Feel Better, Live More with Dr Rangan Chatterjee - #59 Personalising Your Health with Alessandro Ferretti

Episode Date: April 23, 2019

We are all bombarded by stress throughout our daily lives and it comes in many different forms, but how do we actually know what impact that stress is having on our bodies? One of the key messages from today’s conversation is a reminder of how unique we all are. My guest on this week’s episode is nutritionist and researcher, Alessandro Ferretti, who has spent years researching the effects of various stressors on the body by meticulously monitoring the heart rate variability (HRV) and blood sugar levels of both his clients and himself. He shares the fascinating findings of his research and explains that what causes stress on our bodies can be different for different individuals - one man’s medicine really can be another man’s poison - and the way we perceive an event is key. We also discuss the effect of shift work on our bodies, how type 2 diabetes is not just a dietary problem, how the wrong timing of meals can act as a significant stressor on the body and the impact of caffeine and insufficient sleep. Finally, he gives some brilliant tips for optimising your health. This is a really informative conversation – I hope you enjoy it! Show notes available at drchatterjee.com/alessandro  Follow me on instagram.com/drchatterjee/ Follow me on facebook.com/DrChatterjee/ Follow me on twitter.com/drchatterjeeuk DISCLAIMER: The content in the podcast and on this webpage is not intended to constitute or be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your doctor or other qualified health care provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have heard on the podcast or on my website. Hosted on Acast. See acast.com/privacy for more information.

I think people have to really dig deep into what is that takes them into that parasympathetic state. Because most of the time we think the stress is something, but in my experience, it's their perception of what they're doing that is way more important than what they're doing asburgh itself. podcast, I aim to simplify it. I'm going to be having conversations with some of the most interesting and exciting people both within as well as outside the health space to hopefully inspire you as well as empower you with simple tips that you can put into practice immediately to transform the way that you feel. I believe that when we are healthier, we are happier because when we feel better, we live more. happier because when we feel better, we live more. Hello and welcome to episode 59 of my Feel Better Live More podcast. My name is Rangan Chatterjee and I am your host. Today's guest is a good friend of mine, Alessandro Ferretti.

Alessandro is a nutritionist, a published researcher, an international lecturer and a clinician with over 15 years of experience. We actually recorded this conversation back in December 2018, so I'm delighted to finally be able to share it. On today's show, we cover a wide variety of different topics, but one of the key messages is a reminder about how unique we all are, how different stresses in life can affect different people in different ways, how the same life situation can serve as a stressor to one individual but be entirely relaxing to another. A lot of the time this comes down to our own individual perception of the

situation. We also talk about something called HRV or heart rate variability. Now, if you have read my most recent book, The Stress Solution, you will already have a good understanding of what HRV is and why it is such a powerful measure of our health. HRV is a fantastic way to measure the total stress burden on your own body, whether it be from too much work, overload, eating the wrong foods, whether it be from too much work, overload, eating the wrong foods, eating healthy foods but at the wrong time, caffeine, sleep and so much more. Alessandro has a wealth of clinical experience and he has meticulously tracked his own HRV and blood sugar levels as well as those of his clients. This personalized feedback has given Alessandro a lot of expertise in this area, which he shares with us all in our conversation today. I found Alessandro's insights fascinating and I'm sure that you will do too. Now before we get started, I do need to give a very quick shout out to our sponsors who are essential in order for me to be able to put out weekly podcast episodes like this

one. Athletic Greens are a long-term supporter of my podcast. Now whilst I prefer that people get all of their nutrition from food, I do recognise that for some of us this is not always possible. Athletic Greens is one of the most nutrient-dense whole food supplements that I have come across and contains vitamins, minerals, prebiotics and digestive enzymes. So if you are looking to take something each morning as an insurance policy to make sure that you are meeting your own nutritional needs, I can highly recommend it. For listeners of this podcast, if you go to athleticgreens.com forward slash live more,

you will be able to access a special offer where you get a free travel pack box containing 20 servings of Athletic Greens, which is worth around £70 with your first order. You can check it out at athleticgreens.com forward slash live more. Now, on to today's conversation. So Alessandro, welcome to the Feel Better Live More podcast. It's a great honour to be here with you, Rangan. As being one of the podcasters, I thought absolutely fantastic. Oh, brilliant. Well, look, thanks for the feedback. And I think people are really going to enjoy today because you are an expert in nutrition.

There's no question about that. But what we end up talking a lot about is stress, and in particular, something called heart rate variability. So I want to really delve deep into that today. But I wonder if you could start off by talking about stress, you know, what is stress, and then move on to what is heart rate variability? Sure. I think you are far too complimentary to me. I love researching and I love things that I do. But yeah, I never like to call myself an expert on anything. I'm too young for that. But anyhow, to me, it was a very important part of my research to look at the effect of stress.

