The Only 5 Food Rules You Need To Know To Heal The Body & Prevent Disease | Dr. Rangan Chatterjee

Dr. Rangan Chatterjee 0:00 The food you eat can either be the safest and most powerful form of medicine or the slowest form of poison. That's a phrase from Ann Wigmore. I think it absolutely stands true. I have seen tens of thousands of patients over two decades, and I have seen transformative changes, not just things like weight and type 2 diabetes, things like their mood, anxiety and depression, joint pain, and skin health can be improved dramatically when we change the way that we eat. And that's the magic of food. If you change what you put on your fork today, literally within a day or two you can start to feel different. And over time, you transform who you are and you reduce your risk of getting sick in the future. But you have to know what to eat. People fight, they literally fight on social media about what is the perfect diet, and many of them are making a very common mistake. They believe that the diet that works for them is the same diet that's gonna work for everyone else, and it's simply not true. I don't want you to fall into that trap. I have seen patients thrive on a variety of different diets. There is no one perfect diet, but there are some core principles that I have been applying with my patients for years that help them to heal their body and their minds, and these principles work for you no matter who you are. Whether you wanna be low carb or vegan or paleo, doesn't matter because these are the principles that I have seen time and time again work for absolutely everyone. And in this video, I wanna share with you my top five.

Dr. Rangan Chatterjee 1:52 The most important principle when it comes to food is to unprocess your diet because when we mostly eat real food, that food is information for our body. It sends out certain signals, and it helps us feel less hungry, it helps us to manage our weight a lot of the time automatically, and it makes us less likely to be tempted to eat what I call bliss eat foods, which I'll explain very shortly. One of the reasons that these ultra-processed foods are so toxic for so many different aspects of our health is because they encourage us to eat more. Ultra-processed foods are formulations. They're food-like products that have been made intentionally by food corporations and food scientists, and they have been designed a lot of the time in a way that makes it very, very hard to moderate your consumption. Many of these foods, these are foods that I call bliss eat foods, right? Have literally been designed to spike the bliss point in your brain by the absolute perfect combination of salt, sugar, and fat to prompt that reward signal in your brain which makes you want to eat more, and it's all mediated through the neurochemical dopamine. And the more you consume foods like this, your body starts to release dopamine in anticipation of those foods. So even before you've eaten them, just the sight or smell of them can start to increase dopamine in your brain. That's actually one of the big problems with eating so many ultra-processed foods. It gets very hard to moderate our consumption. But you can absolutely change it when you start unprocessing your diet. Now we have to understand that these ultra-processed foods didn't really exist in our food environment, let's say 100 years ago or so. They have been intentionally created, especially over the last 50 years, and the amount of them has rapidly increased. So for many of us, we don't even realize that the bulk of what we're eating is actually highly, highly processed. Here in the UK where I live, ultra-processed foods make up 60% of the average diet. Now that figure is higher in America, and in many countries around the world it is rapidly increasing. Ultra-processed foods have been shown to be the leading cause of premature death all around the world. Now to be completely accurate, in some countries the leading cause is tobacco, but in many countries it's now ultra-processed foods. At the very least, it's right up there with tobacco, so it should be something we take very, very seriously. Now we know that the more of these UPS that we're consuming, the higher our risk of certain disease states. And it's also important to understand that even if you are at what is considered a healthy weight, well, eating ultra-processed foods still increases your risk of all kinds of things like type 2 diabetes, heart disease, dementia, anxiety, depression, inflammatory bowel disease, cancer, and eating disorders. So it's something we really, really needs to be taken seriously. Now what I've learnt over two decades of seeing tens of thousands of patients is asking my patients to mostly eat what I call real food is perhaps one of the most important pieces of health advice I can give them. Now what do I mean by that? Well, when I say eat real food, I mean try and eat food that's minimally processed, as close to its natural state as possible, and food that's instantly recognizable. So fish that looks like fish, meat that looks like meat, vegetables that look like vegetables, et cetera, et cetera. Because when we eat mostly unprocessed food, it has huge benefits on so many aspects of our health and our physiology. Now unfortunately for many of us, the bulk of what we are consuming today are not these minimally processed foods. It's not real food. It's actually these ultra-processed foods. You can define ultra-processed foods in a variety of different ways, but one definition I quite like was from scientists writing in the journal Public Health Nutrition, and this is what they said. "Ultra-processed food and drink products are not modified foods, but formulations mostly of cheap industrial sources of dietary energy and nutrients, plus additives using a series of processes, hence the term ultra-processed. All together, they are energy dense, high in unhealthy types of fat, refined starches, free sugars and salt, and poor sources of protein, dietary fiber, and micronutrients." I mean, it's not great, is it? I mean, eating these kinds of foods over and over again are driving problems in how we feel in the short term, but also in the long term. And I've gotta be honest here, I have had countless patients where I say, "Okay, there's a lot of different things going on here with your health, with the way you're feeling. But if I look at your diet, it mostly consists of ultra-processed foods. Would you be interested in a two-week trial of just eating minimally processed foods?" And a lot of them are up for it, and I think it's a very powerful thing to consider. If you have never done this before, I would highly, highly recommend that you give it a go because you may not know how good you could feel until you've done that. It's so common that when my patients do this, they say, "Oh, wow. I didn't know it was possible to have this much energy, this much vitality. My sleep is better. My relationships are better. I have more discipline." So many things happen, and I think because for many of us, we're eating so much poor quality food so regularly, we've forgotten if we ever even knew how good we could feel. So the truth is, unless we are aware of this and doing something about it, it's likely that the quality of our diet is going to deteriorate. And if we think about these ultra-processed foods, they are designed by food scientists to be irresistible, right? They're designed so that we can eat more of them.

Dr. Rangan Chatterjee 8:51 And there was a really good study done by Kevin Hall a few years ago, which really beautifully demonstrated this exact point. Now, in that study, people spent two weeks with unlimited access to highly processed, what I call blissy foods. And then they spent another two weeks, the same people, right, they had another two weeks where they had unlimited access to freshly cooked food made from whole ingredients. Now, what was interesting about this study is that both diets were matched to have the same amount of fat, sugar, salt, fiber, carbohydrates, and protein. Here's where it gets really interesting. When people were eating highly processed blissy foods, they ate on average around 500 calories extra per day compared to when they were eating minimally processed foods. Just remember, they had unlimited access, right? This wasn't calorie controlled. They could eat as much of this food as they wanted, and essentially when it was unprocessed food, they ate 500 calories less than when it was highly processed. And if you actually measure that out across a year, that would basically add up to almost 180,000 extra calories per year, which is absolutely remarkable. What's the take home? The take home is actually very, very simple. If you can unprocess your diet as much as possible, for most people, they're going to automatically eat less. And I think we all kind of recognize that. If you have some crisps or potato chips or ice cream that you have bought from the supermarket or your local store, I think we've all been in a situation where we can overconsume that. We've had a serving, and we just keep eating. And many of the adverts around these foods will say the same thing. Once you start, you can't stop. And it's true, you can't. But it's a lot harder to do that with whole foods. Now, can some people overeat real food? Yes, but you're less likely to. Think about, I don't know, a meal from our grandparents' generation, a classic roast meal, let's say, right? Roast potatoes, vegetables, and some sort of roast meat. Well, it's pretty hard to overconsume that. There comes a point where you would just stop eating because you're gonna be full, and that's one of the big problems with this highly processed food environment in which we're living, and that's why I still believe the number one principle is to unprocess your diet as much as possible. Now, you don't need to be perfect. I get it. It's gonna be very hard to be perfect. And for many people, they enjoy, they really enjoy some of these highly processed foods that are often devilishly tasty. It's about what is the mainstay of your diet? What are you eating from Monday to Tuesday to Wednesday to Thursday to Friday? What does that consist of? It's that dietary pattern, that overall pattern, that's what's gonna have the most impact on your health rather than the odd ultra-processed food you might have now and again. And I think that's a key point to get across. We're not looking for perfection here because perfection in the modern world When it comes to our food intake, can be very, very hard. A few years ago, I saw this 42-year-old lady who was really struggling with her health. Yes, she was carrying excess weight, which really frustrated her, and she had tried all kinds of diets over a number of years. She'd had short-term success, but nothing that she could stick to long-term. She was also low in energy, lacking in motivation. Was struggling with mood swings, and often she would say that she was feeling depressed. Now, when I was talking to her to figure out what was going on in her life, it was really clear to me that her diet wasn't helping her, so I made the suggestion to her about changing her diet. I asked her whether she would be up for trying for just two weeks to have a diet that was exclusively real food, so minimally processed food. I said she would have to stop all of her ultra-processed foods, her ready meals, her pastries, her supermarket breads, her cakes, her biscuits, her breakfast cereals. And of course, for some people that can be challenging, but for her, we went through what kinds of foods she could eat. She didn't like to cook, so I had to find some resources for her. I had to suggest some simple meals that she could make. But I said, "I don't want you to count calories." Right? "You can eat as much as you want, but all the food you have to eat for these two weeks has got to be minimally processed." And I framed it to her as an experiment, said, "Just see what happens. See what happens when you do this for two weeks." And the results were absolutely remarkable. Within days, she was feeling significantly better. Within a week, her energy was up. She was finding herself more motivated. She was saying that she had less inclination to snack. After about a month, she'd lost around one stone, which is about 14 pounds, which is a significant amount of weight, especially when you're not trying to lose weight. [laughs] And I think two years later when I saw her, she said to me she had never felt better, and she was mostly sticking to it, but not 100% of the time. And I think that's a pretty good place to get to. I think for many of us in the modern world, it's gonna be very hard to stick to this 100% of the time. But this is just one case where moving to real food proved transformative, and I could give you another 50 case studies where I've seen that, if not more. I guess the big point I'm trying to make here, and why I think this is the most important principle to follow for your diet, is when you unprocess your diet, when you mostly eat real foods, you see an improvement in the health of your immune system. You lower levels of inflammation. You generally tend to eat less. You find it easier to not snack so much, and you often find improvements in things like sleep, energy, vitality, motivation, all because you are cutting back on the ultra-processed foods and increasing the amount of real foods. And if this sounds extreme to you, I just want you to think back 100 years. 100 years ago, most humans on the planet were mostly eating unprocessed foods because that's all that was available. In fact, for the bulk of our evolution, that is all that we ate.

Dr. Rangan Chatterjee 15:56 Now, one of the reasons that when we move our diets from being highly processed to minimally processed, one of the reasons why you see so many different things in the body get better is because of a process called inflammation. Now, you may have heard of the term inflammation, but I think it's worth just pausing here to explain what exactly I mean when I say inflammation in this context. I think we all recognize the importance of inflammation at certain times. So let's say you trip over and sprain your ankle. Okay, well, what happens? Well, you get a bit of pain, but your ankle becomes swollen, hot, and red. That's because of inflammation. That is a good thing because that inflammation is bringing all kinds of molecules from around your body to the site, your ankle, to help repair the damage. And over time, over a period of days to weeks, the damage gets repaired and the inflammation switches off. Right? So the inflammation served a role that was there to help you sort out your ankle. The kind of inflammation that's causing problems these days for so many of us is what we call chronic inflammation. And over the past few years, it's become very clear that chronic unresolved inflammation lies at the heart of many different chronic conditions that are afflicting so many people these days. Type 2 diabetes, dementia, heart disease, stroke, even many cases of depression are thought to be driven by chronic inflammation. And some of that chronic inflammation actually comes from your diet. So if we're consuming these highly processed foods regularly, the food comes into our gut, and in our gut, you may have heard before people say that 70% of our immune system cells live and reside in and around our gut. But why would that be? Well, the gut is that interface between our bodies and the outside world. Your food, in many ways you can consider a foreign object that's coming into our bodies, and so your body has to make sure that what it lets in is okay to let in. That's why there's so many immune cells in our gut. And that's why if we consume too many ultra-processed foods too often, what happens is that those foods go into our gut, they interact with our immune system, and that can often cause inflammation. And if you're consuming those foods day in, day out... What happens is that you are stimulating that inflammation day in, day out, and that's why you have this chronic unresolved inflammation going on in your body. Now, that is one of the main reasons why when people can and do make the change to an unprocessed diet as much as possible, they can see all these improvements, as I mentioned before, joint pain, skin, weight, blood sugar going down, all kinds of things getting better because they're no longer driving that constant cycle of inflammation. I want to be really careful that I don't scare you here. Are ultra-processed foods in the quantities that many of us are consuming them a problem? Yes, absolutely. It's a problem we have to take seriously, but at the same time, you've got to understand that eating them now and again is probably not the big issue. It's when they become the mainstay of your diet. That is why the advice here is to unprocess your diet as much as you can.

