WEBVTT

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This episode is sponsored by Bubs Naturals, yet

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another company that I tracked down to bring

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on as a sponsor because I myself love their products.

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They are offering you, the audience of the Behind

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the Shield podcast, a 20 % discount. But before

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younger, definitely a lot more of a concern now.

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However, where I've really seen the impact is

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joint health and gut health, and I've been blown

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away that when I'm consistent using collagen,

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Bubs Collagen in this case, I see a massive improvement

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in both. Another area I drink coffee, love coffee

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originally I used the MCT oil powder but now

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mention as well the altruistic element of Bubz

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Doherty, one of the two Navy SEALs killed in

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Benghazi, and a good friend of the founders,

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Sean and TJ. So 10 % of every single sale goes

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towards the Glenn Doherty Foundation. Now, as

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I mentioned before, they are offering you, the

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audience, 20 % off your purchase if you use the

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code SHIELD. That's S -H -I -E -L -D at bubsnaturals

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.com. And finally, if you want to hear more about

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their products and Glenn's powerful story, listen

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to episode 558 with co -founder Sean Lake. Welcome

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to the Behind the Shield podcast. As always,

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my name is James Gearing, and this week it is

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my absolute honor to welcome back onto the show

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the head of the Nuffield Laboratory of Ophthalmology

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and the Sleep and Circadian Neuroscience Institute

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at the University of Oxford, Professor Russell

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Foster. Now, if you haven't heard my first conversation

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with Russell, it is episode 647, and I highly

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recommend that you listen to that. In the second

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conversation, we discuss a multitude of topics

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from the impact of the pandemic on society, gut

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biome, light, moral courage, some optimistic

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science when it comes to addressing strokes,

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and so much more. Now, before we get to this

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incredible conversation, as I say every week,

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please just take a moment go to whichever app

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you listen to this on subscribe to the show Leave

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feedback and leave a rating. Every single five

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-star rating truly does elevate this podcast,

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therefore making it easier for others to find.

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And this is a free library of over 1 ,100 episodes

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now. So all I ask in return is that you help

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share these incredible men and women's stories

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so I can get them to every single person on planet

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Earth who needs to hear them. So with that being

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said... I welcome back onto the show Professor

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Russell Foster. Enjoy. Well, Russell, I want

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to start by saying thank you so, so much for

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coming back onto the Behind the Shield podcast

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today. Oh, well, thank you, James. It's a great

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honor and a privilege, of course. Our initial

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conversation was about three years ago, and we

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discussed a host of topics. Is it that long?

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It is. I can't believe it was that long. It's

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extraordinary. Yeah, I believe so. August 2022,

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if I'm not mistaken. So I'm sure there'll be

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a little overlap, but some of these topics are

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just going to be worth revisiting. But I think...

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if we're talking about mid -2022, the first kind

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of icebreaker would be what you have seen in

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this world of sleep medicine and this world of

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neuroscience as far as the impact of the pandemic

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for the last few years. Because obviously at

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the time, decisions were made, people were isolated,

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we all know that story. But what isn't being

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told is what was the ripple effect of that and

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what can we learn from maybe doing it a little

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differently next time? Yeah, I think that...

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The fact that people had to stay inside was a

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very significant impact upon sleep and circadian

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health in that we live in dim, dark caves. And

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what I would urge your listeners to do is to

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load onto their smartphone a lux meter. And there's

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lots of different apps that are available free.

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And you can then get a sense of how much light

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we experience inside. Go up to the window and

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you see, you know, three thousand, four thousand.

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And of course, where you are much more than that

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and go outside, you'll be getting one hundred

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thousand lux. And yet inside, we'll be lucky

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to get. maybe 300, 400, 500 lux. And the clock

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needs a very robust exposure to the light -dark

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cycle to regulate it. And we were inside. So

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we were being cut off from that essential signal

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to stabilize the circadian clock and the sleep

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-wake cycle. And so I think people's sleep patterns

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began to drift. And that's not ideal. And there

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was internal desynchrony. So different bits of

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the body were doing different things. It wasn't

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all beautifully coordinated. I think last time

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I used the analogy of an orchestra. You know,

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all the different body parts, like the members

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of an orchestra, playing at the same time in

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this wonderful symphony without that sort of

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robust regulation by the light -dark cycle. Everything

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starts to play at a slightly different time.

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And instead of a symphony, you have a cacophony.

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So that was one thing. But I think a very interesting

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other observation was the change in people's

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patterns of sleep. So what we know is that if

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we have the opportunity to sleep longer, sleep

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can go into a biphasic or polyphasic mode which

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means you go to sleep um you wake up you go back

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to sleep again and you can do this several times

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throughout the night and this occurs you know

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even in young people so so um experiments were

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done in the states um where individuals were

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placed under 12 hours of dark 12 hours of light

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and their sleep pattern became biphasic polyphasic

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and these are in young males and so what happened

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during the pandemic is that people didn't have

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to commute So they gained in many cases, you

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know, they saved two hours or four hours on their

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daily commute and they didn't have to get up

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as early. And so they slept longer. And so despite

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this, though, what was so fascinating is people

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reported having worse sleep, even though they

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had the opportunity to sleep longer. And what

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was going on, of course, is that people didn't

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know about this biphasic polyphasic pattern.

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They'd wake up and they think, oh, my God, you

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know, all the horrors of what was going on, you

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know, worry about family, friends and the bigger

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picture would make it more difficult to go back

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to sleep. And they thought, you know, anyway,

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well, I must, you know. stop struggling, start

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having drinking coffee and doing emails. And

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so even though there was greater opportunity

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to sleep, the reports were people got worse sleep.

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That's because they were unaware of this. It's

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perfectly normal to wake up. If you stay calm,

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stay relaxed, keep the lights relatively low,

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you will go back to sleep. And so those are the

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two observations from my side. And I think the

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other thing while we're talking about light.

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is that unless you get outside, you're not getting

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sufficient UVB exposure to make vitamin D. And

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there are some suggestions that people became

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vitamin D deprived over that period, which, of

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course, has a knock -on effect. We know, of course,

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the role of vitamin D in bone mineralization

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and all the rest of it. but it has a big impact

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upon our immune responses. And there's some evidence

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on mental health and sleep as well. So taking

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vitamin D3 supplement when we have the next horror,

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I think was going to be really quite important.

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Government recommendations should be take vitamin

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D3 supplementation if you're not getting outside.

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And to my knowledge, there was no real discussion

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of that. and that could have a big uh impact

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upon health including our sleep and mental health

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what was interesting i say let me rephrase that

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what was actually quite disappointing was seeing

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the any any topic would turn into like flanders

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fields you'd have two you know trenches of extremism

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and no real kind of common sense in the middle

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in a lot of these areas What is the connection

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between stress, lack of sleep and the simple

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ability to critically think? Oh, it's profound.

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Most people don't have a sleep problem. They

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have an anxiety or a stress issue. And that makes

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it either difficult to get off to sleep. And

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if you wake up getting back to sleep and that

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disrupted sleep can have. a really profound effect

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upon your ability to process information and

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indeed your emotional responses. You become more

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irritable, more impulsive, less empathetic, which

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I think is absolutely fascinating. You fail to

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pick up the social signals from other people,

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whether it's work colleagues or family or friends.

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Another fascinating area is that the tired brain

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remembers negative experiences and forgets the

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positive ones. So one's entire worldview is biased

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towards the negative. And that's the sort of

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the basis for decision making. And so the more

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anxious you get, the greater the levels of stress,

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the worse the sleep becomes and more disrupted.

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And then your ability to process emotional and

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cognitive information really does begin to fall

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apart. And, yeah, lots of people who have contacted

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me since the pandemic said. they they were in

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such a black place in terms of their their mood

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um and their relationships with others uh it

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was a i think a profoundly difficult time and

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and at all levels i mean the uk you know kids

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were doing classes online and so they were isolated

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from their entire peer group and then we throw

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them you know into uh university after the pandemic

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uh or college and they had to learn the skills

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that they would have acquired, you know, sort

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of by osmosis, by just interacting with others.

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So I think it was a really quite damaging time.

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I've made this comment quite a few times recently.

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It really saddens me having grown up in myself,

00:11:20.919 --> 00:11:23.639
kind of I was young in the 80s and having Blue

00:11:23.639 --> 00:11:26.360
Peter and John Craven's Newsround and all these,

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you know, programs for young people that were

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really teaching us about the world. pulling us

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together, the fundraise, you know, for the famine

00:11:34.600 --> 00:11:37.320
in Ethiopia, there was Live Aid, there was Comic

00:11:37.320 --> 00:11:40.340
Relief. And then you circle around again, kind

00:11:40.340 --> 00:11:42.259
of this era now, whether it's COVID, whether

00:11:42.259 --> 00:11:44.360
it's Gaza, whatever it is, where there's clearly

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something that we all need to stand up and talk

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about. And there isn't that compassion. And I

00:11:50.639 --> 00:11:54.200
honestly believe that this overstress, undersleep

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element of modern society, and especially the

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division that we've seen the last few years.

00:11:59.820 --> 00:12:02.440
has really hacked at the compassion that I would

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argue is at the heart of normal American people,

00:12:06.879 --> 00:12:09.720
normal British people. But you're seeing that

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really dulled by, I'm assuming, these environmental

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elements. Yeah, I think that's a very good point.

00:12:17.259 --> 00:12:20.960
Having worked in the States for eight years and

00:12:20.960 --> 00:12:24.659
the rest of my life has been in the UK, I agree.

00:12:26.429 --> 00:12:29.230
is a kindness and there is a generosity of spirit

00:12:29.230 --> 00:12:34.590
and a willingness to help that has become massively

00:12:34.590 --> 00:12:37.600
eroded. And I'm not quite sure why. I mean, you

00:12:37.600 --> 00:12:40.919
can see this just in the way that people drive

00:12:40.919 --> 00:12:43.139
and they won't people, you know, people won't

00:12:43.139 --> 00:12:45.220
be let in. And my daughter had an incident just

00:12:45.220 --> 00:12:47.580
recently where somebody, she was indicating to

00:12:47.580 --> 00:12:50.460
get into the next lane and this person just wouldn't

00:12:50.460 --> 00:12:53.100
let her. And she, you know, she pulled over and

00:12:53.100 --> 00:12:54.759
she called us. She was crying. She said, why

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did he do that? There was no need to behave like

00:12:57.320 --> 00:12:59.659
that. And I think this is what many of us are

00:12:59.659 --> 00:13:03.059
seeing a lot of. And it really, really distresses

00:13:03.059 --> 00:13:07.970
me. For myself, I listened to the morning news

00:13:07.970 --> 00:13:12.830
on the radio since undergraduate days. And I

00:13:12.830 --> 00:13:19.870
suppose 2021, 2020, I just stopped listening

00:13:19.870 --> 00:13:23.590
to the morning news. I wake up now to, in the

00:13:23.590 --> 00:13:26.110
UK, Radio 3, which is the classical channel.

00:13:26.610 --> 00:13:29.909
And we don't, I mean, we used to religiously

00:13:29.909 --> 00:13:32.710
watch the news on the television. We don't, we

00:13:32.710 --> 00:13:36.320
don't. Simply do it at all now. And so I do get

00:13:36.320 --> 00:13:40.039
some news feeds on my smartphone. But, you know,

00:13:40.179 --> 00:13:45.320
it's such an unmitigated drip, drip, drip of

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ghastliness that it can really send you into

00:13:50.019 --> 00:13:53.279
a state where you don't want to be. And I don't

00:13:53.279 --> 00:13:55.840
think it's very difficult. The media have to

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do what the media do. But we only get the negative.

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We don't hear about. the success stories and

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the great scientific breakthroughs all the breakthroughs

00:14:05.740 --> 00:14:08.639
in the social sciences or you know new discoveries

00:14:08.639 --> 00:14:11.360
and excitement and and i don't understand why

00:14:11.360 --> 00:14:15.139
we haven't reoriented our our news channels to

00:14:15.139 --> 00:14:18.059
a lot more of those discussions of human success

00:14:18.059 --> 00:14:21.980
rather than And clearly we have to be aware of

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all the nasty stuff that's going on. But in equal

00:14:24.559 --> 00:14:27.600
measure, we have to realize that we are a species

00:14:27.600 --> 00:14:31.080
capable of such kindness and such humanity and

00:14:31.080 --> 00:14:34.440
such decency that we've got to emphasize that

00:14:34.440 --> 00:14:36.840
again, that we haven't lost it. It's there, but

00:14:36.840 --> 00:14:39.159
we've got to try and get it back up to the surface.

00:14:39.840 --> 00:14:42.620
Yeah, I agree completely. And I post a lot of

00:14:42.620 --> 00:14:45.080
those. kind videos online there was one actually

00:14:45.080 --> 00:14:47.519
it was a children's bbc one and they had all

00:14:47.519 --> 00:14:50.039
these children you know and some were different

00:14:50.039 --> 00:14:53.309
races some had special needs but these kids were

00:14:53.309 --> 00:14:55.090
just talking about, well, yeah, she runs faster

00:14:55.090 --> 00:14:57.250
than me and he likes conkers and I don't like

00:14:57.250 --> 00:15:00.309
conkers and they're not seeing the exterior shell.

00:15:00.409 --> 00:15:02.070
Of course they see it, they're aware of it, but

00:15:02.070 --> 00:15:04.889
that's not the person that they see. And I feel

00:15:04.889 --> 00:15:07.409
like that kind of innocence that is inbred in

00:15:07.409 --> 00:15:09.830
us and children because of these environmental

00:15:09.830 --> 00:15:12.429
pressures are kind of chipped away. But I do

00:15:12.429 --> 00:15:14.049
believe that we're at the beginning of an awakening.

00:15:14.149 --> 00:15:16.090
I feel like the cracks are starting to show and

00:15:16.090 --> 00:15:20.029
there's an urging now, a need to go back to exactly

00:15:20.029 --> 00:15:21.690
what we're talking about when we were younger.

00:15:22.480 --> 00:15:25.779
I mean, again, for me, it's just simple kindness

00:15:25.779 --> 00:15:28.299
and generosity of spirit. You know, I mean, the

00:15:28.299 --> 00:15:30.419
person who lives over the road, they sort of

00:15:30.419 --> 00:15:32.419
say, shall I take your bins in? Oh, thanks so

00:15:32.419 --> 00:15:34.799
much. I'm a bit stiff today. You know, it's that

00:15:34.799 --> 00:15:39.320
kind of connectedness that we don't have as much

00:15:39.320 --> 00:15:42.480
as we did, I think, in the past. Absolutely.

00:15:42.940 --> 00:15:45.899
Well, mentioning, you know, social media and

00:15:45.899 --> 00:15:49.049
some of the things that are. adding to this disconnection

00:15:49.049 --> 00:15:52.049
before we hit record you talked about the study

00:15:52.049 --> 00:15:53.529
that you're you're doing with the government

00:15:53.529 --> 00:15:56.269
now on artificial light and then some of the

00:15:56.269 --> 00:15:59.710
the myths around devices so you know what what

00:15:59.710 --> 00:16:01.730
is the study that you're working on and then

00:16:01.730 --> 00:16:04.330
let's debunk some of the misinformation that's

00:16:04.330 --> 00:16:07.960
being put out there yeah um so so the the title

00:16:07.960 --> 00:16:11.480
it's it's part of a government reporting body

00:16:11.480 --> 00:16:14.539
it's an independent but it is funded by by the

00:16:14.539 --> 00:16:16.820
government called kumari which is the committee

00:16:16.820 --> 00:16:19.080
on the medical aspects of radiation in the environment

00:16:19.080 --> 00:16:22.279
and i i was brought into the committee to deal

00:16:22.279 --> 00:16:25.100
with a visual bit you know there's lots on sort

00:16:25.100 --> 00:16:27.320
of radiation and there's lots on low frequency

00:16:27.320 --> 00:16:29.679
you know radio waves and stuff but there was

00:16:29.679 --> 00:16:33.519
ironically nobody in that vision bit and because

00:16:33.519 --> 00:16:37.259
i'd worked as the science advisor for a House

00:16:37.259 --> 00:16:39.879
of Lords report on the impact of light and noise

00:16:39.879 --> 00:16:42.200
pollution on human health. There were recommendations

00:16:42.200 --> 00:16:45.120
that came from that, so they asked me to join

00:16:45.120 --> 00:16:49.360
the committee and then let's get a clear understanding

00:16:49.360 --> 00:16:52.159
of what we know and what we need to know about

00:16:52.159 --> 00:16:56.259
the impact of light on human health, artificial

00:16:56.259 --> 00:16:59.360
light on human health. So I brought a group together,

00:16:59.460 --> 00:17:02.799
we meet fairly shortly, of experts and we're

00:17:02.799 --> 00:17:05.230
going to take different bits of the subject and

00:17:05.230 --> 00:17:07.710
come up with this report. And let me give you

00:17:07.710 --> 00:17:10.529
an example. And I have to say that some of my

00:17:10.529 --> 00:17:13.789
colleagues in the business of science haven't

00:17:13.789 --> 00:17:16.710
been necessarily as helpful as they could have

00:17:16.710 --> 00:17:18.529
been. You know, there were reports out there

00:17:18.529 --> 00:17:22.109
saying you shouldn't see more than 30 lux of

00:17:22.109 --> 00:17:24.549
light. for two hours before you go to bed. Now,

00:17:24.589 --> 00:17:28.150
that's really dim light. And if you're an elderly

00:17:28.150 --> 00:17:31.450
individual with somewhat reduced sight, let's

00:17:31.450 --> 00:17:35.329
say, then wandering around for two hours under

00:17:35.329 --> 00:17:38.849
30 lux increases the chance of falls and accidents

00:17:38.849 --> 00:17:40.950
and all of that sort of stuff. And that's just

00:17:40.950 --> 00:17:45.029
silly. And it's based upon data. Let me give

00:17:45.029 --> 00:17:48.410
you one example. And we hear a lot in the media

00:17:48.410 --> 00:17:51.450
about you shouldn't look at your light emitting.