Because I started to, let's say, being familiar with heart variability through sport, but then soon realized that the effect that our environment has on our body and affecting heart variability can be from all sorts of sources. And interestingly, my also definition of stress, what I consider stress, has also changed. Because we normally associate stress with work or familial problems. But in actual fact, anything that is allowed that would lead the body to fail within their immediate environment can be considered a load. So in this sense, and obviously I need to be careful about my personal bias,

because being a nutritionist, of course, is everything about the diet. As personal trainers, we think everything is linked to the type of exercise, for example. we think everything is linked to the type of exercise, for example. So I soon found out that stress is probably one of the things that affect our physiology the most. I prefer to call it life load or loads because normally stress has negative connotations attached to it. Whereas I found out that for example i love what i'm doing when i go on tour in on roadshow lecturing uh is all stuff that i really enjoy

doing and yet the impact of my physiology is very very tangible and measurable yeah and i think this is this is super interesting for people because I think, Alessandro, what you've managed to do is through your own research, through tracking heart rate variability and other metrics on your clients, you have really started to build up a picture of what lifestyle factors do what to our body. And what's interesting when we've spoken in the past about this is that it's different things for different people. So I'm guessing there are some commonalities, but there's also some maybe sort of individual differences. Absolutely. And that's the reason why I virtually stopped in telling people what they should be doing to relax. And to a certain

extent, I'm very, very careful with food and diet because I first-hand measured that, for example, a blood glucose curve following a certain meal, following exactly the same meal, eaten exactly at the same time, wife and husband had two completely different profile or profiles in this case. And when you say profile, what do you mean? Are we talking about this heart rate variability? I done it with both, Rangan. I done both with glucose following a meal and also heart rate variability.

In this case, I used an ongoing measuring type of device and it's what was really interesting was exactly what you just mentioned the individual variations that given the same load stressor food had very very different impact on the individual. Yeah. So that was quite enlightening for me because obviously most of the time you think this is good and this is bad. And I think we go slightly, okay, there are things that are extremes. I understand that.

But we need to be really careful in advising things to do because people may respond very differently. Yeah. I mean, Alessandro, we spoke a lot this summer. You were helping me with the heart rate variability section in my book, The Stress Solution, which is brilliant. And I really appreciated your feedback from all the work that you had done with your clients. I think it's worth at this point, some people will be listening to this and wondering what is heart rate variability and why should it matter to them?

Right. So heart rate variability is a reflection of the parasympathetic and sympathetic tone of our nervous system. So our nervous system is divided in a very gross kind of description, of course. When we are active, when we are engaged, and that would be more of this sympathetic activation. And then the more recovery associated, relaxing, resting part. So, for example, when we work all day, we are more likely to be in a sympathetic, activated state. And when we sleep, we should be in a more parasympathetic state. So this will be a balance between us doing things and being in contact with the environment and people and being active, or exercise,

for example, that is reflected in heart availability too, and also the more recovery, then these two should be in a form of balance, in a sort of balance. And I think a useful way that I think about it uh to describe to the public and and to my patients is i think about a stress state and a thrive state it's not necessarily quite the same thing but yeah it's to really get the idea that we we've got a sympathetic nervous system which is there to help us and you know we need it for various things you know we're engaged in things where we get anxious and agitated by something we need to run you know, we need it for various things. You know, we're engaged in things, we get anxious and agitated by something, we need to run. You know, our sympathetic nervous system gets activated, but we also need the opposite, the what I call thrive state when we are relaxed and we're chilling out.

You're saying that these things need to be in balance, but I think you're also saying that heart rate variability is a really nice way of measuring the difference between the two and what state we're in yes yes absolutely so when the the technically the the heart rate variability is basically the variation that there is between heartbeats so So we think that if someone has a, I don't know, 60 beats per minute heart rate, we think that every second, you know, to the count, the heart would beat. Well, a more relaxed, healthy body would have a variation in that. So for example, one beat is at one stage, and then instead of being one beat every other second perhaps is 0.9 of a second 1.1 of a second and it keeps changing so so we want that variability don't we that's a good thing and i think people get confused about that because they they do think that the heart should beat like

a metronome beat to beat um but it it's interesting isn't, that when there is that variability, I guess it reflects that we are able to adapt to a changing environment around us. Precisely. So we're looking for more heart rate variability. That's a good thing, generally speaking? Generally speaking, that's correct. We have instances where in high-end elite athlete when that may not be always associated with a great thing, but we are

talking at a very you know very completely different group so for most of us correct who are not elite athletes who you know are interested in how different things affect our stress response system what are the things that you found i mean i'm guessing there is you know there's obviously going to be variation between individuals but you know everyone's focus these days on you know trying to eat a better diet yeah trying to move more you know i've said in multiple times i think we we neglect things like sleep we neglect stress in a big way and you have seen in your work company that stress for example um or what you what your body perceives as being stressful can have a remarkable effect on multiple things, including your blood sugar level. That in a nutshell is the summary of what I've been trying to research for the last few years.

That is absolutely correct. Going from an example of someone, then I looked at the person's ongoing reading for heart reverability and see that it was pretty stressy. And then every two to three days, I actually saw a very nice mid-afternoon parasympathetic state. And I thought, what the heck is that? And so I challenged, obviously, you need to be careful because you know that he's in a parasympathetic state but you don't know what has led the person then and then in the past i advised the person to take relaxation techniques and maybe look at a certain relaxation books and it was just getting more and more wound up

and i thought okay well so i'll tell you, what is it that happened in that time in the afternoon, I asked the patient. And then he said, I'm a bit hesitant to say. I said, oh, nothing private. Obviously, it's fine. But I thought, okay. He said, I'm washing my car. And I went, right. I think you're going to have a very clean car

because what I'm going to suggest is you need to mimic or wash the car, do something that takes you back into that recovery parasympathetic state. So basically you were tracking his heart rate variability. Correct. And you've found that at some point in the afternoon, remarkably, his heart rate variability was quite high, which indicates that our body's in a state of relaxation. Flow. Flow. Yeah. Or what i was calling thrive state yeah so this is amazing because it allows you to individualize personalized care but that person said hey what were you doing at three o'clock

oh you're washing your car well when you're washing your car you were in a very chilled out state yep absolutely happens to be in in in my personal life. So for example, if I want to meditate in a very specific manner or with a specific structure, it's really hard to actually see me entering this parasympathetic state. Whereas if I practice my karate forms at very low speed in a kind of tai chi manner with no power and I'm right in the woods outside my house, I can see a huge parasympathetic activation, despite that's a martial art. And this could be said for all sorts of things. So I think people have to really dig deep into what is that takes them into that parasympathetic state, because most of the time we think the stress is something.

