This Hidden Cause Wrecks 90% of People’s Health – Try These 5 Fixes Today

1. 0:00 – 2:15

   A terrifying infant seizure reveals a preventable vitamin D crisis

   1. RCDr. Rangan Chatterjee0:00

      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." A- 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 been bringing up all day."

   2. MHDr. Mark Hyman0:54

      Yeah.

   3. RCDr. Rangan Chatterjee0:55

      And I turn him over. I tried to clear his airway. Nothing was happening. If I'm honest, Mark, I froze.

   4. MHDr. Mark Hyman1:01

      You thought he was gonna die.

   5. RCDr. Rangan Chatterjee1:03

      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-

   6. MHDr. Mark Hyman1:17

      [laughs]

   7. RCDr. Rangan Chatterjee1:17

      ... because it had just snowed in the French Alps.

   8. MHDr. Mark Hyman1:20

      Yeah, yeah.

   9. RCDr. Rangan Chatterjee1:20

      I nearly turned the car over. And we got there, and what's really interesting is that the, the doctors and the nurses were really worried. You could tell they were worried 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-

   10. MHDr. Mark Hyman1:39

       A febrile seizure

   11. RCDr. Rangan Chatterjee1:40

       ... a febrile convulsion-

   12. MHDr. Mark Hyman1:41

       Yeah

   13. RCDr. Rangan Chatterjee1:41

       ... you know, secondary to the temperature, but his temperature was normal.

   14. MHDr. Mark Hyman1:45

       Yeah.

   15. RCDr. Rangan Chatterjee1:45

       And you could see the doctors wondering, "Well, his temperature's normal."

   16. MHDr. Mark Hyman1:48

       What's going on?

   17. RCDr. Rangan Chatterjee1:49

       "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.

   18. MHDr. Mark Hyman1:56

       Yeah.

   19. RCDr. Rangan Chatterjee1:57

       He had to be, uh, blue lighted and in an ambulance down to a bigger hospital because this was a very small regional hospital.

   20. MHDr. Mark Hyman2:02

       Yeah.

   21. RCDr. Rangan Chatterjee2:03

       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.

   22. MHDr. Mark Hyman2:08

       Oh, God. Yeah.

   23. RCDr. Rangan Chatterjee2:09

       You're like, "What is going on?" You know.

   24. MHDr. Mark Hyman2:10

       Mm-hmm.

   25. RCDr. Rangan Chatterjee2:11

       We're a pretty health conscious family. Um, you know, why is he having this convulsion?

   26. MHDr. Mark Hyman2:15

       Yeah.

2. 2:15 – 4:14

   Root cause found: severe hypocalcemia driven by vitamin D deficiency

   1. RCDr. Rangan Chatterjee2:15

      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-

   2. MHDr. Mark Hyman2:35

      Yeah. Low calcium levels is dangerous.

   3. RCDr. Rangan Chatterjee2:37

      Yeah.

   4. MHDr. Mark Hyman2:37

      Yeah.

   5. RCDr. Rangan Chatterjee2:37

      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.

   6. MHDr. Mark Hyman2:46

      Wow. That's-

   7. RCDr. Rangan Chatterjee2:46

      So not just low

   8. MHDr. Mark Hyman2:48

      And for those non-doctors in the audience, calcium is super tightly regulated in the body.

   9. RCDr. Rangan Chatterjee2:54

      Yeah.

   10. MHDr. Mark Hyman2:54

       So any slight deviation is very serious. A little high, a little low, and this is very low.

   11. RCDr. Rangan Chatterjee3:00

       Yeah. And then we're trying to figure out, well-

   12. MHDr. Mark Hyman3:02

       Mm

   13. RCDr. Rangan Chatterjee3:02

       ... okay, he's got a low calcium. They can give him intravenous calcium, but what caused the low calcium? And again-

   14. MHDr. Mark Hyman3:08

       And clearly he was getting breast milk, so he was getting a lot of calcium.

   15. RCDr. Rangan Chatterjee3:11

       Yeah, exactly.

   16. MHDr. Mark Hyman3:12

       Right?

   17. RCDr. Rangan Chatterjee3:12

       And it turned out a few hours later, after these lumbar punctures and, you know, I, 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."

   18. MHDr. Mark Hyman3:28

       Good for them for testing it.

   19. RCDr. Rangan Chatterjee3:29

       Yeah.

   20. MHDr. Mark Hyman3:30

       [clears throat]

   21. RCDr. Rangan Chatterjee3:30

       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.

   22. MHDr. Mark Hyman3:51

       Yeah.

   23. RCDr. Rangan Chatterjee3:51

       But then we were discharged, you know, five days later.

   24. MHDr. Mark Hyman3:54

       [clears throat]

   25. RCDr. Rangan Chatterjee3:54

       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?"

   26. MHDr. Mark Hyman4:09

       Hmm.

   27. RCDr. Rangan Chatterjee4:09

       "Could this be why he's got eczema?"

   28. MHDr. Mark Hyman4:11

       Yes.

   29. RCDr. Rangan Chatterjee4:11

       And nobody was giving me the answers to that. So I made a-

3. 4:14 – 6:10

   From guilt to mission: how the crisis reshaped Rangan’s medical approach

   1. MHDr. Mark Hyman4:14

      And your wife also probably had low vitamin D.

   2. RCDr. Rangan Chatterjee4:16

      She had... Yeah, she got tested.

   3. MHDr. Mark Hyman4:17

      [clears throat]

   4. RCDr. Rangan Chatterjee4:18

      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-

   5. MHDr. Mark Hyman4:31

      Kidney specialist

   6. RCDr. Rangan Chatterjee4:31

      ... that's what I was gonna do. Yeah. I, um-

   7. MHDr. Mark Hyman4:33

      Where you learn all about calcium and vitamin D. [laughs]

   8. RCDr. Rangan Chatterjee4:34

      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.

   9. MHDr. Mark Hyman4:47

      Mm-hmm.

   10. RCDr. Rangan Chatterjee4:48

       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.

   11. MHDr. Mark Hyman4:57

       Hmm.

   12. RCDr. Rangan Chatterjee4:58

       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-"

   13. MHDr. Mark Hyman5:09

       Yeah

   14. RCDr. Rangan Chatterjee5:09

       ... "that I've not learnt about as a doctor that I think is relevant for my son."

   15. MHDr. Mark Hyman5:14

       You mean nutrition science?

   16. RCDr. Rangan Chatterjee5:15

       Nutrition science. You know, science on the gut microbiome, science on how our food choices impact our immune system, et cetera, et cetera.

   17. MHDr. Mark Hyman5:23

       Yeah.

   18. RCDr. Rangan Chatterjee5:23

       That led me to come over to America to train and study at conferences. And the more I start 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.

   19. MHDr. Mark Hyman5:42

       [laughs]

   20. RCDr. Rangan Chatterjee5:42

       And I think, "Well, hold on a minute."

   21. MHDr. Mark Hyman5:44

       Everybody's feeling better. It's pretty awesome.

   22. RCDr. Rangan Chatterjee5:45

       Yeah. And I, and I've got to say that-

   23. MHDr. Mark Hyman5:47

       [laughs]

   24. RCDr. Rangan Chatterjee5:47

       ... 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.

   25. MHDr. Mark Hyman5:57

       Yeah.

   26. RCDr. Rangan Chatterjee5:57

       And I'm, I'm starting to let go of that because-

   27. MHDr. Mark Hyman5:59

       Yeah

   28. RCDr. Rangan Chatterjee5:59

       ... 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-

   29. MHDr. Mark Hyman6:04

       Yeah

   30. RCDr. Rangan Chatterjee6:04

       ... to my son. Because had he not got sick-I'm not sure I would be doing what I'm doing now

4. 6:10 – 12:25

   Why chronic stress is a modern health epidemic (and tightly linked to diet)

   1. MHDr. Mark Hyman6:10

      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, and that's why, you know, I'm so excited about your, your new book, which is The Stress Solution. Um, you know, 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, I 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?

   2. RCDr. Rangan Chatterjee8:19

      Yeah, Mark, I think, um, in my first book, How to Make Disease Disappear, I, 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.

   3. MHDr. Mark Hyman8:40

      Yeah.

   4. RCDr. Rangan Chatterjee8:41

      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.

   5. MHDr. Mark Hyman8:52

      Mm-hmm.

   6. RCDr. Rangan Chatterjee8:53

      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-

   7. MHDr. Mark Hyman9:08

      [clears throat]

   8. RCDr. Rangan Chatterjee9:09

      ... 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.

   9. MHDr. Mark Hyman9:26

      The health epidemic. Wow.

   10. RCDr. Rangan Chatterjee9:27

       Yeah, I mean, that's incredible. And then-

   11. MHDr. Mark Hyman9:29

       I might fight a little bit with that. I think food, [laughs] our food problem is a big one, but-

   12. RCDr. Rangan Chatterjee9:33

       Well, w-

   13. MHDr. Mark Hyman9:34

       Right up there. It's right up there.

   14. RCDr. Rangan Chatterjee9:35

       Well, well c- I think stress and food is linked actually because-

   15. MHDr. Mark Hyman9:38

       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.

   16. RCDr. Rangan Chatterjee9:48

       100%.

   17. MHDr. Mark Hyman9:49

       Even if you're not mentally stressed, it makes you physically stressed.

   18. RCDr. Rangan Chatterjee9:51

       Well, a lot of these things actually, a- 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-

   19. MHDr. Mark Hyman10:14

       Yeah

   20. RCDr. Rangan Chatterjee10:14

       ... it's quite hard to make those good, healthy food choices.

   21. MHDr. Mark Hyman10:17

       Yeah.

   22. RCDr. Rangan Chatterjee10:17

       And I... You know, let's take January. In, in the UK, in the US, every January people are trying to get healthy, right? "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-

   23. MHDr. Mark Hyman10:43

       Yeah

   24. RCDr. Rangan Chatterjee10:43

       ... 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.

