The Food Medic - S8 E2: Bonus interview with Dr Hazel

Episode Date: July 7, 2022

To celebrate publication of the female factor, Dr Hazel is interviewed by David Birtwistle. David is Founder & CEO of Endeavour Life LTD, "proper coaching for everyday people" and Hazel’s boyfriend. They chat about the book - why Hazel wrote it, why it’s so important and touch on some important topics covered in the book. This is a really fun episode and we hope you love it. The Female Factor book is now available to purchase on amazon and in all good book stores. Thank you to our season sponsor WHOOP. Right now, you can get your first month free when you checkout through join.whoop.com/thefoodmedic Hosted on Acast. See acast.com/privacy for more information. Learn more about your ad choices. Visit podcastchoices.com/adchoices

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Well, almost, almost anything. So no, you can't get an ice rink on Uber Eats. But iced tea, ice cream, or just plain old ice? Yes, we deliver those. Goal tenders, no. But chicken tenders, yes. Because those are? Yes, we deliver those. Gold tenders, no. But chicken tenders, yes. Because those are groceries, and we deliver those too. Along with your favorite restaurant

food, alcohol, and other everyday essentials. Order Uber Eats now. For alcohol, you must be legal drinking age. Please enjoy responsibly. Product availability varies by region. See app for details. Hello, and welcome back to another episode of the food medic podcast i'm your host as always dr hazel all right so today is publication day for my third book the female factor which is very exciting and david my boyfriend who most of you know as db suggested he should interview me on the podcast about the book which is very different for me and i'm not gonna lie i didn't say yes straight away but i'm really glad that i did this episode was so much fun to record but it also gave me the opportunity to dive into a little more detail from some of the topics in the book if you don't follow David

on Instagram David is founder and CEO of Endeavor Life Limited proper coaching for everyday people I hope you enjoy this episode let Let me know if you did on social media. You can find me under the handle The Food Medic and David is David.Bertwistle. Today's podcast is brought to you by our season sponsor Whoop. Whoop 4.0 is a 24-7 digital fitness and health coach that provides actionable insights to help you recover faster, train smarter and sleep better. And unlike most other wearables in the sense that it doesn't just tell you what you've done, but it tells you what you really need to know. I've been a fan of Whoop for a long time because it allows me to

perform and recover at my best. Each morning when you wake up, you get a recovery score from Whoop and this is based on your sleep and other health metrics. That score helps to guide your day and informs you how much strain you're ready to take on. Another reason why I love Whoop is how they're supporting their female members, which you know is super important to me with features like their menstrual cycle coach. Recently, I've joined Whoop's Women's Performance Collective along with other researchers and athletes to better cater for the unique physical and physiological needs of females using their technology. And right now you can get the first month free when you check out through join.whoop.com slash thefoodmedic. Okay, so the day that this podcast is going out

is publication day for my third book, The Female Factor, which is very exciting. And so David, DB, thought it would be a fun idea for him to interview me. What's up, people? Welcome, DB. Thank you for having me. Thanks for agreeing to do this. I'm a bit nervous. Do you remember when this conversation came about? Yeah, I was like, let me have a chat with the team. I don't know if this is a good idea.

We were sat in the pub and Hazel was telling me all about her new book. And I was just, I got so blown away by everything you were telling me. I was like, the people need to know this information. Are you going to be able to get this out? Right, tell your story. It's hard. Like, if I'm interviewing people it's it's difficult to talk about me I'm like let me interview you there was a moment of silence not gonna lie there was a long

pause I started to question a few things in that moment but Hazel came around and here we are yeah so slight disclaimer in that we haven't talked about what he's gonna ask me hopefully about the book mainly about that's why ask me. Hopefully about the book. Mainly about the book. That's why we're here. Mainly about the book. Yeah, well, there's like, I've got many notes written down. Okay, that is many notes. It's like scrolling for ages and ages here.

The vast majority is book related. The vast majority. What's the rest of it? Well, I thought that at the end of the podcast, we'll tell the people the story of how we met. Okay. Do you agree to this yeah i agree to this so stay tuned guys because at the end you've got something really fun coming all right so let's get stuck in straight away right so my first kind of question is i would like to know if we turn back the clocks all the way to the beginning why did you start the food medic in the first place um i feel like i've told the story so many times but i probably haven't i started the food medic 10 years ago now it's

it was our 10th anniversary this year which is crazy when i was in medical school it was actually the year before i started medicine and at that point in my life I was in my third year of medical sciences and that was three years of uni living my best life in Wales not exactly the healthiest individual and I guess the food medic started from a personal kind of place where I wanted to take control of my own health because I felt if I was going to become a doctor I really wanted to I guess promote health from a lifestyle perspective as well as a kind of conventional medical approach but I think where my whole relationship with nutrition and medicine or lifestyle and medicine stem from was way way back when I was 14 and lost my dad to a stroke and that really was the moment where I thought how we eat,

how we move, our stress levels, our sleep, all of these aspects of our lifestyle are so important for our health and we don't talk about it enough and so I entered medical school thinking I'm going to learn all about this and I didn't learn anything about it so I started the food medic which was my way of bridging that gap and so it was like an Instagram page and a very very basic blog at the time I wrote my first book when I was in my final year of med school which was very challenging because I was doing my finals at the same time. Then moved to London, started working as a doctor, and just kept it going because even when I did start working as a doctor,

my kind of bread and butter was pills and surgery. I still felt very passionate about the role of lifestyle in promoting health, and so that's why the FoodMedic is still going today. My goal was always to make it a bit more of an educational platform. And I'm only really getting there now. I mean, it's always been educational, but it's only now that it's kind of bigger than Instagram. I mean, it's way bigger than just Instagram now.

