The Dr Louise Newson Podcast - 288 - I’m an A&E consultant: the changes you can make for a longer, healthier life

Episode Date: December 24, 2024

Joining Dr Louise Newson on the podcast this week is A&E consultant Professor Rob Galloway, who talks about his career to date and pressures facing the health service. He also shares the nutrition and exercise changes he’s made in his own life that have improved his physical and mental health, as well as his top tips on living healthier for longer. You can follow Professor Galloway on X @DrRobgalloway Click here for more about Newson Health.

Hello, I'm Dr Louise Newsom. I'm a GP and menopause specialist and I'm also the founder of the Newsom Health Menopause and Wellbeing Centre here in Stratford-Pon-Avon. I'm also the founder of the free balance app. Each week on my podcast, join me and my special guests where we discuss all things perimenopause and menopause. We talk about the latest research,

bust myths on menopause symptoms and treatments, and often share moving and always inspirational personal stories. This podcast is brought to you by the Newsome Health Group, which has clinics across the UK dedicated to providing individualised perimenopause and menopause care for all women. So I've been looking forward to this podcast for quite a long time and now it's happening. So I've got with me, Dr Rob Galloway,

who is an A&E consultant, ex-stand-up comedian, someone who's transformed his life and really thinking about medicine in a different way to maybe when he qualified. And I certainly think about medicine. I think about my training. I think about so many things I didn't do right as a junior doctor that I didn't think about because I didn't know. And I've spoken about some of this on my podcast before. But I'm 54 and I'm really committed to improving health of as many people as possible in as many different ways as possible. in as many different ways as possible.

And this podcast is one of those ways. So I'm very excited, Rob, to introduce you to my guest today. Thank you very much for having me. Invite me. So can you just give a very potted history, like who you are and what you do and what you're doing now? So I'm Professor Rob Galloway. I'm an A&E consultant, Darren Brighton, and a work at Brighton Susset's Medical School. I've been a doctor since 2001.

Essentially, it's my third choice career. I did a couple of awful stints of stand-up comedian and failed completely. So I also wanted to be a footballer, but I was rubbish. So basically the two things I wanted to do I couldn't do before I went into medicine. But I got attracted to A&E because for a number of reasons. One, I like the excitement.

Anyone knows me knows I've probably got undiagnosed ADHD, which I probably think is a superpower rather than an ill. And I get bored incredibly easily. But also I had some altruistic view that I wanted to help the most vulnerable in society and it is the most vulnerable in society. And so I trains an A&E consultant, also trains intensive care consultant.

and spent 13 years as a consultant working full-time for the last 24 years. And it's made me reflect, the last few years has made me reflect. So at the beginning of my career, I was quite academic. I'd written a couple of textbooks on critical praise on how to assess the evidence for certain things. I'd also had a little foray into other things. So I'd written a book about what it was like working in A&E called In Stitches, the highs and lows of life's an A&E doctor. And I wrote that under pseudonym Dr. Nick Edwards,

because I didn't want to get sacked at the time. And I also work as the medical advisor for Brighton Football Club. And I'm very interested in patient safety. So I do have an article every couple of weeks with Daily Mail. And I run patient safety courses. I've always had this eclectic career. But over the years, I've concentrated on two things. The clinical work, patient safety and also workforce.

So I've set up different systems for workforce for the junior doctors. But all of it was to create staff and create systems that we could look after patients when they became unwell. So if someone fell over, I could know how to. block their broken hip, if the pain, refer them to orthopedic doctors. If they were having a diabetic crisis, how to treat that. And I, in all honesty, during my late 20s and 30s, I worked incredibly hard to get lots and lots and lots of qualifications. I've got lots of letters after my name, probably to the detriment of my wellbeing in

all honesty, and so I've got a lot more letters than friends. And I was probably at the top of the game, that's a pleased anything like, but I knew how to look after very unwell people. when I worked at a trauma centre and I was providing good care. But the last few years I've gone through a transition in my life, I went through a difficult time. Eight years ago, my dad, or seven years ago, my dad died. I went through a divorce.