   25. MHDr. Mark Hyman10:59

       If you're happy, you know, you're not gonna eat that bag of Chips Ahoy cookies. [laughs]

   26. RCDr. Rangan Chatterjee11:03

       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.

   27. MHDr. Mark Hyman11:20

       Mm-hmm.

   28. RCDr. Rangan Chatterjee11:20

       Um, but you know, the other thing I-

   29. MHDr. Mark Hyman11:22

       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-

   30. RCDr. Rangan Chatterjee11:33

       Mm
5. 12:25 – 17:09

   Measuring stress in real life: heart rate variability and the ‘Wednesday trigger’

   1. RCDr. Rangan Chatterjee12:25

      And what was really interesting about him is that we started to measure something called heart rate variability on him.

   2. MHDr. Mark Hyman12:31

      Yeah.

   3. RCDr. Rangan Chatterjee12:31

      So heart rate variability is-

   4. MHDr. Mark Hyman12:33

      Yeah, what is that?

   5. RCDr. Rangan Chatterjee12:34

      It's, you know, basically it's a measure of how... What, 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.

   6. MHDr. Mark Hyman12:46

      70, 70, 70, 70, right?

   7. RCDr. Rangan Chatterjee12:47

      Yeah, but that's actually incorrect. What we're looking for is a high degree of variability. That-

   8. MHDr. Mark Hyman12:51

      Complexity.

   9. RCDr. Rangan Chatterjee12:52

      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-

   10. MHDr. Mark Hyman13:00

       Yeah, I mean, the worst heart rhythm is got no variability. It's a flat line. [laughs]

   11. RCDr. Rangan Chatterjee13:06

       Yeah. So a low heart rate variability-

   12. MHDr. Mark Hyman13:08

       Yeah

   13. RCDr. Rangan Chatterjee13:08

       ... is actually indicative that we've got high stress levels in our body.

   14. MHDr. Mark Hyman13:11

       Yes.

   15. RCDr. Rangan Chatterjee13:12

       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. Uh, 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?

   16. MHDr. Mark Hyman14:00

       Alcohol.

   17. RCDr. Rangan Chatterjee14:01

       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-

   18. MHDr. Mark Hyman14:17

       Lots of coffee

   19. RCDr. Rangan Chatterjee14:18

       ... 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-

   20. MHDr. Mark Hyman14:48

       Get a massage. Do a yoga class.

   21. RCDr. Rangan Chatterjee14:50

       Well, there was a yoga class very near his office.

   22. MHDr. Mark Hyman14:52

       Yeah.

   23. RCDr. Rangan Chatterjee14:52

       So before he went 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.

   24. MHDr. Mark Hyman15:04

       Yeah.

   25. RCDr. Rangan Chatterjee15:05

       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.

   26. MHDr. Mark Hyman15:16

       Yeah.

   27. RCDr. Rangan Chatterjee15:16

       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.

   28. MHDr. Mark Hyman15:24

       Yeah.

   29. RCDr. Rangan Chatterjee15:24

       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?"

   30. MHDr. Mark Hyman15:33

       Yeah.
6. 17:09 – 19:48

   The biology of stress: helpful in bursts, harmful when constant

   1. RCDr. Rangan Chatterjee17:09

      Yeah. I mean, I try and explain this-

   2. MHDr. Mark Hyman17:11

      Create more inflammation.

   3. RCDr. Rangan Chatterjee17:12

      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 attacked-

   4. MHDr. Mark Hyman17:55

      Bitten [laughs]

   5. RCDr. Rangan Chatterjee17:55

      ... by that lion, bitten, you're not gonna bleed to death.

   6. MHDr. Mark Hyman17:57

      Yeah.

   7. RCDr. Rangan Chatterjee17:58

      You, you're gonna survive.

   8. MHDr. Mark Hyman17:59

      Mm-hmm.

   9. RCDr. Rangan Chatterjee17:59

      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.

   10. MHDr. Mark Hyman18:07

       Mm.

   11. RCDr. Rangan Chatterjee18:07

       That is an appropriate short-term response to a threat.

   12. MHDr. Mark Hyman18:11

       Yeah.

   13. RCDr. Rangan Chatterjee18:11

       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

   14. MHDr. Mark Hyman18:22

       By Twitter. [laughs]

   15. RCDr. Rangan Chatterjee18:23

       By social media, email inboxes

   16. MHDr. Mark Hyman18:26

       By CNN, Fox News. [laughs]

   17. RCDr. Rangan Chatterjee18:28

       To-do lists.

   18. MHDr. Mark Hyman18:29

       Right.

   19. RCDr. Rangan Chatterjee18:29

       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.

   20. MHDr. Mark Hyman18:37

       Yeah.

   21. RCDr. Rangan Chatterjee18:37

       And for many of us, those short-term, uh, responses that are so helpful become harmful. So if your stress response-

   22. MHDr. Mark Hyman18:44

       The chronic stress, yeah

   23. RCDr. Rangan Chatterjee18:44

       ... 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 fr- from the stress response.

   24. MHDr. Mark Hyman19:01

       And now we have so many more stresses than we used to, right?

   25. RCDr. Rangan Chatterjee19:03

       Yeah.

   26. MHDr. Mark Hyman19:03

       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 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.

   27. RCDr. Rangan Chatterjee19:41

       Yeah.

   28. MHDr. Mark Hyman19:41

       And I think it's 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.

7. 19:48 – 31:37

   Meaning, purpose, and a ‘daily dose of pleasure’ as stress resilience tools

   1. RCDr. Rangan Chatterjee19:48

      Yeah. I, I, I totally agree. And actually, the first part of my book is actually on meaning and purpose. Um, and, and 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-

   2. MHDr. Mark Hyman20:05

      Yeah

   3. RCDr. Rangan Chatterjee20:05

      ... in your life.

   4. MHDr. Mark Hyman20:06

      Yeah.

   5. RCDr. Rangan Chatterjee20:06

      Even if you're doing everything else right-

   6. MHDr. Mark Hyman20:07

      Yeah

   7. RCDr. Rangan Chatterjee20:07

      ... 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.

   8. MHDr. Mark Hyman20:30

      Yeah.

   9. RCDr. Rangan Chatterjee20:30

      And I thought-

   10. MHDr. Mark Hyman20:31

       Sounds like you got that nailed, Dr. Chatterjee. [laughs]

   11. RCDr. Rangan Chatterjee20:33

       Hey, I was about to say, well, look, I, I'm very lucky. I have, 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-

   12. MHDr. Mark Hyman20:50

       Yeah

   13. RCDr. Rangan Chatterjee20:51

       ... they found it a little bit intimidating. They thought, "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 got to say I find it really stressful."

   14. MHDr. Mark Hyman21:11

       [laughs]

   15. RCDr. Rangan Chatterjee21:11

       "I find it too high a bar to live to."

   16. MHDr. Mark Hyman21:14

       Yeah.

   17. RCDr. Rangan Chatterjee21:14

       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.

   18. MHDr. Mark Hyman21:40

       Yeah.

   19. RCDr. Rangan Chatterjee21:40

       Right? So the research on this is super clear. Regularly doing things that you love makes you more resilient to stress.

   20. MHDr. Mark Hyman21:47

       Mm.

   21. RCDr. Rangan Chatterjee21:47

       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.

   22. MHDr. Mark Hyman22:01

       Right. No, no, you can't change what's happening out there. You just change-

   23. RCDr. Rangan Chatterjee22:03

       But we can make them more resilient to it.

   24. MHDr. Mark Hyman22:05

       Yes.

   25. RCDr. Rangan Chatterjee22:05

       And, uh, regularly doing things that you love makes you more resilient to stress. At the same time, being chronically stressed makes it harder-

   26. MHDr. Mark Hyman22:14

       Much, much harder

   27. RCDr. Rangan Chatterjee22:14

       ... 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.

   28. MHDr. Mark Hyman22:24

       Mm.

   29. RCDr. Rangan Chatterjee22:24

       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.

   30. MHDr. Mark Hyman22:43

       Yeah.
8. 31:37 – 37:17

   Digital stress and the lost art of downtime: default mode network and creativity

   1. RCDr. Rangan Chatterjee31:37

      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.

   2. MHDr. Mark Hyman31:45

      Mm-hmm.

   3. RCDr. Rangan Chatterjee31:45

      Now, explain what I mean by that. I think one of the biggest stresses 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?"

   4. MHDr. Mark Hyman32:22

      I know.

   5. RCDr. Rangan Chatterjee32:22

      You know, they'd be daydreaming a little bit. Now, if you go to any cafe, what's everyone doing?

   6. MHDr. Mark Hyman32:26

      They're either on their phone, computer. Yeah.

   7. RCDr. Rangan Chatterjee32:28

      Yeah. And look, to be clear, I'm not criticizing.

   8. MHDr. Mark Hyman32:30

      Hmm.

   9. RCDr. Rangan Chatterjee32:30

      I will do that as well a lot of the time, okay? But my point is-

   10. MHDr. Mark Hyman32:34

       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.

   11. RCDr. Rangan Chatterjee32:40

       Wow.

   12. MHDr. Mark Hyman32:40

       And it's a highly secure building, 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.

   13. RCDr. Rangan Chatterjee33:02

       Wow.

   14. MHDr. Mark Hyman33:02

       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.

   15. RCDr. Rangan Chatterjee33:07

       But only a time machine of 15 years.

   16. MHDr. Mark Hyman33:10

       Yeah.

   17. RCDr. Rangan Chatterjee33:10

       That's how quickly things have-

   18. MHDr. Mark Hyman33:12

       10

   19. RCDr. Rangan Chatterjee33:12

       ... 10 years.

   20. MHDr. Mark Hyman33:12

       The iPhone was 2009.

   21. RCDr. Rangan Chatterjee33:13

       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.

   22. MHDr. Mark Hyman33:29

       [laughs]

   23. RCDr. Rangan Chatterjee33:29

       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.