You started off with a personal Instagram page and then writing longer form content on your blog right and now there's contributors which help you've got three books your third one's coming out it's about to change the industry I'm so excited for it honestly I can't tell you I'm super excited to read it like an actual physical you've not read it yet I sent you the copy yeah I would definitely be reading it back to front and front to back don't you worry yeah it's interesting because it's taken 10 years right like it's not an overnight thing it's like you've hustled and you've put in a lot of work to get it to where it is right now which kind of lovely segues me on to the question of like what

position were you in when you wrote the female Factor? So when I was commissioned for the book I was working as a nutrition doctor I had planned to take time out to write this book because it's nothing that I've ever done before and I knew it was going to be a huge project and I came to the end of that contract in that nutrition role I remember I was sitting at my desk and it was my final day and at the time there was a lot happening around me about COVID. When was this then what year was this 2020? Yeah early 2020 so it was end of February maybe and I knew COVID was happening and I was like like, finishing up my notes. And then one of the doctors came and sat next to me and he's more senior than I am. And he was like, Hazel, I know today's your last day, but would you be keen on joining the COVID team on Friday? And I was like,

okay. So I had one day off. And then I joined a COVID team and then did that for two years. But I knew I had a book to write so I had not written anything by then I had done like some research but I was kind of planning that I'd have these six months off to just write and so I contacted my publishers and I was like look I need to just dedicate my time to working as a COVID doctor. I'll do my best. But can we push back the delivery date? We pushed it back maybe six months. We didn't realize how much of a thing COVID was going to be. And so I would write my book on my days off.

And that became really challenging. And we pushed it back even more. And then finally, we agreed on a date which is this summer but I still didn't really have very much time to ride it so I wrapped up Covid May 2021 and then have been riding it ever since and I think I finished it I mean how many times did I say I finished it quite a few yeah months and months I thought I finished it in september of last year and then we handed it in may so there was lots of evolutions of the book you're telling me that you wrote this book while also being a full-time doctor for the nhs in a worldwide pandemic yeah i mean it was very

ad hoc their writing um so shout out to my publishers for being really understanding. But it was honestly the most challenging thing I've ever done. I mean, this book would have been probably the most challenging thing that you'd have ever done if you had six months to do it and just solely focus on that. I can imagine that being a doctor during the pandemic was probably also one of the most challenging things that you've ever done so combining them is like pretty incredible like how did you have the ability to to write a book like this which requires so much detail so much focus so much attention when

you're also trying to react to an ever-changing environment which is presenting you with new struggles and new stresses every single day like How did you have the ability to do that? I didn't have a boyfriend. That's giving me crap. That was so funny. I knew this book was really important for me. And also, I think it's going to be really important for all the women who read it, that I hope hope read it that was the only thing that I really had during COVID I think we all like clutched on to things that were really I don't know like something that was some something that was stable in our lives and I that was mine that was my thing. And it kept me kind of focused and occupied outside of working hours.

And also allowed me to switch off from COVID life. Because if I wasn't in the hospital looking after COVID patients, I was online and my whole social media content became COVID doctor as well. And people just want to know everything. I chose to put out that information, but you just don't escape it. Then you're constantly in it. But then if I was writing about female health, very different.

Obviously the book's out today, people can go and buy it. But circling back to 2020, maybe even late 2019, why did you decide to come up with this concept? Like what was the kind of spark that you were like, I need to do something different because your first two books are recipe books right so this is a bit of a left

turn it's a lot more kind of detailed isn't it so my first two books were like obviously nutrition focused but as a woman and a doctor to many women I noticed that there was this unmet need for women in health and health care from research all the way to how we treat women in the hospital and the outcomes that they have. And again, this isn't like something that is very much talked about in medical school. You know, you know, primary sex differences when it comes to like reproduction, that's pretty obvious. But when it comes to other aspects of health, a lot of the stuff that we have, a lot of the research we have is based on a male body.

And so I was treating women and felt like either they weren't being listened to or we were treating them in a way that was biased to how we treat men. And at the same time, there was more research emerging as to how women, the outcomes that they have when it comes to certain health conditions. And not just, again, gynecology or reproduction, but like heart health or brain health, like Alzheimer's and bone health. And then we were learning more about like the impact of the menstrual cycle, not just on, again, reproduction, but all aspects of health.