Dr. Rangan Chatterjee 19:41 So how do you know if what you're eating is ultra-processed? Well, you have to become what I call a food detective. You have to start looking at food labels, and if you never have them before, I think you'll be surprised by what's on the labels of the things that you're putting inside your mouth. As a rule of thumb, I would say try to avoid any food products that contains more than five ingredients. It doesn't always hold true, but usually if you turn something over and look at the ingredient label and there's more than five ingredients there, it's a pretty good bet that it's a highly processed food. And common ultra-processed foods that many people are consuming are things like breakfast cereals. I mean, s- most of the breakfast cereals I see in my supermarkets are ultra-processed, and more worryingly, they are marketed as being healthy. There's also many of the supermarket breads that are not made in the traditional old-fashioned ways. It could be biscuits, pastries, crisps, ready meals. I mean, they're literally everywhere, but if you start looking at the ingredient labels, you'll start to pick them up straight away. And another way to think about this is to focus mostly on one-ingredient foods. Most foods in nature, most foods that we buy in their natural form in our supermarkets actually don't really have ingredient labels. Vegetables don't. I mean, a broccoli has got broccoli. It is broccoli. That's it. An avocado is an avocado. There aren't four or five ingredients because it's a whole natural food. Again, we're not looking for perfection. I just want you to start shifting your diet in this direction as much as you can. So have a think about the food that you're consuming at the moment. Is it mostly real food, or is it mostly highly processed foods? Now, I do want to take a moment to acknowledge that for some people, this can be really challenging, okay? Depending on your income, depending on where you live in the world, depending on what you have access to, yeah, this is harder for some people than others. But as a doctor, I still need to be honest. I need to explain to you just how toxic these foods can be when consumed in the volumes in which we are consuming them. I have seen patients do remarkable things when given this information. So yes, I think there is a social issue here. I do think as a society we need to make it easier for people to make these healthy choices. But at the same time, I think we should be empowering people and telling individuals and saying, "Hey, listen, even if you can make a 5% or 10% shift in this direction, you are going to improve your health immediately and lower your risk of getting sick in the future." So over the years, I've developed some top tips that I've seen work for patients, and I'm gonna go through a few of them with you now. You don't have to six of them all. Some of them are gonna feel more relevant than others. But the more you can apply, I think the quicker and faster you'll find your health improves. Number one, remove all the highly processed foods within your house as much as you can. It's a very simple but effective tip to use. The whole idea here is we don't want to be using willpower up inside our house. If you have got crisps and sweets and pastries and ice cream in your house and you think that you're gonna be able to use willpower to resist, I've just got to say, in my experience, it's highly, highly unlikely. In my own house, I don't keep any of this stuff in the cupboards because I know that if I did, on a stressful day when I'm feeling tired and I open the cupboards, I'm gonna consume what's there. So for many patients, it's a very simple tip that works really well. Don't bring foods into your house that you don't want to consume. The second tip would be to come up with five simple meals that take 15 minutes or less to prepare. Now, for all the problems in the modern world with this ultra-processed food everywhere, well, some of the benefits are that you have YouTube videos, you have cookbooks, you have an incredible array of information and people out there who can help you do this stuff. So find an influencer or a cookbook that you like and find a way to learn five simple meals that will take 50 minutes or less, and you'll find it much easier to stick with this plan. The third tip would be to keep an emergency snack pack with you, right? So if you're someone who gets the urge to snack on the road, when you're at the office, when you're away from your house, that's when you're often being exposed to all of these ultra-processed foods. You go to the coffee shop to get your favorite drink in the morning, and you have to walk past the counter with all the pain au chocolats, the pastries, the biscuits. That's often when we start to make these choices, right? So if you can keep a healthy snack with you, like nuts or avocado Or hummus or whatever it might be, you know, you're much more likely to make a healthy choice if you get tempted to snack. Fourth tip would be to think about having a meal planner where you actually write out what you're gonna eat for Monday dinner, Tuesday, Wednesday, Thursday, Friday, Saturday, Sunday. You actually plan it out and you just repeat it week after week. Because I've seen so many patients who move to this way of eating and then they say the biggest problem they have is deciding what to eat. So they come home from work, they're tired, they're a bit stressed maybe, they've got to get their kids somewhere, and the decision-making that's required to choose actually results in them going off track. So I think a meal planner is a very simple tool that I've seen been transformative for so many of my patients. And I would probably say the fifth tip to leave you with in this particular section is to make your kitchen area desirable. Now look, we've all got different sized apartments, houses, flats, places where we stay. I get that. But if you can make the kitchen area a bit cleaner, tidier, somewhere where you want to be, you'll find that your desire to spend time in there cooking actually will start to change. It's something for me that's very important when I'm cooking meals for my wife and my children. I want the kitchen area to be nice and clean. I want to put on some music that I enjoy. I leave my phone in a different room so I can actually just be present and enjoy the whole experience. And so for me, that's changed my relationship with cooking where now it's actually a really fun part of my day. Right? So it may be something that also works for you. How can you turn something that maybe you consider stressful at the moment into quite an enjoyable part of your day? Now I do want to acknowledge at this point that not only does cost play a role in terms of the food that we eat, but the amount of time we have. Like a lot of people are working in jobs that got really long hours, they're working shift work, or in some of the practices I've worked at in the past, you know, people are working two or three different jobs. They don't have much family support. And of course, to prepare food, you need time. And for some of these patients, they just didn't have that time. They were always on the go. So I do recognize that. Try and go easy on yourself. But wherever you currently are, even if you can make a 5 or 10% shift from highly processed foods to minimally processed foods, please know that you will immediately be making a noticeable difference with your health.

Dr. Rangan Chatterjee 27:41 The second principle is to pay attention to sugar. Now, we're all hearing about sugar these days, aren't we? About how much sugar we're consuming. And the truth is, if I reflect on my patient population over the past two decades, most people were consuming too much sugar. But it's not a personal weakness of ours, right? All humans are hardwired to crave sugar. We are. We all to a certain degree have sweet tooths. And actually, that was a very helpful adaptation many, many years ago. When that sweet food was available in the summer, the ripe fruit, we would want to eat it, gorge on it, and actually store it as fat in our body, which would help us when food wasn't as readily available, perhaps during winter or perhaps when we're unable to have access to food. So that was a helpful adaptation for humans. So please don't feel bad if you find that you've got a problem with sugar. Many people have issues with sugar in this modern food environment. Now, when you think about sugar, I want you to think about two things. I want you to think about added sugar, but also foods that are rapidly turned to sugar in your bloodstream. Let's start off with added sugar. Many of us are consuming too much added sugar. This is sugar that gets added to the food that we're eating. Now, it may be that you add sugar to your tea or your coffee or when you're cooking something. Okay, that's added sugar. But often it's added to the foods that we're consuming. So let's say you choose to eat meat. Well, I'd encourage you next time you buy something, if it's pre-cooked, for example... I mean, I saw this recently, a chicken breast in my supermarket. It looks fresh and healthy and whole foods. And actually, if you turn it over and look at the ingredients label, you see that one of the first ingredients is sugar. Right? So people are buying what they think is a chicken breast, but actually it's also got sugar within it. So unless you're aware of this, you start to increase the amount of sugar that you are consuming. Information is not enough to make change in your life. You have to take action. So to help you take action after watching this video, I've created a FREE Nutrition Guide for you. This contains the five most important practices I've seen in over two decades of seeing patients. They work for you no matter what your dietary preference. There's a step-by-step action plan to help you implement those changes in your life. If you want to receive that free guide right now, just click on the link in the description box below. So as I mentioned in the first principle, unprocess your diet, if you are going to dramatically improve your health and the food on your plate in the current food landscape, you really have to get good at looking at ingredient labels. Now, when it comes to sugar, there's many different names for sugar that get put on ingredient labels like glucose, dextrose, glucose syrup, cane sugar, glucose fructose syrup, molasses, cane juice, and rice syrup. I'm not saying to never have these foods. Again, like I mentioned with the first principle, this is about your overall pattern of eating. The truth is for most of us now and again having a bit of sugar isn't really the fundamental problem. It's that we're consuming volumes of sugar that we've never consumed before and we're not even aware of. So the first thing I want you to think about is how much sugar are you adding to your diet? Can you reduce that? And how much added sugar is in the food products that you're buying? Now the second here I wanted you to pay attention to is foods that are rapidly converted to sugar in your bloodstream. And what do I mean by that? Well, so let's say for example you buy some supermarket bread and you think, "Okay, there's no sugar added to this." Okay, so it doesn't have added sugar, but a lot of these ultra processed food products are rapidly turned to sugar in your bloodstream, and this can cause a variety of different problems. So let's say for example you have something first thing in the morning like a breakfast cereal. Many modern breakfast cereals spike your blood sugar in a huge way. You consume it. You think you've eaten enough to be full. What will happen is your blood sugar starts to go up, and two to three hours later it starts to come down rapidly. Now when it comes down rapidly, many things start to happen. You can start to feel hungry, shaky, irritable, tired, moody, and that's because blood sugar dropping rapidly is an alarm sign to your body. If you think about this through an evolutionary lens, your blood sugar dropping rapidly might have indicated that you're running out of foods, right? So your body takes action to prompt you you need to do something about it. So you have these symptoms that are expressed. It's your body trying to draw attention to this. And it's not just a hunger problem. When your blood sugar starts to drop rapidly, the stress hormones in your body also start to go up, like adrenaline for example, and that can lead to a whole host of other symptoms including mood issues. And this is one of the reasons why people will leave the house in the morning and say, "Well, I had a huge bowl of breakfast cereal. I was full when I left, but at 10:00 AM in the morning I was ravenous. I couldn't concentrate. I had to go and get something." Now the reality is their bodies are probably not deprived of food. What's happened is that the food that they consumed resulted in their blood sugar going up and their blood sugar going down, and that can very easily be changed by changing what you eat. So what are these foods that tend to elevate our blood sugar rapidly? Well, it's usually a lot of these ultra processed foods. It's the supermarket breads, the breakfast cereals, the biscuits, the pastries, the ready-made pizzas, the ready meals. It's usually these foods. Can some whole real foods do it? Yes, but generally not to the same degree. And again, I think we need to be really clear here. We're not looking for no fluctuations in our blood sugar. We're trying to get away from these rapid ones where there's a rapid correction in the body which can lead to a lot of these symptoms including low mood, depression, and anxiety. And the truth is I've seen many patients when I help them eat in a way that supports more stable blood sugar levels, and I'll explain in just a moment how we can do that, I have seen a whole variety of different symptoms get better including depression, including mood problems. So how do you know if this might be an issue that's affecting you? Well, it could be that you feel really hungry in between meals. It could be that you feel irritable or shaky mid-morning or your concentration starts to go down, or you're getting these things in the afternoon. That classic afternoon slump one or two hours after your lunch. Or it could be that you are overly reliant on things like caffeine and sugar to get you through between meals. Now those symptoms can be related to other things in the body, but at the same time if you've got one or more of them it may well indicate that you are living on this blood sugar rollercoaster which can have problems in the short term and in the long term. So if we just zoom out for a minute, I'm talking here about added sugar and foods that are quickly turned to sugar in your bloodstream. Both of them if they go on for too long can be problematic for a variety of different reasons. Too much added sugar in your diet can affect your dental health, your weight, make you tired, increase your cravings. And if you're constantly having these blood sugar fluctuations, the downstream effects can be absolutely profound. Like in the short term it can be hard to control how much you eat. You're feeling tired, hungry. You're irritable. Your mood's up and down. It affects your work performance. All kinds of things we see. Okay? But in the long term if you are living on a blood sugar rollercoaster and your blood sugar's going up, it's going down, it's going up, it's going down, well, that may increase the risk of you getting sick in the future. One of the things it can do is make you resistant to a really important hormone that's called insulin. Now insulin does many different things in the body, but one of its main roles is to try and keep your blood sugar tightly controlled, keep it within its normal range. So let's say you have that breakfast cereal in the morning. Your blood sugar starts to go up. So what happens is your body will release insulin, and insulin's job is to bring that blood sugar down by taking it out of your bloodstream and usually storing it as fat. If you keep repeating this behavior day in, day out for weeks, for months, for years, what happens is your body needs more and more insulin- To do the same job. Why? Because your body develops what we call insulin resistance. Okay? Your body is trying to respond to what's going on. It makes you resistant to that hormone, so you need more and more of it to do the same job. You can perhaps compare this to something like alcohol. Right? If you've never consumed any alcohol before in your life and you have a few sips of wine, let's say, you're gonna feel tipsy and drunk very, very quickly. But if you drink alcohol regularly and you become more accustomed to it, what happens? You develop a bit of a resistance. Okay? It takes more and more alcohol for you to get the same effect. Your body is responding to the signals you're giving it. And it's quite similar with the food that we're eating and insulin. If you're constantly eating foods that push your blood sugar up rapidly ... And just to be clear, from the whole foods that I mentioned in the first principle, you don't typically get these rapid blood sugar spikes. You only tend to get them with these modern ultra-processed foods. Well, you're gonna be putting a lot of strain on this insulin system in order to bring that blood sugar back down.

Dr. Rangan Chatterjee 38:31 Now, here's the thing. Ultimately, that can lead to type 2 diabetes, for sure, because type 2 diabetes is when your body can no longer keep your blood sugar under control. So it keeps pushing out the insulin, but there's been so much damage done that it can't bring it down anymore. But even if you don't have type 2 diabetes, if you have chronically elevated levels of the hormone insulin, which many of us do, even that can cause problems. It can predispose us to obesity. Levels of something called VLDL, a particularly harmful type of cholesterol, can start to go up. Your blood pressure can start to go up because of fluid retention. Your risk of breast cancer can start to go up. And in women, your testosterone can start to go up, and that can be associated with the development of conditions such as polycystic ovaries. The point I'm trying to make here, a bit similar to the point I made in the first principle on processed your diet, which is in that one I said even if you're at a normal weight but you're still consuming lots of ultra-processed foods, you're still increasing your risk of getting sick. Likewise, in this section about sugar, even if you don't have type 2 diabetes but you're consuming foods that are rapidly elevating your blood sugar, well, you're still gonna be raising levels of the hormone insulin and you're putting yourself at risk of these negative effects. Now I've mentioned some symptoms that you can look out for which might indicate that you're on this blood sugar rollercoaster, but what is there in terms of technology that can help us? Well, you may have heard of something called a CGM, a continuous glucose monitor. These have been used for many years with type 1 diabetics and some patients with type 2 diabetes to help them manage their blood sugar. For a type 1 diabetic, for example, knowing in real time what's happening to your blood sugar can help you dose insulin correctly, which of course can be really helpful. But we're now seeing that people without diabetes, type 1 or type 2, we're seeing people who just wanna look after themselves and optimize their health. We're seeing that CGMs can, for some people, have a very powerful impact here. And I've gotta be honest, I genuinely believe that CGMs, when used responsibly, can provide some incredibly useful information. So I, for example, would be considered someone at a normal, healthy weight, but I will tend to wear a CGM maybe once every three months for two weeks. I put it on, and it helps me in real time see what different foods and different combinations are doing to my own blood sugar, and it's helped me change things for the better. What's really interesting for me is that I already know the principles of healthy eating, yet despite knowing those principles, understanding how certain foods for me affect my blood sugar has helped me tweak things. And then if you do ever use a CGM, you'll find that you and your partner or your friends can often have quite a different response to the same food. We're all different. You know, we're all completely different. We all respond to foods in different ways, and the more we can really understand that and own that, the more likely it is that we're gonna find the right way of eating for us. Now to be really clear, I don't think everyone around the world has access to a CGM. For some people, there will be a cost implication or you can't get your doctor to prescribe it in the country that you live. There are many commercial providers now offering this, but if you can't afford it, then that's completely fine. If you start to pay attention to how you feel, you'll often discover a lot of this information from just seeing how do you feel two or three hours after a meal. Does that change when you change the types of food that you're eating? And one of the best ways for all of us to stabilize our blood sugar more is to focus on protein and healthy fats. It's generally these refined grains that make up so much of the modern diet that are causing these rapid blood sugar fluctuations. But when you eat foods, let's say for breakfast, let's say eggs and avocado, for example, if, you know, you eat eggs, yeah, that would generally for most people keep your blood sugar quite stable in comparison to breakfast cereals. And one of the recommendations [laughs] I often make with my patients is to eat dinner for breakfast. And why do I do that? Well, it all stemmed from this one patient who I saw a few years ago who was really struggling. He came to see me. He was in his 40s. He said that he had a spare tire around his waist, which he was keen to get rid of, that he wasn't able to shift. And he was a bit confused because he was pretty healthy by his admission. And when I looked into what he was eating, it was pretty clear to me that he wasn't in control of his diet, his blood sugar was. He'd start each morning with what he thought was a healthy breakfast granola, but he'd feel hungry mid-morning. His concentration would go. He'd feel an urge to snack. And I asked him what he likes eating in the evening. Because he was vegetarian, it would often be things like goat's cheese with roasted vegetables like courgettes and peppers. I said, "Okay, well why don't you make extra and reheat it in the morning and have your dinner for breakfast?" So he was open to trying this, and the very first day it happened it was transformative for him. He didn't feel hungry again till 2:00 PM. He went right through lunch, he wasn't feeling hungry. He didn't feel any urge to snack in the morning. He wasn't craving caffeine. His concentration was stable. It's all because what he ate first thing was keeping his blood sugar stable. And so for him, he came up with a variety of different meals that he could then reheat in the morning, but over time it transformed his life. He lost the spare tire that was on his waist, but he also gained so much more; energy, vitality, concentration, better performance at work, simply by stabilizing his blood sugar. And so that's why I think all of us should be thinking about how is the food that we're consuming affecting our blood sugar levels, and can we eat in a way that helps to keep them more stable?