   24. MHDr. Mark Hyman34:12

       Totally. When I go for a run or a bike ride and I can just wander off in my head.

   25. RCDr. Rangan Chatterjee34:15

       And this is because-

   26. MHDr. Mark Hyman34:16

       Yeah

   27. RCDr. Rangan Chatterjee34:16

       ... Mark, our brain is trying to solve problems for us if we give it the downtime to do that.

   28. MHDr. Mark Hyman34:22

       Yeah.

   29. RCDr. Rangan Chatterjee34:23

       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, I certainly don't take my phone into the shower with me. I'm sure that will change very soon.

   30. MHDr. Mark Hyman34:34

       Yeah, now the new phones, they go down to four meters underwater, so [laughs]
9. 37:17 – 40:43

   Practical digital detox habits: golden hours, phone-free rooms, and presence

   1. MHDr. Mark Hyman37:17

      And, you know, for my wife, um, for our anniversary, I got her a little box. And, and, and I said, "Here, honey, here's your anniversary present."

   2. RCDr. Rangan Chatterjee37:27

      [laughs]

   3. MHDr. Mark Hyman37:27

      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-

   4. RCDr. Rangan Chatterjee37:47

      Yeah

   5. MHDr. Mark Hyman37:48

      ... 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.

   6. RCDr. Rangan Chatterjee38:07

      Yeah.

   7. MHDr. Mark Hyman38:07

      And it's like a, a regular habit now.

   8. RCDr. Rangan Chatterjee38:09

      It's, it's so awesome.

   9. MHDr. Mark Hyman38:10

      We leave our phones at home if we go for dinner. We, we don't-

   10. RCDr. Rangan Chatterjee38:12

       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, 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.

   11. MHDr. Mark Hyman38:29

       Yeah.

   12. RCDr. Rangan Chatterjee38:30

       Like, you, we don't realize how much this constantly checking our phones is draining us.

   13. MHDr. Mark Hyman38:36

       Yeah.

   14. RCDr. Rangan Chatterjee38:36

       And I got called out by this by my daughter.

   15. MHDr. Mark Hyman38:38

       [laughs]

   16. RCDr. Rangan Chatterjee38:38

       This was a few years ago.

   17. MHDr. Mark Hyman38:39

       Yeah, yeah, the kids.

   18. RCDr. Rangan Chatterjee38:40

       You know, I was playing with her in our living room, and I can't remember what was going on, but, you know, I kept nipping out into the kitchen 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-

   19. MHDr. Mark Hyman38:58

       Yeah

   20. RCDr. Rangan Chatterjee38:58

       ... 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.

   21. MHDr. Mark Hyman39:13

       That'll get you. That'll get you.

   22. RCDr. Rangan Chatterjee39:14

       That did get you.

   23. MHDr. Mark Hyman39:15

       [laughs]

   24. RCDr. Rangan Chatterjee39:15

       That got me big time. Um-

   25. MHDr. Mark Hyman39:16

       Right from the mouth of babes, right? [laughs]

   26. RCDr. Rangan Chatterjee39:18

       Yeah, but 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.

   27. MHDr. Mark Hyman39:37

       Yeah.

   28. RCDr. Rangan Chatterjee39:38

       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.

   29. MHDr. Mark Hyman39:54

       Yeah.

   30. RCDr. Rangan Chatterjee39:55

       Five minutes before you go to bed.
10. 40:43 – 42:57

    Diet and mental health: why ‘healthy eating’ isn’t just adding broccoli

    1. SPSpeaker40:43

       What I think is fascinating is that healthy dietary patterns and unhealthy dietary patterns are not related to each other. They're not just the opposite of each other. There'll be lots of people who have really, particularly like kids, have lots of healthy food at home, but then they have lots of junk and processed foods when they're out and about. That is still problematic for mental health. There's other, other groups-

    2. RCDr. Rangan Chatterjee41:03

       Yeah. That is so key.

    3. SPSpeaker41:04

       Mm.

    4. RCDr. Rangan Chatterjee41:04

       Say that again. That is really, really key, because I think people think, "I can eat what I want, but if I have a bit of broccoli now and again, I'm being healthy."

    5. SPSpeaker41:12

       That's right, and, and the evidence does not support that. In all of the incredibly extensive studies that we've done now, we see that healthy diet and unhealthy diet, wherever you sit on that scale, they're both independently related to mental health outcomes. So if you are having lots of healthy food but also having lots of junk and processed foods, it's still gonna be a problem. Similarly, lots of older people will h- not be going out and having Maccas and, you know, lots of junk and processed foods, but they'll be having a very limited, kind of a white diet, whether at home or in a nursing home or what have you, and that's also problematic. So they're not just the opposite of each other, and we have to tackle both.

    6. RCDr. Rangan Chatterjee41:49

       Yeah, key, key points. In terms of the diet that your participants in the SMILES trial went on, you mentioned what those foods are, and you've also mentioned that we don't know what it was about it.

    7. SPSpeaker42:02

       No.

    8. RCDr. Rangan Chatterjee42:02

       In my last book, The Stress Solution, there's a chapter on fiber and how that can help, you know, with the gut microbiome and therefore stress levels. I quote some of your research. I quote some of John Cryan's research in there. What's really interesting for me, if we think about that diet, and, and I, the, I, I sort of, I think I wrote a paragraph on this. I said, for me, whilst we're waiting for more research, there are a couple of things there which really spring out to me as that could be making a difference. You, you had fatty fish in there. I, I believe there's fatty fish in the diet, was there, sort of?

    9. SPSpeaker42:29

       Yeah, fatty fish and lots and lots of olive oil as well.

    10. RCDr. Rangan Chatterjee42:32

        Yeah, so there was some omega-3s from the fatty fish.

    11. SPSpeaker42:34

        Mm-hmm.

    12. RCDr. Rangan Chatterjee42:34

        You've obviously got all the benefits of olive oil.

    13. SPSpeaker42:36

        Mm.

    14. RCDr. Rangan Chatterjee42:36

        So either of those independently, you could, you could make a case for thinking-

    15. SPSpeaker42:40

        Yeah

    16. RCDr. Rangan Chatterjee42:41

        ... was it that that did it?

    17. SPSpeaker42:42

        Yeah.

    18. RCDr. Rangan Chatterjee42:42

        But then the big one for me as well as that was-This whole point that you were encouraging a very diverse-

    19. SPSpeaker42:48

        Mm

    20. RCDr. Rangan Chatterjee42:48

        ... range of foods.

    21. SPSpeaker42:50

        Mm.

    22. RCDr. Rangan Chatterjee42:50

        And so let's talk a little bit about diversity of foods-

    23. SPSpeaker42:53

        Mm

    24. RCDr. Rangan Chatterjee42:53

        ... and let's talk a little bit about the gut microbiome and why that is so important.

11. 42:57 – 45:44

    Gut microbiome fundamentals: fiber fermentation, metabolites, and rapid change

    1. SPSpeaker42:57

       It, it's so critically important, and it's so interesting. You know, we can see that medical science is being transformed a little bit in like what, how physics was transformed when they discovered the ultra-small particles. This knowledge that these bacteria that have co-evolved with us have such an important role in our health is really giving us some new insights that we can act on to, I think, improve a lot of health outcomes. The bacteria in your gut in particular, uh, very, very simply speaking, they break down the fibrous foods that our human enzymes can't break down. So fiber is found in plant foods, things such as vegetables, fruits, whole grain cereals, legumes, your nuts, uh, your beans and lentils, et cetera. So m- all sorts of different types of plant foods have dietary fiber. The gut microbes break that down by a, a process of fermentation, and in that process of fermentation, they produce many, many, many metabolites, and it's the production of these metabolites that seems to be so important. And we know that they, for example, interact with every cell in the body through these particular receptors. They influence gene activity. I mean, really importantly, most of what we know so far comes from animal studies, so we always have to be a little bit cautious. But there are more and more human studies, and we're doing many studies in our center that is, you know, looking at this.

    2. RCDr. Rangan Chatterjee44:18

       That's the, the Food and Mood Center.

    3. SPSpeaker44:19

       The Food and Mood Center.

    4. RCDr. Rangan Chatterjee44:20

       Love that name.

    5. SPSpeaker44:20

       That's right. Yeah. [laughs]

    6. RCDr. Rangan Chatterjee44:21

       Absolutely love that name. Who came up with that?

    7. SPSpeaker44:23

       Oh, well, it was-

    8. RCDr. Rangan Chatterjee44:24

       [laughs]

    9. SPSpeaker44:25

       ... a joint effort between myself and the, the, the comms department at Deakin. [laughs]

    10. RCDr. Rangan Chatterjee44:29

        But I just, I think-

    11. SPSpeaker44:30

        Yeah

    12. RCDr. Rangan Chatterjee44:30

        ... that's progress in itself, and in the 21st century we actually have an institution called the Food and Mood Center.

    13. SPSpeaker44:35

        Yeah.

    14. RCDr. Rangan Chatterjee44:35

        I think that, that's progress.

    15. SPSpeaker44:36

        Well, it, it's unique in the world in its focus on nutritional psychiatry research, and we've got more than 20 different projects underway at the moment, many more in the planning stages. Trying to get funding for research, of course, is incredibly difficult, but we've had some traction with philanthropic funding, which has been great. But most of the studies that we're doing are looking at this diet, gut microbiome, mental health, um, triangle, because we know that the gut microbiome is so important for our immune system, for our metabolism and body weight, for our, our, the, our brain health, and right across the board, and we know this from a number of different, uh, sources of information. And there's huge amount of research that's being done a- across the world now in this field, which is wonderful 'cause it means that we're getting advances in our knowledge very quickly. But at this point, what we know is that diet is the most important thing that affects the gut microbiota, and that you can change your gut microbiota and the, your gut health within a very short space of time, like even within days-

    16. RCDr. Rangan Chatterjee45:34

        Within days

    17. SPSpeaker45:34

        ... by changing your diet, and that's such a powerful n- um, you know, thing to understand.

