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over again. Welcome to episode 356 of Behind
the Shield podcast. As always, my name is James
Gearing. And this week, it is my absolute honor
to welcome on the show. Dr. Rangan Chatterjee.
Dr. Chatterjee is a physician in the UK. He is
a podcaster, an author, and a TV celebrity. So,
so many angles and perspectives on the world
of wellness. So, we discuss a host of topics
from vitamin D, sunlight exposure, nutrition,
gut biome, the four pillars of health, the importance
of sleep, and so many other areas. Before we
go to interview, as I say, every single week,
please just take a moment, go to whichever app
you listen to this on, subscribe to the show,
leave feedback and leave a rating. Each five
star rating really does elevate this podcast
and make us more visible for people looking for
a project like this. And this is a free library
for you, the audience, whether individually,
whether within an organization. So all I ask
in return is that you pay it forward and help
share these incredible men and women's stories
so I can get them to every single person on planet
Earth that needs to hear them. So with that being
said, I introduce to you Dr. Rangan Chatterjee.
Enjoy. So Dr. Chastier, I just want to start
by saying thank you so much. I know we've been
trying to get this put together and I am extremely
excited about this conversation. So welcome to
the Behind the Shield podcast. James, it's my
absolute pleasure. And I just want to say that
I do get approached quite a lot for people to
come and talk and be on podcasts. But the way
you connected with me, the way you wrote your
message. really jumped out at me and I know it's
taken a while to make this work but I really
just want to say thank you because I think the
way we communicate with people It really makes
a difference to the outcome we get. And you were
very respectful, but you really wrote a thoughtful
message as well. So I just want to appreciate
you for that right at the start of this conversation.
Well, thank you so much. It's the first time
someone's going to comment it on the email. But
I think what made me so passionate about connecting
with you and basically everyone else on this
podcast is I see the mission that you're on.
And obviously your journey is through medicine,
but we definitely align as far as our philosophy.
I've seen the guests that you've had on and the
conversations you have with Johan Hari and Sabrina
Cohen -Hatton and Gabor Mate and people like
that. And I see that same mission, that prevention,
that philosophy that there are solutions to some
of these problems. So I'm very excited about
this conversation. Oh, fantastic. Me too. Right.
So very first question, where on planet Earth
are we finding you today? Okay, so I am in my
garden in South Manchester in my new podcast
studio, which has been built over lockdown and
is where I do my recordings from. So yeah, it's
a beautiful British summer's day. And yeah, I'm
delighted to spend it chatting to you. Fantastic.
Well, just as a side note, how was the last four
or five months for you specifically? Yeah, look.
You know, unquestionably, these are very unusual
times compared to what most of us are used to.
And I think, you know, I've had a variety of
different emotions, if I'm honest, at various
times. I think if I'm completely honest on a
personal level, the first few months of lockdown
were pretty special for me and my family. You've
got to be really sensitive with how you talk
about this, because I fully recognize that for
much of society, it was really difficult. You
know, job pressure, financial pressure, people
close to them maybe getting sick, a lot of frontline
workers, you know, really feeling pressure and
stress in their jobs. So I'm not being disrespectful
to that. I fully understand and appreciate that.
But on a personal level. I feel that it was great
to connect and have, you know, two or three meals
a day with my children, with my wife. The fact
that I wasn't traveling around, doing lots of
other things, which are all about health promotion.
But actually, I was in my own backyard, actually
spending more time with the people that meant
the world to me and still do mean the world to
me. So that was an incredible learning for me
personally. Professionally. You know, what I
saw with patients who I was seeing remotely was,
you know, a huge increase in anxiety and stress
and worry and depression. And, you know, that
was very hard because, as I'm sure many people
listening to this show, James, you know, are
trying to do, we're all trying to help people.
We're all trying to help society run more smoothly.
We're all trying to help people. with their well
-being. And I find it really hard to see how
a lot of people are really struggling from the
world outside them changing. And I think there's
quite an interesting philosophical point there,
because many of us are very reliant on the world
around us, our external environment. So we think
when that's okay, we'll be okay. But what I learned
or what I relearned personally and also what
I've been talking to a lot of my patients about
is you can't control the outside environment.
You know, the only constant in life is change.
And therefore, what we really want to do is try
and get good at dealing with change and try to
get good at managing and controlling what we
can control. Because if you go through life.
You know, allowing the external world to dictate
how you feel. And I will still do this. So I'm
not I'm not preaching about this as if I have
this all sorted. I just feel we've got to really
focus on what we can control rather than what
we can't control. And I couldn't agree more.
And it's a great perspective coming from yourself,
not only from a physician's element, but obviously
the platform that you have as well. And I think
that there's some people that have realized that
you were saying, even with the traveling, that
have commuted to an office and sat in a cubicle
and done exactly what they could have done in
their own home. So I think there's that efficiency
element that has... revolutionize some people's
lives in a positive way. But I think that there's
also a lot of people that realize how much they
missed human communication, that tribe, whether
it was a group in a gym that they went to or
their class at school. So what I'm hoping, I'm
sure we're probably going to expand on a lot
in this conversation. is that we have been given
a lot of lessons. We've been given lessons on
nutrition, on the farming practices and the ill
health maybe of the UK, of the US. Lessons on
mental health, lessons on the environment. And
I'm hoping that we're not going to be so distracted
by this virus itself that we miss the lessons
and go back to the way we did it before. Yeah,
I think that's a really key point, James. I think
the truth is, no matter... And what we had to
go through and what we are still going through
during lockdown, I think it's fair to say that
there's lessons to be learned for all of us,
right? Of course, we all have had different pressures
depending on where you live, whether you had
a garden or a backyard or whether you didn't.
You know, of course, your experience of lockdown
is going to be very different if you've got a
lot of living space and a garden. You know what?
And the weather's good, as it was in the UK for
the first two months of lockdown. Your experience
is going to be very different from someone in
a studio apartment in the centre of London or
in the centre of New York where you have no space
to get outside. Right. So your experience is
going to be very different. But I think no matter
what your experience is. We can all still learn
something. What did we like? What did we not
like? What can we change going forward? And what
you mentioned about us missing our tribes, I
really think that's been playing out throughout
lockdown. I've got a good friend who is probably
a bit of a loner, likes being by themselves,
doesn't really get out and connect with that
many tribes. but interestingly would often go
and sit in coffee shops and do some work. And
she said to me, you know what, I thought I was
a loner, but she's just missing being in a coffee
shop, maybe not chatting to anyone, but just
knowing there's other humans around her. And
I found that really insightful to hear that,
that wow, even if you're a loner. you still want
some human connection, even if it's just a background
noise around you that there's other humans around.
So I think that's super interesting. I'll tell
you one thing, James, that I've been thinking
about a lot, but it was really highlighted this
week. I'm very concerned with the negatives of
lockdown. So, of course, a lot of people are
making the case for lockdown. And, you know,
there's opinions on both sides of that, whether
it was the right move, whether it is the right
move or not. But let's be really clear. There
is going to be a significant consequence of all
these lockdowns. People are going to be more
isolated. I know suicide rates are going up.
Mental health problems are going up. And these
can be harder to quantify in the same way as
that. as a daily death rate from COVID. You know,
that's something immediate and something we can
see and measure. But it's very hard to measure
in the same way those kind of longer term consequences.
And that does concern me. And actually, this
week in the UK, or last week, actually, James,
swimming pools had opened up. So indoor swimming
pools had opened up with various social distancing
measures. And I've only been once and I booked
my slots. And I went. And on the way out, I spoke
to the receptionist behind the screen. And he
said, hey, look, Doc, can you just tell me what's
your take of what's going on? So I had a little
chat with him about what I felt, about some of
the things I'm talking about now. And I said,
what have you found? And he said to me, he said,
I've been working in this leisure center for
20 years. And I'm really worried. I said, why?
He said, I'm seeing people come in now. particularly
people above the age of 55 or 60. They're like
different people. They're withdrawn. They're
very scared. They're fearful. They're not talking
as much. And I found that so interesting, James,
that this is someone who has worked in a sports
facility, a local community leisure facility
where there's football, indoor football or indoor
soccer courts. swimming pools, there's martial
arts classes, there's a gymnasium. And he's just
saying people are different. And I think this
is a story that's not getting amplified enough
in the media, in the press, that actually human
beings are social animals. We've always been
social animals. And we've got to be careful that
there is going to be a consequence that already
is a consequence. of keeping people locked up
and not allowing them to interact. So I know
this is a very political point and I don't want
to make it too political, but I just want to
say as a doctor, I'm concerned about some of
those negative impacts that we're likely, not
likely, that I think we will see of lockdown.
