The Rich Roll Podcast - Rangan Chatterjee, MD on How to Make Disease Disappear

Episode Date: July 2, 2018

The developed world is mired in a cataclysmic epidemic of chronic lifestyle illness. Heart disease, type 2 diabetes, high blood pressure, depression and dementia — the current leading causes of death and disability — are modern day plagues, killing untold millions annually. Quite shockingly, a full one-half of all American adults currently suffer from one of these diseases, with one in four suffering from two or more. Nonetheless, confusion persists when it comes to what can be done to protect ourselves and ultimately lead the long healthy lives we deserve. Most commonly overlooked in this discussion is the incredible power of our daily diet and lifestyle choices. Choices that when made right can prevent, treat and often even reverse these and many other debilitating chronic ailments. Today I explore this terrain — a common, recurring theme of this podcast — with Dr. Rangan Chatterjee, a pioneer in the field of progressive medicine. Regarded as one of the most influential doctors in the UK, Dr. Chatterjee is double board certified in internal medicine and family medicine and holds an honors degree in immunology. An in-demand lecturer, he created the very first “Prescribing Lifestyle Medicine” course accredited by the Royal College of General Practitioners in London, and is the star of the BBC One television show, Doctor In The House where he uses a functional and lifestyle medicine approach to reverse chronic disease. Dr. Chatterjee is also the author of The Four Pillar Plan*, an instant UK Sunday Times best-seller recently released in the United States under the title How To Make Disease Disappear*. He has been extensively profiled in a litany of major media outlets. He hosts the popular Feel Better, Live More podcast (which I will be appearing on soon). And he is a regular contributor to BBC Radio and the HuffPost. Similar to my recent conversation with Dr. Frank Lipman, this is a conversation about the current state of health and lifestyle disease in the modern, developed world. It’s about Dr. Chatterjee's personal course correct — the motivational why behind his decision to segue from a traditional medical practice to the emerging world of functional medicine. And it’s a primer on the crucial role of diet, nutrition, movement, sleep and stress reduction when it comes to health, longevity and disease prevention. As an interesting aside, Rangan is also quite the musician. He even once took a career sabbatical to tour with his band. I was able to talk him into an impromptu performance at the end of the show. So be sure to stick around to the end for his acoustic rendition of The Eagles’ Take It Easy – it’s pretty great. For the visually inclined, you can watch our entire conversation on YouTube here: http://bit.ly/richandrangan I sincerely hope you enjoy the exchange. Peace + Plants, Rich

We exist on a continuum of health. When you get diagnosed with type 2 diabetes, that started 10 years ago. When you get diagnosed with Alzheimer's disease, that started 30 years ago. As a system, we need to better help people identify when they're not at diagnosis stage, but they're moving up that curve. But getting people better in real life doesn't come from reading scientific papers. There is a difference. So how do you convert that into real actionable information for people? And that's what I'm passionate about.

That's Dr. Rangan Chatterjee, and this is The Rich Roll Podcast. The Rich Roll Podcast. Right now, the U.S., North America, the U.K., in fact, most of the developed world, is experiencing this crazy, unprecedented, basically cataclysmic epidemic of chronic lifestyle illness. Heart disease, type 2 diabetes, high blood pressure, depression, dementia. These are the current leading causes of death and disability today. And what's really shocking about all of this is that a full half of all American adults, 50% of all American adults currently suffer from one of these diseases, with one in four, 25%, suffering from two or more of these diseases.

And despite all of this, there's just so much confusion out there, even amongst medical professionals, let alone well-intended consumers, about what can be done. What can be done to protect ourselves and ultimately lead long, healthy lives? protect ourselves, and ultimately lead long, healthy lives. And the truth is that diet and lifestyle are the most powerful factors when it comes to prevention, when it comes to treatment, and even reversal of these chronic ailments. My name is Rich Roll. I'm coming at you today from a hotel room in Dublin. There's a lot of construction outside my window right now, so my apologies.

If you're distracted by noise, there's nothing I can do about it. In any event, today I explore all of this terrain, which, as you probably know, is a common recurring theme on this podcast, with Dr. Rangan Chatterjee, who is a pioneer in the field of progressive, functional, and integrative medicine. It's a great conversation, a dynamic conversation about essentially how we can all avoid these diseases and embrace the lives we deserve. There's a bunch more I want to say about Rangan and the conversation to come, but... We're brought to you today by recovery.com. I've been in recovery for a long time.

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And recovery.com is your partner in starting that journey. When you or a loved one need help, go to recovery.com and take the first step towards recovery. To find the best treatment option for you or a loved one, again, go to recovery.com. Okay, Dr. Rangan Chatterjee, MD. Who is this guy? Rangan is regarded as one of the most influential doctors in the UK.

He is a double board certified practitioner in internal medicine and family medicine who also holds an honors degree in immunology. He's an in-demand lecturer. He created the very first prescribing lifestyle medicine course accredited by the Royal College of General Practitioners in London, which basically provides doctors with this framework to apply lifestyle medicine principles in their clinical practices. Rangan is also the star of the BBC One TV show, Doctor in the House, where he uses a functional and lifestyle medicine approach to reverse chronic disease. And he is the author of a wildly successful new book called The Four Pillar Plan, which

became an instant UK Sunday Times bestseller and was recently released in the US under a brand new title called How to Make Disease Disappear. He is the host of the popular Feel Better, Live More podcast, which I will be appearing on soon as a guest, and he's a regular contributor to BBC Radio and The HuffPost. So this is a conversation that I think in many ways really echoes my conversation with Dr. Frank Lippman. It's about the current state of health in the developed world. It's about what motivated Rangan to course-correct his medical path from a traditional trajectory to this new and exciting and emerging world of functional medicine. And it's a primer on the importance of diet, nutrition, movement, sleep, and stress reduction when it comes to health, longevity, and disease prevention.

As a final note before we get into it, I should also mention that Rangan is quite the musician. He actually once took a break from his medical practice to tour with his band, and I was able to talk him into a song at the musician. He actually once took a break from his medical practice to tour with his band, and I was able to talk him into a song at the end. So stick around to the very end for an impromptu cover rendition of The Eagles' Take It Easy, because it's pretty great. So this is me and Rangan. Enjoy. I've been wandering down the road trying to lose some my love, seven women on my mind. So I woke up this morning feeling super lousy on the verge of getting sick,

and I almost never, ever get sick. Like, almost never. And if I do, when it starts to come on like it was this morning, I can usually kick it in a day, but it made me sort of knowing that I was going to speak to you today. I was like, all right, well, where am I in the four pillars? You know? And it's like, okay, well, my diet's pretty good movement. I'm probably moving too much of anything. Uh, relaxation, I'm completely failing in that and sleep. I probably give myself a B minus C plus right now. Like it's a great, great um little cheat sheet for taking inventory of where you're at and it's like i know i'm overextended right now my adrenals are fried i'm exhausted from travel it's no shock that i wake up and and feel lousy so here i have the good doctor to diagnose me

have we started by the way yeah we started oh my god i didn Yeah, we started. Oh my God. I didn't realize. We're rocking. Oh my God. I had no idea we'd actually started. We're just chatting. Okay. Yeah. I mean, I think the four pillar framework for me is, it's just something I can apply. You can apply. My patients can apply.

It's just a simple way of looking at your own health, right? And figuring out which one of these four areas do i need the most work in you know because i think most of us intuitively know you know most of us i kind of got a pretty good idea actually you know my diet's pretty good you know but i'm not sleeping so well um and and I love it because people get confused and bombarded with health information all the time now. You go on the internet, there's a million blogs out there, often they're saying conflicting things. People get paralyzed. They just don't know what to do with this information. Half of my job as a doctor when people come in is to say, okay, guys, you're confused. Okay, let me try and simplify this down for you. And I know there's a deceptive simplicity to those four pillars, but I think, I really feel

it's deceptively simple because I've seen how life-changing it can be when people apply those in their own life. And it takes the pressure off people. It's not about a perfect diet. It's not about, you know, the perfect gym routine. It's about doing enough in each area. And I'd like to think it takes the pressure off people anyway. Yeah. Well, I think, I mean, just for people that are listening, when we're talking about the four pillars, we have relaxation sleep movement and food right um and what's great about the book is that it really is super accessible and it's like this is not you know you don't have to like stretch and try to adhere to some kind of protocol that only few people are going to actually able going to be able to master like this is is like basic stuff. But I think,

you know, when I'm reading it, I'm like, okay, I get that. I get that. I get that. This is like top level things, but it's that gap between the information and the action where I think most people stumble. It's like, okay, yeah, I know I need to get a good night's sleep. Most nights I don't though. Right. Yeah. Well, that's a huge issue. I mean, that's one of the big issues in health. You know, there's all this great information out there. There's great public health messages often and people aren't following them. Why are people not following them?

And I've got many thoughts on that, but specifically the approach I take with these four pillars, particularly when I was writing the book, is how can I make it accessible to people? How can I write it in such a way? How can I pepper it with real life case studies from my practice that hopefully people can relate to and see how just making some simple changes in those four key areas can have such a profound effect. And, you know, we can all have a fantastic outcome when we do a 10-day diet of some sort, right?

When we exclude everything from our diets, we can feel better in 10 days, okay? Many of us can do that. But I'm interested in what changes can I help someone with that is going to work for them today in the short term, that's also going to work for them in one month, in six months, in 12 months? And how can I help them build in this lifestyle change over a period of time? And that really has come from my practical experience. You know, what I put out in the book is literally nearly 20 years of experience of seeing patients. And it's not just what the science says. The science is important to me, but you know, what's even more important to me is actually what works in

real life. You know, what will a busy mother do who feels that they've got no time to look after themselves and they're just running around just doing, doing, doing for their kids, maybe for their partner, maybe for their elderly parents. They're just go, go, go, right? I'm interested in how can I connect with her so that she feels, yeah, you know, I can do that. And that's why I've tried to make all the recommendations simple and achievable. And I'll tell you, one of the most fun things for me that I've, I had fed back to me since the book came out is that people feel that as they're reading it, that, oh, I want to do that. I can make that change, you know, and that, that makes me excited because I'm not telling people to go on a punishing diet. I'm not telling people to go on a grueling workout regime. You know, I'm,

I'm recommending some very simple things and why I think simple is important because we like as human beings, we like to feel good, right? If we've, if I set the bar low and we meet that, that feels good. You know, I've, I've done what the doc. Right. You created you create an emotional engagement with that process where the patient feels empowered. Yeah. I'll give you a prime example of that is in the MOVE pillar. Okay. So just in case people aren't familiar, there's four pillars and there's a quarter on each of them in the book. In the MOVE pillar, I talk about all kinds of recommendations, but one of my favorites is something to do with strength training. So I think strength training is very much undervalued in society.

something to do with strength training. So I think strength training is very much undervalued in society. You know, we don't think about it enough and, you know, your lean muscle mass, independently prediction mortality, it absolutely determines for a huge part how we're going to be as we get older. And a few years ago, I was in my practice and I'd read all the research on it. And I thought, oh, you know, I'm going to tell my patients about strength training. I remember this guy came in and I said, you know, it's really important for your blood sugar balance, but also for your overall health that we do a bit of strength training. And he goes, what does that mean, doctor? I said, well, you know, you really maybe do some resistance at the gym, maybe 30, 40 minutes, three times a week. He goes, all right, okay, you know, I'll try. He came back maybe four

weeks, six weeks later. And I said, how are you getting on? I said, you know what, doc, you know, I really want to, but you know, work's busy. The gym's not on the way back from work. You know, I just not got around to it. And I thought in that instant, I thought, well, what's going on here? You know, I didn't think, why is he not doing what I it. And I thought in that instant, I thought, well, what's going on here? You know, I didn't think, why is he not doing what I said? I always thought I'm not giving him advice in a way that he feels is applicable to him in the context of his life. And in that moment, I came up with this five minute kitchen workout basically, which is, okay, I need to make it accessible for him. And I literally

took my jacket off and I was literally teaching him five moves that he could do. And I said, I literally want five minutes twice a week. And that was the start for him. And literally he loved it. And he, he's now doing, you know, two hours of strength training a week, but you start off with that. Yeah. I'd make it super digestible. Super digestible. I had a couple in their 60s recently, same thing. They were so skeptical, Rich. You know, they came out of the consultation with me thinking, really? You know, that's what I need to do?

And I said, guys, I'll tell you what, I'm gonna see you back in four weeks. Please try and do these five exercises in your kitchen, right, you don't need to join a gym, you don't need to change, you don't need to buy any equipment, right? They went away. This is a couple in their 60s. And they came back four weeks later and I said, how are you guys doing? They said, Dr. Chassie, we love it. It's changed our lives. You know, we started off doing it in the kitchen,

but now we do it every night for 10 minutes on our upstairs landing as we run our evening bath. And I, so I learned from my patients. I, I love reading the science, but you know, getting people better in real life doesn't come from reading scientific papers. There is a difference. So how do you convert that into, into real actionable information for people? And that's what I'm passionate about. That's what, you know, I, you know, you see all these wars on social media about what the new science says and what the science says, and I read them all, right? But often we just divide people. We confuse people on what they should be doing. And I've tried to come up with a program

and a philosophy in this book where it's as relevant to, let's say, a vegan as it is to a meat eater. It is as relevant to someone in a low socioeconomic neighborhood, to the CEO of a top company. Sorry, someone who's the CEO of a company, you know, earning lots of money. Because I've worked in some of the poorest areas in the UK. I spent seven years in a place called Oldham, you know, a lot of people on social security. And I thought these guys have the right to the same quality health information as you get out here in California, right? And that's, when I was writing the book, I thought, I want these suggestions that I make to work for everyone. I want to bring people together. You know, I want to bring the low carb people with the low fat people. I want to bring them together and go, look, what's the commonality

here? What can we all focus on? And that's a real, that's something I feel very passionate about. And most of the recommendations I make, in fact, there's 20 recommendations, not that everyone has to do them all. I say, you absolutely don't have to do them all. If you don't, if you don't like one of them, don't do them. You know, I'm really trying to allow people to personalize it, but 19 out of the 20 are completely free, right? You can't make an argument that they cost money. The one that you can make an argument for is when I say unprocess your diets. You know, you can argue that depending on where you live, depending on your income level, you may struggle to eat an unprocessed diet potentially in certain parts of the country without a bit of money.

