Dr Paul Ch'en: Right, welcome back! We're now episode three of the Perflow podcast and today I think we're talking about the mindset, is that correct?
Dr Wafaa: Absolutely, the mindset. Actually, last episode, we talked about the diet. ⁓ And I think that the mindset an important role ⁓ about which ⁓ diet or food you eat. I'm very happy that we're talking about mindset this time. But first, let me see what did your CGM tell you from last week, Paul
Dr Paul Ch'en: So for the listeners, this is the continuous glucose monitor that checks my sugar levels. It's now come off. Thank God for that. It was very uncomfortable after a while. Sugar-wise, yes, it got a bit boring at the end because some of the foods didn't really change any of the sugar levels. One thing that I did notice that some rice cracker that I ate surprisingly actually rose the sugar levels. But otherwise, I think I was in the normal range. So did it change my habit? a certain degree I guess, bit more mindful about eating the right stuff and perhaps being bit cautious about the sugary foods or the hidden sugars. But otherwise, at least for me, I don't think it made a huge difference to be frankly honest. But putting that aside, Wafir, how about you?
Dr Wafaa: just want to comment about the continuous glucose monitoring. Did you read the papers about the sugar spikes without sugar? So we have seen that ⁓ using CGM, you can see a spike after eating something if that person thinks that it will contain sugar, even if it doesn't. So it is actually based on the mindset. and if Categorize, of course, stress is one of the main things that someone like, if you have very negative thoughts and you have genetic predisposition that you don't have the blessed gene, which we will talk about later, or you don't methylate properly, stress actually induces spikes. And it's ⁓ triggered by the fear of a sugar spike. When you're wearing a CGM, you're looking at it and you're afraid that the sugar will spike. So if the fear of a sugar spike can release adrenaline, which signals the liver to dump glucose into your liver, creating a real spike from a no sugar food. Isn't that interesting?
Dr Paul Ch'en: I think that's called the placebo effect, is that right?
Dr Wafaa: But if you are afraid that you will get this sugar spike, your adrenaline will go up, talks to your liver, and it will make more sugar. So anyways. Exactly. So yes, so it's very good. had a very nice, I love wearing CGMs, although I'm not diabetic and so are you. And it is nice to play around with it.
Dr Paul Ch'en: And that's called the nocebo effect. The opposite, isn't it?
Dr Wafaa: For me, I successfully made my stock of healthy snacks at home and I actually added beetroot to it as well to increase my nitric oxide. So I am very happy that we are doing what we are preaching, hopefully, till the end of season one. But in order to do that, we have to talk about the mindset because the mindset is the one that will... control everything that we are making moving forward.
Dr Paul Ch'en: Yeah, I totally agree. think if we focus on mindset, which is this week's episode, I I have the privilege of being a college doctor for two of the colleges at Oxford. And of course, looking after students, there are a lot of mental health issues that come my way, whether it's anxiety or depression or stress. And one thing that I often give this example, having partly trained in cognitive behavioural therapy is this idea about interpretation. And usually the students are just looking at me and what are we talking about? And I give this example for saying, imagine yourself walking down the street and you see your best friend and you waved at them. And they then ignored you. How that make you feel? So someone who's anxious or depressed or stressed, they might think, my God, I can't make any friends. It's always my fault. Nothing ever works. God, I feel helpless. I feel hopeless And this is what we call automatic negative thoughts. So one thought leads to the next, to the next, to the next. But for argument sake let's imagine that friend across the road was on their hands free and they didn't recognize you, or didn't see you. How did that then make you feel? Well, most people will say, no harm done. You can call them at a later date. The interesting is that factual thing, that friend ignored you, but how you feel about it and the outcomes. So I think it is important sometimes to try to gauge about the fact that is it Well, could it be two sides of the story? Could it be a misinterpretation of the things that you're, I guess, exposed to? And of course, that sort of then feeds into what we call resilience, both physically and emotionally. And if you're always stressed and anxious, and I guess you have lots of things on your plate, you're running like a headless chicken, and we all know that feeling, it may well be that your resilience is low and therefore you inadvertently tap into whether it's the nocebo effect. or you tap into those negative automatic thoughts that then cause you to then have what things get worse and it may then manifest as actual physical symptoms of the heart racing or being on edge and clammy, irritable, all these things. And again, in general practice, this is like the bread and butter when we talk about mental health. And I think it's important to have those sorts of ideas saying, okay, how do we go about tackling it in terms of the mindset? optimizing the resilience and then in terms of in the interpretation. Wafaa what are your thoughts?