Yeah, well, it's a shame, because people do refer
to it as political. And in my opinion, it's not,
you know, there's two sides that are screaming
each other, we're perfectly aware of them, they
make themselves very known. But then there's
the middle ground of normal people that are in,
especially in the wellness space, that are, you
know, looking at this saying, well, you know,
you keep ignoring the underlying issues. That's
something we could have been addressing now for
five months, the obesity epidemic, you know,
diabetes, mental ill health. And even with the
I'll use the word fear mongering. It's definitely
been that in the US. To me, as someone who's
been in the wellness space now for several decades,
I'm looking at this and look through the lens
of, well, if we want to give people the best
chance of surviving this, we need to maximize
their resilience. And by pumping this fear, I'm
not talking about selfishly, you know, not wearing
masks and breathing over people, but... creating
such a focus on the fear element i think that
we're making people more susceptible to to getting
ill yeah a lot of people don't realize that look
what are we talking about here we're talking
about our immune system right so to fight anything
that we're exposed to we want a well -functioning
immune system and there are many ways to support
good immune system health okay so One of them,
well, one thing that does not support good immune
system health is stress and fear. We know that
stress and fear suppress the ability of our immune
system to adequately respond and react to perceived
threats. There were multiple studies showing
that people exposed to the same virus, let's
say the same rhinovirus or what's often called
the common cold virus. Right. Depending on their
state of stress, depending on how much sleep
they've had, it completely changes how likely
they are to get symptoms. So, you know, no study
that I know of has been done yet on that with
respect to the novel coronavirus that has shut
the world down this year. But we can apply some
common sense principles. If our immune system
works better, whatever threat we face, whether
it's this virus or another virus. we are going
to be able to better mount an effective immune
response if our immune system is working better.
So what are those things? Well, I've spoken about
four pillars of health before. That's basically
what my first book was about. Let's go through
them. Sleep. We know sleep directly impacts the
immune system. So, for example, if you are sleeping
seven to eight hours sleep per night, as opposed
to five hours per night. The activity of a type
of cell called natural killer cells can be as
much as 50 % reduced if you're only having five
hours sleep. Well, let's just think about that.
What are natural killer cells? Natural killer
cells are part of your body's what's called your
innate immune system, right? They're part of
the immune system you're born with. And what
do natural killer cells do? They help fight off
infections. They do other things as well, but
they help fight off viruses. If you can improve
your sleep, let's say from five hours to seven
hours, the amount of natural killer cells you
have going around your body may increase, may
double, right? And we don't need a scientific
trial to tell us, well, that's clearly going
to be beneficial for whatever threats, whatever
infection you're going to face. we can focus
on sleep. Stress, as I've just mentioned, when
you're highly stressed, you suppress immune system
activity. And therefore, stress may well make
you more susceptible to actually getting infected
or coming down with complications. Third pillar,
movement, right? We know that physical activity,
particularly if it's sort of moderate, can really,
really help. balance the immune system, and have
more effective immune system function. Same goes
for food, the fourth pillar. But I mean, they
aren't necessarily the order in which I sort
of write about them. But if people just think
about food, movement, sleep, and stress, like
these four key pillars of health that we actually
have, you know, what I love about these four
pillars, not only do they have a huge impact
on how we feel, what our health is, how our immune
system functions. There are also things that
a lot of us have quite a high degree of control
over, right? So I like focusing on things that
people can do. So for example, air pollution,
yes, is causing a lot of health problems in society,
but there's not that much many of us can do about
it. Sure, we can change. The car we drive, we
can cycle more, we can not contribute to it.
But by and large, we can't do that much about
air pollution. So I prefer to focus with people
on things they can do. And I would ask everyone
listening to this right now to ask themselves,
on those four pillars, food, movement, sleep,
and stress, which of those pillars do they feel
they need the most work in? And I would simply
start by changing one small thing in that pillar.
And what we often do, James, is we go to our
favorite area. So let's say, you know, we're
really into our diet and our diet's already pretty
good, but we're only sleeping five hours a night.
We often will try and make our diet 5 % even
better and go, oh, you know what? I can make
my diet a little bit even better than this. But
we're actually much better off. making our weak
areas a little bit better than making our strong
areas a little bit stronger. And I think that's
a key message I want people to take from this.
What is your blind spot? For me, James, it's
stress. You know, honestly, my foods, my movements
is pretty good because I've been working on it
for years. So I built up some good practices
and some good habits. My sleep is not too bad.
But, you know, honestly, for me, I'm going to
get the most bang for my buck. by spending five
or 10 minutes a day just trying to manage my
stress. And I'd ask everyone listening to figure
out what is that pillar for them that they could
start making small changes in. And it's such
a powerful... topic that you hit, and you talked
about sleep first. So a lot of the people listening
to this, whether they're in the US, the UK, wherever
they are around the world are shift workers.
So whether it's a firefighter, whether it's,
you know, a member of the military or someone
in the ER. And when COVID first came about, And
I've been talking about this for four years now.
It's one of the underlying issues, I think, behind
the physical disease that kills our men and women
and the mental disease that kills our men and
women. But the people that the world leaned into,
the frontline personnel, to me, the way a lot
of their work weeks look, whether it's a junior
doctor in the NHS or whether it's a firefighter
in the US, those are some of the most overworked,
sleep deprived men and women that we have. Again,
lessons learned from this. We've seen, sadly,
a lot of doctors, nurses, firefighters, police
officers, medics pass away during COVID. And
I hope that we can reframe not only my professions,
but obviously the civilian population, but understand
how important that pillar, sleep, is to every
other element of your health. Yeah, absolutely.
I really appreciate you bringing that up, James.
And it's great to hear that you've been talking
about this for a number of years now, as many
people who are trying to help promote health
have. It's tricky because... You know, if you
are working shifts, your circadian rhythm, which
is your body's natural daily rhythm that helps
get you up in the morning and helps you wind
down before hopefully you fall into a deep, relaxing
sleep every night, that gets affected by shift
work. And it's really a very sad thing in society
that some of the professions that look after
us the most in our time of need, whether it's
firefighters, healthcare workers. Even people
doing security in offices or in hospitals or
wherever. You know, these are the guys and women
whose circadian rhythms and whose sleep quality
are probably being affected the most. And they're
doing some of the most important roles in society.
And I think that's something we should really
be acknowledging, that actually a lot of people
in these professions are literally... are going
beyond the call of duty to help society as a
whole. And I think we should be very grateful
and thankful for all the work they are doing.
I'm very proud to be in the medical profession.
And I think most people who are doing something
in one of these professions are very proud of
the work they do, even though it often comes
at a personal cost. And I think that is sad.
But I would also say. that although these things
make shift, make it challenging, make it more
challenging to sleep well and get into a routine,
it's not impossible. And I always try and leave
things optimistically with people. There are
things that people can do once you turn your
attention to the fact that I'm going to start
prioritizing this. And I think with something
like sleep, for example, James, I would say whether
you're a shift worker or not. One of the big
problems is that we don't prioritize it. So even
if a patient of mine or someone listening to
my podcast or whoever it is I'm communicating
with, once they even start to prioritize sleep,
often that makes a big difference. In the same
way that they might change their diet in January,
it's kind of like, oh, I'm going to change my
sleep diet now. I'm going to actually... work
on my sleep. And it's amazing with sleep how
simple little things can make a very big difference.
Yeah, absolutely. And I think that's an area
that I think everyone needs to understand. And
if you get the individual to understand the sleep
hygiene element, you know, what you can do, as
you said, whether it's temperature, whether it's
ambient light, whether it's your routine prior
to going to bed. and then see the benefits then
as an employer understanding well maybe we need
to change the way you know the work week for
example if we're getting people that are out
in the streets all night every night maybe they
need a little extra time to recover to catch
up on their sleep so i think whether it's the
employee or the employer i think sleep education
is important for all of us for for overall wellness
yeah i think that's a great point and It's amazing
how a lot of us in the wellness space forget
that when we've been talking about this for a
long time, a lot of people, I think, make the
understandable mistake that everyone already
knows it now. But they don't. I'm sure you get
it all the time, whether you're posting on Instagram
or on your podcast. The same tips often that
you might have said before, someone will hear
and go, I had no idea. I tried that, James, and
it improved my sleep. I never get tired of talking
about this stuff because there's always going
to be somebody out there who's hearing it for
the first time or somebody who's heard it five
times already and either hasn't made the change
or weren't ready to make the change. Like it's
not a one hit wonder. It's not that you, for
everyone, it's not that you just hear it and
go, oh, is that all I have to do? Okay, great.
I'm going to now sleep perfectly every night.
No, actually real life often gets in the way
and we often need, myself included, need to.
hear or remind ourselves of the same messages
over and over again. Or it may be that you had
this sorted and lit before COVID hit. And then
maybe your life changed overnight and stress
levels went up. Or maybe there was stress in
your family. Or maybe you were trying to juggle
your work and homeschool your kids. So, you know,
life never stays static. Of course, we've seen
that to a very extreme degree in the last few
months. But the principle is always the same,
James. Life is never static. It's never the same.