But precisely, as you mentioned in my experience, is their perception of what they're doing that is way more important than what they're doing as per itself. Yeah. So it's very hard, I guess, to say this activity is stressful or this activity is unstressful because it depends on the individual. So, you know, one man's poison is another man's medicine to a certain degree. So that's interesting. So one of your clients washes cars and his body just loves it and he's chilled. What else have you found? Are there some other surprising things that you have found when observing this with clients? Things that potentially we might think are conventionally stressful, yet that has not been reflected in their heart rate variability reading?

Mama, quite a few i guess i think i might mention some of the the ones that perhaps i wasn't expecting so we all expect that work is stressful and yet i see sometimes people when they are what we say in the fly you can see this massive parasympathetic rebound um massive parasympathetic rebound. So parasympathetic rebound, you're saying high heart rate variability. High heart rate variability. Which indicates the body's in a relaxed state. Yes. One thing that I think has been really, really revealing for me is routine.

If your body would know that every day at a certain time, certain things are happening, if mentally there are cues to tell the body that that is the starting of the relaxation, it doesn't seem to matter if he's, you know, candle in a hot bath or watching your favorite program or playing a board game it doesn't seem to matter the body will seem to enter so basically what i'm trying to say is the people that had more scattered type of lifestyle are the one with the lowest heart rate variability and which indicates more stress on the body that is correct yeah which which really i think we all well certainly i know that i respond better when i'm in a routine um when when i go to bed at the same time and wake up at the same time yeah i just i'm i'm like a different person i i find it easier to eat better i've got more energy i can feel that I'm less stressed um and you the longer you stay in that routine the more locked in you get you sleep deeply you wake up at roughly the same time without an alarm etc etc um it's incredibly challenging of course for people with shift

work to do that they're constantly changing some of them from day shifts to night shifts um have you got any clients who've done shift work that you've seen any of this data on? Yeah, it's... What happens? So in some of your clients who are shift workers, what happens? Do you see this really low heart rate variability a lot, which reflects a very stressed out body? That is in a nutshell what I tend to see. Now, an interesting point, the people, they seem to have... So if we take the sum of all the things that impact on our health, people, generally speaking, have a little give on certain things.

So instead of having to follow an absolutely perfect diet, as long as they reach a certain degree of health same thing with exercise same thing with stress or life flow same thing with anything else so they as long as there is a certain baseline then they are okay people that the the few people i have seen but taking experience from colleagues, that they work on shifts, that leeway is very, very reduced. They have to have a great diet. They have to have good diligence in every other area in order to account for the shift work. I mean, Alessandro, I think that's a really

important point. So, you know, I talk about this four pillar framework a lot because I think, you know, when we look at food, movement, sleep and relaxation, and if we maybe don't strive for perfection in one area, but we're doing enough in each area. So, you know, this is the opposite really of someone having the perfect diet. And I have got patients who frankly do have what appears to be quite a perfect or optimal diet. Yet at the same time, they're only sleeping five and a half hours sleep a night and they're working hard, really, really hard into the evenings and they're really stressed out. And I say, hey, you know what? You might be better off just chilling out a little bit on your diet, but going to bed one hour earlier and having a bit of a wind down in the evening. And I say, hey, you know what, you might be better off just chilling out a little bit on your diet, but going to bed one hour earlier, and having a bit of a wind down in the evening. And

it's interesting. So what you're saying is with shift workers, if, you know, because many people even listening to this podcast will work shifts and think, well, I have to do that. I know I've got lots of nurses who listen to this podcast. Yeah, like, well, I have to go on night shifts. So I think the empowering thing here from what I'm hearing is that, okay, that is a stressor on your body. That's an insult. So that means you've got to sort of make sure

the other areas of your life are optimized as much as possible. So you can almost mitigate it as much as you can. Is that fair to say? Yeah, yeah, yeah, absolutely, absolutely. Of course, anything else as you can is that is that fair to say yeah yeah yeah absolutely absolutely of course anything else that you can do to support your body i think is it is brilliant um the problems start to happen when you don't do that or you can't do that and on top of that you have the shift work impact on your physiology and what i find a little bit upsetting is these are the very people they offer are looking after other

people in the medical profession or with high responsibility jobs security police security absolutely absolutely absolutely and unfortunately i only know really a handful of people that can maintain health, that have maintained health, but they are so diligent in their lifestyle, they can't afford to have a poor lifestyle. They can't afford to not go to the gym or not have physical activity. It doesn't matter, just the gym. They have to be as diligent as they possibly can because sleep and chronobiology is already out yeah because you're right these are the people in society who you know a lot of them look after us and keep us safe and yep you know and manning us when someone has a heart attack at two in the morning you know there are people there to help them and it would be nice if we could could a way to support them better. I've interviewed a couple of sleep experts, a chronobiologist and really, really enjoy that.