I was quite down. I was on antidepressants. I was overweight. I was unhealthy. And it was going through that time that I also realized that actually what good was I doing at work? Because however much effort we put in to keep the NHS going, because I was managing the workforce,

the more and more staff I put into the systems, the more and more medicines we prescribed, the health wasn't getting any better. The weights were getting worse. And I work in any, I can see the current Westernised system has utterly failed. Yeah. I'm about to do a late shift tomorrow and then a set of night shifts. The last time I was at work, there's 36 people in a corridor.

This is not 36 people just waiting to be seen. This is 36 people in a corridor for hours and hours and hours. Who's been seen by doctors, have had treatment started, but they're waiting to go to a bed. The demands are just way greater than what we can towards society. And if you look for the first time in society, life expectancy is going down. But it's not just life expectancy. It's health span.

It's getting worried. And it made me realise that actually everything I've been doing has possibly been wrong and I've possibly wasted the last 24 years. And it made me reflect and that's the journey I've been going on. And it's so interesting because we're very reactive in medicine. and I think when I was doing A&A many, many years ago, I enjoyed it, but I'm not like you, I don't like the uncontrolled nature of someone coming in really sick and I like to be really calm and in control. So I found that quite difficult. But I love, being a medic means that you

are exposed to all sorts of people from all sorts of life, which I think is such a privilege, and I still do now. I love working in areas of deprivation. I've been doing a lot of work in prisons recently. And I just love it. I think there's so much we can give back. But medicine, as I used to know, it was very reactive. It's like playing ping pong. You're just firing, firing, firing, and you're treating the condition. And then more and more over the years, partly because I've got older, but my knowledge has really improved about inflammatory diseases, how we reduce inflammation in the body. And I know you're really interested in it too. I didn't know that clinical depression, osteoporosis are inflammatory diseases. And I also didn't know that we are less healthy

as we age. And this whole lifespan versus health span is so different, especially actually for women, most of us as women, spend the last 10 years of our life in ill health. And even as a doctor, as a GP, I used to visit nursing homes, care homes, sheltered accommodation, every single time I visited. And it was 90% of the times women, did I ever once think about their hormones? Never. I would love to go back in time, Rob, because all those UTIs, urinary tract infections, didn't even think about giving them even just a bit of local hormone that we know there's evidence reduces human retract infections. But then, you know, people with total body pain, people with confusion, people with palpitations.

Didn't even think about hormones. But we're not trained to do that, are we? No, I think we've got a medical model, which is very much pharmaceutical-led. There is a treatment, there is a drug you can prescribe, and this is the protocols we're given. Similar to you, the opposite to you, I love the chaos, the not knowing what's going on.

I couldn't do your job because I just can't stand, just doing single issue. I like the chaos of someone who's had a heart attack. then someone's coming with a trauma, then someone's trying to stab me. That type of thing gets me excited at work. But the thing which, you know, that after a while you think, are we doing the right thing by always treating patients? Are we doing the right thing by saying, right, this is what you need?

But actually, should we stand back and be more of what I call a risk petition? Are we actually doing the right thing for the patient by organising another CT scan? Or should we step back and say, are we doing too much medicine? Are we giving another antidepressant, anti-hypertensive, anti-cholesterol? drug, is there other things we should be doing? But crucially, what I've realised from all my experience is actually so much of what I see is preventable. And the amount of money we're pumping into hospital, it's in the wrong place. If there's one thing I could prescribe and to everybody, it will be exercise. Because exercise is antidepressant. The evidence for exercise is, I would say,