    18. RCDr. Rangan Chatterjee45:39

        So, so do you have a certain recommendation you make for people in terms of diversity?

12. 45:44 – 48:41

    What to eat (and avoid) for microbial diversity: fiber, polyphenols, fats, and fewer additives

    1. SPSpeaker45:44

       Yeah, so what we know so far, and again, we need more studies in humans, but on the basis of some pretty good evidence in humans as well as many, many studies in animals, we know that obviously we need dietary fiber because the bugs can't do what they're supposed to do without the dietary fiber. And you know, none of us are getting enough dietary fiber.

    2. RCDr. Rangan Chatterjee46:02

       Yeah.

    3. SPSpeaker46:02

       Not even close. Uh, in Australia, less than half a percent of children and adolescents get their recommended intake of vegetables and legumes. That's less than half a percent. So this is-

    4. RCDr. Rangan Chatterjee46:11

       Less than half a percent?

    5. SPSpeaker46:12

       Yes.

    6. RCDr. Rangan Chatterjee46:13

       Wow.

    7. SPSpeaker46:13

       This is not just an issue for those of, um, lower education or income. This is something across the board, less than 5% of adults in Australia. So we're not getting enough dietary fiber, so the bugs can't do what they're supposed to do. But polyphenols seem to be really important. These are the things that are in colorful fruits and vegetables and green tea and, and dark chocolate and things like that.

    8. RCDr. Rangan Chatterjee46:35

       And coffee for lo- those coffee lovers out there-

    9. SPSpeaker46:37

       Yeah

    10. RCDr. Rangan Chatterjee46:37

        ... they contain polyphenols.

    11. SPSpeaker46:38

        That's right. Yeah, yeah. And, uh, really fascinating work, again, in animals, but showing that if you, if you put one bunch of, of rodents on a normal diet, they don't necessarily gain weight, but if you put another group on a high-fat diet, of course, they, they gain a lot of weight. But if you put a third group on a high-fat diet and then supplement it with polyphenols, they only put on about half as much weight.

    12. RCDr. Rangan Chatterjee46:59

        Yeah, you mitigate it.

    13. SPSpeaker47:01

        Yeah, so incredibly interesting research. But then your healthy fats, your mono and your polyunsaturated fats, uh, and your quality proteins. But it might also be what you're not eating that's really important in your gut health.

    14. RCDr. Rangan Chatterjee47:12

        Yeah.

    15. SPSpeaker47:12

        Again, from animal studies, we see that, uh, emulsifiers, which are ubiquitous in processed food, seem to strip the gut lining. We see that artificial sugars seem to have a negative impact on, on the gut. It's very complex. We're really only just scratching the surface. But I think the key understanding is we already know what sort of diet is consistently linked to longevity, and that's a diet that is high in plant foods and high in a diversity of plant foods, because the more diverse your diet, the more diverse your gut microbiome, and that seems to be a marker of gut health.

    16. RCDr. Rangan Chatterjee47:46

        Yeah. It's incredible. The, the, the Hadza tribe, this hunter-gatherer tribe in Tanzania whose, whose lives are relatively untouched by modernity, I read that they're exposed to 2,000 different plant foods in their lifetime. I think they eat about 800 of them.

    17. SPSpeaker48:00

        Mm.

    18. RCDr. Rangan Chatterjee48:00

        Um, and, and you compare that, so I think about 60% of the world's food intake comes from three plants, which is, it's just remarkable to see.

    19. SPSpeaker48:06

        Yeah.

    20. RCDr. Rangan Chatterjee48:06

        And I, and I believe that they have between 100 and 150 grams of fiber per day.

    21. SPSpeaker48:11

        Yeah.

    22. RCDr. Rangan Chatterjee48:11

        Per day. And-

    23. SPSpeaker48:12

        And we're lucky to get 20 in the West.

    24. RCDr. Rangan Chatterjee48:14

        Yeah. We're, we're lucky to get 20.

    25. SPSpeaker48:15

        And then your microbiome, y- you know, it sort of goes down the toilet, so to speak-

    26. RCDr. Rangan Chatterjee48:20

        [laughs]

    27. SPSpeaker48:20

        ... because it can't do what it's supposed to do, and then you're losing microbial diversity. And we also see that the, the large scale industrial food system and the changes to our global diets, not only is that, uh, of course, driving this massive increase in chronic disease, but also we're seeing a lot of autoimmune conditions and allergic, you know-

    28. RCDr. Rangan Chatterjee48:41

        Yeah

13. 48:41 – 1:00:25

    Early-life nutrition: pregnancy diet, infant microbiome, and compassion over blame

    1. SPSpeaker48:41

       ... illnesses. In Australia, where I am, in Melbourne, it is the food allergy capital of the world, and it's certainly one of the asthma cap- uh, capitals as well. No one really understands why, but we think it's linked to the early life gut microbiome because based on what we know so far, the early life gut microbiota plays a really key role in the development of our immune system.And also our brain development. Now we've just finished a really important study in pregnant women at the Royal Children's Hospital, looking at whether if you help women to change their diet during pregnancy, does it affect the infant microbiome? Because we, we need to make sure that the infant microbiome is optimized, we think, to ensure that that child has a strong immune system and, um, optimal brain development.

    2. RCDr. Rangan Chatterjee49:31

       Yeah, I mean, the implications of this are huge really because-

    3. SPSpeaker49:35

       Yeah

    4. RCDr. Rangan Chatterjee49:35

       ... you know, we, we started sort of talking about the SMILES trial, so somebody who has got depression may start to get some benefit from changing their diet. That's incredible in itself, but, but taking that research on and talking about, and, and thinking about what you just said, if early life is so important, and if the, the diet of a pregnant lady is so important, you know, if we're trying to get to the root of the root of the root of a problem, yes, it's great to be able to treat people who've got a problem, but wouldn't it be great if the research builds up where we know actually, you know what, when you're pregnant or, or, or maybe when y- even pre-conceiving-

    5. SPSpeaker50:13

       Mm

    6. RCDr. Rangan Chatterjee50:13

       ... it's important then to focus on your health and your microbiome health. The, the implications in terms of the downstream effects-

    7. SPSpeaker50:20

       Yeah

    8. RCDr. Rangan Chatterjee50:20

       ... could be profound.

    9. SPSpeaker50:21

       That's right, and I talk about that a lot in the book.

    10. RCDr. Rangan Chatterjee50:23

        You do.

    11. SPSpeaker50:23

        That-

    12. RCDr. Rangan Chatterjee50:23

        It's a really nice bit

    13. SPSpeaker50:24

        ... you know, the, the, the metabolic state, so whether parents to be are overweight or obese, whether they've got high blood glucose, all of those things seem to be very clearly linked to, um, both cognition and other developmental outcomes in children. We led the first study looking at the role, the potential role of, um, mothers' diets during pregnancy on children's emotional health. There's been many, many s- more studies since then showing that what mothers eat during pregnancy is linked to their children's emotional health, even when you take into account all sorts of other really important factors. And certainly if you look at the animal studies, you see that if you feed pregnant rats or mice or other non-human primates, those sorts of, uh, animals, a, a junk food, Western-type diet during their pregnancy, you see all sorts of impacts on the offspring that are relevant to mental health in humans.

    14. RCDr. Rangan Chatterjee51:16

        Y- you see it in, you know, we talk about diet. Um, I, I wrote a chapter on touch in, in, when I was writing about stress, and I was looking at this research that shows that, um, pups who lick their offspring a lot when they're young, you modify their response to stress-

    15. SPSpeaker51:35

        Mm

    16. RCDr. Rangan Chatterjee51:36

        ... for the rest of their life.

    17. SPSpeaker51:36

        That's right.

    18. RCDr. Rangan Chatterjee51:36

        Because that, that sort of close contact with your parents at a young age almost in many ways sets your stress responsiveness for the rest of your life. It-

    19. SPSpeaker51:44

        Mm

    20. RCDr. Rangan Chatterjee51:44

        ... it's really quite incredible. But one thing, uh, Felice, I think you do beautifully well in the book is you write with real compassion, and when you talk about diet for pregnant women, you also talk about, wait a second, let's not feel bad about this. Let's not put blame on people, and I think it's really important when we're talking about what a pregnant mother is eating-

    21. SPSpeaker52:02

        Mm

    22. RCDr. Rangan Chatterjee52:03

        ... because a lot of people will hear that and go, "Oh, no, you know, when, when I conceived, um, I was having McDonald's every day, and what impact has that had?" And, and I think there's a... Well, I, I'd love to explore what you think about that. It's not about putting, making people feel bad about their choices, is it?

    23. SPSpeaker52:18

        No, that's right, and, um, my, my jumping off point is always around public health and the fact that we need to make our environment supportive of healthful food choices. So in the West now, even if you go and fill up your car with petrol or anywhere you go, you are bombarded with opportunities and marketing to prompt you to consume these ultra-processed food products. Now, in the US, nearly 60% of energy intake is coming from ultra-processed food products. 60% of children alive today in the US will be obese, not just overweight, obese by the time they're 35, which is their prime child-rearing years. It's not quite as bad in the U- UK and Australia, but we're certainly getting there, and that's because the food environment supports really poor choices. We have, uh, very few limits on marketing, so big food can market, you know, um, really, uh, with impunity. These foods are very, very cheap. They're very easy to produce. They've got a very long shelf life. They're highly palatable. I mean, we are designed to want those sorts of high-fat, high-sugar foods. And they're ubiquitous. They're just everywhere. We can't escape them, so the food environment makes it very difficult to make healthful food choices, and I talk about this a lot in the book, is that it's not about individuals.

    24. RCDr. Rangan Chatterjee53:34

        Yeah.

    25. SPSpeaker53:34

        It... You know, yes, we want to empower people to make healthful choices in their life, but it shouldn't be that hard because the environment needs to support those healthful choices.