Dr Wafaa: Well, I totally agree with you. been all, like the three of us in this podcast, we have been through the process of being medical students, the stress of studying, like who's coming first, which residency I'm going to take. for me, like I remember very well during our final exams, like you have a student that's like just go through the exam finishes it and just go right out of the hall of the exam hall. And then another one who faints and another one who gets diarrhea and another one who actually vomits. And if you think of it actually, and we're going to talk about this at a later episode, that it's the gut brain connection. So it was like diarrhea, vomiting, someone like lost their consciousness. So it is the mindset that like, why would someone finish the exam and be cool about it? And the other gets really stressed out. So it is the mindset and it depends also on the meds as you like, ⁓ the meds that we discussed in the first episode, like the mindset, the exercise, the diets, the sleep, the stress, all of these things, it all pours into ⁓ in the meds, the number one, the mindset. So if your lifestyle modifications are not good, robust and like in sync, then your mindset will... ⁓ interpret things in a negative way. Like if you didn't have good sleep and then I saw Paul walking down the street I said, hey Paul, and he didn't look at me and he left. Like if I didn't sleep well, I'd say like, did I do something that made Paul angry for me? Or he probably didn't, he was thinking about something else and he was late for work. So it depends. Like I really like the example that you mentioned here. the thing is that we can talk about mindset examples for many things. Like we talked about the mindset about eating something sugary and when it didn't have sugar and spiked your sugar, stuff like that. So what I want to actually provide our listeners is how to improve the status of our mindset.
Dr Paul Ch'en: think you're totally right. So if we're talking about the take your meds, ⁓ the ⁓ the acronym, I think it feeds ⁓ into itself. ⁓ there's a of a synergistic effect. So as you tap into one bit, it helps with the other bit and the other bit, the other one works as well. And I think when we're talking about mindset, I mean, it's intricately linked, I suspect it to stress and that's an episode for the next one. But I think it's an interesting one. Because I think usually the conversations that I have with my patients, particularly when it's about mental health, is about taking a deeper dive on how you operate as an individual. And it's that realization. Sometimes it might be the hedonic treadmill ⁓ of, OK, you might have a dopamine kick to feel happy, and then you sort of normalize it. The stress of life means that actually you're still constantly stressed. and then you sort of not really attune to how you can feel slightly happier in yourself or how you can then start tapping into that mindset. I think it is important to have awareness of how you are as a person. So some people are perhaps inherently more stressed or anxious personality wise and of course there's a huge spectrum. But that said, I think as you start to understand how you are as a person, it's really then important than say, well, how can you mitigate or reduce some of these problems as they come along? It may well be sometimes it's distraction techniques, and that's fine to one level. But sometimes you may feel that if you can then perhaps find ways to, I guess, be able to function at a level cognitively that allows you to filter all those negative thoughts, like the monkey mind theory, and then funnel it to one thought or a few thoughts that are perhaps slightly more positive, ⁓ bringing the benchmark back less negative, then again, it then spills over to you even have a bit more resilience and be able to have that lateral ⁓ to think laterally I guess, to make those smarter choices. Because I think we all have a good day. And often what happens is that when we have a good day, everything seems to work out really well. And it's bit like a puzzle piece, right? So you've got one piece, it fits into the next one, fits in the next one, fits in the next one, it feels really nice, right? But also we can have those really bad days and it may feel as if you like swimming in treacle, but there's nothing to say that you can go both ways. And so sometimes I do tell some of my patients and saying, well, imagine yourself having a bit of a range in terms of your mood going up and down. And again, there's going to be a variation for one person to the next. And let's say you've got this imaginary line here as the baseline being normal. It might be that you personality wise may fit in the lower count of being slightly more negatively minded than say someone else who's slightly higher up. Of course, we want to make this this this range slightly smaller. But ideally, we want to bring this up on the positive side, which means that even if you are a bit low or depressed, or even if you are subject to the stress, because you're slightly more positive, it then means that that that drop isn't as profound as if you were in the negative realms. And I think when you have that feeling of these things, I think that means that you can then sort of tap in and hack into this to utilise it to your advantage. But again, it has to be wrapped around with all the other bits of the exercise, the diet, the sleep, the social connection and learning to be the happiest you. And that's the sort of conversation that I would often have sometimes on a bit of a loop. with some of my patients. How about you Wafey on the cancer side of things? mean, I'm sure patients, of course, there's a psychological burden with cancer How do you go about discussing this?