And actually, the podcast I've just released
yesterday was with someone called Julia Samuel,
and it's on change. Actually, you should really
talk to her. I think she's a wonderful, she's
one of the UK's leading psychotherapists. And
we really explored this whole idea that change
and death are the only two inevitables in life,
right? Change is going to happen. And so... We
never get to a perfect state of health and well
-being. I've made this mistake in my life where
I think, oh, I've got this sorted now. I've got
these four pillars working. Well, you know what?
Life doesn't stay static. Something will change.
A work pressure will change. There'll be maybe
pressures from your children or one of them is
not doing so well at school or an elderly relative
doesn't do so well. Like this is what happened
to me at the start of lockdown, right? I remember
that my mum. who lives nearby to me, who lives
by herself since my dad died seven years ago,
she had a fall. And I remember going around,
it took a few hours to sort of pick her up. And
it was just incredibly stressful because people
wanted to get her into hospital. And I did not
want her to go into hospital because, you know,
COVID had literally just hit in a big way a week
or two ago. So everyone was still trying to understand
what it meant. You know, what we were hearing
on the news, certainly me as a doctor, what the
chief medical officer was saying. And I was like,
I really don't want my mum going to hospital
at the moment. So I went and slept on her floor
in a bedroom for maybe three to five days just
to make sure I was around, that she was OK. And
of course, my sleep went down. My stress went
through the roof, even though I knew. all the
things I should do you know I've written three
books on this stuff right I know with my rational
brain what I should be doing but at that time
there was so much stress in my life that I wasn't
able to apply them all and therefore I was tired
I was stressed I was a bit more reactive that's
okay we don't need to beat ourselves up about
that that was like okay cool I'm going through
a stressful time this is the way it is at the
moment I'll do what I can but as soon as life
starts to calm down again I'll try and make a
few small tweets to get back on track. And, you
know, I think it's just important that we don't
beat ourselves up and we're kind to ourselves
and go, you know, if you're listening to this
show and you are a military responder or a hospital
responder and you've had to deal with pressures
and stress and grief and work pressures and home
pressures, and you know what? Your sleep has
gone off and your stress has gone up a bit. That's
okay. Right. We're all human. That's OK. But
maybe as we go through this conversation, hopefully
you might hear a couple of things that you think,
hey, you know what? I reckon I could apply that.
I reckon I might be able to start doing that.
And it's these small changes can really, really
make big changes. I just really want people to
to be kind to themselves and not beat themselves
up too much. Brilliant. No, I love that. I really
want to explore the kind of preventative holistic
element of your philosophy. So you mentioned
your mom and dad. So going now to your early
life, I'd love to kind of hear the journey that
you took into medicine. So where were you actually
born? And then tell me about your family dynamic,
what your parents did and how many siblings.
Yeah. Okay, James. So my dad was born in India.
And he was an Indian immigrant to the UK in 1962.
So in the 1960s, the UK government had a shortage
of doctors and they actively recruited doctors
from the Indian subcontinent. And my dad was
one of the many doctors who came over. He absolutely
came over for better opportunity and a desire
to build a better life for him, his children
and his wider family. So dad came out. in the
early 1960s. My mum came in the sort of early
1970s. And so I was born in the centre of Manchester
in the north of England in the late 70s, right?
So I was born and brought up in the UK. I've
got one older brother. He's three years older
than me. And, you know, it's interesting. You
know, I'm a father of two young kids, a 10 -year
-old boy, a seven -year -old girl. And what I've
really seen, James, as a father, and also I filmed
quite a few BBC documentaries where I go around
the country and spend a lot of time with families
to see if I can help them improve their health.
And I've really become acutely aware that for
children, what you get exposed to often determines
what you think is possible. And, you know, the
truth is, my dad, all his friends, were doctors.
So as a kid, any social gathering to do with
the family, I was surrounded by doctors. And
you know what? In that group, any of the kids
older than me, at least one person in each family
would end up becoming a doctor or going to medical
school. So if I'm honest, that was my norm, James,
growing up. I was just surrounded by doctors
and kids going to medical school. So a lot of
people... A lot of people think in society, oh,
you know, wow, you got into med school. And,
you know, I'm not sort of downplaying that. But
I'll be honest. And I say I had an advantage
because that was my norm. So I just didn't think
it was anything special or anything abnormal
to apply and get into med school because that's
all I saw around me. Now, that doesn't mean I
didn't want to be a doctor. I've often spoken
to my mother about this. And she said, you always
had this caring side, like you always. very good
at empathizing and nurturing people and caring
for people. I think that's what led me into medicine.
But I think even within medicine, I think I was
dissatisfied for a number of years without even
realizing it. I started off, I went to Edinburgh
Medical School. I did an immunology degree also
while I was up there. So I finished with a medical
degree and an immunology degree. I thought I
was going to work in hospital. So I did all my
specialist training and exams. I was going to
specialize in kidney medicine. But something
just didn't sit with me, James, if I'm honest.
Something just didn't feel right. I was always
interested in people. I was always interested
in how different parts of the body are linked.
And I thought, I don't really want to spend the
rest of my career just focusing on one area.
I want to see everything. I want to see every
person. I want to see different walks of life.
I want to see every organ system. So I took the
step to move from that to general practice. And
my dad, I must be honest, he was very surprised
and confused as to why I would have done all
those specialist exams or certainly the first
batch of them and then actually leave to do general
practice. I remember a few maybe heated conversations
with my father over that. But I did, and I loved
general practice because I got to see everything.
I got to see all kinds of symptoms. But a few
years in, James, I was, again, feeling dissatisfied.
At the end of one day, I looked at my list of
patients, and I saw close to 50 patients that
day. And I went down the list, and I said, Rangan,
how many people have you really helped today?
and honestly I thought I've helped about 20 %
of my patients that really helped them the other
80 % sure I've done something I've listened attentively
which I think is very powerful for people in
general I might have sent them for tests I might
have given them a pill to suppress their symptoms
but by and large I felt I was just putting a
sticking plaster on their problems and not really
either understanding myself or helping them understand
how to really get on top of what was going on
And that dissatisfaction, along with a personal
experience with my son, I don't know if you've
read the story on my son or not, but, I mean,
you know, well, my son's 10 now. When he was
six months old, my wife and I were on holiday
in France. And, you know, essentially he had
a convulsion. He stopped moving. We took him
to the ER. The doctors were super worried. He
got transferred down the valley to a different
hospital. We thought we might lose him. And it
turned out that he had what's called a hypocalcemic
convulsion. So he had very low levels of calcium
in his blood that was secondary to a vitamin
D deficiency. So he had no vitamin D in his body.
And as a consequence, his calcium dropped, which
ended up in him having a convulsion. That was
a very scary time. And modern medicine saved
his life for sure. But what was really interesting
is once everything had returned to normal with
its levels, it was just like, okay, you can go
now. And I said, okay, but what about the implications
of that? And there was nothing. It was like,
oh, well, we fixed all the levels now. And I
was thinking, well, could this be if vitamin
D is important for the immune system, And my
son's got bad eczema. Could it be that this in
some way has contributed to that? And nobody
had any answers. And I thought, James, not only
did I think, how has this happened? I felt a
lot of guilt because at that time, you know,
I was looking externally. I'd gone to one of
Europe's most prestigious medical schools. I'd
done specialist exams. I had an immunology degree.
Yet I wasn't able to prevent my own son. from
nearly dying, from something completely preventable.
And I, rightly or wrongly, but clearly wrongly,
but I felt a lot of guilt. I thought, how have
I let this happen? And I made a vow to myself,
and I've not told this story in a long time,
it's actually bringing up a lot of emotions,
but I made a vow to myself, James, that I'm going
to get my son back to full fitness and full health
as if this had never happened. And I started
reading and researching. I started to look up
vitamin D. Why do the immune system, the gut
microbiome? I started to travel the world. I
went to go on various courses to learn from experts
in various areas. And as I learned more, I started
to apply those principles with my son. He was
getting better and thriving. Apply the same principles
with myself, my wife, my daughter, my wider family.
And then also the same principles with my patients.
And I realized that actually a lot of my, you
know, I was getting people better in a way that
I never had managed to before. I was prescribing
a lot less medication than I'd ever needed to
before. And a lot of it came down to lifestyle.
And I thought, well, why as a doctor, do I not
know any of this stuff? Why was I not taught
any of this stuff? But once you know something,
you can't unknow it, right? You can't just pretend
you don't know it and go back to the way you
used to do things. So really, my son nearly dying
was a hugely transformative experience for me
personally, in my own life, but also professionally.
has changed the course of my entire career. I
don't think I'd be writing books, doing podcasts,
making TV shows if that hadn't happened. Of course,
I may have done, but I don't think I would have
done. So it's literally been life -changing.