But you did also in the book sort of provide a roadmap for how to do that cost effectively. I do. Yeah. And I think, you know, one of the observation, I mean, I've spent a lot of time thinking about this subject of, you know, our respective silos, especially in the diet world and what you see on social media and the bickering and the conflicting science. And, you know, I'm always thinking like, well, what is the best way to navigate this and communicate to the audience in a way that will be the most positively impactful. And I spent a lot of time thinking about how to bring people together like yourself. And it's tricky, you know, when people get very entrenched in their ideologies and, you know, somebody who's part of the plant-based camp, I see it on all sides and everybody's guilty of it at various times. And it's not helping anyone.

What it's doing is paralyzing the average, well-intentioned consumer who's just trying to get actionable advice to improve their lives maybe 10%. Yeah, I totally agree. And you say we're all guilty of this from time to time. And I think as I get a bit older, a bit more experienced, I think actually, you know what, why does one group have to be right? Why can't many different groups be right for different people? And, you know, we often don't

think about the context of someone's life or their cultural beliefs or how they've grown up. And I always, as a practicing physician, I just bring it back to my consultation. I think, okay, what have I seen? What do I keep seeing? And I've seen the reality is if you talk about diet, for example, which again, I think we overly focus on it. And what I mean by that is, I think food is very, very important, but food is much more than fat versus carbs, right? But good health is much more than just food. And my own personal bias is that when I change my diet, right, my health starts to improve, right? But that's my personal bias because I've had many patients who that wasn't the route they wanted to take.

Some of them, like I've got so many patients who've got mental health problems, they didn't want to change their diet, even though I knew that would help improve the way they felt about themselves and their wellbeing. They started getting more physically active first and then that made them feel better. So then they wanted to change their diets. And that has almost been pivotal in this four pillar approach,

which is, okay, guys, you choose where you want to start. I don't mind. If you want to start with food, start there. But if you don't want to start there, that's okay as well. And, you know, I want to make this, you know, this book came out a few months ago in the UK, right? And it's doing incredibly well. And I think the reason it is doing so well is because I've really tried hard to not talk down to people, not to tell people what to do. Nobody wants to be told what to do, right? And I don't do that, and it surprises people, but as a doctor, I have never still, in nearly 20 years of practice,

I've still never told a patient of mine that they have to give up smoking. And what I mean by that is I feel that my job as a doctor is to have an honest conversation with them. If they come into my consultation room and if they ask me, my job is to tell them what that is doing for their health and their wellbeing. If at the end of that conversation, the man or the woman says to me, hey doc, I get it. I hear what you're saying. But you know what? I get so much enjoyment out of that. I'm not going to quit. I feel as a human being, I feel what right do I have to say to him? No, you must give it up. And actually, I think one of the reasons why I tend to get really good compliance with my patients is because I do

treat them like partners. I treat them like like adults even if that smoking conversation is just setting the scene for six months down the line or 12 months down the line when they thought about it and reflected we've done a bit of other work and they come back go hey you know what i might be ready for it now um so i think you know i think that side of things is is really really important yeah finding the the psychological button that's going to activate the person. And everybody has something different. There's a different way in with every individual. So you almost have to really take like an inventory of someone when they come into your office to try to determine what is the thing that I can talk about with this person that's going to catalyze change in them.

Yeah. can talk about with this person that's going to catalyze change in them. Yeah. And do you know what the hardest thing for me, Rich, was I know how to do that one-on-one with a patient, you know, or I'd like to think I do, you know, it's, I think the biggest skill of a healthcare professional is actually how do you interact, communicate with your patient? I think that is the number one thing that actually leads to good outcomes. I don't care how many papers and how many science things you've read, if you don't know how to make it personal and relatable to that person in front of you, it doesn't matter. It really doesn't matter. The system is not set up to encourage that. And that's one thing I want to explore with you. And I want to get into the four pillars and all of that. But I think maybe it would be good to kind of contextualize all of this by establishing the lay of the land right now in terms of what is going on with chronic lifestyle disease in North America and the developed world.

Because the statistics and specifically some of the numbers that you use in your book, they're just appalling. They're beyond appalling. They're unsustainable for every single healthcare system on a financial level. But on a human level, on a moral level, chronic disease is affecting so many families and it's causing pain, disability, heartache, premature death. I've gone on record before as saying 80% of what I see as a medical doctor in my practice is in some way related to our collective modern lifestyles. I'm not putting

blame on people, right? Because I get it. It can be tricky. But I'm saying collectively, the way we're living our lifestyles is having a negative impact on the way that we feel. And look, in the book, there's some US statistics, but I'll give you a UK statistic that is frankly alarming, right? And this is from 2012, okay? That in 2012, so what, six years ago, one report suggested that the UK was paying 20 billion pounds. So that is about 27, 28 billion dollars, sorry, million dollars on the direct and indirect costs of type two diabetes. It's insane. A type two diabetes is a fully preventable, in most cases, it is a preventable condition.

It is a lifestyle, environmental-driven condition. And we're saying we're going to effectively, if we don't do anything different, we're going to allow it to bankrupt our healthcare systems. And I find it incredibly, incredibly sad. Yeah. I'm looking at your book right now. One in 10 Americans currently has type 2 diabetes. Between 1990 and 2013, rates of this disease shot up by an incredible 71% in the U.S., one of the most dramatic increases of any nation. It costs us $245 billion a year. Half of all American adults currently suffer from a chronic disease, with one in four people suffering from two or more.

Chronic disease is by a wide margin now the deadliest problem facing America. It's true, it's unbelievable. It's, this is, for America, this is not just a health problem. This is an economic problem. You know, I think the US are gonna struggle to be a well-functioning economy, a global power,

you know, whatever you want to call it, with this rate of chronic disease. Because people don't often think about, is this chronic disease is affecting their whole bodies? It's affecting the way that their brain operates. It's affecting their ability to be productive in the workplace, productive and happy and interact with their families, with their work colleagues. And that's the other thing, you know, I see a lot of the disharmony I see in relationships and families. Often it comes down to, you know, not the only thing, but often a key part of that is that people don't feel good in themselves. They're functioning day-to-day sub-optimally. They're not functioning at peak performance. So

they are, you know, they're having little rows and little, little problems with their partners, with their kids, with their work colleagues. And often that's because they're putting junk in their mouth, right. Which is affecting their brain and their mood. They're sort of only having five hours sleep a night, which is, you know, you know, trashing their brain in the morning when, in terms of, you know, you know yourself or something I know as a father, you know, haven't slept well my ability to deal with the stress is at home and you know let things just lie you know or when the kids are doing something it's much reduced yeah it's not even close yeah so a lot of these things are happening because we're not looking

after our health uh and you know i think when we say chronic disease i think it's always worth explaining that we're talking about things like yes type 2 diabetes yes high blood pressure yes heart disease and stroke yes alzheimer's disease but we're also talking about things like mental health problems you know the latest statistic in the uk right which comes from the mind charity is that one in four people in the UK are going to have a mental health problem in any given year. I just find it an incredible statistic. And, you know, we're still looking for this pharmaceutical model of care to try and fix

these problems. I could tell you, it's just simply, in a lot of cases, it is not working. And heroin is the crux of the matter. 40, 50 years ago, what we were seeing as medical doctors responded very well to the magic bullet. You know, you come in, right? You've got a, let's say you've got a chest infection or a pneumonia, right? You've got the overgrowth of the bug that's causing you this problem. Come and see the doctor. They identify it and give you a pill to zap that bug. And then in a week, or maybe 10 days, you're better, right? We can talk about the knock-on consequences of that, but that's a separate story. But that worked 40, 50 years ago. The bulk of what we see now does not respond to this, you know, one pill for every ill model. There's

multiple things that are going on and you, it's not just one suggestion you've got to make. You've got to tackle multiple things in one's lifestyle if you're going to get a result. And, you know, those four pillars could have been five, six, seven, right? I could have expanded it out. Right. Frank's got six. Frank's got six. Yeah. You guys can battle it out. Like, is it four or six? Yeah, exactly. And the reality is, is that the clash always is, is how can you communicate complex health information simplistically? Not in a patronizing fashion, but in a way that actually people feel, okay, I get it, I can do that. And I nearly went to five, you know, but I thought, no, I'm just going to stick

to four. Like, so I think connection and community. Yeah, that was one of Frank's, I think. And I actually wondered that, especially since, you know, you talk about the sort of the blue zones and the diet part, and that's such a key component of longevity from those studies. Yeah. Oh, absolutely. I mean, the connection piece I put in the relax pillar. So one of my recommendations is to eat around, reclaim your dining table, right? And it's to sit around at least once a day if possible to have a meal with someone else if you can. And I bring in that chapter why community is so important. And that really is what I hang it off in the book because you're right. I could have made a fifth pillar all about it, but I also think there's something in keeping it simple, simple enough

that people think, I get it. I can do that today. I don't need to wait till January next year to start this big program. This feels pretty achievable. And I can tell you, Rich, where did that reclaim your dining table come from? Because people might go, yeah, well, how's that going to help with my health? Why is that important? I made some TV documentaries for BBC television, where I went and lived with and alongside families to help them with their health problems. And I was very fortunate, I feel very humbled to have had that experience to be invited into people's homes and actually see in real life what they do, not what they tell me in the consultation room, but what they actually do in real life.

room, but what they actually do in real life. And so many of the families I stayed with didn't sit and eat together. Forget about what they're eating for a minute. One of the kids is maybe on the sofa, scrolling their Facebook whilst they're eating. Mum might be watching television, but also doing her emails while she's eating. Dad's in another room, the son's somewhere else. And I saw that and I thought, what was the norm? I'm sure it was the norm in the US just as in the UK, maybe 40 years ago that every dining table, every house would have a dining table. Now we're knocking them out. We're making room for big widescreen televisions and all this sort of stuff. And I made the recommendation to so many of those families, hey guys, look, you know, we aren't going to change what you eat, but I wonder if

you guys could manage once a day where you sit together and eat as a family. And I saw the profound benefits. Yes, they were eating less because they were eating more mindfully and they were connecting whilst they were eating. But there was this couple who, lovely middle-aged couple. And I came back after a few days and I said, how are you guys doing with that? And the husband said to me, he said, it's incredible. You know, I feel like I'm really connecting with my wife. I'm, we're sitting, we never used to sit around

and without devices and have our meal. But I'm asking her about her day. I'm learning things that happened. His wife said the same thing and have our meal. But I'm asking her about her day. I'm learning things that happened. His wife said the same thing and they feel closer, they're more intimacy, they're just from making that suggestion. And I learned, I didn't learn that in my consultation room. Had I not gone and stayed with those families,

I wouldn't have seen that something that I thought was relatively normal is frankly not normal anymore. Right, right, right, right. Yeah, it's becoming, you know, it's gone the way of the dodo. You know, it's sort of thought of as antiquarian and quaint and, you know, at this point, but there's so much truth in what you just said. But I think the first hurdle is really getting people to understand on a very basic elementary fundamental level that they have control over their health, that the decisions that they make about how they're living their life hour to hour, day to day, have profound implications

in terms of whether they're going to succumb to disease or live vibrantly. And I think for a lot of people, that's revelatory and new. That's brand new. Even the way I was taught at medical school really didn't empower us, you know, didn't empower me as a medical doctor with that information. Because back then, we thought our genes were our destiny, right? That's kind of what we thought was going to happen then was we've got, as we do the Human Genome Project, we get more and more, we understand that it's all to do with our genes. What cards have we been dealt when we come out of the womb? But the last 10 years has changed all of that, you know, and again, the statistics

vary depending on who you read, but you know, there seems to be a bit of consensus now that about 10% of our health outcomes for most of us is down to our genes. 90% of it is down to our environment and our lifestyle. And that's incredibly empowering. So I think there is a generation out there who think and have been trained to believe that it's, you know, oh, my father had type 2 diabetes. Of course, I'm going to have type 2 diabetes. There's nothing I can do, you know. And in some way that plays into the whole emotional piece, which is, you know what, I'm going to keep making these choices because it doesn't matter. It doesn't matter.

Dad got it. I'm going to get it. So I might as well enjoy my life, right? That's the perception. And that's the key message I try whenever I speak, whenever I teach doctors, whenever I talk to the public, I'm always trying to say, guys, we've got the control. We've got more control than we think. Just to be clear, there are some genetic conditions that are related to, you know, like even Alzheimer's, for example, you know, there is under 1% of Alzheimer's is due to your genes,

right? Some people are born with something that means it's very likely they're going to get it, okay? But that is not the vast majority of us. And I think even that message is like a revelation for people. And even if I could, you know, help the, the, the incredible, you know, people like yourself and other doctors and other, other people who are trying to spread this message around the world. If, if all we do is get that message out there, that's a great starting point. Because here's the other thing, right? Is that one of the things that frustrates me about the infighting on social media and on the internet about a lot of these things is that many people are kind of saying similar things, right? So to give you one extreme viewpoint here, I wouldn't call it an extreme viewpoint, but just to sort of paint the picture,

obviously there is a lot of animosity between certain groups, whether it's vegan plant-based versus low-carbon, you know, animal products, you know, for an example. But both groups, right, are saying now that actually we can reverse a lot of these chronic diseases you know both groups will say we can reverse type 2 diabetes we can reduce our chances of getting out time is by adopting our dietary pattern right so i trying to trying to sift through that and sit just outside it and look at it and go okay okay, so compared to 10 years ago, when very few people were saying that we could reverse a condition like type two diabetes, now we've got- That was crazy making.