00:17:52.000 --> 00:17:55.200
tablet your your kindle before you go to bed

00:17:55.200 --> 00:17:59.819
and it's based upon a study that got people to

00:17:59.819 --> 00:18:02.440
look at a kindle on its brightest light intensity

00:18:02.440 --> 00:18:07.980
for four hours immediately before bedtime on

00:18:07.980 --> 00:18:12.859
five consecutive nights at the end of that Yes,

00:18:12.859 --> 00:18:16.579
there were some effects upon melatonin, but melatonin

00:18:16.579 --> 00:18:21.180
is a hormone that modulates sleep. If you actually

00:18:21.180 --> 00:18:24.319
looked at sleep -wake timing, sleep -wake timing

00:18:24.319 --> 00:18:28.680
was delayed by nine minutes, just statistically

00:18:28.680 --> 00:18:31.569
significantly. And one of my colleagues... from

00:18:31.569 --> 00:18:33.549
the states said well that may be statistically

00:18:33.549 --> 00:18:36.769
significant but biology biologically that's meaningless

00:18:36.769 --> 00:18:40.230
and yet you know the headlines from all over

00:18:40.230 --> 00:18:41.890
the world is if you look at a kindle before you

00:18:41.890 --> 00:18:44.069
go to bed you're going to harm your health and

00:18:44.069 --> 00:18:48.049
your sleep now one key point about that experiment

00:18:48.049 --> 00:18:51.670
is that prior to that four hours of light exposure

00:18:51.670 --> 00:18:54.170
in the evening people were maintained under dim

00:18:54.170 --> 00:18:58.480
light 90 lux during the day And what the Scandinavian

00:18:58.480 --> 00:19:01.720
group then did was give people 500 to 600 lux

00:19:01.720 --> 00:19:05.079
for six hours during the middle of the day. That

00:19:05.079 --> 00:19:09.640
abolished all effects of melatonin and sleep

00:19:09.640 --> 00:19:12.759
-wake timing. No detectable effect of looking

00:19:12.759 --> 00:19:15.519
at Kindle before you go to bed. And this is the

00:19:15.519 --> 00:19:19.640
problem. We've got lab -based studies which are

00:19:19.640 --> 00:19:22.480
then being extrapolated to the real world. and

00:19:22.480 --> 00:19:25.299
it's just not good enough um and if people are

00:19:25.299 --> 00:19:27.140
getting out and getting a moderate amount of

00:19:27.140 --> 00:19:31.420
light during the day they're going to not sensitize

00:19:31.420 --> 00:19:33.980
their their clock in the evening so it's those

00:19:33.980 --> 00:19:36.579
sorts of things we also so so what we've got

00:19:36.579 --> 00:19:39.720
to do is try and integrate how much light for

00:19:39.720 --> 00:19:43.420
how long what its color its wavelength should

00:19:43.420 --> 00:19:46.420
be what your light history is have you spent

00:19:46.420 --> 00:19:49.259
time outside or are you inside all the time how

00:19:49.259 --> 00:19:52.240
old you are it's clear that young people are

00:19:52.240 --> 00:19:54.559
more that their circadian system is more sensitive

00:19:54.559 --> 00:19:58.059
to light than in elderly people we've got to

00:19:58.059 --> 00:20:01.039
take into account seasons and i and i think rather

00:20:01.039 --> 00:20:03.359
than you know you stick a bunch of scientists

00:20:03.359 --> 00:20:05.180
into a room and you ask them to come up with

00:20:05.180 --> 00:20:07.339
recommendations sure they're going to come up

00:20:07.339 --> 00:20:09.000
with the recommendations on the basis of the

00:20:09.000 --> 00:20:11.960
data we've got and my argument is we don't have

00:20:11.960 --> 00:20:14.799
all the data yet and it's a very biased set of

00:20:14.799 --> 00:20:18.069
data because it's using assays which may not

00:20:18.069 --> 00:20:22.869
be real world and they're all lab based so that's

00:20:22.869 --> 00:20:26.329
what I'm trying to do and as I say we're starting

00:20:26.329 --> 00:20:29.430
our studies shortly to get that paper together

00:20:29.430 --> 00:20:31.910
and hopefully it will define the experiments

00:20:31.910 --> 00:20:34.109
that we need to do in the real world and they're

00:20:34.109 --> 00:20:37.089
not that difficult. I mean, it's easy now to

00:20:37.089 --> 00:20:39.970
measure people's rest activity cycles, how alert

00:20:39.970 --> 00:20:42.869
they are, what light exposure they get in a whole

00:20:42.869 --> 00:20:46.549
different set of settings. And we can use that

00:20:46.549 --> 00:20:50.309
field data, I think, then to genuinely inform

00:20:50.309 --> 00:20:55.130
evidence -based guidelines for how we should

00:20:55.130 --> 00:20:58.740
expose ourselves to artificial light. and and

00:20:58.740 --> 00:21:00.799
it is really important the architects are crying

00:21:00.799 --> 00:21:03.059
out for this sort of information it's fascinating

00:21:03.059 --> 00:21:04.880
i've been talking to architects over the past

00:21:04.880 --> 00:21:07.559
few years and they sort of fall into two groups

00:21:07.559 --> 00:21:11.619
one group say oh god light natural light oh i

00:21:11.619 --> 00:21:14.279
just ignore it you just build a space and you

00:21:14.279 --> 00:21:16.279
just stick electric lights in it and that's it

00:21:16.279 --> 00:21:21.299
um it's a nuisance um and and in fact it's quite

00:21:21.299 --> 00:21:24.180
interesting there are some proposals for building

00:21:24.180 --> 00:21:27.309
a new builds in London, where they limit the

00:21:27.309 --> 00:21:31.369
size of the windows hugely because of the fear

00:21:31.369 --> 00:21:35.309
of overheating. And with increased warmth in

00:21:35.309 --> 00:21:37.170
the environment, you know, they don't want to

00:21:37.170 --> 00:21:39.589
use air conditioning in the UK. So they're going

00:21:39.589 --> 00:21:42.849
to make tiny, tiny windows. Just madness. And

00:21:42.849 --> 00:21:45.450
the other group of architects are, you should

00:21:45.450 --> 00:21:48.190
only use artificial light when you can't use

00:21:48.190 --> 00:21:51.089
natural light. And so they embrace natural light.

00:21:51.170 --> 00:21:54.380
I was at a meeting. early in the year by the

00:21:54.380 --> 00:21:57.220
daylight academy and it was uh it was wonderful

00:21:57.220 --> 00:22:00.440
they made me a fellow and it's absolutely fascinating

00:22:00.440 --> 00:22:03.579
um listening to what the architects are interested

00:22:03.579 --> 00:22:05.940
in and what they want and i think we've let them

00:22:05.940 --> 00:22:09.039
down we haven't given them the evidence -based

00:22:09.039 --> 00:22:11.970
guidelines that we absolutely need Well, I can

00:22:11.970 --> 00:22:15.029
just say as a consumer or as an employee, when

00:22:15.029 --> 00:22:17.250
you're in a place that has a lot of natural light,

00:22:17.349 --> 00:22:20.109
again, as long as it's not overwhelming, then

00:22:20.109 --> 00:22:23.930
it's a more pleasant place to be. And what blows

00:22:23.930 --> 00:22:26.650
me away in America here, in Florida specifically,

00:22:26.890 --> 00:22:29.490
is you'll have one of these big stores, Target,

00:22:29.690 --> 00:22:32.569
Walmart, and they'll have no skylights and then

00:22:32.569 --> 00:22:35.069
artificial light, which must cost hundreds of

00:22:35.069 --> 00:22:38.049
thousands of dollars as well. But it also, you

00:22:38.049 --> 00:22:40.279
walk in and you just... don't want to be in there

00:22:40.279 --> 00:22:43.380
because it is this kind of you know non -natural

00:22:43.380 --> 00:22:45.619
environment whereas you you see some of these

00:22:45.619 --> 00:22:47.019
people that have spent a little bit more money

00:22:47.019 --> 00:22:49.839
on whatever it is the way that they've designed

00:22:49.839 --> 00:22:52.059
their stores and maybe there are like you said

00:22:52.059 --> 00:22:54.259
a combination of skylights and some lights because

00:22:54.259 --> 00:22:55.500
obviously in the evening you're going to need

00:22:55.500 --> 00:22:57.859
the light and you just you want to stay there

00:22:57.859 --> 00:23:00.000
whether it's as an employee or whether it's someone

00:23:00.000 --> 00:23:02.839
who's just shopping in a shop Absolutely right.

00:23:03.000 --> 00:23:07.400
And I'm working on a new book about light and

00:23:07.400 --> 00:23:10.460
its impact on health. And there's some sections

00:23:10.460 --> 00:23:14.279
on psychology of light and lighting. And the

00:23:14.279 --> 00:23:16.559
thing that's so fascinating, again, talking to

00:23:16.559 --> 00:23:19.059
the architects, oh, yeah, we can just sort of...

00:23:19.289 --> 00:23:24.049
bung in LED lights, which are cheap. They don't

00:23:24.049 --> 00:23:27.009
use lots of energy. So it's great. But of course,

00:23:27.049 --> 00:23:30.549
where we used to use one incandescent bulb, because

00:23:30.549 --> 00:23:35.650
LEDs are so cheap, there's a huge amount of LED

00:23:35.650 --> 00:23:39.910
lighting, which of course, multiplies the cost

00:23:39.910 --> 00:23:43.589
of the electrical usage. So whilst they individually

00:23:43.589 --> 00:23:47.430
are quite cheap to run, because we use them at

00:23:47.430 --> 00:23:50.440
high density, you know we're not saving that

00:23:50.440 --> 00:23:52.480
much money any longer which goes back to your

00:23:52.480 --> 00:23:55.000
point why the hell aren't we letting uh light

00:23:55.000 --> 00:23:57.700
light in natural light into our built spaces

00:23:57.700 --> 00:24:00.839
um and as i say it's sort of they're a group

00:24:00.839 --> 00:24:03.200
of architects they just they no no no they said

00:24:03.200 --> 00:24:05.759
i can't deal with it let's just just get rid

00:24:05.759 --> 00:24:09.000
of it um fascinating actually completely different

00:24:09.000 --> 00:24:11.619
mindset to i think um those of us who like to

00:24:11.619 --> 00:24:14.750
live in buildings Yeah. Well, we even have things

00:24:14.750 --> 00:24:17.009
called solar tubes in my house. There's two of

00:24:17.009 --> 00:24:18.589
them, one in my son's bathroom, one in the laundry

00:24:18.589 --> 00:24:20.509
room. And I keep, you know, you'll think, oh,

00:24:20.529 --> 00:24:22.009
God, I left the light on. Then you realize you

00:24:22.009 --> 00:24:24.609
didn't. Just that one little tube is probably

00:24:24.609 --> 00:24:28.710
eight inches, you know, diameter. And it just

00:24:28.710 --> 00:24:30.509
illuminates the whole room. It's incredible.

00:24:30.730 --> 00:24:33.009
So just those two rooms. What are you saving

00:24:33.009 --> 00:24:37.410
just on that? Well, but on the other side, which

00:24:37.410 --> 00:24:40.150
is also quite interesting because of the ubiquitous

00:24:40.150 --> 00:24:44.000
use of light. Of course, artificial light at

00:24:44.000 --> 00:24:50.000
night, Alan, on the animal world is a big problem.

00:24:50.119 --> 00:24:53.519
I mean, insect life, bird life. But up until

00:24:53.519 --> 00:24:57.059
recently, the work on humans wasn't... so well

00:24:57.059 --> 00:24:59.160
developed. Because what people do is they'd use

00:24:59.160 --> 00:25:03.519
satellite imagery to calculate the sort of predicted

00:25:03.519 --> 00:25:06.359
light exposure of individuals of light at night.

00:25:06.460 --> 00:25:09.240
And then they correlate it with incidents of

00:25:09.240 --> 00:25:11.299
coronary heart disease. And my criticism of those

00:25:11.299 --> 00:25:14.140
studies was, well, you've got to get individual

00:25:14.140 --> 00:25:16.559
light exposure. You can't just have a satellite

00:25:16.559 --> 00:25:21.640
image, which covers about a mile in area. And

00:25:21.640 --> 00:25:23.960
just recently a paper has just been published

00:25:23.960 --> 00:25:26.259
where they've measured individual light exposure

00:25:26.259 --> 00:25:29.319
and the whole risk of health conditions of keeping

00:25:29.319 --> 00:25:33.500
the lights on at night. And actually with thousands

00:25:33.500 --> 00:25:35.900
of individuals, and it's quite convincing, there

00:25:35.900 --> 00:25:40.190
are impacts upon coronary heart disease. and

00:25:40.190 --> 00:25:43.829
emotions and sleep and so i think um yeah we're

00:25:43.829 --> 00:25:45.589
getting beginning to get the data that it's not

00:25:45.589 --> 00:25:48.150
just the the animal world and indeed the plant

00:25:48.150 --> 00:25:50.910
world i mean when plants start to flower for

00:25:50.910 --> 00:25:53.750
example um with with artificial light at night

00:25:53.750 --> 00:25:57.670
but also on humans so so not connecting with

00:25:57.670 --> 00:26:00.309
with the light dark cycle the natural light dark

00:26:00.309 --> 00:26:03.299
cycle and just flicking a switch We've got to,

00:26:03.299 --> 00:26:05.660
again, tune into that, I think, a lot more than

00:26:05.660 --> 00:26:07.779
we have done. And of course, that was going back

00:26:07.779 --> 00:26:09.380
to where we started. One of the great problems

00:26:09.380 --> 00:26:12.700
with COVID, we're inside and we were almost exclusively

00:26:12.700 --> 00:26:19.240
exposed to light at night. Since we spoke, I

00:26:19.240 --> 00:26:21.539
came across a study and I had the gentleman on

00:26:21.539 --> 00:26:25.740
the show who, and he did a study on, and we've

00:26:25.740 --> 00:26:27.180
talked about this in the previous conversation.

00:26:28.059 --> 00:26:30.500
most firefighters in america work 56 hours a

00:26:30.500 --> 00:26:33.640
week and the usual one is what's called 24 48

00:26:33.640 --> 00:26:37.240
24 hours you know at the station so disrupted

00:26:37.240 --> 00:26:41.019
or no sleep and then a 48 hour period off and

00:26:41.019 --> 00:26:43.619
there's been a push to because things aren't

00:26:43.619 --> 00:26:45.839
working recruitment crisis is getting worse and

00:26:45.839 --> 00:26:47.480
worse and you know the health crisis and the

00:26:47.480 --> 00:26:49.779
mental health crisis and one of the solutions

00:26:49.779 --> 00:26:53.559
was do well let's do 48 hours in a row and then

00:26:53.559 --> 00:26:57.650
have a 96 hour period Which to anyone who understands

00:26:57.650 --> 00:26:59.990
anything about physiology, immediately you just

00:26:59.990 --> 00:27:03.130
go, well, that's insane. The problem was this

00:27:03.130 --> 00:27:05.549
gentleman did a study and I'm defending him.