Dr Wafaa: Well, lot of people who come to me, they ask me for nutritional advice, ⁓ which I can give, but I'm not a nutritional ⁓ But, and then another thing they ask, I give them the emotional psychological support by I would need ⁓ a mental health therapist with me. so that they can tackle into their deepest fears, especially with the diagnosis of having cancer, or not even cancer, if someone had an autoimmune disease and he went to his GP and then to his consultant and they tell them, you're gonna have this until the end of your time. Or even people with hypertension, you have hypertension and you're gonna take antihypertensive medications. for the rest of your life. So these are the thoughts that needs to be changed from both like the patient should not be thinking that way and the doctor should not be saying that to the patient because now we know like Dr. David Unwin in Liverpool he actually reversed 133 cases of type 2 diabetes and he published it at the British Medical Journal just from lifestyle modifications and diet but in doing so He was actually with his wife, Dr. Jen Unwin, who was working on the psychological aspect of the patient, on their mindset, in order to reverse something that their GP or their consultant deemed that they're going to have for the rest of their lives. So a lot of them, not only that they reversed their type 2 diabetes, they actually ⁓ improved their ⁓ weight gain. actually, some of them actually dropped their hypertensive medications because it made their blood pressure lower. So I think it's very important that when someone is diagnosed with whatever disease or whatever symptom that they have, they shouldn't be drowned into the end, but they should actually take a step back, pause, and... ⁓ take it from a mental aspect, a mindset aspect, what am I going to do about it? And then hopefully they will be lucky to have someone like you, Paul, or someone like Elliott meeting them in the clinic and talking about the mindset and how to take it one step at a time. It's always one step at a time. So for me, I'm very mindful of the mindset of my patients. And I always, always try to put myself in their shoes. So because sometimes patients like attack you and say that you don't know anything, you're going to give me this, I'm going to die either way, or I'm going to... But you just have to put yourself in their shoes. And God forbid that anyone would get any disease. And that's why this podcast is about, it's about prevention. It's about improving if anyone has an uncommunicable disease, how to improve that on the long run. So, but we have to be ⁓ conscious about what we say to our patients and the patients or the listeners, there don't have to be patients. So the listeners or anyone else in the family, friends, they have to be ⁓ conscious about what they're facing, whether they have a disease, financial crisis, lost a beloved one. So the mindset is extremely important because it actually ⁓ programs how your body works, as you see. So it, and we will talk about stress and how chronic stress actually ⁓ impacts a lot of biological processes in your body.
Dr Paul Ch'en: I mean think the power of the mind is amazing. mean another classic example is the story about the lemon of, and some of the listeners may have heard this, advance apologies, but for the listeners, imagine yourself closing your eyes, you've got a lemon on your hand, you know, I cut of lemon, and then you have a cup. Let's imagine yourself squeezing the lemon into the cup. How do feel about that? We're now going to bring that cup to your mouth slowly. Smell the content in the cup. Now slowly start tipping that cup so as if you're drinking it. And whilst I'm saying this, surprisingly, I can actually feel myself a lot of the saliva burning up in my mouth. And it's a good point to make here because this is the power of the mind, right? The lemon doesn't exist. But me telling you this and you imagining it, actually the outcome is a physical outcome. And so it shows the fact that things that you think about will manifest in physical symptoms, both way positively and negatively. And I think it is important to therefore try, I mean, of course, we can't be always positive, but I think try to be able to inject positivity in one's day to day life may then enable us to function better. also reduce some of those negative impacts that may have presented in terms of being sort of on edge or with the palpitations, etc. I think another interesting thing is that, Wafaa you just reminded me early on when you're talking, is the concept I talk to small kiddies that sometimes I have to talk about anxiety, because the problem with mental health is that year on year out, incidence, so the numbers of patients that do have ⁓ health is just increasing. And it's difficult to give the answer as to why, but putting that aside, I sometimes give the example of the toy shop or the bookshop. So as kids, I don't know if it's yourself Wafaa or Elliott for that matter. When I was a kid, when I