    26. RCDr. Rangan Chatterjee53:43

        Yeah, I think you start off in the book talking about the Victorian times, don't you?

    27. SPSpeaker53:47

        Yeah, yeah.

    28. RCDr. Rangan Chatterjee53:47

        And that, that's a nice example of this.

    29. SPSpeaker53:49

        Well, it was such an interesting st- uh, it was an interesting paper

    30. RCDr. Rangan Chatterjee53:51

        I never, I never heard of this before.
14. 1:00:25 – 1:11:04

    Whole grains, FODMAPs, and the ‘short-term relief vs long-term optimum’ question

    1. SPSpeaker1:00:25

       It's, it's long term. So what we, what we see from all of the evidence is that long-term diets that are higher in complex carbohydrates and lower in animal protein and fat are linked to longevity. But in the short term, diets that are lower in carbohydrates and higher in animal protein and fat are linked to leaner body weight and more reproductive success.

    2. RCDr. Rangan Chatterjee1:00:47

       I, I do wanna touch on whole grains because whole grains have become quite a controversial area in, in the diet wars, and I think that's because often what we consider to be whole grains are not whole grains.

    3. SPSpeaker1:00:59

       Mm.

    4. RCDr. Rangan Chatterjee1:01:00

       Um, so I think it's quite clear that there's pretty good research suggesting that real whole grains can have beneficial impacts on your gut microbiome and consequently on your overall health, including your moods.

    5. SPSpeaker1:01:12

       Mm-hmm.

    6. RCDr. Rangan Chatterjee1:01:12

       Um, what do you see the problem with whole grains? Is, is it that interpretation? Is it that we're, the food industry are marketing-... refined grains as whole grains

    7. SPSpeaker1:01:21

       Yes. Basically, yes. And I think, you know, people in, in the US where their food system is just so broken and has been-

    8. RCDr. Rangan Chatterjee1:01:28

       It is

    9. SPSpeaker1:01:28

       ... for decades to the point where nobody alive today in the US remembers what normal food looks like. I mean, it really is, it's a, it's a rarity. And for them, whole grain might be a brown bread that's still highly refined and full of all sorts of things. But if you look at certainly the epidemiological data, whole grain intake is at, out of all of the food groups, the most strongly associated with improved health outcomes. If you look at the gut and what we know so far, whole grains, and here we're talking about things like oats and barley and freekeh and spelt and, and buckwheat and brown rice, so things that are true whole grains, are just a really valuable source of fiber for that fermentation process of, of the gut, but they're also anti-inflammatory.

    10. RCDr. Rangan Chatterjee1:02:14

        Yeah

    11. SPSpeaker1:02:14

        Um, and, you know, they also help with satiety. They help you to feel full. Now, in Korea, they have these multi-stage meals, you know, and you start off with... and you have about 10 dishes or, you know, however many depending on the meal, but you start off with salads, and then you move on to seafood, and there may be a little bit of meat. And then right at the end you'll have a small pot of, um, mixed rice that, you know, wild rice and black rice and that sort of thing, right at the end just to aid with satiety. And that's probably how we should be eating, with small amounts but lots of diversity of grains. And for me, what, what I would just say is that people, half of their plate should be vegetables and salads. Uh, a quarter should be a form of a whole grain. A, a quarter should be a form of good quality protein, and then topped off with some healthy oil in the form of olive oil. So it can be really simple like that.

    12. RCDr. Rangan Chatterjee1:03:06

        Yeah. It's re- that's really good, simple advice. I mean, one thing I've seen clinically, and you, you see a lot of these case reports online, but I have seen it, people who've read them and have cut out all grains, and they actually do feel better in the short term sometimes, and I often wonder why that is. Is it... Because then I also look at the data showing that whole grains are, are really great for longevity and the health of the gut microbiome.

    13. SPSpeaker1:03:26

        Mm-hmm.

    14. RCDr. Rangan Chatterjee1:03:26

        And sort of my hypothesis at the moment is that many of us have got disrupted gut microbiomes, you know, because of the way we're living our lives-

    15. SPSpeaker1:03:33

        Mm-hmm

    16. RCDr. Rangan Chatterjee1:03:34

        ... because of our diets, because of our stress levels, the fact that we're sleep deprived, all these things that in- influence the gut microbiome.

    17. SPSpeaker1:03:39

        Mm-hmm.

    18. RCDr. Rangan Chatterjee1:03:39

        And I think many of the patients who come to see me with, who are not feeling well have already got a disrupted gut microbiome. So sometimes when they eliminate certain foods in the short term, actually, because you could eliminate grains and eliminate a lot of the processed stuff as well, and then, then, then-

    19. SPSpeaker1:03:54

        That's right

    20. RCDr. Rangan Chatterjee1:03:54

        ... so you start to feel great.

    21. SPSpeaker1:03:56

        Mm-hmm.

    22. RCDr. Rangan Chatterjee1:03:56

        And it doesn't necessarily mean that that needs to be the long-term approach. And, and I, I think this is a key thing that I'm gonna explore more in the future, is the difference between a short-term approach versus what is an optimal long-term approach. And-

    23. SPSpeaker1:04:08

        Yeah

    24. RCDr. Rangan Chatterjee1:04:08

        ... I guess FODMAPs might play part of the s-

    25. SPSpeaker1:04:10

        Mm

    26. RCDr. Rangan Chatterjee1:04:10

        ... you know, might be part of the story there. Um-

    27. SPSpeaker1:04:12

        That's right. One of my postdocs is one of the world experts on FODMAP, um, uh, FODMAPs and FODMAP, low FODMAP diets and the impact on the microbiome. And what we know about FODMAPs is that they are a primary source of fermentation for the gut microbiota. Like, in other words, they're probably the best gut food, gut bug food that you can feed it. But as you say, if you've got a gut that is not a healthy gut because of a long-term Western diet and stress and all of those other things, then you're gonna have problems digesting those sorts of foods because your gut bugs aren't optimized to actually deal with them. And then a short-term solution, uh, is the low FODMAP diet, but it's never intended to be a long-term thing. It should only ever be a short term, and then people can gradually reintroduce the FODMAP foods, but preferably do it, I would say, with fermented foods and maybe some probiotics. I know that there's a lot of work going into looking at whether supplementing with probiotics and/or fermented foods on reintroduction helps the bacteria to adapt so that people can tolerate those foods more. But I do agree that a lot of people in the West, because our diets are so low in fiber and so low in diversity, they react poorly to, to whole grains, often to legumes and f- the foods that provide the substrate for the gut bacteria because their guts are just not able to deal with them.

    28. RCDr. Rangan Chatterjee1:05:36

        Yeah, absolutely, and I think it goes back to this whole lack of training in healthcare professionals on nutrition means that a lot of people go to their doctors, they feel very frustrated that they're not being offered decent solutions that make sense to them, so they're reading things online. They're trying them, feeling good in the short term, but then continuing that long term without any support on it.

    29. SPSpeaker1:05:56

        Yes.

    30. RCDr. Rangan Chatterjee1:05:56

        And again, I'm not criticizing. I totally get it. That's one of the reasons why I like to do these podcasts every week, is to talk to world-leading experts like yourself and really just tease out, you know, practical experience, research evidence, where we're at, just so people can start thinking. 'Cause I, I think the more we can empower people, you know, I think the better able they are to make healthy choices.
15. 1:11:04 – 1:20:31

    Artificial sweeteners and sweetness conditioning: why ‘diet’ drinks may not help

    1. RCDr. Rangan Chatterjee1:11:04

       Sorry to interrupt. If you're enjoying this conversation, there's loads more like it on my channel. Please do press Subscribe and hit that bell. Now, back to the conversation. So what is your current view on artificial sweeteners?

    2. SPSpeaker1:11:20

       All the data suggests that when you do a clinical trial and you give kids or, uh, overweight adults, um, uh, either two cans of, of fizzy drinks with sugar or two cans of the diet equivalent, uh, and you do that for six months or, or so, you do not see any difference in weight or, uh, diabetes risk or any other metabolic parameters. So there's no clear benefit from swapping from someone from a sugar drink to, uh, a, a diet drink, except, uh, maybe for, if, if your dentist, okay? So, uh, the dentists like it because definitely it, it, it's, uh, good for your teeth. Um, and so that, just that fact alone, think about it. W- in each, you know, the average can will have maybe 150 calories, so people have two a day at least. That's 300 calories less. Why are these, why are these kids and these adults not losing some weight? Now, it wouldn't be massive but, you know, we're told that that would be about 15% of our, um, intakes, right?

    3. RCDr. Rangan Chatterjee1:12:30

       Yeah.

    4. SPSpeaker1:12:30

       So if you believe the calories in, calories out, actually they should lose weight. They don't. So clearly, in my view, something else is happening, uh, metabolically to the, to these individuals. Either their brain is being reset by the sweetness chemicals, so it's at a neural level, or, uh, something is happening metabolically and you are getting some change in insulin in ways we still don't understand, and I've put myself with monitors and given myself sucralose and I can see, uh, I, I do get a sugar peak, uh, and my insulin peaks strangely-

    5. RCDr. Rangan Chatterjee1:13:07

       Wow

    6. SPSpeaker1:13:07

       ... with the sweetness, which I can't explain. Or more likely, it's affecting our gut microbes, and so-They don't know how to deal with these chemicals, which are all derived from things like petrol and, um, uh, paraffin, uh, very ultra c- things that we're never supposed to eat. And so they, they produce weird chemicals in response, and those chemicals then have a reaction on our body, which, um, interferes with the metabolism, and in a way, either makes us put on some weight or, or predisposes to diabetes in the same way as the sugar. So, uh, we don't know the mechanisms yet. There may be differences between them. They definitely work in different ways, and some people might be okay with some and not with others, because, you know, I admit everyone is, is unique. But I think the whole idea of, uh, reducing sugar by just adding, uh, unlimited amounts of these chemicals, which is, you know, one side effect of the, the sugar levy-

    7. RCDr. Rangan Chatterjee1:14:07

       Yeah

    8. SPSpeaker1:14:07

       ... um, has to be thought through, and we should be weaning people off ultra-sweetened products, which make them more likely, particularly kids, to, to seek sugar and avoid sour things, which may be good for them. Uh, and that's my major worry. So, um, you know, I'm looking forward to seeing whether stevia, for example, which would appear to be the more natural of these ones, does have any particular benefits. But I suspect that this whole sweetness thing, by artificially creating these, these sort of flavors that people crave, um, is gonna have some other knock-on effects down the line that we don't know. So we should be treat, teaching kids and, you know, a- adults how to go back to enjoying things that, uh, like water or like teas and, um, uh-

    9. RCDr. Rangan Chatterjee1:14:57

       Yeah

    10. SPSpeaker1:14:57

        ... herbal teas and things that have a bit of interest in it, rather than this, this blunderbuss massive amounts of sugar-

    11. RCDr. Rangan Chatterjee1:15:04

        Yeah

    12. SPSpeaker1:15:05

        ... uh, whether it's fake or real.

