DO THIS DAILY To Reduce Inflammation & PREVENT DISEASE Today! | Andrew Weil

It is

this

type of food that is the root of many of our cancers, coronary artery

disease

, obesity, type 2 diabetes, hypertension, etc. Chronic

inflammation

is the root cause of

disease

. It's fascinating for me to talk to someone like you who was way ahead. from the game, did you know about it before it became sort of common vernacular and what happened there? The first thing that caught my attention were articles in the scientific literature from the mid-1980s that made it seem like there was common ground in origin. of pathological entities that I had been taught had nothing to do with each other, that coronary artery disease and cancer and neurodegenerative diseases, that there could be a common root in inappropriate chronic

inflammation

, is a completely new idea and hypothesis and would have a good sense of knowing when things are good and that there will be evidence to support it, so I had that idea very early and I was excited because if these broad categories of diseases that we had previously thought of had nothing in common, if they actually have a common root, then there is a common strategy for treating them and reducing the risk of them occurring and that is to do everything possible to contain inappropriate inflammation.

There are many influences on one's inflammatory state, some of which you can do things about and so on. You can't, you know, one thing you can do something about is exposure to environmental toxins. Secondhand tobacco smoke is an important pro-inflammatory agent, for example, but what particularly caught my attention was the possibility that dietary changes could

reduce

inappropriate inflammation. and I developed an anti-inflammatory diet with that in mind and long after I started looking at

this

and started writing about this, I started seeing other evidence that mental and emotional health was also related here and this, the cytokine hypothesis of Depression, which is a much more recent idea to me, seems much stronger than the serotonin hypothesis of depression, which has led to the use of pharmaceutical antidepressants, and the idea that chronic inflammation and depression are related, That's fascinating to me, how can you?

Describe inflammation or chronic inflammation well to your patients or students. I usually say that you know we are all, we all know inflammation on the surface of the body, it is local redness, heat swelling and pain in an area that is injured or under attack and that, although it can be uncomfortable inflammation is the cornerstone of The body's healing response is the body's way of getting more food and more immune activity into an area that needs it, but inflammation is so powerful and so potentially destructive that if it persists it escapes its limits over time and space, becomes destructive and in the short term can cause allergies and autoimmunity, but in the long term it appears to increase the risk of a wide range of very serious chronic diseases.

I think coronary artery disease starts as inflammation in the lining of the arteries, Alzheimer's disease clearly starts as inflammation of the brain and that is why anti-inflammatory agents like ibuprofen and turmeric have a

prevent

ative effect and the Cancer is also linked here because anything that increases inflammation also increases cell proliferation, the two are totally linked and when cells proliferate more the risk of malignant transformation increases, so again it's fascinating that this is so different from what we think. I was taught in medical school in terms of foods and this anti-inflammatory diet that you put together many years ago.

I'm wondering if we could talk about what this kind of dietary pattern looks like, is it more about the kind of general types of foods that you're eating or can we see within that something specific to both me and me? I developed it using the Mediterranean diet. as a model because we have a lot of scientific evidence that that way of eating is associated with, you know, optimal health and longevity, and it's a way of eating that in no way restricts the pleasure of food, which I think is extremely important and I modified it. adding Asian influences to it because I've spent a lot of time in Asian countries and there are specific foods and drinks that are found particularly in Japan, China, India, that I think are very useful, so, um, First rule of Atlanta, first of all, no It's a diet, you know, it's because diets are things we get off of, so it's a lifelong eating plan and the first rule is to stop eating or greatly

reduce

your consumption of refined, processed foods. and manufactured.

I mean, that's simple, is that type of food is made by someone else, that's really the root of a lot of our chronic diseases in our societies of obesity, type 2 diabetes, hypertension, etc., so the first step is. just to try to eliminate refined, processed, manufactured foods and then the next thing is to eat a variety of high quality fresh produce, especially vegetables, you know, fruits, yes, but fruits are often concentrated sources of sugar and I think we should be more moderate about it, but a variety of vegetables with all different colors because they are all protective compounds.

I think it is good to reduce the amount of animal protein in the diet. I don't tell people to go full vegetarian or you know, I eat fish and vegetables, but I think restricting animal foods is a good idea. Increase the consumption of vegetable proteins in the form of legumes. Soy protein, for example. Use olive oil as your primary cooking oil and be very careful about the types of fats you consume. You are getting omega-3 fatty acids, which are strongly anti-inflammatory, by eating oily fish or supplements derived from algae. If you don't want to eat fish, use spices like turmeric and ginger, which are powerful anti-inflammatory agents. especially green tea, which has many useful antioxidant properties.

I have developed some forms of carbohydrates that do not raise blood sugar quickly. I'm not anti-carb, but I think it's important to distinguish between types of carbs that are digested quickly. and especially products made with flour and pulverized grains, as opposed to truly whole grains that are broken down whole or into large pieces. I have an anti-inflammatory diet pyramid and at the top is dark chocolate, which I think is a health benefit. food and I and consumed in moderation, I think it's very good for you, the first step when you described it was to eliminate or eliminate these highly processed foods and it makes me think of something that I've been contemplating a lot recently, Andrew.

What is this idea? It's more important? I guess the question itself is contrived, but it's just, I guess, you know, thought experiments. Know? Is it more important to exclude these problematic modern highly processed products? I guess not even food, food-like substances. Or is it more important? I guess we can keep them but add some of these so-called superfoods or you know, your dark chocolate, your berries, that kind of thing, I mean, how would you look at that kind of conundrum? I think it is more important to reduce or eliminate the process. I also think it's really unhealthy and on every level it's the wrong fats, the wrong types of carbs, not enough protective elements, so I guess it could be offset. for the protective elements by adding some of those other things, but you're not going to eliminate the damage that unhealthy fats and unhealthy forms of carbohydrates and additives are causing, how do you know? these diet wars and again I'm really interested because you've been in this field for so many years, you know something has changed, hasn't it in the last I don't know 10 or 20 years?

I know it's the best time, now you know everyone is talking about well, not everyone, not enough people, but a lot of people within the health space are talking about diets, there are fights between vegan versus carnivore versus keto versus low carb and you know I'm interested. As for how you view all of that as someone who's been at this for so long, has anything happened to alter your view? You know, it changes things over time or you know what's been going on there. Well, I've seen a lot of these come and go and I think a lot of the ones that are hot right now will go away.

Some of the ones that are popular, I think are really unhealthy. I think a ketogenic diet is extremely unhealthy unless it is for the specific use of children with intractable seizures. For example, well, why do you say that? Because many people, even within the health field, describe the enormous benefits of a ketogenic diet and I appreciate that casino can be done in many different ways. I mean, a lot of people can do it in a lot of ways. Also many types of green leafy vegetables to get these phytonutrients, but do you know why you think it is so unhealthy?

I think these diets tend to be very unhealthy in fiber, for example, I think restricting carbohydrates is unhealthy, I think it doesn't distinguish between better and worse forms of carbohydrates. I think beans are very healthy forms of carbohydrates. I think whole grains are healthy. I think the ketogenic diet is also very unhealthy for the planet and this is something we all need to worry about

today

. It's the environmental impact of different ways of eating and this is, you know, one of the strong arguments for reducing animal protein in a diet, especially beef and ketogenic people tend to eat a lot of meat, and I think it's one of the big contributors to climate change and we can no longer afford to do this, so for all those reasons I think it is not a good eating plan on an individual level.

I'm just asking this because I know a lot of people ask this question if Is there anyone listening to this right now, or you know, watching this on YouTube or whatever, somehow consuming this information and let's say I don't know, three months ago they went on a diet of ketogenic type and now they are experiencing that they did. They've lost weight, they've got more energy, they've got better skin, they've got more focus because this is what you hear a lot so if anything it's experiencing that and then they hear you, someone I really respect Say you don't actually think it's so helpful How would you help that individual make sense of that?

Firstly, a general belief I have is that in many cases there are health benefits that people experience when they change the way they eat. In reality, it is not directly due to the change in diet, but rather the commitment of mental energy to do something to improve health. You know there's no way to do that experiment, but I think it's not easy for people to change the way they eat and therefore do it. It represents a large commitment of mental energy and that often initiates a healing response or improves the health function of the body, so I think that any beneficial changes seen after a change in diet should be assumed to be due to some extent and perhaps largely to that.

You know, if you want to call that a placebo response, fine, but unless we have controlled experiments to know how much of it is due to the change in actual diet, it's very difficult to know. You also asked about any major changes I've made to my thinking. I know one of the biggest ones was that I lived through the anti-fat era in the 1970s, when we were told that dietary fat was the main culprit and caused heart disease and all kinds of things, and this was the year that manufacturers They made low-fat and fat-free products and in that period people gained weight and there really was no change in disease patterns and I think that way of thinking has been totally discredited although still, if I go to a spa in many countries, the food I'm Ultra low fat food is served and people think that's the way to make food healthier by reducing the fat content and you know that has nothing to do with it.

I think carbohydrates and the nature of carbohydrates are much more relevant there, so yeah, I've seen big changes and how we're thinking uh and uh, you know, I was hoping there would be more, but our core was formed over several years, I think for 15 years we had national nutrition conferences where we brought together leading nutrition researchers to present their findings to doctors and these conferences were very well attended and in organizing them one of the things that I learned is that in the nutrition community Nutrition researchers there is a high degree of consensus on the big questions: do we know what good fats are and what are bad fats?