And it seems to me that there are slightly different theories. As far as I understand it, and I'm not a chronobiologist or a sleep expert, if someone can get into a shift night routine, that seems to be not as detrimental as constantly changing the shift time. Yeah. Let's move on to type 2 diabetes because type 2 diabetes is commonly called a blood sugar problem. And clearly, you know, the way we diagnose type 2 diabetes is when your blood sugar can no longer be maintained in a physiological range.

It starts to go higher. And once it reaches a certain point, we diagnose you with type 2 diabetes. And of course, I know you're a nutritionist. I know that much of the debate around type 2 diabetes focuses on sugar and carbs. And of course, whilst sugar and in particular, refined and processed carbs are a real problem for many people with type 2 diabetes. I'm very passionate that it is not a dietary problem. It's an environmental problem, diet being one component. And you've done some interesting research, haven't you, on stress and how that impacts blood sugar? Yeah, I decided to do basically a preliminary run for a proper trial.

And this has been happening for a while now in the field of nutrition. There are trends, are there? So there was the Mediterranean diet, there was the ketogenic diet, the low-carb diet, the low-fat diet. So we have seen them all. And one of the things that I love doing is trying to research these, not necessarily bias in advising them love doing is trying to research these not necessarily bias in advising them but is to actually research so i started to see that people with a tendency

to diabetes on a low carb diet seems to do very well and it's still probably now one of the things that i might consider when someone with type 2 diabetes. However, I seem to have obtained very, very similar results to not just reducing the carbohydrate and be on a low-carb, high-fat diet with good level, matched level of protein, but also when people started to restrict the eating window, for example. So when they eat.

When they eat and also how long they eat for in the space of a day. So how many roughly hours that they are eating for during the day. So when from the first meal to the last meal, so the first time they introduce food to the to the last time i also noticed that people on a slight restricted um energetic intake also seem to have a very similar benefit so we need to start to ask a few questions here because obviously there is the same result with three slightly different approaches and many times you see people on a low carbohydrate diet they're also what they do they do other things that would actually help their health so they're starting to eating in

they're starting eating uh in a in a narrower window of time they also take other things so there could be some confounders attached to that so i decided to take health individuals and see what impact because it's much harder to see big changes in individuals if you're already healthy. And strangely enough, glucose was very, very poorly correlated with the amount of carbs intake, not only the day before, but for the four to six weeks period that I have tested. These were 37. This is super interesting. You're saying then blood glucose, which is another way we describe blood sugar you're saying that in the the data that you have seen and what you have been tracking and you meticulously track i've got to say you meticulously

track your own data on yourself you're always tracking your heart rate variability yeah and matching what you do in your life and how that reflects things and you're altering it, which is why you look the picture of health in front of me at the moment. Yeah. So you, you take this very seriously, both as a guinea pig yourself, um, but, but also with, with some of your clients. And that's really fascinating that you're saying that the blood sugar level is not necessarily correlating with how many carbs they've been eating in health individual that that was my findings out of 37 individuals monitor for four to six weeks some people would have four some other people we started from 52 but unfortunately i had to eliminate certain data because it was just not precise enough.

So they had blood glucose in one day or HIV in the other day, and I couldn't mind that. Yeah. And that's very, it's important. You know, this is a small data set relative to a big trial, but it's something you meticulously do. You take very seriously. You want to be able to find out more so you can help your clients get better. So what are those factors then if it's not carbs that's correlated with blood sugar and healthy individuals what is it so to firstly answer your question on type 2 diabetes i think uh excess of carbs do play a role and is one of

the things as mentioned that i would definitely would, but not then to rebound on other substrates. So it's not that they keep the carbs very low and then they, you know, splash out on fats and they, you know, have a very, very poor diet is not the only factor. So these are things that definitely we need to consider. Physical activity in type 2 diabetic is still the factor that has impacted the most alongside high life load, people may call that stress, and sleep. It wasn't so much dietary based. I mean, what you're saying is really, I think, really important because, just to be clear, you know, from what you're saying, and I've said this before, you know, I think that what is called a low-carb diet does have extreme clinical utility for some patients. Correct. I'm not a huge fan of the term low carb because I think we're calling one macronutrient where, you know, a carb, one carb can have a very different impact on the body than another carb.

Correct. You know, a highly processed cracker can have a very different impact from a sweet potato, let's say. Absolutely. And so, but the sort of thing most people consider when they think about a low carb diet is a diet low in i hope refined and processed carbohydrates and some people go quite aggressive on all carbohydrates that's for sure there's a big variation out there yeah but i do think this is really interesting that it's not just that that is correlated with your blood sugar

sleep is playing a big role yeah Physical activity is playing a big role. And stress is playing a big role. And you've seen that, I think, yourself, haven't you, when you're very stressed, that your blood sugar goes up. So if I'm doing like a lecture tour or we call it a roadshow or whatever, after the third day, my HIV drops fine. So just to make sure we're clear on that, your HIV is getting lower, which means there is more stress on the body. The body is in more time sympathetically activated.

Both I measure ongoing measurements, but also snapshot in the morning. In snapshot in the morning, it takes 60 seconds to measure. And you can see, you normally, you can see an increase in the first day, which is what we call rebound. But then following that, if you keep traveling, lecturing and et cetera, you can start to see a steady drop to a point. I was speaking to Jules the other day. And I said, how do professors at university, do they do this all day, seven days a week?