    13. RCDr. Rangan Chatterjee1:15:06

        It's amazing, you know, my kids are sort of 10 and 7 at the moment, and it's amazing how many of their friends don't drink water.

    14. SPSpeaker1:15:16

        They're allergic. [laughs]

    15. RCDr. Rangan Chatterjee1:15:18

        No, you know what? It's kind of, it, it's, it's, it's really sad actually on a-

    16. SPSpeaker1:15:25

        Mm

    17. RCDr. Rangan Chatterjee1:15:25

        ... on a, on a deep level because think of, if you think about it in, in terms of our evolutionary heritage, we could never have survived if we didn't drink water, right? You know, [laughs] 500 years ago, I don't think we had the choice to not drink water. Whereas now we have that choice, and I suspect it's because it's been conditioned out of them, uh, via society, via various choices that they've been given, um, because I just fundamentally cannot believe that a human being cannot drink water. But I, but just to be super compassionate to parents who are listening who might struggle with their own children, I get it. I get it can be tough, but actually it's very unnatural to not, to not drink water.

    18. SPSpeaker1:16:09

        No, uh, totally agree, but I think it's, as you said, part of conditioning and, uh, you know, I go into the water business i- in the book in a fair way and, you know, we've been conditioned that tap water is perhaps bad for us and, uh, it tastes bad or, um, has m- metallic things in it or there've been, you know, history of you go abroad and everyone said, "Well, don't, don't drink the water. You know, what are you gonna... It could be deadly." Uh, and that, that fueled this whole rise in, um, mineral waters and, uh, this con that basically, you know, Pepsi and, and Coca-Cola and Nestle take tap water and they, they just stick it through, uh, a processing plant and, um, rebottle it, uh, minus any taste and, uh, do that. But, uh, and then, then have to add some, uh, flavorings to it as they, they were doing with, um, for kids to add a twist of fake lime or, uh-

    19. RCDr. Rangan Chatterjee1:17:12

        [laughs]

    20. SPSpeaker1:17:12

        ... orange to make it palatable.

    21. RCDr. Rangan Chatterjee1:17:14

        Yeah.

    22. SPSpeaker1:17:14

        Uh, no, a- absolutely, I think we, really important we get kids' taste back, re- reset the thermostat away from the super sweetness that, uh, i- is the problem.

    23. RCDr. Rangan Chatterjee1:17:25

        But, but-

    24. SPSpeaker1:17:25

        'Cause they, they can't then appreciate other foods because in a way, everything's set so high-

    25. RCDr. Rangan Chatterjee1:17:31

        Yeah

    26. SPSpeaker1:17:31

        ... uh, that they need it. And I-

    27. RCDr. Rangan Chatterjee1:17:33

        I, I, I love that phrase, reset the thermostat. That's exactly what it is really. Um, I think, I can't remember how I put it in my, in my very first book. Uh, the, I, I wrote about, you know, if a child, you know, 100 years ago, you know, the taste of a ripe peach on a sum- you know, a nice, in the peak of summer, that would be like a treat. It would be, "Man, this is so gorgeous and sweet." Whereas I think if you're used to having things like Haribos or, um, you know, every day, and that becomes your definition or your normal sweetness is a packet of sweets, then of course a peach no longer holds the magical allure that it used to.

    28. SPSpeaker1:18:15

        Yeah.

    29. RCDr. Rangan Chatterjee1:18:15

        And, and I think it's just been this steady downgrading of our taste buds without-

    30. SPSpeaker1:18:20

        When did you ever last have a grape that was slightly tangy? You know?
16. 1:20:31 – 1:35:32

    Kids, schools, and the snacking culture: how institutions shape lifelong ‘normal’

    1. RCDr. Rangan Chatterjee1:20:31

       of the school timetable. There's morning snack time, afternoon snack time, which of course y- we were mentioning before how snacking is a reasonably modern invention, certainly to the degree that we have it in this country. Um, I know this is controversial, but I wonder if you could elaborate on some of your views on nutrition in schools and what we possibly should be doing.

    2. SPSpeaker1:20:55

       Well, everything you said is, um, absolutely true around this country and probably, uh, very prevalent in places like Australia and the, and, and the US. And it is different from when I was at school. So we didn't have a, a mid-morning break for snacks. We were expected to last until lunch without fainting. And I think this, this whole idea, and it, it ki- all comes to this idea that, you know, you, you have to give kids regular food, otherwise their blood sugar level drops, and they're, uh, they can't concentrate, and they run amok. And this, uh, this idea was probably came about... It was a brilliant idea probably for some marketing, marketing executive, uh, selling s- selling, you know, chocolate biscuits or, or, you know, one of these big companies. And so they started it and then probably did a lot of really bad, promoted a lot of bad studies in nutrition departments to show there was some correlation between, uh, kids who ran amok and, uh, them not getting a, a snack at, uh, uh, 10:30, right? They didn't get a chocolate fix or whatever. They didn't get their chocolate finger, and the, and they did a correlation, they ran amok. Well, the fact that little Johnny who ran amok, uh, was the sort of kid who would just forget to [laughs] to, to pick up his satchel or whatever, um, or, you know, had refused breakfast 'cause he was, you know, a bit hyper, um, it was irrelevant because that became ingrained in, in, uh, sort of pediatrics and in, uh, school education that it was really important to keep maintaining sort of high sugar levels, uh, in school. And it, and this is where the problems absolutely start.

    3. RCDr. Rangan Chatterjee1:22:51

       So wh- why, why, why I think this is so important, Tim, is because if kids get ingrained and conditioned with this from the age of three, four, five, six, seven, it is so hard to change that conditioning later. And, you know, we've not put this video out. I made it with, with Gareth last week, uh, about, you know, s- food in schools, and I personally believe in the current climate where one in three kids in the UK start secondary school overweight and obese, and we know how much the environment influences our choices, you know, and some would argue are they even choices in a very obesogenic environment. I've really struggled to, to make the case that schools should have vending machines anymore with fizzy drinks, and with chocolate bars, with crisps. I can't see the case for an ice cream van in the middle of a big secondary school anymore. But I feel sometimes as though saying that, it for some reason, that's quite controversial to say that. It's almost as if, you know, when I was speaking to teachers about it, and some teachers say, some teachers agree, but they say, "Well, I'm t- we're too scared of parents and what they'll say, so we don't change anything." And other teachers say, "Well, we want our children to have choice." But I think, I don't think people understand true choice. I don't think they understand what goes on, the bliss point of food, how they're manufactured to particularly, you know, spike that dopamine beautifully well. So, you know, I don't think people get it right.

    4. SPSpeaker1:24:24

       There's, there's no choice. If you put a big pile of chocolate biscuits in front of me now, I'd have a nibble, you know? [laughs]

    5. RCDr. Rangan Chatterjee1:24:29

       Yeah.

    6. SPSpeaker1:24:30

       Because they're specially designed, uh, for that, and kids are so vulnerable. Um, but it, I, I agree. It's like a religion. And, and, and some peop- And many parents feel, you know, they've been educated the same way. They've been indoctrinated the same way.

    7. RCDr. Rangan Chatterjee1:24:46

       Yeah.

    8. SPSpeaker1:24:46

       And they feel they would be really bad parents if they let that kid have a sugar dip or, you know, their energy level went down, because such is this dogma that, uh, if you don't have some carbs, you know, your sugar level drops, your energy goes down. And, and what we've shown in our recent studies, in the PREDICT study, is complete oppositeYou actually have a sugar dip after you have a carb load. So it is the complete opposite of what everyone thinks. And, uh, and so what they're doing is they are giving their kid... If you give your kid a, a chocolate biscuit or whatever it is at, at 10 o'clock, they're gonna have a sugar dip, and a third of them will have real problems of fatigue and concentration for the next hour. We've, we've s- done these studies in adults, not in children, but it, you know, it, there are-- we see these sugar dippers. They don't know they're dipping 'cause we've got these monitors on them. They don't know what's happening. Uh, and they report their concentration levels, their fatigue levels. And it is not because they're not eating. It's, it's after they've had that, uh, sugar load. Uh, in our case it was muffins, but the point is exactly the same, that it is madness to think that, uh, this happens. And you only gotta look... I mean, I, I was in Tanzania, um, with this hunter-gatherer tribe, and I get asked this all the time, you know, oh, um, everyone needs breakfast otherwise you can't concentrate. Um, they didn't have a word for breakfast, uh, because it didn't exist. Uh, no one was there, you know, up at dawn getting everything ready to, uh, s- otherwise they couldn't make it through the day. Nobody ate anything before about 10:00, 10:30. Um, and usually just waited till lunch. But the, the point was that these people, you know, they would go hunting. They didn't need the equivalent of a chocolate biscuit to, uh, keep them going, otherwise they'd faint. Uh, evolutions, you know, wouldn't do that, you know? It, it's madness. And so we've actually been poisoning ourselves with the exact opposite. Uh, and but as you, as you can see from the reaction of teachers and parents, it is so ingrained, this idea, that, uh, you're a bad parent if you don't do this.