And I'm like, why aren't we talking about this? And why are women suffering? And why don't we have enough research? And so that opened a can of worms. And I went to my publisher and I was like, we need to write a book on this. We need to write a book that basically puts the lens back on women like it started as a very activist book because I felt really frustrated and really angry and then I took a back seat and I was like I need this to be practical I need women to pick up this book and actually use the information to improve their health and feel empowered and not feel like woe is women and everything we have is terrible. It started that way and it was a big turn for me from a career point of view but I felt like I was at the point in my career where I was the best person to write the book.

Why isn't there that much research on women? There's like a couple of reasons and And it's like not just biological reasons, but it's wrapped up in gender and social norms and things. But basically, the biggest difference is that women have fluctuating hormones. And from a research point of view, that can be like noise in the data and considered a bit of a nuisance. So like researchers would just exclude women from trials. There's also the risk of pregnancy. So if you're doing like a drug trials,

ethics just would be like, no, we won't include women. And then women tend to be like traditionally, not all the time, primary caregivers. So they have to like pick the kids up from school and stuff like that. So they can't actually make research trials. And so there's loads of reasons why we've just excluded women. And we've also carried the assumption that women are just smaller men. So we'll just make everything a little bit smaller. And that way of thinking is really problematic because taking drugs, for example, like yes, body size size is important but women have like different amount of body fat and that will change like drug absorption we also have different speed of drug motility through our gut so like absorption is changed as a result of that women are twice as

likely to experience an adverse drug reaction which can cause multiple problems from like allergies to death so it's not just that it's unfair it's that like women are actually being harmed by this and things are changing you know now there's a huge call for having more women in research and if you are designing a study you need to show that you're including women as well if it's applicable. Is this like a social pressure to include more women or is there another reason why it is now starting to change and more women are being put into the studies and considered? Because we've realized that we've been excluding them for such a long time that there's so much we don't know and we could be better serving women. When it comes to this research we just don't really have

that much on women either so even when I'm talking about it I always have to caveat like this is what we think we know but we need more research what are some of the key ways that men and women differ I guess uh hormones are really important difference men also have the same hormones but women just kind of have different levels and it fluctuates across your monthly cycle and that influences so many different things from like your sleep, your mood, your nutritional needs, how you should move your body, how energetic you are and so they're the kind of primary areas that I've focused on in the book but one kind of big example that comes to mind is heart disease. Traditionally, if you've seen an advert for a heart attack, I'm sure it was an older white male clutching his chest.

And it's true that the biggest killer in men is heart disease, but it's also the biggest killer in women. And no one talks about that. Is it? Yes. That is definitely news to my ears. So it's considered like uh man's disease and so from bench to bedside in the uk women are twice as likely to die from heart disease

than men are and there's so many reasons why that is so if you kind of think about symptom onset when you first experience your symptoms of a heart attack picture this woman's at home she feels like a tightness in her chest but she thinks it's anxiety or palpitations she's more likely to put off going to the hospital or she'll try and self-medicate because she doesn't have time that's like step number one where there's a delay and when it comes to heart attacks time is muscle and so you want to get to hospital ASAP. Also, some women don't experience typical central crushing chest pain. It may feel like nausea or anxiety or something else. So they might come to hospital and say those things.

Obviously, it's a doctor's job to like rule out other things, but it might lead them down a different path, first of all. That's the next step. They come in with different symptoms typically the tests that we use and we do like ecgs and things like that and we'll do um blood tests to check enzymes this conversation around whether those kind of thresholds for whether you're having a heart attack or not are actually accurate in women because we may have lower levels of it, of like this enzyme. And then the diagnostic tests that we use when we're looking at your vessels may also be different because women may experience like a different type of heart attack,

if that makes sense, in that different vessels are affected, but we're not actually looking at that. We don't pick it up in the traditional testing that we're using. So that's the next step. And then when we're discharging them, women are also less likely to be sent for rehabilitation or they're less likely to show up. So there's all these steps and it's kind of like a Swiss cheese model. Women are falling through these loopholes. And there is loads of research by the British Heart Foundation on this

and they've produced this huge publication on women's heart health. And so it's a big conversation which is fantastic but I still think there's a lot of women who are out there and they would think when they have chest pain that it's anxiety and I can tell you at least three patients from the top of my head who are female who have come into me and told me that they have anxiety or heartburn or palpitations when they were having a heart attack. That's pretty scary. Are they okay? Yeah, I hope so.

You kind of mentioned a few things about the book there. Can you give us an overview of like what the core pillars of the book are? Yeah, so I've focused it around like the four kind of main pillars of lifestyle, I guess. Nutrition, movement, sleep, and then mood. Because like I said, I wanted to make it really practical. So I talk about how that applies to women. But at the end of every chapter, there's obviously like practical takeaways. And it's not just for women who are young and have a menstrual cycle. It's for women all the way from puberty up beyond the menopause.