Yeah. And now we've got this coming out from people who may have a different viewpoint on how the best way to do that is, right? But they're all saying we can reverse this stuff. That I think is a revelation. I think we need to focus on that and go, okay, great. So I don't necessarily need to be on medication for the rest of my life. I might be able to do something about this. And I find that exciting. And I think that's the message we need to get to people and then help them make small changes. So why do people find it so hard? So many reasons for that. You know, there's a lot of emotional reasons behind that as well. But I think if we can make it seem accessible to them, if they feel, hey,

you know what? I can do that. Like one of my recommendations is 15 minutes of me time a day. Most people, what? 15 minutes, you know? And it's incredible because that, it's like a domino effect. You start it off simple. You get people go, why? I can do that. I think I can manage 15 minutes, right? And then that domino falls. You start to feel the benefits. And then the other dominoes start to come in line. But Dr. Chatterjee, you don't understand my life. I get up at 4.30 in the morning. I got four kids. I got to get them dressed and to school. And then I work two jobs't understand my life. I get up at 4.30 in the morning, I got four kids, I gotta get them dressed and to school and then I work two jobs. And by the time I get home at 10.30, 11 o'clock at night,

and I gotta try to make a little bit of food for my kids and I'm just exhausted. I get it, I understand. So what do you think you can manage? Can we start with five minutes? Do you think you can find five minutes in your day? And that's the approach I take. These are just suggestions, these are not prescriptions. These are saying, look,

I think 50 minutes is a great starting point, but if all you can manage is five minutes, right? And even that fictional lady who, you know, you just spoke about, I bet you she can manage five minutes somewhere in her day, you know, and that's not me being judgmental at all. I'm just saying I've got patients like that. And what I try to do one-on-one is find the way in, find what is it that they're doing? Where can I get a bit of traction here? What can I start them with? I've made a deal with a patient before that they're going to do two minutes meditation a day. So I can't do it. They said, I can't meditate. I can't, I'm not going to have going to have time. You know, it doesn't fit with my lifestyle. I said, okay, you brush your teeth for two minutes in the morning. Okay. Why do you do two minutes in the morning? Because I've always

done that. I said, yeah, you've, you've ingrained that in a habit. Even if you're busy, you never don't brush your teeth for two minutes in the morning, two minutes in the evening. Okay. He goes, yeah, that's right. I don't. I said, well said well how about then do you think you can manage two minutes of meditation yeah two minutes sure and and we made a deal i said okay i'll tell you what let's make a commitment now that you're going to do that she goes away she starts doing that you know within about two or three months she's doing 20 minutes a day so i very much you know this comes from real life experience rich this is you know I, when I look back on my career and I think early on in my career, I really had a real disconnect with, you know, I went to, you know, a very prestigious medical school.

I qualified as a specialist and I moved to general practice because I was always searching for something in medicine that resonated with me. When I was working in kidney medicine, I thought, ah, I don't want to spend my whole career just looking at kidneys. I always intuitively knew that everything was connected. And I felt that we were getting too super specialized in medicine. So I moved much of my dad's- Yeah, you come from a line of doctors. I come from a line of doctors. He's an Indian doctor who came over to the UK. You know, they value the specialist.

Right. His son- GP? His son had qualified as a specialist, had done all the hard work to get there. I said, dad, you know, I think I'm going to change. I'm going to become a generalist. He's like, why do you want to do that?

And I've always now, now that I get it, now that I understand what I love doing with patients, I can look back now and go, that's why I was slightly frustrated. I didn't get that deep enjoyment out of my job that I do today. Because I just thought I was giving pills out left, right, center. Well, you're a people guy too, right? Like I can tell that you're somebody who enjoys basically like figuring out what makes other people tick. And that's such a huge part of practicing medicine that I think we lost touch with that is now slowly starting to come back.

We're seeing this, you know, influx, this rise of functional integrative medicine doctors like yourself. It's become, you know know it's becoming a thing and yet it's still very much a small sliver in comparison to the way most people are practicing medicine and the way that most patients experience their health care practitioners and it's it's very sad it's very sad because this very sad because this is affecting people's lives. People are dying early. Their day-to-day lives are being hindered because we're not evolving with the times. The health landscape of the developed world, and actually the developing world as well, has changed. and actually the developing world as well has changed. So the way we practice medicine also has to change, but it hasn't.

And therein lies one of the big problems. And, you know, I say, you know, I was getting so frustrated with this. I thought, okay, you know, I can keep talking about it. I can keep going on BBC television and talking about this being a problem, but how are we going to start fixing this? So with a colleague of mine, I create a brand new course called Prescribing Lifestyle Medicine. That was the first Prescribing Lifestyle Medicine course to be accredited by the Royal

College of GPs. So yeah, and we taught 200 docs in the UK back in January. We ran it again in April and why that accreditation was important because it gave it a bit of validity it gave it to other docs who were like yeah I kind of I'm reading all the stuff on the internet I'm interested but you know having the CPD points there for people to come right legitimizes it legitimized it and you know it took you know we spent six months working up this course you know we're trying to do it in one day but it's my way of trying to say, look, yes, I've showcased on television that type 2 diabetes, fibromyalgia, you know, can be reversed in many cases. Panic anxiety attacks can come down by 70% by making lifestyle changes. Autoimmune diseases, Crohn's, like all sorts of things. I feel like, you know, I've helped showcase that to a mainstream audience on BBC One and in countries all over the world,

that these conditions can often be reversed, but certainly dramatically improved, right? By making these changes to these four key areas. And I thought, well, that's great. But if the public are watching that, then they go to their own doctor for help in that. But the doctor doesn't know what to do with that. That's where we got a problem. So I thought as a medical doctor, maybe I can be part of the solution by helping to educate a new generation of doctors in what is possible. And we end the course with me and my colleague, we do a role play, right? And people love the role play because what we do is we, on stage, we sort of go through how a consultation might roll when someone comes in with type 2 diabetes.

And the first one is what typically happens, which is, you know, someone knocks on the door. I'm the doc. I'm looking at my computer. You know, I'm typing away. The guy comes in, I barely make eye contact. I'll say, hey, Barry, look, you know, we've got some news for you, Barry. You know, pretty worrying blood results have come through. You've been diagnosed with a condition called type 2 diabetes. Type 2 diabetes, you know, it puts you at increased risk of heart disease, you know, stroke,

Alzheimer's, you know, you may start getting nerve damage. We may, you know, it puts you at increased risk of heart disease, you know, stroke, Alzheimer's, you know, you may start getting nerve damage. We may, you know, some people need to amputate their legs, but don't worry, we've got a great medication for that. You know, so we're going to start you on that today within, you know, we're going to start you on something called metformin today. Normally within six months, 12 months, we'll put you on a second pill. Sometimes we'll need to progress to insulin injections, but don't worry, we'll be keeping a regular eye on you. And as Barry's walking out in shell shocked, hey, and if you can lose a bit of weight as well and go to the gym, that'd be great. Okay. If that is even said.

If that is even said, but if it is said like that, what does the patient walk out with? They walk out with, okay, I've got this condition. It's serious. Okay. But the doc said there's loads of, yeah, there's loads of drugs he can give me. Yeah. He only mentioned lifestyle. That's not really that important because he spent the whole time talking about drugs. So I say to people, if we prioritize lifestyle, the patient will prioritize lifestyle. If we prioritize drugs, they'll prioritize drugs. And so you compare that with Barry coming in and me saying, hey, Barry, look, you know those blood tests you've recently done. Actually, a few things have shown up in there. And you have a conversation, you say, Barry, look,

your blood sugar's a little bit high. And you're actually in the range now, what we would call type 2 diabetes. Do you know what that is? I don't know. Well, you explain what it is. You say, hey, Barry, look, here's the thing. You will have been doing things in your lifestyle, possibly without realizing it, for a good 10 years now, that has led you up this continuum so that you now actually have a diagnosis of type 2 diabetes. Would you like me to help you understand what those things are, how we can change them? And then hopefully, if we're lucky, we can start turning this thing around. Yeah, hey, don't stretch. Yeah. I'd love to. Yeah. You know, let's talk again. I don't want to labor the point, but the whole dynamic is different. Barry goes out of that consultation with some actionable steps thinking, hey, you know,

there's something I can do about this. Right. Empowered. Yeah. But that comes to our skill as a clinician and also our willingness to prioritize that. But in fairness, there also has to be systemic changes to the way the entire system is set up. I mean, look, you know, doctors are well-intentioned. They want to help people. They want to be healers. That's why they get into it. But when the system is constructed doctors need to be trained in all of this stuff. And systemic changes have to be made that allow for that kind of bandwidth with each patient so that that person can leave with that sense of empowerment. Rich, you're absolutely right. And, you know, ultimately this is not just going to be the doctor, you know, this is arguably, you arguably, we need to collaborate more with nutrition

professionals, with health coaches. But what I say to people is, people say to me sometimes, why do doctors need this training? Why can't doctors refer to the right people? And there's a fundamental misunderstanding of what our job is, you see, because if we don't know, right? Okay, we've spoken about targeted diabetes and let's say obesity, right? These are things which are obviously, for many people, related to our lifestyle, okay? So arguably, we might refer here, okay? What about conditions like mental health problems, right? What about something like migraines, which affects, cause huge disability, you know, huge morbidity across the population.

What about these problems where we don't automatically think that lifestyle has a role? When I know full well, and I've seen that you can absolutely make a huge impact with these patients with lifestyle changes. Unless we get the training, we're never ever going to be

even referring these guys to health coaches or lifestyle professionals to help them. Yeah, you wouldn't even know to do so. You wouldn't even know to do that. You know, I gave a lecture. It was in Bristol in the UK in January for the Royal College of GPs on well-being for doctors because burnout in physicians is a huge problem. And I said to these guys at the start, I said, how many of you, with a patient who comes in with a mental health problem like depression, how many of you talk about food with those patients? And, you know, about 5% of the room put their hand up. Then I presented some of the science behind it, including,

you know, there's this beautiful trial from February 2017 called the SMILES trial in Australia, very small, okay, but it was a randomized control trial showing that people who followed a modified Mediterranean diet, these are all patients with depression, moderate or severe depression, they were already on therapy. None of that was changed, but one group went on a modified Mediterranean diet for 12 weeks. The other group had some sort of talking social therapy. And at the end of 12 weeks, there was a statistically significant remission rate in the group who went on a modified Mediterranean diet. Now, there was only 67 participants, but that adds to the weight of evidence that is already building. And I said, guys, look, how many of you now

are going to have this conversation with your mental health patients? And pretty much everyone put their hand up. Because, you know, something that seems so obvious to me is not mainstream knowledge amongst these professionals. So yes, the training needs to help. You know, this training needs to be compulsory in medical schools. I absolutely agree. As some people said when we put on this course, they, you know, because everyone's, you know, a social media expert these days is like, you know is not enough you know you need to get some medical schools i agree with all that but you've got to start somewhere start yeah you've got to start somewhere you've got to give this movement credibility the mental health piece is is so huge and i think you know i'm interested in your experience like if you when you start talking about treating mental illness or things like depression through lifestyle alterations, people get nervous.

Yeah. Right? Because we're just used to thinking of it a little bit differently than we think about physical health. But it is so debilitating for so many people. And it kind of lurks in the shadows. in the shadows. And my experience is in working with lots of people and being part of the recovery community for many years is that even when you're amongst people who are very high functioning, who seem like they have everything together, if you can get them in a safe environment where they have an inkling, a slight willingness to be vulnerable, and you just poke them ever so

slightly, you'd be amazed at what comes out. We're all dealing on some level with all kinds of stressors and anxieties that are really indicia of our times. Like how we live our lives now is so antithetical to the natural rhythms of how we evolved. Yeah. I mean, absolutely. And, you know, there's this theory about sickness behavior, which is if we think about the body and our stress response system, okay. And let's say in paleolithic times that we had come down with an infection. Okay. So we're, our immune system goes on high alert. So it produces all kinds of inflammatory markers

to help us fight that infection. But what it also does is make us tired. It makes us sleepy. It makes us withdraw. We don't take pleasure from things. And it almost sends us back to the back of the cave in the dark so we can just rest and recuperate, you know, whilst the body is attacking what it needs to attack. And a lot

of people are speculating that actually is very similar to what's going on with mental health problems. It's potentially an appropriate or an inappropriate response. Well, it's something that was an appropriate response in a different environment, but as the environment has changed, our 21st century living, that response is actually doing us harm now. But it served us very well in the past. And I kind of like that because it really helps me understand why does our body have all these mechanisms at play? Why things suddenly start to go wrong with all these different systems in our body and what's changed is the environment. But the other great point you bring up, Rich, is that, you know, lifestyle, you know, what's that got to do with mental health? You know, that's a,

and what I would say to that is, and I've got to be very careful to caveat this, is that any chronic disease, even type 2 diabetes, but let's talk about mental health, there are multiple factors that play a role. It ain't just one thing. So yeah, you may have huge emotional trauma that needs dealing with, right? But it doesn't mean you can't also get an improvement from optimizing your lifestyle. And it's not necessarily one or the other. We're always looking for what is it?

Is it emotional or is it physical? Well, maybe it's a combination. And I talk a lot in my book and in my sort of work that I do, I talk about thresholds, right? We've all got an individual threshold. So the way I try and explain it is if we're born in perfect health, let's say, we start down here in perfect health, we can deal with multiple insults up to a point. So let's say, you know, I don't know, we had a ton of antibiotics as a baby. Okay. We didn't enjoy our school. You know, we got bullied at school. We eat a poor diet. We don't work out. We work too hard. We get very,

very close to our threshold. Then something happens, you know, you have a bereavement in the family or your girlfriend breaks up with you and that tips you over your threshold. That's when you get sick. And we think, oh, it was the last thing that we need to fix. No, once you cross your threshold, you need to start again. It's like in life, you've got one ball, two balls, you're juggling three, four, right? You just about keep everything going. Then someone throws a fifth ball in, everything falls down. And so my approach is about making multiple changes. And so, you know, on the last series of Doctor in the House, there was a lady, right, who had a significantly traumatic emotional event when she was 19, right? You know, ended up in intensive care, in a coma. She woke up, she was scared out of her mind. Since then, she had really bad panic and anxiety attacks, okay, which is crippling her life. And she applied to be on the show because

she was desperate. She had tried counseling. She tried antidepressants and nothing was working. And again, I didn't know if I was going to be able to help her or not, but I thought, okay, what's going on here? Her diet was appalling. You know, she was compensating with the way she felt with junk food and processed food. You know, she was up late with the way she felt with junk food and processed food. You know, she was up late on her screens, all this kind of stuff, right? And again, she was very skeptical when I suggested that we would start by changing her diet. You know, there was a huge resistance. Well, you know, you're saying I've done this to myself with the food. I'm not saying that. I'm saying that something significant happened when you were 19.