I think the fact that I thought I was only helping
20 % of my patients was also significant. And
I think the other piece is that when I was at
medical school, my dad, who was a consultant
physician here in the UK, He suddenly got unwell
and, you know, ultimately what happened, he had
to retire suddenly from work. He got diagnosed
with lupus, which is an autoimmune condition.
He had really bad kidney failure and he was on
dialysis for 15 years. So I cared for dads. I
moved back to where I grew up. I was in Edinburgh,
but I moved back to South Manchester to help
my mother and my brother care for my dad until
dad died seven years ago. I think all those sort
of three things have hugely influenced me as
a person, has hugely affected the way I practice
medicine. I think, you know, I'm sure many people
listening have been carers or are carers. And
I think when you've been on the other side and
you've seen what it's like caring for someone
day in, day out, seven days a week, 365 days
a year, and you've been waiting in hospitals,
worried, scared. not getting answers. You see
things in a very different way. And I would like
to think that those experiences have made me
a much more compassionate and empathetic doctor.
Well, firstly, thank you so much for telling
the story. I didn't mean to pull emotion out
of you, but I think that's the main reason why
I started this too. I buried five, excuse me,
buried six firefighters over two years. And like
yourself, That was kind of my moment to look
back and have just a whole bunch of aha moments.
I think of myself as a paramedic. And here in
America, we're firefighters and EMTs or medics
as well. And all of the cardiac arrest patients
that we lost that were our age and, you know,
the wife or the husband hands you a big, big
bag of medication. Which in the doctor's office,
I'm sure his blood pressure was 120 over 80.
I'm sure his blood sugar was 88. But that just
changed the metric. It didn't affect the human
being. And they still died with a tube in their
throat while we were pounding on their chest.
So it's very powerful hearing you talk about
your son. And I can absolutely relate to the
men and women we've lost. that what makes it
so heart -wrenching is when you realize that
it is preventable and that's what i want to explore
now but so many people i think even more so in
the u .s and the uk are sold this facade that
these pills are going to fix you and that's like
you said not the case as a band -aid it's a plaster
it's just addressing symptoms but you haven't
addressed the underlying issue at all so i want
to explore that whole thing but i'm intrigued
about your son specifically so what What holistic
element were you able to find or what underlying
factor can you attribute to that low vitamin
D? And then how did you fix that with an infant?
Yeah, so, I mean, thank you for sharing your
own experience, James, there as well. Really,
really interesting to hear. And I can't imagine
what that must have felt like when, you know,
you're burying colleagues of yours. But with
respect to my son, It's quite complex, really.
But to try and simplify, essentially, vitamin
D is quite well known in the wellness space now.
But I can tell you, seven, eight years ago, it
really wasn't. Certainly, most doctors had no
real idea about it. That is, I would challenge
anyone who disagrees with me on that to give
me some data to support that's not the case.
I spoke to so many experts and specialists and
GPs and nobody had a clue. In fact, two weeks
before this happened to my son, I was in my practice,
in my medical practice where I was working in
a place called Oldham. And I was seeing, starting
to see patients who were very low in vitamin
D. and were symptomatic, all kinds of, whether
it was fatigue, whether it was bone pain. You
know, this wasn't like overt deficiency where
they had none at all. It was just what I would
call suboptimal deficiency where it was just
a little bit low, but actually when we addressed
it, other symptoms got better. And I started
to look into trials on vitamin D and heart failure.
I thought, okay, there's quite a lot here. And
I was thinking, why do we not test it more? Why
do I not really know that much about it? And
I was spending a lot of time researching it.
And I thought, hmm, I wonder if my kids should
be on vitamin D because, you know, for people,
I know this is an audio podcast, so my parents
are Indian background, so I've got brown skin.
And vitamin D, I'm sure many people know, but
just in case they don't, by and large, we get
most of it from the sun. Our skin converts. the
sunlight into the active form of vitamin D. Now,
if you have darker skin, you need proportionately
more sunlight exposure to make the same amount
of vitamin D. So, you know, the melanin in our
skin that gives us protection from the sun also
makes it harder to extract that vitamin D. So
I phoned my wife from my practice one day. I
said, hey, babe, look, I know you're going to
see the, you know, you and my son are going to
see the doctor this afternoon. I actually think
he should be on vitamin D. Could you just check
and have that conversation with the doctor? Now,
I've asked myself a million times why I didn't
just make that decision myself. But as many medical
professionals who might be listening to the show
know, certainly here in the UK, the GMC, the
General Medical Council, actually discourage
us to make decisions around health on our own
family. It's considered... you know, not best
practice. So I thought, you know, I'm not going
to make this call at the moment. But let me just
see what he says. So I sent my wife a protocol
that I found. And the doctor actually said to
her, you could have just made this up and type
this up on Word and basically gave it back to
her and said, he doesn't need anything, you're
breastfeeding, he doesn't have to do anything.
So she was pretty offended with that consultation.
And I thought I'd get around to it. I had no
idea. We were two weeks away from my son collapsing
and having a convulsion. I wish I'd changed things
now. But in some ways, had I not, and had I started
supplementing him then, maybe this never would
have happened, which of course would have been
a good thing. But maybe it wouldn't have been.
Maybe I learned so much from it that I was better
able to help him. So the first thing I learned
was how important vitamin D supplementation can
be for certain populations. And there was actually
guidance in the UK at the time that every child
up to the age of five years should be on vitamin
D drops. And I was thinking, well, if that's
guidance, how come I don't know this? How come
my colleagues don't know this? How come when
I phone my doctor friends, nobody knows about
this? And this may surprise you, James, that
rickets, what was known as a Victorian illness,
rickets is on the rise in the UK year on year.
Really? Yeah, which is just... It's ridiculous,
really, when we think about it. It's so easy
to prevent. So anyway, in terms of what I did
with my son, we optimized vitamin D. We did various
things with diet to improve how the gut microbiome
works. We've been very diligent with all aspects
of lifestyle, including sleep. And it's what
we actually went through in terms of all the
details around his case are probably too complex
for the purposes of the show. But essentially...
on my journey to find out more i learned just
how powerful lifestyle can be for a whole variety
of different health conditions and i just want
to say when we talk about lifestyle right i understand
that it can be hard for people and that for some
people find it easier to make lifestyle changes
than others but we talk about lifestyle as only
prevention and i really want to expand the conversation
because lifestyle yes works beautifully well
as prevention But in many cases, you can also
use lifestyle as part of the treatment. So even
when things have gone quite bad, even when you've
got a diagnosis of something, sometimes making
changes to your lifestyle can reduce symptoms
or help you reduce how much medication you need
to take. So it's not just a prevention piece.
It can also be a treatment and a management piece
as well. Absolutely. And I want to explore that
because I think that's such a... a hard concept
for people to understand they're told you know
you're you're a diabetic so you're going to be
taking these pills the rest of your life and
and understanding that no you can actually reverse
that with nutrition for example is a very very
powerful element but we're just staying on the
vitamin d for a second it's interesting during
this whole phase that we've all gone through
where the immunity is so important for everyone.
As we mentioned, a lot of people have been staying
in home and not having the exposure to sunlight.
And then even, as you were mentioning, the East
Asian communities, just some of the traditional
dress, and I'm thinking about it now, coming
from a very hot climate to gloomy England, and
now wearing the particular... clothing that they
wear you kind of got to take a step back and
look at that too are you actually getting the
exposure here in florida it's really hot so there's
two things that happen firstly everyone hides
inside and goes in the ac and secondly there's
this which i have to question as well this whole
element of you see the sun you're immediately
going to get skin cancer which or you know you
got to lather yourself in in um you know sun
lotion which i still personally question well
which is actually contributing to the cancer
is it the sun or is it the lotion but regardless
people are scared of being out in the sun sometimes
so i think that contributes to the low vitamin
d as well yeah i think you've raised some some
really good points there james um i think we're
going to see a lot more about sun cream and what
it actually does over the coming years one thing
i think it's safe to say now that What a lot
of people don't realize is that they go outside
in the sun and they've got sun cream on, that
will block the conversion, that will block how
much vitamin D you make. So one thing I think
is it's a pretty safe and ethical recommendation
is, you know, aim for at least 10 or 15 minutes
sun exposure without sun cream on. And I often
talk to my patients about that. You know, nobody
wants a patient to burn. But of course, some
people need to be super careful. But I think
a lot of people become so scared of the sun that
they won't step outside their house, either them
or their children, before the sun cream has covered
every ounce of visible skin. And I'm like, look,
get out a little bit, get a bit of that sun exposure.