went to the toy shop, I just want to go to the loo straight away. Nothing's really changed. It's just how everything is physiologically all intertwined or going to the bookshop in anticipation. Just that thought makes me a bit more anxious and excited. But you talked about the gut. and how the brain works. And it's just a good example, basically with the bladder as well, for that matter, and how this all linked together. And it's trying to be as holistic as possible as well, understanding the physiology, the biochemistry, and maybe sometimes medications may be the answer to help, not on its own. I think it's important to wrap it around the lifestyle, sometimes in terms of psychological therapy input, whether that's cognitive behaviour therapy or... psychodynamic therapy, psychoanalytical therapy, EMDR, there's different types of therapy, not saying therapy is always the answer and there's no one size fits all. But it might be that you of lean into these things in parallel, to be able to then also have a think about yourself as the individual and then to enable you to then function better, ⁓ when we're coming to that mindset, which personally, I think, ranks exceptionally high on that take your meds acronym. ⁓ I didn't know what the stats are, I guess it's quite difficult to be able to then say this is more important than that I knew that sleep is of course very important, because if we don't sleep, well, we're not compatible with life, but ditto with food, if we don't eat, it's not compatible with life. However, I think as we learn who we are and how we operate, I think there are a lot of big wins to be made.
Dr Wafaa: I think that what you eat ⁓ impacts, you know, when there are a lot of like social media, you know, overwhelming a lot of posts about the sugar spike and the insulin resistance. But actually, when you try it as a person, and I would like our listeners try it, if you start your breakfast, if you eat like eggs ⁓ in your ⁓ compared to eating your porridge ⁓ with honey or ⁓ like a lot of like, or dates, you know. So when you spike your sugar, you actually get a crash of energy afterwards. But when you start your breakfast with proteins, with avocados and good omega-3s in it, you actually have mental sharp minds. it was surprising for me when I attended my very first keto live conference. It was in Switzerland. It was a keto buffet and I used to eat so much. The buffet was excellent. I lost weight, my bloating around my colon was, it was gone. And I had the sharpest mind ever. And I was never hungry. I only ate because they served us food. But even after that food, I never had this crash of energy after that food, after you eat a dessert, et cetera. So I think that food diet plays a very important role. Exercise where you oxygenate your body plays a major role. Sleep. major role it all affects your ⁓ ⁓ one of the things that I would love to which I actually advise my patients and my friends to do it, and I've never done it because I've never had time, I need to read the, you have read it or Elliot, the book that's called The Body Keeps Score. So if anyone read it, please send me your feedback and I will try to read it as much as I can. But your mindset is extremely important.
Dr Paul Ch'en: So given where things are, Wafaa What are your thoughts in terms of what you're gonna do by our, until our next episode, when we talk about the mindset?
Dr Wafaa: I will try to pause more often during the day and reflect at what I have done during that day because you never pause.
Dr Paul Ch'en: such a good good answer. I think particularly where people are just so busy for the next thing, the next thing, I think it's just that realization that we do need to pause and reflect and so I think that's a fantastic thing that you're going to do and carry forward onwards. What am I going to do mindset wise? it's a good one. I'm going to anchor it onto something positive in terms of, I'm going to try to find something that gives me joy and happiness from being positively minded about things. So one of my philosophies in life is I try to be kind to others. And I think with that, it brings a lot of joy. And I think mindset wise, I think indirectly. I think it will then help with me being more positive. And I see finding the positive side of all things. I think one of my mentors has mentioned once, consider your challenges in life, whether they're good or bad, I guess, as an opportunity. And I think if you could change that mindset towards even the hardships is something that's potentially has a positive outcome, then I think it's a win. So I think I'm going to do that.
Dr Wafaa: Excellent. think that I will try to do that as well. But one thing.
Dr Paul Ch'en: Exactly. So on that note, think the listener is your turn, as always. please have a bit of a think of what you might be able to do, given what you've just heard in terms of optimizing your mindset. So on that note, we shall call it a day, I look forward to seeing you on the next episode. So bye for now.