What are good carbohydrates? What are bad carbohydrates? But somehow that information does not reach either the education of doctors or the general public because people seem to think that everything is confusion and one day they tell us this. one thing and then tell us another thing is that they'll just eat whatever you want and that's not the case, yeah, I think that's the big problem with wars.about diets, which a lot of people who don't feel that strongly get really discouraged when they see someone they respect say I changed my life on a ketogenic diet they see someone else I respect say I went vegan and I felt amazing and I guess there's a broader issue there, I think is that you know, I'm interested in your opinion on this.

Andrew, but I feel like we as a society have put a lot of faith, maybe too much faith in experts and other people, and it's like we have to become our own experts, right? I tell people to listen, listen to what they do. reshare, then try it yourself, you know, yeah, exactly, trust how you feel, you know, just because your neighbor did this diet and felt amazing, doesn't mean that's the right approach for you, I mean, does it? how do you see that? Yes, I feel that way and I am also concerned that some of these very restrictive ways of eating have a very unhealthy impact on social interaction, on the ability to enjoy food or to enjoy it together with other people.

You know, I see this happen all the time and people say you have to do it. eat this way, if you don't eat this way you will go to nutritional hell. I just don't have the patience for that, yeah, so food is clearly one of those things where we can address the inflammation that you mentioned by avoiding sort of air. Pollutants, toxins like cigarette smoke, are also very important in helping to reduce inflammation, but what are some of the other things that we can do with our lifestyle that can help reduce inflammation? Well, stress has one effect on inflammation in the inflammatory state and stress is another.

It is a major root of many types of health problems. I guess I would say that learning and practicing methods to neutralize the harmful effects of stress is right up there with nutrition and physical activity, and adequate rest and sleep are one of the pillars of a healthy life. I don't think it's possible to live without stress, but I think you can learn to manage it and not let it harm your body or mind. What are some of your favorite stress-reducing practices that people get real benefits from? So far, my favorites are the breathing techniques. I believe that learning to regulate your breathing is the most cost-effective and time-consuming method to reduce anxiety and promote calm.

And I have been surprised by how little scientific attention has been paid to breathing. By the way, this is something that comes from Indian culture, if you look around the world at places, whether it's martial arts, natural childbirth, or athletic performance, where breathing is stressed and you try to find where this knowledge came from. All roads lead to ancient India. You know, this is a science that was developed thousands of years ago in India and has spread throughout the world. uh and uh, as I say, it's surprising how little scientific research has been done on breathing and its ability to change physiology, although that is finally changing.

Yes, it really is, I mean, you have widely popularized the 478 breath. Can you tell us what the 478 breath is and do you know when it started coming into your consciousness and when you started talking about it? It's a yoga technique, so again, thousands of years and I learned it from dr. fulford and I've been practicing it probably since the early 1980s and teaching it. I teach it to every patient I come into contact with, to all my students, sometimes to a great extent. groups of people, um, it's so time efficient, you just know the method is simply, quietly inhale through your nose for a count of four, hold your breath for a count of seven, and exhale forcefully through your mouth for a count of eight and repeat that. for four breathing cycles when you're first learning it and doing it twice a day religiously and that's it and just doing it over time you know that in the space of a month or two months you really change the dynamics of the involuntary nervous system decreases the sympathetic tone increases parasympathetic tone relaxation response reduces heart rate reduces blood pressure improves digestion i have really amazing results and uh, take 30 seconds twice a day, I mean, I love recommendations like that, you know, very, very effective, but free and accessible to everyone, which I think is something I always try to keep in mind when I talk about health, what topic comes up? um Andrew, you know I mentioned inflammation before you realized?

In the early '80s, there's this kind of root cause of unresolved chronic inflammation that may be behind or at least a major contributor to things like hypertension, type 2 diabetes, heart disease, you know, depression, what whatever, okay, great, you also mentioned that you teach the 478. I encourage almost each and every one of your patients, so what I really love is this understanding and this idea that there are some basics of health, there are some commonalities if we focus on creating health in the body if Focus on reducing inflammation in the body through, hopefully, a lot of lifestyle practices, you know, we can address multiple different diseases, although we don't we target them specifically and, as he says, 478 encouragement, it seems that he uses it as

prevent

ion. prophylaxis, but also as a treatment when someone has a problem and I think this is changing in many ways the way we look at medicine because we have been taught in a way that certainly I was trained maybe 30 or 35 years after you, but in a quite In a reductionist model we are very good at putting labels on different diseases.

We separate the body into different specialties and that can have value, but we also forget that we want an interconnected system and if you change one part of that system, you have that too. a knock-on effect elsewhere too, yes, let me give you an example with breath 478. This is by far the most effective anti-anxiety measure I have found. It makes the medications we use for anxiety seem very pathetic in comparison and I have used it on patients with the most extreme forms of panic disorder with success, although in some cases it took some time of regular practice to get it under control, but the difference between treating an anxiety attack or panic disorder with a drug like a benzodiazepine and with breath 478 there is a stark contrast when people have panic or anxiety states, the subjective experience is usually that of being out of control, if you deal with that Giving you a medication reinforces the false idea that the locus of control is external and over time that method becomes less and less effective and often creates dependency if when a person discovers that they have within themselves the ability to control a state of anxiety By regulating your breathing is a revelation, it is totally empowering and that method becomes more effective with repetition and creates greater independence and autonomy.

There simply couldn't be a greater contrast between those two approaches. Yes, I completely agree. It's about connecting the patient with what is happening. The feeling that he has something. control over the opposite yeah I agree it's not just the fact that the treatment itself has very little to no side effects so it's amazing you know it's also about empowerment and I guess that leads to this term mind-body medicine. I've heard you talk a lot and I think it's worth trying to understand it. Do you know what you mean when you say mind and body medicine? Do you see the mind and body as separate?

Does society see them as separate? and you know what that general term really means. I believe the only way to separate the mind and body is verbally. I think they are two poles of the same reality. And I think the reigning paradigm in Western science and medicine just doesn't see. that you know that we have a current materialist paradigm that establishes that everything that is real is the physical, what can be touched, I suppose in extracted medicine and that if you observe a change in a physical system, the cause has to be physical, non-physical, the causation of physical events is simply not allowed in that paradigm and that is why mind-body interactions have never been given their due why research in that area has atrophied why hypnosis has never been given its due. been completely accepted as a medical modality, for example, why we can't understand cures for warts, I mean, there's a whole range of things, but that's changing and part of the change has come from validating placebo responses through of brain imaging and showing that there are correlations with activity in particular areas of the brain, so this makes it accessible to people who change gradually, but I would say that there is a wide range of therapies under the heading mind-body medicine from biofeedback, hypnosis, visualization, etc., in general, these methods.

They are very cost effective, they save time, they are even fun for both the doctor and the patient and yet they are very underused in medicine and they are underused because we simply don't take this kind of thing seriously in my clinical experience, I have seen it a and again. The fundamental causes of the disease are in the non-physical compartment, unless all the physical intervention that is done is resolved it will not solve the problem, sometimes it is difficult to present this to patients because many patients are very sensitive to being accused ​​of committing your illness or imagining that it is all in your head and that is not what this means.

No. It is very difficult to use the term psychosomatic because of that connotation. I don't think we have it as a profession. We've gotten a bit of a bad rap in the past telling people that their ibs aerosol bowel syndrome is more or less in their head or that their fibromyalgia is more or less in their head and I think there's a lot of things that there's a real defensiveness. by It's understandable that people know that everything is in both, yes, it's really interesting, isn't it the mind and the body? I suppose we are now in this field of research and I am interested to know what state it was in. in the 60s and 70s, but you know, in the last five ten years we have the microbiome, the gut brain axis, a lot of research shows this two-way communication between the body, the gut and the mind in our brain, and you know?

This, from the beginning, you know what the research said or you just intuitively and through your experience knew that this was happening. I took a medical hypnosis course at Columbia University right after finishing my internship. It was one of the most fascinating courses. I ever took and I certainly became aware of the research that was out there and it totally resonated with my own interests, so I paid attention to that for a long time I have a colleague that I worked with for many years who is on our faculty, who is Faculty member of the American Academy of Clinical Hypnosis and I have sent many patients to him and I remember he told me at first that he thought every dermatology patient and every GI patient should go to hypnotherapy first. before going to dermatologists or gastroenterologists because those two systems of the body have the greatest proportion of innervation and connection to the mind and I absolutely found that to be true and another experience I had shortly after he said that the A leading Tucson gastroenterologist He asked me to have dinner with him.

He is in his 60s and was very depressed and he said he hoped I had something that could help him because he said 90 of the patients he saw had conditions that his training didn't help. not equip them to do anything about it, I mean, that's remarkable, um and I think this is absolutely true and it's not just for gastrointestinal disorders and terminological disorders, it applies to a lot of other things as well and that doesn't mean you shouldn't. do it. work on the physical problem but you also want to work on the non-physical aspect of it, but there are two things that come to mind: That statistic of 90 is very surprising.