How do they manage? They need to be pretty fit. So I think there are variations on, because obviously I do this only at times. I don't do this all day long in an established environment where I go in, you know. You're tracking it just from time to time to see what's going on. Exactly.

And that I think is very relevant in everyday life because people tend to single out things. So it's the diet or it's the stress. It's that, which can be but the combination of many factors is way more detrimental than the single one and this really resonates with my approach alexander as you well know this is why i'm always trying to expand the conversation beyond diets or beyond physical activity it's a combination of factors that result in your health. You may be excelling in one area, but you may be neglecting three other areas. And we've got to start not looking for perfection, but looking for balance across all these areas, which is a big thing that I stand for. I think you have said to me before,

I'm pretty sure, that actually when you're tracking your own data, you find that, is it putting your child to bed is when you are in one of the most stressed states of the day? Yeah, absolutely. It was me. And I was measuring. Because I know some parents this is it. And this is incredible. I think lots of them will actually think, hold on a minute, I want to know more. What is going on there?

So this was some time ago. So I had this report and I was taking ongoing measurements. So it's not only that I can see the baseline, but I can also see what has affected directly at that moment in time, my heart availability. So it could be an unpleasant call, or it could be something that has happened, or I don't know, what have you. And I could see that it was actually pretty great. And I thought, what is that? And I've noticed that for four, five days in a row, I could see this massive spike. And at least this little program actually said to me this were your first um this is these were the highest most stressful um 15 minutes of your day so the most stressed or 50 minutes of your day has been reflected with a low hrv reading that is correct

and you were thinking what's going on there yeah and you have the possibility to put a diary online. And I thought, family time, I put family time. So and then I started to see the exact time. And it was my son's bedtime. He is renowningly so one of the probably latest chronotype children I have ever come across. And it doesn't matter what you do. He just does it. He does all of them. He stalls. He doesn't want to say that he's scared at the time. Not now. So I'm hoping that, you know, psychologists and counselors will not sue me for this, for saying this. I went up to him and I said,

dude, see this? See this graph? Yeah, you are the biggest stressor in my life. I said that in a jokey manner, etc. Milo, we can't have these arguments day in, day out for exactly the same thing. So we need to find a way. And there was some unfortunate bartering. I detest doing that with children. But we have came to and suddenly that was reflected straight away. It's not just the fact that it's the most stressful 15 minutes. Consider, Rangan, that in this most stressful 15 minutes,

you should be recovering, but it's going to take you a while to wind down from that. This is if you see that as a stressor. If the parents say, well, okay well okay whatever then obviously it's a very different approach yeah you're right so that your reflections you know what you put onto that situation really determines whether your body perceives it as stressful if you are really trying to get them onto bed on time because you know it's good for them and they need the routine yep they might well they might be

chilling out they may not be but we might be feeling stressed i mean i certainly know that feeling um i you know i think one of the things that this is saying to me is that there's there's huge benefit in understanding your body better understanding what things in your life start to have an impact on your stress levels and it will be different from different for different people so is this the sort of thing that people can do themselves absolutely absolutely so they can start with something really really really cheap and cheerful with like an app that measure heart variability they don't even need for certain apps to actually buy any heart rate strap so they can just use the camera of a smartphone for example um and that's what i use yeah yes absolutely um i do it once a day in the morning yeah and at the

same time every day and it you know it's also but you start to build up a picture you go you know i'm not individualizing everything in a day, but I see, oh, you know, whenever I've been traveling, for example, I see my heart rate variability the next morning is really low. Yeah, yeah, absolutely. But what are the other, I guess, what are the factors that you have seen?

Are there some common things that people can hear, which they might be expecting, they might not be expecting, really have an impact on, for want of a better term, stress on the body? So, for example, you mentioned earlier the time of eating. That was a big one for me because I thought as long as you can digest a bit before you retire, it should be okay. We did not cover chronobiology as far as eating is concerned

at college i think i don't know even know if there were any studies about and there are now starting to emerge in in humans i think um but was uh um what was interesting is that up to so i i had to transform the data into block of two hours. So I had to make a categorical data. And what was interesting, so it was between 2 and 4, 4 and 6, 6 and 8, 8 and 10 p.m. And heart rate variability didn't seem to be affected until after 8 o'clock. until after 8 o'clock. So when people ate after 8 o'clock, do consider that there is a two hours chunk.

So I'm not saying is 8 to 1 has the same effect as 9.59 or 9.59. So it could go worse or better. Oh, yes, absolutely. But I could actually start to see a trend. And the heart availability doesn't seem to be affected. Blood glucose does. The later we eat, or this 37 people cohort ate, the higher is the fasting glucose the following day,

especially if that is prolonged. they do that continuously so even if they're eating a healthy diet correct a diet that might be low in refined and processed carbohydrates that one might think is optimal for their blood sugar you're saying that by eating late the body still mounts a blood sugar response to that. That is correct. In fact, in some people has manifested as what is normally referred as dawn phenomena. So basically, they go to bed with a certain blood glucose and they wake up, which is much, much higher blood glucose. And often, even on a healthy diet, especially for the breakfast skippers then unfortunately we then have observed a rebound in the evening because they've been skipping breakfast perhaps having stimulants during the morning to try to get some you know to try to get going um

yeah absolutely but you'd be surprised green tea and yerba mate matcha whatever you anything um and then what was to me really interesting is that then the choices in the evening were not only different but the quantity of the food they were ingesting it was it was really really heavy load on the digestive system. You know, I think this is really echoing what a lot of the time-restricted eating research is suggesting, that actually when we eat is arguably or potentially as important as what you eat. And that's something that I don't think the message has got out there yet. I think people think as long as I'm having a healthy meal yeah it doesn't matter and you know it's a

brilliant point that's an absolutely brilliant point because most nutritionists wouldn't no i'm so sorry i rephrase that um many times i hear practitioners they don't seem to take in consideration the timing of it yeah timing and time is huge and you know i was telling you two nights ago i was in london i i was you know busy all day and there was an event on gut health i was lecturing out in the evening and i remember we ate after the event now i normally eat pretty early i try to eat with my children when i can yeah and then stop you know yeah it's not always possible when you're back late or you're on the roads, but everyone at the event ate after the conference, after the event in the evening. Right. And we probably had dinner at 10 p.m.