But you have, you know, because of the way you felt, you put loads and loads of layers onto that as well. And lots of compensatory behaviors around that. Let's just start. You've tried counseling. You've tried antidepressants. Okay. Let's take a different approach. So we started with her diet and it was just incredible. By the end of six weeks, her symptoms had gone down by 70%. Not a miraculous reversal, but her quality of life had improved immeasurably. And I feel, and towards the end, we then got her to a talking therapist, but she was in a much better state that she could now access that and deal with that. And, you know, we've got to, sorry to labor the point, but you've got to do multiple things in multiple areas. And that's why this is not a book about food. This is why it's a book about, you know, there are many great books on

food. I'm not against that, right? But I think, well, that stuff is out there, right? What can I contribute? I want to show people that the quality of your sleep is as important as the food that you put in your mouth. And I didn't know that five years ago. And you may be skeptical of that potentially, but when you look at the research of what sleep deprivation does to us, I've helped patients reverse or certainly put their toxic diabetes into remission. Yeah. There's something in the book about insulin resistance, the impact of poor sleep on insulin resistance, which I did not know how significant that was. It's crazy. It's huge. And there was a study recently done where they sleep deprived a healthy group of people down to four to five hours a night, which is not

dissimilar to what a lot of the population are getting. A lot of people, and a lot of people will swear that they're fine with that. A lot of people will swear they're okay with that. But here's the thing, a lot of the time, so there's two points there. When you say people say they're okay with that, if we go back to my threshold analogy, okay, they may find that that sleep deprivation, and they may not have any symptoms yet. They may be getting away with it, right? But they may be moving up towards their threshold. So that sleep deprivation may be okay day to day. They may perceive it as being okay. But then when the stress goes up at work, when something happens that they're not expecting, when they lose their job or their mother gets sick, suddenly they're that much closer and they tip over. And that's why I think, you know, we exist on a continuum of health. You know, when you get diagnosed with

type 2 diabetes, that started 10 years ago. Right, of course. When you get diagnosed with Alzheimer's disease, that started 30 years ago, right? So we need, as a system, we need to better help people identify when they're moving up that curve, when they're not at diagnosis stage, but they're moving up that curve. But the thing with sleep deprivation, and I've got patients who've come to see me, they have changed their diets. They've read the blogs, right? Whether it's plant-based, whether it's another approach, they've read all that and they've changed their diet. And I come in and I see them and their blood sugars still aren't coming down. I think your diet's pretty good, you know? And then some of them super stressed and they're not sleeping.

And there was one particular case, a 52 year old guy, you know, busy, you know, high performer, executive, his diet was fantastic, but he was getting so frustrated that he couldn't get his sugar down anymore. And when I started to say, look, we need to think about switching off your computer one hour before beds. We need to do five minutes of meditation a day, right? Just to get you started. You know, six months later,

his blood sugar starts coming down, you know, because it's not always diets. And that really is the, you know, I'm not trying to say diet's not important. It is clearly very, very important. Yeah, it's just not all diet. It ain't all diet. And I think that's what, when you get into these silos and these arguments, you know,

this sort of implicit message is, it is all diet, right? And yeah, diet's huge. It's super important. But beyond that, there's so many things. You could be the most perfect raw vegan, fruitarian, whatever. But if you're bananas and you argue with people all day long and you're an asshole and you don't sleep at night and you're staring at your phone all day long, like you're not a healthy person. Yeah, you're not. And if

we go back to sleep for a second, that study where they deprived people to four to five hours a night for I think six nights, okay, they had a 40% reduction in their capability to manage their blood sugar. And the end of that, some of them would have been diagnosed as pre-diabetic, right? Just from sleep deprivation. Wow. And I think we've got to start bringing this into the equation because you mentioned the blue zones. I talk about the blue zones and I find them fascinating because we can learn so much from them. But when, you know, I know you've had Dan on the show before and, you know, I know you've had Dan on the show before, and, you know, I had the privilege of meeting Michel Poulin, who's the Belgian researcher who,

I think, along with Dan, helped to sort of coin the term and do all that work. I met him in Guernsey last year, which was just an incredible experience, which I'll tell you about actually. But when we look at them and we try and look at the perfect diets, I understand the rationale behind that, but we're looking at populations who are eating well, they're also pretty physically active every day, they're sleeping well, they've got low levels of stress and they've got a strong sense of community, right? So when we look at them, it's a lifestyle. It's the whole piece put together. And when we compare in the West, where we are underslept, we're overly stressed, we're physically inactive, and a lot of us are eating highly processed junk food, right? That's just a recipe for trouble.

And we can't, I don't think, just take one aspect of the Blue blue zones. We have to look at it all and go, you know, let's try and optimize as many of these as we can. And the other thing I sort of would love to sort of try and get across is, I get it. Life is tricky for some people. You may work shifts, right? You may find it hard, right? So maybe if your sleep pillar ain't going very well, maybe you need to optimize the food pillar and the movement pillar and the relaxation pillar. You know, you can get to your, you can lower your threshold in many different ways. And I think the blue zones are a prime example of people lowering their thresholds, you know, and keeping themselves very resilient. Because that's the thing, lowering, keeping yourself away from that threshold doesn't just mean you're going to feel better.

And keeping yourself away from that threshold doesn't just mean you're going to feel better. You've got more resilience. So when life does chuck you, it's curveballs. And that will happen. Nothing stays static. Everything's always changing. You're more resilient to fight it. Yeah.

And I think, you know, it's only getting crazier. I mean, with these, you know, devices in our pockets, it's becoming harder and harder to to detach to disconnect and you know what's going to happen 10 20 years from now it's going to be almost impossible to unplug at all and the pace of life just continues to to get uh rapider and rapider and you know there's no there's no like you actually have to work to be bored now there's just no there's no, like you actually have to work to be bored now. There's just no, there's no reason to ever be bored again. You can be overstimulated during every minute of every waking hour. We've lost the art of stillness.

We've lost that ability to just sit there and let our mind wander. And actually that's when a lot of the creativity happens. Your default mode network, your DMN in your brain, which is when a lot of the creativity happens. You know, your default mode network, your DMN in your brain, which is where a lot of these creative ideas come from, that goes into overdrive when we're not focusing on a task,

when we're just sitting there, you know, just watching the world go by or maybe when you're going for a run. I'm going to bet that you get a lot of your great ideas when you're out running. Oh yeah, absolutely. Rather than when you're- It's the only time where I can just be by myself

and my thoughts in nature. Yeah, because you're not trying to sit here figuring it out. I've got this problem. I can't get to the bottom of this. You probably go out for a run and you find, oh, I've got the solution. Right. Or when I am grinding it out and trying to figure it out,

I'm like, oh, let's see what's happening on Twitter. I'm going to stare at my phone now. Hey man, I know that feeling. But I say, I recently gave a talk to Apple in London on wellbeing for their employees. And, you know, incredibly, you know, privileged and I feel very humble to go in there and talk to them.

And I actually spoke to them about tech. And I said, I feel, I felt like I was in the lion's den talking about tech and some of the problems, but also how, what a great opportunity they've got, because so many people use their products, they can actually shape the world. And I think they do take some of these things quite responsibly. You can actually really shape what people do. But what was interesting, I spoke about my four pillars to them to try and improve their wellbeing. At the end of the talk, this chap came up to me. must have been in his mid-20s right he said hey

you know actually i found that really really interesting but can i ask you something i said yeah sure fire away it's like if i switch my phone off an hour before bed what am i gonna do rich he was serious man yeah i'm not i'm not kidding you. This is a kid. Panic, panic. He was deadly serious. And I thought, I learned a lot that I thought, wow. Actually, for some people that are so embedded to this, they genuinely don't know what they're going to do without it. And I thought, you know, I've got two young kids,

seven, well, no, now eight, eight and five years old. And I worry about this, you know, as a father, there's always something to worry about as a parent. And I think, what am I going to do? You know, very soon, everyone in my son's class is going to have a phone and he's going to be like, daddy, can I have one? And he already asked it for his birthday recently. And, you know, I looked at his thought, you know, I'm not going there with dad, you know, I know what the answer is, but I worry because I don't want to make my children social outcasts yeah i i really struggle with knowing some of the problems i yeah it's a legit it's a legit concern i mean i'm older than you but you know i i didn't grow up with you know i

didn't start using a computer until i was in college and that was still many years prior to the internet so you know myself and to some extent yourself, like we're the last generation of people to know what it's like to be without all of these things. There will never be another generation of humans who lived through, you know, what it's like to not be on the internet. And so it is tricky, you know, as a parent myself, to try to find that balance, because some level, we have to accept the fact that these devices are part of what it means to be fluent in the language of our times.

So it's not about like, no, you can't have it. It's about creating responsible habits around it, which is difficult when you're talking about a device that has the addictive potency of heroin. I mean, you've just hit the nail on the head. It's not about demonizing these devices and this technology is fantastic, right? It's utterly life-changing. We're having like what we're doing right now. What we're doing right now. Or we could have done this, you know, or, you know, we could have done this, let's say over Skype, right? We could have been 5,000 miles away from each other, having a conversation because of this technology, which is utterly incredible. And I think what we have to just

remember is that this is a new technology, right? We haven't quite yet figured out as a human race, how do we use it in a way that it really helps us and serves us rather than enslaves us? And just as we've got like sleep hygiene rules, I think we need technology hygiene rules. We need, you know, what are good practice rules? You know, do we need a bit of tech free time every day? I absolutely believe we need a bit of tech free time every day. But here's the thing. If you've got that device near you, it's very, very hard because they are addictive. You know, when I, you know, one of the sort of recommendations I make is, you know, can you have a screen free Sabbath? Can you have one day a week without a screen completely? Now I get it. People are going to almost be having palpitations at the

thought of that. What am I going to do? Yeah. So I say, well, if you can't do a whole day, try with it, try an hour, start there. I tell you on a Sunday morning, right? If I go with my wife and my two kids to the, to the local park, right? If I go and my phone's in my pocket, right? It goes something like this. Kids are playing, we're all interacting before you know it. I'm just, Hey, they're on the climbing. I just got a cheeky little look, you know, what's going on on Instagram. What's, you know, and then before just, hey, they're on the climbing. Just have a cheeky little look, you know, what's going on on Instagram. You know, and then before you know, where are the kids? You know, something like that. Somebody abducted them.

Yeah, but before you know it, you're drawn into this world because it's powerful. It's engaging. If I make the decision, I'm leaving my phone at home, I have a completely different experience. I'm present. I'm mindful. I'm paying attention to what's going on. And my kids call me up kids you're not panicky and feeling naked yeah no I love it but I've got used to it I've got used to it and and ultimately

my kids particularly my daughter she'll call me out if I'm in the room with her somewhere and I'm distracted on my phone she's like daddy you're not listening to me are you I tell you that's like a dagger in the heart for me and I'm like okay yeah I'm just gonna put my phone off in another room and uh so I as as a father, one thing I think is really important is something I really try and adhere to is spend at least one hour a day with my kids when I'm around, you know, without my phone anywhere in sight and not even on, because I just, that's my strategy. Again, I'm not saying everyone has to do this. I'm just saying, I'm trying to figure it out.

I'm as addicted to this technology as anyone else is. I'm trying to figure out a way where I can still get the best of it without harboring myself and also my relationship with my kids in the process. Yeah, well, when you figure it out, let me know. It's hard, right? It's hard.

It's really hard. You know, I mean, it's like's really hard you know i i mean it's like and i like i make my living through this you know through through this ecosystem so it's even more difficult for me to create because i can just make a justification wow this is what you know i need to be doing i need to be i got to promote the latest podcast i gotta do it and you know it's not good for me you know and so i go through um phases where i'm really good and then i it and you know it's not good for me you know and so i go through um phases where i'm really good and then i lapse and you know as somebody who's a recovering alcoholic like it just pings every part of my brain that like wants to use and check out and get that little brush

you know you compare it to alcohol but let's talk about food for a minute. People will often say, yeah, I could eat well for a short period of time, then I've fallen off the wagon. I couldn't do it. And it's the same thing with these phones. I'm not expecting perfection from people. A, it's not my right to expect perfection from anyone, but I'm not, that's not what I'm trying to suggest in what I do with patients, what I do when I speak to the public or in the book. What I'm trying to do is empower people with information, say, look guys, this is what's going on, right? This is going to be having an impact on you. Here are some strategies that you might want to adopt. Why don't you suck it and see? Why don't you try this? You like this one? You don't like this one? Fine. You've tried it. That doesn't work for you. Try

this one. I mean, one thing I will say is one of the most life-changing things people can do, okay, is take off notifications, right? And I'm deadly serious. You don't need, you know, that's the way you can start taking control of that technology and go, I don't need to be notified every single time someone likes my Instagram post or my latest Facebook article or someone's just retweeted me. I don't need to be notified every time. You know, so all my notifications are off. My email inbox is on manual refresh. So I can look at my phone. I could have 20 emails waiting for me.

I don't know. I have to go into the app and I have to refresh the screen. And then I see. And that's a small step that I think most people can manage. And I would say to people listening to this who attempted to do something, I'd say start there. Just start there. That's one thing I have done. And that was life-changing.