00:27:05.589 --> 00:27:07.750
He was a volunteer firefighter, never worked

00:27:07.750 --> 00:27:10.490
in the career field, and just went in there with

00:27:10.490 --> 00:27:14.210
a good heart. And he did the study and oh, actually

00:27:14.210 --> 00:27:17.210
the 48 hours in a row is healthier than the 24.

00:27:18.210 --> 00:27:21.109
And so what ended up happening when we had our

00:27:21.109 --> 00:27:23.829
conversation is the department that he studied

00:27:23.829 --> 00:27:28.079
ran. one call a shift and usually slept all night

00:27:28.079 --> 00:27:30.680
every shift. Now you have all these urban and

00:27:30.680 --> 00:27:32.660
suburban fire departments that took that study

00:27:32.660 --> 00:27:34.720
and were like, well, it's healthier, who are

00:27:34.720 --> 00:27:38.519
running 20 calls a shift and are up all night.

00:27:38.859 --> 00:27:41.759
And what I realized very recently, because they

00:27:41.759 --> 00:27:44.279
keep doing this, they keep studying this 56 rather

00:27:44.279 --> 00:27:47.220
than, well, the Northeast of America works 42

00:27:47.220 --> 00:27:49.940
hours a week. Why don't we study those two and

00:27:49.940 --> 00:27:53.309
put them side by side? And so we have a... a

00:27:53.309 --> 00:27:57.069
lack of cultural competency in the research of

00:27:57.069 --> 00:28:00.670
our profession which i'm seeing is becoming very

00:28:00.670 --> 00:28:02.950
dangerous because someone you know little knowledge

00:28:02.950 --> 00:28:05.009
is a dangerous thing they grab one study just

00:28:05.009 --> 00:28:07.390
like you alluded to and they run with it and

00:28:07.390 --> 00:28:10.690
arguably make an already broken system even worse

00:28:10.690 --> 00:28:14.019
so What is your kind of perspective on science?

00:28:14.119 --> 00:28:16.900
Everyone screams for data. Where is that line,

00:28:17.019 --> 00:28:19.559
A, between common sense where a study isn't even

00:28:19.559 --> 00:28:22.619
needed and B, where the wrong science can be

00:28:22.619 --> 00:28:26.119
latched onto and making things even worse? Yeah,

00:28:26.160 --> 00:28:31.579
I think it is complicated. And we do need, I

00:28:31.579 --> 00:28:33.539
think the thing that we haven't done is longitudinal

00:28:33.539 --> 00:28:37.960
studies. So it's all been very short term. And

00:28:37.960 --> 00:28:43.539
as you say, very selected groups. So it is complicated

00:28:43.539 --> 00:28:46.500
and what we need to do, and we can do, as I was

00:28:46.500 --> 00:28:49.140
alluding to earlier, we can measure rest activity

00:28:49.140 --> 00:28:52.759
cycles. We can get a reaction time easily from

00:28:52.759 --> 00:28:57.480
a thing on a smartphone. We can look at the impact

00:28:57.480 --> 00:29:01.980
of blood glucose really easily. We can look at

00:29:01.980 --> 00:29:05.279
stress hormones. And so rather than sort of biting

00:29:05.279 --> 00:29:08.160
off bits and chunks of this sort of question,

00:29:08.400 --> 00:29:14.039
we need some long term deep dive studies on large

00:29:14.039 --> 00:29:16.539
numbers of individuals in different sectors.

00:29:16.599 --> 00:29:19.319
And you were saying, you know, comparing the

00:29:19.319 --> 00:29:23.819
sort of rural fire engine, fireman, fire person

00:29:23.819 --> 00:29:27.759
population versus inner city Chicago or whatever.

00:29:29.579 --> 00:29:32.640
with that make some evidence -based conclusions

00:29:32.640 --> 00:29:34.619
i think we're all you know it's like the lighting

00:29:34.619 --> 00:29:36.660
industry it's like architects all thrashing around

00:29:36.660 --> 00:29:41.180
for some data and we'll latch on to data that

00:29:41.559 --> 00:29:43.660
can, as you rightly point out, James, can be

00:29:43.660 --> 00:29:46.680
profoundly misleading. And so what I'm trying

00:29:46.680 --> 00:29:49.000
to do with the impact of artificial light on

00:29:49.000 --> 00:29:52.539
human health is get some consensus and identify

00:29:52.539 --> 00:29:55.539
what we need to know to get those evidence -based

00:29:55.539 --> 00:29:58.359
guidelines, rather than just jumping in with

00:29:58.359 --> 00:30:01.740
the best will, as this individual clearly was

00:30:01.740 --> 00:30:05.039
trying to do a good job. can be taken out of

00:30:05.039 --> 00:30:08.940
context so yes some scientific rigor um and engagement

00:30:08.940 --> 00:30:11.160
with the scientific community i think is really

00:30:11.160 --> 00:30:13.980
important but but the problem is that these studies

00:30:13.980 --> 00:30:18.400
are not cheap and i and i i'm bombarded by people

00:30:18.400 --> 00:30:21.099
saying oh you know why don't we do this and can

00:30:21.099 --> 00:30:24.579
i can i be and i'd say i'd love to but do you

00:30:24.579 --> 00:30:27.140
know it's really expensive because to do it properly

00:30:27.140 --> 00:30:29.940
i'm going to have to employ a postdoctoral scientist

00:30:29.940 --> 00:30:34.089
or a phd student on of this for three or four

00:30:34.089 --> 00:30:38.210
years um to make it coherent and that's really

00:30:38.210 --> 00:30:41.190
expensive and i think you know they can say can

00:30:41.190 --> 00:30:43.609
you just tack it on can you just add it on to

00:30:43.609 --> 00:30:46.509
what you're already doing and you can't you've

00:30:46.509 --> 00:30:49.009
got to take it seriously and you've got to regard

00:30:49.009 --> 00:30:52.190
as a freestanding you know a set of experiments

00:30:52.190 --> 00:30:58.289
and and so yeah we've it's it's sadly um uh it's

00:30:58.289 --> 00:31:01.700
throwing money up to get it done properly Well,

00:31:01.720 --> 00:31:04.099
the one takeaway that he found, and I'll credit

00:31:04.099 --> 00:31:06.160
him absolutely for this because it really opened

00:31:06.160 --> 00:31:09.140
the door for this conversation, is bearing in

00:31:09.140 --> 00:31:11.980
mind that they didn't get woken up that night,

00:31:12.059 --> 00:31:14.240
still somewhat disrupted because the potential

00:31:14.240 --> 00:31:15.900
of getting woken up, I think, still keeps you

00:31:15.900 --> 00:31:19.759
from a deep sleep. But as you alluded to earlier,

00:31:19.880 --> 00:31:23.950
the commute. So we normally start 7, 7 .30, 8

00:31:23.950 --> 00:31:26.289
o 'clock in the morning. And a lot of us can't

00:31:26.289 --> 00:31:28.390
afford to live anywhere near if we work in a

00:31:28.390 --> 00:31:31.650
city. So my commute was like a 75 -minute commute.

00:31:31.970 --> 00:31:34.150
So I'm getting up at 5 in the morning to go to

00:31:34.150 --> 00:31:36.910
the station. Well, if you've got this 48 -hour

00:31:36.910 --> 00:31:40.230
period, day two, you're in the station. If you

00:31:40.230 --> 00:31:42.910
didn't get any calls that night, now you've technically

00:31:42.910 --> 00:31:45.829
had a longer sleep because you didn't get up

00:31:45.829 --> 00:31:49.839
at 5 to go to work. The 48 hour thing still is

00:31:49.839 --> 00:31:53.680
a horrible idea. But to take that away, we work

00:31:53.680 --> 00:31:56.640
24 hour shifts. That's a dial that we can spin

00:31:56.640 --> 00:32:00.059
in any way, shape or form. So now the conversation

00:32:00.059 --> 00:32:02.079
is also being, well, then why don't we start

00:32:02.079 --> 00:32:06.039
at 11 a .m., 12 noon? So now you wake up, you

00:32:06.039 --> 00:32:07.900
have breakfast with your family, you wake up

00:32:07.900 --> 00:32:10.160
at a normal time, then you take the kids to school,

00:32:10.259 --> 00:32:12.539
then you drive to the fire station. And if you

00:32:12.539 --> 00:32:15.589
were at the station. and you just got beat up

00:32:15.589 --> 00:32:18.089
all night, you're running calls. Now you can

00:32:18.089 --> 00:32:20.730
sleep in an extra hour or two and then get out

00:32:20.730 --> 00:32:24.230
at 10 o 'clock, get your rig ready, have coffee

00:32:24.230 --> 00:32:27.230
with everyone and then head home. So I know there's

00:32:27.230 --> 00:32:30.130
been conversations in the schools, but talk to

00:32:30.130 --> 00:32:33.529
me about the way we've always done it as everyone

00:32:33.529 --> 00:32:36.109
starts work at eight or goes to school at eight.

00:32:36.410 --> 00:32:39.029
What is the conversation now about extending?

00:32:39.759 --> 00:32:43.000
wake -up time and the physical and mental health

00:32:43.000 --> 00:32:46.059
of whatever population that's affecting? Yeah,

00:32:46.099 --> 00:32:48.839
well, there's some rumbles of a discussion. So

00:32:48.839 --> 00:32:54.200
I work with colleagues in Western Australia,

00:32:54.400 --> 00:32:57.539
up in the northwest in the mining district of

00:32:57.539 --> 00:33:00.460
the Pilbara. So they're flying in a fly -in,

00:33:00.480 --> 00:33:04.980
fly -out group. They're flying from Perth to

00:33:04.980 --> 00:33:10.700
the Pilbara. But their shift starts, let's say,

00:33:10.740 --> 00:33:12.859
at 9 o 'clock or 10 o 'clock or whatever. But

00:33:12.859 --> 00:33:15.259
as you say, they've had to get up at 4 o 'clock

00:33:15.259 --> 00:33:17.940
in the morning to get the bus or the car to get

00:33:17.940 --> 00:33:20.740
the plane that then flies them up. And so people

00:33:20.740 --> 00:33:23.519
aren't thinking about that part of the commute,

00:33:23.740 --> 00:33:32.140
which is, I think, really important. The medics

00:33:32.140 --> 00:33:37.039
I work with, they're still... of us that they're

00:33:37.039 --> 00:33:40.119
getting better but it's still well you know it's

00:33:40.119 --> 00:33:42.299
part of the rites of passage you know you just

00:33:42.299 --> 00:33:45.220
got to work through it and and and and you know

00:33:45.220 --> 00:33:48.700
again that whole area of sleep is for wimps um

00:33:48.700 --> 00:33:52.720
and and uh it's still lingers like a rather nasty

00:33:52.720 --> 00:33:55.440
smell out there we haven't got rid of it completely

00:33:55.440 --> 00:33:59.519
uh even even in the medical professions um although

00:33:59.519 --> 00:34:01.500
they're becoming more aware of it as the new

00:34:01.500 --> 00:34:04.799
generation are coming through so i think there

00:34:04.799 --> 00:34:07.660
is increased awareness but it's not really taken

00:34:07.660 --> 00:34:10.860
the sector that i think is moving the fastest

00:34:10.860 --> 00:34:13.360
which i think is fascinating is the business

00:34:13.360 --> 00:34:16.539
sector i spend quite a bit of time talking to

00:34:16.539 --> 00:34:19.880
various businesses you know about prioritizing

00:34:19.880 --> 00:34:22.760
sleep about the opportunities that good sleep

00:34:22.760 --> 00:34:26.440
can provide a business um and what bad sleep

00:34:26.440 --> 00:34:28.639
will how bad sleep will harm a business you know

00:34:28.639 --> 00:34:31.119
i often wonder and i've got no data for it but

00:34:31.119 --> 00:34:33.000
you know if we think about the last financial

00:34:33.000 --> 00:34:36.639
crash it was a whole bunch of jocks who were

00:34:36.639 --> 00:34:40.139
utterly sleep deprived you know and therefore

00:34:40.139 --> 00:34:44.900
making i suspect making incredibly poor decisions

00:34:44.900 --> 00:34:48.119
and impulsive decisions because they were chronically

00:34:48.119 --> 00:34:51.179
sleep deprived, which ultimately cost the world

00:34:51.179 --> 00:34:55.260
economy trillions because a bunch of tired jocks

00:34:55.260 --> 00:34:59.119
were pushing the wrong buttons. And I think the

00:34:59.119 --> 00:35:03.179
business sector have sort of got that and are

00:35:03.179 --> 00:35:06.079
beginning to understand how you should structure

00:35:06.079 --> 00:35:09.630
a working day, making it more flexible. and taking

00:35:09.630 --> 00:35:11.949
into account chronotype, you know, whether you're

00:35:11.949 --> 00:35:14.010
a morning type or an evening type. And something

00:35:14.010 --> 00:35:17.289
I've long argued is that if you have an international

00:35:17.289 --> 00:35:22.489
business, you should voluntarily chronotype your

00:35:22.489 --> 00:35:26.690
workforce. So those in, you know, Europe, let's

00:35:26.690 --> 00:35:30.570
say it's a European based industry, then the

00:35:30.570 --> 00:35:34.489
morning types, you know. look after the asian

00:35:34.489 --> 00:35:37.150
markets then the intermediate types and then

00:35:37.150 --> 00:35:39.329
the late types are doing the north america markets

00:35:39.329 --> 00:35:42.329
and so essentially you're accommodating and you've

00:35:42.329 --> 00:35:45.900
got a team which is to some extent, optimised

00:35:45.900 --> 00:35:48.780
to the particular time zone, and or certainly

00:35:48.780 --> 00:35:51.019
be sensitive to the fact that people will be

00:35:51.019 --> 00:35:54.199
working outside of their biological time, which

00:35:54.199 --> 00:35:57.199
would allow them to make the most efficient and

00:35:57.199 --> 00:36:00.340
sensible decisions. And so, you know, what we

00:36:00.340 --> 00:36:02.860
argue for surgeons and surgery was there was

00:36:02.860 --> 00:36:06.079
a point saying, yeah, let's have surgeries running

00:36:06.079 --> 00:36:09.800
24 hours a day, then we can use the operating

00:36:09.800 --> 00:36:12.739
theatres, you know, fully. We can get through

00:36:12.739 --> 00:36:14.980
the waiting lists and all the rest of it. And

00:36:14.980 --> 00:36:16.599
then I said, well, yeah, but you're going to

00:36:16.599 --> 00:36:19.980
need two people to do this because one's got

00:36:19.980 --> 00:36:22.059
to check what the other is doing and not making

00:36:22.059 --> 00:36:24.300
mistakes. And therefore, you're not going to

00:36:24.300 --> 00:36:26.280
have a saviour of costs because sessions are

00:36:26.280 --> 00:36:29.619
very expensive, as are all the nursing staff

00:36:29.619 --> 00:36:32.300
and all the support that you need to do that.

00:36:34.619 --> 00:36:37.400
you know it's still a pretty simplistic view

00:36:37.400 --> 00:36:41.780
of of our biology by our by our by our rulers

00:36:41.780 --> 00:36:45.500
um they don't get it yet but it it is shuffling

00:36:45.500 --> 00:36:48.539
forward and as i say you know i find it fascinating

00:36:48.539 --> 00:36:52.039
that most of the talks i'm asked to to give outside

00:36:52.039 --> 00:36:54.840
of academia are to the business sector in fact

00:36:54.840 --> 00:36:58.420
it was great i i got to i got a trip to um istanbul

00:36:58.420 --> 00:37:02.019
uh very recently as a result talking to some

00:37:02.460 --> 00:37:06.840
very serious, financially powerful individuals.

00:37:07.119 --> 00:37:09.079
And we had a brilliant time. I mean, they're

00:37:09.079 --> 00:37:11.679
open to it and open to the discussion. And we

00:37:11.679 --> 00:37:16.739
spent a big chunk of a day and a half discussing

00:37:16.739 --> 00:37:19.519
the impact and the importance of this. So they're

00:37:19.519 --> 00:37:22.920
open to it. And they want to look at ways in

00:37:22.920 --> 00:37:25.420
which they can improve performance. In the same

00:37:25.420 --> 00:37:27.940
way that another sector, which I'm not directly...