Dr. Rangan Chatterjee 45:03 So some things to think about which will help you change your relationship with sugar. Check food labels. Again, if you're not looking at what you're consuming, you may be having more sugar than you think. Again, try and avoid as many of these highly processed foods as you can. They tend to be the ones that rapidly spike your blood sugar. Refined grains, in particular breakfast cereals, supermarket breads, pastries, and biscuits tend to be some of the worst offenders in this regard. Another tip would be to maybe don't keep added sugar in your house. Now look, you may be somebody who uses it in cooking or someone in the house puts a teaspoon in their cup of tea or whatever it might be. I understand not all of these things are gonna be relevant for everyone, but again, if you have the foods in your house, you're much more likely to be consuming them. Do try having your dinner for breakfast. For many patients, this is pretty transformative. We've already mentioned goat's cheese and roast vegetables, which worked for one of my patients, but you can think about eggs and avocado, a leftover roast dinner. If you're vegan and are having dal and brown rice in the evening, lentils and brown rice, you can try having that in the morning. But again, with all this stuff, it's about experimenting. Pay attention to how you feel. See what happens when you swap out your breakfast cereal for some of these healthy whole food meals. And I guess the last few tips here are related to added sugar. If you are thinking at this point that you are consuming way too much added sugar and you wanna go cold turkey, like some patients like to do, you can do it this way, but just be aware you can feel tired, you can have mood swings. It can be quite hard, so be careful when you're gonna do this. And if you are gonna do it, maybe avoid social engagements for a couple of weeks if you can to make it easier for you. But also, you need a strategy for when you are craving that sugar. There's so many different strategies that can work. Um, a couple of pieces of dark chocolate can sometimes be good. Having some nuts can sometimes help. Drinking some water, sparkling water, something like this can often help. And sometimes even just changing your room, right? Going to a different room, going for a walk, doing some deep breathing can actually change the power of that craving. Just because you feel that urge to have the sugar doesn't mean you have to give into it, so perhaps some of those strategies you might find useful. I think resetting our relationship with sugar is one of the most powerful things we can do. We're living in a world where sugar is everywhere. Don't worry about perfection. Think about the added sugar in your diet, also think about foods that are rapidly turned into sugar, and just remember any changes you can make here will make a difference.

Dr. Rangan Chatterjee 48:00 The third principle I like people to think about when it comes to improving their diet is to eat in a way that supports their gut health. Now, the research on gut health has been exploding over the past 5 or 10 years. We're seeing articles in the media, podcasts, blogs, books, all about this topic of gut health. Many scientists will say that our gut microbiome is like a brand-new organ in the body that we weren't aware of until recently. So your gut microbiome basically consists of these trillions of bugs that live inside of you; bacteria, viruses, fungi, protozoa. You know, so many bugs, trillions that live inside of us, and we now know from research that the health of your gut influences the health of the rest of your body. And there are some really strong correlations between a healthy gut microbiome and your weight, your mood, your risk of type 2 diabetes. Even things like depression or Alzheimer's or rheumatoid arthritis or skin problems can be related to the health of our gut bugs. So as things stand today, we think that an ideal microbiome is a diverse one, so lots of different species of bugs that live in harmony with each other. Now, for all that we know, there's absolutely a lot that we don't know and- And so I think we need to be careful when interpreting this research. But one way that you can think about this is just as in a factory, if you had a factory, you had different departments, and in each different department there were different amounts of staff, they all have different roles. And if all the departments are working well, the factory runs well. Well, your gut microbiome is a bit like that. You can think of your gut bugs a bit like a factory. There's different departments, there's different staff. Some are responsible for making chemicals like serotonin, some help you make vitamins, et cetera, et cetera. And if you eat in a way that supports those gut bugs, they in turn help support your health. Now, as things stand today, we believe a healthy microbiome to be a diverse microbiome. So for example, when we study a modern hunter-gatherer tribe, like the Hadza in Tanzania, who are still living in ways that are comparable to how their ancestors lived, we see that the diversity in their gut microbiome is significantly greater than in modern, Western, urbanized populations. In fact, some studies suggest that we may have lost over 50% of our diversity. So our ancestors had a hugely robust and diverse microbiome. Many of us have a much sparser one, where we've lost a lot of that diversity. And some scientists believe that that loss of diversity is one of the main reasons why we are struggling so much today with allergies, intolerances, autoimmune illness, and growing rates of chronic disease. So I think in this field over the coming years, we're gonna see a lot of new research and developments. But I guess the question is: what can we do today? How can we eat in a way that supports our gut's health using the best available evidence? Well, I think there's many ways to do this. So I wanna share with you some simple things that we can do that are immediately going to improve the health of our gut bugs. The first one is to eat more plants. And the reason we say that is because your gut bugs like to feed on plant fiber. They eat the fiber in those plants, and they make something called short-chain fatty acids, which are these really powerful chemicals that can have a positive impact on your immune system and on levels of inflammation. And most people in the gut health field would encourage you to have a diverse range of plants. For many years, I've recommended that my patients try to have five different colored vegetables a day if they can. And my rationale for that advice was that the different colors represent different phytochemicals which have a different impact on your body. For example, red plants like tomatoes contain lycopene, which can help reduce our risk of cancer and heart disease. Orange plants can often contain beta carotene, which can help promote healthy vision. And the list goes on. So focusing on having five different colors a day means that you're likely to be getting this range of phytochemicals, which is gonna have a range of different benefits for your health. Another way to improve your gut's health is to focus on prebiotic fiber. Okay? So these are plant foods that are rich in a type of fiber called prebiotic fiber, which is basically the fiber that your gut bugs consume. And there was a recent study from San Jose State University that ranked the top five foods when it comes to the amount of prebiotics they contain: leeks, garlic, onions, Jerusalem artichokes, and dandelion greens. And what I really love about that study is that most of those foods are really cheap and widely available. So that's another strategy you might want to bring into your life. Sorry to interrupt. To make sure you are taking action after watching this video, I have created a free special guide to help you improve your sleep and reduce fatigue. Now, in my clinical experience, most people who are struggling to sleep are doing something unconsciously in their day-to-day life that is negatively impacting their ability to sleep at night. So in this free guide, I share with you five of my very top tips, tips that I have seen transform the lives of many of my patients. So if you wanna get a hold of this guide, all you have to do is click on the link in the description box below. I think it's really important to mention those first two strategies I mentioned that can work for some people to improve their gut's health, having five different colored plants per day or increasing the amount of prebiotic fiber in your diet, they don't work for everyone. And I think this is something that's not commonly spoken about in the conversation around gut health. Some people just can't do this. They get bloating, abdominal discomfort. They don't feel good when they eat in this way, when they start introducing more plants into their diet. And sure, sometimes it may be because the introduction was too rapid, and if people slowed down and did it more gradually, they'd be able to tolerate that. Sure, that is the case sometimes. But often, even with a slow, gradual introduction, people can often still struggle. So if they work for you and you're able to, great. But if they're not, please don't worry, there are other things that you can do. So the next tip to eat in a way to support your gut's health is to increase the amount of fermented foods in your diet. We know that fermented foods help to support our gut's health. This could be sauerkraut, kimchi, kefir, kombucha... All of these are fermented products that we know from studies can improve the health of our gut bugs. And some people who can't tolerate an increase in plants often find that fermented foods are really, really helpful. Now, I will say as wellness becomes more popular around the world, it can actually be quite expensive to buy [laughs] some of these fermented foods. But a lot of them can be made at home very easily and very cheaply. So if that is something that's of interest to you, please do look around, whether it's books or YouTube videos. There's many resources out there. But I do think that for many of us, increasing the amount of fermented foods in our diet can prove really, really helpful. The next thing you can think about when it comes to improving your gut's health is to eat foods containing probiotic bacteria. The most common food would be some live yogurt, for example, which contains bacteria, live bacteria, which would then go into your gut. Just be careful if you're buying foods like this. Look at the ingredient labels. Make sure that there's nothing that you wouldn't want in your body being added, like sugar for example. And of course, if you have allergies or intolerances, you need to be a bit careful here, but there are sheep's yogurt products and goat's yogurt products out there for those of you who struggle with cow's milk. And of course, we could consider probiotic supplements. Broadly speaking, I think probiotic supplements can be helpful for some people. I've certainly used them to good effect in my practice over a number of years. The problem is, is that there's such a wide variety available out there now that it's very hard to know which is the high quality products and which one isn't. So if you're interested in going down that route, it's always good to talk to a qualified healthcare professional who can advise you. And I think a really important point to make about gut's health is that if you do the first two things that I've asked you to do, which is to unprocess your diet and reset your relationship with sugar, you immediately start to improve your gut's health, even if you do nothing else. That is the big thing. Unprocessing your diet will straightaway start to improve the health of your gut. Even if you don't focus on fermented foods and eating more plants and prebiotic fiber, just that one change alone will make a huge, huge difference. And the other thing to be aware of is that your gut's health is influenced by many things, not just foods. People who don't sleep well will have a negative impact on their gut's health. And when they improve their sleep, their gut's health can subsequently improve. Same goes with things like movement and stress. You know, regularly moving your body in ways that are helpful for your short and long-term health also has a positive impact on your gut microbiome. Same thing we can say with stress and relaxation. So it's important to know that it's not just food that's gonna impact your gut microbiome, it's the way you're living your life in other ways that has a powerful effect as well. Now, when it comes to improving our food intake, it's not just about what we're eating. Of course, what we eat is important, and I've covered already some of the key principles that I ideally would have people follow when it comes to what they're putting into their mouth. But when we eat and why we eat are also really, really important, and I don't think people give enough attention to these two things.