All the notifications on my phone are off. The one thing where it gets me into trouble, though, is when you take notifications off your text messages because there's an expectation when someone texts you that it prompts an immediate response. But where does that expectation come from? Well, I don't know. Maybe it's self-generated in my own mind. But I've trained now. I basically, unless it's really pertinent um i don't respond to text matches messages right away so that people who text me don't then develop that expectation

but i don't know if you've noticed this like texting has now become like email it's like it's almost like my i used to just not get that many texts but now i get so many texts that it's like the same thing but then i don't think to check my texts because I don't have that little number on there. I don't know when I have new ones. Yeah, it's... You know, I can also grayscale your phone too, which I think is a great thing.

What's that? I'm not familiar with that. There's a setting where you can go in and remove all the color. And so it's just black and white screen. And there's something about the way that everything is colored in a specific way. There's a lot of money in science that's gone into creating that compulsive, addictive response.

And color has a big role in that. So there's been studies done that when you grayscale your phone, that it really tempers that compulsivity. Yeah. There's a guy called Tristan Harris harris who's doing like a lot of research in this right now he's been kind of doing the podcast rounds and super fascinating that's super interesting yeah you know communication is changing isn't it you're saying like text messages are becoming a bit more like emails and it's very hard now to it's very hard to put those boundaries in now. You know, I try my best to guard

my number, my phone number with my life, you know, because that then means people have got access to me on a Sunday, on a Saturday, you know, when I'm on family time. And those boundaries have just got blurred now. And, you know, it's funny, you know, I also think that we, we've lost an element of respect on other people's time and their boundaries, not because we're meaning to, but I give an example recently, somebody who's got my number, um, added me to a WhatsApp group of like 15 people, 14 of which don't have my number. And when it first happened, I was, you know, I was like, oh man, I'm on this WhatsApp group now. And these 14 people who don't have my number have now got my number so they can contact me personally in a way that they couldn't do before. And again, it's nothing about ego or anything like that. It's just more, I'm really trying to guard my

own personal time, my private space. And I feel that's been taken away from me now. And the person who did it didn't do that with any malice. Right. But we haven't really written the etiquette rules. Exactly. And that's what I think is going to be written over the next few years. And now is what is the right etiquette? Like, as you say, there's an expectation of the text message you should be responding so you're helping to educate your community your friends people who have access to you via your text you're helping to just educate them a little bit go hey you know when you text me i'll get back to you but it won't be quick and i think we all have to do that you know tim ferris wrote in his in the four-hour work week you know about that's

when i learned about the emails about pre-setting the expectation when someone's actually, you know, this email gets checked twice a week or once a day. You know, I did that for a while, then I took it off and, you know, I'm always experimenting, but it's about changing the expectation, right? Yeah. He was, he was here and he showed me his phone and it said that he had like 8,000 unread emails or something like that. And I was like, do you read them and then mark them on red? He's like, no, I've never looked at them. And I did an experiment when I was in, as I told you before the podcast, just got back from Italy. I did an experiment where I had a colleague of mine, my assistant handle all my emails while I was gone. I'd never like turned over my entire email box to somebody else and gone away for like two weeks and not looked at it.

And that was definitely a learning experience. It was great, but it was like for a minute there, I felt very weird, you know? Almost like naked. Yeah, yeah, yeah. That's your thing. And I think the key, as you say, is that we don't know the rules yet. We're all trying to figure this out. We're in the infancy of the most powerful technology that we don't know the rules yet. We're all trying to figure this out. Yeah, we're in the infancy

of the most powerful technology that we've ever created. Yeah. And we're trying to find our way and we're stumbling without the tools yet. Yeah, I mean, this is such a huge impact on us. I don't think we even realize how big this is. In fact, I'd go as far as saying that this arguably our stress component in our lives and the way we use

our technology for many of my patients is arguably more important than the food that they're putting in their mouth, right? It is to be on the entire time, to wake up and go first thing on that phone and the noise that comes in from that constantly throughout the day, and often it's still going on when we're in bed at night, lying there, still checking everything, no downtime, that is having a huge consequence on the way many of us feel. And, you know, I actually, I think I start the book with this story about this 16-year-old boy who I saw maybe six years ago, this chap called Devin. This was in a typical conventional medical practice, you know, in our national health service. I have 10 minute appointments and it was a Monday

afternoon surgery. Okay. We call them surgeries. They're just clinics basically. Okay. A Monday afternoon clinic. I had about three or four people in the waiting room. I was already running a little bit late and this 16 year old boy walks in with his mother. I was already running a little bit late. And this 16-year-old boy walks in with his mother. I open up the file and I see there's a letter. And basically on the Saturday, this guy ended up in the ER because he tried to harm himself. And there was a letter there from the ER doctor saying, hey, Dr. Chachi, look, this is what's happened. We assessed him. He was safe to discharge, but could you please start one antidepressants? So he's there, he's with his mom. I sort of know the family anyway, because I've been looking after them for a period of time. And I thought, okay, what's going on here? Why is this 16 year old boy

from a seemingly well-balanced family that I've never really detected any issues with before, why has he ended up harming himself in the ER department on the Saturday? I thought, I just can't start one on antidepressant. I need to figure out what's going on here. I just couldn't do it. So I spent maybe 10, 20 minutes with them. And I thought, I need a bit more time. I said, guys, look, are you able to come in tomorrow morning at the end of my morning clinic? And I'll spend a bit longer with you. And I said, yeah, sure. So they came in the following day. At the end of that, I thought, okay, there's many factors at play here. But one thing really worries me, which is his use of social media and his smartphone. And I said to him, I said,

look, Devin, would you be interested in me helping you reduce your usage? And he said, well, is that going to help? I said, well, look, I don't know, but I don't think it's helping your current mental state. Would you be willing to give it a go? And he was at, you know, that low ebb. And he said, yeah, sure. If you think it's going to help. So we agreed for the first week that just for one hour before bed, he'd switch off his phone and he wouldn't go on the internet. He comes about seven days later. And I said to him, you know, how are you doing? And he said, well, you know, Dr. Chachi, I'm still not great, but I feel less up and down in the day. I'm sleeping better. I

just, you know, I've got a bit more energy. Things aren't quite as bad as they were. I said, okay, so you've already seen that that's having a little bit of an impact. What if we increase that a little bit more? And over the next few weeks, we increased that to two hours in the evening before bed and two hours in the morning where he doesn't go on his phone. Okay. He's starting to feel better. Not cured or anything, but significantly better. Then I thought, okay, we tackled that. He's getting that bedded in. I also then went into his diet. I said, hey, what are you eating? It was a typical teenage diet, lots of highly processed sugary junk food, snacking all throughout the day. And I said, hey, Devin, did you realize that actually the food that you eat can have an

impact on your mood? He's like, really? I said, look, what happens when you have this food? Deadly serious. I'm like, you know, when you're eating this food, you're this high sugar foods, you're going on a blood sugar rollercoaster. So what happens? You're having that in the morning before school, mid-morning, your sugar's crashing fast. That's not just an energy problem. That's not just a sugar problem. That is also a mood problem because when it crashes, that your stress response goes up in your body, adrenaline, cortisol go up, right? This will have an impact on your mood hormones. He's like, are you kidding me? I'm like, no, this will be playing a role here. So because he understood why I was asking to make the changes, it wasn't just me saying, you've got to change your diet. I drew out a

little graph for him. I explained to him, he goes, okay, that makes sense. Show me, right? So I explained what he might be able to do. You know, take some nuts with him for those snacks to keep his blood sugar stable throughout the day, those kinds of things. It wasn't a perfect diet. He didn't go full on Mediterranean, right? He just made enough changes. And then he started to improve again, bit by bit, he's getting better. And then I stopped seeing him. Suddenly he doesn't come in as much. I'm getting on with my busy practice. And then I come in about six months later and there's a letter on, you know, as part of my mail, I'm going through, I open this letter and it's from Devin's mum. And he says, dear Dr. Chattier, I just want to thank you. You've completely changed Devin's life. He's happy at

school. He's interacting with his friends. He's joining local clubs at the weekends. He's just, you know, he's just a joy to be around. I just want to say thank you. And I've learned so much from that case, Rich, because I thought, wow, yes, I think there are emotional issues as well, but simply by tackling two of those four pillars, right? The relax pillar, where I helped him reduce his social media use by helping him understand what was going on. I helped him improve his diet by maybe 20, 30%. It's not full on, right? He started to be empowered enough to see how that impacted his lifestyle. So this is a 16 year old boy. He was at a fork in the road, right? He could go down one path. I'm on my antidepressants. I've got depression, right? That's the label I've got. No doubt he would have been

put on a repeat prescription. He could still have been on that five years later. But at that moment, he took another path. He now has empowered himself, you know, really helped him to understand how the environmental choices he makes impacts his mental health. And I very much hope that that's going to keep him in good stead going forward, because if things get tough in the future, he will know, actually, there are some things I might be able to do which are going to help me. And really, this is what I'm saying, this four-part approach is deceptively simple, right? You know, where's the real medicine? Where's the cool stuff? This is the cool stuff. If you get this stuff right, everything gets better. Yeah, if you're lucky, you can reverse

your disease, but you can certainly improve the way you feel. Pretty much everybody can improve the way they feel. You know, whether you've got a disease or not, if you're just someone who's, who wakes up tired every day and needs sugar and coffee to get you through each day, these principles are going to help you. If you've got type two diabetes, it's going to help you. It doesn't matter because these are universal. I can't invent the principles of good health. They're the same principles that existed 100 years ago. I can't come up with a new concept for a book and say, hey guys, I've got the secret, right?

I don't. It's the secret no one wants to tell you that you've never heard before. Yeah, I mean, I think the most powerful thing in all of it is getting the lights to go on in the patient. Like by making, you know, like a lot of the book is about like, look, let's just these baby steps, right? And if you can just get a patient to implement one or two of those, the lights go on, they start to make that connection

between how they're living and how they're feeling, and then they're invested. And then you're basically catalyzing that person's journey for the rest of their life. They're going to go off and, you know, continue to grow and explore and refine and change and do all of that, you know, on their own with guidance, of course, from people like yourself. But it's that empowerment piece that I think is so important. And I think it's a fundamental paradigm shift in the doctor patient relationship from one of you know the traditional paradigm of like i'm the expert you're going to do what i tell you and there's no we're not we're not in a partnership here like you know i'm the authority

to okay let's sit down and have a chat and like we're we we're a team here and what can we do together? Where it just, it fosters that sense of self-determinantism. Yeah, it's a partnership. It's gotta be a partnership between doctor and patient because those days of that paternalistic relationship, they're over, they're gone. I mean, there's still a certain generation who expects that. They're still, I mean, yeah, most of it is that way still.

Most of it is that way. You're the rarity still. I think I've always been slightly odd in the head because I've never seen it like that. I've always kind of wanted to have that partnership, that conversation. I've always... But it didn't start that way for you. Like, we didn't even tell the story about how you got into all this. Yeah, it didn't. Well, you know, it's interesting that because I reflect back now on my career and you're right, it didn't start that way, but on some level it did. So, you know, to put it in perspective is I qualified for medical school and I thought I've got all the skills now I need to get out there and make people better. Great. So I for let's go and make dad proud yeah exactly you know and family proud and

all this kind of stuff that you know I grew up with and I I woke up and I'm you know doing acute medicine and then within a couple years I'm you know leading the cardiac arrest team in the hospital and doing all this all the kind of cool acute stuff that you think being a doctor is all about. But actually I reflect back and I think even then, I don't think I was deeply satisfied. I, you know, I saw how powerful modern medicine can be for acute problems. People walking in through the door sick and you give them whatever you need to give them and suddenly they're transformed. Just incredible. So you don't really question at the time. You don't even know yourself. Hey, we go to med school really early in the UK. We don't do a degree first. So, you know, when I qualified as a doctor, I must've been 21, 22. Oh, really? Wow. That's way earlier than in the States.

So early, something like that, maybe 22, you know, and I think now I think I didn't even have the life experience to be able to understand what people were going through. But the point is I, something like that, maybe 22, you know, and I think now I think I didn't even have the life experience to be able to understand what people were going through. But the point is I, I was, you know, I was okay. My career was going fine and I was doing my specialist exams and I thought, yeah, okay, fine. I'm going to figure this out. Um, you know, and, and you've alluded to, you know, my, my, my personal story, which is that, you know, I had already made the move to general practice because I was, I really felt that we were just missing the big picture. We were just getting so down rabbit holes in one area without seeing how everything is connected.

And I was working in general practice and, you know, we just had our first child, you know, my wife had breastfed him for the first six months as per the guidelines. And as you know, we just had our first child. You know, my wife had breastfed him for the first six months as per the guidelines. And as you know, we thought we were doing the best thing. And I'm not saying we weren't doing the best thing, but we were, you know, we were a pretty health conscious family. And we went on holiday to France and the Christmas holidays.

And man, I can still remember it so vividly that we were staying in my friend's chalet in a place called Chamonix in France. And, um, they weren't there yet. We were just there. And my son hadn't been well throughout the day. He'd had a bit of a cold. And for some reason, my wife didn't put him down in his, in his cot, which is in the basement. It didn't feel right. So, you know, maternal intuition, whatever you want to call it, she't do that and um i remember that she was sitting it was a big open plans you know living room and kitchen and she was sitting there and i think i had the kettle on and she just called out to me and said you know wrong and he stopped moving come you know he just shouted out i just came over. He put my son at his arms had gone back. He was rigid and he just stopped.

And, you know, I thought he was choking. I thought maybe he was choking on his mucus and his phlegm. And, you know, my sort of, my medical training was sort of like, okay, so I turned him over. I tried to clear his airway. He's not breathing. He's not breathing. It's just, you know, I, frankly, I tried to clear his airway. He's not breathing. He's not breathing. It's just, you know, frankly, I tried to clear his airway. Nothing was happening. And in that moment, I wasn't a highly qualified doctor. I was a scared dad. And I froze, right?