Whoa. Which is, A, it's out of my normal routine. And we sort of intuitively know this, you know, I didn't sleep well at all. You know, I didn't have to get up early, but I just couldn't sleep very well all night. I was tossing and turning. And then all day, obviously, I was tired. I was craving sweet foods all day. And I don't really eat that much sweet food.

You know, I've got my diet pretty dialed in most of the time. But you just see how one thing can have such a knock-on effect. And for people listening, I'd really encourage you to think about what time can have such a knock-on effect and for people listening i'd really encourage you to think about what time you have your evening meal i think it's i think it's a really simple way to impact multiple premises in your health by bringing it forward do you think in your experience are you saying that an earlier dinner time is better? Absolutely. Without no shadow of a doubt, we leave out very specific demographics, for example, athletic performance and et cetera, et cetera. But generally speaking, within reason,

it would be wise to have an earlier type of dinner. So you mentioned that some people may take stimulants in the morning, whether it's green tea, coffee, all kinds of things that we take to get us going because we are living such busy, stressed out lifestyles that many of us need help to get going in the morning. A lot of people drink a lot of caffeine. And I'm just wondering, have you seen anything in HRV in the readings that you've done that correlates to caffeine oh you you mentioned the caffeine it's been one of the things that's interested me so much so um everything started because i did an experiment with my hiv i mean my blood glucose so i measured the typical um hotel

sachets that you find uh which i clearly don't drink um but i thought i'll give a test because we were taught not to have caffeine because caffeine is excitatory is bad for us is dehydrating and etc so i started to dig a little bit more in the science um now caffeine seems to be affected by many things we are affected by caffeine due to many things one of them is how we clear the caffeine how sensitive we are to the caffeine so uh straight away we have an individual reaction to the caffeine however i took I took myself and I thought, right, okay, let's see how I react with that. And another day I took a very high quality caffeine coffee drink. I'm talking coffee, not necessarily caffeine alone. Okay. So my glucose within less than 10, 12 minutes shot above 6.2 millimolar, which is pretty high.

For you? For me, with a freeze-dried hotel typical coffee sachet. Did that coffee sachet have sugar in? No, no, no, just black. Okay, so black an instant sort of black coffee yeah that you'd find in any hotel room in any hotel room usual spikes your blood sugar that had created that massive spike i do not know if i cannot quantify the caffeine content of that i cannot quantify so many things but what i took as things. But what I took as a guideline is

one coffee. So we wanted to see the effect of different one coffees, if that makes any sense. Okay, so you had one of those and then did you compare that with a high quality coffee as well? Then I did the same a few days later. Obviously, you don't want to add too much caffeine in the same go um and i tested with my normal coffee which is high quality i go to the roastery personally i grinded myself yada yada yada so i did that and my glucose went from 4.5 to 4.6 so a minimal rise well the change is below the error of the instrument i was using so it could have been negligible it could have been the same could have been lower yeah absolutely so i started to study a little bit more on that adding the heart rate variability and if the so the what i'm trying to say here is that the quality of the coffee can have a substantial impact on top of the amount of caffeine taken.

So there are two things here. People may react to coffee or people may react to caffeine. People may react to both and people may react to neither. So when people have a coffee, to me, opens like 10 questions. OK, what type of coffee? How was it made? Is it percolated or just a really simple, quick espresso normally showing less quantity of caffeine? my personal limit is 120 milligrams of caffeine before 2 p.m so you have been that precise you have quantified for you if you do that and you don't go above that correct and you stick to that amount of good quality coffee before 2 p.m yeah there was what minimal effect on the rest of your physiology the the

effect is not statistically significant at all i cannot see any changes in hiv blood glucose following day the day following that so over a period this is ongoing data it's so impressive that you actually go through this that meticulously, because then you really are able to personalize your lifestyle for your physiology. It's just incredible because you literally know how things affect you. So can I ask you, what happens if you do go above 120 milligrams?

That depends what is coming after that. So if I have more caffeine and then later on I'm training or doing very physical work it doesn't it doesn't seem to have a very noticeable in effect but i still see a slight variation in what in generally for example sleep onset is a big one. So it's harder to fall asleep. Yeah, or just later, perhaps, I'm just not tired. You're a bit more wired and you don't want to fall asleep.

Yeah, or even just feeling awake. And that is the problem. Because if you're feeling wired, then you think, right, I'm wired. This is not normal. I need to do something about it. But if you feel just awake and you feel good, then you're less likely to do something about it. But if you feel just awake and you feel good, then you're less likely to do something about it because you feel good about it. And you might think then also that you're a night owl.