Dr. Rangan Chatterjee 59:20 So for this fourth principle that I want you to think about when it comes to improving your food intake, I want you to think about when you're eating. Now, if I was to ask you when you took your first bite of food and when you take your last bite of food on any given day, do you know when that would be? How many hours are there between your first bite and your last bite? Well, Professor Satchin Panda, who's this incredible scientist from the Salk Institute in California, he's been researching something called time-restricted eating for over a decade now. And what's really interesting is a few years ago he found that in America, at least 50% of people are eating food over a 15-hour period, one, five, 15 hours. Which is actually remarkable because our bodies are not designed to be in a fed state the entire time. There are certain things that happen in our body that only happen really when we give it a break from food. And when I say food, I'm also including any milk or sugar you might be having in your first tea or coffee of the day, but also any wine or snacks you might be having last thing at night. So our bodies operate on what we call circadian rhythms, okay? Every organ system in your body has its own clock. It's got its own rhythm. And actually, the more we can stick to those rhythms, the better we feel and the better the impact on our health. And food absolutely plays a role here. If we can have some sort of routine and regularity with our food and some periods of time where we're not eating, we can get some quite incredible benefits for our health. And I've probably been recommending a form of time-restricted eating to my patients for quite a few years now, maybe seven or eight years, something like that. And if you're eating over 15 hours in any 24-hour period, you're only giving your body nine hours or so without food, and it's not really enough. And one of the simplest and most effective recommendations I make to my patients is to say, "Can you eat all of the food you're gonna eat in that day within 12 hours?" What we would call a 12-hour eating window. And that would be, let's say you have your breakfast at 8:00 AM, but you finish your dinner by 8:00 PM or 7 till 7 or 9 till 9, whatever works for you and your lifestyle. Outside that eating window, you can have black tea or black coffee, herbal teas, water, sparkling water are all completely fine, and they don't count as foods. And I have seen just incredible benefits when patients who were eating in eating windows more than 12 hours, they move down to 12 hours. I've seen people lose weight, improve their blood sugar control, improve immune system function, improve their energy, their sleep, and often I've seen symptoms of IBS, irritable bowel syndrome, get significantly better as well. Now, there's one really important process called autophagy that really kicks in when you give your body a break from foods, and it's really a housekeeping type of process. Just imagine your kitchen. Imagine that each day in your kitchen you're cooking, hopefully, uh, you're using dishes and cutlery, and you put them in the sink and you don't clean up. What happens? Well, day after day, the plates and the cutlery starts to build up. Your kitchen starts to become smelly. It becomes a place you don't want to go into because you're not taking care of what needs to be taken care of. Well, you can think about autophagy and the human body in quite a similar way. If you're constantly eating over 15 hours each day, and you do this day in, day out, you're not giving your body a chance to clean up. If you can have that break, you give your body time to reset, rejuvenate, and repair. So I'm a huge fan of these 12-hour eating windows, and I've gotta be honest, for most people, it's pretty achievable. In fact, I would argue that pretty much every human on the planet 50 years ago was doing just this. We never evolved to be eating food all the time. We need a fed state, and we need a fasted state, and this is a really simple way of doing this. In fact, if I reflect on the patients who I've helped do this over the years, I think there's hardly anyone who didn't manage to do it. If you are struggling with that, if you try it and you're struggling, it doesn't mean that the advice is not relevant for you. It means that there's something going on perhaps with your metabolism that we need to help repair so that you can do this. Because let's think about this on an evolutionary level. If you couldn't go for 12 hours without eating, you were gonna struggle to survive. Okay, all of us in the past would've been able to do this, or we wouldn't be here. The reason why some people might struggle is because of the modern food environment and the modern living environment with so much stress and busyness. It's resulted in many of us having broken metabolisms. In fact, a recent study suggested that 90% of adults in America have some degree of metabolic dysfunction. You know, that's really, really worrying, and I don't think it has to be like that. And this tip to eat all of your food within a 12-hour eating window, I think is a very simple one that can be very, very effective. Now, if you're not used to it, you may have to start slowly. If you're used to eating over 14 or 15 hours and you stop eating at, let's say 7:00 PM, yeah, you may feel hungry at 9:00 PM, or you may be craving some sugar or whatever it might be. That will pass. If you can get through the first few days, your body starts to adapt. And what you'll also find is that when you have this tight rhythm, when you're consuming food in a predictable fashion, you'll often find then that not only are you not hungry later on when you used to eat, but you often find that actually if you do eat outside your eating window, you often have what I call a food hangover. You wake up the next day feeling groggy with a headache, feeling tired because you ate at a time when your body wasn't expecting it. So I'm a big fan of us trying our best to eat within 12-hour eating windows. Now, if you can do 12 hours, the obvious next question is, well, can I go lower? And the truth is, yes, you can. For some people you can. You can go to 11 hours to 10 hours. Some people, you know, take it even further. They have 8-hour or 6-hour eating windows, and the truth is different things can work for different people. Now, without having someone in front of me being my patient, being able to properly assess them, I've gotta be careful with the advice that I give. I would say 12 hours works for pretty much everyone. I think most people can do well also with a 10-hour eating window. If you wanna go lower than that, yes, I think you can experiment by yourself, but if you do have access to a healthcare professional who is interested in this area and has some experience, it can often be worth talking to them. For some people, let's say you're on blood sugar-lowering medication from your doctor for whatever reason, it might be worth just having a chat with them before you go for prolonged periods of time without eating. But I'll be honest, I've got lots of patients with type 2 diabetes who have used 12-hour or even 10-hour eating windows to really, really good effect. But do check with your doctor if you're concerned and you're on one of these blood sugar-lowering medications. I know sometimes for some women, if they're having hormonal issues, this has to be carefully managed. But again, we don't need to get too worried, I think, about simple things like trying to eat all of our food within 12 hours or even 10 hours. It's a pretty safe recommendation for most people. So if you are interested in trying this and you live with other people, let's say a family or flatmates or friends It's often good to try and do it with other people, and you do it together. It helps give you support. Be aware that for the first few days it may take a bit of time to get used to. Don't worry too much about the times. Find a time that works for you and your lifestyle. Now, as it happens, there is quite a lot of research suggesting that eating earlier in the day is better for our circadian rhythms and our overall health. And if you do eat too late near bedtime, it can impact negatively the quality of your sleep. But again, these are fine-tuning things that we can bring in once you've brought it into your life. And if, for example, you work night shifts, I know many people are working shifts. If you work night shifts, let's say you're doing an 8:00 till 8:00, 8:00 PM till 8:00 AM, well, one way you could put this into practice is to have a big meal before you start your evening shift, let's say at 7:30 PM, and make sure you take something to work with you so you finish consuming any food before 7:30 AM. And I've seen that when night shift workers do this, it can help them with many aspects of their health, but also help them switch off and sleep during

Dr. Rangan Chatterjee 1:09:13 the day. The fifth and final principle that I want you to have a think about when it comes to food is why you eat. This is really important. We can talk about what we're eating, we can talk about when we're eating, but the truth is many of us know the basics of that. Many of us know, broadly speaking, what health-promoting foods look like. Yet we still find ourselves on the sofa in the evening consuming ice cream or sugar. We know we're trying not to, but we still find ourselves there. And I think this is something that we don't speak enough about in the context of food. You know, why are we eating? And the truth is that we used to eat to fill a hole in our stomachs, but these days we often eat to fill a hole in our hearts. We're not actually physically hungry, we're emotionally hungry. And if you are really going to change your relationship with food, you really need to understand what are your drivers for eating. When is it that you go off plan? When is it that you get stuck on the sofa eating a box of chocolates or biscuits that you don't ideally want to be consuming? Now, this is not about guilt or shame. Not at all. This is about understanding. This is about you understanding why you make certain choices. We all do. I've been there before. I have used sugar before to help me manage stress. And the truth is that stress is endemic in modern society. The World Health Organization calls stress the health epidemic of the st century. There's plenty of scientific research suggesting that 80 to 90% of what a doctor like me sees in any given day is in some way related to stress because stress affects every single organ system of the body. And there was a report in America a few years ago which found that 79% of us alter our food intake when we're under stress. 43% of people ate too much, whilst 36% of us ate too little. I mean, that's quite remarkable, isn't it? What happens with you? You know when you're feeling stressed or you're under a lot of stress, do you eat more or do you eat less? Of course, for some of us it makes no difference, but that report shows that most of us, nearly 80% of us, we do change our food intake when we're stressed. I've not really spoken much about the relationship between sleep and food intake, but we know that if you're chronically sleep deprived, you eat more. There's some research showing that if you're sleeping maybe five and a half hours per night compared to seven and a half hours, on average, you eat 22% more calories the following day just from sleep deprivation. So for so many of my patients who are trying to lose excess weight, the way I help them was not by changing their food intake, it was by helping them get better sleep. Because when you sleep better, and I appreciate for some people it can be tricky, you change hormone levels in your body. For example, leptin and ghrelin. Leptin is a hormone that signals fullness. Ghrelin is a hormone that signals hunger. We know that when you haven't slept well, ghrelin goes up, you feel more hungry, and leptin goes down, you feel less full, hence you eat more calories. So again, these things, stress, sleep, emotions, are all things that we need to think about if we want to change our food intake for good. Because the truth is, anyone can follow a diet or new eating plan for two or three weeks. You know, most people can do that. They can use willpower. They can just push through. But that's not what most people are looking for. Most people are looking for sustainable change, changes that they can sustain in the long term. And that's why it's important that you find the right eating plan for you that's gonna work for your taste, your preferences, your desires. The right eating plan for your lifestyle, but also understanding what drives you to eat in the first place Now, I created an exercise that I call the freedom exercise a few years ago to help patients of mine who were really struggling with eating things that they knew they didn't want to eat. And the exercise comprises the three Fs, which I'm gonna go through. The underlying idea behind this exercise is that all behaviors in life serve a role. Everything we do, there's a purpose to it. Far too often we try and change the behavior without understanding the role it's playing in our life. So let's go through that classic example of sitting on the sofa in the evening and somehow being stuck with some ice cream that we said we didn't wanna consume. Well, the first F is feel. Okay, so you're sitting on the sofa. You have the urge to have the ice cream or the sugar or the biscuits or whatever it might be. Take a pause and ask yourself, "What am I really feeling? Is it physical hunger or is it emotional hunger? You know, what am I feeling? Am I feeling a bit low? Have I just had a row with my partner and I don't feel good? Has the kids' bedtime taken a bit longer than usual? Have I spent all day on Zoom calls, so I feel a bit yucky because I've not been outside?" You know, what is it? Just pay attention for a second. What is it that you're really feeling? Then if you want, go ahead and eat it. Fine. You're just trying to build up that self-awareness. Then the next time it happens, okay, you do the first F again, but then you go to the second F. So the first F is feel. What am I feeling? The second F is feed. How does food feed that feeling? Okay, so let's say you identify that, you know, "I'm feeling stressed. I've had a bad day at work. I didn't take a lunch break. This is a little treat to myself. Okay, this is my time. This is me time." Okay, fine. Then you try and figure out, well, what is that food doing? Ah, when I have the sugar, I feel less stressed. So that's how food is feeding that emotion, right? The emotion is stress, and food is helping you manage that. So you're starting to build up that self-awareness, and that self-awareness is what is critical if you're gonna make long-term change in anything, frankly. I really think self-awareness is the most important thing to cultivate. Then the third F is find. Okay, so next time it happens, you're sitting on the sofa. It's 9:00 PM. You're going, "Okay, what am I feeling? How is food feeding that feeling?" And the third F is find. Can you find an alternative non-food related behavior to feed that feeling? So for example, if it's stress you're feeding and you know that sugar soothes your stress, can you find another behavior to soothe the stress that isn't the sugar? And that could be a whole variety of different things. It could be that you have a quick workout, right? One minute of star jumps to burn off that stress. It could be that you enjoy yoga, so instead of going to the ice cream tub, you do a five or ten-minute yoga sequence from your favorite instructor on YouTube. Maybe you're feeling lonely and sugar is your little treat to yourself. Okay, well how can you feel less lonely? Could you phone a friend? Could you phone your parents? Could you get together with someone? Maybe you've had no me time in the day. You've just been on Zoom calls for work. You've just been taking the kids to after school clubs. You haven't had any time to yourself, so that sugar or ice cream in the evening was a treat to yourself. Well, can you nourish yourself in other ways? What would happen if you ran yourself a bath and put a candle on and you nourished your body and mind in that way rather than with foods? You see, the possibilities are endless, but what you really need to develop is that self-awareness. And the truth is that three F exercise, whilst I did design it around food, it works pretty well for other behaviors that we may be trying to reduce, such as alcohol or social media scrolling, because it's just a very simple way of tapping into what you're really feeling. I hope you found those five tips useful. Please do pay attention to how you feel when you are following them, and don't worry about being perfect. It's that process of experimentation that's ultimately gonna teach you what's right for you and your lifestyle.

Dr. Rangan Chatterjee 1:18:40 My son, um, who was six months old at the time, um, he, he had been breastfed for six months, uh, by my wife. And we went on holiday to France just after Christmas. And on the first day he was, he wasn't so well. We thought he had a cold. He was bringing up a lot of mucus. And, and my wife didn't put him down to sleep as normal in the evening. It's his mother's intuition. She knew something wasn't quite right, and she just kept him with her in her arms. And we were in France at my friend's chalet, and she called out to me, said, "Rangan, Rangan, you've got to come here. He's not moving." And, and basically my son had put his arms back. He'd gone rigid and stiff, um, and wasn't really responsive. Now, I thought, maybe he's choking. Maybe he's, he's choked on some of the mucus that he's, he'd been bringing up all day.

Speaker 1:19:35 Yeah.

Dr. Rangan Chatterjee 1:19:35 And I turn him over. I tried to clear his airway. Nothing was happening. Uh, if I'm honest, Mark, I froze.

Speaker 1:19:42 You thought he was gonna die.

Dr. Rangan Chatterjee 1:19:43 Yeah, I, I froze in that moment. I, I wasn't a doctor with all my experience. I was just a scared father. And it was actually my wife who said, "Rangan, look, we've got to get him to the hospital now." So we drove to the hospital, which wasn't far. It was just two minutes down the road, although I nearly killed us on the way-

Speaker 1:19:58 [laughs]

Dr. Rangan Chatterjee 1:19:58 ... because it had just snowed in the French Alps.

Speaker 1:20:00 Yeah, yeah.

Dr. Rangan Chatterjee 1:20:00 I nearly turned the car over. And we got there, and what was really interesting is that the, the doctors and the nurses were really worried. You could tell they were worried.

1:20:10 Because my son didn't have a temperature. And, you know, as, as you well know, it's not uncommon for a six-month-old baby to have a convulsion-

Speaker 1:20:20 A febrile seizure

Dr. Rangan Chatterjee 1:20:20 ... a febrile convulsion-

Speaker 1:20:21 Yeah

Dr. Rangan Chatterjee 1:20:21 ... you know, secondary to the temperature, but his temperature was normal.

Speaker 1:20:25 Yeah.

Dr. Rangan Chatterjee 1:20:25 And you could see the doctors wondering, "Well, his temperature's-

Speaker 1:20:28 "What's going on?"

Dr. Rangan Chatterjee 1:20:28 ... normal. What is going on?" So they put a line in his neck. You know, I actually had to help hold him down while they put a line in his neck, which was pretty traumatic for me.

Speaker 1:20:36 Yeah.

Dr. Rangan Chatterjee 1:20:37 He had to be, uh, blue lighted and in an ambulance down to a bigger hospital 'cause this was a very small regional hospital.

Speaker 1:20:42 Yeah.

Dr. Rangan Chatterjee 1:20:43 We got there. They didn't know what was going on. He had two lumbar punctures. And, you know, my wife and I were in a bit of a state of shock.

Speaker 1:20:49 Shock, yeah.

Dr. Rangan Chatterjee 1:20:49 You're like, "What is going on?"

Speaker 1:20:51 Mm-hmm.

Dr. Rangan Chatterjee 1:20:51 You know, we're a pretty-

Speaker 1:20:51 Yeah

Dr. Rangan Chatterjee 1:20:51 ... health-conscious family. Um, you know, why is he having this convulsion?

Speaker 1:20:56 Yeah.