And then if you wish to use sun cream, then put
the sun cream on. But at least get that vitamin
D conversion. You know, there's a wider point
there, James, that goes beyond vitamin D. We're
seeing just how important sunlight, but just
natural light per se, is for our health and well
-being. You know, human beings, the only thing
probably that has been consistent in all of evolution
is that the sun will rise in the morning and
go down in the evening. And that is how our circadian
rhythms operate, right? Light in the day, in
the morning, gets us up. That symbolizes the
start of the day. And the sun goes down, night
falls, that indicates it's time to sleep, right?
That has always been a constant. And it's only
in the modern world now that we can actually
play, you know, mess around with that. And actually,
many of us are brightening up our evenings with
screens and devices. And when we're dimming our
days by staying inside, we're actually reversing
how we've actually evolved to live. Let's think
about that practically. So we've mentioned sleep
and how important that is for health. Well, let's
think about that. A lot of people are thinking
about what they do just before bed or how much
caffeine they're drinking. Okay, these are very
important things, so we can come to that. But
a lot of people aren't thinking about their light
exposure. We know very clearly that if you get
15 or 20 minutes of natural light exposure in
the mornings, that can help to set your circadian
rhythm. That can help you sleep at night. A lot
of people aren't thinking about that. So in my
first book, I said to people, it was one of my
recommendations, and I said, you might want to
have a cup of tea or a cup of coffee in your
backyard or in your garden in the morning rather
than in your kitchen or in your bedroom just
to get a bit of that light exposure. Now, to
really bring this to life for people, let's think
about light. So light is measured in units called
lux. A completely dark room where you can't see
your fingers moving in front of your face would
be zero lux. If you go outside on a sunny day,
let's say you're in Florida, right? Or my perception
as a Brit of what Florida would be like. You
go outside for 20 minutes on a sunny day, you're
going to make around, you're going to be exposed
to about 30 ,000 lux of light, right? If you
go outside on a cloudy British day for... 15,
20 minutes, right? So it's cloudy, it's overcast,
there's no sun exposure. You're going to be exposed
to 10 ,000 lux. If you go into most offices and
most indoor environments in the US or the UK,
you're probably getting at a maximum 500, 600,
maybe 700 lux, right? So being indoor, even being
outside on a cloudy day gives you... maybe 20
times the amount of exposure that you get even
in a brightly lit indoor room. So we have designed,
we've evolved to be outside. So getting outside
whenever you can, but ideally in the morning
or at the very latest lunchtime is so valuable
to help people with their circadian rhythm, with
their sleep. But also there's some new data,
James, which again is really exciting because
a lot of us are aware that looking at screens
before bed, and it's very hard to resist that.
I get it. I sometimes fall prey to that. That
can affect the secretion of a hormone called
melatonin, which can absolutely delay your circadian,
put your circadian rhythm back by maybe three
hours, right? It literally light changes your
hormones. If a drug we were prescribing did that,
there would be a side effect label. Yet many
of us are looking at our iPhones or our smartphones
right in front of our faces. in bed just before
we fall asleep. And to think that's not having
an impact on our health and our ability to sleep
is very, very short -sighted. In fact, James,
when my first book came out, one of my best mates
in America, a guy called James, he phoned me
and said, listen, mate, I love the book. I love
what's in it. But, you know, the stuff about
screens, you know, I feel sorry for people who
can't look at screens before bed. I look at screens
every night in bed and I'm absolutely fine. I
was like, okay, fine. There was nothing really
to add to that. A few weeks later, he bought
something called an Aura Ring, which is probably,
I'm not saying people should buy this at all,
but I'm just saying he chose to buy something
called an Aura Ring, which is a very good sleep
tracking device. And he phoned me a few weeks
later and he said, wrong and wrong and oh my
word, I've just discovered something. I said,
what? He says, anytime I look at my screen in
bed. And then when I look at my data in the morning,
I haven't gone into anywhere near the same levels
of deep sleep as when I don't look at my screen.
So a lot of people may have their eyes closed
and be technically sleeping. But what's the quality
of their sleep like? And that changed his behavior
to the point now where he won't look at a screen
for one hour before bed. And the only other point
I wanted to make, James, on that is there's some
new research which is suggesting that. if you
have a lot of natural light exposure in the day
you kind of buffer yourself and insulate yourself
from some of the negative impacts of looking
at a screen late into the evening so although
i'm not advising people to do that if you spent
your whole day or three hours outside in the
day if you're lucky enough to be able to do that
you might get away with looking at your screen
in the evening in in a very different way than
had you spent all day indoors yeah and i can
attest personally like i know When I've done
that, it just keeps me awake, like you were saying.
It's not even so much the effects on the sleep
as the fact that you're losing sleep. You're
losing hours of sleep. And one of the tools that
I found that's effective, and I try not to look
at my phone, but we might watch TV as we wind
down. We still have electric lights in the house,
is blue blocking glasses. And I found that very,
very effective. Yeah, I also have some blue blocking
glasses. I wear something called blue blocks.
I think they're incredible. And if I am on screens
in the evening and, you know, I'm human like
everyone else, you know, so it's all very well
knowing this, but we're all, you know, I'm subject
to the same pressures that anyone else is subject
to. And if I have to be on my screen in the evening
or if I perceive I have to, then I'll put on
my red glasses and it makes a big, big difference.
So, yeah, just. I hope there's a few take -homes
there for people to start applying in their lives.
Absolutely. All right. Well, I want to transition
to one more area and then we'll go to some closing
questions. Obviously, we'll make sure we talk
about the books too. You mentioned about looking
at lifestyle choices, not just for prevention,
but for cure as well. And that's an area I want
to expand on. So without loading the question
at all, what are some of the common health issues
that you see with your patients? that you absolutely
can reverse using better lifestyle choices? Yeah,
so look, just to be super clear at the top, like
it's not always possible to reverse things, okay?
So I'm not trying to sell something to you that
is, you know, like a miracle. Sometimes you can
reverse conditions, but other times you can...
manage them better you can reduce pain you can
reduce symptoms you can sometimes come off medication
you can sometimes only reduce medication but
I've seen this over and over again so an obvious
one would be type 2 diabetes I think you know
in 2015 when my first BBC documentary came out
I showed I demonstrated the case of a lady who
I diagnosed with type 2 diabetes on the show
and within 30 days I'd helped her put her blood
tests into the level that was no longer diabetic.
It was probably one of the first cases on mainstream
primetime television where it was shown that
this was possible. And, you know, there was a
lot of criticism at the time saying this is unproven,
you know, type 2 diabetes is a chronic irreversible
condition. It was like, well, that may be the
common narrative, but actually as many doctors
and many healthcare professionals around the
world are demonstrating now. it is possible to
put type 2 diabetes into remission in a lot of
cases by some small, consistent changes to our
lifestyle. Now, sometimes you can't put it into
full remission. Sometimes you can just reduce
how many drugs you're going to take. But even
that, that is a very attainable goal and a very
worthwhile goal. You know, if you, instead of
taking four different medications three times
a day, if you're only having to take one of those
medications twice a day, I tell you, most patients
will take that and go, oh, fantastic. I no longer
need to take as many. So I think whatever state
you're in, making changes to your lifestyle does
have an impact. But if I think about some patients
I've seen in clinic in the last week, chronic
pain. I've seen people with chronic pain for
years. And by applying some changes to their
lifestyle, whether it's dietary changes, whether
it's more sleep. and in particular reducing stress,
which I think is such a big one, that actually
often their pain goes down. So it's not so the
pain vanishes, although sometimes it does, but
often it's gone down by 80%. For somebody suffering
with chronic pain, an 80 % reduction in pain
is huge for their quality of life, right? So
if anyone listening to this has got chronic pain,
I really would encourage you to think about some
breathing exercises each day. Five minutes a
day, either do some yoga or do some sort of deep
breathing practices. One of my favorite ones
is one that I use in my patients. It's called
the three, four, five breath. The idea was really
simple. You breathe in for three, you hold for
four, and you breathe out for five. Okay, so
really easy, very easy to remember. And when
you do that, you help to switch off. the stress
part of your nervous system and you have to promote
relaxation. And I've got a lot of patients who
use that to help reduce anxiety, to help with
their mood, to help them sleep. But I've got
a lot of patients with chronic pain who do that
for five minutes in the morning, five minutes
at night, and it dramatically reduces how much
pain they feel. So, you know, these are a couple
of conditions. There's quite a few autoimmune
conditions now that we know that you can often
slow down the progression. or reduce how many
symptom flares you get by actively trying to
manage your lifestyle. And look, James, I just
want to make it clear. I understand that sometimes
it's tricky. Sometimes people may, you know,
you may be a single parent managing working two
jobs with pressures around bills. I get it. Maybe
that's more of a priority at the moment than
actually breathing twice a day. But I will say.
And I really want to make this point because
a lot of people say that lifestyle medicine or
looking after yourself with lifestyle is a very
privileged thing to do. And it's only the preserve
of the affluent or the middle classes. And I
want to address this point because a lot of the
things being promoted in the wellness space are
expensive and are out of the reach of many people.