Dr Wafaa: Bye, a bientot!
Dr Wafaa: Absolutely, the mindset. Actually, last episode, we talked about the diet. ⁓ And I think that the mindset an important role ⁓ about which ⁓ diet or food you eat. I'm very happy that we're talking about mindset this time. But first, let me see what did your CGM tell you from last week, Paul
Dr Paul Ch'en: So for the listeners, this is the continuous glucose monitor that checks my sugar levels. It's now come off. Thank God for that. It was very uncomfortable after a while. Sugar-wise, yes, it got a bit boring at the end because some of the foods didn't really change any of the sugar levels. One thing that I did notice that some rice cracker that I ate surprisingly actually rose the sugar levels. But otherwise, I think I was in the normal range. So did it change my habit? a certain degree I guess, bit more mindful about eating the right stuff and perhaps being bit cautious about the sugary foods or the hidden sugars. But otherwise, at least for me, I don't think it made a huge difference to be frankly honest. But putting that aside, Wafir, how about you?
Dr Wafaa: just want to comment about the continuous glucose monitoring. Did you read the papers about the sugar spikes without sugar? So we have seen that ⁓ using CGM, you can see a spike after eating something if that person thinks that it will contain sugar, even if it doesn't. So it is actually based on the mindset. and if Categorize, of course, stress is one of the main things that someone like, if you have very negative thoughts and you have genetic predisposition that you don't have the blessed gene, which we will talk about later, or you don't methylate properly, stress actually induces spikes. And it's ⁓ triggered by the fear of a sugar spike. When you're wearing a CGM, you're looking at it and you're afraid that the sugar will spike. So if the fear of a sugar spike can release adrenaline, which signals the liver to dump glucose into your liver, creating a real spike from a no sugar food. Isn't that interesting?
Dr Paul Ch'en: I think that's called the placebo effect, is that right?
Dr Wafaa: But if you are afraid that you will get this sugar spike, your adrenaline will go up, talks to your liver, and it will make more sugar. So anyways. Exactly. So yes, so it's very good. had a very nice, I love wearing CGMs, although I'm not diabetic and so are you. And it is nice to play around with it.
Dr Paul Ch'en: And that's called the nocebo effect. The opposite, isn't it?
Dr Wafaa: For me, I successfully made my stock of healthy snacks at home and I actually added beetroot to it as well to increase my nitric oxide. So I am very happy that we are doing what we are preaching, hopefully, till the end of season one. But in order to do that, we have to talk about the mindset because the mindset is the one that will... control everything that we are making moving forward.
Dr Paul Ch'en: Yeah, I totally agree. think if we focus on mindset, which is this week's episode, I I have the privilege of being a college doctor for two of the colleges at Oxford. And of course, looking after students, there are a lot of mental health issues that come my way, whether it's anxiety or depression or stress. And one thing that I often give this example, having partly trained in cognitive behavioural therapy is this idea about interpretation. And usually the students are just looking at me and what are we talking about? And I give this example for saying, imagine yourself walking down the street and you see your best friend and you waved at them. And they then ignored you. How that make you feel? So someone who's anxious or depressed or stressed, they might think, my God, I can't make any friends. It's always my fault. Nothing ever works. God, I feel helpless. I feel hopeless And this is what we call automatic negative thoughts. So one thought leads to the next, to the next, to the next. But for argument sake let's imagine that friend across the road was on their hands free and they didn't recognize you, or didn't see you. How did that then make you feel? Well, most people will say, no harm done. You can call them at a later date. The interesting is that factual thing, that friend ignored you, but how you feel about it and the outcomes. So I think it is important sometimes to try to gauge about the fact that is it Well, could it be two sides of the story? Could it be a misinterpretation of the things that you're, I guess, exposed to? And of course, that sort of then feeds into what we call resilience, both physically and emotionally. And if you're always stressed and anxious, and I guess you have lots of things on your plate, you're running like a headless chicken, and we all know that feeling, it may well be that your resilience is low and therefore you inadvertently tap into whether it's the nocebo effect. or you tap into those negative automatic thoughts that then cause you to then have what things get worse and it may then manifest as actual physical symptoms of the heart racing or being on edge and clammy, irritable, all these things. And again, in general practice, this is like the bread and butter when we talk about mental health. And I think it's important to have those sorts of ideas saying, okay, how do we go about tackling it in terms of the mindset? optimizing the resilience and then in terms of in the interpretation. Wafaa what are your thoughts?