Dr. Rangan Chatterjee 1:20:56 And, you know, we weren't sure he was gonna make it. And, um, you know, it, it took a few hours before a doctor came and spoke to us and said, "Look, we know why he's had a convulsion. He's got very low levels of calcium in his body, so he's got a... He had a hypocalcemic convulsion." So-

Speaker 1:21:16 Yeah, low calcium levels is-

Dr. Rangan Chatterjee 1:21:17 Yeah

Speaker 1:21:17 ... dangerous. Yeah.

Dr. Rangan Chatterjee 1:21:18 To put it in perspective, the normal range in that French hospital of a serum calcium was 2.2 to 2.6. His level was 0.97.

Speaker 1:21:26 Wow. That's-

Dr. Rangan Chatterjee 1:21:26 So not just low-

Speaker 1:21:28 And for those non-doctors in the audience, calcium is super tightly regulated in the body.

Dr. Rangan Chatterjee 1:21:34 Yeah.

Speaker 1:21:34 So any slight deviation is very serious. A little high, a little low, and this is very low.

Dr. Rangan Chatterjee 1:21:40 Yeah. And then we're trying to figure out, well-

Speaker 1:21:42 Mm

Dr. Rangan Chatterjee 1:21:42 ... okay, he's got a low calcium. They can give him intravenous calcium, but what caused the low calcium? And again-

Speaker 1:21:49 And clearly he was getting breast milk, so he was getting a lot of calcium.

Dr. Rangan Chatterjee 1:21:51 Yeah, exactly.

Speaker 1:21:52 Right?

Dr. Rangan Chatterjee 1:21:52 And it turned out a few hours later, after these lumbar punctures... And, you know, I, I just couldn't believe that this was going on with my kids. And they said, "Look, Dr. Chatterjee, we understand why he's had his convulsion. He's got hardly any levels of vitamin D in his body."

Speaker 1:22:08 Good for them for testing it.

Dr. Rangan Chatterjee 1:22:10 Yeah.

Speaker 1:22:10 [clears throat]

Dr. Rangan Chatterjee 1:22:11 And, um, that's why he's had it. And then this was like, what is going on? You know, this is a fully preventable vitamin deficiency, and my son's nearly died from that. Now, look, modern medicine saved his life. They gave him a calcium infusion. They gave him vitamin D. The acute problem was fixed.

Speaker 1:22:31 Yeah.

Dr. Rangan Chatterjee 1:22:32 But then we were discharged. You know, five days later-

Speaker 1:22:34 [clears throat]

Dr. Rangan Chatterjee 1:22:35 ... I was like... I was reading up about vitamin D, and I was thinking, "Well, hold on a minute. If he's been deficient for the last six months, if he's been deficient whilst he was in the womb, what impact has that had on his immune system development?"

Speaker 1:22:49 Mm.

Dr. Rangan Chatterjee 1:22:49 "Could this be why he's got eczema?"

Speaker 1:22:51 Yes.

Dr. Rangan Chatterjee 1:22:52 And nobody was giving me the answers to that, so I made it-

Speaker 1:22:55 And your wife also probably had low vitamin D.

Dr. Rangan Chatterjee 1:22:56 She had... Yeah, she got tested.

Speaker 1:22:58 [clears throat]

Dr. Rangan Chatterjee 1:22:58 She had low vitamin D. And that really drove me, Mark, because if I'm honest, I had a lot of guilt. I thought, "How did I not know this?" How, as a... You know, I used to do nephrology. That was what I've... You know, I-

Speaker 1:23:11 Kidney specialists

Dr. Rangan Chatterjee 1:23:11 ... that's what I was gonna do. Yeah. Uh-

Speaker 1:23:13 Where you learn all about calcium and vitamin D.

Dr. Rangan Chatterjee 1:23:15 I, I had an... I've got an immunology degree. Um, I, I'm a member of the Royal College of GPs. With all these so-called qualifications, I wasn't able to prevent my son having this preventable vitamin deficiency.

Speaker 1:23:28 Mm-hmm.

Dr. Rangan Chatterjee 1:23:28 And there's a lot of guilt there. And I thought, "Right, I'm gonna get my son back to full health as if this had never happened." That was the, the vow I made to myself.

Speaker 1:23:37 Mm.

Dr. Rangan Chatterjee 1:23:38 And that drove me. Every evening, every day, I'd spend two, three hours on the internet, in textbooks, reading, learning, researching, thinking, "Well, hold on a minute. There's a lot of science out there-"

Speaker 1:23:49 Yeah

Dr. Rangan Chatterjee 1:23:49 ... "that I've not learnt about as a doctor that I think is relevant for my son."

Speaker 1:23:54 You mean nutrition science.

Dr. Rangan Chatterjee 1:23:56 Nutrition science. You know, science on the gut microbiome, science on how our food choices impact our immune system, et cetera, et cetera.

Speaker 1:24:03 Yeah.

Dr. Rangan Chatterjee 1:24:03 That led me to come over to America to train and study at conferences. And the more I started to understand, I'd put it into practice with my son. He starts to get better. I start to apply those principles with myself, with my wife, with my family. We start to feel better. Then I start applying those same principles with my patients. They're starting to feel better.

Speaker 1:24:22 [laughs]

Dr. Rangan Chatterjee 1:24:22 And I think, "Well, hold on a minute."

Speaker 1:24:24 Everybody's feeling better. It's pretty awesome.

Dr. Rangan Chatterjee 1:24:26 Yeah. And, and I've got to say that-

Speaker 1:24:27 [laughs]

Dr. Rangan Chatterjee 1:24:28 ... yes, my son was the trigger for me. Um, but n- uh, you know, I used to be guilt... I used to feel guilty about that, Mark. For years, I think I had this guilt.

Speaker 1:24:37 Oh.

Dr. Rangan Chatterjee 1:24:37 And I'm, I'm starting to let go of that because-

Speaker 1:24:39 Yeah

Dr. Rangan Chatterjee 1:24:39 ... I don't think that helps me be the best father I can be. Um, but now I think it was a gift what happened-

Speaker 1:24:44 Yeah

Dr. Rangan Chatterjee 1:24:44 ... to my son because had he not got sick, I'm not sure I would be doing what I'm doing now.

Speaker 1:24:50 No. Yeah, you know, often many of us who are in this field has some crisis with ourselves or a family member where we wake up and we go, "Okay, wait a minute. What we learned in medical school isn't the whole story," that we missed a whole lot about how to create a healthy human. Um, none of us took a class called Creating Healthy Human 101 in medical school. [laughs] And yet that is the most essential thing that we need to figure out so we can live healthy, vibrant, long lives. And most of the diseases we see today are actually the result of our environment affecting us, whether it's our diet or stress or toxins, infections. These are things that we can actually modify.

Speaker 1:25:31 And that's why, you know, I'm so excited about your, your new book, which is The Stress Solution. Um, you know, uh, the, the truth is that s- you can't avoid stress. Stress is just a part of life. And the question is, you know, how do you define stress? How do you relate to stress? How do you interact with it in a way that doesn't control you or affect you in the way that it could? Uh, you know, I was, uh, learned that the stress is defined as the perception of a real or imagined threat to your body or your ego. So it could be a lion chasing you. That's a real threat to your body. Or it could be you think your spouse is having an affair even if they're not. Your body has the same response as if it's being chased by a tiger or a lion. [laughs] And I think we, we, we don't in our society have mechanisms or systems- ... for addressing that. And, and not only do we not have systems, but we, we are exposed to chronic unremitting stress day in, day out, minute to minute, from the minute we wake up to the minute we go to sleep, and we haven't any structures in our society for really managing that. And most cultures have had ritual, have had prayer, have had, you know, ceremony, have had meditation, have had various kinds of rituals that take a pause in life to stop and to reset and to reconnect with what matters, and we just don't do that. So what, what inspired you to, to sort of write this book and, and deal with this big un- often addressed epidemic of chronic stress?

Dr. Rangan Chatterjee 1:26:59 Yeah, Mark, I think, um, in my first book, How To Make Disease Disappear, where I spoke about what I consider to be the four sort of pillars of health, as it were, the four things that I think have the most impacts on our health, but also we've got a fair degree of control over: food, movement, which we've been talking about for years, but equally important, sleep and relaxation.

Speaker 1:27:20 Yeah.

Dr. Rangan Chatterjee 1:27:21 And what was quite clear to me is that people were feeding back to me that the pillar they were struggling with the most, or many of them were, was the whole relax pillar, this whole piece about stress.

Speaker 1:27:33 Mm-hmm.

Dr. Rangan Chatterjee 1:27:33 People were l- sort of thinking about their food and their movement, but they really struggled with stress. And I thought, "You know what? Food gets a lot of air time. Movement gets a lot of air time. I don't think stress is getting the air time that it deserves." And that's why I thought, "Well, I'm gonna write a book-

Speaker 1:27:48 [clears throat]

Dr. Rangan Chatterjee 1:27:49 ... on stress to really elevate it in, in terms of our consciousness, in terms of what we're thinking about." And you mentioned in the introduction the World Health Organization right now, if you go on their website, will say that stress is the health epidemic of the 21st century. Now, that's an alarming statement.

Speaker 1:28:06 The health epidemic. Wow.

Dr. Rangan Chatterjee 1:28:08 Yeah, I mean, that's incredible. And then-

Speaker 1:28:10 I might fight a little bit with that. I think food or food [laughs] problem is a big one, but-

Dr. Rangan Chatterjee 1:28:13 Well-

Speaker 1:28:14 Right up there. It's right up there

Dr. Rangan Chatterjee 1:28:15 ... well, what c- I think stress and food is linked actually because-

Speaker 1:28:19 Actually, our diet, you probably know this, but our diet, if it's bad, causes physiologic stress. So when you eat sugar and crap, it actually raises your cortisol and stress hormones.

Dr. Rangan Chatterjee 1:28:28 100%.

Speaker 1:28:29 Even if you're not mentally stressed, it makes you physically stressed.

Dr. Rangan Chatterjee 1:28:31 Well, a lot of these things actually, as you know, Mark, work both ways. So yeah, the poor, poor dietary choices, um, can send stress signals up to your brain. Good food choices can send calm signals up to your brain. What this is all to do with the gut-brain axis, which, you know, you've written about before, I've written about in this book. Um, but also, I would say it works both ways. So if you are chronically stressed-

Speaker 1:28:54 Yeah

Dr. Rangan Chatterjee 1:28:55 ... it's quite hard to make those good, healthy food choices.

Speaker 1:28:57 Yeah.

Dr. Rangan Chatterjee 1:28:58 And I, you know, let's take January. In, in the UK and the US, every January, people are trying to get healthy. "Well, I'm gonna reduce my sugar intake this year. I'm gonna cut out alcohol this year." But here's the problem I've seen, is that people can use willpower for a week, for two weeks, maybe three weeks, but if the sugar or the alcohol was being used to help them soothe the stresses in their life-

Speaker 1:29:23 Yeah

Dr. Rangan Chatterjee 1:29:23 ... they're never gonna maintain it long term. So I actually, I agree food is a big problem, but I found with some patients, addressing their stress levels means they feel less of a need to, you know, to, to binge on sugar because they're not feeling as stressed.

Speaker 1:29:39 If you're happy, you know, you're not gonna eat that bag of Chips Ahoy! cookies. [laughs]

Dr. Rangan Chatterjee 1:29:43 Yeah, because a lot of, a lot of our food choices are dictated by our emotions. And, you know, if we're feeling down, if we're feeling stressed, if we feel we've got too much on, actually, that sugary chocolate bar or that bag of chips actually helps us feel good in that moment. So short-term benefit, but long-term harm.

Speaker 1:30:00 Mm-hmm.

Dr. Rangan Chatterjee 1:30:01 Um, but you know, the other thing-

Speaker 1:30:02 Yeah, it was interesting. Last night I, I, um, went out. I, I recorded a, my public television show for my new book, and it was a very intense day, and I'd been really s- you know, sort of under a fair bit of pressure writing the script and getting it all done and performing it and rehearsing. And, you know, it's a big production-

Dr. Rangan Chatterjee 1:30:18 Sure

Speaker 1:30:19 ... everybody's... And like, you know, at the end of the day, we went out and had a celebration, and I had, you know, two tequilas, which is, you know, for me, a fair bit. And I noticed last night that my sleep wasn't as good, that my heart rate didn't go down en- enough, that it was really impacting me in a negative way. And today I don't feel as sharp as I normally would because I probably did something that was counterproductive to manage the, quote, "stress" of all the stuff, and I was, like, giving myself a treat, but actually it may have been counterproductive.

Dr. Rangan Chatterjee 1:30:50 Yeah. But this is a story that I think many of your listeners will be able to relate to that. Um, in fact, I tell a story in, in my book about this chap who I saw. Um, he was a, you know, busy business guy in his early 50s.

Speaker 1:31:06 Right.

Dr. Rangan Chatterjee 1:31:07 And what's really interesting about him is that we started to measure something called heart rate variability on him.

Speaker 1:31:12 Yeah.

Dr. Rangan Chatterjee 1:31:12 So heart rate variability-

Speaker 1:31:13 And what is that?

Dr. Rangan Chatterjee 1:31:14 It's, you know, basically it's a measure of how... Well, what is the beat-to-beat variation between our heartbeats? Now, people will think it should be like a metronome, you know, tick-tock, tick-tock.

Speaker 1:31:26 70, 70, 70, 70, right?

Dr. Rangan Chatterjee 1:31:27 Yeah, but that's actually incorrect. What we're looking for is a high degree of variability that-

Speaker 1:31:32 Complexity.

Dr. Rangan Chatterjee 1:31:33 Yeah, complexity, and it shows that we're constantly adapting and able to adapt to these changing environments around us. And what was interesting with him-

Speaker 1:31:40 Yeah, and the worst heart rhythm is got no variability. It's a flat line. [laughs]

Dr. Rangan Chatterjee 1:31:46 Yeah. So a low heart rate variability-

Speaker 1:31:48 Yeah

Dr. Rangan Chatterjee 1:31:48 ... is actually indicative that we've got high stress levels in our body.

Speaker 1:31:51 Yeah.