Basically, it takes you through a journey in each chapter across a lifespan, and that's it. There's also 50 recipes at the end. Nice, nice. It's interesting because if this was a book for men, then it would just have the kind of pillars that you're talking about and it'd be kind of just like this is the information full stop whereas because there's all these different factors which affect women your hormones right they're not even

constant though and so there's not only just the things but then there's the the things and how they're affected across a 28, 30 day cycle. And so it's, you know, a much more complicated topic to discuss really than if it was the other way around. Yeah. Does that make it hard? Was that like a real difficult component about writing the book? Yeah, I think, I guess it feeds back to the reason why women haven't been considered is

because there is varying hormonal profiles that you can be in. Even on a day to day, you could be in one phase of your cycle or the other, and that could drastically change how you metabolize nutrients, for example. And I think the other important thing that I want to say is that overall, we're probably more similar than we are different. What, me and you? Not me and you not me and you

what men and women men and women in general okay but i think there's these small differences actually add up and can and should be considered and they make a huge difference in the long run disregarding the fact that the cycle has any effect on our health is just silly and again beyond the menopause just assuming that women are at the end of their lifespan when really it's just the end of their reproductive lifespan and there's a third of your life to live after that one thing that is quite a considerable difference between you and i is that when we're working out i'm much faster and stronger you look better as well that's for sure you wear a sports bra I want to talk about boobs for a moment why is it so important to wear the right sports bra

when you're training breast tissue is not muscle tissue and I think people confuse that they think that you can kind of build muscle there There is pectoral muscles underneath breast tissue, but in general, they're not very well supported structures. They've got ligaments inside them called Cooper's ligaments, but they're not like the ligaments that we have in our joints in that they are elastic and they're not very strong. So most of our support's coming from our skin which again isn't very strong and as we get older we lose elasticity and so it sags a bit so when you

exercise there's obviously an element of bounce whether that's walking or running and actually there is like research to say that your breasts can move from like one to four centimeters when walking to up to like 15 to 19 centimeters, which is huge, on like a star jump. Like obviously this will depend on how big your breasts are. But that level of movement is not only detrimental

to the structures of the breasts in that like it's going to cause sag. It's also going to cause pain. There's evidence that... Yeah, I imagine that's really uncomfortable. Yeah. It can impair performance. So there's like evidence and research from like the London Marathon that women who have poorly supported breasts are less likely to finish early. There's loads of kind of things and I guess

it makes sense and how I explain it to women is like if you are experiencing pain or you're very conscious that you're not well supported you're going to change your running mechanics you're going to like kind of try to protect yourself you're going to shorten your stride you're actually going to reduce how heavy you breathe you're going to breathe more shallow in a bid to protect yourself and we don't realize we're doing this and maybe for an everyday runner like me it doesn't make a huge difference but what if you're someone who's like super keen into marathons and you really want to get your times down or you're like a crossfit athlete you need to be wearing bras that are supporting you and I think over the years,

there's been a big pushback against wearing a bra. And I know that they're not the most comfortable thing, but there should be education around it for women. I imagine there's quite a large psychological component to this as well. Because if I had breasts and was working out, and they were moving a lot, like even just thinking about that would distract me from

the actual performance because if you are trying to perform at like the highest level or even if you're just in the gym doing a workout you want to feel comfortable you want to feel um like you're focused on the thing that you're trying to do and so i can imagine that if you have something that's constantly distracting you like even just from a psychological component there's an issue and then if you are self-conscious if you are perhaps a woman that's got larger breasts and she's exercising then there's men around there might be another consideration there as well so how does the structure of the sports bra affect its performance? I mean it depends on what sport you're doing and also depends on the size of your breasts but like you said it can

impair how you perform for multiple reasons because you're uncomfortable because you're aware if you think about it like if you were wearing a poorly fit running trainer and you're running it might be fine for like a mile or two but then it's gonna affect you and then you're gonna be thinking about it and then you will want to stop your run and you'll probably slow down because now it's rubbing. That's just one example. And so there's so many sports brands now because we've had this big boom in the industry. But none of them, when they say low, medium, high impact, that's not like scientifically backed. So you can just slap on a label if you want.

You can have them tested, but not many brands do. And if they get it tested, they actually don't have to prove what the testing outcome was and i'm talking about big brands that most people are using now so it's really frustrating do you think there should be an industry standard test that everyone goes through so that the consumer knows what it's been rated to and how supportive it's going to be yeah that'd be useful information, wouldn't it? It'd be useful information. Do you think that men and women should train differently? This is a really hard question because I think men and women can train the same

because that's what we want at the end of the day. We want people to be physically active. But... I was dancing for you guys questionable dancing but there are a couple of things that affect how women perform when it comes to

particularly like competitive training it's why men always outperform women in sports I think the only sport is like ultra endurance open water swimming and i think even after that there's still a gap but it's like one percent because women are really good at swimming are they're better are they not better than men at like long long distance women generally yes but they men still outperform women it's just a very narrow gap when it comes

to swimming or any ultra endurance events. And the reason for that is from a kind of anatomical and physiological point of view. Women have more of a particular type of muscle fiber, which is better for endurance, whereas men have more like power output fibers. So they tend to be stronger. They also, in general, are bigger people.