Dr Wafaa: Well, I totally agree with you. been all, like the three of us in this podcast, we have been through the process of being medical students, the stress of studying, like who's coming first, which residency I'm going to take. for me, like I remember very well during our final exams, like you have a student that's like just go through the exam finishes it and just go right out of the hall of the exam hall. And then another one who faints and another one who gets diarrhea and another one who actually vomits. And if you think of it actually, and we're going to talk about this at a later episode, that it's the gut brain connection. So it was like diarrhea, vomiting, someone like lost their consciousness. So it is the mindset that like, why would someone finish the exam and be cool about it? And the other gets really stressed out. So it is the mindset and it depends also on the meds as you like, ⁓ the meds that we discussed in the first episode, like the mindset, the exercise, the diets, the sleep, the stress, all of these things, it all pours into ⁓ in the meds, the number one, the mindset. So if your lifestyle modifications are not good, robust and like in sync, then your mindset will... ⁓ interpret things in a negative way. Like if you didn't have good sleep and then I saw Paul walking down the street I said, hey Paul, and he didn't look at me and he left. Like if I didn't sleep well, I'd say like, did I do something that made Paul angry for me? Or he probably didn't, he was thinking about something else and he was late for work. So it depends. Like I really like the example that you mentioned here. the thing is that we can talk about mindset examples for many things. Like we talked about the mindset about eating something sugary and when it didn't have sugar and spiked your sugar, stuff like that. So what I want to actually provide our listeners is how to improve the status of our mindset.
Dr Paul Ch'en: think you're totally right. So if we're talking about the take your meds, ⁓ the ⁓ the acronym, I think it feeds ⁓ into itself. ⁓ there's a of a synergistic effect. So as you tap into one bit, it helps with the other bit and the other bit, the other one works as well. And I think when we're talking about mindset, I mean, it's intricately linked, I suspect it to stress and that's an episode for the next one. But I think it's an interesting one. Because I think usually the conversations that I have with my patients, particularly when it's about mental health, is about taking a deeper dive on how you operate as an individual. And it's that realization. Sometimes it might be the hedonic treadmill ⁓ of, OK, you might have a dopamine kick to feel happy, and then you sort of normalize it. The stress of life means that actually you're still constantly stressed. and then you sort of not really attune to how you can feel slightly happier in yourself or how you can then start tapping into that mindset. I think it is important to have awareness of how you are as a person. So some people are perhaps inherently more stressed or anxious personality wise and of course there's a huge spectrum. But that said, I think as you start to understand how you are as a person, it's really then important than say, well, how can you mitigate or reduce some of these problems as they come along? It may well be sometimes it's distraction techniques, and that's fine to one level. But sometimes you may feel that if you can then perhaps find ways to, I guess, be able to function at a level cognitively that allows you to filter all those negative thoughts, like the monkey mind theory, and then funnel it to one thought or a few thoughts that are perhaps slightly more positive, ⁓ bringing the benchmark back less negative, then again, it then spills over to you even have a bit more resilience and be able to have that lateral ⁓ to think laterally I guess, to make those smarter choices. Because I think we all have a good day. And often what happens is that when we have a good day, everything seems to work out really well. And it's bit like a puzzle piece, right? So you've got one piece, it fits into the next one, fits in the next one, fits in the next one, it feels really nice, right? But also we can have those really bad days and it may feel as if you like swimming in treacle, but there's nothing to say that you can go both ways. And so sometimes I do tell some of my patients and saying, well, imagine yourself having a bit of a range in terms of your mood going up and down. And again, there's going to be a variation for one person to the next. And let's say you've got this imaginary line here as the baseline being normal. It might be that you personality wise may fit in the lower count of being slightly more negatively minded than say someone else who's slightly higher up. Of course, we want to make this this this range slightly smaller. But ideally, we want to bring this up on the positive side, which means that even if you are a bit low or depressed, or even if you are subject to the stress, because you're slightly more positive, it then means that that that drop isn't as profound as if you were in the negative realms. And I think when you have that feeling of these things, I think that means that you can then sort of tap in and hack into this to utilise it to your advantage. But again, it has to be wrapped around with all the other bits of the exercise, the diet, the sleep, the social connection and learning to be the happiest you. And that's the sort of conversation that I would often have sometimes on a bit of a loop. with some of my patients. How about you Wafey on the cancer side of things? mean, I'm sure patients, of course, there's a psychological burden with cancer How do you go about discussing this?