Dr. Rangan Chatterjee 1:31:52 And this chap actually on a Wednesday evening, he would find that he was drinking a lot of alcohol. He wasn't sleeping well. He was having a lot of caffeine on Thursday, more alcohol on the Thursday. He was basically... He came in, he was really, really stressed. Uh, it was impacting his relationships, impacting his sleep, et cetera, et cetera. The very common story. But as we started to look at his life and actually use HRV, heart rate variability readings, we could see that everything changed for him on a Wednesday. So what happened on a Wednesday at lunchtime, he had a team meeting Right? He found that incredibly stressful. He had to present to his team. It, you know, it was quite a high-pressure meeting, and that stress would last throughout the day. So what would happen is, on a Wednesday late afternoon when he would leave work, he had to compensate with that stress. How would he do that?

Speaker 1:32:41 Alcohol.

Dr. Rangan Chatterjee 1:32:41 Alcohol. So he'd open a bottle of wine. He'd have a glass. That glass, one glass would turn into two. Two, two would turn into three, and by the end of the evening, he'd had the whole bottle of wine. So what happens then? He doesn't sleep well on the Wednesday nights, so Thursday morning he's feeling groggy. He needs-

Speaker 1:32:57 Lots of coffee

Dr. Rangan Chatterjee 1:32:58 ... lots of coffee, lots of sugar to get him through. Coffee in the afternoon as well, which again impacts his ability to sleep on Thursday nights. He's not feeling good, and that cycle continues where he's having a bottle of wine on Thursday, two bottles of wine on the Friday, and et cetera, et cetera. But what did we do? We identified his trigger point was a Wednesday lunchtime. So I could show him that on the data. He could see it very clearly. So we, we, we discussed about certain things he might be able to do on a Wednesday evening instead of alcohol. Now, there was a yo-

Speaker 1:33:29 Get a massage. Do a yoga class.

Dr. Rangan Chatterjee 1:33:30 Well, there was a yoga class very near his office. So before he went-

Speaker 1:33:33 Yeah

Dr. Rangan Chatterjee 1:33:33 ... home, he went to the yoga class. So what happens then? He goes to that yoga class. That helps him de-stress. When he gets home, he no longer feels the need to drink a bottle of wine.

Speaker 1:33:45 Yeah.

Dr. Rangan Chatterjee 1:33:45 So he might have a glass, but it's one glass and it stops there. He sleeps well. Thursday, he feels fresh. He doesn't get as stressed at work. He doesn't have as much coffee.

Speaker 1:33:56 Yeah.

Dr. Rangan Chatterjee 1:33:56 And, and before you know it, all we had to do was give him a yoga class on a Wednesday afternoon, and suddenly that changed his whole week.

Speaker 1:34:04 Yeah.

Dr. Rangan Chatterjee 1:34:04 And, and people who are listening to this, I'd really ask them to reflect on their own life and think, "Actually, is there a trigger point in my week where things start to go downhill?"

Speaker 1:34:13 Yeah.

Dr. Rangan Chatterjee 1:34:13 'Cause if you can identify that and change your behavior, it is incredible what y- what you can achieve.

Speaker 1:34:19 It's true. I mean, most of us understand, you know, we need to eat well. Most of us understand how to exercise and what that means. But very few of us understand, how can we actually deactivate that stress response, activate what we call the relaxation response or the healing response in the body in a deliberate, methodical way, just like we exercise or eat well? And I think those are skills we never learn, that are hard for people to understand how to incorporate, and yet they're pretty easy to do, and they're actually fun, and you feel amazing after.

Dr. Rangan Chatterjee 1:34:51 Yeah. That-

Speaker 1:34:51 [clears throat]

Dr. Rangan Chatterjee 1:34:51 That's the beautiful thing about this, is that they're not as hard as we think.

Speaker 1:34:56 Mm-hmm.

Dr. Rangan Chatterjee 1:34:57 They're quite simple. Most of them, I think pretty much all of the recommendations in my book I think are free. Like, literally you don't have to buy fancy equipment or fancy apps.

Speaker 1:35:07 Right.

Dr. Rangan Chatterjee 1:35:07 Actually, a lot of this is accessible to all of us.

Speaker 1:35:10 Yeah.

Dr. Rangan Chatterjee 1:35:10 To make sure you're taking action after watching this video, I've created a free breathing guide that's gonna help you reduce stress, calm your mind, and boost your energy. In this guide, I share with you six really simple breathing practices that work immediately. Even just one minute a day will start to make a big difference. To receive your free guide, all you have to do is click on the link in the description box below. But just to put in context, uh, the scale of this problem, Mark, I mentioned what the World Health Organization say.

Speaker 1:35:43 Mm-hmm.

Dr. Rangan Chatterjee 1:35:44 But there was a paper in the Journal of the American Medical Association in 2013. It was a... I think it was an editorial piece which suggested that between 70 and 90% of what a primary care physician like me sees in any given day is in some way related to stress.

Speaker 1:36:01 Of course. Of course. Yeah.

Dr. Rangan Chatterjee 1:36:01 I mean, that's... Th- these, these are remarkable statistics.

Speaker 1:36:04 It's either, it's either caused by or made worse by stress.

Dr. Rangan Chatterjee 1:36:06 100%. And I think once people understand-

Speaker 1:36:09 I mean, if you're stressed, your blood sugar goes up. Your blood pressure goes up.

Dr. Rangan Chatterjee 1:36:13 Well-

Speaker 1:36:13 Your blood vessels get stiff and hard, right?

Dr. Rangan Chatterjee 1:36:17 Yeah. I mean, I try and explain this-

Speaker 1:36:18 You create more inflammation.

Dr. Rangan Chatterjee 1:36:20 Yeah. I, I find that when patients understand what the stress response is, I find they're really engaged in trying to change it. So I, I say to them, "Look, your stress response is ultimately trying to keep you safe. It thinks... It's when your body thinks you're in danger. It's trying to keep you safe. So let's go back 2 million years ago, and then you can understand what the stress response is, how it's evolved." So you are in your hunter-gatherer tribe, and a wild predator is a- is, is approaching, right? In an instant, your stress response gets activated and your physiology starts to change. So as you said, your blood sugar goes up, which is gonna help deliver more glucose to the brain. Your blood becomes more prone to clotting so that if you get-

Speaker 1:37:02 Bitten

Dr. Rangan Chatterjee 1:37:02 ... attacked by that lion or bitten, you're not gonna bleed to death.

Speaker 1:37:05 Yeah.

Dr. Rangan Chatterjee 1:37:05 You, you're gonna survive.

Speaker 1:37:06 Mm-hmm.

Dr. Rangan Chatterjee 1:37:07 You know, your amygdala, which is the emotional part of your brain, becomes more reactive, so you're hypervigilant to all those threats around you.

Speaker 1:37:14 Hmm.

Dr. Rangan Chatterjee 1:37:15 That is an appropriate short-term response to a threat.

Speaker 1:37:19 Yeah.

Dr. Rangan Chatterjee 1:37:19 The problem now, Mark, is that for many of us, our stress response is not being activated by wild predators. It's being activated by our daily lives.

Speaker 1:37:29 By Twitter. [laughs]

Dr. Rangan Chatterjee 1:37:31 By social media, email inboxes.

Speaker 1:37:33 By CNN, Fox News. [laughs]

Dr. Rangan Chatterjee 1:37:35 To-do lists, right? Elderly parents we're looking after. Um, you know, two parents working in a family, one's trying to rush home from work to pick up the kids, et cetera, et cetera.

Speaker 1:37:45 Yeah.

Dr. Rangan Chatterjee 1:37:45 And for many of us, those short-term, uh, responses that are so helpful become harmful. So if your stress response-

Speaker 1:37:52 The chronic stress, yeah

Dr. Rangan Chatterjee 1:37:52 ... is going up every day, right? And blood sugar going up for a short period of time is not a problem, right? But if that's happening day in, day out to your email inbox, well, that's gonna lead to fatigue, lethargy, type 2 diabetes, high blood pressure, you know, all f- from the stress response.

Speaker 1:38:08 And now we have so many more stresses than we used to, right?

Dr. Rangan Chatterjee 1:38:11 Yeah.

Speaker 1:38:11 We have the, the culture we live in, the stress. We have the toxic food system. We have the chronic amount of financial stress that most people feel. I think, you know, 40% of Americans can't withstand a $500 emergency. 100 million live in poverty or near poverty, which is hugely stressful. I mean, what... You know, one of the studies that I, I found most striking, uh, a number of years ago was that more than a q- ... poor diet, more than smoking, more than lack of exercise, that s- socioeconomic status and a lack of sense of control over your life, really stress, is the number one predictor of death and disease.

Dr. Rangan Chatterjee 1:38:48 Yeah.

Speaker 1:38:48 And I think this is something we don't really appreciate, and we don't as physicians really learn how to address it, how to measure it, and how to help treat people.

Dr. Rangan Chatterjee 1:38:56 Yeah. I, I, I totally agree. And actually, the first part of my book is actually on meaning and purpose. Um, and it, it's relevant to this because not having that control over your life, not having a sense of meaning, not having something to get up for every day, that is arguably the most stressful thing-

Speaker 1:39:13 Yeah

Dr. Rangan Chatterjee 1:39:13 ... in your life.

Speaker 1:39:14 Yeah.

Dr. Rangan Chatterjee 1:39:14 Even if you're doing everything else right-

Speaker 1:39:15 Yeah

Dr. Rangan Chatterjee 1:39:15 ... if you don't have that. And, you know, a few years ago I came across this Japanese concept of ikigai, you know, which... and I, I know you're familiar with. You know, this... I saw these four circles, and it's where these four circles intersect in the middle is your ikigai. You know, when you are doing something in your life that you're good at, something that you love, something that the world needs, and something that pays you money.

Speaker 1:39:37 Yeah.

Dr. Rangan Chatterjee 1:39:38 And I thought-

Speaker 1:39:39 Sounds like you got that nailed, Dr. Chatterjee [laughs] .

Dr. Rangan Chatterjee 1:39:41 Hey, that's... Well, look, I, I'm very lucky. I have-

Speaker 1:39:43 [laughs]

Dr. Rangan Chatterjee 1:39:43 I now have, um, in my life, my job, I, I absolutely love my job. That's, that's for sure. But what's interesting for me is I saw that and I thought, "Yeah, I want some ikigai in my life. That sounds brilliant." I started talking about this concept to my patients, and for many of them-

Speaker 1:39:58 Yeah

Dr. Rangan Chatterjee 1:39:58 ... they found it a little bit intimidating. They thought-

Speaker 1:40:00 Yeah

Dr. Rangan Chatterjee 1:40:00 ... "Well, how am I gonna find one thing in my life to tick all those four boxes?" And actually, when I was giving a talk in London recently, um, on, on stress, this Japanese student put her hand up at the end and she asked me a question. She said, "Hey, Dr. Chatterjee, you know, I've grown up with this philosophy, and I've gotta say I find it really stressful."

Speaker 1:40:19 [laughs]

Dr. Rangan Chatterjee 1:40:19 "I find it too high a bar to live to."

Speaker 1:40:21 Yeah.

Dr. Rangan Chatterjee 1:40:22 And what I did in the book is I created a new framework that I use with my patients. I call it the LIVE framework. It's a much more achievable way, I think, for a lot of people to find their meaning and purpose. Um, the L is for love, I is for intention, V is for vision, E is for engage. We probably can't go through all of that, but, you know, I, I, I sort of... I, I use it with my patients to help them start to find meaning and purpose. And the first one I think is really important, love.

Speaker 1:40:47 Yeah.

Dr. Rangan Chatterjee 1:40:47 Right? So the research on this is super clear. Regularly doing things that you love makes you more resilient to stress.

Speaker 1:40:54 Mm.

Dr. Rangan Chatterjee 1:40:55 Right. So you mentioned a lot of Americans are struggling, that they don't have control over their life. And this is the interesting thing about stress, Mark, is that sometimes we can't as physicians change the stressors in our patients' lives.

Speaker 1:41:08 Right. No, no, you can't change what's happening out there. You just change-

Dr. Rangan Chatterjee 1:41:11 But we can make them more resilient to it.

Speaker 1:41:13 Yes.

Dr. Rangan Chatterjee 1:41:13 And, uh, regularly doing things that you love makes you more resilient to stress. At the same time, being chronically stressed makes it harder-

Speaker 1:41:22 To push through

Dr. Rangan Chatterjee 1:41:22 ... for us to experience pleasure in day-to-day things. So one of my, uh, recommendations to my patients is have a daily dose of pleasure, even if it's just for five minutes.

Speaker 1:41:31 Mm.

Dr. Rangan Chatterjee 1:41:32 You know, can you each day give pleasure the same priority as you might give to the amount of vegetables you have on your plate, or whether you go to the gym? This could be going for a walk. It could be reading a book, listening to a podcast. It could even be coming home from work, putting on YouTube, watching your favorite comedian for five minutes and laughing.

Speaker 1:41:50 Yeah.

Dr. Rangan Chatterjee 1:41:51 That is very important and very valuable. And, and-

Speaker 1:41:54 It makes a huge difference. I mean, I, I, you know, I'm out in California doing my, uh, public television show and I, you know, was at the hotel and it was right on the beach, and I went out to the beach and I jumped in the water, swam a little bit, and I came back and I literally just laid there in the sand doing absolutely nothing. And I [laughs] can't tell you how pleasurable that was to just be unplugged for a minute-

Dr. Rangan Chatterjee 1:42:15 Yeah

Speaker 1:42:15 ... and stop. And most of us just keep go, go, go all day long and distract, distract, distract.

Dr. Rangan Chatterjee 1:42:20 Well, there's, there's obviously the nature piece there as well, which is very impactful for stress. But let me tell you about a patient I saw recently. I think you'll find this interesting. Um, 54-year-old chap, I think he was. Certainly mid-50s. He was a local, um... He, he was the CFO of a local plastics company. And, you know, he was in a good job, uh, earning good money, uh, married with two kids. He came in to see me and he said, "Dr. Chatterjee, look, I'm, I'm sort of, I'm struggling a bit. I find it hard to get out of bed sometimes in the morning. I'm finding it hard to concentrate at work. Um, you know, I just feel a bit indifferent to things. Is this what depression is?" Now, I started to chat to him. We did some tests. I, I was looking into all aspects of his lifestyle. Um, but ultimately one thing was quite clear to me is that he never did anything that he loved.