What's interesting to me is that I actually agree with that. There's a lot that we see that we certainly don't know, as doctors we don't have tools that work very well for them, yeah, I feel like I don't know what it is, I'm not trying to understand it too. I am very proud to be a doctor. I'm glad I went through that conventional medical training like you, but sometimes I feel like there's a certain arrogance within the profession. I don't know what it is about medical school, where you come in as kind of a curious, open-minded individual and you come out, or a lot of us come out pretty closed-minded thinking that we know everything and, really, anything that we weren't. . what was taught is worthless and because you know it was a really amazing moment for me, uh, Andrew, it was one of my days as a general practitioner.

You know, I went from specialty to general practice. I was getting quite frustrated just looking at the kidneys and I really wanted to see how everything linked together and one day I had seen about 50 patients and I was a little frustrated and before I left the clinic to go home I went through the whole list and asked myself: Is it right, wrong and how? You have really helped many patients

today

and honestlyI thought it was about 20. I thought yeah, those 20. I think I've actually done something called the other 80 percent. You know, I've referred them to some place where I've given them. something to suppress a sensor, but I didn't really understand what was going on.

I knew they would come back and I thought I can't do this for 34 years like there has to be more to it than that, why? Some of us look at that with honesty and transparency. Actually, we are very good at these things, we are not that good at those things and why do others almost ignore that and just stay within that system? to go no no no no this is the way to do it you know do you have any answer? What happens there? Well, I consider myself an open-minded skeptic. I'm willing to look at anything, believe in anything, but then I need to see. uh, test, I need to confirm that, from my own experience, many people that I encounter in medicine and science in general, I would say are closed-minded skeptics, which is very different and I think in medicine, especially, There is a tendency to be suspicious. defensive about any information that comes from unknown sources, so all a lot of the ideas of that exist in the world of alternative medicine, you know, anything of that kind is just dismissed as nonsense without even paying attention to it, the dean of the university of arizona school of medicine that gave me the green light to start this center years ago uh Jim Dolan he was a cardiologist and he had been a psychologist when he was a student, which probably explains part of his openness to this uh when he retired he said which was the accomplishment he was most proud of The point of his career was starting the center for integrative medicine and he said this about all the criticism he received for allowing this to happen and he told a story about the attitudes of people in our profession and I think which is an interesting observation.

I think the idea that aspirin was a blood thinner and could have a preventive effect on coronary artery disease was in the 1950s by a general practitioner in Kansas who noticed that when he was taking aspirin he noticed that when he cut himself shaving, His bleeding was more than usual, so he thought maybe the aspirin was responsible. He started giving aspen to some of his friends and confirmed this effect. He wrote an article in the journal of general practice saying that aspirin had anticoagulant activities and could be useful as a preventative. In the case of coronary artery disease, it took the medical profession about 30 years to come to that view and one of the main reasons they didn't was that this had been proposed by a general practitioner and published in a magazine that cardiologists did not know.

I didn't read it and it was dismissed as a scandalous idea and that's within the profession, so imagine that when something comes from the world of traditional Chinese medicine or the world of herbal medicine, you know that it provokes the same kind of response when you were giving the definition of integrated medicine I think you used the word conventional medicine and you just mentioned the phrase traditional Chinese medicine and it's an interesting idea, isn't that the case when we talk about conventional medicine or traditional medicine? Again, there is a type. of innate arrogance there it's like well, yeah, it is, you know, our system of medicine isn't that old and if you're going to call something traditional, I think it should be at least a thousand years old, yeah, exactly, it's Native American medicine. , Ayurvedic medicine, but no.

What we're doing today as allopathic medicine, I mean, that only goes back maybe 100 years. I mean, what's amazing is seeing, like you said, with the breath, but there's a lot of science coming out now that doesn't support what these ancient healing modalities that you know, traditional Chinese medicine, Oyaveta Indian medicine, have been talking about. for years, whether it's a period of time each day without food or a period of time every 24 hours where you're not eating food, whether it's breathing practices, whether it's um, the fact that different organs have different genetic activity and that They are more or less active at different times of the day.

I remember the Guardian newspaper in the UK covered a study maybe two or three years ago that showed you know that's the case. about the circadian clock and how the liver is becoming less active at certain parts of the day, other organs are too and the kind of conclusion was oh, so we can use different medications at different times of the day and okay, that can be a of the conclusions, but I was also thinking: hasn't traditional Chinese medicine and Indian medicine been saying this for thousands of years that there is a different rhythm for different organs at different times of the day?

I guess for you, as someone who has been preaching this message. For a good 50 years, we're now seeing a lot more mainstream support in a way that presumably there wasn't 40 or 50 years ago. I guess for some of these other modalities it's not like they need it, I guess, but it must be quite rewarding. Look, oh, these guys are catching up with what we already knew, you know, like I say, there are ideas in these systems that I find very powerful and useful and there are other ideas that don't seem that way and I look at them at all. . this and I am very selective in what I take from other systems.

An idea that I find very powerful in Chinese medicine. I have another colleague in Maryland in New York who practices what he calls modern Chinese medicine and I heard it once. He said that if you could sum up all of Chinese medical philosophy in one sentence it would be to dispel evil and support good. In Western medicine, our entire focus is on dispelling evil. You know, we identify what we see as agents or causes of diseases. diseases and we bombard them with usually pharmaceutical weapons and we don't really pay attention to supporting how good the intrinsic or defensive functions of the human body are and just as a concrete example of this if you look at the way we manage gastroesophageal diseases. reflux disease you know we use these very powerful drugs that suppress the production of stomach acid you know that's the problem, there's too much acid in the stomach and we stop it with a very powerful drug that is an example of this, the philosophy that dispels the wrong that we do nothing to support the defensive function of the body, which is how to make the gastric mucosa more resistant to the erosive action of stomach acid and there are several ways to do it, there are natural products that make that dietary adjustment.

I see many. patients taking these drugs without any dietary history and without warning about the addictive nature of these drugs, the long-term problems they cause, I mean, that's the unbalanced Western approach that could really benefit from paying attention to that idea. of Chinese medical philosophy, yeah, and the system that the modern medical system really feeds, that's not like that because you know she said I had a flashback from I don't know 12 or 13 years ago. I'll guess at the clinic. I know a lot of patients waiting outside, this is a much more conventional NHS general practice and I can't remember the exact patient, but when they came in they still had these gut acid type symptoms that they had already had I think.

They started meprazole, the proton pump inhibitor, yeah, then the doctor changed it, it wasn't working, and then I think they had a protocol that said, "Oh, there's a new one called esomeprazole, let's try to make that the third line." recommended". through the local hospitals and you get into this maddening vortex where you know that no one has understood the root cause of the problem. They have been given a proton pump inhibitor. My understanding is that the first trials with professional inhibitors and background inhibitors only looked at their Use it for a few weeks, three four weeks maximum exactly where it is now and people are taking them for over ten years just with repeat prescriptions and this is a problem which I think is really underappreciated and I've been trying to get people's attention.

To both my colleagues and my patients, when you use these powerful counteracting agents long term, you run into a problem that I call a homeostatic trap: the body will reject what you are doing, if you try to block stomach acid production with Over time the body will try to make more acid, so if you reduce the dose or stop the medication, there will be a much worse acid outpouring than you had at the beginning, so people think well, then I can't get it . out of these I have to take them and over time you are worsening or prolonging the problem and the same thing happens with depression, you give ssri antidepressant medications to increase serotonin in the neuronal junctions, how is the body going to respond?

Will try. it will produce less serotonin and it will reduce the serotonin receptors, so if after a year of use you try to stop that or reduce the dose, the depression increases, you know, there is even a name for this now: tardive dysphoria, which is a depression persistent. as a result of the treatment, uh, and you see this over and over again with many of our pharmaceutical agents and it's a double whammy, isn't it, Andrew? There is the problem that the person who initially went to the doctor with these heartburn symptoms that were causing problems at work or when they went to sleep because we didn't address the root cause, we gave them a pill that, unless we stopped very clear that this is a short-term intervention to help their symptoms while we deal with the underlying root cause, which is where I think those things can potentially have value sometimes for some patients in the short term, yeah, you know, yeah we explain that but we take power away from the patient, they start taking it, people think, oh I have a problem I need this pill to solve it and then when they can't stop it, yes it reinforces itself, yes I have that problem I need the pill or I can't function without realizing that your body is reacting and it feels like we're talking about this.

In rare cases I bet you if you go to any general practice in the UK you will have hundreds if not thousands of patients in each practice who are in this situation and it is very frustrating because once I run it it is a challenge . make them very challenging, very challenging and, by the way, wrong when I was a kid in the '19s, '40s, '50s, reflux, gastric reflux didn't exist, people had heartburn and they treated it primarily by taking flavored calcium carbonate. to mint, which is relatively safe and I think most people understood that heartburn was the stomach's way of telling you that you had mistreated it or ate too much or ate the wrong things, but now this has become completely medicalized in this condition, you know, due to excess stomach acid and treat it with these powerful medications and then go about your business and as I say, almost all the patients that I see are in this situation where they are dependent on the medication and they cannot quit, they began to take them without being asked any questions. about what they ate, uh, if they drank coffee, if they smoked, what their stress levels were, no, in Korean, none of that, yeah, or how stressful their lives were, if they ate on the go, you know, it sounds so basic, but there is always almost always a way to help people with those symptoms if you take the time to understand what is causing them in the first place and realize that it is this medicalization of the symptoms, while you know that it is the body sign the one who is trying to talk to you and get up, get up, is trying to yell at you, you have to do something different, right, you're not treating me right, but instead of listening, I guess it's a reflection of how busy and How stressed people are right now, whether it's the doctors in practice, whether it's the patients in their lives so busy it almost feels like it's the perfect storm.