00:37:28.360 --> 00:37:32.519
speaking to. But in sports and high performance

00:37:32.519 --> 00:37:37.360
athletics, they really are embracing sleep and

00:37:37.360 --> 00:37:40.579
timing and all of those sorts of things. To get

00:37:40.579 --> 00:37:43.619
that subtle edge is the difference between a

00:37:43.619 --> 00:37:49.110
gold medal and a fourth place position. Well,

00:37:49.150 --> 00:37:50.710
and that's what's so crazy. Then you flip that

00:37:50.710 --> 00:37:53.610
round to police, fire, EMS. I mean, you're talking

00:37:53.610 --> 00:37:56.329
about split -second decisions that, you know,

00:37:56.329 --> 00:37:59.070
a life is at stake, you know. So this is why

00:37:59.070 --> 00:38:01.110
we have it kind of backwards, you know. I think

00:38:01.110 --> 00:38:04.090
if the sporting community is using it, we certainly

00:38:04.090 --> 00:38:06.349
need to be using it in all the areas where people

00:38:06.349 --> 00:38:09.130
could die. I could not agree more, which is why

00:38:09.130 --> 00:38:11.230
I'm so happy to chat to you, James, because our

00:38:11.230 --> 00:38:15.909
front line, you know, are the... group that we

00:38:15.909 --> 00:38:18.730
need to look after in that regard i mean you

00:38:18.730 --> 00:38:21.130
were talking about you know the commute home

00:38:21.130 --> 00:38:24.809
so um there's a study which i think i may have

00:38:24.809 --> 00:38:28.050
mentioned last time in junior doctors you know

00:38:28.050 --> 00:38:31.670
57 had reported either having a crash or a near

00:38:31.670 --> 00:38:34.650
miss on the drive home in the early hours of

00:38:34.650 --> 00:38:37.269
the morning after the night shift you know and

00:38:37.269 --> 00:38:41.489
and so why on earth were they not being given

00:38:41.489 --> 00:38:44.860
an app for their smartphone that they could detect

00:38:44.860 --> 00:38:47.579
whether they were nodding or the car was moving

00:38:47.579 --> 00:38:50.679
laterally. And of course, high -end cars have

00:38:50.679 --> 00:38:53.699
all this technology built into it, but junior

00:38:53.699 --> 00:38:55.860
doctors don't usually have that kind of income.

00:38:56.619 --> 00:39:00.179
And the same for nurses and the same for the

00:39:00.179 --> 00:39:05.460
other first -line individuals. And so we've got

00:39:05.460 --> 00:39:07.739
to do a better job. I mean, the other thing which

00:39:07.739 --> 00:39:10.179
I can't remember if we talked about or not, but

00:39:10.179 --> 00:39:14.940
vaccination. the impact of a vaccination has

00:39:14.940 --> 00:39:17.300
a big effect depending upon how tired you are.

00:39:17.400 --> 00:39:21.980
And presumably because how high the stress hormones

00:39:21.980 --> 00:39:26.099
are hitting. So if you haven't slept before a

00:39:26.099 --> 00:39:31.199
vaccination, then the efficacy of that vaccination

00:39:31.199 --> 00:39:34.440
drops really very significantly. And also the

00:39:34.440 --> 00:39:37.039
same if you haven't slept significantly after

00:39:37.039 --> 00:39:40.780
a vaccination as well. So we should be... prioritizing

00:39:40.780 --> 00:39:43.440
that when our frontline staff get vaccination,

00:39:43.780 --> 00:39:47.719
they should make sure they're rested in that

00:39:47.719 --> 00:39:49.800
period before the vaccination. Otherwise, the

00:39:49.800 --> 00:39:53.000
vaccination will drop in its efficiency and they're

00:39:53.000 --> 00:39:54.940
the ones that are most vulnerable. It's that

00:39:54.940 --> 00:39:58.460
kind of stuff we can do. We know enough to institute

00:39:58.460 --> 00:40:01.659
that. It's interesting you say that because during

00:40:01.659 --> 00:40:05.679
COVID, my whole platform was just standing in

00:40:05.679 --> 00:40:09.000
the middle because there was one truth in all

00:40:09.000 --> 00:40:11.989
of that. If you were all in on the vaccines and

00:40:11.989 --> 00:40:13.630
you thought that was the be -all and end -all

00:40:13.630 --> 00:40:17.610
and masks, then the healthier you are, just as

00:40:17.610 --> 00:40:19.809
you alluded to, the healthier and more wet -rested

00:40:19.809 --> 00:40:21.989
you are, the higher the efficacy of the vaccine.

00:40:22.309 --> 00:40:25.469
If you are completely opposed to the vaccine

00:40:25.469 --> 00:40:28.530
and the time developing all that stuff was worrying

00:40:28.530 --> 00:40:31.409
you, then again, the health of the individual

00:40:31.409 --> 00:40:33.849
determines your resistance to that virus without

00:40:33.849 --> 00:40:36.530
any immunization. So there was one truth where

00:40:36.530 --> 00:40:39.150
people were fighting in this World War I trenches,

00:40:39.210 --> 00:40:41.719
but... The thing was, let's make the nation healthier.

00:40:42.079 --> 00:40:44.579
And that's what was so sad is in the US, certainly,

00:40:44.639 --> 00:40:46.280
I don't know if it is any different in the UK,

00:40:46.380 --> 00:40:49.239
but in the US, that was completely discarded.

00:40:49.239 --> 00:40:53.800
It was heresy. I was lauded for daring to say

00:40:53.800 --> 00:40:55.599
the underlying health conditions were contributing

00:40:55.599 --> 00:40:58.719
to some of these deaths during COVID. But you

00:40:58.719 --> 00:41:00.739
come out the other end, and as you said, communities

00:41:00.739 --> 00:41:03.880
were split apart. Sleep was disrupted. People

00:41:03.880 --> 00:41:06.940
had gained weight. Alcoholism was higher because

00:41:06.940 --> 00:41:08.980
everyone was ordering stuff into their house.

00:41:09.579 --> 00:41:12.960
And so we came away really worse off and more

00:41:12.960 --> 00:41:15.980
vulnerable to the next virus than we did at the

00:41:15.980 --> 00:41:18.820
beginning of 2020. Yeah, and it's a very good

00:41:18.820 --> 00:41:20.800
point because we weren't going out. It was so

00:41:20.800 --> 00:41:24.659
much easier just to check that extra bottle of

00:41:24.659 --> 00:41:27.940
whiskey or vodka or gin or whatever. Oh, you

00:41:27.940 --> 00:41:30.840
know, because it's too for the price. All those

00:41:30.840 --> 00:41:35.019
sorts of offers. And people still haven't recovered

00:41:35.019 --> 00:41:37.679
from the increased alcohol consumption since

00:41:37.679 --> 00:41:40.920
COVID times. And indeed, and other, you know,

00:41:40.940 --> 00:41:44.699
comfort food and comfort eating. It's taking

00:41:44.699 --> 00:41:48.489
a long time to get back from that. Circling around

00:41:48.489 --> 00:41:49.889
to what you're talking about with the doctors

00:41:49.889 --> 00:41:52.309
is interesting. I think it was Sir William Halstead,

00:41:52.349 --> 00:41:54.050
if I've got that, William or Edward Halstead.

00:41:54.090 --> 00:41:56.869
But anyway, when I did some kind of digging into

00:41:56.869 --> 00:42:00.110
air quotes, the way we've always done it, the

00:42:00.110 --> 00:42:04.230
crazy residencies that these doctors had stems

00:42:04.230 --> 00:42:07.969
back to this surgical surgeon back in, I think

00:42:07.969 --> 00:42:10.670
it was the 1800s, if I'm not mistaken, or beginning

00:42:10.670 --> 00:42:14.929
of the 1900s. And he would do these. you know,

00:42:14.929 --> 00:42:17.889
just marathon residencies, marathon surgeries.

00:42:18.190 --> 00:42:20.570
Well, years later, when they were kind of looking

00:42:20.570 --> 00:42:23.530
at it again, he was addicted to heroin and cocaine.

00:42:23.849 --> 00:42:26.230
So I'm pretty sure I could stay up for 48 hours

00:42:26.230 --> 00:42:29.190
if I was loaded with those two. With amphetamines,

00:42:29.190 --> 00:42:32.050
yeah. Well, you're absolutely right. And that's

00:42:32.050 --> 00:42:35.510
what people do. They will drive, I mean, at a

00:42:35.510 --> 00:42:39.289
less severe level, it's driving the waking day

00:42:39.289 --> 00:42:42.659
on endless cups of coffee. And then thinking,

00:42:42.780 --> 00:42:46.500
oh, I've got to get some sleep. And then taking

00:42:46.500 --> 00:42:49.039
alcohol or sedatives to try and reverse that.

00:42:49.119 --> 00:42:51.219
And as we discussed last time, they're sedatives.

00:42:51.260 --> 00:42:53.840
They don't provide a biological mimic for sleep.

00:42:54.039 --> 00:42:56.079
So some of the wonderful stuff that's going on

00:42:56.079 --> 00:42:59.280
in the brain, you know, memory formation, the

00:42:59.280 --> 00:43:03.260
creation of ideas, the clearance of toxins are

00:43:03.260 --> 00:43:06.199
actually impaired by some of these sedatives.

00:43:06.320 --> 00:43:10.619
I mean, particularly alcohol is very bad on memory

00:43:10.619 --> 00:43:13.460
formation. and processing of information. And

00:43:13.460 --> 00:43:17.179
yet that cycle of stimulants and sedatives is

00:43:17.179 --> 00:43:20.559
very much the drive, I think, for many frontline

00:43:20.559 --> 00:43:26.400
staff. Where was I going to go with that? I just

00:43:26.400 --> 00:43:28.480
was about to cycle. Oh, that's what it was. Okay,

00:43:28.539 --> 00:43:30.800
let me just write down so I can remove my dramatic

00:43:30.800 --> 00:43:35.000
pause there. All right. Well, one more thing

00:43:35.000 --> 00:43:37.320
about the business side before we transition.

00:43:38.219 --> 00:43:40.360
An interesting thing that's just really kind

00:43:40.360 --> 00:43:42.619
of popped up a lot in conversation is out of

00:43:42.619 --> 00:43:45.800
the UK. And that is a lot of corporations have

00:43:45.800 --> 00:43:48.760
tried the four day work weeks of four, nine hour

00:43:48.760 --> 00:43:51.539
days. And it seems like it's had huge success

00:43:51.539 --> 00:43:55.380
there in Iceland and some other places. And from

00:43:55.380 --> 00:43:57.280
what I understand, there's a higher level of

00:43:57.280 --> 00:44:00.619
efficiency, more innovation, and then obviously,

00:44:00.659 --> 00:44:02.480
you know, less sick time and those kind of things

00:44:02.480 --> 00:44:05.059
as well. So what are you seeing as far as that?

00:44:05.119 --> 00:44:07.570
Because as you alluded to. i think if we're going

00:44:07.570 --> 00:44:09.610
to look at the thought leaders a lot of times

00:44:09.610 --> 00:44:12.210
the business business space is really where the

00:44:12.210 --> 00:44:15.090
most you know cut and edge innovations are coming

00:44:15.090 --> 00:44:18.409
from yeah i think it's complicated and i think

00:44:18.409 --> 00:44:20.530
it depends very much on the nature of the job

00:44:20.530 --> 00:44:24.730
um and one of the the the great things that has

00:44:24.730 --> 00:44:27.449
evaporated from the scientific community is is

00:44:27.449 --> 00:44:30.750
particularly early mid -career people meeting

00:44:30.750 --> 00:44:34.050
other early mid -career scientists and forming

00:44:34.050 --> 00:44:37.650
that sort of network and those you know interactions

00:44:37.650 --> 00:44:41.469
and the creativity of ideas which you can't really

00:44:41.469 --> 00:44:46.619
replicate online and so i i think that We in

00:44:46.619 --> 00:44:49.280
the university sector have been really trying

00:44:49.280 --> 00:44:52.800
to encourage people to get into the lab, get

00:44:52.800 --> 00:44:55.820
into the office. But the problem that we face

00:44:55.820 --> 00:44:58.579
in Oxford is that the commute in, this is a medieval

00:44:58.579 --> 00:45:05.199
city with very little parking and it's expensive.

00:45:05.679 --> 00:45:07.960
I mean, you know, for young people to come from

00:45:07.960 --> 00:45:10.340
the outskirts into the city is a big deal. And

00:45:10.340 --> 00:45:12.079
you think, well, why should I spend two hours?

00:45:12.750 --> 00:45:14.590
you know, commuting when I would actually be

00:45:14.590 --> 00:45:17.010
more productive if I was in front of my laptop

00:45:17.010 --> 00:45:20.650
for two hours. So I think there's a tension.

00:45:20.869 --> 00:45:23.449
I think it's early days and I think it needs

00:45:23.449 --> 00:45:27.909
to be looked at longitudinally. And it'll depend

00:45:27.909 --> 00:45:31.809
upon the nature of the task. I do worry, you

00:45:31.809 --> 00:45:36.869
know, we started with that loss of empathy and

00:45:36.869 --> 00:45:40.130
generosity of spirit and all the rest of it.

00:45:40.210 --> 00:45:43.659
And I wonder if... our isolation from Covid times

00:45:43.659 --> 00:45:47.380
spilling into a shorter working week there have

00:45:47.380 --> 00:45:50.539
been unintended consequences which is we don't

00:45:50.539 --> 00:45:54.300
socialise as much and we perhaps haven't learnt

00:45:54.300 --> 00:46:00.159
ways of compromise and the subtlety and the nuances

00:46:00.159 --> 00:46:05.960
of having a joke and laughing and so I can see

00:46:05.960 --> 00:46:08.239
that it could be extremely useful and very helpful.

00:46:08.920 --> 00:46:12.539
But I'm slightly uneasy that there will be unintended

00:46:12.539 --> 00:46:15.960
consequences because we are a deeply social species.

00:46:16.380 --> 00:46:19.820
You know, that's what we are. We've evolved to

00:46:19.820 --> 00:46:23.599
be part of a family and a community. And sitting

00:46:23.599 --> 00:46:27.019
in front of one of these screens day after day,

00:46:27.099 --> 00:46:31.639
not actually... meeting our colleagues and friends

00:46:31.639 --> 00:46:34.159
does worry me a bit. Now, of course, I'm exaggerating.

00:46:34.579 --> 00:46:36.860
The proposal is dropping to a four -day week

00:46:36.860 --> 00:46:40.719
and that could well make sense. And so it means

00:46:40.719 --> 00:46:45.000
that, you know, you've got a bit of extra time.

00:46:46.300 --> 00:46:50.360
But I don't want it to go too far. And certainly

00:46:50.360 --> 00:46:55.199
in the university sector, we were saying to support

00:46:55.199 --> 00:46:58.840
staff, well, you can work. three days out of

00:46:58.840 --> 00:47:03.079
five actually in the workplace and now we're

00:47:03.079 --> 00:47:06.300
moving away from that and it's much more you're

00:47:06.300 --> 00:47:10.619
expected to come in and I think as long as there's

00:47:10.619 --> 00:47:13.369
flexibility That makes sense. I mean, I think

00:47:13.369 --> 00:47:16.429
particularly if you've got young families, you

00:47:16.429 --> 00:47:19.530
know, or you're a carer for elderly parents or

00:47:19.530 --> 00:47:21.590
whomever, you know, having the flexibility to

00:47:21.590 --> 00:47:24.150
say, look, I've got to do a hospital appointment.

00:47:24.289 --> 00:47:27.849
I can work from home and then carry on a bit

00:47:27.849 --> 00:47:30.050
further. That's really important. I think that

00:47:30.050 --> 00:47:37.050
flexibility is powerful. But I do worry a little

00:47:37.050 --> 00:47:40.909
bit about isolating ourselves from... colleagues

00:47:40.909 --> 00:47:46.269
uh and and and and and a work environment it's

00:47:46.269 --> 00:47:49.070
interesting the more progressive fire stations

00:47:49.070 --> 00:47:52.230
now they've built individual rooms for the firefighters

00:47:52.230 --> 00:47:55.289
so now you're not getting woken up if you know

00:47:55.289 --> 00:47:56.710
we have what we call rescues which are basically

00:47:56.710 --> 00:47:58.949
ambulances with fire gear on them and then you've

00:47:58.949 --> 00:48:00.769
got you know engines and trucks so if the if

00:48:00.769 --> 00:48:03.150
the rescue has a call the engine and the truck

00:48:03.150 --> 00:48:05.190
crew don't hear it and they stay asleep i think

00:48:05.190 --> 00:48:08.460
it's it's incredible But the problem is, is just

00:48:08.460 --> 00:48:10.739
exactly what you're talking about. The danger

00:48:10.739 --> 00:48:12.519
is that those crews will go to their individual

00:48:12.519 --> 00:48:15.800
rooms, you know, between calls and barely see

00:48:15.800 --> 00:48:18.139
each other. So I think there's definitely a happy

00:48:18.139 --> 00:48:21.039
medium. It makes perfect sense to protect the

00:48:21.039 --> 00:48:23.579
sleep that way. But I think now the leader in

00:48:23.579 --> 00:48:25.659
that station has to say, all right, you know,

00:48:25.679 --> 00:48:27.239
if you're going to go take a nap, that's fine.