Speaker 1:43:10 Mm.

Dr. Rangan Chatterjee 1:43:10 So, you know, I asked him, you know, "How's your job?" He said, "Yeah, it's fine. You know, I don't really enjoy it, but it pays the mortgage, pays the bills, feeds the family." I said, "Okay, how's your relationship with your wife?" "Yeah, so-so. You know, I don't really see her much, but it's, you know, it's fine, I guess." He was very, very indifferent. Um, I said... The same about his kids. And I said, "Do you do... You know, have you got any hobbies?" He said, "Dr. Chatterjee, I don't have time. My work's busy. At the weekends I've got to do all the chores. I've got to take the kids to their classes and their sports games. I don't have any time." I said, "Did you ever have any hobbies?" And he said, "Yeah, sure. When I was a teenager, I used to love playing with train sets." I said, "Okay, fine."

Speaker 1:43:50 [laughs]

Dr. Rangan Chatterjee 1:43:51 "Do you, do you have a train set at home?" He said, "Well, yeah, I've got one in my attic, but I haven't played with it for years." And I said, "What I'd love you to do when you get home-

Speaker 1:44:00 [laughs]

Dr. Rangan Chatterjee 1:44:00 ... this evening is get, get your train set out." Now, look, Mark, I appreciate this may not be the advice-

Speaker 1:44:04 Do you write that on your prescription pad? [laughs]

Dr. Rangan Chatterjee 1:44:06 Yeah. Well, kind of. You know, I, I'm all for lifestyle prescriptions, right? And he-

Speaker 1:44:10 Play with train set three times a week for 15 minutes

Dr. Rangan Chatterjee 1:44:13 ... But I'll tell you what happened. What was fascinating is that-

Speaker 1:44:15 Refills unlimited. [laughs]

Dr. Rangan Chatterjee 1:44:16 Re- exactly. But, you know, it may not be the advice that he was expecting from his doctor-

Speaker 1:44:20 [laughs]

Dr. Rangan Chatterjee 1:44:20 ... but he said, "Yeah, okay, sure. I'll do that."

Speaker 1:44:22 Mm.

Dr. Rangan Chatterjee 1:44:23 Then this was in a conventional medical practice. These were 10-minute consultations. This is, uh, in the, in the National Health Service in the UK. I... We don't get the chance to follow up all our patients.

Speaker 1:44:33 Yeah.

Dr. Rangan Chatterjee 1:44:33 We see maybe 40 to 50 patients a day. We simply can't follow them all up. I didn't know what was going on with him. Three months later- I finished my morning surgery and I was in the car park about to go and do my home visits, and I bumped into his wife. And I said, "Hey, how's your husband getting on?" She said, "Dr. Chatterjee, I cannot believe the difference. I feel like I've got the guy I married back again. My husband comes home from work, he's pottering around on his train set. He's always on eBay looking for collector's items-

Speaker 1:45:03 [laughs]

Dr. Rangan Chatterjee 1:45:03 ... and he's now subscribed to this, you know, this magazine." I thought, "Okay, that's incredible." I still hadn't seen him. Three months after that, he comes in for a well man check to my office, and he comes in with his, with his blood tests, and I'm about to go through them with him. And I said, "Hey, how you doing?"

Speaker 1:45:21 [laughs]

Dr. Rangan Chatterjee 1:45:22 "Dr. Chatterjee, I feel incredible. I've got energy. Um, my mood is good, and I feel motivated." I said, "How's your marriage?" "Marriage is great. I'm getting on really, really well with my wife." "How is your job?" "Love it. Really, really enjoy the job." So why is that so powerful, Mark, is this: Did he have a mental health problem? Or-

Speaker 1:45:41 He had a train set deficiency [laughs] .

Dr. Rangan Chatterjee 1:45:43 Or did he have a deficiency of passion in his life?

Speaker 1:45:45 Yeah.

Dr. Rangan Chatterjee 1:45:45 And when he corrected that passion deficiency-

Speaker 1:45:48 It's true. It's true

Dr. Rangan Chatterjee 1:45:48 ... everything else starts to come back online.

Speaker 1:45:50 Yeah.

Dr. Rangan Chatterjee 1:45:51 So I want to expand the conversation about stress to go, yeah, sure, breathing, nature, meditation, exercise, these things are fantastic, and of course I talk about them and I go into the science and the practical implications for people. But what about something about passion, doing things that you love?

Speaker 1:46:06 Yeah.

Dr. Rangan Chatterjee 1:46:06 It's just as important.

Speaker 1:46:07 It's true. You know, I often talk about what are the ingredients for health, and one of them is meaning and purpose. And I was just shocked a number of months ago to see an article in the Journal of the American Medical Association that people who lacked meaning and purpose had a higher risk of death and disease.

Dr. Rangan Chatterjee 1:46:22 Yeah.

Speaker 1:46:22 I mean, it's just striking [laughs] it turns out in the research that, that it's not just smoking or bad diet or lack of exercise, but lack of meaning and purpose that increases your risk of death. I mean, that's a very striking finding.

Dr. Rangan Chatterjee 1:46:35 Yeah. It's amazing. And obviously the way we look at health, we're looking at all of these multiple inputs that play a role in someone's health. And of course, I'm just as passionate about food, physical activity, sleep, you know, all these things that are critical. But we've also got to think about those social pieces. You know, our community, the relationships we've got. Um, you know, what, why do we get up each morning? Do we feel that we've got control over our life, or do we feel... You know, do we, do we sit in traffic for two, three hours a day in a job that we can't stand for a boss who doesn't value us? The reality is, if that is the case, you know, we're gonna have to think about with our patients how we tackle that.

Speaker 1:47:14 Yeah.

Dr. Rangan Chatterjee 1:47:14 Of course, not all our patients can leave that job, right? So I'm passionate. And I u- I've used these tips that I've, you know... The, the book is full of so many tips, so people can literally choose the ones that are relevant for their life. But I have worked in deprived areas in the UK for many years, and these tips also work for people in deprived areas-

Speaker 1:47:35 Yeah

Dr. Rangan Chatterjee 1:47:35 ... on low incomes, because the common criticism of wellness is that it's just for the wealthy.

Speaker 1:47:41 For the elite. Yeah.

Dr. Rangan Chatterjee 1:47:41 It's for the middle classes.

Speaker 1:47:42 Yeah.

Dr. Rangan Chatterjee 1:47:43 And I'm passionate to say-

Speaker 1:47:44 No

Dr. Rangan Chatterjee 1:47:44 ... it, it is applicable to everyone.

Speaker 1:47:47 Oh.

Dr. Rangan Chatterjee 1:47:47 You give people these tools of nature, of passion, of, um, you know, a quick five-minute workouts. Even if you're living in a, in a lifestyle that you don't enjoy, that there are lots of stresses in your life, you can help process that stress.

Speaker 1:48:03 Yeah.

Dr. Rangan Chatterjee 1:48:03 Um, you really can, and it can make a huge difference.

Speaker 1:48:06 And one of the things that people don't realize is they think stress is objective, but it's subjective, right? It's the perception of how something impacts us. It's our beliefs about something, right? So I think if, if, if that's true, then how do we sort of create a different mindset so that when something happens, you know, it's not stressful. I was talking to my wife this morning and, you know, she's putting on a show, a comedy show called The Consciousness Show, and she had some issue with the tickets, and she was getting stressed about it 'cause she thought the one that were on the waiting list were actually given tickets, and she was kind of freaking out. [laughs] And I'm like, "That is not really a big stressor." I mean, it's your belief about it. It's not a big deal. Like, there are things to really be worried about. And I think for most of us, we get caught in this vicious cycle of stress and worry about things that are not really worth worrying about, and I think it's our beliefs about it that make it seem so. And I think there are real things to worry about. You know, if you have income issues, if you have, you know, real trauma in your family or... I mean, there are real things that are going on that are stressful. Like, my dad died last summer, and that was very stressful for me. But I think there, there are, are ways of looking at changing our mindset. So can you talk about how that, how that works?

Dr. Rangan Chatterjee 1:49:23 Yeah. Well, I think there's a couple of things to say there. I think when it comes to stresses, um, I think we need to think about what we can control and what we can't control.

Speaker 1:49:31 Yeah.

Dr. Rangan Chatterjee 1:49:32 Many of us, I have for years spent time and energy worrying about things that I have no control over, and that's something that I've changed a lot in, in my life. I've really had to work hard on that. And once you get into that mindset, it's amazing how your stress levels just come down-

Speaker 1:49:47 Yeah

Dr. Rangan Chatterjee 1:49:47 ... because so many of those things, like traffic, I can't do anything about traffic. I just don't let it worry me anymore. I'm just like-

Speaker 1:49:53 You don't get road rage, Dr. Chatterjee? [laughs]

Dr. Rangan Chatterjee 1:49:55 Hey, you know, I, I... If I'm honest, seven, eight years ago, you know, when I was a carer for my dad, when I was working a busy job, when my kids were very young, I wasn't sleeping very much, you know what? If I was driving to work and someone would come in front of me or cut me up, I'd probably get quite agitated, if I'm honest. Um, but now I just don't. I'm like, "Ah, they're probably having a bad day if they're sort of screaming at me from the window," and I'm just a lot more chilled and relaxed.

Speaker 1:50:19 And you give your power over to other people if you let them affect you that way.

Dr. Rangan Chatterjee 1:50:22 Yeah, for sure. But it's something we have to work on, and I think the reason why many of us struggle with this is because of time.

Speaker 1:50:30 Mm-hmm.

Dr. Rangan Chatterjee 1:50:30 Now, explain what I mean by that. I think one of the biggest stressors in the modern world today, in the 21st century, is our lack of downtime. So the modern world has stolen downtime from us. It's, it's gradually been eroded out of our lives. I'll give you an example. We're here in Santa Monica, right, in California. I bet 10 years ago if we were here and we went into a local cafe to buy a coffee, I bet people would be standing in line, they'd be looking around, they might bump into a friend, they might be looking at all the, all the sweet treats, and they might be thinking, "Which one am I gonna have?"

Speaker 1:51:07 I know.

Dr. Rangan Chatterjee 1:51:08 You know, they'd be daydreaming a little bit. Now, if you go to any cafe, what's everyone doing?

Speaker 1:51:11 They're either on their phone, computer. Yeah.

Dr. Rangan Chatterjee 1:51:13 Yeah. And look, to be clear, I'm not criticizing.

Speaker 1:51:15 No.

Dr. Rangan Chatterjee 1:51:15 I will do that as well a lot of the time, okay? But my point is-

Speaker 1:51:18 Just busy. Just lack of time. You know, it was fascinating. I, I just went to, uh, give a talk at the CIA, the Central Intelligence Agency.

Dr. Rangan Chatterjee 1:51:25 Wow.

Speaker 1:51:25 And it's a highly secure building in Langley, and there's no technology allowed. So you can't bring in a phone, computer, nothing. Not even a Fitbit. And what was striking to me is that everybody was present. I gave a lecture to 300 people, and nobody was on their phone. I was in a room giving a talk to 30 or 40 doctors and health professionals. Nobody was on their phone.

Dr. Rangan Chatterjee 1:51:47 Wow.

Speaker 1:51:47 And everybody was focused and paying attention. It was the most remarkable thing. It was like, it was like, uh, going back in a time machine.

Dr. Rangan Chatterjee 1:51:53 But only a time machine of 15 years.

Speaker 1:51:55 Yeah.

Dr. Rangan Chatterjee 1:51:55 That's how quickly things have-

Speaker 1:51:57 10

Dr. Rangan Chatterjee 1:51:57 ... 10 years.

Speaker 1:51:57 The iPhone was 2009.

Dr. Rangan Chatterjee 1:51:58 Yeah. That's, and I don't think we've realized how toxic that is. 'Cause you may, you may say, "Well, why does that matter? You know, what's the problem that we're using this downtime to get ahead? You know, we're, we're sending an email. We're, we're quickly updating our Instagram." Well, I'll tell you the problem with that.

Speaker 1:52:14 [laughs]

Dr. Rangan Chatterjee 1:52:14 There's many problems with that, but we used to think that our brain went to sleep when we switched off, right? When we stop focusing on a task in front of us, our brain went to sleep. Neuroscience shows us that's not the case. When we stop focusing on a task in front of us, there's a part of the brain called the default mode network, or the DMN, that goes into overdrive. Now, what does that part of the brain do? Well, there's many things, but two things I think listeners will find really interesting is that part of the brain helps us solve problems and helps us be more creative. So this is why so many of us get our best ideas when we're out for a walk, out for a run, or we're in the shower. I don't know if it's just me or you, do you get... I get my best ideas when I'm in the shower.

Speaker 1:52:57 Totally. When I go for a run or a bike ride and I can just wander around in my head.

Dr. Rangan Chatterjee 1:53:00 And this is because, Mark-

Speaker 1:53:02 Yeah

Dr. Rangan Chatterjee 1:53:02 ... our brain is trying to solve problems for us if we give it the downtime to do that.

Speaker 1:53:08 Yeah.

Dr. Rangan Chatterjee 1:53:08 And I think showers are one of the few places still where our phones haven't, you know, we don't, I don't know about you, [laughs] I certainly don't take my phone into the shower with me. I'm sure that will change very soon, but-

Speaker 1:53:19 Yeah, now the new phones, they go down to four meters underwater, so. [laughs]

Dr. Rangan Chatterjee 1:53:21 Yeah. I mean, this is why I'm actually trying out swimming actually, 'cause I think swimming is, again, one of those sports now where you can still do without technology. You know, even in the gym now, people are posting selfies of them doing their workout, updating their feed. You know, uh, and, and the DMN is a really important part of our brain, and I, I go into a lot of companies now to, uh, talk to them about employee wellbeing. And one of my top tips for them is take a tech-free lunch break.

Speaker 1:53:49 Digital detox.