Well, not just that I talk about. If I think
about my first few books, pretty much everything
I recommend is free of charge and accessible
to all walks of society. I worked in Oldham,
James, for seven years, right in the centre of
Oldham. It's an area that is commonly regarded
as having very low socioeconomic status. A lot
of people on social security benefits, low income
levels, a lot of fragmented families. a lot of
a big sort of immigrant population. You know
what? I used these same principles with that
population very successfully for seven years
because the way you get people to make change
in their lifestyle, and I'm sorry for going off
on a slight tangent here, but I think it's really
relevant because a lot of doctors would say,
oh, Dr. Shasta, you know, all this advice is
great, but patients just don't do what I ask
them to do. And it's really interesting because,
of course, sometimes that does happen. But even
the way that's phrased, patients don't do what
I've told them to do. That phrase tells you a
lot. Nobody does anything that they've been told
to do. If you tell me to do something, I may
do it for a day or a week. I won't continue with
it long term unless I feel I've been involved
with that process and I have some agency over
it. So the way I interact with my patients. And
I teach doctors these principles and we run courses
for doctors and other healthcare professionals,
actually, which is really exciting. We're just
opening up to global healthcare professionals
and running it online now, which is super exciting.
First time we're ever going to do that. But what
we do is I always say connect first, educate
second. And I think it's a general good principle
for life. Like if I've got a patient in front
of me and I think I know what's best for them
and I don't listen. and I tell them what they
should be doing in their life, you know what?
I'm not that successful. But if I listen to them,
if I hear the difficulties and the struggles
they have, and then I find some common ground
where they know I've heard them and I understand,
and if only then I try and give some advice,
then patients want to do what you've asked them
to do. And I honestly have very good compliance
with my patients, but that's because I think
I spend the time. connecting first and educating
second. And if you can give people advice that
is relevant for them in the context of their
life, James, they will do what you've asked them
to do. I really do believe that. And can I give
you an example of that to sort of bring it to
life at all? Yeah, please. All the time in the
world. You know, I remember a patient I saw maybe
seven or eight years ago, right? in in my practice
and it was a 42 year old chap who was struggling
with energy low mood and was a little bit overweight
you know frankly very common issues that people
are struggling with these days and he came to
see me he wanted help and it's very clear to
me that there were a number of factors in his
lifestyle that may have been contributing to
how he was feeling and I discussed a number of
options with him and he said oh, Dr. Chachi,
strength training. I really want to do strength
training. I used to do it when I was a teenager.
I've not done it for years, but I get it. You're
going to say it's going to help me with my mood,
with my weight, with my energy. I'm in. I said,
okay, great. You really want to do that? Brilliant.
And he said, what should I do? Should I do 40
minutes three times a week? I said, well, sure.
Yeah, if you can do that, that'll be amazing.
So he walks out, James, with a big smile on his
face, full of motivation. Four weeks later, he
comes in for a follow -up. And I said, hey, look,
how are you getting on? How's the gym? And his
body language dropped. His shoulders were rolled
in. He looked a bit sheepish. And he said, hey,
Doc, you know what? Work's been super busy, super
stressful. The gym's not on the way either to
work or back from work. And it's quite expensive.
I've just not managed to do it yet. And I remember
James thinking then. I just thought. And Rangan,
you've clearly not given him advice that he feels
is relevant for him in the context of his life.
I never thought, why has he not done what I've
asked him to do? I thought, Rangan, you've got
to do better here. So I took my jacket off and
I said, right, I'm going to teach you a strength
workout right now. So I taught him these five
exercises that I call the classic five. And I
taught him how to do them. I modified them for
his ability level. You can modify them for any
ability level. I said, what do you think? Can
you do them? He goes, yeah, that's not too bad.
I said, OK, can you manage five minutes in your
kitchen twice a week? And he looked at me and
he said, what, 10 minutes a week? I said, yeah,
can you manage that? He goes, yeah, easy. I said,
OK, cool. I'll see you in four weeks. So he goes
out a little bit confused, thinking I've only
asked him to do 10 minutes a week. Four weeks
later, James, he walks in. And I say, you know,
how are you getting on? James, his body language
was different this time. He had a big beaming
smile. His chest was puffed out. He was feeling
really, you could see he was feeling pretty good
about himself. And he said, hey, Doc, you asked
me to do 10 minutes, but I found it so easy.
And I felt so good afterwards. And I now do it
for 10 minutes every evening before I have my
evening meal. So he ends up doing 70 minutes
of strength training a week. Because I've broken
it down and made it super easy for him. He's
continued doing that for well over five years,
James, right? He's transformed his life. And
that led to what I call a ripple effect. That
one change done consistently made him start to
feel good about himself because his identity
started to change. He wasn't then someone, like
initially, he was someone who can't follow a
health plan. He was reinforcing his identity
that, oh, I can't do health. It's too hard. I
can't go to the gym. when I made it practical
for him, when I broke down all the barriers to
entry, he starts doing it. And then he starts
increasing it, not because I've asked him to,
but because he wants to. And now, you know, he
eats well, he sleeps well, he gets up every morning
and does five minutes of breath work. I would
never have gotten to do this stuff seven years
ago. Never. But by starting small, by making
it easy, actionable and relevant to his life.
He starts to do it. And James, I can tell you,
this is the approach I take with most of my patients.
And I've seen consistently that this works. When
it comes to health, James, we think it's got
to be more complicated than it needs to be. And
this is something I covered in my last book,
Feel Better in Five. I really walk people through
how to make new behaviors stick because everyone
wants to be healthier. It's not as if you can
ask anyone on the street and go, hey, look, would
you like to be unhealthier than you are now?
And no one's going to put their hand up and say,
yes, everyone wants to feel better than they
currently do. But the problem is we think it's
too hard. We think when it comes to health, it's
got to be about deprivation and punishment. And
it really doesn't. Now, business has got this
figured out. Right. So Amazon, for example, right.
Amazon, when they moved to one click ordering
about five or maybe seven years ago now. estimates
say their profits went up by $300 million a year.
Can you believe that? $300 million a year, right?
Why is that? Well, that's because Amazon understand
human behavior. They've studied the science,
as I have, and they know that if you make something
easy to do, people do it. So seven years ago,
what did you have to do? Had to go to your checkout,
confirm your order, put in your card details.
Confirm again before you place the order. Every
single step you take is a reason to back out
and not do the behavior. Now they've made it
so easy that profits are up $300 million. Netflix,
YouTube, they use the same science to get you
to use their platforms more. They roll one video
into the next video. So before you've realized
it's midnight, I should probably go to bed now.
I need to be up at six. You're into the next
episode and you're hooked. And the point I'm
trying to make is when it comes to health, we
don't apply the same rules. We think it only
counts if it's hard, if it's really difficult.
But Amazon knows that's not the way you get people
to change their behavior. The way to get most
people to change behavior is to start small and
make things easy. So what did I do with that
patient, James? I incorporated so many principles
of behavior change in me asking him to do five
minutes in his kitchen. I made it easy. Because
he's like, yeah, five minutes, I can do that.
I can't really say I don't have time. I made
sure he did not have to go to a gym, he did not
have to buy any equipment, and he didn't have
to get changed. Because that's what I say to
people. I say, look, you don't have to buy anything,
you don't have to go to a gym, you don't even
need to get changed. I do, for example, James,
I do a five -minute strength workout every single
morning without fail. It's not because I've got
more motivation than anyone else. It's because
I understand how you create a new behavior. You
make it easy and you stick it onto an existing
habit that you are already doing without thinking.
So what do I do every morning? I make a cup of
coffee, right? I don't need a reminder. I don't
need my PA to phone me. I don't need to put it
in my diary. I'm going to make coffee. And I
suspect many people listening to this are also
going to do that. So what do I do? I weigh out
the coffee in the French press and then I put
a timer on for it to brew for four or five minutes.
In those four to five minutes, I don't look at
Instagram. I don't look at my email. I do a strength
workout in my kitchen, either body weight or
sometimes I use a dumbbell I've got in there.
That is just part of my daily routine, just as
brushing my teeth is. I don't go to the gym,
James. It doesn't fit with my lifestyle. I've
not been for a long period of time. But I think
I regard myself as being in good shape and most
people probably regard me as being in good shape.
That comes from a five -minute strength workout
every morning. I do it in my pajamas. I don't
actually wear sports gear for it. So I'm just
hoping by telling these stories, James, that
somebody listening to this goes, oh, yeah, I've
tried to work out, but I can never make it stick.
Maybe this is the approach that's going to work
for me. And, yeah, James, I could keep talking
about this stuff, but I know I'm sort of going
off on lots of tangents here. I would really
say to people, if you're trying to create a new
behavior or if you've tried to create a new behavior
in the past, ask yourself two questions. Did
you make it easy? Second question is, did you
stick it on to an existing habit? And I bet you
for most people who've not managed to make a
new behavior stick, they probably didn't follow
one of those two principles. And I love that.