Medicine has these quick fixes for busy people who feel like they don't have the time and energy to make changes and then end up in this really problematic and quite toxic situation, well this is the perfect opportunity for doctors to be teachers and to be able to Explain to patients why prolonged use of these counteracting pharmaceutical strategies is unwise and will cause worse problems. uh and it can produce its own negative effects and what are the root causes of these things and what changes can you make, you know, that's what we should do and it's very rewarding to do it and see that you know good results, yeah.

I mentioned the placebo effect before and the power of the mind and I've shared it on this podcast before I realized in the last few years that yes, the movement of food, the stress of sleep, the super importance, these are very things. , very important to try to help everyone, but In fact, if you go one step further, I really feel more and more that it's the mind, it's our belief systems up here, how we see the world actually determines a lot of those behaviors in first and unless we address that, yes, we can do it. great improvements with food, movement and stress, but at some point to really make that long-term change we have to address what's happening here and you mentioned placebo and it's interesting thatThere is such powerful research behind the placebo, but how do we talk? in medicine, it's the most derogatory thing in the world when we talk about essays, isn't it?

It speaks to how little credibility we give or have typically given to the power of our minds, yes, the two most common uses of the word placebo that I hear in medicine are how do you know it's not just a placebo effect and the most interesting word that it exists is simply or we have to rule out the placebo effect. You know, we should rule it out in the placebo responses. they are pure healing responses from within, you know, mediated by the mind and that is what we should try to make happen more often, that is the art of medicine, how are treatments presented to patients to get the maximum healing response with minimal direct physical intervention again? something that I started writing about a long time ago and that I'm talking about and I'm happy to see gradually a change happening in that area, but that word is so loaded and loaded and you know the idea that the answers to the placebo are imaginary and You're not that important here's a little task I like to give to medical students and also doctors in training: look for any random medical journal that reports on randomized controlled trials of drugs and look for one article and flip Back where there is a table summarizing the results in the placebo group there will always be one or two or a small number of subjects showing all the changes produced in the experimental group;

In other words, any change we can produce in the human body with a pharmaceutical agent can be exactly reproduced in at least some individuals sometimes by a purely mind-mediated action. To me, that mechanism is the most important fact that has emerged from this whole 70-year era of randomized, controlled drug testing and that's what we should try to figure out how to take advantage of and make it happen more time, it's something that doctors that I Train, I ask a lot, they say this and I guess you've heard this too many times, you know, Dr. Weil Dot Chassis, you know I understand what you're saying, but you know that patients don't, patients just don't do it. what I tell them to do and I find that language and phraseology very revealing in themselves.

What I tell them to do I think is potentially problematic and there are these kinds of things that, oh, you know, I know everything, but patients just don't do what I ask them to do and one thing I teach doctors is that when They ask me what is the most important thing I have learned in 20 years of caring for patients, my answer is always to connect first, educate, second and I always say yes and also to model the behavior of patients, as I said before, you have to model, you have to embody the changes you want to see in others, so you have to model health for your patient, but I'm interesting, I totally agree, and I know why.

I'm so passionate about it that I've realized that until the patient in front of you has really connected with you, made eye contact like they're actually in pain, I just don't think they're that willing or that committed to then make the decision. . next step, whereas if we just rush to the solution, it just doesn't work as well and then if you take that external medication, because what is the doctor-patient relationship? Well, it's a relationship, right? So how does it work with your your partner, your wife or your children, do you know who responds well when they tell you what to do, it's always about feeling seen, feeling heard, really, having someone validate who you are and how you feel before to take the next step, and that's how it is.

One obvious thing again, they don't teach us in a medical school, but for me, doctor, that is one of the great truths that I have learned from seeing thousands of patients and I am interested to see your point of view on it. that something that you have encountered before, would you agree with it or would you modify it? I really agree with that, by the way, one of the reasons I like to do 478 breathing with patients is that it establishes a very intimate connection with the patient to breathe with them uh they don't expect that they're not used to that and I think that that facilitates greater connection uh also a practical technique that we teach the people that we train is motivational interviewing and this is a recently developed technique is a dialogue that you have with a patient that helps you and the patient identify mental patterns. which are obstacles to making changes in behavior and lifestyle and then helping them develop alternative mental patterns that facilitate the changes you want.

It is a very useful technique and it is something practical that can be taught, I mean talking about Hippocrates that you mentioned before, a phrase that came to mind was: I think this is hypocrisy, it is more useful to know what kind of person has a disease that what type of disease a person has and I I think that's really something that I discovered over many years of being frustrated and not being able to help my patients as much as I wanted to. I kind of got to that truth that way and I guess it talks about the power of the mind and how we're all kind of individuals, you know, you mentioned the power of the mind, I'm sorry, yeah, go, please, no, you made me. to think I just had a flash when I was in medical school and an attending physician told me, you know, go.

Look at the gallbladder in room seven, yeah, that says it all, doesn't it say it all? Yes, I am right in thinking that you have shared a story in the past where I think you had potentially taken some form of psychedelic mushroom and while you were under Its influence you were able to do a yoga pose that you couldn't do before or if you could just share that story because I think that really speaks beautifully to how our mind can get in the way of being an An example of what the potential of these agents is was actually LSD and I was 28 years old and living in rural Virginia. .

It was a beautiful spring day and I took LSD with a group of friends outside and I had just been getting started. to practice yoga I had been doing it for I don't know a month or so and one posture that I had a hard time with is the plow position in which you lie face up on the ground and raise your legs and then try to touch the toes of your feet behind your head, my toes were a foot off the ground and I had a horrible pain in my neck and I was stuck there, I couldn't, I couldn't do it, no matter how much I practiced and I was on the verge of giving up I thought. that I was too old, my body was too stiff, uh, and then on this day, when I was under the influence of LSD, I felt great, my body felt very elastic, I was, you know, wonderful, I thought, wow, ought. to try that so I lay down and I was putting my feet down I thought I was missing like a foot and they touched the ground I couldn't believe it and I did it repeatedly I was so happy I could do that The next day I tried to do it and I put my feet one foot away off the ground and had excruciating pain in his neck, but there was a difference.

Now I knew it was possible and until then I didn't believe it. so I continued doing it for a couple more weeks. I could have done it if I hadn't had that experience. I think I would have given up. Then I saw a possibility that I didn't believe in and that motivated me and I believe. There is tremendous potential for psychedelics in medicine, not just psychiatric medicine, to show people that it is possible to experience their bodies in a different way. I think that's very applicable to chronic pain, for example, allergies, autoimmunity, but there are other ways that you know that you can get it. glimpses of that you also know that one of them is simply meeting a person who has had your illness and is now better and if I can arrange for patients to meet other people who are well and who have had the same illness, that is a very powerful way to override any negative predictions they've had, you mentioned psychedelics and my sense is that in the United States, at least the things and the interviews and the conversations that I consume from the United States, a lot of fairly prominent people seem to be talking about the potential value of uh certain psychedelics for certain conditions and I know I think Johns Hopkins I think a lot of prestigious research institutions are now studying this so I'm wondering if you know you're someone who was, I think, studying marijuana and its effects on health in the 1960s for a long time.

A while ago, maybe one of the first people to do this. I'm wondering if you, for any naïve listeners who've never heard of this, you're a highly respected doctor, you train at Harvard Medical School, could you just summarize? What are psychedelics? How can they provide usefulness to people and why have they been demonized for so long? Well, are there psychedelics? There are two groups of them chemically. There are natural sources of them and they are chemical sources. These are substances that I. I think they have an extremely low toxicity potential, probably lower than any other drug we know of.

They can produce very dramatic psychological effects that depend quite a bit on the sentence, people's expectations and the environment in which they are taken, which is why they are the most common. some are lsd psilocybin uh male which comes from the peyote cactus psilocybin is from mushrooms there is a drug called mdma which is a slightly different category marijuana cannabis is not a psychedelic it is something else but there was a lot of research interest in these in the 1950s uh and some really wonderful research on them and then it all came to a close when, in the wake of the hippies and Timothy Leary, very restrictive laws were passed against them and only recently has this happened again. and it's not just in the US, although I think we're further along in Canada, you know, they're very advanced in making psilocybin available for the treatment of depression and, in fact, there's a lot of activity with the psychedelics in the UK and in some of continental Europe, I think this is happening everywhere and we will see, very quickly, that you know, I think we will see psilocybin available for the treatment of drug-resistant depression and anxiety, mdma, for post-traumatic stress disorder, which is a huge problem in the United States among returning veterans, so I think we will see these compounds available for therapeutic use, but at the same time there is tremendous interest in the general public In them on free covid when I was traveling a lot and talking whatever the topic I was talking about, whether it was healthy aging, integrative medicine, nutrition, uh, the questions I got were about psychedelics, you know, where can we get them? how can we find them?, guides, experiences, tremendous widespread interest, I think two months ago, vogue.

A magazine in the US had a cover story on psilocybin. You know, that's a kind of widespread interest that's really remarkable. Wow, so you mentioned earlier, when we were talking about anti-inflammatory diets, you mentioned green tea and I know you're a particular fan of green. Tea in particular, as I understand it, is matcha, can you tell me about when you became aware of matcha, what happened there and why you are so passionate about people drinking more? When I was a kid, tea was something that old and sick people drank, and I drank heavily sweetened iced tea when I was 17.