And this is something that I did write about in the Stress Solution, actually, the myth of the night owl. Now, night owls do exist, right? From what I can tell, from looking at the research, there are some genetic differences. But in my experience, a lot of people put themselves down as being night owls, when it's actually their lifestyle that is driving them to be a night owl. And when they alter their lifestyle, suddenly they can go to bed early, they can wake up early. And I'm talking about coffee and caffeine. I'm talking about light

exposure in the evening, all these things. I'm looking at your smartphone late into the evening, which it's, I mean, you're very impressive actually. I've noticed if I ever text you past 7pm, I'd say you rarely respond. I don't think you've ever responded until the morning. Correct. I think that's quite interesting ever responded until the morning. Correct. I think that's quite interesting for people. Tell me what goes on there. So to me, the brain will have more power on my physiology. Call it whatever you want, class A type personality,

or it doesn't matter what you call it. But if my brain gets stimulated, we call it hyperarousal, you then are able to offshift the natural calming, cooling, recovering, relaxing time that can potentially have an effect on your sleep. Not necessarily just the length, but also the quality or just even simply the onset. I always thought I was a late night owl. Did you? I'm not. I just constantly crave for that time by myself, alone, being exposed to light in the evening, being exposed to things. I used to be more creative in the evening. So I kind of prolonged that and really, really struggled to then fall asleep for hours and hours and hours. And then that had to be compensated for the late start of the day.

And what was interesting is that what it seems to me, based on my research, it seems that our modern society is exacerbating the chronotype thing. So if you are a night owl, you're also more likely to do more stuff in the evening. Now, that is not going to help the chronotype anyhow. It's not going to help anyone. So could it be that our modern lifestyle, our modern society, training late, eating late, getting engaged cognitively late is exacerbating the difference between the chronotype? part if you go to a place i'm reluctant to say holiday because then people on holiday do other stuff to be like chronotype but if you're going to a holiday that you can just live by the natural rhythm i i have been very surprised on how many patients and colleagues have mentioned well i was

actually waking up with the sunlight and then going to bed a lot earlier despite I was on holiday, especially in camping holiday. In fact, one of the studies specific was measuring dim-light melatonin onset in people that were not sure if it was sleep-deprived or they were socially jet-lagged. But they went out camping in, I think it was around Denver, Colorado. And they just naturally picked up a very natural rhythm. And the difference between the chronotype was very, very small.

If I recall correctly. Hey, this is exactly what Professor Sachin Panda said to me. Love his work. His work is brilliant. He's been on the podcast before. Two of the most popular episodes I've had actually were with Professor Panda. And I was lecturing with him last year in Iceland

and we went out for dinner in the evening and I asked him that question. I said, hey, look, what happens? You know, this night owl thing really confuses me because a lot of my patients who say they're night owls, actually, once we start altering their lifestyle, getting them to wind down in the evening, switching off their technology, before you know it, then they're no longer night owls. Again, me, I used to be up very late, creative time,

everyone's asleep, put the lights on, I've got quiet time. But you know what? I flipped completely where now, to be fair, I've always been an early wiser, but I now fall asleep often at half nine. My rhythm now is about 9.30 to 5.30. And, you know, I feel great. So I often get that quiet time first thing in the morning. It wasn't the fact that it was nighttime. It was just, I was craving quiet time when the rest of the world around me was asleep. And I can have that in the morning just as well as I can have in the evening yeah um so i do think a lot of people sort of tell themselves at their night hours and they might be of course but even if you are a night owl you could be exacerbating that correct with with our behaviors um hey alessandro look i i there's so

much more i want to ask you and i know you're writing a book at the moment on all of this so maybe once that's complete i can get you back on but absolutely it would be my utter pleasure is what i'd love to finish on for people who have been fascinated by this first of all we were mentioning how you can track this yourself i have got an app that you recommended to me actually that i just do once a day to give me an idea of what my base level of stress is per day and it is really i find it really really useful can you just tell tell people what those apps are in case they want to download them sure sure absolutely i i i tend to use mainly two apps uh one is more perhaps um sport related that you can use with the smartphone camera there is hrv4 training where

four is the number four so hrv4 the number training or one word both on itune and and google play and the other one is elite hrv there are other apps it. It just happens to be that many, many years ago, I started to work with these and I'm just more familiar. So there are other apps out there that they don't have necessarily to use these. I will link to all these guys in the show notes page of this podcast, which will be drchatterjee.com forward slash Alessandro. So if you go to that at the end of the podcast or now, you'll see all the links to everything we've talked about in case you do want to download some of those apps. But finally, you know, I like to finish off, you know, the whole point of this podcast really is

to inspire people to be the architects of their own health, you know, to empower them with tips that they can apply immediately. So you have done a lot of complex testing on yourself, on your clients. Not everyone who's listening to this is going to A, know how to do it, be motivated to do it. So are there sort of, I don't know, are there four kind of big take-home tips for people that you can think of based upon your data, based on your work, based on your clinical experience that you can give them and potential ones that they're not already thinking about? Wow, what a question. Yeah, the first one that I keep always in my head, go back to the basics, check the basics, check if you have addressed truly the basics.

Rather than go into a very advanced type of classes and, I don't know, whatever, CrossFit or something weird, just move. Get some physical activity, whatever that may be. Eat cleanly in what makes you feel good these are all really simple things follow try really to follow as much as you possibly can just natural cycles this is how body has evolved and seemingly now research is coming out to see that is how actually feels the best um the two people i quote the most in in in the book i'm writing are my grandparents despite the 250 papers that i'm arguing quoting referencing and so on so that's the first thing second thing i would say listen to your body you know more about yourself than anyone on the planet. Allow for recovery.