00:48:27.320 --> 00:48:29.900
If you know at nighttime, that's fine. But you're

00:48:29.900 --> 00:48:31.079
going to call your family. You need a little

00:48:31.079 --> 00:48:32.760
quiet. That's fine. But the rest of the time,

00:48:32.840 --> 00:48:35.139
you need to be in these communal spaces so that

00:48:35.139 --> 00:48:39.280
we can. train, work out, eat together, etc. Well,

00:48:39.340 --> 00:48:40.800
particularly in your profession where you're

00:48:40.800 --> 00:48:46.420
so reliant on your colleagues for your safety

00:48:46.420 --> 00:48:48.420
and the safety of the job that you're doing.

00:48:48.539 --> 00:48:51.780
So yeah, I think that bonding is even more critical

00:48:51.780 --> 00:48:55.119
than the sorts of things that I do. Now, you

00:48:55.119 --> 00:48:57.840
worked with my father a long time ago, and I'm

00:48:57.840 --> 00:48:59.960
going to bring up his favorite subject, which

00:48:59.960 --> 00:49:04.199
is poo. He is mad about the gut biome. If I want

00:49:04.199 --> 00:49:06.079
an hour conversation with my dad, I just start

00:49:06.079 --> 00:49:09.730
talking about pooticles. But I think it's a really

00:49:09.730 --> 00:49:11.829
important conversation because, you know, the

00:49:11.829 --> 00:49:15.050
more we learn about, you know, the brain and

00:49:15.050 --> 00:49:17.090
gut health and the more, you know, it's more

00:49:17.090 --> 00:49:19.610
evident that there's a huge connection between

00:49:19.610 --> 00:49:23.329
the two. So we have certainly where I am sitting

00:49:23.329 --> 00:49:26.530
now, we have a population that sadly their nutrition

00:49:26.530 --> 00:49:29.570
is very poor. And then, you know, as we alluded

00:49:29.570 --> 00:49:31.449
to earlier, you've got sleep deprivation, you've

00:49:31.449 --> 00:49:33.750
got stress, et cetera. So, you know, what are

00:49:33.750 --> 00:49:37.639
some of the kind of breakthrough? thoughts about

00:49:37.639 --> 00:49:40.739
the importance of gut health when it comes to

00:49:40.739 --> 00:49:45.139
mental health. Yeah, I think originally when

00:49:45.139 --> 00:49:49.400
people started talking about the gut -brain axis

00:49:49.400 --> 00:49:52.380
and the role of bacteria, we thought, well, how?

00:49:52.659 --> 00:49:56.340
How can that work? And then, of course, depending

00:49:56.340 --> 00:49:58.679
upon the bacteria that you've got in the gut

00:49:58.679 --> 00:50:02.670
will depend upon your immune response. to those

00:50:02.670 --> 00:50:05.530
bacteria and we do know elements of the immune

00:50:05.530 --> 00:50:09.230
system can pass the blood -brain barrier and

00:50:09.230 --> 00:50:14.210
influence mood and behaviour. We also know that

00:50:14.210 --> 00:50:17.429
different bacteria can be very important in the

00:50:17.429 --> 00:50:23.010
synthesis of vitamin K, certainly vitamin B,

00:50:23.190 --> 00:50:27.630
and they can impact upon health. There's also

00:50:27.630 --> 00:50:30.269
evidence that the type of bacteria that you've

00:50:30.269 --> 00:50:33.510
got can influence your levels of of dopamine

00:50:33.510 --> 00:50:36.369
and serotonin you know really important neural

00:50:36.369 --> 00:50:41.329
hormones in in in mental health um and there

00:50:41.329 --> 00:50:44.130
was a paper published just very recently and

00:50:44.130 --> 00:50:47.449
i thought this is fabulous um and in fact i i've

00:50:47.449 --> 00:50:49.690
just been really rereading it again by it was

00:50:49.690 --> 00:50:54.619
in general psychiatry And we could send the reference

00:50:54.619 --> 00:50:57.579
to anybody who wants to read it. Because what

00:50:57.579 --> 00:50:59.960
this study had shown, I think, really very interestingly,

00:51:00.039 --> 00:51:03.559
is that there were eight different types of bacteria

00:51:03.559 --> 00:51:07.460
which were correlated with higher rates of insomnia.

00:51:07.659 --> 00:51:09.800
So the implication is that if you don't have

00:51:09.800 --> 00:51:13.519
the right gut biome and you've got a bunch of

00:51:13.519 --> 00:51:17.159
bacteria of this particular group, you're going

00:51:17.159 --> 00:51:19.110
to have... you're going to be predisposed to

00:51:19.110 --> 00:51:21.690
insomnia but in the same way which is so fascinating

00:51:21.690 --> 00:51:25.570
is that individuals with insomnia could very

00:51:25.570 --> 00:51:29.210
much influence the type of bacteria in their

00:51:29.210 --> 00:51:33.170
gut and so there does seem to be a real correlation

00:51:33.170 --> 00:51:37.170
between sleep disturbance insomnia and the type

00:51:37.170 --> 00:51:40.929
of bacteria that you have and the impact that

00:51:40.929 --> 00:51:44.469
you'll have on your gut bacteria so i think it's

00:51:44.469 --> 00:51:46.969
a i think it's a very exciting time mechanisms

00:51:46.969 --> 00:51:50.690
still we're teasing apart but i mean the thing

00:51:50.690 --> 00:51:54.000
that i suppose we were uneasy about when it first

00:51:54.000 --> 00:51:57.420
surfaced is that what's the evidence that these

00:51:57.420 --> 00:52:03.219
bacteria can actually interact with us and there

00:52:03.219 --> 00:52:05.579
were some studies showing that the surface proteins

00:52:05.579 --> 00:52:09.659
of some bacteria could interact with the receptors

00:52:09.659 --> 00:52:13.360
of our gut lining and could change their biology

00:52:13.360 --> 00:52:17.699
which I thought was absolutely fascinating and

00:52:17.699 --> 00:52:21.059
now we know which I think is An extraordinary

00:52:21.059 --> 00:52:24.699
colleague of mine, Martha Marrow, in Germany,

00:52:24.920 --> 00:52:27.539
in Munich, she's got some amazing data, and I

00:52:27.539 --> 00:52:30.579
got to see this just recently, of circadian rhythms

00:52:30.579 --> 00:52:33.739
in bacteria. I mean, you know, so even these

00:52:33.739 --> 00:52:36.139
creatures that we didn't think, you know, we

00:52:36.139 --> 00:52:37.880
thought, oh, yeah, sure, the photosynthetic ones,

00:52:37.980 --> 00:52:41.860
the green photosynthetic bacteria, but... what

00:52:41.860 --> 00:52:43.820
about the others well they seem to have they

00:52:43.820 --> 00:52:45.860
have clocks as well and and you can see them

00:52:45.860 --> 00:52:48.019
under certain circumstances so i think this is

00:52:48.019 --> 00:52:51.559
an immensely exciting area and and and so you

00:52:51.559 --> 00:52:54.519
know i think there were some studies that took

00:52:54.519 --> 00:52:59.059
immunodeficient mice who had oh no it was it

00:52:59.059 --> 00:53:02.320
was mice with who'd had depleted gut bacteria

00:53:02.320 --> 00:53:06.579
and they put um bacteria from humans who either

00:53:06.579 --> 00:53:09.980
had good sleep or bad sleep from their gut into

00:53:09.980 --> 00:53:12.559
the into the mice and you could replicate either

00:53:12.559 --> 00:53:15.320
good sleep or bad sleep depending upon in the

00:53:15.320 --> 00:53:18.320
mice depending upon the the the donor humans

00:53:18.320 --> 00:53:21.619
so there's something going on there really really

00:53:21.619 --> 00:53:24.570
interesting i mean Details are still emerging,

00:53:24.730 --> 00:53:29.289
but it's fascinating. I love it, actually. So

00:53:29.289 --> 00:53:32.869
I share that with you. Thank you. Thank you.

00:53:32.949 --> 00:53:37.710
Well, what about the other way, too? Before we

00:53:37.710 --> 00:53:41.110
hit record, I was talking about the book that

00:53:41.110 --> 00:53:44.429
I wrote, and that really put me almost to a point

00:53:44.429 --> 00:53:46.909
of burnout. And I think it was just the actual

00:53:46.909 --> 00:53:49.469
workload and the stress and then revisiting some

00:53:49.469 --> 00:53:51.750
of the things, going deep as far as the stories.

00:53:52.519 --> 00:53:56.940
But that really had a massive impact on my GI

00:53:56.940 --> 00:53:59.659
system, you know, and to the point where, you

00:53:59.659 --> 00:54:01.460
know, if I'm being completely transparent, if

00:54:01.460 --> 00:54:04.280
I had to go, I had to go, you know, certain times.

00:54:04.519 --> 00:54:07.019
So kind of flipping it around now, the gut health

00:54:07.019 --> 00:54:09.260
impact on the brain. But what about the other

00:54:09.260 --> 00:54:12.340
way around anxiety, stress, the impact on the

00:54:12.340 --> 00:54:16.460
gut itself? Oh, yeah. Well, absolutely. And the

00:54:16.460 --> 00:54:19.460
bacteria that live in that gut. So you're going

00:54:19.460 --> 00:54:25.159
to change, you know, gut mobility and the processing

00:54:25.159 --> 00:54:29.320
of your food, you know, increased gastric acid

00:54:29.320 --> 00:54:32.219
secretion and the knock -on consequences of that.

00:54:32.300 --> 00:54:36.440
So absolutely. I mean, it's a bit trite, but

00:54:36.440 --> 00:54:40.460
it really does require a holistic approach. And,

00:54:40.460 --> 00:54:43.829
you know, if you... Prod one thing, it's going

00:54:43.829 --> 00:54:48.829
to wobble through the system. And so we're now

00:54:48.829 --> 00:54:51.030
beginning to realize you can't take anything

00:54:51.030 --> 00:54:53.750
in isolation. And it's very interesting because,

00:54:53.869 --> 00:54:56.210
of course, how do we divide up our medicine?

00:54:57.889 --> 00:55:01.670
Intersectors. So you have coronary heart disease.

00:55:01.789 --> 00:55:05.309
You have psychiatry who don't often talk to the

00:55:05.309 --> 00:55:08.349
people in neurology. I mean, it's just extraordinary.

00:55:09.530 --> 00:55:11.550
things that we've been increasingly interested

00:55:11.550 --> 00:55:15.730
in is the whole concept of multi -morbidity which

00:55:15.730 --> 00:55:18.210
which of course if is if you have one condition

00:55:18.210 --> 00:55:21.570
let's say obesity type 2 diabetes you're almost

00:55:21.570 --> 00:55:24.389
certainly going to have coronary heart problems

00:55:24.389 --> 00:55:28.090
um and a whole bunch of and and possibly mental

00:55:28.090 --> 00:55:33.170
health issues as well and so we should stop siloing

00:55:33.170 --> 00:55:36.550
our treatments um and start to think about you

00:55:36.550 --> 00:55:41.119
know a much more cross sectional treatment to

00:55:41.119 --> 00:55:43.199
things like multimorbidity. One of the interesting

00:55:43.199 --> 00:55:45.860
things about that, what's the one thing that

00:55:45.860 --> 00:55:48.980
we know that can reduce multimorbidity other

00:55:48.980 --> 00:55:51.519
than major dietary change and all the rest of

00:55:51.519 --> 00:55:54.800
it? Well, it's sleep and circadian health. It's

00:55:54.800 --> 00:55:57.420
quite fascinating. A common cross -cutting theme

00:55:57.420 --> 00:56:01.960
across multimorbidity is good sleep and circadian

00:56:01.960 --> 00:56:07.170
health. Which opens up some exciting opportunities

00:56:07.170 --> 00:56:10.070
because it's an additional therapeutic option.

00:56:10.190 --> 00:56:17.869
If we can deliver good sleep, good circadian

00:56:17.869 --> 00:56:23.650
health, we can tackle a whole raft of different

00:56:23.650 --> 00:56:28.369
conditions. Well, this is why when I talk about

00:56:28.369 --> 00:56:30.389
the fire service, I always say we don't die of

00:56:30.389 --> 00:56:33.309
one thing, we die of everything. And this, I

00:56:33.309 --> 00:56:36.150
think, is underlining, obviously, the second

00:56:36.150 --> 00:56:39.150
conversation now, why this topic is so important,

00:56:39.269 --> 00:56:42.550
is whatever your weakest link is, is going to

00:56:42.550 --> 00:56:44.449
manifest. And actually, this is a good segue

00:56:44.449 --> 00:56:47.730
to the next area. One thing I've seen a high

00:56:47.730 --> 00:56:51.909
prevalence of in arguably very young firefighters

00:56:51.909 --> 00:56:54.349
is strokes. I know that's an area that you're

00:56:54.349 --> 00:56:58.010
working in now, but have you seen a correlation

00:56:58.010 --> 00:57:01.650
between sleep -deprived? groups and incidence

00:57:01.650 --> 00:57:06.210
of stroke well we we if we take the extreme situation

00:57:06.210 --> 00:57:10.510
of of night shift workers then coronary heart

00:57:10.510 --> 00:57:14.170
disease and stroke um uh is is much higher in

00:57:14.170 --> 00:57:17.389
that group um and again it goes back to our sort

00:57:17.389 --> 00:57:20.469
of analogy of of the orchestra you know if you

00:57:20.469 --> 00:57:22.789
think about our biology what it's they've been

00:57:22.789 --> 00:57:24.929
evolved to do is deliver the right stuff at the

00:57:24.929 --> 00:57:26.929
right concentration to the right tissues and

00:57:26.929 --> 00:57:29.030
organs at the right time of day and when you

00:57:29.030 --> 00:57:32.309
do that you have an efficient beautifully harmonious

00:57:32.309 --> 00:57:36.000
set of biology But if all the bits of the body

00:57:36.000 --> 00:57:37.639
are doing things at a slightly different time,

00:57:37.760 --> 00:57:40.760
you're going to cause huge metabolic and physiological

00:57:40.760 --> 00:57:44.139
stress. And those who are vulnerable to, let's

00:57:44.139 --> 00:57:46.780
say, coronary heart disease or stroke, they will

00:57:46.780 --> 00:57:51.659
be much more likely to have these conditions.

00:57:51.960 --> 00:57:54.739
So, yes, I mean, what we're doing in that space

00:57:54.739 --> 00:58:00.639
is using mouse models, is looking at when you

00:58:00.639 --> 00:58:05.329
have a stroke. What's the impact of time of day

00:58:05.329 --> 00:58:09.909
on the size of the stroke? And what's turning

00:58:09.909 --> 00:58:12.170
out to be fascinating is that there's a big time

00:58:12.170 --> 00:58:14.889
of day effect, and we think of circadian effect.

00:58:15.969 --> 00:58:18.530
And so why is that interesting? Because strokes

00:58:18.530 --> 00:58:21.929
happen when strokes happen. But if we know why...

