower every step of the way you go to a gas station right and you go to pay you're walking past all the chocolates or the bags of chips everything right you're having to exert your willpower there if you want to buy coffee in a coffee shop right you stand in line you water you you're walking past the muffins the pastries the croissants you're constantly having to use the willpower when you step outside your house i'm saying don't use it inside your house right if you're serious about making those choices and you want a sugary treat you know what have it once a week once every two weeks when you go out and meet your buddies and you sit in a cafe and have it have it there don't bring it in your house because what will happen is that you will come back tired you'll come back stress one day from work you'll feel a bit low and you'll start gorging on what's in the house you know a few months ago i came i was going through a very stressful time at work and all kinds of things were going on and i'm sitting at home and evening with my wife and i thought you know i fancy something sweet but i looked in the cupboards there was nuts there was olives i was like you know i don't feel like though see i want something sweet but there was nothing there and you know what 10 minutes later that craven goes it's what i call an itchy mouth right i'm not hungry it's just you know i fancy something to put in my mouth so you're controlling the environment you can control i think it's a very important thing that i taught all of those families to do and they really although they were resistant at first they really saw the benefit all right two things i want to dive a little deeper there so number one do you ever get into the psychology of like oh i got this for you no you got it for you what are you talking about do you ever just like put a finger on and say hey let's talk about what's driving that yeah absolutely and more more these days than i even used to do because i've realized that people have got very powerful emotional attachments as to why they do certain things i'm going to tell you about the very first day i ever filmed for this documentary series right there's a first family this is i i rock up into this town called shoes bringing the uk and you know a little bit nervous because i'm there's a camera crew that's going to watch me be a doctor and try and help these guys right first time i've done that and i meet the family lovely family that's been struggling with the health whole variety of health issues and they i said guys what would you typically eat right so the father says to the says to the family hey guys you know just as usual tonight i said yeah dad just usual please he says come on dog come with me so i go sit in the car right we drive 15 minutes out of town to go to a mcdonald's drive-thru on the way there the guy says to me he says doc you know what i know this stuff isn't good for us and it's really really embarrassing for me to actually be taking you here but this is what we do right and i don't think i quite got it back then but i reflected on this a lot since then which is these guys knew that these weren't healthy choices he knew that but it's only when this third party comes in someone who's got no emotional uh attachment to this family he starts to feel really guilty and he feels you know he feels he has to apologize to me for the choices he's making which he which first of all he doesn't need to apologize but i found that really interesting what's going on there why do people make choices that you know are not serving them right why do you think they do it for real because i think those choices you know i think those choices on some level nourish them you know they if they're lacking something in some aspects of their life they're getting they're feeding their reward pathways you know so many people will eat to make themselves feel better you know if they had a stressful day at work or they're feeling a bit low food is a comfort for them food helps them feel better about themselves albeit for a short period of time you know we all know that feeling if we have a sugary treats you know we can feel good yeah you know we so we know intuitively that food can change our mood right there's a lot of science now behind all of that but i think it's because on a deep emotional level maybe when they were a kid they were conditioned that you know you're not feeling so good you're thinking well oh should we have some nice sweet treats and this particular family for example again you know the the the dad would say that i buy this stuff because it makes my wife happy she really likes it so in some way he felt that he was doing a really nice thing for his wife you know his wife really enjoyed that sort of food so he felt as a loving husband i'm going to give it to her right you know so i feel on some level he felt that was him helping you know his part of being a good husband um but i'll tell you on that on that with that particular family that as as we went to mcdonald's and he ordered the food and what was incredible for me is that he ordered it was about it was 48 pounds it was that figure is locked into my head so that's about 65 70 maybe something like that just for one meal for a family of four but then we got back to the house with the food right and check this we got there and in the kitchen they've got trays right so they've got mcdonald's trays in their kitchen so they dish up onto the trays and they serve them so this is what happened then the son is sitting at the dining table eating by himself whilst sort of scrolling his phone at the same time okay the mum i think was watching television okay and she was eating watching television i think the daughter might have been on her phone at a different part of the living room but i can't remember where the dad was the point is is that they're a family of four the food is already at the same time yet they weren't eating together okay they were mindlessly eating whilst also you know doing their emails sending text messages doing their social media updates whatever and so the intervention i made with them and i made it with the lots of those families is to have one meal a day with someone else if possible sitting around the table and i'm telling you tom that was transformative that whole social connection piece when and one of the recommendations i make in the relaxed pillar is that eat around a dinner table for at least one meal a day with someone else if you can you eat less when you do that right why because you're not mindlessly eating we can easily over eat when we're doing something else there are studies showing if you eat whilst watching television you eat much more right we know the feeling i know when i used to watch a lot of sports games on on on tv with my buddies and there'd be like a bowl of crisps there or tortilla chips how many of those things can you do whilst you're whilst you're watching the game yeah it's super interesting the way that people deal with food if you enjoyed that conversation i really think you're going to enjoy the one i had with professor bj fogg from stanford all about habits it's right there so give it a click and let me know what you think the feeling of success is what wires in the habit emotions create habits and specifically in tiny habits what we focus on is

Channel: Dr Rangan Chatterjee

Views: 4,783

Rating: 4.9545455 out of 5

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: OkqLeJ-xVh4

Length: 85min 55sec (5155 seconds)

Published: Sat Sep 18 2021