better than for circling, for mild depression, not for severe depression, but for mild like I had. So I was put on circling because I think I had a response to misery, a normal response to misery rather than severe depression. But exercise is such a good thing. But what's ridiculous, I went to the GP asking for circling. Well, you didn't know. Because I was so fixed in that medical model. But things like exercise, so good for depression, for reduction of cancer, reduction of diabetes, for Alzheimer's. We forget how important that is. Then there's diet. And I've lost about 10 kilos. By the just looking at what I eat, I used to eat just dreadful food. I used to think nothing of having a, you know, a Mars bar packet of crisps during my lunch break. You know, at work, the hospitals are such an unhealthy environment. You cannot eat healthy food because most of the vending machines just sell variations of awful ultra-processed food. The way managed health has to be done from the very beginning. Every department in the country, every policy needs to look at their different areas and how we can promote health.

I took my kids to the leisure centre the other day to go swimming. I tried to get some food. The only food at a leisure centre was awful ultra-processed food. And this is the bastions of health leisure centres, and I couldn't feed them healthily. So we've got to do everything to promote good health and prevention because we are facing this rise and rise and rise in cost of ill health.

Society can't afford it. We've got one life. we need to not waste it by getting ill. And that's why people need to invest in their own health. Rather than just accepting illness, we need to invest in our own health. And do you really need to go to another work meeting? Do you really need to send that other email? Or would you be better off at 6 o'clock in the morning going for a run?

And that's the tough thing I've started to tell myself. I think you're absolutely right. And I've certainly become more selfish as I've got older. I carve time in my week to do yoga. I make my own lunch because otherwise I can't get it. And I'm here because I'm too busy. and then I could eat something, but I'm lucky and not lucky that I get quite bad migraines. So if I don't eat healthy, it will trigger a migraine.

So I've always got that to tell me. But a lot of people haven't. They can just eat what they like, when they like, but it catches up. But also part of our training is not looking holistically. It's looking at which drug for which treatment. And I know, obviously, all I do is hormones, but they affect every single organ in the body. So today I've seen a patient who's been given antidepressants by the psychiatrist. She's been given blood pressure treatment and treatment for her fast heartbeat from the cardiologist.

She's been given pain killers because she's been diagnosed with fibromyalgia. They're talking about statins because her cholesterol's up. But she's also 48 and her periods have nearly stopped. And she's perimenopausal. So in medicine, we did get taught. I know I did. Treat the underlying cause. But no one is looking at the common denominator.

And medicine's become more siloed, hasn't it, with time? And it's also become what, as well as the hormones, what else is underlying for all those things? Is it obese? I don't know your patient, obviously, but is there a diet? There is obesity, you know, as well as the hormones, is there something that if she could lose? It's definitely together. Absolutely. And often when people's hormones are balanced, they're like, do you know what, Dr.

I'm getting up in the morning. I'm going for a run. I'm going for a little, you know, oh, I'm going outside. Because most of us are inside the whole time. I'm going outside. I'm talking to my friends. I'm having a cup of herbal tea rather than. and some, I don't know, busy drink.

And it's all those little things, isn't that? Also, society has become too medicalised. Everyone's scared to going outside on the sun, you get skin cancer. But actually, sunlight is so good in preventing depression, preventing inflammation. All these things we need to think about that we've just become forgotten. And when I look back at, you know, the medical model I was taught until about five years ago, I would teach, in all honesty, was based on drugs and operations are the solution. I can't remember any nutrition training I had. Nutrition training I had was incorrect because it talked about the dangers of fats

rather than the dangers of ultra-processed food and too many carbs and sugars and crisps and that type of thing. But I remember as a junior doctor and medical student, we were taking out constantly by drug reps. So I would get my good meals by going to restaurants with a drug rep. And so that's subliminal. I'd sit there for 10 minutes and think, oh, I'm not going to listen to them. But actually, that's subliminal message. And I'll have a... No, you do, because I'm a bit older than you.