00:58:23.009 --> 00:58:24.789
strokes are smaller at one time of day than the

00:58:24.789 --> 00:58:27.869
other, we can then say, well, what's the environment

00:58:27.869 --> 00:58:30.949
of the brain at that time? What's causing protection

00:58:30.949 --> 00:58:33.630
at one time and taking away that protection at

00:58:33.630 --> 00:58:37.889
another time? And we think it's early days, but

00:58:37.889 --> 00:58:42.059
it's... its antioxidant activity seems to be

00:58:42.059 --> 00:58:44.800
quite important in protecting you from the size

00:58:44.800 --> 00:58:47.519
of the stroke you'll get. If that turns out to

00:58:47.519 --> 00:58:50.840
be true, then whenever you have a stroke, you

00:58:50.840 --> 00:58:55.539
can go in, provide the brain with those agents,

00:58:55.880 --> 00:58:59.340
let's say antioxidants, which will reduce the

00:58:59.340 --> 00:59:04.099
size of the stroke. So I think that that offers,

00:59:04.199 --> 00:59:07.780
again, another good example of using circadian

00:59:07.780 --> 00:59:11.340
knowledge. to improve our therapeutic interventions,

00:59:11.579 --> 00:59:15.920
in this case, in stroke. I should go back. I

00:59:15.920 --> 00:59:17.519
think I may have flippantly said, you know, a

00:59:17.519 --> 00:59:20.840
stroke whenever it happens. Well, actually, the

00:59:20.840 --> 00:59:25.360
chances of having a stroke for most people, there's

00:59:25.360 --> 00:59:28.739
about a 50 % greater chance between 6 a .m. and

00:59:28.739 --> 00:59:33.820
12 noon. So there's a... German colleagues call

00:59:33.820 --> 00:59:40.019
it the... which is the death zone because they

00:59:40.019 --> 00:59:43.320
know very well what about this and it's due to

00:59:43.320 --> 00:59:49.400
several factors one is that plasma stickiness

00:59:49.400 --> 00:59:52.480
the platelets stick together there's a there's

00:59:52.480 --> 00:59:54.360
that early morning window when they are really

00:59:54.360 --> 00:59:58.969
quite sticky and also in anticipation of wake,

00:59:59.269 --> 01:00:02.610
you're increasing blood pressure to send oxygen

01:00:02.610 --> 01:00:05.670
and nutrients to a more active body. And the

01:00:05.670 --> 01:00:08.010
combination of a sharp rise in blood pressure

01:00:08.010 --> 01:00:13.849
and stronger blood viscosity can be a real problem

01:00:13.849 --> 01:00:18.590
for ischemic stroke. And when you then take your

01:00:18.590 --> 01:00:24.989
anticoagulants or your antihypertensives will

01:00:24.989 --> 01:00:28.170
matter enormously. And there's some evidence

01:00:28.170 --> 01:00:30.949
suggesting that in these long -acting drugs,

01:00:31.150 --> 01:00:34.130
if you take them before you go to bed, they're

01:00:34.130 --> 01:00:37.469
still at high enough concentrations to reduce

01:00:37.469 --> 01:00:41.590
that stickiness of the platelets and blunt that

01:00:41.590 --> 01:00:47.030
sharp rise in blood pressure. But if you take

01:00:47.030 --> 01:00:49.010
them in the morning, the time you've got up...

01:00:49.230 --> 01:00:51.969
The time you've remembered to take them and the

01:00:51.969 --> 01:00:53.809
time they've entered the body and have their

01:00:53.809 --> 01:00:57.289
effect, you're past that tosdona, you know, that

01:00:57.289 --> 01:01:00.789
death zone. And one study from Spain suggests

01:01:00.789 --> 01:01:04.110
that there's over, I think, about a six, seven

01:01:04.110 --> 01:01:08.599
year... maybe up to 10 years, that the chances

01:01:08.599 --> 01:01:16.539
of stroke were halved by taking your drugs before

01:01:16.539 --> 01:01:19.739
you went to bed, your antihypertensives, rather

01:01:19.739 --> 01:01:21.659
than taking them first thing in the morning,

01:01:21.739 --> 01:01:24.739
which I think is really interesting. So I don't

01:01:24.739 --> 01:01:27.500
know the extent to which your young colleagues,

01:01:27.639 --> 01:01:31.639
first of all, would be aware that they might

01:01:31.639 --> 01:01:34.679
have a problem. in terms of high blood pressure,

01:01:34.760 --> 01:01:37.159
because they're young and therefore they think

01:01:37.159 --> 01:01:39.519
they're immune to their invulnerable and probably

01:01:39.519 --> 01:01:42.199
wouldn't even have it checked out. And if they

01:01:42.199 --> 01:01:46.380
are on drugs to improve the chances of surviving

01:01:46.380 --> 01:01:48.679
or reducing a stroke, they may be taking the

01:01:48.679 --> 01:01:51.139
drugs at perhaps an inappropriate time. It's

01:01:51.139 --> 01:01:53.139
difficult, as we said, because, of course, everything

01:01:53.139 --> 01:01:57.440
is misaligned. So it's a problem. But I think

01:01:57.440 --> 01:02:00.780
awareness and certainly I think the point you

01:02:00.780 --> 01:02:03.659
made, which is. even young people are vulnerable

01:02:03.659 --> 01:02:06.260
to heart attacks and stroke, should be taken

01:02:06.260 --> 01:02:08.500
into consideration and there should be high frequency

01:02:08.500 --> 01:02:12.960
health checks in this group. And it's not difficult

01:02:12.960 --> 01:02:15.840
to do. And I don't know, I mean, what is the

01:02:15.840 --> 01:02:20.920
policy, James, about screening for high blood

01:02:20.920 --> 01:02:24.719
pressure and stroke vulnerability in that young

01:02:24.719 --> 01:02:28.659
sector? It depends department to department.

01:02:28.880 --> 01:02:32.159
Some have pretty good physicals and they'll do

01:02:32.159 --> 01:02:34.760
ultrasounds and solid blood work. But a lot of

01:02:34.760 --> 01:02:36.719
them, it's the bare minimum. There are recommendations

01:02:36.719 --> 01:02:41.239
by our governing bodies that, again, recommend

01:02:41.239 --> 01:02:44.480
doesn't mean anyone has to do it. And some of

01:02:44.480 --> 01:02:46.820
these are very, very poor. And unless you have

01:02:46.820 --> 01:02:48.920
some sort of hypertensive crisis, you may not

01:02:48.920 --> 01:02:51.550
even be on the radar. And what you were saying

01:02:51.550 --> 01:02:53.849
about, you know, waking up and then having to,

01:02:53.869 --> 01:02:57.630
you know, that spike in activity and perfusion,

01:02:57.650 --> 01:02:59.929
you think about the firefighter that's woken

01:02:59.929 --> 01:03:02.070
up at 2, 3 in the morning and literally goes

01:03:02.070 --> 01:03:05.550
from zero to extreme activity. And now they're

01:03:05.550 --> 01:03:07.250
dragging hoes or, you know, whatever they need

01:03:07.250 --> 01:03:10.730
to be doing. I can see how that viscosity along

01:03:10.730 --> 01:03:13.190
with that sudden spike, I mean, a huge, huge

01:03:13.190 --> 01:03:16.070
spike would contribute to some of the cardiac

01:03:16.070 --> 01:03:18.190
events and the stroke events that we see in our

01:03:18.190 --> 01:03:24.199
profession. Yeah. And so what about the concept

01:03:24.199 --> 01:03:27.659
of duty of care? Knowing that there is that potential

01:03:27.659 --> 01:03:32.099
vulnerability, why are not all young, why are

01:03:32.099 --> 01:03:35.780
not all firefighters checked for these things

01:03:35.780 --> 01:03:38.099
on a routine basis? Because after all, there

01:03:38.099 --> 01:03:41.480
is a moral duty of care, but also it opens up

01:03:41.480 --> 01:03:45.079
a service to litigation. You know, I mean, there's

01:03:45.079 --> 01:03:47.079
going to be enough. So hang on. You know, why

01:03:47.079 --> 01:03:50.239
did you not? You know, I am my occupation. It

01:03:50.239 --> 01:03:52.800
means that I'm much more vulnerable to that sort

01:03:52.800 --> 01:03:56.039
of incident. Why aren't you screening me for

01:03:56.039 --> 01:03:59.260
my my vulnerability to that? So I can imagine

01:03:59.260 --> 01:04:02.639
that the employers might be resistant, but also

01:04:02.639 --> 01:04:05.380
some employees might be resistant because they

01:04:05.380 --> 01:04:07.800
don't want to lose their job. I mean, what's

01:04:07.800 --> 01:04:12.130
how does that work out? What we've really seen

01:04:12.130 --> 01:04:14.469
is there's a complete resistance to the proactive

01:04:14.469 --> 01:04:17.750
approach. So for example, there will be like

01:04:17.750 --> 01:04:21.309
a heart and lung bill. So if I get cancer, then

01:04:21.309 --> 01:04:23.510
you can show this related to the profession,

01:04:23.670 --> 01:04:27.110
then you might get a $50 ,000 payout to your

01:04:27.110 --> 01:04:29.849
family when you die. I don't think that's a very...

01:04:30.030 --> 01:04:33.050
you know, positive way of doing it. So what we

01:04:33.050 --> 01:04:35.690
need to do as a profession is shift to the proactive

01:04:35.690 --> 01:04:37.329
approach. And one of the big things that you

01:04:37.329 --> 01:04:39.829
and I spoke about last time is this resistance

01:04:39.829 --> 01:04:43.210
to the very concept that the work week that we

01:04:43.210 --> 01:04:45.989
have at the moment is killing our people. And

01:04:45.989 --> 01:04:49.269
then since we spoke, the recruitment crisis just

01:04:49.269 --> 01:04:52.030
got worse. So as less and less people wanted

01:04:52.030 --> 01:04:54.030
to join the profession, the ones of the left.

01:04:54.639 --> 01:04:57.179
are working even longer now so a 56 hour week

01:04:57.179 --> 01:04:59.320
you know you get a phone call at 7 30 in the

01:04:59.320 --> 01:05:01.940
morning gearing you can't go home and now it's

01:05:01.940 --> 01:05:04.800
an 80 hour work week that week you know of you

01:05:04.800 --> 01:05:07.159
know like disrupted or no sleep four days of

01:05:07.159 --> 01:05:10.519
that week so until they acknowledge the elephants

01:05:10.519 --> 01:05:13.079
in the room the herd of them you know with that

01:05:13.079 --> 01:05:15.699
then you know i feel like that the other conversations

01:05:15.699 --> 01:05:19.190
are falling on even deaf ears but there is a

01:05:19.190 --> 01:05:22.030
revolution happening in florida where uh the

01:05:22.030 --> 01:05:24.690
last two years since we spoke i think we're up

01:05:24.690 --> 01:05:27.369
to nine fire departments now have made this shift

01:05:27.369 --> 01:05:30.510
and lo and behold when they fix that now this

01:05:30.510 --> 01:05:32.369
conversation of putting in fitness standards

01:05:32.369 --> 01:05:34.989
and annual screenings and so when you address

01:05:34.989 --> 01:05:38.230
that massive roadblock that is just you know

01:05:38.230 --> 01:05:41.469
in my opinion really being used as a tool of

01:05:41.469 --> 01:05:44.239
cowardice because If I just deny it, then I don't

01:05:44.239 --> 01:05:45.719
have to deal with it, you know, as a leader.

01:05:45.800 --> 01:05:48.239
So now that they are starting to deal with it,

01:05:48.260 --> 01:05:50.739
it's opening the door to all these other areas

01:05:50.739 --> 01:05:53.360
that they can improve simultaneously. So it's

01:05:53.360 --> 01:05:55.539
exciting to see these real leaders in the fire

01:05:55.539 --> 01:05:59.099
service kind of pushing that forward. That's

01:05:59.099 --> 01:06:01.599
really good. And of course, you know, we touched

01:06:01.599 --> 01:06:03.820
last time on the educational piece about people

01:06:03.820 --> 01:06:05.820
also need to take some responsibility and to

01:06:05.820 --> 01:06:08.559
be sensitive to what may be happening to them.

01:06:09.179 --> 01:06:11.300
But not just them, but the people they spend

01:06:11.300 --> 01:06:14.159
their lives with. So their partners and their

01:06:14.159 --> 01:06:17.659
families also need to know about some of the

01:06:17.659 --> 01:06:19.840
problems. And I think, again, we touched on last

01:06:19.840 --> 01:06:22.440
time. In some sectors, the divorce rate can be

01:06:22.440 --> 01:06:25.579
six times higher in the night shift compared

01:06:25.579 --> 01:06:27.380
to the day shift. Now, I don't know what the

01:06:27.380 --> 01:06:32.280
statistics are like in your area, but I suspect...

01:06:32.280 --> 01:06:37.860
Yeah. Yeah. And, of course, I think they're awful.

01:06:39.039 --> 01:06:41.380
i remember when we were talking about this sort

01:06:41.380 --> 01:06:44.260
of thing again going back to the mining area

01:06:44.260 --> 01:06:47.179
in in northwestern australia and we were saying

01:06:47.179 --> 01:06:49.400
these are all the things and you know the the

01:06:49.400 --> 01:06:52.460
impulsivity the lack of empathy and all the rest

01:06:52.460 --> 01:06:54.420
of it and this woman in the audience started

01:06:54.420 --> 01:06:57.780
crying and she said i've been so mean to my husband

01:06:57.780 --> 01:07:00.360
and you know accusing of all these things and

01:07:00.360 --> 01:07:03.780
i had no idea that this was the consequence of

01:07:03.780 --> 01:07:06.500
the job he's doing which is trying to put food

01:07:06.500 --> 01:07:09.559
on the table for us and and i think i think there's

01:07:09.559 --> 01:07:14.059
a very important educational piece for for for

01:07:14.059 --> 01:07:17.659
partners and families. It's a problem that is

01:07:17.659 --> 01:07:20.739
not just on the individual but it's the broader

01:07:20.739 --> 01:07:24.059
community in which they spend their time. Well,

01:07:24.079 --> 01:07:26.460
I mean, twofold. Firstly, when we are at the

01:07:26.460 --> 01:07:29.440
station, our partners are single parents for

01:07:29.440 --> 01:07:31.940
24 hours. If they're wildland firefighters, it

01:07:31.940 --> 01:07:33.659
might be, you know, a week, a couple of weeks.

01:07:33.960 --> 01:07:36.019
And so you do, you have this kind of shifted

01:07:36.019 --> 01:07:38.340
dynamic that way because we come home exhausted,

01:07:38.400 --> 01:07:40.199
but they've been, you know, taking care of the

01:07:40.199 --> 01:07:43.039
children and their own profession. And so, you

01:07:43.039 --> 01:07:44.860
know, you've got that kind of jarring interaction

01:07:44.860 --> 01:07:48.000
when we come back. Yeah, it's interesting. One

01:07:48.000 --> 01:07:51.320
of the people said, you know, when my partner

01:07:51.320 --> 01:07:54.760
comes back, I say, right, I've done my bit. Here's

01:07:54.760 --> 01:07:57.739
the child. You take over. And of course, they're

01:07:57.739 --> 01:08:01.739
exhausted. They can't do it. But it's that failure

01:08:01.739 --> 01:08:06.239
to appreciate the demands of the job. And again,

01:08:06.659 --> 01:08:09.059
there's an educational piece here that we must

01:08:09.059 --> 01:08:12.409
address. Well, even the ownership. I think this

01:08:12.409 --> 01:08:14.530
circles around to my question about critical

01:08:14.530 --> 01:08:17.289
thinking and fatigue is I have literally had

01:08:17.289 --> 01:08:21.029
people say, we don't want the 24 -72, the 42

01:08:21.029 --> 01:08:24.250
-hour workweek. We want the 48 -96, the 56 -hour

01:08:24.250 --> 01:08:28.289
workweek. Now, any person who's well -rested

01:08:28.289 --> 01:08:30.250
is going to look at that and go, that's ridiculous.

01:08:30.430 --> 01:08:32.329
The partners of these people are going to say,

01:08:32.369 --> 01:08:34.090
that's ridiculous. You don't want to come home.