I had the opportunity to live in Japan with Japanese families and I really came to love green tea, very good and I didn't see anything like it in the United States and I was also introduced to it. At that time, matcha in the Japanese tea sermon coincides with powdered green tea that is whipped into foam and consumed in the tea ceremony and I started bringing it when I went to Japan and convinced people about it, no one I had heard about him. In the United States and then sometime in the 1980s, I think this was again way ahead of its time.

I formed a connection with a Japanese company that produced matcha and tried to sell it through my website dr wild.com, but the timing wasn't right. And then, it's been surprising to me to see how trendy matcha has become in the last few years, but I was worried that most of the things people were drinking weren't good quality because matcha is such a fine powder that It oxidizes very quickly. and it loses its bright green color and good taste so I wanted to have very good quality matcha available and again I formed a relationship with another Japanese company near Kyoto and formed a company called matcha.com machikari that sells this and you know. making a lot of people realize this, I think it's a wonderful product.

Firstly, there is a lot of research on the health benefits of tea in general and green tea in particular, due to its antioxidant content. Matcha is different in that the leaves are grown in a way that increases the antioxidant content and is also high in an amino acid called l-theanine which has a calming effect and I believe modifies the effect of caffeine and makes it easier. stimulation of tea and Matcha in particular is very different from that of coffee. It doesn't have the tinkling effect of coffee. Doesn't leave you with a shock whenthe stimulation disappears. People say it causes a state of alertness and calm.

I think that is very desirable. I think it's a good thing. It is also beautiful and delicious. I'm going to grab a plate after we finish talking. However, there is a ritual in Japan about how it is prepared and I feel that way. matcha tea you sell when what people buy is the powder they then have to find the powder and I don't care what they do with it, I mean if they want to use an electric whisk if they want to make a latte if they want to sweeten it, You know how they want to do it.

I like to do it the traditional way, which is to use a bamboo whisk in a small amount of hot unsweetened water, but you know, in Japan now matcha has run away. the tea ceremony ritual, that's really kind of old-fashioned and matcha is now mainly consumed by people, not as part of a ritual, although I think there is a long association of tea in general and matcha in particular with meditation and , Again, a very different association to coffee, I think matcha has been associated with contemplation, meditation and the ritual of making it, and when whisked in a bowl, I find it to be very meditative and relaxing, I think What We're talking about something that, again, I think is a missing piece in modern life and even health promotion today, and that is that it's not just about what you're doing, but also how you're doing it, to know if you're taking five or ten minutes to brew your green tea, you know it's not just a habit, it's a ritual, it's a time to dedicate to yourself to really be present in a certain process and you know, I mean, interested, it's your point of view on this, but I've been thinking recently that we do science, we look at green tea or we look at polyphenols in coffee and we say, oh, this is a great thing and so in our hurried lives, you know, we make a quick coffee.

We hit it and go and then we say oh yeah, it has a lot of polyphenols and it's very good for me and I feel like we've lost something somewhere because for me, for example, I drink coffee. I have limited it. I know what works for me, but I take it first thing in the morning. Now I know that people will say that because I'm an early riser, I'm usually awake by five people will say that you know it's probably not, because of your circadian biology, the perfect time to have it, however, I would say that you know what that time is. . and a half in the morning before my wife and kids get up is my sacred time for myself and I do it in a very ritualistic way, I don't have a drink while I'm doing something else I'm paying attention to and I really feel myself in balance.

When you take into account everything that is a very important part of my day and you know, I feel more and more that we are missing this piece when I listen to you, I agree with you and I would extend it to food in general. And one of the things that struck me when I spent time in Italy and France is how different people's attitudes are towards food. You know that in the United States they rush you out of restaurants. He's in a hurry. There's a lot of concern about whether this is healthy, it's not healthy, I think in continental Europe, especially France and Italy, there is a lot more attention and time paid to enjoying food, dwelling on it and sharing eating in company. as a social ritual and I think that has a lot to do with reducing obesity rates, for example, since you know what people eat.

Yeah, I mean, I think there was a study, a study in the UK, I think it was the university. of Birmingham a few years ago showed that, in reality, if you eat in a hurry while you are distracted and therefore doing something else, watching television, you eat more at that meal and at subsequent meals for the rest of the day, which in turn really speaks to what you're doing. saying you know there's not just what you're eating but how you're eating it's the intention it's what's going on in the mind while you're eating um yeah, super interesting so I feel like it definitely uh sparked my interest in having some tea. matcha this weekend what's what's the URL I think it's what would it be it's just matcha.com matcha.com fantastic yeah, what's up with your

daily

routine?

I mean, you're someone who's been You know really a pioneer in this field and I think a lot of us would be interested in knowing how? I mean, do you know how old you are now. I think it is. I'm 79. I mean, 79, amazing and I'm looking. excellent health, what do you do

daily

? because I think it would be pretty if you were, if you're happy, I get up early, I beat you bad and I got up at 4:20 this morning, I tend to get up. when the sky starts to lighten and that's my best moment. I do a little sitting meditation in the morning.

I have two dogs, I go down and feed them. I usually have my matcha bowl and something light to eat and then. I take the dogs for a walk. I have a garden that I take care of. I grow a lot of my own food. I try to go for a walk or swim every day. That's my favorite form of exercise. I am mentally active more in the morning if I am going to write or do intellectual work. I like to do that in the morning and the afternoons are more for relaxing, reading, spending time with friends, preparing food, cooking, you know, that's my usual day and I'm usually in bed. nine at the latest ten yes, I love thinking about that, just to close this conversation, doctor, while I'm interested, you've seen a lot of changes in healthcare in the last 50 years, you've seen things. come in, go, you've seen things, take the public interest and leave the public interest if you look at the US healthcare system because I know that's where you're based, I know you've traveled the world so you're probably pretty familiar I think with other health systems it's very easy for many of us to criticize our own health systems, other health systems, but if you look at the US health system, yes, there are some negative aspects that we already you have spoken before.

Talked about on this show, maybe you can summarize what some of those negatives are, but are there any positive announcements that we can take around the world? We can learn and say, Oh gosh, America is doing really, really well when it comes to health. I'm really interested in your point of view on this and you know how other countries also need to evolve their healthcare systems. We don't have a health care system in the US. We have a disease management system and it is working very imperfectly and getting worse. minute by minute and also we as the richest nation cannot guarantee basic healthcare services to all of our citizens, that is inconceivable, so those are the big black marks, I think as a result of the economic collapse of our healthcare system medical, you know.

We are spending an outrageous amount of our gross domestic product on healthcare and we have terrible health outcomes that are unsustainable, but as a result of that, that is what is fueling the integrative medicine movement, which is much more developed in the US. .US than anywhere else if our health care system, we are not in such problems, our institutions would not be open to this. You know that many of the people who come to study as fellows are sponsored by their institutions, by their hospital systems, who pay their tuition. You know this wouldn't be happening if the health care economy in this country wasn't a disaster.

I see this happening all over the world. You know, until very recently, for example, we didn't get people from the UK or Western Europe, but as the healthcare economy starts to deteriorate, everywhere there is an openness to integrative medicine and I think that's the big change. Do people from all over the world have to come to the United States to do that residency or can they do it online? You know until Covid we had three residential weeks in Tucson that were spread out over the two-year fellowship, but the last two years we've done everything online and now we may go back to residential teaching, yes.

I mean, we'll get a link from you and we'll put it in the show notes of people and doctors who are interested in that you mentioned universal healthcare, of course, that's something we have in the UK, we have the national health service. which is something this country is very proud of, but something I've been thinking about over the summer is that I'm on a social media hiatus right now for four weeks and it's really the time of year where I really I feel like I can really tune back into my own thoughts and what I think, rather than being influenced by what I read online every day and I've been thinking about the NHS and of course you know the amazing benefits of having something like the national health service.

You know my own father who had lupus when he was 59 years old. Kidneys failed on dialysis for 15 years. There was no problem. He paid for everything. You know if he was in India or another country in the world and couldn't afford dialysis. Do you know I wouldn't do it? I've had those 15 years with dad that I had, so there are huge benefits, but in a 21st century era in an area where most of our health problems are driven by our collective modern lifestyle, I'm really interested in to know if there's any downside to having this kind of universal healthcare system where we're not really personally incentivized to take care of ourselves because actually, if you take care of yourself you don't even need to go to the doctor, so you don't even you get what you put in.

It's a thought experiment for me right now to figure out if there's any downside here. Do you see what I mean? Yes, but first of all, I don't think it's sustainable because in the UK, like everywhere now, you have ageism. In the population, there are epidemics of lifestyle diseases, there are rising costs of high-tech interventions, which is what conventional medicine depends on, and all of those trends are making healthcare increasingly unaffordable. , so the system can't continue that way and the problem is that you make the point that this doesn't really provide incentives for prevention, uh, and for people to take responsibility for how they live and manage their disease risks, everything it feeds off of this, so I don't see how this can continue, yeah, sure, well, okay, that's how it has been.

It has been a true honor speaking with you today. I could have talked to you for many more hours and I hope we have the opportunity to meet at some point in the future when the world opens up. Just to wrap up, so this podcast. It's called feeling better, living longer when we feel better about ourselves, we get more out of our life. You've shared a lot of things today on the show and I wonder if we could end with you sharing some of the most practical and impactful ones. The advice you've seen over 50 years makes the biggest difference in people's lives.