And I remember when ameprosol came out, which is a PPI proton pump inhibitor, and it was game-changing. And we went to Granada Studios because I was in Manchester. And I've never been before because we were students, actually. And doing any trips was a big thing. And we didn't really go to those sorts of trips. So we went to Granada Studios, a whole tour. We felt really privileged because we weren't even doctors. We were medical students.

And I remember having such a great time, but it was still drip-fed. Drip-fed. acid is bad, acid is bad, you can't have acid in your stomach, this is really good. And we were like, oh, wait till we start prescribing. They sound really interesting. And now we're trying to get people off some of these drugs. You know, don't get me wrong, they have a role. But they're not something we should be just giving to everybody.

And they have significant. There are risk for them. And what we don't teach in medicine is to think about number needs to treat. How many patients ones in front of us, with the same condition, do I need to treat to save one life? And then what are the harms of that? So you've got people who've got a slightly higher raised cholesterol. You may need to treat hundreds of people like that person in front of you with statins to save one stroke or one heart attack over 10 years. But the side effects of those medications are massive.

And then when we think about, we also are far too quick to organise diagnostic tests sometimes. So we don't think about number of need to investigate. How many patients in front of me with this condition do I need to investigate? do I need to investigate to save a life? So a really good example is we've got any person from a nursing home who comes in with a fall and it's standard protocol that if they bang their head, they've got some bruises, got some confusion, would get a CT head, which is fine, but actually how many CT heads do you need to save life?

Because most of these patients wouldn't go from an operation anyway. We are treating our own anxieties and our own risk of being sued. And that is one of the problems. we've got defensive medicine rather than being risk additions. We've become too protocolised and we've not thought about the bigger picture and thought about the person. We think about illness, not people.

Yeah, I think that's so true. And so many times I'll say to patients, I will only do a blood test or a scan if it's going to change my management. You are more than just a number. And sometimes it can be quite hard for them to understand that. But once they realize that, obviously, then if they don't get better,

we will consider if they need a scan or a test or a referral or something else. But it is also this multi-pronged approach that I think so much in medicine we think we'll give a treatment and then see if it works. But actually we'll give a treatment, but also we'll talk to you about your lifestyle. And actually I did an Instagram live the other day just about exercise. And I'm not an exercise specialist. I am honestly not incredibly fit. But I do yoga regularly for my mental health, my physical health as well.

And I was just talking generally about moving, not always exercise, just doing something. And somebody then messaged me the next day and say, Do you News and because I listened to your chat, I got up at 6 and went for a walk. Thank you so much. And I'm like, yes, come on, that's brilliant, isn't it? I don't think you don't need exercise specialists to necessarily help you about to exercise. Just need to do something you enjoy. Yeah.

If you enjoy playing tennis, play tennis, you enjoy going for a run, go for a run. Just make sure you get out an exercise. The other thing is people forget is how important weights are. And it's not just aerobic running and cycling. It's actually physical, you know, lifting weights. And that's, you know, if you want to lose weight, it's about diet and it's about improving your muscle. You won't be able to run yourself out into a diet. It's about building up the muscle because that increase your metabolic rate.

And that makes it easy to lose weight, plus it's the diet. And so it's a weight as well as the aerobic exercise, which is so important. And one of the things I really worry about is frailty. I've spoken about it before this osteosarcopenia, so loss of bone mass, muscle mass, and just general vastly more likely to trip over the carpet, more likely to have a break. You know more than I,

but all these factors that especially elderly women are coming into hospital with. The number of ladies I see who postmen are causal, their bones are brittle and they fall over, they break their hips. Now, it is such an awful condition. because it's not necessarily the hip breaking, which is the problem. It's the sign of how unwell they are.

And there are things you can do to prevent it. Now, I am on vitamin D and K2, which is a tablet I take every single day just to improve my bone density. And because I've got into this, I've got a dexas scan to look at my bone mass and my muscle. And I'm in the top 95% of the population of my age group for bone mass. And it's not that that's too high. Probably 50% is too low because that's what the average person is. but I don't want to break my hip when I'm older because I know what a death sentence that means.