01:08:34.409 --> 01:08:36.869
an extra day between your shifts. But this is

01:08:36.869 --> 01:08:38.590
where I think, you know, with the ownership piece,

01:08:38.670 --> 01:08:40.710
we struggle so much. I mean, we talked, I think

01:08:40.710 --> 01:08:42.529
we touched on it last time, as far as the impact

01:08:42.529 --> 01:08:44.930
of sleep deprivation on obesity and testosterone

01:08:44.930 --> 01:08:48.229
and all these other areas too. But when you have

01:08:48.229 --> 01:08:52.050
an underslept overstressed population, getting

01:08:52.050 --> 01:08:55.149
them to advocate for themselves is so hard because

01:08:55.149 --> 01:08:58.810
they cannot critically think. Yeah. Yeah, no,

01:08:58.909 --> 01:09:02.050
absolutely. Well, I want to hit one more area

01:09:02.050 --> 01:09:04.470
because I know we're getting close to time. Last

01:09:04.470 --> 01:09:06.670
time you and I spoke, you told some incredible

01:09:06.670 --> 01:09:09.369
stories about some of the blind veterans. And

01:09:09.369 --> 01:09:12.350
then you talked about developing a drug that

01:09:12.350 --> 01:09:15.470
can initiate the chronobiology when someone doesn't

01:09:15.470 --> 01:09:18.189
have the capacity to with the eye. So talk to

01:09:18.189 --> 01:09:20.729
me about where you are now. And then what are

01:09:20.729 --> 01:09:22.189
some of the hurdles that you're trying to overcome

01:09:22.189 --> 01:09:26.050
at the moment? Yeah, so it's been both exciting

01:09:26.050 --> 01:09:30.050
and disappointing. So on the basis of the preclinical

01:09:30.050 --> 01:09:34.630
work that we've done, the FDA said this is priority

01:09:34.630 --> 01:09:38.590
area and you've got orphan drug status, which

01:09:38.590 --> 01:09:42.489
is this is very exciting. And this could be used

01:09:42.489 --> 01:09:45.449
for non 24 hour individuals, individuals who

01:09:45.449 --> 01:09:48.229
cannot lock their internal clock onto the external

01:09:48.229 --> 01:09:52.689
light dark cycle. And we then went on and with

01:09:52.689 --> 01:09:55.630
our colleagues in Australia showed that the drug

01:09:55.630 --> 01:09:59.090
is safe. But we've now fallen into that classic

01:09:59.090 --> 01:10:01.869
sort of valley of death that you find for so

01:10:01.869 --> 01:10:06.390
many startups, which is we're too tiny for big

01:10:06.390 --> 01:10:10.390
pharma because we're asking for about $7 million,

01:10:10.729 --> 01:10:13.569
something like that. And they said, well, no,

01:10:13.649 --> 01:10:14.989
that's just not, you know, that's the kind of

01:10:14.989 --> 01:10:17.670
stuff you find down the back of your sofa. We're

01:10:17.670 --> 01:10:21.909
interested in the 50, 100, 300 million type stuff.

01:10:22.390 --> 01:10:26.560
But $7 million is too big. for small investors.

01:10:27.060 --> 01:10:32.220
So we're still in that valley. One very exciting

01:10:32.220 --> 01:10:34.699
piece of news, though, is that the Michael J.

01:10:34.760 --> 01:10:38.800
Fox Foundation, who are aware that sleep disruption

01:10:38.800 --> 01:10:42.199
is a big issue in Parkinson's, have asked us

01:10:42.199 --> 01:10:45.039
to see whether this drug might be useful in,

01:10:45.100 --> 01:10:47.039
again, these are preclinical, these are mouse

01:10:47.039 --> 01:10:49.659
studies, where there are mouse models of Parkinson's.

01:10:49.659 --> 01:10:53.199
Will it improve their rest activity and their

01:10:53.199 --> 01:10:58.020
sleep? wake so we're we're we're we are shuffling

01:10:58.020 --> 01:11:01.260
forward but you know it's so easy to do the human

01:11:01.260 --> 01:11:03.779
trial which is basically you keep people under

01:11:03.779 --> 01:11:06.840
dim constant light you give an injection of the

01:11:06.840 --> 01:11:09.359
drug at the same time every day do their rhythms

01:11:09.359 --> 01:11:12.479
lock on or don't they if they lock on just like

01:11:12.479 --> 01:11:16.000
mice and i'm i have every anticipation that they

01:11:16.000 --> 01:11:19.239
will um then we've we've we've actually given

01:11:19.239 --> 01:11:22.279
black back a sense of time to the time blind

01:11:22.960 --> 01:11:25.739
And as I think we said last time, I mean, so

01:11:25.739 --> 01:11:30.260
many people have lost their eyes. They say to

01:11:30.260 --> 01:11:33.600
me, look, I can cope with the blindness. It's

01:11:33.600 --> 01:11:36.920
awful, but I can find ways around it. What I

01:11:36.920 --> 01:11:41.300
can't cope with is my body constantly fooling

01:11:41.300 --> 01:11:43.880
me about what time of day it is and what I should

01:11:43.880 --> 01:11:46.739
be doing when. And so when I should feel hungry

01:11:46.739 --> 01:11:49.470
with my family, when I should... try and work.

01:11:49.569 --> 01:11:53.930
And I think that's what I want to do for the

01:11:53.930 --> 01:11:55.930
last part of my career, is give back a sense

01:11:55.930 --> 01:11:58.329
of time to the time blind. And as we probably

01:11:58.329 --> 01:12:00.970
also said, it's not just the profoundly blind,

01:12:01.130 --> 01:12:05.189
but our work on schizophrenia and other... mental

01:12:05.189 --> 01:12:09.229
health conditions and in neurodevelopmental conditions

01:12:09.229 --> 01:12:12.430
and in neurodiversity where sleep -wake timing

01:12:12.430 --> 01:12:16.689
is a major issue for the individual and the family

01:12:16.689 --> 01:12:19.069
or the people they spend their lives with. So

01:12:19.069 --> 01:12:21.590
I think there's enormous potential and some further

01:12:21.590 --> 01:12:26.930
work has also looked at another drug which Very

01:12:26.930 --> 01:12:29.729
exciting because it increases the amplitude of

01:12:29.729 --> 01:12:32.449
the circadian oscillation. As we age, for example,

01:12:32.569 --> 01:12:36.430
that begins to flatten out, which means that

01:12:36.430 --> 01:12:38.710
you don't have the same precision, which is why

01:12:38.710 --> 01:12:42.579
sleep is... less robust as we age. Why, for example,

01:12:42.619 --> 01:12:45.319
urine production, you know, the hormones underpinning

01:12:45.319 --> 01:12:48.439
urine production, you know, produce urine during

01:12:48.439 --> 01:12:51.300
the day, not at night, starts to flatten out.

01:12:52.060 --> 01:12:54.699
And therefore, you're going to be more disturbed

01:12:54.699 --> 01:12:58.979
by wanting to get up and pee at night. metabolic

01:12:58.979 --> 01:13:01.500
conditions there's also strong evidence there's

01:13:01.500 --> 01:13:05.699
a flattening out of of of metabolic dynamics

01:13:05.699 --> 01:13:10.760
and so for example we we were looking on mice

01:13:10.760 --> 01:13:14.220
fed on a high fat diet with fatty liver disease

01:13:14.859 --> 01:13:18.000
And under a normal diet, when you gave this drug,

01:13:18.100 --> 01:13:20.359
all it was doing was increase the amplitude of

01:13:20.359 --> 01:13:22.920
the circadian oscillation. You reduce the fatty

01:13:22.920 --> 01:13:26.680
liver by a huge amount. So, again, I think there

01:13:26.680 --> 01:13:29.119
are exciting things sort of in the pipeline.

01:13:30.600 --> 01:13:35.380
But the problem is we still are sort of regarded

01:13:35.380 --> 01:13:39.100
as a bit kind of peripheral. Circadian rhythms

01:13:39.100 --> 01:13:41.840
and sleep are not thought about as being central

01:13:41.840 --> 01:13:45.109
and one of the pillars of health. Which is why,

01:13:45.250 --> 01:13:48.529
and we were chatting about this before we started

01:13:48.529 --> 01:13:51.130
recording, there's going to be an initiative

01:13:51.130 --> 01:13:54.630
in Oxford for a centre for circadian health.

01:13:54.829 --> 01:13:57.930
We've got the Sleep and Circadian Neuroscience

01:13:57.930 --> 01:13:59.850
Institute, which is fundamental neuroscience

01:13:59.850 --> 01:14:03.390
and underpinning. Now we want to embed this knowledge

01:14:03.390 --> 01:14:05.869
across the health spectrum. We've talked about

01:14:05.869 --> 01:14:08.550
stroke, cardiovascular disease. I mean, there's

01:14:08.550 --> 01:14:11.989
metabolism, there's mental health, and we've

01:14:11.989 --> 01:14:15.779
got to get... practitioners in these areas utilizing

01:14:15.779 --> 01:14:19.439
this knowledge and also fundamental scientists

01:14:19.439 --> 01:14:21.340
working with our clinical colleagues developing

01:14:21.340 --> 01:14:24.800
new knowledge to to to to solve some of these

01:14:24.800 --> 01:14:28.739
problems so yeah it we shuffle forward um but

01:14:28.739 --> 01:14:31.500
i remain optimistic um and particularly i think

01:14:31.500 --> 01:14:34.000
with this new initiative if we can get a center

01:14:34.000 --> 01:14:36.340
for circadian health off the ground and it's

01:14:36.340 --> 01:14:38.760
and it will be based in oxford but we'll obviously

01:14:38.760 --> 01:14:41.159
have close connections with our colleagues in

01:14:41.159 --> 01:14:44.760
australia and japan um and and in germany where

01:14:44.760 --> 01:14:47.800
we already have active collaborations um i think

01:14:47.850 --> 01:14:51.229
we can probably do something exciting. Change

01:14:51.229 --> 01:14:54.609
some ideas, change some attitudes. And of course,

01:14:54.609 --> 01:15:01.609
shift work will be a key area. Yeah. This is,

01:15:01.609 --> 01:15:03.770
I guess, illustrating the fact that it's not

01:15:03.770 --> 01:15:06.689
just my profession, that even in your world,

01:15:06.710 --> 01:15:09.250
in the health world in general, that there's

01:15:09.250 --> 01:15:11.770
still this kind of poo -pooing of the importance

01:15:11.770 --> 01:15:15.229
of sleep. And I think this resistance I'm seeing,

01:15:15.329 --> 01:15:18.640
sadly, is because sleep is free. it's going to

01:15:18.640 --> 01:15:23.300
be hard to keep selling some of these drugs when

01:15:23.300 --> 01:15:25.319
you realize that, as you mentioned earlier, this

01:15:25.319 --> 01:15:28.220
holistic approach to exercise, to sleep, the

01:15:28.220 --> 01:15:31.560
nutrition truly is the answer to so many areas.

01:15:31.819 --> 01:15:33.699
But I know that we've talked about this. I think

01:15:33.699 --> 01:15:35.939
we hit it last time. Even the sleep disruption

01:15:35.939 --> 01:15:39.239
amplifying issues of autism and some of these

01:15:39.239 --> 01:15:42.039
other issues. If we can just get people back

01:15:42.039 --> 01:15:46.159
sleeping again from obesity to neurodiversity,

01:15:47.279 --> 01:15:51.140
massive impact would that have well i think neurodiversity

01:15:51.140 --> 01:15:53.199
is a very interesting area because there's since

01:15:53.199 --> 01:15:55.680
last we talked there is much greater interest

01:15:55.680 --> 01:15:58.979
in that in that whole area and and it's trying

01:15:58.979 --> 01:16:01.939
to understand well why is sleep so difficult

01:16:01.939 --> 01:16:05.840
in neurodivergent kids in particular and it's

01:16:05.840 --> 01:16:08.880
and it's trying to understand well it's It's

01:16:08.880 --> 01:16:10.979
a lack of understanding in some neurodivergent

01:16:10.979 --> 01:16:14.840
individuals of picking up the signals for transitioning

01:16:14.840 --> 01:16:17.260
from, well, now you should be awake and now you

01:16:17.260 --> 01:16:19.899
should be asleep. What are the signs? What are

01:16:19.899 --> 01:16:22.039
the things that they need to log on to, to know

01:16:22.039 --> 01:16:24.239
that this is what's going? And therefore structure

01:16:24.239 --> 01:16:27.020
becomes so very important in those kids. You

01:16:27.020 --> 01:16:29.340
know, now, and explain, this is what we're doing.

01:16:29.420 --> 01:16:32.420
You now put your night clothes on because, and

01:16:32.420 --> 01:16:35.939
it's just making it very, very structured. The

01:16:35.939 --> 01:16:38.729
other problem, of course, is that the... Sensory

01:16:38.729 --> 01:16:41.909
thresholds for some neurodivergent children are

01:16:41.909 --> 01:16:44.850
very different. So they're going to be much more

01:16:44.850 --> 01:16:48.489
alert and much more awake because of what's going

01:16:48.489 --> 01:16:50.890
on in their environment. And so again, minimizing

01:16:50.890 --> 01:16:55.350
noise, minimizing light, keeping stability. Practically,

01:16:55.369 --> 01:16:57.949
that's often very tricky in a normal domestic

01:16:57.949 --> 01:17:00.630
setting. But these are the things that people

01:17:00.630 --> 01:17:03.470
are now beginning to take seriously in trying

01:17:03.470 --> 01:17:07.710
to get the sleep for these individuals. Well,

01:17:07.729 --> 01:17:09.649
correct me if I'm wrong, isn't the drug that

01:17:09.649 --> 01:17:11.489
they usually prescribe, namphetamine as well,

01:17:11.529 --> 01:17:14.670
which I'm assuming would dysregulate sleep? Well,

01:17:14.810 --> 01:17:17.609
absolutely, yes. I mean, I think this is the

01:17:17.609 --> 01:17:20.890
problem because we've got so very few tools that

01:17:20.890 --> 01:17:24.670
will regulate sleep and circadian rhythms. We've

01:17:24.670 --> 01:17:30.149
got drugs that will sedate you, but that isn't

01:17:30.149 --> 01:17:34.609
the issue. We need to regulate those different

01:17:34.609 --> 01:17:38.250
systems, not sedate the individual. And that's

01:17:38.250 --> 01:17:40.869
that's the I think the exciting future. And I

01:17:40.869 --> 01:17:43.069
and I suspect, you know, when I'm long retired,

01:17:43.329 --> 01:17:47.329
it's going to be a conversation 20 years from

01:17:47.329 --> 01:17:50.149
now that, oh, yeah, it's extraordinary. You know,

01:17:50.149 --> 01:17:52.029
these have come on the market. We've just now

01:17:52.029 --> 01:17:56.590
transformed this space. And I and I don't I don't

01:17:56.590 --> 01:17:59.010
want to imply that a drug is the magic answer.

01:17:59.449 --> 01:18:02.109
I'm talking about where we can't use cognitive

01:18:02.109 --> 01:18:04.630
behavioral therapy and behavioral change, where

01:18:04.630 --> 01:18:07.100
behavioral change. isn't going to work as in

01:18:07.100 --> 01:18:10.619
the blind for example um then then drugs could

01:18:10.619 --> 01:18:12.899
be useful and and i wouldn't wouldn't propose

01:18:12.899 --> 01:18:15.399
that you know you use a drug to to mimic the

01:18:15.399 --> 01:18:17.260
effects of light on the clock and keep somebody

01:18:17.260 --> 01:18:21.000
on it you you get the situation stable and then

01:18:21.000 --> 01:18:23.960
you then you move to sort of behavioral change

01:18:23.960 --> 01:18:26.680
and the expo the regular exposure to light and

01:18:26.680 --> 01:18:29.720
things like that so i i and it there's one trend

01:18:29.720 --> 01:18:33.920
that's alarming me in the States, which is the

01:18:33.920 --> 01:18:39.640
use of melatonin gummies for kids. And first

01:18:39.640 --> 01:18:43.079
of all, the evidence that melatonin is, well,

01:18:43.119 --> 01:18:45.000
it's not, as we discussed last time, it's not

01:18:45.000 --> 01:18:48.739
a sleep hormone. It's a mild regulator. But I

01:18:48.739 --> 01:18:53.300
do feel uneasy that parents are just giving a

01:18:53.300 --> 01:18:57.039
gummy rather than using behavioral approaches.

01:18:57.760 --> 01:19:01.659
to allow the child to understand what they need

01:19:01.659 --> 01:19:04.600
to do to transition into sleep. Because, you

01:19:04.600 --> 01:19:07.880
know, even young kids know what's going on. And

01:19:07.880 --> 01:19:10.560
again, we go back to autism, but, you know, a

01:19:10.560 --> 01:19:13.060
structure. Now this is what you're doing and

01:19:13.060 --> 01:19:15.720
you're winding down. And certainly from my time

01:19:15.720 --> 01:19:20.039
in the States, I saw some parents who would put

01:19:20.039 --> 01:19:23.279
their kids in front of the telly and it was these

01:19:23.279 --> 01:19:28.409
really violent cartoons. And very, very lots

01:19:28.409 --> 01:19:30.590
of images, lots of bright and all the rest of

01:19:30.590 --> 01:19:33.810
it. And then expect them to go to sleep after

01:19:33.810 --> 01:19:38.550
that. It's it's where we go. We come full circle.