    9. RCDr. Rangan Chatterjee1:27:08

       Yeah. And, and what it wa- um, the other thing which happens, and I know many of my listeners will resonate with this bit in particular, that what it does is that when you're trying to educate and bring up your kids to know the value of food and know the value that it's for physical health, mental health, and mood, focus, concentration, et cetera, et cetera. If you subscribe to the view as idea that schools should be the model educationally, behaviorally, but also nutritionally, then you just start to create that friction where, oh, well, Mummy and Daddy are telling me one thing at home-

    10. SPSpeaker1:27:43

        Mm

    11. RCDr. Rangan Chatterjee1:27:43

        ... but, like at school... You know, yesterday my son said, uh, you know, I said, "How-- guys, how was it?" And, you know, "School?" And everybody goes, "Yeah, you know what, you know what my friends had today? They had pizza and chips for lunch." Um, and we don't-- You know, what's really tricky is that I'm not saying that that is something that no one should ever eat. Right? I get it. But I actually feel that schools are taking away some of the parental choice and responsibility because why not let parents decide if and when they wanna give their kids a bit of sugar or, uh, a cake or a dessert? I know what I'm saying is against the grain of what a lot of people now think, um, but, but I really do think schools need to, need to take this seriously.

    12. SPSpeaker1:28:28

        No, I think they need to take responsibility because what they are doing is, is for the rest of that kid's life, they're dictating what's normal.

    13. RCDr. Rangan Chatterjee1:28:36

        Exactly.

    14. SPSpeaker1:28:37

        And, and, and so, yeah, you can have parents that are stricter or more relaxed, but your idea of authority and what's, you know, the way the rules are-

    15. RCDr. Rangan Chatterjee1:28:46

        Yeah

    16. SPSpeaker1:28:47

        ... is that the rule is L- L- Little Johnny has, uh, you know, a carb break at, at 10 o'clock and another one at three o'clock, and he has, he can eat whatever he likes at, at lunch. And that is just plain wrong. And w- you know, and it, it all-- And it's again, because of brainwashing, you know, you can't blame any of these two-

    17. RCDr. Rangan Chatterjee1:29:09

        No, no

    18. SPSpeaker1:29:10

        ... 'cause there is no, there's no great expert that stands up there f- you know, uh, you know, in Eng- England we got Jamie Oliver who, who tried to do this and got a lot of, you know-

    19. RCDr. Rangan Chatterjee1:29:19

        A lot of flak

    20. SPSpeaker1:29:20

        ... um, a lot of flak for trying to, to do this. But he didn't take on really the whole concept of how much you need to eat during the day. And, you know, this, this idea, I was brought up on, uh, this, that grazing was better than gorging. Uh, I talk about it in the book. And, um-

    21. RCDr. Rangan Chatterjee1:29:37

        You do, yeah

    22. SPSpeaker1:29:37

        ... and it ended up this pathetic study of about, you know, 10 people, uh, done 30 years ago that, um, doesn't stand up to any scrutiny. And yet this one study, you know, has, had had ramifications because obviously this whole industry came around it, and people felt, you know what? It's really important to keep people, um, you know, topped up. And, uh, how are you gonna top up these kids? 'Cause otherwise they'll go crazy. And so suddenly it was a, a guilt thing. If you, if you took it away and then they did something, then the parents would blame them, and then that, then it-

    23. RCDr. Rangan Chatterjee1:30:15

        Yeah

    24. SPSpeaker1:30:15

        ... this responsibility comes out. So it's gonna take someone brave to do this.

    25. RCDr. Rangan Chatterjee1:30:20

        Yeah.

    26. SPSpeaker1:30:20

        Um, but I just hope that, you know, some people will read the book and say, "Okay, well, you can blame me now." Um, uh, you know, some head, headteacher might be listening, say, "You know what? I'm gonna, gonna change this. Let's give it a go for a term, uh, you know, and, uh-

    27. RCDr. Rangan Chatterjee1:30:35

        Yeah

    28. SPSpeaker1:30:35

        ... be unpopular, but give these kids something, some similar to what really is normal-

    29. RCDr. Rangan Chatterjee1:30:41

        Yeah

    30. SPSpeaker1:30:41

        ... and what other kids in healthier countries are doing." 'Cause-
17. 1:35:32 – 1:49:01

    Personalized nutrition and fasting: meal timing, metabolic ‘dips,’ and experimentation

    1. RCDr. Rangan Chatterjee1:35:32

       or in some of, in some patients, if they snack before a meal, it changes their metabolic response to that meal. So I wonder if we could just dive into that a little bit. So let's say you're gonna have your dinner at 6:00 PM. But at 4:30 PM, you have, I don't know, a cake, piece of cake, you know, with a cup of tea. How might that impact the same meal that someone has at 6:00 PM if they've not had that cake?

    2. SPSpeaker1:36:04

       Well, it's gonna vary for different people-

    3. RCDr. Rangan Chatterjee1:36:06

       Yeah

    4. SPSpeaker1:36:06

       ... because I've told you there's this, uh, unique response. But we're generally seeing a higher, uh, insulin and glucose peak, uh-

    5. RCDr. Rangan Chatterjee1:36:17

       If they've snacked before

    6. SPSpeaker1:36:18

       ... if they've snacked before. So there'd be more stress on the body, uh, having snacked than if they hadn't eaten at all. Um, it will depend on the time of day and other things like this, 'cause again, it, it's not a simple, you know, black and white type relationship.

    7. RCDr. Rangan Chatterjee1:36:35

       Sure.

    8. SPSpeaker1:36:35

       But, but everything that you eat, you do before you have whatever it is you're eating has a role in that response to that meal. And so, uh, for most people who have anything to eat before that time, uh, that will induce a sugar surge, will cause an even bigger one in the subsequent meal, okay? So, so this is why once you start thinking of food in a different way, as a chemical reaction in a, in your body, you realize that you don't want to have these big sugar peaks, these fat peaks after food. You want to, you know, you accept some of them, but you want to balance it for your body so that your body's not overreacting all the time and in a sort of stressed, inflamed state, which is what-We think is happening for people on very bad diets. They're just constantly stressing the body, the insulin's being pumped up, inflammation levels go up, vessels start getting inflamed. Long-term stress equals weight gain and, you know, concentration problems and, uh, energy problems. So what, you know, getting a good night's sleep, having a good rest between meals, um, trying to work out whether you should be eating your food early in the morning or, uh, late at night, depending on your particular circadian rhythm. All these things are important, but absolutely we should be eating less meals. We should just having two decent meals a day, um, rather than this standard six, which we are now, uh, being told it is still the right way to eat. Oh, and by the, you know, just happen to be this, these, these, uh, cheap snack foods you can, you can buy that parents are told is good for their children, you know, and it's just complete nonsense. Uh, we have to break that cycle, realize, break it down again, and start, you know, people experimenting and getting people used to, and kids particularly. You know, you imagine a child that's used to eating six or seven times a day, how do they cope with a fast? You know, the, the, you know, after two, two hours they're, they're conditioned to start looking for something else to eat. Uh, whereas the French kid, the Spanish kid, the Italian kid, they'll be patient. They'll wait, you know, and they'll wait for some decent food, and I think that's the other thing. It's this conditioning that's-

    9. RCDr. Rangan Chatterjee1:38:58

       Yeah

    10. SPSpeaker1:38:59

        ... maybe just as bad as this metabolic, uh, problem. So-

    11. RCDr. Rangan Chatterjee1:39:02

        Yeah, and I, I think the, the uncomfortable truth for, for many of us as parents [chuckles] is that our behavior can also condition our own kids, right? So what they-

    12. SPSpeaker1:39:11

        Mm-hmm

    13. RCDr. Rangan Chatterjee1:39:11

        ... see us doing, and if we've, let's say, picked up habits that maybe ideally we would change but we haven't, yet our kids are around us and seeing it, they're also gonna pick up that as well, and I think, you know, I say that as a reminder to myself, just be careful [chuckles] how much you snack. You know, it's not, it's not like looking down on anyone. It's, it's purely understanding that we, we're all susceptible. Um-

    14. SPSpeaker1:39:36

        But these religious, you know, but, uh, I'm a big fan of, you know, fasting and, and virtually every religion has had fasting in there as a way of training. Um, you know, as, as a sort of health thing and bonding a community together, but I think it's a great training for, for kids, uh, to be able to fast for a period of time.

    15. RCDr. Rangan Chatterjee1:39:57

        Sure.

    16. SPSpeaker1:39:57

        To realize that you don't, you're not gonna die if you don't [chuckles] eat. You know, and you, you just wait until the next day or, uh, you know, when the sun goes down or whatever it is. Uh, and, and it's very sad that we, you know, it's slowly being lost, and certainly in the Christian world it's virtually lost. Uh, and it's only the other, other religions that do it. But, uh, but bringing back, you know, some non-religious fast day-

    17. RCDr. Rangan Chatterjee1:40:26

        Yeah

    18. SPSpeaker1:40:26

        ... um, for the whole family might be a, a fun thing that everyone should do, you know, that, um-

    19. RCDr. Rangan Chatterjee1:40:30

        Well-

    20. SPSpeaker1:40:30

        With a big feast at the end to-

    21. RCDr. Rangan Chatterjee1:40:32

        Yeah

    22. SPSpeaker1:40:32

        ... uh, to celebrate.

    23. RCDr. Rangan Chatterjee1:40:33

        Yeah, you're right, this sort of feast famine type pattern that we've no doubt had in evolution. How can we bring that back? When you say you're a fan of fasting, um, what do you mean by fasting? Because if I don't clarify this, we'll get a ton of questions afterwards. "What do you mean by fasting? Are you talking about intermittent fasting? Tim Ferriss said he's saying how many hours?" You know, all those questions will come up, so I'd love to know what d- what does Professor Tim Spector think of fasting?