And so it's about making sure your vitamin D levels are high enough. I don't know any harms. If you take the standard amount, virtually no harms. Obviously, if you're over there as vitamin D toxicity, but if you just take the standard amount in the vitamins, not causing any harms, then exercise, that makes a mass difference. And then where you know, you're the exponent in terms of the hormones, that's not my area at all.

But I do know that one of the, it is such a danger that someone breaks the hip, tragedy. Yeah, but we've known actually since 1941, someone Professor Albright first noticed that hormones are very good at building bone. And so one of the first indications for HRT actually was for osteoporosis, both treatment and prevention. But then since the bisphosphonates and other drugs have come on, they've obviously a lot more expensive, lots of drug companies make them. And so that's been pushed out and pushed out. And they, of course, have a role. But actually, again, treat the underlying cause. If they're postmenopausal, the low estrogen has contributed to their thinning of the bone, then give back the oestrogen to help build the bone. But we found out last

year with a number of fractures, fragility fractures in women, only 0.15% of those women were prescribed HRT. That is nothing, is it, Rob? Yeah. And even before we become perimenopausal, you can do all the other things like with the vitamin D way before you get there to do everything you can. And that's just, you know, bone fracture is just an example of all the things we can start doing to try and to improve our health span. Because ultimately that's the only way that the health service should go is in trying to improve health span. And, you know, we've got to have that mind flip. We've got to have that mind flip. Otherwise, the health service won't be there for us when we really need it for some awful accident or illness that isn't preventable.

We need to get rid of as much preventable unwellness as possible. So a really good example is type 2 diabetes. It's such a killer. It causes strokes, heart attacks, cataracts, blindness, everything. But actually, instead of just treating it with more and more medications, you can diet your way out of type 2 diabetes, not type 1, not when you need the insulin injections if you're young, but an obesity-related type 2 diabetes,

basically go on a virtually no-carb diet that is not harmful at all, do it with a dietitian, you completely change your body's relationship with insulin, and you stop becoming diabetic. And you can add years and years and years of quality life yourself by just lifestyle changes. And then you combine those lifestyle changes with the treatments you need, and people's health can be utterly transformed. And it's interesting. So before I left general practice, I had a few patients who finally started listening because it's hard to make changes. It really is to lifestyle when you've had certain. food choices ingrained in you.

But they did start, and I had a few men actually who were transformed, but it meant they came off their anti-hypertensive, they came off their statins, they reduced their type-to-diabetes medication, they stopped their antidepressants, and they felt so well as well. But that's not great for big pharma though, is it, Bob? There is this sort of thing about the money when I look at some of the turnos of these big pharmaceutical companies. The turnover for some of these drug companies is actually in billions, not millions, isn't it? It is not good for profits if people stop being diabetic

because they'll need a lot less of all those medications. And actually we should be investing our money in longevity clinics, in wellbeing clinics. You know, I had a meeting today with a place called the Wellbeing Pharmacy in Hovi. So private pharmacy where they're starting to do a lot of wellbeing checks, longevity clinics, exercise performance tests. And they've got a great setup to look at how to improve your longevity, improve your health span. And actually, if some of that investment was moved that way rather than to treatment, the impact could have been massive. And I can signpost, if anybody wants to email me, it's DR Rob Galloway at gmail.com, and I can signpost you to the pharmacy who do this type of things. But it's just so much good which can come from it.