I was just standing there. What's going on? I've got to figure this out. And my wife had said, look, we just got to get to the hospital. So we rushed into the car. You know, I almost kill us all because we are on this little slope and the car skids because I'm just so panicked. We end up in the hospital, which isn't very far. And you could see when we got there that the doctors were worried because for people who don't know, a six-month-old child can have a convulsion. It's called a febrile convulsion if they've got a fever

with it. That is not actually that worrying. That can happen in that age. He had no fever. So you could see the doctors were really panicked. Okay, what's going on here? Why has he got no fever? Because that's the common cause. You know, they were sticking a line in his neck, you know, all kinds of stuff. Then he had to be blue lighted down the mountain to the big mountain hospital because we were in a little resort. But did they get him breathing? They got him breathing. They gave him a diazepam to get him going, you know, and stop all that. And I wasn't allowed in the ambulance. I had to follow it in a car and I was just panicked what the hell was going on. No one knew. They took blood from him. He had two lumbar punctures.

You know, we thought we were going to lose him that night. We were absolutely so scared. A few hours later, the doctor comes into the room and he says um you know we know you know he's you know we know what's happened is that what's happened he said he's got a very low level of calcium and because of that low level of calcium he's had a convulsion so what we call a hypocalcemic convulsion i, fine. They didn't know why at that point. They just said, okay, this is the cause. So to put it in perspective, the normal calcium level on that particular test is 2.2 to 2.6. Even if we see it at 1.9, we consider that very low. His was 0.97. So his was tanked, barely compatible with functioning. That's why he had his convulsion.

So they gave him an intravenous calcium infusion. This is what modern medicine does best, right? Fix that acute problem. But then what happens, I think about an hour or two later, I can't even remember the time, it's all a bit of a blur, but he said, we now know why. He has no vitamin D in his body. He's very, very low. So because he has no vitamin D, his calcium has dropped low. So to cut a long story short, and I'm sorry to have labored the point, it's just, it gets quite emotional when I think back and I'm, you know, I still can't clear that out of my head. It's terrifying. And in a nutshell, this is a fully preventable problem, right? My son nearly died from a preventable vitamin deficiency and his dad as a highly qualified specialist, general practitioner, immunology, honors degree, you know, all this kind of stuff, all these labels, right, which I had,

biology honors degree you know all this kind of stuff all these labels right which i had i wasn't able to prevent that happening in my son but how would you even know i mean if he's breastfeeding you would be you would presume that he's getting all the nutrients ultimately you know i now know that and again people are going to listen and go well why weren't you putting him on vitamin d maybe and the reality is is, is that, you know, that is just not at that time. And even now it wasn't that common knowledge that a lot of kids need vitamin D, you know, particularly in the modern world, you know, there are regular, there are guidelines that all children need vitamin D drops, you know, and he wasn't getting them. But I've got to say about four or five weeks before this happened, I was doing some reading. I was coming across this

in my own practice. And I, you know, I thought, I wonder if my son should be on vitamin D. So what I did is I phoned my wife from work and I emailed her a protocol. I said, hey, babe, can you just make an appointment? Can you just go and see the doctor and just ask? Because we get told, it's drilled into us as medical doctors in the UK, we're not to make decisions on our own family. It's considered bad practice. You're consider too close. And so I thought, okay, I'm going to do the right thing. So she printed it off. She went to see our GP and the GP said, you know, and she knew, he knew that I was a doctor. And he said to my wife, you could have just printed, made this up on word. This is not, this is rubbish. You don't need to do anything. You know, you're doing the best.

And so she phoned me and said, this is what's going on. I said, okay, let me do a bit more research. And so I said, let me, you know, cause I, I, I wasn't confident enough to make that call myself. Right. Whereas now with hindsight, I should have just done it myself, bought the drops over the counter and given them to him. But I didn't. And I've gone through years of trying to figure out why I didn't do that and having a lot of guilt attached to that, which is a separate issue, but I think quite an important one because that guilt, see what happens, he's in hospital, he nearly dies, modern medicine saves him. But then I'm reading about vitamin D and I think, well, this is a critical vitamin for your immune system to develop.

This is a critical vitamin for his bones to develop. So he was diagnosed with rickets as well, right? A Victorian illness that he's now got in the 21st century. And actually, on a side note, in the UK, rickets is on the rise, which is just incredible. Oh, wow. I would not have thought that. I didn't think anybody got rickets anymore. We're going up in the UK, Ricketts is on the rise, which is just incredible. Oh, wow. I would not have thought that. I didn't think anybody got Ricketts anymore. We're going up in the UK every year. I don't know the US stats, but it's going up. And, you know, what happened in that moment was that I thought, well, maybe this is the reason he's

got eczema. Maybe because, you know, because eczema in some ways related to your immune system, having an element of dysfunction in it. And instead of just putting creams on to suppress the symptoms, it's like, well, maybe this is why he's got it. I felt so guilty about this that I said, right, I'm going to figure out how to get my son back to optimal health as if this has never happened. And that was my drive, right? I became obsessed. I'd be reading, i'd be going on the internet be reading about vitamin d and nutrition and as you start reading you start to come across i start to come across a whole ton of science that frankly i had never seen before that i thought

why do i not know about this right that's the shocking thing why do i not know about this i learned more i thought right i'm going to figure this out. I spent a ton of money, of my own money. I started going out to America. I started coming on conferences, on courses, with the goal to get him better, right? And I've got to say, I'm very, very thankful that my son is thriving. He's eight now.

He's happy. He has no skin problems. He's doing well. He's sporty. You know, I really feel that everything I've learned has helped me get him back to full health. Okay. So that was a, it wasn't just the instance of going to the emergency room and treating it. This was something that, that required treatment over a prolonged period of time to get him well.

But it was how you look at it. Modern medicine would say, well, he had a problem. He had a convulsion. Okay. We've identified that and fixed it you're discharged now good to go okay but we but we're not looking at what are the implications how long was he low in that vitamin for how much of an impact has that held on the developments of his immune system right and which that kills me to even think about that, you know, what that might have potentially done already. What I know is that if you think about that threshold concept, even if there has been, you know, an impact from that, which no doubt there has, I feel that I'm helping him optimize everything else that is possible to kind of mean that that is going to have less of an impact. But here's the key. The science I learned from trying to get him better,

yes, I helped him. Then as a family, we started applying it in our lives, right? Then I started applying it with my patients. And for the first time in my career, I felt I was excited. I thought I'm getting people better. I'm getting them off their medication. I'm actually understanding what the root cause of that problem is and how to get to it. And it changed my career. And I, you know, it's, you know, in some ways, Richard, this had never happened to my son. Would I be doing what I'm doing? Yeah. It's that classic thing of, you know, in some ways, Rich, if this had never happened to my son, would I be doing what I'm doing? Yeah, it's that classic thing of, you know, the worst thing that happens to you is the silver lining that, you know, creates something beautiful out of it. I mean, silver lining for me.

Was it a silver lining for him? You know, I don't know, but I can tell you, I can, I think so. And I can tell you one thing I've started to do now is I'm, I'm really working hard on myself to let go of that guilt because actually that guilt, I think it served its purpose. And I think now that that guilt is hindering my ability to be as good a, good a father as I could be. Yeah. You can't keep punishing yourself and wear the hair shirt. Yeah. And he doesn't want that either. He doesn't want his dad to be guilty, you know, and it's, for me, it was that transformative experience, you know, and I kind of, I used to justify it to myself. I thought, okay, because of that, I've learned this. I'm helping my patients now. Then I get this BBC One show, this primetime show, which goes out to 5 million people a week in the UK. And then, you know, 70 countries around the world where I can showcase this.

So to millions of people around the globe, how no matter what your condition is, we can improve it with these lifestyle recommendations. And I thought, you know, maybe that's his gift to the world. Maybe in some ways that's what was required to give me this drive to do what I do. Yeah, that's cool. Yeah. So, wow, my head's gone.

But no, no, it's, it's, it's, it's an amazing story and I'm sure he's going to be fine. Hey, he is going to be fine. He's, he's incredible. In the context of your practice and all these people that you treat and see, like, what is the, well, two questions really, but the first being like what is the the number one thing that people struggle with the most and i know you don't want to like sort of parse the differences between these four pillars because of this you know delicate interplay between all of them but you know where where are people going wrong the most what's the most chronic persistent condition or stumbling block that people face in your experience yeah what is the most

well i think the most common stumbling block you're right i mean i i think you you got to take those four pillars individually because in different people it's going to be a different one but if i had to really pick one, and this is different from if I had come on the show five years ago, I didn't know if you were doing the podcast five years ago. Yeah. So if I was here five years ago, I would have given you a different answer. Back then I would have told you it was food, but now I'd say it's stress. You know, I think the majority of people I see are just stressed out, they're busy, they just got their brains full of stuff. There's no quiet, there's no stillness, there's no respite from the noise.

And I'm finding more and more, I'm going there a lot earlier than I used to. So I'd say that's probably the big one for me. That's the one that I struggle with the most. Hey, me too. You know, and yeah, as somebody who's driven and as an athlete, like I just, you know, my whole frame of mind is push, push, push. I can do more. I can make it better. And I just dig myself into a hole, which is why I wake up, woke up this morning, not feeling so great, you know? But it's about saying you can do more.

You can do it all, right? But you just gotta, you gotta have a stop point. You gotta just, you gotta schedule in these stop points where, because these days, it doesn't matter what you do, your work is never done. There is always something else you can be doing. So I, like, I rather romantically look back to time 15, 20 years ago. And I imagine that people would, and I'm sure I'm overly, you know, I'm sure it wasn't quite like this,

but I kind of imagine that, you know, let's say a working couple would come back and they might sort of have dinner with their children, let's say, for argument's sake. And at some point the children would go off to bed and then it would be like, okay, let's chill out together. Let's maybe put the television on. Let's watch something together. You know, there wasn't the ability to go, right, that's done. Now I can get on with more work. Now I can actually open up my work emails. Now I can catch up with what I've not done yet. Now I can get ahead for tomorrow. I don't think, certainly for the largest part of our evolution, we didn't have that possibility. No, when you went home, you were home. You were home. Work was at work. You're home now. You chill. And nobody could reach you and nobody would unless there was some crazy

emergency. Yeah, exactly. So because we've got the ability to do these things, we always feel we can do more. So that's never going to go. Your to-do list is never going to be done. If you think you're ever going to tick it all off and you're done now, that ain't happening. There's always something else. There's always an email to get back to. There's always your Facebook to check. There's always a DM you just got on Instagram that you could get back to. You know, it's endless now. Or that WhatsApp group you've been added to that you've got to respond to, right? Well, we all have like 20 inboxes now. You know, and people can't get you on one, they get you on another one. So you've just got this constant bombardment. So I think that stress piece, and a lot of people don't realize that that is a big risk factor for disease, but that will even negate you. That will even stop you

from losing weight. People can't get their heads around that. But so many, particularly I've got to say women, okay? And that's because I'm going from my experience. I'm not saying this affects women more than men. What I am saying is in my clinical experience, I've seen a lot of women suffer hugely with stress. And a lot of them are really caring. They don't put themselves first. They put their children first. They put their partner first. They put their parents first. They, they do everything for other people and they've got no time for themselves. And what happens is because they're wired the whole time, their cortisol levels, which are our primary stress response hormone, those levels are high.

They're persistently raised. But if they are persistently raised, it means your body thinks it's under attack. So it holds on to weight. And I've helped women get rid of menopausal symptoms. I've helped them get rid of their weight problems. When they've jumped from diet to diet for years and they keep hitting a plateau and they think, what's the right diet? You know, this is the wrong diet for me. What's the next book I can write? What's the perfect diet? And I say, hey, this ain't a dietary problem. All of these are pretty good diets. Your mind never switches off. And just by some simple stress management techniques, the weight starts coming off or the menopausal symptoms start getting better. So stress impacts everything. And, you know, I see it in my practice. I saw it when I did doctor in

the house. I saw it in people's lives. And, you know, I see it in my practice. I saw it when I did Doctor in the House. I saw it in people's lives. And, you know, when I mentioned people sit back and let's say a couple are sitting watching television in the evening, there's another issue there, which is now, let's, if we play that scenario out, let's say the couple do want to watch something together, right? Actually, it's very common now for people to be on their own devices because we can personalize everything so i don't need to watch my wife's watching i can watch my favorite show she can watch hers yeah so the whole we're all having our own personal experiences on our on our own yeah so we're together in the same room but we're not together together right we're not having a shared experience and that actually that plays out in in other areas so you know many people come and see their doctor about you know their sex life or lack of intimacy and these kind of things and the classic cliche now is as a

husband and wife or whoever you know partner two partners are in bed together right but they're both on their own devices so that they're occupying the same physical space, yet actually they're in their own world, their own emails, their own Facebook messages, their own Netflix shows. And that opportunity for intimacy, that is going as well. And, you know, as a doctor, these things come up into my practice every day. People are complaining about this. And again, this technology is so great on so many levels, but if we don't, we don't rein it in, it's affecting all aspects of our life. Yeah. Yeah. It's crazy to think that, but it's so true. I mean, you know, sort of what you're saying on some level is like your device

is making you fat. That's the way to get people to pay attention. That is the way. And then, so you could talk about all the other things, but it really is amazing, these crazy times that we're living in right now. They're crazy times. We're having to deal with all this kind of stuff that even 10 years ago was non-existent. Yeah, I know.

I really want to make clear, Rich, if people listen to this and go, yeah, look, I get all that, but it's just too hard. I would say, look, maybe something they've heard that we've already spoken about or something they might read about, right? Just pick something small. Just pick something small and start there. Maybe it's simply that you are one of these people who go on your phone and in your bed at night, right? What if you didn't bring it into your bedroom? What if 20 minutes before bedtime,

you thought, okay, I'm just going to put this off now. Okay. Start there. Keep, you know, I live in a house and we keep our phone charges downstairs, right? And the rule is, but we don't always stick to it, right? But the rule is, is that we leave our phones downstairs, we don't bring them upstairs into the bedroom, right? Now I'm human, right? We don't always stick to it. Are you on call though at times where you have to have the phone nearby? No, the way I do practice now, no, I'm not. So I don't need that. But look, I've worked with people who do, right? So I'm like, okay, fine. On those nights you do it. I get it. But what about the other six nights in the week when you're not, right? Because we can all make those justifications that you can make the justification that I run an online business.