01:19:38.609 --> 01:19:41.949
Where have we stopped reading a gentle bedtime

01:19:41.949 --> 01:19:46.170
story to a child at the end of the day and have

01:19:46.170 --> 01:19:49.750
that bonding and that relaxation and the realization

01:19:49.750 --> 01:19:54.130
that now it's sleep time? And we seemed we've

01:19:54.130 --> 01:19:57.529
lost the. the childhood story, I think, in so

01:19:57.529 --> 01:19:59.510
many families. And of course, you can understand

01:19:59.510 --> 01:20:02.710
it because so many families are utterly pressure

01:20:02.710 --> 01:20:05.829
driven and exhausted at the end of the day. It's

01:20:05.829 --> 01:20:07.750
usually the mother or the father that falls asleep

01:20:07.750 --> 01:20:10.369
before the child if they do a bedtime story.

01:20:11.569 --> 01:20:13.329
Yeah, that's funny. Actually, I used to read

01:20:13.329 --> 01:20:16.189
my son, Dr. Seuss, that, oh, the places you'll

01:20:16.189 --> 01:20:19.369
go. And he just turned 18 a couple of days ago.

01:20:19.649 --> 01:20:22.130
And I put a little social media collage, but

01:20:22.130 --> 01:20:26.359
I found a song that had those words. You know,

01:20:26.359 --> 01:20:28.800
if I if I just stuck a tablet in front of him,

01:20:28.859 --> 01:20:30.779
I would have lost that quality time with him,

01:20:30.819 --> 01:20:32.960
that bonding, you know, and that's a chance for

01:20:32.960 --> 01:20:34.600
the child to kind of talk about their day and

01:20:34.600 --> 01:20:36.399
get anything off their mind before they then

01:20:36.399 --> 01:20:39.020
go to sleep. So I couldn't agree more. I mean,

01:20:39.060 --> 01:20:41.260
I think even if, you know, you are a very electronic

01:20:41.260 --> 01:20:44.600
based family, still carve out, you know, 10 minutes

01:20:44.600 --> 01:20:46.859
before the child goes to bed and just pick up

01:20:46.859 --> 01:20:50.060
a book. My mother used to sing a song to me,

01:20:50.140 --> 01:20:53.340
which is a little man, you've had a busy day.

01:20:54.090 --> 01:20:58.390
and i can still remember vaguely her singing

01:20:58.390 --> 01:21:00.770
this to me and i actually went online and i got

01:21:00.770 --> 01:21:03.949
the score to it and and and i read the words

01:21:03.949 --> 01:21:06.829
and and it all came flooding back because that's

01:21:06.829 --> 01:21:08.970
how we used to end the day you know a little

01:21:08.970 --> 01:21:11.270
man you've had a busy day it's wonderful absolutely

01:21:12.000 --> 01:21:14.239
Well, for people listening, your book is lifetime.

01:21:14.859 --> 01:21:17.239
I mean, so many things that we spoke about last

01:21:17.239 --> 01:21:20.220
time and this time are in here under understanding,

01:21:20.479 --> 01:21:22.680
you know, sleep biology in the first place and

01:21:22.680 --> 01:21:25.439
then shift work and the chronic effects and the

01:21:25.439 --> 01:21:28.000
acute effects and, you know, solutions, you know,

01:21:28.020 --> 01:21:31.100
sleep hygiene, so much in there. So for people

01:21:31.100 --> 01:21:32.920
listening, where are the best places to find

01:21:32.920 --> 01:21:34.720
the book? And then when are you anticipating

01:21:34.720 --> 01:21:38.680
the second one coming out? Well, so Lifetime,

01:21:38.760 --> 01:21:41.300
it should be available in all good bookstores.

01:21:41.300 --> 01:21:44.939
You can order it, of course, through online retailers

01:21:44.939 --> 01:21:50.319
like Amazon. And yeah, it's done well. It was

01:21:50.319 --> 01:21:52.539
a bestseller in the UK, both in paperback and

01:21:52.539 --> 01:21:56.710
hardback, which was really exciting. um the next

01:21:56.710 --> 01:22:01.130
book is on um we're still deciding on the title

01:22:01.130 --> 01:22:03.770
but it's all about light and a big chunk of it

01:22:03.770 --> 01:22:06.350
will be the impact of light on human health going

01:22:06.350 --> 01:22:10.470
through i mean i'm fascinated you know and i

01:22:10.470 --> 01:22:13.130
really the whole nature of the book started because

01:22:13.130 --> 01:22:15.670
um you know you sit around with a bunch of friends

01:22:15.670 --> 01:22:17.829
and say okay well tell me how light is generated

01:22:17.829 --> 01:22:21.489
in the sun and yeah this is a reasonably well

01:22:21.489 --> 01:22:23.729
educated group of people nobody could explain

01:22:23.729 --> 01:22:26.750
it So I thought, God, this is fundamental, you

01:22:26.750 --> 01:22:30.750
know. And so the book deals with vision, obviously,

01:22:31.010 --> 01:22:34.909
and how we detect light and process light. And

01:22:34.909 --> 01:22:37.210
to some extent, why we're different from other

01:22:37.210 --> 01:22:39.590
animals. So there'll be a comparative, you know,

01:22:39.609 --> 01:22:43.810
who are stuff. Then we'll have the vitamin D

01:22:43.810 --> 01:22:47.199
synthesis. which is, again, so interesting. You

01:22:47.199 --> 01:22:48.920
know, we all think vitamin D is made in the skin.

01:22:49.119 --> 01:22:52.539
No, the precursor is made in the skin because

01:22:52.539 --> 01:22:55.420
of UVB light, but then it has to go to the liver

01:22:55.420 --> 01:22:58.359
and then the kidney to produce the active form

01:22:58.359 --> 01:23:01.140
of vitamin D, which means if you have liver disease

01:23:01.140 --> 01:23:03.380
or kidney disease, you're going to be vitamin

01:23:03.380 --> 01:23:06.720
D deprived. And what's the latest science on

01:23:06.720 --> 01:23:10.159
the use of the role of vitamin D? And then, of

01:23:10.159 --> 01:23:13.409
course, skin cancer. Then colour psychology,

01:23:13.810 --> 01:23:16.010
which is, I think, really incredible. So the

01:23:16.010 --> 01:23:21.350
power of red. And so that will be photosynthesis.

01:23:21.550 --> 01:23:24.970
Why the production of oxygen by green plants

01:23:24.970 --> 01:23:28.250
essentially has allowed complex life to exist

01:23:28.250 --> 01:23:30.710
on the planet. And of course, if it weren't for

01:23:30.710 --> 01:23:36.470
ozone, which is a form of oxygen, we would be

01:23:36.470 --> 01:23:39.810
bombarded with high energy photons from the sun.

01:23:41.809 --> 01:23:45.810
killed we all get you know mutations um and and

01:23:45.810 --> 01:23:48.130
all the way through to to light and architecture

01:23:48.130 --> 01:23:51.010
so i wanted to try and bring all these topics

01:23:51.010 --> 01:23:53.729
with a central theme of human health together

01:23:53.729 --> 01:23:57.989
it'll be out assuming i can i think the plans

01:23:57.989 --> 01:24:01.130
are to try and get it out at the beginning of

01:24:01.130 --> 01:24:07.260
2027 so in about a year and a half's time So

01:24:07.260 --> 01:24:09.140
if I can peel my finger out and get the revisions

01:24:09.140 --> 01:24:12.579
done. Well, just super quickly, I know you've

01:24:12.579 --> 01:24:18.159
got to go. With skin cancer, I kind of try and

01:24:18.159 --> 01:24:19.880
revert my thinking back to what have we done

01:24:19.880 --> 01:24:23.199
most of the time as far as human history. And

01:24:23.199 --> 01:24:26.020
there's this culture now where if you step out

01:24:26.020 --> 01:24:27.800
the sun for five minutes and you're going to

01:24:27.800 --> 01:24:29.239
get sunburned, you're going to get skin cancer.

01:24:29.279 --> 01:24:31.340
So slather yourself in these chemicals before

01:24:31.340 --> 01:24:34.920
you walk out the door. What are you seeing very

01:24:34.920 --> 01:24:39.420
briefly between the connection of sensible skin

01:24:39.420 --> 01:24:41.680
exposure, because obviously your skin will tell

01:24:41.680 --> 01:24:45.000
you when it's had too much, and skin cancer specifically?

01:24:46.060 --> 01:24:48.760
It's tricky. And of course, this is what the

01:24:48.760 --> 01:24:51.039
Australians face is a huge dilemma because they

01:24:51.039 --> 01:24:52.800
have this slip -slap -slop, which is, you know,

01:24:52.800 --> 01:24:55.159
it's all about going out and covering up and

01:24:55.159 --> 01:24:59.369
putting... And that makes a lot of sense with

01:24:59.369 --> 01:25:02.310
that high, high levels of sun. You don't need

01:25:02.310 --> 01:25:04.850
to be out for long to get the vitamin D that

01:25:04.850 --> 01:25:10.029
you need. So it does pay to take, obviously,

01:25:10.050 --> 01:25:13.170
protection. And the number of skin cancers has

01:25:13.170 --> 01:25:17.529
gone up, even in places like the UK. That has,

01:25:17.729 --> 01:25:19.630
of course, been associated with increased use

01:25:19.630 --> 01:25:25.590
of sunbeds, which are largely unregulated. And

01:25:25.590 --> 01:25:29.270
certainly a survey by the European Commission

01:25:29.270 --> 01:25:33.399
fairly recently showed that most of the... or

01:25:33.399 --> 01:25:35.779
a big chunk of the sunbeds that were being used

01:25:35.779 --> 01:25:39.140
were actually producing dangerous levels of ultraviolet

01:25:39.140 --> 01:25:41.720
light. So, you know, you should never use a sunbed.

01:25:41.859 --> 01:25:45.420
And if you get out there, be careful. And there's

01:25:45.420 --> 01:25:47.340
also been a move saying, oh, there's too many

01:25:47.340 --> 01:25:49.439
skin checks for melanoma and all the rest of

01:25:49.439 --> 01:25:53.859
it. And I chatted, and there's a group of individuals

01:25:53.859 --> 01:25:56.840
proposing this. I spoke to the skincare people

01:25:56.840 --> 01:25:59.479
in Australia and elsewhere. They said, no, no,

01:25:59.520 --> 01:26:02.579
no. Don't ever think about not having regular

01:26:02.579 --> 01:26:07.119
skin checks because it will save your life. The

01:26:07.119 --> 01:26:10.260
other area, though, that is incredibly interesting

01:26:10.260 --> 01:26:14.579
is the development of myopia and short -sightedness.

01:26:14.979 --> 01:26:20.720
So in some Southeast Asian countries, in urban

01:26:20.720 --> 01:26:24.760
young, the level of myopia is greater than 95%.

01:26:25.239 --> 01:26:29.640
So these kids are having to wear corrective spectacles

01:26:29.640 --> 01:26:32.500
to get rid of the short sightedness. And there's

01:26:32.500 --> 01:26:35.640
now very interesting data showing that time outside

01:26:35.640 --> 01:26:40.739
is strongly correlated with the reduction in

01:26:40.739 --> 01:26:43.640
the chance of developing myopia. And we were

01:26:43.640 --> 01:26:45.819
saying earlier, right at the beginning, you know,

01:26:45.819 --> 01:26:48.579
we live in dim, dark caves. And that's the problem.

01:26:48.640 --> 01:26:51.039
You know, we're spending all of our time inside

01:26:51.039 --> 01:26:54.510
under. low levels of light. And it seems that

01:26:54.510 --> 01:26:57.869
that is a serious issue and a serious risk factor

01:26:57.869 --> 01:27:01.229
for the development of myopia. So anyway, the

01:27:01.229 --> 01:27:03.670
book is trying to pull all these fascinating,

01:27:03.750 --> 01:27:07.430
you know, this extraordinary giver of life, sunlight.

01:27:07.670 --> 01:27:11.649
I mean, it's made us what we are. And also, you

01:27:11.649 --> 01:27:14.189
know, allows us to sample our world through vision

01:27:14.189 --> 01:27:17.430
and change our... view of the world depending

01:27:17.430 --> 01:27:19.550
on what color we see i mean there's a there's

01:27:19.550 --> 01:27:21.949
a whole area of commercial the color psychology

01:27:21.949 --> 01:27:24.890
of why you buy certain objects because of the

01:27:24.890 --> 01:27:27.210
color and and so i've got i go through the you

01:27:27.210 --> 01:27:29.710
know the entire gambit and and i hadn't realized

01:27:29.710 --> 01:27:32.529
how difficult the book would be to write of course

01:27:32.529 --> 01:27:34.569
and there's lots of stuff on circadian rhythms

01:27:34.569 --> 01:27:37.729
and and uh and uh and seasonal rhythms actually

01:27:37.729 --> 01:27:42.069
yeah It's interesting you say about the myopia.

01:27:42.090 --> 01:27:44.350
My wife just became a doctor of optometry here.

01:27:44.470 --> 01:27:46.949
And that's what I've said to her is, you know,

01:27:46.970 --> 01:27:49.670
from thinking from an evolutionary point of view.

01:27:50.489 --> 01:27:53.430
why is it that so many of us need glasses so

01:27:53.430 --> 01:27:56.010
often because from a survival point of view you'd

01:27:56.010 --> 01:27:57.989
think that that wouldn't be the case and i'm

01:27:57.989 --> 01:27:59.850
and i get you know i was saying to her i guarantee

01:27:59.850 --> 01:28:01.489
you a lot of these modern things that we have

01:28:01.489 --> 01:28:03.850
now are making this worse and what you've just

01:28:03.850 --> 01:28:05.409
said makes perfect sense you know if we're not

01:28:05.409 --> 01:28:07.869
having that distal focus or distance focus excuse

01:28:07.869 --> 01:28:10.390
me over and over again and the exposure to light

01:28:10.390 --> 01:28:12.670
and we're looking at these devices you know a

01:28:12.670 --> 01:28:14.710
few inches from our face of course it's gonna

01:28:14.710 --> 01:28:17.310
even just from a muscular point of view optically

01:28:17.310 --> 01:28:19.970
it's going to change the way that you know the

01:28:19.970 --> 01:28:24.770
spectrum of use of that particular organ. Yeah,

01:28:24.909 --> 01:28:28.470
the precise mechanisms are not absolutely clear,

01:28:28.590 --> 01:28:32.369
but it looks like the role of light releasing

01:28:32.369 --> 01:28:35.670
dopamine within the eye, which is changing the

01:28:35.670 --> 01:28:39.670
architecture and the shape of the eye. So stop

01:28:39.670 --> 01:28:43.569
it elongating, which is causing myopia, and get

01:28:43.569 --> 01:28:48.250
it to sort of correct. But the precise mechanisms...

01:28:48.489 --> 01:28:50.369
remain unknown, which I think is extraordinary.

01:28:50.590 --> 01:28:52.550
When you think of the percentage of individuals

01:28:52.550 --> 01:28:55.829
that will need corrective sort of spectacles

01:28:55.829 --> 01:28:59.649
around the world because of myopia is in the

01:28:59.649 --> 01:29:03.329
billions. And the cost of that to the individual

01:29:03.329 --> 01:29:06.270
in the state will be huge. Yet we don't understand

01:29:06.270 --> 01:29:09.250
the mechanisms. Amazing. It really is. All right.

01:29:09.250 --> 01:29:11.270
Well, for people listening, if they want to learn

01:29:11.270 --> 01:29:13.350
more about your work, reach out to you. Where

01:29:13.350 --> 01:29:16.239
are the best places online? Yeah, the website,

01:29:16.500 --> 01:29:20.279
of course, most websites are a little bit out

01:29:20.279 --> 01:29:23.680
of date, but there's websites. But if you do

01:29:23.680 --> 01:29:25.979
a Google, then there's sort of various talks

01:29:25.979 --> 01:29:28.800
and things I've done that will be online and

01:29:28.800 --> 01:29:31.300
available. And of course, if you really need

01:29:31.300 --> 01:29:35.720
a question answered, then drop me an email. Brilliant.

01:29:35.720 --> 01:29:38.319
Well, I want to thank you so much again for being

01:29:38.319 --> 01:29:40.420
so generous with your time. I know you've got

01:29:40.420 --> 01:29:41.960
to go now, but it's been another fascinating

01:29:41.960 --> 01:29:44.699
conversation. So thank you for coming back onto

01:29:44.699 --> 01:29:48.260
the Behind the Shield podcast today. James, always

01:29:48.260 --> 01:29:50.100
my pleasure. Thank you so much for inviting me.

01:29:50.180 --> 01:29:51.880
And we'll hopefully catch up again soon.