They've got a bigger heart and lungs so a bigger engine and so from that point of view they tend to be able to go harder faster but women can go harder for longer they're less likely to hit the wall and you'll see this in like um ultra endurance events whereas men will start out really fast and slow down, still finish before women, but a woman will hold a pace longer. From a menstrual cycle point of view, again, we've got like fluctuating hormones. I should say that this doesn't count if you're on a pill or taking hormonal contraception because that's going to flatline your normal kind of rhythm. But with women who are going through a normal cycle, there'll be parts of their cycle where they will be stronger

and there will be parts of their cycle where they won't be. So typically just before ovulation, women are at their strongest. But again, it's not every woman. Every cycle is different. Every woman is different. So I get a lot of women who come up to me

and they're like, what should I do? I've got like a competition or a marathon and it's the week before my period. And I know that's the week that I'm going to be holding more water, feel more bloated, more lethargic, less strong. And I'm like, potentially, but you don't know that until you get there. And so control the controllables.

Around that time, we tend to sleep worse. We are burning more fat for fuel. We also burn more energy at rest during that time as well. So I'm like, up your calories, get lots of complex carbs in because you're going to have probably lots of cravings for sugar. Make sure you're getting healthy fats in.

You also break down more protein during that time as well. So ensuring you're getting lean servings of protein and sleeping more and prioritizing recovery. If you do all of those things, then you're doing your best and then it's just what happens on game day that must be like pretty annoying though if you're a female elite athlete and in competitions across multiple sports it comes down to one percent or

not even one percent variability between first and fourth that must be so frustrating if you're going into that competition and you think that you're not going to perform at your best because of your hormonal cycle yeah but what if we had far more education for female athletes so they know exactly what they need to do at that part of their cycle and we're not there yet we don't have enough research to give out guidelines and say eat this not that during that time but i have seen a lot of nutritionists especially in the sports space who will like alter the nutrition around a footballer cycle and it's really interesting and you know you can't play around with it I definitely do it myself I just don't think we're in the position where we

can have like guidelines for it and with your everyday individual who's not an elite athlete that just goes to the gym or they go and work out or they do classes, should they be varying how they train across that cycle as well? Should PTs be programming completely different stuff across a cycle taking into account the hormonal profile of the individual that they're coaching? Yes and no. I think PTs and clients if should have that conversation but it's very much individual so first things first is start tracking your cycle and your strength and your sleep and your nutrition and your cravings and any symptoms that you're having is there a good app for that yeah there's a few like you can use like clue app

or flow and then fitter app is like for or fitter woman is like more menstrual cycle cycle tracking app but for fitness people the whoop have it you can also track it with you can add a toggle whenever you're menstruating and then it will tell you how much strain you can do on a daily basis so that's really helpful but i think the key point is understanding what's normal for you so track for at least three months and don't just change things because you read somewhere that, or because I told you this is what we typically see in women. Because I don't want women going away from reading the book

or hearing this podcast and thinking, oh crap, I'm going to feel like rubbish just before my period and I should avoid the gym because that's not what I want. Let's just go back to basics for a second. In a typical textbook 28-day menstrual cycle, there's two phases. And just to say that most people aren't textbooks, so don't panic if you don't have a 28-day cycle. You've got two phases, follicular and then luteal, and then you've got ovulation in the middle. The start of your follicular phase, that's when you have your period. And generally, that's when you have your period and generally that's when women perform at their

lowest and it makes sense right because you're going to be feeling a bit rubbish after that just before ovulation estrogen is high and then that boosts mood and strength generally and if I was to say that there's one part in your cycle where you could try get a PB that's probably the best part and then the next part of your cycle is your luteal phase and at that point both oestrogen and progesterone are high but progesterone is even higher and you tend to retain more water your temperature is half a degree to one degree higher so your sleep is worse also your sleep structure between REM and non-REM also changes which is really interesting there's quite a few things happening there which will reduce your um kind of motivation to train

but again some women don't experience that and they feel fine and it might not be until the couple of days before their period where they feel a bit more bloated and heavy and lethargic and don't want to train and if you're feeling like that just make sure that that part of the month is when you take a recovery week or you reduce the intensity of your sessions or you swap hit for low slow runs it's just about being intuitive with your body good coaches will put percentages right so like on a program they'll write it out they'll know what your 1rm is in all your different key lifts then they'll program percentages to hit at different stages as they program through the month right do you think that then based on this for a female athlete actually it might make more

sense to use like an rpe scale, like a rate of perceived exertion. So like effectively your effort level, your intensity level, so that it becomes more subjective to the individual so that when they are in their follicular phase and they're not feeling great, that a 7 out of 10 on that day might actually be a bit lower than 7 out of 10 the week before, but it's still a seven