I think really trust and pay attention to your body's healing ability because it is your greatest asset. You know, learn the basic facts about nutrition. Avoid processed and manufactured foods. pay attention to your breathing and learn to breathe, I mean, that's absolutely basic, thank you so much for joining us, thank you for all your work over the years and I hope we meet at some point in the future, I enjoyed it, take care of yourself , thank you. watch out, goodbye gut bugs, the microbiota at the interface of your digestion and the rest of your body is one of the key educators of the immune system and again this is something that has probably exploded in the field of immunology in the last 10 to 15 years.

If you don't, if you take an experimental animal model where the animals have a reduced or minimal collection of good bacteria in their gut, their immune system doesn't develop and the way they respond and heal is greatly affected. and even things like protection against cancer because our immune system is the main cancer surveillance system, so these insects help educate, teach and mature our immune system and this happens potentially in the womb before we are born, but predominantly when we enter the world. Because we go from a relatively sterile world, there is some evidence that there may be some microbes in the placenta, but we enter this enormously germ-filled world and suddenly our immune system has to deal with it, because you know it has all of these .

It has receptors to detect pathogens as problematic, so it has to learn to tolerate them because you know that most of the insects around us are safe and harmless and we need them because they are helping us and that is how the immune system develops. But it's through exposure to the environment around him to the insects around him to give him that kind of continuing education so he starts to learn. Oh, I answer this. I don't need to answer that exactly. I often say that. you know, the immune system is created, it's not born, maybe there's a percentage in the genetics that we inherit, but then it's created, it's built throughout our life and it changes throughout our life, so it's an idea lovely, it's a Maine that is not born, we can, we canbuild. and we can develop it the way we want if we give it the right, yes, yes, and I often think of inputs as a way of shaping the immune system and I was trying.

I was working on a talk the other day and I was trying to make a slide of all the inputs, some we can control, some we can't, that are shaping our immune system from birth and then it became a very busy slide. and messy because there was too much to put there, but yeah. A lot of this happens in childhood and in some ways I find it quite daunting as a mother and you think, well you know there's sort of the first three years, I would say that's when you're being colonized by all these good bacteria and there are big changes. happens in the immune system during that time and this type of interaction occurs, these bacteria help protect the intestinal barrier to keep it very nice and firm and prevent any bacteria from entering the body because they are only good bacteria if they are in the right place, so they are not meant to cross the intestine and enter our body, yes, because then they become a problem, but one of the most important things that they are doing to help our immune system is that they are there. you're eating our food and I often think that your diet is only as good as your gut microbiota because they're the interface, they're eating your food, they're helping you produce these vitamins and minerals from your diet, but we're also producing these postbiotics, and People may have heard of prebiotics and probiotics, but postbiotics are basically the metabolic waste of insects in the gut, so they're producing things that are their kind of waste product from eating foods like shorts. . -Sharing fatty acids Fatty acids is the classic one that I used to work on when I lived in Switzerland and look at how they influence inflammation in the gut and beyond, so short chain fatty acids are a kind of metabolic byproduct of the insects in your gut and they bind directly to the immune cells at that site and help educate them and teach them to tolerate whatever you put in your mouth because we're not supposed to react to that because we should You know, there are benign things that are happening. there, but they have to help achieve that balance.

If you suffer from some type of food poisoning, they can also identify the bad bugs, so they help create an environment that is what we call tolerogenic, so it encourages tolerance. of the foods that you're eating and there's a kind of dynamic interaction between these bugs and the immune cells and I would say that what happens in the intestine doesn't just stay there, this influence, this kind of tolerogenic influence of things like fatty acids short chain, it is also absorbed into the bloodstream and helps regulate the immune system in the distal science of the intestine, and also helps it regulate itself.

Isn't it exactly before it existed? I think you mentioned the term peacemaker. I think the first time I read it, I think it was in a nature article in 2014, I think I think I use that on one of my slides. calls them our peacekeepers, yeah, I think that was the first time I saw it in Prince, which is kind of what they are, yeah, really, and in a way, yeah, I mean, I really think a lot of people talks about gut health these days, but i. I don't think people understand that the immune system is related, you know they think they have something separate, but I often teach doctors about this triad between our diet, our gut viruses, and our immune system and how they all intersect. oh, definitely, yes, there is two-way communication between diets and gut bugs, diets and the immune system and gut bugs and the immune system together, it's like that so you know that if you make certain dietary choices you will improve the health of your bugs. gut that will improve the health of your immune system, yes, exactly, just empowering, because we can do something about it, yes, exactly, and I think as a nation we are not eating enough fiber and also fiber in the UK has a really bad effect. as an image problem, I think like most people, I think come on, let's give it a little PR.

Yeah, if you were to ask my husband what he thinks, five is that he's not in any kind of wellness field, medical nutrition, in fact, the other day. I came home with some cookies that they said were like look, they say they have added fiber and I was like, "Okay, because we think they're breakfast cereals, like cardboard with the big fiber logo and um or fiber." as one thing, but again it's diversity, different insects need different forms of fiber and we find it in all plant foods, so it's not just the fruits and vegetables, nuts and seeds, legumes, legumes and grains whole foods, and it's about trying to incorporate diversity, I think in the last few years there's been a post about kind of trying to include 30 different plant foods in your diet because it's about a week, yeah, because it's about diversity , but it also includes, I think, lentils and nuts, yeah, you know, I think it's very achievable once people keep it in mind, exactly, yeah, and they're very common in traditional diets.

I remember growing up, you know, my mother would add a lot of different grains and beans and pulses to spin things up as she put it so you can make a dish go a lot further, yeah, wonderful advice. So far we've said that lots of different colors, lots of different diversity of plants will help your gut microbiome. helping your immune system eating less is also something that could be helpful, yeah, so this is another field that I've become fascinated with and that's immunometabolism. I don't know if you've heard anything about that word, you know, metabolism. two words together, yes, and it's only been in the last five years that something like this has come up and people have started to look at this, but metabolism basically breaks down the main components of our diet, so proteins, carbohydrates and fats are convert into energy and building blocks that our cells can use and people can hear things about metabolic rate or I have a good metabolism these kinds of things that people say um and you know, metabolism and the immune system are closely intertwined and I You don't know why it's taken us so long to realize that, because immune responses are energetically very expensive, you know it has to be some kind of resource selection to be right, we're going to fight this infection and ignite all the inflammation. , turn everything on. the production of antibodies and all those molecules that are being produced and the proliferation of immune cells requires a lot of resources, so it needs energy, it needs building blocks.

That's why we feel tired when we have a fire skin infection, because the body diverts resources, yes, to produce. all of those things and you may need to get well again after you've been sick, particularly if you've been sick for quite a while or if you have an ongoing illness, your nutritional needs could be very different from someone who doesn't, so immunometabolism is the field that tries to understand how metabolism can shape immune responses and vice versa, so this happens at the level of the individual immune cell but can also happen in a tissue environment. and an environment of our entire body and this is something that there really isn't any kind of absolute concrete understanding yet in this area, but we do know that when an immune cell is fighting an infection, it goes through a metabolic switch and goes from being in this kind of resting state to suddenly absorbing a lot more glucose to fuel proliferation immune cells are forming armies of themselves building antibodies requires you to know the building blocks of proteins all these kinds of things are happening and that metabolic change is known as the warburg effect this is also what happens to cancer cells but immune cells do this when and it is perfectly normal when they are fighting an infection or fighting any type of problem and then it turns off and the immune cells come back to normal. and they no longer have this great need for metabolites, but what people are starting to wonder is whether the overall environment of a body influences the metabolic switches within our immune cells and activates them aberrantly when they are not needed.

We know that diabetics have poorly controlled blood sugar, so they have high blood sugar and their body creates an environment that causes some of our immune cells, like neutrophils, to not work as well. , so it affects immune cells to have nutrient sensing switches. inside them so they can sense what nutrients are available and they are assimilating that information and then that affects how they can function now what is not known is whether we can feed someone different macronutrients, protein, carbohydrates or fats and influence how their immune system. working, can you activate or deactivate unwanted immune responses based on the different macronutrients your body metabolizes?

I think this is where the field of immunology is going to go in terms of treating chronic diseases because we know that people with chronic diseases like metabolic syndrome, type 2 diabetes, heart disease, or people who have too much visceral fat, who all environment of their bodies is metabolically different and this could be causing immune cells to act abnormally and become more pro-inflammatory, for example, wow, super interesting, yes. There's a lot of research to come exactly in that area and I think we don't know enough yet to say specifics, but I think for so long we've focused on the micronutrients, but it's actually the macronutrient, so you could adjust the The diet gives them different ratios of protein, fat and carbohydrates to maybe alter their metabolism and alter the immune cells that were malfunctioning, so someone who had a chronic flat inflammatory disease we could direct that and incredibly exciting, right? ?

So what you said about eating less or something else that I mention in the book because I wanted people to stop thinking about a vitamin supplement for their immune system is that immune function is affected by overnutrition and lack of nutrition. nutrition, so if you are not eating enough or you are eating too much, this will cause your immune system to malfunction and I should contextualize it by saying that if you are doing it consistently, then we will have this field of research on Fasting and Immune Function . I remember being at conferences decades ago when they talked about fasting and how it would regenerate all kinds of body parts.