    24. SPSpeaker1:41:00

        Well, firstly, uh, everything in moderation, so I'm not, uh, someone who believes in multiple day fasting. Um, you know, I've never fasted for more than 24 hours and, uh, I d- [clears throat] wouldn't recommend it. Uh, but I, I do think just in general principle, the idea of going on a fast psychologically is really important so that you remember what hunger's really like, and you remember that you can distract yourself from hunger, and that also you can, uh, paint a nice picture of, you know, having this enormous breakfast the next day, and amazingly you can fall asleep and get around it. So until I started doing it, I, I didn't believe that was sort of possible. [chuckles]

    25. RCDr. Rangan Chatterjee1:41:45

        Yeah.

    26. SPSpeaker1:41:46

        So I, I thought, "I'm too weak. I'm not gonna be able to do that." But so the, just the principle of any, any fast, um, it, it's quite a just a thing to do for your own psychological wellbeing, I think, uh, to realize that we've, you know, we've got this, we've got these chemicals in our brain and they're telling us to do this and, but you can switch them off, you can divert them. Y- you know, when you don't have to, it's fine, and most of us will come across some medical thing that we have to fast.

    27. RCDr. Rangan Chatterjee1:42:14

        Yeah.

    28. SPSpeaker1:42:15

        Uh, but y- we're usually just distracted by that medical thing that we do it, and if you t- and that, that's interesting that, uh-

    29. RCDr. Rangan Chatterjee1:42:21

        Yeah

    30. SPSpeaker1:42:21

        ... that's quite easy. Um, but when you do it voluntarily it's somewhat harder. So the principle is I, I like it. Um, I was a big fan of, uh, intermittent fasting when it first came out because it allowed you to, um, eat less food but not in a restricted way. So you could have, you could pick what the food was you were gonna eat and just had only a quarter of the amount on that day. And I don't think it was shown to be better than any other diets, but you could stay on it for longer because you had the variety. You could change it all. It wasn't dull. It didn't, you know, didn't interfere with, uh, anything else. And, um-
18. 1:49:01 – 2:00:03

    How we eat matters: stress, digestion, and the case for mindful meal rituals

    1. RCDr. Rangan Chatterjee1:49:01

       say I eat until, I'd have a dinner at 7:00 PM, actually, you know what? That seems to work for me." When we talk about food and health, it's all on what we eat. We forget about why we eat, we forget about how we eat, we forget about when we eat, and we forget about where we eat. All of those four other factors are just as important, yeah, just as important as what we eat, but we just don't give them enough attention. Well, I don't know if you've heard of the French Paradox, butI've always loved it. It was this idea that people in France could have apparently all these so-called unhealthy foods, right? You know, at lunch, a glass of red wine, a steak, uh, a nice bit of full-fat cheese. Yet, when they looked at the data, they didn't seem to suffer from the same health problems that, let's say, us in the UK would suffer from if we had the same foods. And there's all kinds of theories as to what's going on. You know, is it the fact that they're eating real food, whole foods? Uh, there, there's all kinds of things out there, but I, but I've gotta be honest, what I think it is more than anything, it's not what they're eating, it's how they're eating. So it is well-known in French culture, mealtimes are sacrosanct. You stop. You know, if you're in an office, the laptop goes down [laughs] , the pen goes down, and you go and you sit somewhere, usually in company, and you will enjoy your meal, right? It's really, really interesting. I did an interview with a French journalist about a year ago, uh, when The Four Pillar Plan was coming out in France, and at the end of the interview I asked them, I said, "Hey, can I just ask you a question? I'm really interested. Does French culture still have that now, today, in the 21st century?" And she said to me, "Yeah, absolutely. W- it's just, it's just part of what we do." She said the only place she's seen it's changed is in some of the international offices in Paris, she said, because we've got people from all over the world, and that culture of sort of busyness, of working at your desk, getting stuff done, is starting to infiltrate in. And, and I think that's, you know, that kind of says a lot. It's, it's, you know, a little bit sad that that's happening. But, but why should this make a difference? Well, there's a certain mode in which we're designed to eat, right? We're not designed to eat when we're stressed out. So if, you know, if we think about our stress response, it evolved, you know, let's say a million, two million years ago. We're in our hunter-gatherer tribes, we're trying to, uh, you know, we're trying to get on with our business, and a wild predator, like a lion, is approaching, right? In an instant, our stress response kicks into gear to keep us safe, right? Blood sugar goes up so we can run faster. Blood pressure goes up to get more oxygen in our brain, et cetera, et cetera. But your body does something else. It switches off your digestion. Because if you need to run away from a wild predator, you don't need to be able to calmly and efficiently digest and process your food, so your body's clever, it switches it off. The problem today is that our stress responses are being activated not by predators, but by our daily lives. So it's our email in-inboxes. It's our to-do lists. It's our social media channels, right? So if you are eating your healthy, whole food lunch at your desk whilst also, you know, with a laptop on trying to answer emails, and again, I'm not looking down at you, I will do that sometimes even though I know it's not the best thing to do, it's gonna have a different impact. You know? It, it, it's gonna... Your body's gonna deal with it in a different way. And so the way we eat, how we eat absolutely matters. And for some of my patients who wanna improve their health, they wanna lose some of their excess weight, actually how they eat is the first place they should start. You know, having a bit of a ritual between work time and meal time. You know, I, I say, you know, an athlete doesn't just rock up to the start line. They, they have a process to get themselves in the right state of mind so that their body and their mind can have peak performance. What I say to some of my patients, "I wanna help you have peak performance for eating." Right? It only needs to take a few minutes. It could be simple things like putting the laptop down, doing one minute of three, four, five breathing, saying one line of gratitude. Little things that were in our own culture just 20, 30 years ago, little things that are actually still in French culture today. These things make a big difference. And if you focus on how you eat, you'll actually find something interesting happens. You often end up eating less. You're satisfied with less because you're being attentive. You're allowing these signals to register. You're allowing the hunger signal to register, the fullness signal to register. You know, you're, you're really feeling nourished at the end of that meal. Whereas you could have the same meal, let's say the same healthy whole food meal, and be trying to sort of edit your, your latest video or get your emails done, and before you know it, you've, you've finished what's on your plate. That's assuming you even had a plate in the first place. And you don't quite know what's happened. Your mind hasn't registered that you've eaten it. Your stomach in some ways hasn't registered, and then you wonder why you're snacking all afternoon, right? So once you understand this, you can go, "Ah, well, maybe for me, how I eat is the most important thing, or the thing that I want to address at the moment." If I look back over the past 20 years and really try and examine how the way I treat patients has changed, I think the key thing for me is really trying to get to the root cause. It's trying to get to the why. Okay, so if we talk about, let's say, weight, right? So many people around this country, around the world, are actively trying to lose weight at this very moment in time.A lot of them are beating themselves up, right? A lot of them are, are, are feeling bad about themselves because they seem unable to do it. But let's just think about this for a second, right? What is going on? If you are watching this and you're actively trying to lose weight, does me telling you that eating too many crisps or digestive biscuits or ice cream in front of the sofa in the evening is unlikely to be helping your cause, is it, it's not really new information for most people. No. You know, it's like trying to tell a smoker that smoking's not good for their health. I think every smoker who's trying to give up already knows that. So it's not knowledge that's the problem. No. It, it's, it, it's why. It's understanding. And here's the reality with food, right? For the bulk of our evolution, we have used food to fill a hole in our stomachs. But today, we use food to fill a hole in our hearts, and we, we need to understand that. When we're lonely, we eat food. When we're stressed, we eat food. When we're bored, we eat food. When we've had a row with our partner, we eat food. When we've had a crap day at work, we eat food, right? So if that's your pattern with food, and you are choosing to change it, right? 'Cause I'm not here to tell anybody what to do if they don't wanna change, right? If you want to change that, then you've gotta understand that if stress is driving your eating behavior, well, maybe you don't need a new diet plan. Maybe you need to understand how to reduce the stress. And so, it, it is... I, I think for me, in a nutshell, that is one of the biggest problems we're facing today when it comes to health, when it comes to excess weight, and I don't think enough people are talking about it. The government are certainly not talking about it, you know? And they should be. They should be. I'm not against the whole idea of personal responsibility. I get that, but it ain't just personal responsibility, you know? It's easy for the middle classes to make more personally responsible decisions than it is for someone who's living in a very stressful environment, where there's financial stress, when there's emotional stress. Uh, you know, we, we really have to understand that. We have to be a lot more compassionate about that, and I don't think we are. But you've really gotta understand what's going on, what's driving the behavior in the first place. You know, you don't go into... You know, if your car breaks down, right, you don't go to the mechanic and, you know, w- you know, tell the pro- You, you don't... You know, the car's not working. You don't go to the mechanic and the mechanic says, "You've got a moral problem" or, "You didn't have enough willpower." No, they understand, actually, there's something going on with the car. Something's broken. I need to fix it. And they will then do some tests. They'll run diagnostics to find out, well, what is the exact problem here that I need to address? Without knowing the problem, they can't fix it. It's the same when it comes to our health, whether it's weight, mental health, whatever it is. If we don't know what's causing it, how are we gonna fix it? So, you know, my, my approach with my patients, my approach in every book that I write, my approach on my podcast is always the same. Empower people with information. Don't judge them. Be compassionate. Be kind. Let people, once they understand, people will make the right choices. They'll make the right choices for them. Over and over again, I've seen this in practice. You don't have to tell people long-term what to do. You have to empathize. You have to connect with them. And once you've done that, when people feel heard, they get it, and they start to change because they want to, not because I told them to. If you enjoyed that conversation, I think you are going to love the one I had with the incredible immunologist Jenna Macciochi all about the immune system. It's right there, so give it a click, and let me know what you think. And click here to download my free breathing PDF.

    2. SPSpeaker1:59:58

       Gut bugs, the microbiota, are one of the key educators of the immune system

Episode duration: 2:00:04