out of ten for them because they're in a different stage of the cycle yeah i think because that's like intuitive for that person that individual and i think that's a really helpful thing to do because it's also psychological so you can really get bogged down by it whereas i will go for a run at the start of my cycle and a lot of women will be like how can you do that on day one or two of your period I could never do that I'm like for me it helps me feel better and I don't feel like it's that taxing on my body there's also evidence to say that moderate intensity exercise during menstruation can reduce symptoms it's a win-win situation in my mind it may be that for you I mean you're quite a good runner so for you going on a gentle run is like quite relative to your ability to run you're fast for you it could be like quite

a gentle runs actually like very low intensity but even someone else who might not have the same yeah fitness level as you a gentle run or even just one at your gentle pace might be like still quite high intensity but you could swap it out for something else right so you could like go on a bike ride or like the rower or use a stairmaster or any sort of or whatever yeah yoga whatever is like a low intensity version of exercise for you i think that's what i'm getting a lot out of this is is essentially like become more aware of you and make everything relative rather than absolute. Yeah, yeah, that's it.

You summarized the book. You should still buy it though, everyone. There's a lot more in there, I promise. There is, there's way more stuff in there because we haven't even touched on like psychological stuff and like mental health differences between men and women I know that anxiety is something that men and women kind of feel differently I suppose specifically with regards to stress like how do

men and women differ in their responses to stress so I found this part of the book really interesting there's lots of different theories and things like that so nothing's like absolute again but typically we do respond to stress differently and there seems to be kind of like a biological reason for that and also like this kind of like socio-cultural reason for it as well is stress just like you're having a bad day at work or is stress what is stress because it's quite a generic term isn't it yeah stress is i guess how your body responds to as stressor what you perceive as stressful i might not perceive as stressful and vice versa and this is holds very true for me and you because i find so many things stressful and you just goes

over your head but i feel like that's more differences in personality than how we kind of deal with stress. But from a physiological point of view, there's like an axis in our body, kind of from our brain to our adrenal glands, and we perceive stress and then our brain picks that up and it's like, this is really stressful, alert to the adrenals to release stress hormones like cortisol, adrenaline and things like that. And then how your body feels when that happens is like palpitations, sweaty palms, feeling anxious, ruminating over things, feeling sick, unable to sleep. How are you feeling right now?

My palms are a little bit sweaty. So that's one part of it. But also how we deal with stress is really important. And women tend to kind of internalize things and ruminate over things so we will worry about things more and that's that may be why women suffer from anxiety and depression more than men because we will just kind of fixate on it and think about it whereas men tend to experience more like externalizing mental health disorders so things like alcohol dependence and also men are more likely to commit suicide so they're quite like external aggressive responses

to things that they find stressful so there's lots of differences and it's not saying that women suffer more from mental health we just suffer from it differently and I think there's also women are more likely to be given a psychiatric diagnosis for a physical problem so what I mean by that is if I come into you and you're my doctor yeah because I wear a tie and a pen um and i tell you that i have um like this palpitating feeling in my chest i have my heart's pending all the time and you tell me that it's just anxiety that's basically what happens in more times than not whereas if a man came in people would be more likely to sit up because they're like it's it's less likely for a man to come into hospital unless he really needs to see

someone and so there may be some bias there that we're over diagnosing women with anxiety and the other thing is when you have anxiety on your medical record it's very easy for doctors to see that as the red herring when you come in with another set of symptoms and just kind of bring it back to that. So we all have biases, you and me, doctors, the healthcare system, even the patients. And it's like unraveling that.

I don't really know how we do that. But I think having the conversation, having awareness is the best place to start maybe does anxiety show up differently in men and women yeah potentially it shows up different everyone really I think like I said men are less likely to men may act out in a different way they may like turn to drugs and alcohol to deal with their anxiety. Whereas like women are less likely. And again, we're really generalizing here because there's some women who will. But if we're looking at the majority and what we know from the research,

that's kind of how it happens. There's so much conversation about men's mental health because men are less likely to speak up. And then it gets to, to you know really devastating consequences when they commit suicide with this conversation about anxiety before it gets to the point where you're in hospital and you're trying to get a diagnosis and people are misdiagnosing potentially is the first step just having the conversation and talking to someone about what's going on and starting to chat through the issues that maybe are causing this anxiety i think yeah but

that's the hardest part i think like a lot of people just see it part and parcel of being human and living in the life that we live in and that like a little bit of stress and anxiety is normal whereas it's not and it can manifest in physical symptoms so like heart palpitations feeling nauseous insomnia they're all losing your appetite they're all symptoms of anxiety yeah they're the ones i get i get uh like heart palpitations i know if i feel anxious my chest kind of goes it's like a really distinct feeling and i've like associated that because back when i was younger i'd like get feelings and i'd be like i don't know what's going on and people are talking about anxiety as this blanket term.