It was kind of mind-blowing and now we see it more in the mainstream and having all these kinds of different forms of diets and this again is causing metabolic changes in the body that then when you go back to feeding after someone has had a period without food, It increases growth hormone and you get new and fresh immunity production. The bone marrow cells and the stress of starvation cause some of the older immune cells and the ones that might be more likely to malfunction to be eliminated, so you're replenishing your immune system and we're starting to see experimental models. of autoimmune diseases, this is, you know, highly therapeutic, yeah, it's fascinating that it's not necessarily just about what we eat, but how much or how little we fast, don't we fast?

All these different types of components that influence. I assume they play a role in the signals the body receives because I assume that's all the immune system is trying to interpret the signals. Somehow you're okay. What does that mean? It is safe? Or is it not said? Do I need to act? Yes or I can just keep calm. I guess everything we do, even our thoughts, our words, our sleep, our stress, are all giving a signal in some way. Our immune system is exactly what I need. answer or okay exactly yes, it always is, yes, it's that simple, isn't it?, it's central, yes, yes, yes, it is this decision making that is continuous and constant, it is the integration of all these different inputs to decide and I think the thing with those kinds of - so-called Western diets that we talk about like they have a negative impact on our health um it's just very tasty and we just want to eat it all the time it's salty it's sweet it's delicious it's everywhere we can quickly override any lack of hunger cues just to eat we kind of pathologize being hungry it's like you're never allowed to be hungry you have to have 10 snacks in your bag in case you can't reach for some food and thenWe have There are millions of incidences of eating during a large part of our waking time and some of the research that I was involved in several years ago looked at postprandial inflammation, so when we eat there is a subtle inflammation that occurs in the body and this is quite normal.

We have a lot of checks and balances to keep that in check and in fact, dietary fiber is one of the best ways to seal that back in and prevent that from happening, as is having a period of time without food between meals, so eating enough and the right things in one meal that you don't need to eat until the next meal and it's actually pretty good for overall gut health, but also whole body health. I'm super fascinated by this research as well and You know many of us not only eat too much, but we eat too frequently throughout the day and as you just said, you know the act of eating is inflammatory, yeah, so that's one response to eating that your body will become inflamed as you say.

There's nothing to worry about, it's part of the process, but I guess you know that and you know I know that Sachin Panda has looked at this Professor Panda a lot and I think when he started his application in 2015, I think it's called. My circadian clock. I can't remember the numbers on the hands, but it's something like 20. 30 years ago, most people ate three times a day in the US. I think it can probably be inferred in the UK as well and then in 2015, when I was measuring. and people were pushing the app, I think the top 10 percent of people were eating 15 times a day and it was a yes, you know, so if we think about that, let's say I'm eating 15 times a day and let's say in theory , they are all whole foods, right, everything is good, health, what is considered, yes, we have to be careful with the language, but what is considered a type of food useful for our health, the question to ask is eat them. times a day is useful, that's like 15 attacks of inflammation, whereas if you ate the same type of food, you know it's not a perfect analogy, but three times a day for five days you'll still have 15 attacks of inflammation, but that's it . week, yes, rather than in just one day, and I really think that socially and culturally there is a problem with how much we are encouraged to eat even healthy foods, like you can buy healthy snacks here and healthy snacks there, but you're kind of inflamed every time and I don't know what you would think of that.

Yeah, no, I think it's a real problem. I think the scientific community doesn't understand it well enough to really translate it into some kind of clear health message. people, but from the research that I was involved in and work like what Sachin Panda and others did, I definitely think that we need to look at the incidence of diet as well as, you know, the period of time that we're eating , believe. Some of the studies show that we spend 18 hours a day eating, it's like all the time we're awake and I don't think we're designed to deal with that consistently long term.

Going back to traditional diets, you know my grandparents didn't eat all day every day, because that just wasn't how it was constructed in different cultures or eaten in different ways, but it's certainly not common to eat all the time and I want to Merge the tradition with modern life in some way because I think that is the key we need. We cannot go back to times past, but we can bring parts that we have left behind and integrate them. This is reflected in what we have to work on right now in some way when I find a very effective and powerful recommendation that I use in my patients is to try not to eat for 12 hours and every 24 hours so you know to basically eat all your food within 12 hours. time window that you know really was the norm for almost everyone, yeah, maybe 30 or 40 years ago, I mean, yeah, you know, we could stop eating at 8:00 p.m. m. and maybe we wouldn't have breakfast too late, I mean, I'm not talking. about extreme fasting I'm just saying, I said, I think that's quite a bit, I certainly know when I've managed to maintain that consistently, I sleep better, I feel more energetic, yeah, and I think there's really this idea that you know you need time for the body to regenerate a little bit if your gut constantly has to use energy to constantly digest food, that's going to affect your immune system, it's going to affect the resource you have for something else, yeah, exactly, there's, you know, the gut.

In the lining there's also a sort of um uh, it's energetically expensive because there's a turnover of those cells quite regularly and things like the short chain fatty acids that we mentioned earlier, which are produced when our gut bugs digest fiber, are really nurturing growth. of and repair of the cells that line the intestinal barrier and those are sort of the interface cells between what happens in the intestines and what gets put into the bloodstream that could exacerbate that inflammation and we know that certain things like saturated fats and high fructose diets low in fiber, as well as other things like stress and extreme exercise, can disrupt the integrity of the intestinal barrier and exacerbate this type of inflammation seen after eating.

There's a really interesting study that looked at these five main personality types. They are broadly divided into openness to experiencing conscientiousness, extroversion, agreeableness and neuroticism, so in terms of psychology there are ways in which we can be categorized based on our personality and each of these personality types has specific immunological characteristics and one of the most interesting things. is that some of them are more likely to be pro-inflammatory and have higher levels of C-reactive protein, which is a blood marker of inflammation, and things like being neurotic and being less introverted can affect inflammation. in our bodies it's because I guess we're all very different, we're all on kind of a spectrum of different personalities, but that's evolved from different roles that you can play within a community and then what your exposure might be to different infections or You The risk of injury and things like anger are known to prime the body to get hurt because maybe anger preceded violence and throughout our evolution we've liked, okay, if you're angry, something could happen that It could hurt you, so we need to prepare. parts of our immune system to prepare for that you mentioned anger and it's something I wrote about.

I feel like question 5 is the importance of forgiveness. There is good research on forgiveness. A guy named Fred Luskins went to Stanford University. I think the essay or research on forgiveness that I don't remember exactly, yes your research is amazing and in my last book I shared a story about one of my patients who had high blood pressure and again you know that to make it relevant For our conversation, you know that high blood pressure is chronic. non-communicable disease that you know will play a role in chronic inflammation, yeah, in some ways, and you know what she had changed in her lifestyle, even though I was, you know I was doing these things, I try and talk about food. , movement and sleep, you know? which wasn't moving and had to do with um, you know, basically, her um, her husband of many years had cheated on her and they had separated and it was only once she started practicing forgiveness that her blood pressure started to go up. lower.

It was amazing and that's a lot, it's an anecdotal story from my clinic, but I really think it holds true and consistent with the research that's out there in terms of whether you hold on to resentment and anger. They influence exactly your biology and your immune system and maybe that's culturally what we see dividing different groups and also how they deal with illness because they can feel marginalized. I think social status is also very important. I know that in the animal kingdom being lower in the pecking order can be quite stressful for an animal and that can be seen in their blood chemistry, but also for us humans, and I think that's something we see developing.

With the lowest socioeconomic population type, demographics are the most affected. For some of these lifestyle diseases, yes, they may have more stressful lifestyles, but we always rule that out, don't we? Less access to good food, more stress, and of course I think that plays a role, but what if it also plays a role? related to stasis since it's the animal kingdom what you know is something I haven't thought about that much and probably isn't that common of a narrative is how where I guess you know in many ways it's how you feel your life has a purpose yeah , yes, you know how you view your life, what the meaning behind it is, because that too in itself has a lot of research suggesting that you just know that if you feel like your life has meaning and value, you tend to have a better life. happier and a healthier life, yes, I am referring to other research that I found recently that compared Samoan individuals to European individuals with the Epstein-barr virus, which is a virus that almost all of us harbor, but when we activate our stress chemistry , this may actually be a sign that the virus often allows itself to reactivate and cause problems, and we know in Western culture that having a lower socioeconomic status means you are more likely to experience a spiral reactivation, but in Samoan culture, Being in a lower socioeconomic level has a totally different impact on stress chemistry, which actually means that it was the people in the higher socioeconomic levels who were most affected by latent viral reactivation and this is just they use viral reactivation as a readout empirically. of measuring changes in the immune system, but in different cultures, you know it and we never think about this in medicine, I mean, what is that like for you as a scientist and as a lecturer?

These are the kind of yes, these would be, they would be perceived as a little bit softer, yes, aspects of health and science, but that's exactly what we need to bring together. A lot of the data is quite old now, but I guess it's just been sitting there and we have this real kind of biomedical model that we focus on. We focus on one type of cell and what that cell is doing and it's really reductionist and then we try to put the puzzle together and we need to merge it with anthropology and say, "Okay, now how do we bring these two fields together?" I think the only way we can address where we are, yeah, is with our health and you know you kind of connect it so beautifully throughout the book, all these different components, emotions, food, movement, sleep , stress, yeah, you know, it has a good section on supplements.