Dr Wafaa: Well, lot of people who come to me, they ask me for nutritional advice, ⁓ which I can give, but I'm not a nutritional ⁓ But, and then another thing they ask, I give them the emotional psychological support by I would need ⁓ a mental health therapist with me. so that they can tackle into their deepest fears, especially with the diagnosis of having cancer, or not even cancer, if someone had an autoimmune disease and he went to his GP and then to his consultant and they tell them, you're gonna have this until the end of your time. Or even people with hypertension, you have hypertension and you're gonna take antihypertensive medications. for the rest of your life. So these are the thoughts that needs to be changed from both like the patient should not be thinking that way and the doctor should not be saying that to the patient because now we know like Dr. David Unwin in Liverpool he actually reversed 133 cases of type 2 diabetes and he published it at the British Medical Journal just from lifestyle modifications and diet but in doing so He was actually with his wife, Dr. Jen Unwin, who was working on the psychological aspect of the patient, on their mindset, in order to reverse something that their GP or their consultant deemed that they're going to have for the rest of their lives. So a lot of them, not only that they reversed their type 2 diabetes, they actually ⁓ improved their ⁓ weight gain. actually, some of them actually dropped their hypertensive medications because it made their blood pressure lower. So I think it's very important that when someone is diagnosed with whatever disease or whatever symptom that they have, they shouldn't be drowned into the end, but they should actually take a step back, pause, and... ⁓ take it from a mental aspect, a mindset aspect, what am I going to do about it? And then hopefully they will be lucky to have someone like you, Paul, or someone like Elliott meeting them in the clinic and talking about the mindset and how to take it one step at a time. It's always one step at a time. So for me, I'm very mindful of the mindset of my patients. And I always, always try to put myself in their shoes. So because sometimes patients like attack you and say that you don't know anything, you're going to give me this, I'm going to die either way, or I'm going to... But you just have to put yourself in their shoes. And God forbid that anyone would get any disease. And that's why this podcast is about, it's about prevention. It's about improving if anyone has an uncommunicable disease, how to improve that on the long run. So, but we have to be ⁓ conscious about what we say to our patients and the patients or the listeners, there don't have to be patients. So the listeners or anyone else in the family, friends, they have to be ⁓ conscious about what they're facing, whether they have a disease, financial crisis, lost a beloved one. So the mindset is extremely important because it actually ⁓ programs how your body works, as you see. So it, and we will talk about stress and how chronic stress actually ⁓ impacts a lot of biological processes in your body.
Dr Paul Ch'en: I mean think the power of the mind is amazing. mean another classic example is the story about the lemon of, and some of the listeners may have heard this, advance apologies, but for the listeners, imagine yourself closing your eyes, you've got a lemon on your hand, you know, I cut of lemon, and then you have a cup. Let's imagine yourself squeezing the lemon into the cup. How do feel about that? We're now going to bring that cup to your mouth slowly. Smell the content in the cup. Now slowly start tipping that cup so as if you're drinking it. And whilst I'm saying this, surprisingly, I can actually feel myself a lot of the saliva burning up in my mouth. And it's a good point to make here because this is the power of the mind, right? The lemon doesn't exist. But me telling you this and you imagining it, actually the outcome is a physical outcome. And so it shows the fact that things that you think about will manifest in physical symptoms, both way positively and negatively. And I think it is important to therefore try, I mean, of course, we can't be always positive, but I think try to be able to inject positivity in one's day to day life may then enable us to function better. also reduce some of those negative impacts that may have presented in terms of being sort of on edge or with the palpitations, etc. I think another interesting thing is that, Wafaa you just reminded me early on when you're talking, is the concept I talk to small kiddies that sometimes I have to talk about anxiety, because the problem with mental health is that year on year out, incidence, so the numbers of patients that do have ⁓ health is just increasing. And it's difficult to give the answer as to why, but putting that aside, I sometimes give the example of the toy shop or the bookshop. So as kids, I don't know if it's yourself Wafaa or Elliott for that matter. When I was a kid, when I went to the