And it took me years to connect that a big thump in my chest is when I start to feel anxious. Yeah. And insomnia is the other one personally that I get sometimes. Like if I'm anxious, overthinking stuff in my head, then I struggle to sleep. And I usually get to sleep really quickly. But the thing I found for that one is if I'm overthinking things in my head I need to just get it out my head put it on my whiteboard or write it down in my note section my phone literally

like it's like metaphorically taking the information that's spinning in circles in your head and aligning it on a piece of paper for me that works really really well yeah that like rumination that you talk about and insomnia is like another reason why women are they're more likely to spend time in bed but they're less likely to have good quality sleep and one of the reasons again feeding into that like anxious ruminating mind but like you said like you're a man and you still experience it we all experience it um but yeah it's just interesting how something in our brain can manifest in our body yeah it's pretty incredible how important is sleep to reducing stress and being able to deal with the stresses of life?

So important. From a kind of baseline, if you're not having enough sleep, you are going to feel a bit aggy, aren't you? No, I always feel great. And so that's going to feed into your everyday and you're going to perform less and you're going to be irritable. But also you're not going to feel great from a physical point of view so you might feel a little bit nauseous you might feel more anxious you might have a headache all of those things chronic loss of sleep is also being associated with like poor

health outcomes from dementia to heart disease it's so important for kind of total body health which is why I did focus a whole chapter on it because I was like I didn't realize I thought women were okay at sleeping I've personally experienced insomnia and then when I stepped into that area of research and looked at it I seen these important milestones that women go through premenstrually perinatally so around like pregnancy and postnatal and perimenopause and menopause there's these spikes in insomnia it's not just hormones but it's a very clear pattern so what is it apart from the hormones then is it like quite a complicated multifactorial

issue yes it is it is we know that these patterns. So instead of just saying that we know what happens and it's really crap, then during that time, what can we do to improve sleep? And everyone knows like basic sleep hygiene measures, put your phone away, go into a dark room, don't eat late at night, don't have caffeine past midday. But again, all of this research is so generic and most of it is based on men. When I was writing the sleep hygiene part for the book, I'm like, it's basically not much on women. But then you've got women who are unable to sleep after having a baby or women who are going through the menopause and they're waking up with night sweats at night. And so there's kind of, we know this stuff and we should be able to support women during that time but there are things that you can do like from a just taking that kind of menopause as an example

you're more likely to experience insomnia because you're waking up at night with like hot flashes and stuff like that but if you control that through either medication or lifestyle measures then you can improve your sleep and so there's like a lot of kind of research around that where but women are typically given a lot of medication for that instead so address the symptoms first and then the sleep should improve is that where your stance kind of is on medicating sleep is that it's better to in the short term at least get someone to be able to sleep and then whilst kind of medicating that sleep you're trying to solve the problem yeah and actually there was one big study that was looking at women in the

menopause and um kind of sleep measures that would improve their sleep so it was like different medications estrogen things like that and cbt which is like cognitive behavioral therapy was the most effective which is basically talk therapy obviously there's something going on there from an anxiety rumination point of view that needs to be untangled because it essentially is a 12-week program that changes the way you process thoughts i want to talk about the orgasm gap Gap. Go on. What is it? Basically, the orgasm gap is gap in the rate of orgasm between heterosexual men and heterosexual women.

So women are, I think, 65% of the time straight women versus 95% of the time for straight men in terms of when they're going to orgasm I do talk about this in the book which people might think is a little bit left field but there's a reason for it and it feeds into the whole sleep thing and so people who have sex or masturbate before they sleep especially especially if they orgasm, are more likely to have better sleep. And women are, in general, less likely to orgasm. So that's also feeding into the fact that they're going to have worse sleep

if they have a sexual partner. Why don't they orgasm as much? So there's lots of reasons for this. Lesbian women are actually slightly more likely to orgasm and that's because they've got a female partner. So it's not to say it's all on in porn and um even sex ed that sex is only for the purpose of producing a baby when really it's for pleasure as well right and men can experience pleasure through just penetrative sex alone which is like your basic penis and vagina sex that you learn about in school.

But you don't learn about anything else. You don't learn that other forms of sex exist. And even if you lose your virginity, that's kind of gold standard for sex. But most women can't orgasm from that and they need stimulation of the clitoris, basically. But clitoral anatomy in general is just very poor you don't really like ever learn about it or hear about it and that is

one of the main reasons why women are less likely to orgasm so there's really interesting research that shows if you do actually teach men and women about the clitoris it increases orgasm rates and also increases the longer you're with a partner which suggests that women feel more comfortable to communicate their needs whereas if they're just having a one-night stand they're not going to be like hold up this isn't working for me you need to do this they're not whereas men just it's very easy for them i reckon it's probably quite different with men and women on how they discuss sex as well because like if a guy makes a girl orgasm he's usually pretty proud of it it's not always real babe

oh no everything's been a lie also chat about faking orgasms in the book is there really? just a brief mention yeah no like men generally like they're pretty proud if they make a girl it seems like a challenge that you've completed yeah you've got pleasure for both partners so it's a win-win situation if a couple can communicate what they both need but obviously it's easier said than done yeah have you ever faked an orgasm with me we're not talking about this my mum listens to this podcast next question what do you talk about with regards to faking orgasms in the book i haven't seen this