Yeah, absolutely. No one's ever too young to start making changes. but the other side is no one's too old. I think there are quite a few people who think, well, I've always been like this. It's really difficult. And certainly I've had some great responses to people in their 70s or 80s who have made very simple changes to their lifestyle. Usually by a combination of changing their diet,

maybe not having as many biscuits with a cup of tea in the afternoon, but also just walking up the stairs rather than using the lift or walking to the bus stop or the next bus stop rather than the first one nearest to their house. and those little things really can be transformational to future house, can't they, Roeb? I completely agree. So I'm involved in a company called Healthy for Longer. It's about trying to move physical exercise into carers. And when carers go to patients' homes and also into nursing homes, residential homes,

instead of just making the patient a cup of tea, get them to actually do 15 minutes of exercise. And so this small start-up company called Healthy for Longer, the impact they could have on patients is unbelievable. It genuinely is unbelievable because we've made a series of exercise videos and the carers are trained into becoming personal trainers. There's all evidence-based things and I've advised what exercise to do and they get these patients who normally sedentary don't move,

are getting weaker and weaker to start lifting weights, start doing simple exercises and then actually the number of falls goes down. The mental wellbeing goes up and it's that type of attitude. That's where the money needs to be in. That's where the investment needs to be in. That's where, you know, you do that. then for a year, you won't necessarily need to send them from a home into a nursing home. You won't need that dependent care.

We create that different attitude. It can make such a big difference. So how are we going to do this? Is anyone at the forefront of this? The problem is it's not sexy. What I used to be interested, I'm an A&I because someone, you know, a lot of my colleagues work in the helicopter emergency service. They jump out of helicopters, not jump in there, and save people's lives.

You've had a big car accident. That's quite sexy. doing a angiogram when someone's having a heart attack is quite sexy, doing CPR, you know, but actually what we're talking about, not being rude, is pretty dull. You're not going to have 24 hours in Louise's clinic as a TV program. You're not going to have 24 hours in longevity. You're not going to have the new casualty to be based on someone going through, right, this is your risk factors.

Why don't you take that? Why don't you stop smoking? Why don't you drink less? Why don't you lose weight? Why don't you go and speak to Louise about hormones? because that's quite dull. What we need to do is make it interesting. Get people excited about it because I'm an older father.

I've got, I'm 47, I've got five kids. My youngest one is three months. I want her to, I can't cope. I'm struggling to be honest. I'm actually exhausted. But I don't want my baby daughter to have a 65-year-old dad who then dies from stress and a heart attack. I want to live to 100.

I want to live to 100 when I'm active and well. and it's biologically possible. We've got a modern society which has got antibiotics and has got clean water and that's what used to kill people and there used to be wars, trauma and infections used to kill people.

We've got over that. Now what kills people is dementia, is diabetes, cardiovascular and cancer. But a lot of that is preventable by lifestyle things. And so actually by thinking I want to live longer to be able to still provide for my family, still work, interested, do things which excite me because I find life exciting. I want to live longer,

healthier. That to me is exciting. It's as exciting as what I used to think was exciting. And so that's how we do it. We get people excited. We get a movement of people interested in that holistic way, rather thinking your quacks who are mad to show the evidence behind it. And you can only do evidence-based medicine. Everything we have to do has to be evidence-based. And a lot of people always talk about, you can only do something if there's a randomised control studies showing it. I always practice best available evidence-based medicine. Now, there's a difference between evidence-based medicine and best-available evidence-based medicine. So there is no randomized control studies which shows smoking is dangerous. It's observational studies. We know from observational studies

that it's dangerous. The people who fund the best, you know, what you call the gold standard randomized control studies are often pharmacy companies or pharmaceuticals. But actually, double-blind placebo-controlled trials and things like acupuncture, they're has been some which now show that it can work. You know, we can see these difference is of more holistic ways of working can make a difference. You know, it's going to be hard to show a randomized control study in the dangers of ultra-processed food because I would not want to be in the control group who get ultra-processed food. But so observational studies we'll have to show the dangers. But we need to make this patient-centric view sexy rather than that individual

treatments and the exciting thing sexy because then we can really make that transformation of what our NHS needs and what we as individuals need. I totally agree and some of it doesn't need huge evidence because a lot of it is common sense as well. Yeah. And I think we're forgetting common sense. You know, I grew up in the 70s and we had street parties for the Jubilee in 1977 and I was looking at some photos recently and there was no one overweight.