That was a fantastic tangent. It reminds me of,
I think it's one of the leadership gurus talked
about. The best plan is the one you follow. There's
no point having a perfect plan that you don't
execute. I'm paraphrasing, but those small wins.
I think that what you've done with your podcast,
what I'm trying to do with my podcast, is the
same kind of thing. You're leading someone to
find the first step of their why. So any sort
of wellness change. I mean, there's a perfect
example. I'm sitting here with my French press
coffee right next to me, so I can relate 100%.
But there's no point telling someone, or do an
hour of exercise if they're not going to do it.
And then they're also going to feel even worse
about themselves. I'm a failure. Look, I can't
even do this. I've got no discipline. I'm horrible.
Versus a five -minute workout that's between
two things that you know you're going to do anyway.
And now when you've achieved that, you feel good.
And that sense of well -being, a sense of pride
is then going to spur you on and you may or may
not even do more than you were told to do or
asked to do. Yeah, exactly. And look, what I
talk about, James, it comes from 20 years of
seeing patients, right? So I didn't come out
of medical school knowing this stuff. But one
thing I've always done is I've learned from my
patients. I always say that my patients have
taught me a lot more than I've taught them. Because
if you listen, your patients will tell you what's
going on. So I've always spent time listening.
not being so in my own head that I think I know
what's best, if I've asked them to do something
and they're not doing it, the only sensible question
to me is why? That patient's coming to see me,
so that means on one level they want help, yet
they're not taking the advice. There's clearly
a disconnect somewhere. Am I not communicating
it properly? Am I not making it relevant for
them? Or are they asking for help when they don't
really want it? And it can be any one of those
things. But I've always been very interested
in not only the patients who do well, it's the
patients who are not doing well or not managing
to follow things. And I've studied carefully
and observed what the commonalities are. And
I've got to say, by and large, it's when we make
things too difficult. Now, I will say, James,
there is a type of person who can change their
life overnight. This tends to be somebody who's
had a health scare. or gone through a major life
event like a divorce or a bereavement, or they've
lost their job, something so traumatic that it's
caused them to rethink everything in their life.
Sure, there's many stories like that where people
have literally overnight changed their life.
Okay, I get that. But for most people who don't
have that, actually trying to do that overnight
overhaul. just doesn't tend to be that successful
in the long term. You see this every year in
January when people, you know, they try to revolutionize
their life with a new diet plan that somehow
is going to work this January that never works
for any previous January. And for two weeks,
they're sticking to it three weeks. And by the
end of January, they've fallen off the wagon.
And I think there's some statistic that I think.
I think 80 % of people are no longer following
their New Year's resolutions by the first week
in Feb or something like that. And that really
speaks to what I've just said. Make it small,
make it achievable. As you said, the best plan
is the one that you do, right? So make it so
if all people do, in fact, let's make the ask
really clear. If anybody's listening to this
show right now, James, and they feel they want
to make improvements with their health and well
-being, the challenge I make is... Have you heard
something yet, either on this show or any of
your previous podcasts or anywhere? Maybe it
was something you saw on Instagram earlier today,
right? How are you going to take that inspiration
and turn it into action? Because inspiration
alone does nothing, right? It's just an idea.
You've got to take action. Instead of taking
action on everything, choose one thing, one thing
that think you're going to benefit, then break
it down to the smallest component. Let's say
it's meditation, right? And you've heard about
20 minutes a day or 10 minutes a day. Can you
do that? Can you honestly do that consistently?
Because I've made deals with my patients before
that they do one minute, but they commit to me
they're going to do one minute a day. So let's
say that's someone who, listen, they want to
start meditating, right? Choose the time that
you honestly feel you can commit, even if that's
only one minute a day. Then figure out where
are you going to put it in your day? Do not miss
that step out. Please think about what is that?
Fix point in your day where you can stick it.
For me, it's first thing in the morning. If I
don't meditate when I wake up, I don't ever meditate.
By and large, I've seen that. I know if I don't
meditate first thing in the morning, it doesn't
happen. It could be with your morning cup of
coffee. It could be at the start of your lunch
break. It could be the last thing at night. But
make sure you have an idea of where that's going
to be. And then just try that for a few days.
For seven days, try and do that one minute a
day and just see what happens. I bet you what
will happen is that one minute will lead to two
minutes. That two minutes will lead to five minutes.
That five will lead to 10 over a period of weeks.
But if you start with the goal of 20 minutes
a day, what often happens, you do it for three
days, for four days. And one day you're busy.
You say, I don't have time today. I'll do it
later. Later doesn't come. The next day you don't
do it. And before you know it, it was something
that you used to do. I love it. Absolutely love
it. And there's areas that I still need to apply
that myself. Meditation's a big one. Me too.
Headspace is something I've loved and I've given
it lip service and haven't done it. So I need
to find that space in my daily routine to put
that consistently. Well, that's a good segue
to talk about the books. You just released Feel
Better in Five and then the other ones are The
Four Pillar Plan and the... The Stress Solution.
I couldn't read my handwriting. I'm sorry about
that. Don't worry. So tell me about the books
and where people can find those. Yeah, look,
I mean, I'm on this show, James, to try and give
value to you and your audience. You know, for
me, I write books to help promote health in as
accessible a way as possible. As I say, everything
I do is about making it simple, making it practical
and making it as cheap as possible so people
actually can do the behavior. Although I promote
these books, I'm really not out here to sell
books. I want to sell people the idea that good
health is achievable. The books, I think, very
much condense what I talk about into very actionable
steps, which is why I think they've been so successful.
And, you know, here in the UK, the last one,
Field Bastion 5, is used by lots of responders.
You know, lots of hospital trusts now and the
National Health Service have contacted me saying
we're using the Field Bastion 5 principles. with
our patients, lots of schools have contacted
me saying that we're using these principles with
our patients because with these little five -minute
habits, I cover physical health, mental health,
and emotional health. And for me, it's just a
real honor and delight that so many people are
finding them practical. So a quick summary, my
first book was called The Four -Pillar Plan in
the UK and around the world, but it's got a different
title in America. In Canada, it's called How
to Make Disease Disappear. This is where I talk
about my overall philosophy of health, these
four pillars and what we can all do in each one.
Second book is called The Stress Solution All
Around the World. And that's basically, you know,
about stress, which is where stress lives in
the modern world and what you can do about it.
It's very, very practical. And it addresses the
point that the World Health Organization say
that stress is the health epidemic of the 21st
century. So I think that's a real deep dive into
stress and how to be happier and calmer. Then
the final book, Field Question 5, is literally
about taking everything I've learned in 20 years
of practice and putting it into five -minute
what I call health snacks. They're not literally
snacks that you eat, although one of them is.
But there's about 40, I think, five -minute health
snacks. And I ask people to choose two or three
to do a day. One for your mental health. one
for your physical health and one for your emotional
health. And I've got to say that the impact that
book is having around the world, and it's been
out in the US for a few weeks now, and it's just
been a delight to see how many people, whether
it's health coaches, whether it's Arianna Huffington,
who's been raving about the book, people who
I don't know who are just saying, wow, you've
really made something super, super simple. Mark
Hyman actually said to me when I was on his podcast,
he said, So we're going to have written about
15 books now that I'm so jealous actually of
this book. This is the book I wish I'd written
because you've just made health about as simple
as it can be. So, you know, please, hopefully
people got enough value from this, but if they
feel they want to learn more, I'd probably point
it towards the new one, Feel, Brush and Fight,
because it really, I feel I've simplified health
down into, I've distilled health down. into as
little, it's a deceptively simple book. It's
basically got everything I know about health
and it's condensed into a small amount of space
as I possibly can. You know, if in my first or
second book, I take eight or 10 pages to work
up an idea, the challenge in Feel Better in Five
was, can you make the same case in one page?
What is the absolute essence of what you're trying
to say? Put that in and no more. hopefully that's
a bit of a bit of an overview for people yeah
well i can attest as well you were kind enough
to send me a copy of the book and actually i'm
gonna they offer to send a paperback as well
which i'm gonna ask for because i'm very old
-fashioned in in the way i read um but it was
it was exactly like you said it was fantastic
and for so many of us that always seem to bite
off more than we can chew with our planned wellness
changes It spoon feeds it. And I mean that in
a very positive way, not a patronizing way, but
it just gives you little bites, you know, the
bites of the elephant, as they say, and to able
to just just flick through and say, all right,
oh, I didn't realize this food actually deregulates
my nervous system as well. There's all those
little nuggets in there that I think are invaluable.
So I thought it was a fantastic book. Oh, thank
you. I really appreciate that, James. And yeah.