toy shop, I just want to go to the loo straight away. Nothing's really changed. It's just how everything is physiologically all intertwined or going to the bookshop in anticipation. Just that thought makes me a bit more anxious and excited. But you talked about the gut. and how the brain works. And it's just a good example, basically with the bladder as well, for that matter, and how this all linked together. And it's trying to be as holistic as possible as well, understanding the physiology, the biochemistry, and maybe sometimes medications may be the answer to help, not on its own. I think it's important to wrap it around the lifestyle, sometimes in terms of psychological therapy input, whether that's cognitive behaviour therapy or... psychodynamic therapy, psychoanalytical therapy, EMDR, there's different types of therapy, not saying therapy is always the answer and there's no one size fits all. But it might be that you of lean into these things in parallel, to be able to then also have a think about yourself as the individual and then to enable you to then function better, ⁓ when we're coming to that mindset, which personally, I think, ranks exceptionally high on that take your meds acronym. ⁓ I didn't know what the stats are, I guess it's quite difficult to be able to then say this is more important than that I knew that sleep is of course very important, because if we don't sleep, well, we're not compatible with life, but ditto with food, if we don't eat, it's not compatible with life. However, I think as we learn who we are and how we operate, I think there are a lot of big wins to be made.
Dr Wafaa: I think that what you eat ⁓ impacts, you know, when there are a lot of like social media, you know, overwhelming a lot of posts about the sugar spike and the insulin resistance. But actually, when you try it as a person, and I would like our listeners try it, if you start your breakfast, if you eat like eggs ⁓ in your ⁓ compared to eating your porridge ⁓ with honey or ⁓ like a lot of like, or dates, you know. So when you spike your sugar, you actually get a crash of energy afterwards. But when you start your breakfast with proteins, with avocados and good omega-3s in it, you actually have mental sharp minds. it was surprising for me when I attended my very first keto live conference. It was in Switzerland. It was a keto buffet and I used to eat so much. The buffet was excellent. I lost weight, my bloating around my colon was, it was gone. And I had the sharpest mind ever. And I was never hungry. I only ate because they served us food. But even after that food, I never had this crash of energy after that food, after you eat a dessert, et cetera. So I think that food diet plays a very important role. Exercise where you oxygenate your body plays a major role. Sleep. major role it all affects your ⁓ ⁓ one of the things that I would love to which I actually advise my patients and my friends to do it, and I've never done it because I've never had time, I need to read the, you have read it or Elliot, the book that's called The Body Keeps Score. So if anyone read it, please send me your feedback and I will try to read it as much as I can. But your mindset is extremely important.
Dr Paul Ch'en: So given where things are, Wafaa What are your thoughts in terms of what you're gonna do by our, until our next episode, when we talk about the mindset?
Dr Wafaa: I will try to pause more often during the day and reflect at what I have done during that day because you never pause.
Dr Paul Ch'en: such a good good answer. I think particularly where people are just so busy for the next thing, the next thing, I think it's just that realization that we do need to pause and reflect and so I think that's a fantastic thing that you're going to do and carry forward onwards. What am I going to do mindset wise? it's a good one. I'm going to anchor it onto something positive in terms of, I'm going to try to find something that gives me joy and happiness from being positively minded about things. So one of my philosophies in life is I try to be kind to others. And I think with that, it brings a lot of joy. And I think mindset wise, I think indirectly. I think it will then help with me being more positive. And I see finding the positive side of all things. I think one of my mentors has mentioned once, consider your challenges in life, whether they're good or bad, I guess, as an opportunity. And I think if you could change that mindset towards even the hardships is something that's potentially has a positive outcome, then I think it's a win. So I think I'm going to do that.
Dr Wafaa: Excellent. think that I will try to do that as well. But one thing.
Dr Paul Ch'en: Exactly. So on that note, think the listener is your turn, as always. please have a bit of a think of what you might be able to do, given what you've just heard in terms of optimizing your mindset. So on that note, we shall call it a day, I look forward to seeing you on the next episode. So bye for now.
Dr Wafaa: Bye, a bientot!