Also, what you probably won't be able to get into today, the joy of the table, the joy of the tavola, which is an Italian phrase for enjoying being at the table and linking what we were talking about before with food and emotions. Know that make your table a happy place because endorphins when enjoying being at your table with your family, your friends or even alone and just enjoying the food, endorphins can alter the function of our immune cells because they have receptors for the that are in them. So those feel-good hormones that really help nourish things like regulatory t cells, so pairing food with emotion and enjoying that is really important.

Yeah, we haven't had a kitchen for the last four months, so. I haven't had a table or joy, but we've still been trying to improvise as a family, you know, little meals on the floor and you know what I'm so delighted to hear you talk about these things because I think they are things. we've missed the health advice, yeah, it's been too reductionist, you know, eating at a table with your community, your tribe has always been part of human culture, yeah, and I think if you extend the argument that what What you're doing is like you can eat the same foods feeling stressed and alone, yeah, and the same food might have a different response if you eat it with good friends when you're feeling relaxed and calm.

I'm convinced that you know one thing that I've actually observed clinically, maybe for two or three years, a lot of people today react or perceive themselves as reacting to food, yeah, and I think what's really interesting for me is and I think I really understood this the year before I wrote the solution for stress because I thought well, if stress significantly changes your intestines and your gastrointestinal tracts in your digestion, as it does well, are they really reacting to the food or are they reacting to the event? They are eating in a state of stress and I have seen with some patients the same food if they do some type of what I call a transition between states of action and eating when they do it for a minute or two before eating, yes.

They no longer react to the same foods, yes, which you already know, I think this has even been shown with gluten as a nocebo effect, yes, which I don't know,People say this all the time I go on vacation, I can eat the bread. it doesn't make me feel bloated but the bread at home must be somehow different maybe it is different but you are also different you are in a different mood when you are on vacation and you are eating and chewing your food while looking at the beautiful view and feeling more relaxed and that's affecting your digestion this matters yeah people think you know when I do it not really I hardly drink anymore um but when I did I used to remember I was going on vacation and as you know , a glass of red wine would affect my sleep in the UK or you know I feel a little groggy the next day, but I found that when I was on holiday I could have. a glass or two with dinner I didn't feel anything, yes I thought this was stress, it's like there is no load of stress in my life, I'm relaxing with my wife and children and there is a bee, yes, so no It bothers me, but if your life is chronically too busy, you're stressed all the time, not only are you going to get sicker or potentially, you know you won't be able to tolerate various things, you're going to, you're going to, I'm not going to have to put up with those. insults exactly, I call it food prison.

You know, I see so many people who are so stressed about eating the perfect diet that it's just eroding their health, no matter what they're eating. helpful but I guess you know you asked me before what I do to manage my stress and I think it's still my learning curve but it's on my radar now that I'm always experimenting. I'm learning to say no. I think having boundaries was one of the most important things I learned as an adult, like why don't we teach this to kids in school and tell them it's okay and there's a time and place for projects if I want to achieve them. involved and it can't be now because that compromises my time as a mother or my time with family or my time, you know, being alone or doing the things that nourish my day, so I have to say no and let it go. of that and I guess it's like you know the catharticism of writing or some ways of putting a narrative to what's stressful because I have a release and you can feel like you know like a big physiological sigh that your body is emitting. when you're okay and once you make the decisions you get over it, I said no, it's sad and I wish I could say yes, but I don't think about it the next day when I've moved on and other things are, you know, it's very liberating. , actually, you know, something that I've struggled with for years is that I'm getting a lot better at it, but it feels good, yeah, yeah, half the time I used to say yes and stuff and then I was just stressed out because what did I say? that yes I have to do this, I have committed now that they started advertising, I am getting much better at nipping it in the bud, yes, source, yes, but it has taken a lot of work, oh yes, I had to learn it the hard way, yes , but I started to feel like I was doing everything wrong when you start to feel like you're being a bad parent, I probably wasn't, but in my mind I wasn't doing what I wanted to do and I think with my kids there had to be a firm line that I could never cross again.

Now you mentioned eating and you said you know there are some studies that our immune system works differently if we eat together feel joy feel happy that reminds me of something else I read in your book about it having something to do with you were giving a list of strategies to people, but it was about, you know, how to walk while listening to music, it was about putting two senses together, could you expand on that? Yes, this is really interesting. This was actually data that was generated in the 1980s. There are some scientists who were trying to refute the research that came out of Russia at that time on conditioning, making the classic example of conditioning.

They are Pavlov's dogs. Most people will be aware of that, but there are these experiments that they had done where they had looked at trying to condition the immune system and that's why these scientists were like that. They can't be right. You know we're going to redo the experiments much more strictly and see if it's really what it seems. Can you condition your immune system with various rituals and routines and what they did was what they used? an experiment with an animal model and they gave the animals a sweet solution to drink and one group got the sweet solution that also had a particular chemical inside of it that would modulate the antibody responses so they could measure the antibody responses in the blood and see if that there was an effect, some kind of tangible data readout that they could observe, so the mice were given this sugar solution with this chemical over a period of time and after a while, when they just they gave them the sugar solution alone, the same effect happened to the immune system, so it's like a placebo effect, it's like you expected something more expected this effect to take place in their body on some kind of subconscious level because it was so accustomed to that happening that the effect occurred anyway even without the chemical presence that would actually cause the modulation of the immune system and people have been doing research to try to understand the mechanism and I think the best thing we have found is the placebo effect as if there was somewhere. of us who don't really understand what embodies things and when a response is expected, the biology changes and we can start pairing things, so what you're referring to in the book is like the kind of little stress relief rituals like you know, playing your favorite music while you do something like taking a nice bath or having a particular aroma in the room while you do something else and eventually you can play that music and you start to feel just as relaxed. feeling you get when you're in a nice warm bath even without taking the bath yeah, you know, it makes me think of you, you know if your house is or has been a stressful place, then you know that it works, that you can come in that and your body it can start to almost make the immune system sense it and go well, this is a stressful place and react even if nothing stressful happens, yes, but you can also turn it around and you know I'm a big fan of ritual. and kind of daily practices that even if they only take five minutes can be very powerful and I think when I hear that I think of a morning routine and I think, what if someone you know could design their ideal morning routine, let's say, let's say it.

It was five ten minutes, yeah, you know, a little bit of maybe a minute or two of breathing, yeah, you know, three or four minutes of light movement practice, yeah, and then let's say five minutes of reading a positive book. , yeah, for example, I mean, that's what you know. In the season of stress I write about three hours in the morning, we have seen mindfulness movements and mindsets. I think you can create one that lasts an hour. You can create one of the last five minutes, but the point I'm trying to make is if someone started doing that in the same room, let's say they lit a candle, yes, in the room they did that, but even on a day in the who are a little busy or haven't done it at all, they can't disconnect and it's only your turn.

I know they sit there with their coffee with the candle lit, yeah, maybe that also conditions their immune system the other way and go, hey, everything's fine because he has the candle lit, yeah, it's pretty powerful, well, all the sensors are integrated so there could be a particular smell that you are burning, there could be a particular song or playlist that you always play when you do those activities for your morning routine and then in the morning you wake up and just you're tired and you don't want to To do your movements you just want to sit and enjoy some tea, but you're in that room with that space and you can still be reaping the benefits of meditation and movement that you would normally do and I think as a human being.

We seem to be stuck in routines for me, especially being a mother. It's been so important that now I can cushion the lack of routine more because I can get back into a really strong routine that I've built over time. and I think when we went into lockdown this year, everything became unbalanced and we haven't, we're basically living on a construction site right now, so I'm emphasizing that it's stressful, the routine is a shock, you know, every shot has really It did us a huge disservice, but I think having been someone who needs routine, especially because we're a bit of a stress-buster, it didn't take us long to find a new rhythm.

Being at home and that's an anchor, I think that's how I love the form. you, the way you say certain things, you said you know we can create a routine like you can build your immune system, yes, those are very empowering words, yes, building means we can do it right, it doesn't mean it's fixed exactly, we have some agency about that, yeah, it's really interesting, as you know, as I mentioned from the beginning, this is the first day in the new studio, yeah, and Gareth, who's recording and sitting in the corner, we've been talking about what You know.

We create a stress-free space that allows deep authentic vulnerable conversation to happen, yes, and you know it's not ready yet, but bringing in plants is one thing, you know, we'll probably have a lit candle or some kind of You know, nice aroma , yeah, you know, my dream is because this podcast is about authentic conversations, it's not interviews, it's conversation. I want someone like you to come in and inside you know I almost want to program it so that people feel calm. and they say they want to open up and they actually do, you know what I mean?

Yes, I think you've already done a very good job, but I also think that what you convey as a person really helps put people's eyes at ease. You know, when we're angry we like to squint or if we're feeling quite negative or stressed and then we pick it up when we read body language and if someone has a relaxed disposition, that will be interpreted by the other person and make them feel comfortable as well. interpreted by our immune system yes, exactly because this is a safe environment, it's about all those millions of inputs that come in, yes, every minute of every day and our immune system. systems reading them shaping and responding if you enjoyed that conversation i think you're going to love the one i had with professor tim spector everything about food is there so click on it and let me know what you think if you eat a couple of hours before a meal, your metabolic response to that meal is worse than if you didn't have a snack, okay, just say that again because I think that's really important.