If you have any problems getting hold of the
paper, let me know. We'll get a copy sent out
to you. Beautiful. And actually, I just finished
writing a book. I want to send that to you. So
we'll discuss that in a moment when we're done
recording. Oh, I can't wait. So yeah, that sounds
great. Brilliant. So the first of the closing
questions, we talked about your books. Is there
a book that you've read that you love to recommend
to people? Wow. One book. Or it can be a few,
but it doesn't have to be related to what we
talked about either. Any book at all. Yeah, I
think there are so many. Your audience is mostly
in the US as well, so I'm trying to make sure
it's one that people can get over there. One
that I've really been mesmerized with over the
summer, and it's a book by someone called Dr.
Pippa Grange called Fear Less, How to Win at
Life Without Losing Yourself. It's just incredible.
I know it's in the UK. Is it out of the US? I
hope it is. It's basically from this psychologist
who has worked for the England rugby team, the
England football or soccer team. She was widely
credited with getting them to the semifinals
at the last World Cup. She's such a humble individual
and she basically makes the case beautifully
how fear affects all of us and how fear holds
us back from doing the things that we want to
live our best life. I think that's an incredible
book. So I definitely would encourage people
to get that book. What else? It's an old one,
but I think I've not read it in a few years.
But there's a book called, a lot of people will
know, The Four Hour Work Week from Tim Ferriss.
And that was life changing for me. And why it
was life changing, not because I want to work
four hours a week, but because it helped me understand
that time. It's the most precious commodity we've
got. And how do you use your time effectively?
So for me, that lesson has really stayed with
me that time has a value. And often we don't
recognize that value. We give away our time freely
to other people and other things that are not
serving us. And it just helps me. So although
it's over 10 years old, if someone hasn't read
that, I'd probably recommend they give that a
read. Absolutely. That's someone I'm sure you
would love to get as well. But I think Tim Ferriss
would be a great interviewee. Oh, for sure. He's
definitely on my list of people I'm trying to
get at some point. And then Dr. Pippa Grange
sounds like she'd be fascinating as well. Yeah,
for sure. I think you'd enjoy talking to her
as well. So anyway, see what you think of the
book. But I think those two, there's many more.
I think I'm a big fan of Gabor Maté books. Gabor
Maté talks a lot about the impacts of stress
and trauma on our body, on our emotions, on our
health. I think. Those books are well worth reading.
And if people just want an intro into Gabor Massey,
I'd probably recommend just go to YouTube and
look up a few of his lectures just to give you
a bit of a taste of what he stands for. But I
think that's pretty life -changing stuff for
people as well. Yeah. Well, I heard you interview
him, Johan, and all kinds of people on your podcast,
Feel Better, Live More. So again, shout out to
that. I think it's very, very powerful. And you
have so many kind of... uh parallel interests
that i do and some of the guests you've had are
incredible so i applaud your podcast as well
oh thanks man all right so then um very quickly
is there a film that you love is there a film
that i love um yeah there are actually um i guess
can i say a documentary yeah please and i'm gonna
say i've only seen it in the last week like i
we're recording this on what thursday I saw it
on Saturday on Netflix on Saturday evening with
my wife. I don't know if you've seen it yet or
not, but it's called The Social Dilemma. I just
watched it two days ago. Amazing. I just thought
it was one of the most impactful documentaries
I've ever seen. I've not been able to stop thinking
about it since. It kind of reinforced concerns
that I've had over social media for a period
of time, particularly for children. And I think
it's done really well. It just makes you think
and reflect on your own usage, on your children's
usage and the wider implications for society.
So I would highly, highly recommend people watch
it just to empower and sort of educate themselves.
I couldn't agree more. And the people they've
got. speaking are you know founders and the the
top people in the social media world prior to
to where they are now where they kind of pulled
out for ethical reasons so it's not like they've
got a bunch of people whining about social media
these are some of the founders of the platforms
that we use yeah people who created the algorithms
and now they're seeing the downside of it so
Definitely worth watching, I would say. Absolutely.
Okay, next question. Is there a person that you'd
recommend to come on the podcast as a guest to
speak to the first responders, military and medical
personnel of the world? Yeah, I would recommend
Dr. Pippa Grange, the lady who I've just spoken
about, who wrote the book Fear Less. I think
that she is so sought after in so many different
areas because... Her tools, I think, are widely
applicable to sports teams, to first responders,
to any walk of life, frankly. So I have no hesitation
in recommending her. Fantastic. Thank you. All
right, the last question then before we underline
where people can find you online. What do you
do to decompress? Yeah, so my routine changes
from week to week, depending on what else is
going on. I've just submitted... my manuscript
for my fourth book so that has been six months
of you know hard work getting that done so I'm
looking forward to being able to indulge myself
in some more kind of relaxation practices over
the next few weeks but by and large what stays
the same I always have a morning routine like
so I will always do a few things each morning
and actually I wrote about this in the stress
solution I call it the three m's of a morning
routine so this can Work whether you have five
minutes or an hour, right? So like with everything,
I want to make it accessible to everybody. And
I feel a good morning routine ideally should
have three components, mindfulness, movement,
and mindset. So I start out each day with either
a five -minute meditation or a five -minute breathwork
practice, which I'll literally come down in my
pajamas downstairs. I'll sit in my living room
for five minutes or actually 10 at the moment.
I will do some meditation or breath work. Then
I will go and put coffee on. And during the five
minutes it's brewing, I do a five minute workout.
Then I'll sit with my coffee with a book. So
some sort of positive book that I'm enjoying
just to get my mind in the right place for the
day. So that's how I start every day, almost
always. And the days when I don't. I'm just more
reactive and less calm. I'm less productive.
So I've learned over a period of time not to
beat myself up when I don't do it, but just to
observe what happens. So I know I'm a better
doctor, I'm a better husband, I'm a better father
when I've taken those 15 or 20 minutes for myself
first thing in the morning. So that's one thing
I do. I'll go for a walk pretty much every day
for at least half an hour. In fact, that's probably
a new habit from lockdown. When we were all locked
down and we made it a habit with the family of
going out for a good walk for a half an hour
every day, ideally in nature, that is something
I've kept going, even though lockdown isn't anywhere
near as stringent as it was certainly here in
the UK. I think those are the main things that
I do. I like going for a run or a bike ride a
few times a week if I can, but there's no real
set pattern to that. The other thing I really,
really... I'm pretty diligent on now. I stop
eating two to three hours before bed. I have
tracked this. I've used monitors to track this.
And when I eat late, even if it's healthy food,
my heart rate stays higher for longer at night.
And when I saw the data, I was like, oh, wow.
So again, I thought I was okay, even though I
knew it wasn't the best thing to do. But I've
seen literally with my biological data that when
I eat earlier. sleep better and i'm more refreshed
so those are those are probably the main things
i'm working on at the moment brilliant yeah i
love it i have a morning routine as well and
i absolutely the same if i if i adhere to it
and i mean you know organically adhere not force
myself then it absolutely sets me up for the
day and even like you said the daylight but i
walk my dog when my son goes to school so i get
that immediate daylight first thing in the morning
and it absolutely sets you up for the day oh
fantastic Brilliant. All right. So then for people
listening, how can they find you online and where's
the best place to get the books? Yeah, look,
the books are available everywhere. They're available
on Amazon. If you do have a local independent
bookstore, hopefully they've got it there. It's
always good to support local independent bricks
and mortar stores, I feel. But yes, if you have
an Amazon account, you can pretty much get it
all over the world on Amazon now. Just a lot
of people ask this, but yes, they are available
in the paperback, but also in e -book. And all
of them are available in audio book, which I
narrate as well. In terms of finding me, I'm
pretty easy to find online. I guess the best
place social media wise is probably Instagram
or Twitter. So I'm at Dr. Chastity on Instagram,
which is D -R -C -H -A -T -T -E -R -J -E -E.
And same on Twitter. I'm just at Dr. Chastity
UK on Twitter. Or I release a weekly podcast
every Wednesday called Feel Better Live More,
which you can find on pretty much every podcast
app. Brilliant. And then the website? My website
is drchastity .com. There's lots of blogs and
resources on there. So yeah, wherever people
find value, come and find me on there. And always
send me a message. I love to hear from people.
Beautiful. Well, I want to say thank you so much.
I think I first came across you when you had
Sabrina on. And it was right when I was about
to interview her as well. So I think we did it
around the same time. So I listened to, I believe
I listened to your podcast first or vice versa,
but regardless. And then I saw you had Johan
on. And then my mom had sat next to a bloke on
a plane who she had mentioned that I had a podcast.
And he said, oh, you should, you know, he should
listen to this gentleman. And it was you. So
it's so amazing that we're finally able to have
this conversation. But I want to thank you so
much for being so generous with your time. I've
really, really enjoyed this. Hey, no problem.
And thanks so much, James, for advising me and
anything I can do to help you and your audience
in the future, please do let me know.