I've got to be connected at all times. Well, you can always make excuses for whatever it is that you're trying to wiggle out of. Yeah. And the thing is, when we say we're trying to wiggle out of it, I think this is where the empowerment comes in. Because the first thing we've got to do is people have got to want to change. They might be listening and going, yeah, but I don't want to do is people have got to want to change, right? They might be listening and going, yeah, you know, but I don't want to do that. You know, if people aren't ready for that, they may buy my book, right? And they may read it and do something for a week,

but then they're just going to put it on the shelf and they'll go back to their old habits. Or more commonly, they'll buy the book and give it to somebody who they want. They want to help without appreciating the fact that if that person they're trying to help, doesn't want to change, it doesn't matter. It doesn't matter. Because people think that they can will people into that wanting to change mindset.

And that is, that's a recipe for disaster. Since I got into this world and since I've suddenly seen the light, you know, and trying to sing it from the rooftops at first i've learned that you know what you cannot make anybody make these changes you know particularly not your family no and i'm sure you get like as i do tons of emails hey you know so my mom my brother my my husband my what whatever i they they need to understand this how can i make

them understand it you can't't. You can't. You just got to, I say to people, you know, and this is what I try to do. I try and lead by example, you know, not because I'm trying to be an example. I just, I'm just going to concentrate. I've realized it's enough work to do it myself, right? In this crazy modern world we live in, I'm going to focus on that. And bit by bit, hopefully people around you will, you know, if they're interested, you might just, you know, spark that little bit of that. And bit by bit, hopefully people around you will, you know, if they're interested, you might just, you know, spark that little bit of interest. And I'll tell you, I'll tell you one, one place this has, this has played out recently, which is probably not what people would expect me

to say, but I, you know, because I've got two young children, you know, now that they're at school, it's always tricky for me to sort of, knowing what I know, I, you know, I can't control everything about them anymore. And that's just part of growing up, right? But, you know, often there's a culture at schools of like sugary junk food and all this kind of stuff, which, you know, really on one level I find very frustrating. And initially when they, when my son started at school, it would stress me out. Like, ah, this is, this is crazy. What am I going to do? And then my wife and I decided, you know what, we're just going to focus on doing what we do.

And at the end of that first year, they went on a school trip and people could bring their treats in for their school trip. So what we did is that, again, we're not trying to make any judgment on anybody else. We're literally always cautious when we're talking about children. I genuinely believe that every parent is trying to do the best that they can for their child's within the context of their life and within their health belief system. But we felt that we want to keep feeding him healthy, nourishing foods, you know, and we made these, well, I say we, my wife, let's be really honest about this. My wife made these beautiful fruit kebabs. I think there was mangoes, strawberry, it was just these colourful kebabs. And he took them in. And then at their lunch break on their school trip, you know, everyone's having their stuff and he's

having his fruit kebabs, which he loves because he thinks that's a treat. You know, I'm allowed all this super sweet fruit today. And we went to pick him up and his teacher said to us, I was just incredible. You know, I think we're going to institute this now as a practice for school trips. We're going to now do these fruit kebabs for everyone. We thought that was fantastic. And I really learned a lesson that day. I, again, I thought this is incredible. You know, we're not telling other people what to do. I don't feel it's my place or our place to tell other people what to do. I don't feel it's my place or our place to tell other people what to do. We're just focusing on what we do. And that has been observed. And other parents had asked us as well, said that's incredible. And now other people are

starting to adopt that with their children because of what they saw us do. And again, it's that same principle that applies, which is you can't make someone else change. You just got to focus on doing what you're doing. And it is hard because if you're, let's say, if you have had a health revelation by changing your lifestyle, yet your partner is not, all you want to do is tell them, say, no, no, no, no, it's, you know, you do this, you do this. But I found it doesn't work. No, it doesn't work. And it's tough. I'm sympathetic to people that are in that situation. Like I was lucky enough to have, you know, a wife who was super supportive. I don't know that I would have made the changes that I would have been able to make them or make them stick without that kind of support. So it's very

difficult. And on the, you know, the thing about kids, I mean, we're very similar with our kids. My wife is an insane cook. She makes amazing food. It's the food that our kids prefer, but we don't make rules with them about what they can and can't do when they leave the house. Like I'm not that concerned about whether my daughter is going to have a piece of cake at a birthday party. What I am concerned about is her habits 10 years from now and what her default settings are going to be exactly and that comes through setting the example and through constant education and using food the kitchen the farmer's market the grocery store all of that the cooking teaching them how to make certain things

it's all like a homeschool recipe to instill you know those those ideals around food that I think are so important. And it's about serving the long-term. Yeah. And you've got much more experience than me as a parent, so I'm always happy to hear. And each kid's different. Each kid's different. And I'm realizing more and more I need to let go. And at some point they're going to push back and experiment. And you cannot, it's very hard to fight societal norms. But if you don't give them going to push back and experiments and you know, you cannot, it's very hard to fight societal norms. But if you don't give them anything to push back against the impulse to rebel is, is diffused, right? So if you're not saying like, Oh, you know, this is, if you're, if you're making all these rules,

then when they get to a certain age, they're like, Oh, I'm out of the house. I can break the rule. Yeah, exactly. And I'm, you know, we become acutely aware of that recently and really trying to modify our behavior around the kids because of that. And, you know, I mentioned before that I met Michelle Poulin. I don't know if you've... I don't know. I don't know her. It's a he. He's a Belgian researcher who I think went out with Dan initially to sort of help do all the research on the blue zones with Dan. And I was lecturing with him in Guernsey. In Guernsey, they were looking at Guernsey to see, could this qualify potentially as a Blue Zone?

I don't know where they've got up to with that. But very kindly, the people who organized this arranged for me and Dan, not me and Dan, me and Michelle, to go and visit some of Guernsey's centenarians. I remember we went in a taxi and we went to this chap's house. He was 102 years old. I remember we got out of the taxi and I knocked on the door and he comes up and he answers the door, which in itself was amazing to me because as a doctor, I do home visits, right? That's something we still do in the UK. I, you know, if someone

phones in and they can't get in, we go. And obviously it's a self-selecting population. People are sick and ill, generally frail. That's why they're calling the doctor. But I've never had one of those patients. Well, very rarely open the door for me. And normally there's a key lock or a carer lets me in. This guy rocks up and he lets me in. And we go and we sit down and there's a cup of tea made for us. And we sit there and we talk. It was really interesting to talk to him about his life. And he said until he was 95 and started seeing doctors, he was great. And once he started seeing doctors, his health went down, which I found super interesting on one level. But he'd spoke to me, I can't remember the name of this thing, but he

said, you know, one of his favorite treats was this Guernsey loaf. It's like a mixture between an English cake and a French croissant. I can't remember the name of it. I was really interested. I thought, okay, you know, because I'm trying to work out what's the secret here, you know? And I say, you know, that's great. How often would you have that? Would you, what, sort of most days or the weekends? It's like, oh no, Dr. Chastity, Easter and Christmas. We just have it at special times. Yeah, I can't have that every day. And I thought that's the key. It's not about, and I think this is consistent in all these blue zones. It's not about deprivation. These guys have sweet treats. They don't have it every day after school or every mid-morning coffee break at work, right? They have it now and again. It's a

celebration time as a treat. And, you know, that's why the recommendation I make in the book is to denormalize sugar, right? I'm not saying, look, we crave sugar. If you were trying to avoid sugar in this modern food environment, I think you're setting yourself up for failure, really, because it's going to be incredibly challenging, I feel, to long-term completely avoid sugar. I think we need to denormalize sugar. You know, it just, it can't be the everyday norm. It's got to be the occasional treats. That's the key with sugar. But I think you have to be specific about what you mean by occasional,

because I think people have different definitions of that. And I do think, and I think you'll agree with me on this, that there's something to be said for completely cutting something out like sugar to allow your microbiome to adjust and your physiology to adjust and there very well may be some discomfort because we are addicted to these kinds of foods and when we remove them there's a craving that ensues. But if you can kind of weigh, you know, sort of weather that, you can get to the other side and those cravings dissipate and your relationship

to those foods that once triggered you and held so much power over you, no longer do. Rich, I absolutely agree. Look, you know, I go through this process. If you wanna go cold turkey on it,, I talk people through how to do that because for me, that's the approach I would take because within four or five days, you start to learn how good you can feel and how, frankly, hooked you are on this stuff. But some people, that's too much for them. So I also take them through a step-by-step process that they can take if they want to go more gradually. But I agree. Often people will say,

you know, I'm addicted to sugar or yeah, but I've got a sweet tooth. You know what? We've all got a sweet tooth. We crave sugar. But if your norm is to have sugar in your cereal, even if you're not adding sugar, the inbuilt sugar in your cereal and your bread that you have in your sandwich at lunchtime, potentially in some of those breads and your bread that you have in your sandwich at lunchtime, potentially in some of those breads, and your ready-made pasta sauce in the evening, right? Your body gets used to sugar. Your taste buds adapt to what you're giving it. I remember a few years ago when I used to drink tea, when I first started drinking tea, I had sugar in it. And I remember giving it up. The first few days, I couldn't stand the tea. This is awful. And then I got used to it.

Three weeks later, I was at work and I'd picked up the wrong cup of tea and it had sugar in it. And I had to spit it out because something that I could have drunk three weeks previously now felt horrendously sweet to me because our taste buds adapt. Yeah, I've had the same experience. So I do feel that it's much better to have a period of, let's say two weeks where you go cold turkey. Yes, you will may well go through some withdrawal symptoms. Okay. People don't like to hear that. People don't like to hear that, but you know, we can willpower things for a week or two, right? You know, maybe for four to six weeks, that's harder, but we can willpower for a week or two. Most people can. My big tip for that, not only for that, my big tip in general

for making lifestyle change, if people are serious about lifestyle change, no matter what that is, I would say, make your home a safe zone, right? If you're trying to avoid certain foods, do not bring them into the house. And the reason is, is because in the 21st century, in most places now, if you step outside your front door, you're having to exercise willpower everywhere you go, right? You want to fill up petrol or gas in your car, right? You've got to walk past all the junk in the petrol station. You want to go to coffee, right? You know, in the UK, it's like this. You want to buy coffee. You stand in line, right? You walk past all the pan of chocolates, all the pastries, all the muffins. You may well have mentally thought, right, I'm going to say no.

You go to pay. The barista will then say to you, hey, sir, would you like a pan of chocolate with that? You know, you're constantly being questioned and pushed. So I'm saying that's going to be hard. No, and yeah, ultimately willpower is going to fail you over time. Yeah, so don't use your willpower in the house, right? I know you will come back one day tired, stressed out, underslept, right? And you will crave something sweet. And this happened to me a few weeks ago. I was, you know, going around the country, talking about the book,

talking to people, trying to promote health. I was exhausted, right? Sitting there at home, I thought, I really feel like something sweet. I opened the cupboards. There's nothing. There's olives. There's nuts.

I don't feel like olives and nuts at the moment. And you know what? After a little while, that craving goes. You're pissed for a minute. And then you're like. Exactly. But that's it. But if I had that bag of potato chips then, I would have smashed through it because that's how I felt. And I really feel that it's such a

key point, control the environment that you can control. You're setting yourself up for winning. I talk about these little glutes exercises that I do with a lot of my patients that really help me get rid of 10-year history of backache. I do three to four minutes of them a day. But do you know why I do that? I wake up, have a bit of downtime in the morning. I very mindfully and particularly weigh out my coffee beans. I sort of, I weigh it all out, a little bit obsessed with it. I pour the water in and then my timer goes on for four minutes. And as the coffee's brewing, my step is there in the kitchen

and I do three minutes of glute exercises. So it's inbuilt into my, you know, I keep the stepper in the kitchen, right? I'm sure my wife's not a huge fan that it lives in the kitchen, but the point is you've got to set these things up so that you can make the lifestyle change easy. It ain't that hard, man.

Honestly, it's not that hard. Right. The teachable kind of takeaway is construct your environment to be conducive to making the healthy choice. And that's, you know, what you do in your home is kind of a microcosm version of what Dan Buettner talks about in the macrocosm. Like he always is saying, look, you know, we can browbeat people into trying to exercise and eat well, but ultimately you're not going to really solve the problem on like a civic level, on a social level, until you create infrastructures that are conducive to that. You have bike paths and you make sure that there are no, you know, terrible foods in

the schools, like all this stuff so that everything is sort of out of reach. It's inconvenient to make the unhealthy choice, and everything is set up to be conducive to driving you towards making that healthy choice. And you can do that in your home, and to the extent that you can control your environment at work or at play, whatever, you have the ability to control, that's going to ultimately pay big dividends long-term. Yeah. That's the key, right? But we look at these blue zones and I don't feel, Dan would clearly know better. He spent a lot of time out there, but I don't feel that these guys are necessarily trying to be healthy. No, they're not trying to do anything. They're trying to get on with life. Yeah, their environment is just conducive to them living long because they have to be moving and they're just living proximate to their family members and

they're a part of a faith community. It's all just set up to promote that without them having to give it a second thought. They don't need to go to the gym. They're not going to the gym. Exactly. They're just to get around, to get their food, to go and to do whatever they need to do. They need to walk. They're just to get around, to get their food, to go and to do whatever they need to do. They need to walk. They're doing this stuff. And that's why I think overall, there are two pieces here. One is the education piece, right? Okay. The education piece is, you know, books like yours, books like mine, so many great books out there to try and help people understand what they might be able to do. But that's only one part of the piece, right? One

part of the puzzle. The other part is the environment, right? Ultimately, the only time we're going to get the real public health gains that are going to transform your country, going to transform my country, are when there is infrastructure set up so that people find it easy to make those choices. That, you know, I posted a photo of this recently on my Instagram, you know, I was in London on the underground and I was in a station and it was, I think, two sets of escalators. And then in the middle, there was a set of stairs, nobody on the stairs, everyone on the escalators. And again, I try and always take the stairs where I can. Always take the stairs. Yeah. And again, I'm not, again, I'm and always take the stairs where I can. Always take the stairs. Yeah.