part yet well no i just mean that we a lot of the time women will do that because they feel inadequate that they can't orgasm through penetration alone. And my message to women in the book is that don't feel like you're abnormal. You're actually part of the majority. Whereas a very, very, very small percentage of women will orgasm through penetration alone. And like one study that I quote in the book was like 4% of women. So it's very rare and if we talk about how rare that is and how normal that is women should feel oh okay so it's not me i don't have to feel like i have to fake it all the time i can actually say to my partner this is what i need and is it because of draconis because of porn i suppose it's

like positive not positive it's feedback like you you see what's going on in a porn film and how people are behaving and the woman seems to be having a great time most of the time and usually couture stimulation is not a part of this and she may welcome multiple times from i mean i don't know i never watched porn but she may well come uh multiple times uh just from penetrative sex and that might be quite misleading if you're a guy that watches porn i don't watch porn but if you're a guy that watched porn then you might be like this is what you do i guess education is the first thing yeah education is the first thing cool moving on you still feeling comfortable babe yeah I'm fine how are you yeah I'm a little bit uncomfortable

well I think we're kind of like starting to get towards the end of the book now at this stage and what do you think kind of looking forward is going to be potentially the next thing that you want to go into like you're kind of already on this part of your career now which is not just nutrition but you're looking at things from a female lens after this book where do you think your focus is going to be? I mean I kind of fell into this area when you get labeled with women's health doctor people automatically assume that you're like an obs and gyne doctor and that's not what I do but I think this area should be a specialty I think there should be a big focus on women's health or like female health

essentially when I say that I mean whole body health so I'm hoping I can like contribute a bit to that through research and I work closely with Whoop who are the sponsor of this season and we have started a women's performance collective and so all the data that we gather from that will inform kind of how we can improve women's health moving forward that's obviously just one kind of organization but I'm starting to see other organizations pick it up so even like Adidas and other brands like that who are listening to what women need even from a shoe point of view like footwear and sports bras and things like that so I think the more conversations I have and using my platform from where that will be really important but I will continue to still

do all of the other things I do all right let's wrap this up I think that the last story what was it going to tell about when we met you're going going to tell the story. Do you want me to tell this story? We can tell it together. Okay so it was actually when Hazel it's relevant to this book actually because the reason that we met was because we were both out at a bar and Hazel was celebrating because it was her belief that she'd finished writing the book this was back that was fact it wasn't a belief it was your belief at the time but the amount of revisions that went on between then and when it actually got finished it tells me that it wasn't finished okay i think like the vast vast vast vast vast vast vast majority it was like small revisions

afterwards but you were celebrating weren't you yeah we're both having a pretty good night you certainly were having a good night i was having a very good night i might have had a couple of a pro spritz and espresso martinis and uh at this point i was wandering through a bar and then lo and behold dr. Wallace walks up to me. So I walked up to David. I knew him from years ago. We met one time, didn't we? Yeah, we did one gym session. And I was like, David. And he looked at me for a solid minute before he realized who I was.

Looked me up and down, I should add. I was looking you up and down. I was was looking you up and i was like i recognize this person i fully recognize this person i know who it is but my brain in its drunken stupor could not put a sentence together i'm just looking at you he got there in the end the first words out of my mouth were your name though weren't they you? You were like, Hazel. Boom. Can I buy you a drink? And I said, no. I got shot down immediately. First conversation.

Boom. So we just parted ways, didn't we? No, I said, text me tomorrow and ask me on a date. Yeah. Yeah, yeah. She didn't give me her number though. I was like, I know. We'll see what he does with that information.

Fully thinking you would just never remember that conversation. No, I woke up like very, I was like. I had a 7am text. So hungover, but. I did. It was 7am. Hello, Hazel. It's David.

Are you dating? And I said, I'm dating in general. And he goes, that's good enough for me. Are you free on Friday? And that was it. That was the story of how we met. Oh, Hazel,

thank you very much for allowing me to interview you. Actually, I feel so honored to be even on the podcast. Like, this is pretty big stuff. Yeah, it is. Thank you for having like this is pretty big stuff yeah it is

thank you for having me it's big stuff thank you for interviewing me how did it go is it alright yeah it was good slightly uncomfortable at points

apologies to the rest of the team who had to sit through that apologies to my mum and David's mum okay guys I hope that was both fun and informative for you it certainly was a new experience for me

huge thank you to DB for interviewing me and being my number one hype man throughout this whole process if you loved it you know what to do leave us a review a rating hopefully five stars and share it with someone you know will love it too make sure to subscribe so you're the first to hear of any new episodes and if you would like to submit a question to my weekly Q&A, ask Dr. Hazel, please send your voice recorded questions to lindsayatthefoodmedic.co.uk for your chance to be featured. That's all from me. See you again next time.