Yeah. Everyone was lean. Everyone was sick. But our food was very difficult. different. Everything we did was very different. So we have to just go back to basics as well and think about what we're eating, what we're drinking, how we're moving, and that will make a huge difference. So there's a lot we're going to do, even if we do all this, Rob, you will still have a job, people will still have accidents, people will still have heart attacks and stroke.

Absolutely. And I want to be there for unpreventful things because at a moment we are utterly overwhelmed. And I'm providing treatment, not care, because care is. is treatment with dignity. I no longer provide dignified care because the NHS in all honesty is failing. The medical model that we've grown up with that I've taught, that it's been part of my psyche, has failed.

And it's only the last few years when I've gone through my own transition of, you know, I was unwell with Crohn's and depression. My Crohn's is so much better now. I've changed my diet. But, you know, I still get anxious, but my upset about things was to be pulled by 5K run every day. You know, I've gone through,

my own journey in how I've transformed my health. I think I'm stressed because I've got five kids and I do night still, but I'm still maintaining a vaguely healthy balance because I've re-looked at myself. I want to look at the whole population of the people I treat and the current model has failed, is failing and we can't just tweak the status quo. We own an absolute health crisis and what we mustn't do is waste a good crisis. We've got to use this crisis to transform the health. of our population, and it's once in a generation opportunity at the moment.

So right, and such a wonderful way to end. But before we end, I always ask for three take-home tips, and these are going to be quite easy, actually. But three things that we can all do, because I know however healthy we are, we can always do better. So three things that we can all do that will help keep us healthier for longer, Rob. I think number one is think about what you want to be like in 20 years' time, 30 years time with your grandchildren. Do you want to lift up your kids and fly them around? Do you want to be

able to lift up a suitcase and go on holiday with them? If the answer is yes, then you need to invest in your health. Like you invest in shares, you invest in your health. So can you run 100 metres with your kids? Can you pick up their suitcase and take them on holiday? Can you lift them over your shoulder and fly them in the air? Are you going to be there for your grandchildren's 18th birthday? once you realize what your answer is, then everybody knows the answers. Because I could say, number one, stop smoking, number two, do some exercise, number three, eat healthy, you know that. So that's that being my number one tip.

Think about where you want to be. Number two, make things easy to live healthily. So I have a chocolate addiction. I am utterly obsessed. I love chocolate. And the first thing is I just try never to buy it now in the house. But the third thing is I say to my kids, if you ever see me eating chocolate, I can guarantee you I will give you 15 pound. I don't like losing money and I have a fine system.

So if they catch me to eat in chocolate or crisps or awful fizzy drinks, I'll pay that fine. So make it, create an environment where it is easy to live healthy. So make habits. So get up in the morning. First thing to do, have some water, go for one before you do anything. or get up, just make it into a habit because if you're outside of a habit, you won't do it. So number one, have an aim.

Number two, have a habit. And just trying to think of number three, you didn't give me any warning for this, so I hadn't really thought of a third one. Come back to me, do something like I'll think of a third thing. Well, I think number three is empower yourself with information actually. Yeah. And make choices that are right for you.

Yeah. I think the days are saying you can't do it. You can. because even though things aren't hard, it is very hard, you know, ultra-process food is cheaper. It is probably sometimes cheaper to drive than to buy a new bicycle and cycle, but there are things we can do. And so we need to realise where we want to go. We need to make those habits easy and we need to believe that we can make a difference because actually we can. Perfect.

Very good. So thank you so much for your time. I know you're going off to do more work, but I really appreciate you. cramming in this space so we can educate and make people think differently about their health and disease prevention as well. So thanks so much for your time today. Thanks for family. You can find out more about Newsome Health Group by visiting www.new.combe. And you can download the free balance app on the App Store or Google Play.