And again, I'm not trying to sort of settle my high horse. I know. How dare you? You know, I really not. I get it, right? You think you're so much better. Yeah, I really don't. I genuinely don't, man.

Honestly, it's not my thing. But you see it when people come off. You know, I flew in to LA a couple of days ago. And you get off, you go through customs and everything, and then there's those stairs to the luggage claim hall. And there's an escalator. Nobody's on the stairs. We've just been sat on-

I just did that last week. I know exactly what you're talking about. Yeah, we've been sat on our butts. I was the only one on the stairs. Yeah, we've sat on our butts for 12 hours. And it's easy, because we're tired from the flight, it's easy to stand on the escalator, right? And I get it.

And again, I'm not criticising people for doing that, but this is the point about the environment. Even if there was a sign at LAX, right? And we know there's good studies that show in workplaces, if you put a sign on the lift, if you put a sign there that, have you thought about taking the stairs? Yeah, there's a UK paper.

I'll send you the link. It's incredible. It makes a difference. You just get people thinking. It makes a difference. You just get people thinking. It makes a difference, right? I gave- That's wild. I gave, so my UK publisher of Penguin, right?

So a few months ago, I gave them a wellbeing talk. The whole of Penguin in London, I went to talk to them about the four pillars, basically. And their offices are on the eighth floor of the building. So every time I've gone there, I get escorted up there. Everyone takes you to the lift. And at the end, I made them a challenge. I said, guys, look, obviously you guys personalise this to your own lives, but there's an opportunity here. You all work on the eighth floor. You've all been at this talk. It's much easier to make change in groups

and communities together. What if those of you who were able to, you know, what if from tomorrow morning, not next week, not next January, what if from tomorrow morning, you all try to help each other take the stairs each day? You know, how would that be? And there was a, you know, there was a mixed reaction a little bit, but people okay you know that sounds pretty reasonable well i tracked this right the next day all of them took it all of them took it okay 100 of the people who attended four months later 85 of them were taking it four times a week that's pretty good i would have thought the attrition would have been higher really no i would the drop-off. Yeah.

Meaning, yeah. No, again, I was surprised, but that goes, that plays, that really teaches us how much of a role community plays. Because if it's left up to an individual that, hey, you go out for lunch and you have to come back and you say, oh, let's take the lift. What if your colleague says, yeah, I know, but why don't we just take the stairs? Right? When you do it in a group together, you start to make those changes. And I've got emails from so many people in Penguins telling, hey, I didn't realize the impact it had. I feel better about myself. I'm more productive in the afternoon. My relationship with my wife is better since I started doing that. I'm sleeping better. And I'm not kidding you. This is not me exaggerating how powerful these changes are. It's these little changes,

bit by bit, these small changes become our new habits. These new habits become our health. You've got to start somewhere. And it doesn't matter. You know, these guys weren't changing their diets, right? All these guys did, right, was take the stairs together four times a week. It's eight blocks of stairs, Yeah. Right. And people are emailing saying all these kinds of great benefits and what that does that then makes them feel better. Then they want to make a dietary change or then they think, you know, I wonder what else I could do. Maybe this 15 minutes of me time isn't all woo. Maybe I can actually do this. And that's why I'm passionate. Say one-on-one with someone, I will try and find a spot

that I can really connect with them where I think, okay, and find something that they can agree with, agree to with me. The difficulty I had with writing a book is I really believe in a personalized approach. So I thought, how the hell do I write a book for the general population that personalizes it?

And the way I've tried to do it is by give people options, give people so many options, real life options, right? Not that I fabricate it, but that I have seen over nearly 20 years that patients have reported back telling me this works in my life, right? Not what the research paper says. Yeah, that's all in there, right? People want to read the research. I can give them that. But what I think I'm most proud of is that this book is making people want to make lifestyle change because they think, yeah, I can do that. Wow. I relate to that person he's just told me about. Man, I'm going to start there. And it's been out for a few months in the UK and it's just, it's, it's really transforming the way people are thinking about health. You know, the four pillar framework is almost,

it won't quite go as far as saying it's in common parlance yet, but a lot of people are talking about it. A lot of doctors, a lot of healthcare professionals, a lot of nutrition professionals are raising the concepts in their little 10 minute consultation and then giving them the book. I had a psychiatrist contact me last week, a psychiatrist saying, Hey, Dr. Chachi, can you talk to your publishers? I've actually bought 30 copies of your book and I've given them to 30 of my patients, but is there any way we can get a discounted rate? Right? Because this is not just about type two diabetes and obesity. This is about mental health problems. This is about gut symptoms. This is about migraines, insomnia, depression. You know, It's about all these things. These

are the chronic diseases. This is what I'm seeing day in, day out as a doctor. And this is what I'm seeing that frankly, a one pill solution, it ain't working. For the bulk of these people, it ain't working. And I'm sorry to go on. I know this works. I've seen this work. And I just want people to give it a shot, give it a chance. The beauty of it is the accessibility and the fact that the ask is so digestible. It's like, what is the one thing that you can change? What's the tweak that doesn't take up any time and doesn't cost any money that can ignite you and get you engaged in your life in a different way and allowing that person to explore that, take ownership of it and go on their journey. Yeah. So the call, the really the call to action, and we gotta, we gotta land this plane,

the call to action to everybody listening is, you know, what does that change for you? What does that, what is that one small thing that you can agree to that can begin to catalyze that shift? Yeah, absolutely. It really is about that one thing. That's the start. I mean, I don't know, Rich, what would be the one thing be for you? I think for me, I mean, there's a whole, there's a litany of areas where I could use some improvement. But I think, you know, I have challenges around eating food late at night that I know negatively impacts my sleep. I have issues about turning the devices off, you know, within a given timeframe before going to bed. those are two big ones and i have a tendency to push myself too hard in in work and in play that leaves me depleted and so i don't carve out i get uncomfortable when it comes time to carving out like relaxation and reflection time yeah and i'm not dissimilar to that if i'm honest i mean i've recently particularly since i've looked at all the circadian rhythm research

from California on, you know, not eating too late at night, which is just incredible. I've really tried to limit that, but I struggle to carve out time for myself. I will sometimes, you know, particularly when traveling and your time zones are all off, you start looking at devices. But I wonder, I mean, I know you're interviewing me, but I'm at devices but i wonder i mean i know you're

interviewing me but i'm just i can't it's like this whole what i do in a consultation is i say well okay these are things you're struggling with um perhaps i can also commit to something at the same time and then maybe for the next seven days we can sort of make a commitment to each other we're gonna try and do this one thing and i I have done that with patients before. So if you want, I'm happy to offer this. Yeah, what are we going to commit to here? What about devices before bed? I mean, how do you feel about that? I can do that.

What do you reckon? What's achievable? Achievable? 90 minutes before bed. You think 90 minutes? I think I could do that. Yeah? Yeah.

So it's what I call a no tech 90. Are we going to do it? We're going to do it. Okay, I's what i call a no tech 90 you won't wait we're gonna do it we're gonna do it okay i will also commit is it doable for you it is i think so you know it's i went through a really good patch a couple months ago i was doing it all the time and then i've fallen into a few bad habits but this has renewed me this has been like okay i've made a commitment to rich i'm gonna do it so i think i can do it as well all right we'll check in with each other yeah And anyone who's listening and wants to let us know if they can do something as well, they should let us know, right? Right.

Yeah, for sure. Like, well, yeah. Why don't we make it a hashtag or something? Yeah. Hashtag no tech 90. No tech 90. All right. That is, there you go.

No tech 90. Let us know when you hear this. Let us know how many people are doing it. Not in the 90 minutes before bed. Do it the next morning. Right. Cool. Final question. And then I'll let you go.

And I ask this of all doctors that come on the show. If you woke up in a parallel universe and you had become an American citizen and been appointed to become Surgeon General, what changes do you put in place? You know what? I should have prepared an answer like this. I've heard your podcast so many times and I have just not.

So I mean, on a kind of, whether it's regulatory or legislative, like what kind of systemic changes would you like to see in health or the practice of medicine? I would say that culturally, I'd like legislative changes that prioritize health. So I would like it to be almost in legislation that schools and hospitals don't sell junk food, don't stock junk food. Let's start there. Even that would be transformative. And another, I guess, systemic change would be to really push companies and this culture, particularly I think you have it in America more than any other country, this work hard, constantly be on call, always be available on your phone, always be available. We need to take a leaf out of like a German company.

I think Volkswagen did this recently, where their employees physically cannot access their emails in the evenings, weekends, and on holiday time. They're just locked out, right? And again, it may not be Volkswagen, I think it is, but one of the German companies, and it's very common in Europe now for this to be implemented. I think that would be a huge thing for America if that corporate culture would change where we accept, hey, you're going home now. I do not expect, my boss does not expect me to answer an email till 8.30 tomorrow morning when I'm back at my desk. I think even that,

because I think many people have got that expectation. They don't want to lose their job. They're like, oh, I need to reply to my boss. Even those small things would have a huge impact. Yeah, beautiful, man. Thank you so much. Rich, the pleasure's been mine. I'm just such an incredible honor for me to be here.

I, you know, 5,000 miles away, I am going up and down the country on the train to London. I'm often listening to your podcast. I'm often learning a lot from what you gleaned from your guests. So I just want to thank you for the opportunity to come and talk to you myself. Thank you.

Awesome. Thank you. I appreciate that. That's very cool to hear. Excited for you, excited for the opportunity to come and talk to myself. Thank you. Awesome. Thank you. I appreciate that. That's very cool to hear. Excited for you. Excited for the new book. The book is in the UK. It's The Four Pillar Plan.

You can see it here on video. And in the US, they have changed the title. It is How to Make Disease Disappear. Why did they change the title? They've Americanized it. I know. It's a totally different cover, the whole thing. The content's the same. Yeah, the content's exactly the title. They've Americanized it. It's a totally different cover, the whole thing. The content's the same. Yeah, the content's exactly the same. So depending upon where you live,

those are the titles. Pick it up wherever you buy fine books and come back and talk to me sometime. I'd love to. Cool. If you want to connect with Dr. Chatterjee, what's the best place to do that? We say Facebook or Instagram. It's at Dr. Chatterjee. It's probably the best place to get hold of me and we can have a conversation on there or possibly my podcast, Feel Better, Live More podcast. People can listen to that as well. And you can get that on iTunes and all those usual places. Yeah.

Cool. Are you doing any public speaking events that are open to the general public? While some people... Yeah, no. Well, by the time this goes up, is there like a schedule on your website or anything like that yeah we're putting on the website uh on drchatterjee.com it's also

on my facebook page facebook.com forward slash drchatterjee there's an events section there where all my all my events are there so uh yeah i love speaking to the public so if you if you want to come along please do awesome and uh final thing are you going to take us out with a little guitar? We didn't even talk about the fact that you're a touring rock star. Oh, man. You took a sabbatical from your medical practice to tour with your band? I did, yeah. What kind of music do you play? My solo EP, yeah. That was a long way back. What's the name of your band? Well, I did it under my own name, the solo EP. It was under Rangan. It was when I, back in the days when I had long hair, you know, I did my thing. Did you?

Did you have long hair? I did, yeah. I feel pressured. I don't know what to play. Do you want to? Well, I mean. It's up to you. Well, I'm here in, say what feels right.

I'm here in the hills in California. And yeah, this will be a cover. That's that good with you? Good. Feel free to sing along, man. You don't want that. I've been wandering down the road trying to loosen my load, seven women on my mind.

For the one who won't meet too the one who stole me once so she's a friend of mine take it easy take it easy don't let the sound of your own wheels on wheels, drive you crazy. Lighten up while you still can. Don't even try to understand. Just take a place to find your stand and take it easy. Well, I was standing on a corner of Winslow, Arizona. Such a fine sight to see It's a girl, my lord, in a flatbed for a sundown Have a look at me Take it easy

Take it easy Don't let the sound of your own wheels Drive you crazy Lighten up, or you still can Don't let the sound of your own wheels drive you crazy. Lighten up, or you still can. Don't even try to understand. Just find a place to make your stand and take it easy. Bit of jet lag in the voice and i've not played that in a few years all right now that was great little eagles for california hey that's what that's what i felt like

awesome man thank you until next time buddy all right peace plants Great. Little eagles for California. Hey, that's what I felt like. Cool. Awesome, man. Thank you. Until next time, buddy. All right. Peace. Plants. Multi-talented, that Dr. Chatterjee.

What can I say? Hope you guys enjoyed that. Hope you got a good education, a good overview on how you too can sidestep these chronic ailments, avoid becoming a statistic, and live a long, healthy life. Do me a favor. Share your thoughts about this conversation with Rangan himself. You can find him on Twitter at DrChatterjeeUK, DrChatterjeeUK on Twitter, and also at DrChatterjee, DrChatterjee on Instagram.

Make a point of picking up his new book, The Four Pillar Plan, if you're in the UK. If you're in the US or North America, pick it up. It's called How to Make Disease Disappear. I have links to those books in the show notes on the episode page at richroll.com for this episode. And while we're talking about show notes, make a point of checking them out. We put a ton of time into them.

They're essentially like a syllabus to extend your experience, your learning, your edification of this podcast episode beyond the earbuds. And they're awesome. If you would like to support my work, the easiest and best way is probably to share this show, whatever your favorite episode is, with your friends and on social media. Hit that subscribe button on Apple Podcasts or on Google Podcasts on their brand new app if you're an Android user. Leave a comment on the comment section on Apple Podcasts.

All of this really just helps with the show's visibility, helps extend reach and audience, which helps me track and book the best guests for you guys. You can also support the show on Patreon at richworld.com forward slash donate. And I wanna thank everybody who helped put on the show today. Jason Camiolo for audio engineering production, show notes, interstitial music.

Blake Curtis and Margo Lubin for video work. This entire podcast is on YouTube and for editing that video and for graphics. And theme music is always by Analema. Thanks for the love, you guys. See you back here in a couple of days with a brand new Coach's Corner with Chris Howe. And until then, go easy on yourself.

Reduce that stress. Eat right, sleep well, move much, and love more. Thank you.