Dr. Rangan Chatterjee 1:53:50 Even if it's just for 15 minutes, take a tech-free lunch break. And last year actually, I made, um, actually it was earlier this year, I made an ITV documentary on stress, and we got to take three or four people, we got to measure their stress levels minute to minute throughout the day for three days. And one chap in particular, he was a manager of his local company, um, he took his job seriously. He wanted to lead by example, but he was complaining of stress. He was thinking, he was complaining that he was drinking too much alcohol, his relationship with his wife was under strain, um, and he was always tired. Now, we measured his stress levels. It was HRV, heart rate variability, and we could see that actually on his workday, his stress levels would climb throughout the morning. At lunchtime, he would work through his lunch, and they'd keep climbing, and all afternoon as well. They, they were just constantly elevated. He would go home late. He would drink alcohol to unwind. He wouldn't be present with his wife.

Speaker 1:54:50 Mm-hmm. Yep.

Dr. Rangan Chatterjee 1:54:50 That would cause issues. He wouldn't sleep well, and the cycle would continue. All I changed with him, Mark, was I said, "Okay, look, I want you to take a 15-minute break at lunchtime. I want you to leave your phone in your drawer and go outside for a walk." He was very lucky he had a river nearby, and we can maybe touch on why nature's so important. So all he did was for 15 minutes at lunchtime, he went for a walk in nature without his phone. Now, when we remeasured his data, objectively, his stress levels were right down, but subjectively, what did he say? He said, "Dr. Chatterjee, I feel like a different person."

Speaker 1:55:25 Yeah.

Dr. Rangan Chatterjee 1:55:26 "I'm more creative in the afternoon. I enjoy my job more. I'm leaving early now rather than late. It's not just on time. I'm leaving early. I'm drinking less alcohol, and my relationship with my wife has improved."

Speaker 1:55:38 Yeah, yeah.

Dr. Rangan Chatterjee 1:55:38 So this is what I call the ripple effects, right?

Speaker 1:55:41 Yeah.

Dr. Rangan Chatterjee 1:55:41 One small thing.

Speaker 1:55:42 It's powerful.

Dr. Rangan Chatterjee 1:55:43 So when we say that wellness is for the middle classes, well, hold on a minute. Who doesn't have the ability to have a 15-minute tech-free lunch break?

Speaker 1:55:52 Yeah.

Dr. Rangan Chatterjee 1:55:52 Right? That is free.

Speaker 1:55:53 That's not, that's not asking a lot. It's true. And I-

Dr. Rangan Chatterjee 1:55:56 And I'm not trying to underplay this, but I'm very care-

Speaker 1:55:58 It's powerful. I mean, I, I think the whole digital detox movement's really growing.

Dr. Rangan Chatterjee 1:56:02 Yeah.

Speaker 1:56:03 And, you know, for my wife, um, for our anniversary, I got her a little box. And-

Dr. Rangan Chatterjee 1:56:08 [laughs]

Speaker 1:56:09 And, and I said, "Here, honey, here's your anniversary present."

Dr. Rangan Chatterjee 1:56:12 [laughs]

Speaker 1:56:12 And she's like, "Oh, this is such a nice little box." I said, "No, no. That's not the present. The present is I put my phone in the box Friday night, and I don't take it out till Sunday night." [laughs] And she's like, started crying. Like, that was the best present I could give her, to be present with her, right? The present of presence, right? And-

Dr. Rangan Chatterjee 1:56:32 Yeah

Speaker 1:56:33 ... and then I did it, and I thought, "Oh, this is for her," you know? But my experience was so transformational. I was, like, laying on the carpet, playing with the cats, listening to jazz, wa- just daydreaming, relaxing, not grabbing my phone every second. And it was the most wonderful experience for me [laughs] that I, I love it.

Dr. Rangan Chatterjee 1:56:52 Yeah.

Speaker 1:56:52 And it's like a, a regular habit now.

Dr. Rangan Chatterjee 1:56:54 It's, it's so awesome.

Speaker 1:56:55 We leave our phones at home if we go for dinner. We, we don't-

Dr. Rangan Chatterjee 1:56:58 We, we, um, and on Sunday mornings, uh, my wife and I will go out with our kids, and we'll both leave our phone at home And, you know, I'd, I'd ideally I'd do it for the whole day, but often it's like four hours, four or five hours. And what's incredible is that you come home and I feel like I've been on holiday.

Speaker 1:57:14 Yeah.

Dr. Rangan Chatterjee 1:57:15 Like, you, we don't realize how much this constantly checking our phones is draining us.

Speaker 1:57:21 Yeah.

Dr. Rangan Chatterjee 1:57:21 And I got called out by this, by my daughter.

Speaker 1:57:23 [laughs]

Dr. Rangan Chatterjee 1:57:24 This was a few years ago.

Speaker 1:57:25 Yeah, yeah. The kids.

Dr. Rangan Chatterjee 1:57:25 You know, I was playing with her in our living room, and I can't remember what was going on, but, but, you know, I kept nipping out into the kitchen to, to keep checking my phone. And she said to me, "Daddy, you're not really here, are you?" And that really, really struck me. I mean, kids really can teach us how to be present-

Speaker 1:57:43 Yeah

Dr. Rangan Chatterjee 1:57:43 ... and live in the moment. And I thought, "Wow, she's right. I'm not really here." Because, yes, I'm in the room playing with her, but my mind is actually not quite there. It's thinking about what's going on on my phone. And that really, that really changed my behavior.

Speaker 1:57:59 That'll get you. That'll get you.

Dr. Rangan Chatterjee 1:57:59 That did get you.

Speaker 1:58:00 [laughs]

Dr. Rangan Chatterjee 1:58:00 That got me big time. And-

Speaker 1:58:01 Right from the mouth of babes, right? [laughs]

Dr. Rangan Chatterjee 1:58:03 Yeah, but I, I think it's a very powerful, um, lesson for all of us. And I think people need strategies because these things are designed to be addictive. So, you know, I will not charge my phone in my bedroom anymore. If I bring that phone into my bedroom, right, I can't resist it. I simply cannot resist. It's too addictive. So I charge it in my kitchen.

Speaker 1:58:23 Yeah.

Dr. Rangan Chatterjee 1:58:23 And so I, I say to people, you need to try and create a bit of tech-free time in your day. Sure, lunch break is a great time to do it, but if you can have some time, i- ideally a golden hour in the morning and a golden hour before going to bed. If a golden hour is too much, start with five minutes in the morning.

Speaker 1:58:39 Yeah.

Dr. Rangan Chatterjee 1:58:40 Five minutes before you go to bed.

Speaker 1:58:41 Well, if you can't figure out how to do it for five minutes, there's definitely a bigger problem in your life. [laughs]

Dr. Rangan Chatterjee 1:58:46 Yeah, there is. But, you know-

Speaker 1:58:47 Yeah

Dr. Rangan Chatterjee 1:58:47 ... and, and also when people are commuting, right? That's a time when often people are on the train, on a bus. You know, what you wanna do then is instead of trying to catch up on those emails, use that as a, as a way of, of unwinding. You know, listen to some music.

Speaker 1:59:02 Mm-hmm.

Dr. Rangan Chatterjee 1:59:02 Do 10 minutes on your meditation app, like Calm or Headspace.

Speaker 1:59:06 Listen to your podcast. [laughs]

Dr. Rangan Chatterjee 1:59:07 Listen to an inspiring podcast that feels good, like my one or your one or any one that they like, right? Use that time. Really value your mental space. What information are you feeding it? If you watch the news and you're putting toxic information, right, into your brain the whole time, that is gonna impact the way you feel, your stress levels. I said take the news app off your phone. I, in fact, another tip I say to people, and this is probably one of the most-

Speaker 1:59:30 Notifications? [laughs]

Dr. Rangan Chatterjee 1:59:31 ... powerful things. Notifications, take them off your phone. And-

Speaker 1:59:36 How did I guess? [laughs]

Dr. Rangan Chatterjee 1:59:37 Hey, it's one of the most-

Speaker 1:59:38 I mean... [laughs]

Dr. Rangan Chatterjee 1:59:39 It's one of the most powerful things. But Mark, I would challenge anybody listening to this podcast-

Speaker 1:59:43 Yeah

Dr. Rangan Chatterjee 1:59:43 ... for seven days to switch off their notifications, which simply means-

Speaker 1:59:48 Ooh

Dr. Rangan Chatterjee 1:59:48 ... you know, if someone likes your Instagram post, you're not gonna get a notification. If you have a new email, you're not gonna get a notification-

Speaker 1:59:55 Right

Dr. Rangan Chatterjee 1:59:55 ... et cetera, et cetera.

Speaker 1:59:56 Right.

Dr. Rangan Chatterjee 1:59:56 Try it for seven days. If you don't feel better, fine.

Speaker 1:59:59 It's huge

Dr. Rangan Chatterjee 1:59:59 Go back to it.

Speaker 1:59:59 And then people are on their phone so much they don't realize there's a new screen app where you can look on your iPhone and see how many times you picked up-

Dr. Rangan Chatterjee 2:00:05 Yeah

Speaker 2:00:05 ... your phone. And I was sitting next to this friend of mine. We were at a lecture, and she was picking up her phone, doing Instagram, whatever, and I'm like, "Give me your phone." And I grabbed her phone and I'm like, showed her, like, she picked up her phone 1,000 times [laughs] in a day. And I'm like, "That is a lot of time picking up your phone." So let's talk about some of the strategies that you put in the book. You talk about the importance of a morning routine, 'cause, yes, we know the harm of stress, and we can go into that more, but I think people get it. What are the three M's you talk about that you can practice every morning to start your day and actually kinda get ahead of the stress?

Dr. Rangan Chatterjee 2:00:40 Yeah. So I, I call these the three M's of a morning routine. Uh, the first M is mindfulness, the second M is movement, and the third M is mindset. So I say, look, I'm a huge fan of morning routines 'cause they give you a period of calm in the morning that's just gonna make you a bit more resilient to cope with those stresses that will come up in your day. It's not if they're gonna come up, they will come up. But I think the three M's provides a very valuable structure to help you think about what are you gonna put into your morning routine. And it works. If you have an hour in the morning, it works beautifully well. If you only have five minutes, like some of my patients, it can still work really well. So the first M, mindfulness, can be, it can be meditation, it can be breathing, um, you know, it can be a practice in mindfulness. Whatever you want can go under that umbrella of mindfulness. I personally, currently I'm doing the Calm meditation app. So first thing when I get up in the morning, I'm plugging into the Calm meditation app. I put my phone on airplane mode so I can't see any of the incoming noise that might be on there, and I do 10 or 15 minutes meditation. Some days, Mark, I hit the zone and I feel really, really calm. Other days, I just go through my to-do list. But what I've learnt to do is not beat myself up about it on those days where I'm going through my to-do list. I'm accepting that, hey, you know what? My mind's a little bit busy today. That's okay. Whereas even 18 months ago, I would get slightly frustrated, oh, I can't switch my mind off. I can't clear my mind. So I think that's a great practice for people to do. Then I move on to movement. Again, movement can be anything depending on what you like. I do a lot of hip stretches, maybe some yoga moves, uh, maybe some workouts on a step, maybe some press-ups. Whatever I feel like for 5 or 10 minutes, that is all I do. And then I'll move on to mindset. So mindset can be anything to put you in a positive frame of mind. So it could be reading a book that you find very uplifting for a few minutes with a cup of tea in the morning. It could be doing affirmations. And actually, you know, like many people listening, I've got young kids, right?

Speaker 2:02:44 Mm.

Dr. Rangan Chatterjee 2:02:45 So my daughter, who's currently six, has a sixth sense when Daddy is up, right? So I try and get up before them and get my morning routine done, but she can sense when I'm downstairs doing it, and often she'll, she'll creep down in. Often it's in my second M, in my movement, which is fine because she just does the movement with me. But if she's there with me for the third M, which is mindset- I'll do affirmations with her. So we'll sit there together, I'll hold her hand, she'll hold my hand, and we will say for about two minutes, "I'm happy, I'm calm, I'm stress-free. I'm happy, I'm calm, I'm stress-free." And we'll just repeat that for two minutes. And at the end of those two minutes, she's got the most peaceful smile on her face. I feel totally relaxed and calm, and that calm continues throughout the day.

Speaker 2:03:31 Yeah.

Dr. Rangan Chatterjee 2:03:32 That's the beauty of it. It's not just in the moment. I'm more resilient to the stressors in my life. Now, for people who are thinking, "I don't have time for that," 'cause I've got a lot of patients who are single moms who might be working two jobs.

Speaker 2:03:44 Yeah.

Dr. Rangan Chatterjee 2:03:44 I manage to persuade them to give it a go even for five minutes. And one of my patients simply does this. She does her morning routine with those three M's in just five minutes. She gets up, and for one minute she will do deep breathing. She does a breath that I taught her called the 3-4-5 breath, when you breathe in for three, hold for four, and breathe out for five. Okay? She does that for one minute. Then she does two minutes of some yoga moves that she learnt on YouTube, right? So this is super accessible. She didn't have to go to a class, even though I recommend yoga classes. She learnt some moves on YouTube which she likes. And then for the final two minutes, she's got a, she's got about three or four books that make her feel good, and she literally, for two minutes, she reads three or four pages from that book. And she has reported back that actually, that has really, really helped her. In fact, she thinks it's helped her eczema get better, which is remarkable, because there are many things that can cause eczema. Eczema, we know, ultimately, is a slight dysfunction of the immune system. Stress impacts the immune system.

Speaker 2:04:42 Of course.

Dr. Rangan Chatterjee 2:04:42 So for her, doing that morning routine, she feels is helping her with her skin. For somebody else, it may not do that, right?

Speaker 2:04:51 Yeah.

Dr. Rangan Chatterjee 2:04:51 But I just wanna really get across how powerful these small, intentional moments of calm are. So again, I hope people listening think, you know, maybe I'll try that 3M morning routine for about seven days or so, and see how you feel. If you enjoyed that video, I think you are really going to enjoy this one where I outline the common things I have seen patients do in the evening, that without them realizing, is negatively impacting the quality of their sleep. When I can help them improve their sleep quality, immediately they feel a change in their energy and their vitality.