You push your body. It's one of the most metabolically intelligent things we are ever going to have to our disposal. And just make sure that if you're pushing through, you have to allow for recovery. That's the reason why some of the best tools for athletic performance now are focusing on sleep on chronobiology or things that are in that in build and performance enhancing

performance enhancing if you do that right absolutely you said something really interesting because we're what time is it it's about i don't know maybe 6 30 p.m in the evening we're recording this in december at the moment and you have got to drive home tonight um which is probably going to be two or three hours i imagine in the car correct so you know that this is a big stress on your body and so you are taking compensatory action tomorrow i believe correct i cancelled pretty much everything so if i'm going to feel good, I may train. I'm teaching a karate class on Sunday, and I have to be on form because that's demanding, clearly. So you're going to rest tomorrow. You're going to say, hey, look, it's been a stressful week.

See how I feel, absolutely. Yeah, which is a great lesson for people. Sometimes the best thing to do is say, hey, you know what? I'm going to do nothing today, and I'm just going to relax read a book yeah um the doing nothing thing um it would stress me out so i would do something that you know is soothing for you if it is i don't know watching your favorite series so as long as it's truly relaxing to you to i keep reminding people the kind of gentleman that was washing the car and being parasympathetic i don't know wash the car of the whole village what have you it doesn't matter that's his thing so we need to find our

thing beautiful and whatever that is you're going to do your thing tomorrow to relax and i think we all kind of know what our thing is or many of us do anyway i would just don't feel we've got time to engage in it correct so that's a really nice message for people that they must prioritize recovery find find what you know what brings recovery um please consider social interaction so of course i'm a nutritionist i'm trying not to be biased and mention eat a clean diet of course but um social well-being is dramatically important uh what do you mean by that exactly just make sure that you you you spend time with people you love um if you don't have in any find one um yeah on that i mean it's really important to say that if you don't feel you have people

close to you um whether it's friends or family you know a simple way of trying to um build up those connections it might be to join a local sports club or a local hobby absolutely something you're interested in because you're likely to find similar people to you at that event it might be hard at first you might feel nervous and shy yeah is exactly as you say so join a sport club with people that are like you or similar to you or very different from you it doesn't really matter you share a common interest you share a common interest and and and sometime you should be feeling like you can pick up a conversation exactly where you left it even after two three four five weeks you haven't spoken to someone i mean these are lovely tips and particularly i think coming from

a nutritionist you know it's it's it is remarkable that the four tips that you gave were actually not really related to nutrition yeah i mean there's just great tips for people uh that you know yes you can do all the data that you've done but you can also try and listen to your body a bit more and see, you know, you'll probably get some of the way there just by doing that. Al-Sajjad, thank you for your time today. I appreciate you coming up to see me and actually us able to have this podcast

that we have been trying to have for a few months now. I think that's really interesting for people and I hope to have you back on soon. Rangan, it in my absolute pleasure uh yours this year is probably the book i recommended the most because people are missing the basics and they embark on all sort of fads things and and things they are way too extreme so they go the mile deep, meter wide kind of approach. Whereas what you are doing for this nation and what you're doing in general, have people listening to you from Australia, for example. And what you're doing is, I think, consolidating, crystallizing the message to listen to the basics. And that is absolutely awesome. So you can have me anytime you want. it's been definitely a pleasure for me

alessandro thank you and we'll see you soon you're welcome thank you that concludes this week's episode of the feel better live more podcast i really hope you enjoyed the conversation and that you feel inspired to take on board some of alessandro's top tips there at the end. I think for me, one of the standout tips is about allowing yourself recovery. This is such a simple concept, yet one that we often don't think about enough in our day-to-day lives. But if we have exerted ourselves, we need to allow some time to recover. I'm sure that some of you will feel like tracking your own HRV after hearing our conversation and I hope you find the apps that we mentioned in the conversation useful you can see links to all of

those apps in the show notes page for this episode which is drchastity.com forward slash alessandro as well as those links I have put a few online articles there that I think you will find interesting so that you can continue your learning experience now that the podcast is over. There's also a link there to Alessandro's own website and all of my books. Now, for those of you who are interested in learning more about HRV, I summarise the key take-home points in a very accessible way in my most recent book, The Stress Solution. I walk you through what HRV is, why it is relevant and then most importantly give plenty of tips on how you can improve your own HRV score which basically helps

you to minimize the impact of stress on your own body which in turn will allow you to thrive. I've also outlined some of my top tips for shift workers in the book to really try and help minimize the impact that shift work has on one's health. If this is something that interests you, you can pick up a copy of The Stress Solution in all the usual places either as a paperback, an ebook or as an audiobook which I am narrating. As always, please do let Alessandro and I watch your thoughts of today's show on social media. And if you do enjoy my weekly podcasts, one of the best ways that you can support them is by leaving a review on whichever platform you listen to podcasts on.

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It literally takes under 10 seconds to do. So if you can spare the time, I genuinely do appreciate it. A big thank you to Richard Hughes for editing the podcast and to Ali Ferguson and Liam Saunders for the theme tune. That is it for today. I hope you have a fabulous week. Make sure that you have pressed subscribe and I'll be back in one week's time with my latest episode. Remember, you are the architects of your own health. Making lifestyle change is always worth it because when you feel better, you live more.

I'll see you next time. Thank you.