Dr Wafaa: Why is it more important? It's about us. ⁓ Thank you Paul for your consideration. Well, I actually talked to several of my friends that I haven't been in touch with recently. One of them actually was in need, so I was happy that I got in touch with her. She knew how busy I was, etc. And she had like this medical issue. So I thank God I sorted it out for her.
Dr Paul Ch'en: It is.
Dr Wafaa: So it's nice to get in touch with people and offer help whenever you can. And then I felt like I am still needed, you know, and I'm always needed, of course. Every mother is always needed. But the thing is that when you help someone who is in need, my God, but I'm always helping someone who is in need. I don't know, like I felt nice because she's my friend and I miss her. So it was good.
Dr Paul Ch'en: talking about social connections. Just remind me, I know that ⁓ our social we're always talking to each other, what's up with each other. And I know you love paddles. ⁓ And I that you also have groups, group tournament type things as well. And there's obviously clearly social connections. So do you do enough or do you do too much?
Dr Wafaa: Well, recently I've been doing too much because it was an opportunity. know, everyone in Ramadan is fasting all night, all day. So you either play paddle before breaking your fast or in my case, I do it, which is worse, at 10 p.m. at night. So at 10 p.m. at night, all the kids have fallen asleep, I don't have any responsibilities. I can do just exercise. So I talk into my spirituality and physical health. But the thing is that the next day it's not so good because I sleep after midnight. However, I loved playing paddle as you know, I'm not a professional because you think that I am, but I am not. But hopefully in that, going in that direction. But I have been very sore. to tell you the truth because I haven't been exercising properly. So exercise is a good thing, but if you're not exercising properly and preparing your body for that, it might actually have a negative impact on your health, which we don't want our listeners to listen to me playing pedal and getting sore. So if you can actually tuck into the NHS or read the recommendations for... the exercise routine which a normal person not a crazy one like me should be doing.
Dr Paul Ch'en: Yes, no, absolutely. I think you need to be careful. mean, I think the science is also saying that Olympians in high training and athletes at high levels also struggle later on in life because they've overdone things. So I think it is a bit of a balance. On the NHS, I know that the standard recommendation for physical activity is least something like 150 minutes of moderate intensity exercise per week. clearly I know that you had done two hours just yesterday of paddle. So you've already done your weekly quota And then I think it's like 75 of vigorous intensity aerobic activity. ⁓ instead of the moderate intensity. And I think how they mention it with the moderate intensity is ⁓ in terms of being able to maintain a conversation. ⁓ I think in terms of intensity, it's to be slightly on the edge of feeling a bit breathless while speaking. That said, mean, When I see my patients and we talk about the aspects of exercise, I always wrap it around saying, doesn't have to be exercise, physical activities is fine. And even movement is fine. And I think that the standard saying, I think somebody plucked a number out of their hat saying it's worth doing 10,000 steps a day. I think the science, depending on the age, is probably around 6,000 to 7,000 is sufficient. I think it's important to just get a flavor of the importance of physical activities and movement. Whether there is a sport that you like and you want to do exercise by all means, well done, do that. But it's again about balance balance in relation to all the other stuff that we've been ⁓ about ⁓ over the last weeks. ⁓ Wafaa we're going to take a deep dive. And again, this is more your knowledge than mine. And I will try to help say, I've come across some cool molecules, something called the hope molecules, that I think are what called myokines. So these are like cytokines. These are sort of peptides, proteins, sort of things that are within the muscle that help release when we do exercise. Do you know much about it?
Dr Wafaa: Well, I think that ⁓ when you exercise, you release certain hormones that makes you be in a good mood, fights inflammation, ⁓ improves cognitive functions, and we'll get to that in a moment. But I think that if you exercise ⁓ in functional medicine, we ask the patients, are you doing strength training, cardio, and what are your daily movements? So they should have daily movements. They should have strength training, which consists mainly of body, so weight lifting and resistance training. Because with the weight lifting, you are actually, of course, getting those myokines coming out, even with brisk walking. But with the weight training, actually for men, and as you know that as men grow, the testosterone levels decline. So the best way to improve the testosterone level is to actually do weight lifting. So this is one thing. The other thing, when you do weight lifting, you actually end the resistance training. let me just, so they are intermingling because you can't do weight lifting without doing some resistance training in it at the same time. I'm not an expert in exercise. We will get an expert in the next episode. But what I'm trying to say is with... Weight lifting is very important for both men and women. ⁓ On the stronger side, the men, because they need the testosterone, etc. Women need testosterone as well, which they can get from weight lifting. However, it prevents osteoporosis. So when you use your muscle ⁓ regularly, lifting weight and doing resistance training, you actually pull on the insertion of the muscle in the bone. in the specified bones. You have to train all the muscles in your body. And when you pull on the insertion of that muscle in your bone, you actually activate the osteoblastic activity and you improve the wear and tear of that bone. And then there is cardio, which is responsible for your cardiovascular and breathing ⁓ health. So there is aerobic exercises, like you mentioned, people don't like sometimes aerobic exercises or doing those cross fits, which is combining aerobic with resistance and weight training. So they do like maybe Zumba or dancing or something like that. with that, getting back to the hope molecules, because I always think about a thousand thing at the same time, well, they release like those peptides. hormones called serotonin, oxytocin, dopamine, and endorphins. And those hormones, you know how they are the happy hormones. They put you in a good mood. They are actually there. If we talk about just one of them, like serotonin, it actually is known as the feel-good chemical. It helps maintain feelings of happiness and stability. And we're going to talk about happiness in the next episode. And it helps in your digestive functions, the movement of your bowel, it helps in wound healing, and it helps in the sleep and wake cycle. And it has so many things, like if we just talk about melatonin, but I don't want to take all the episode talking about, sorry, serotonin, not melatonin. But... ⁓ Why I mentioned melatonin, because it helped in the wake and sleep cycle, but the best ways to boost serotonin is exercise, eating ⁓ foods that is rich in high tryptophan, and actually some exposure increases the production of serotonin. So it's amazing how a simple thing can actually... So we go back to the meds.
Dr Paul Ch'en: Mm.
Dr Wafaa: We go back to the mindfulness, so happiness, go back to the diet, go back to the... Everything goes into the same... We are in the same circle about self-care and the meds to the power three.
Dr Paul Ch'en: Yeah, totally. I mean, I think they're all linked in some way or another. And again, it's not a linear relationship. So as you optimize one domain or life domain, you'll find that actually it helps with the other bits. And overall, there's a holistic side of things. I think things start moving in your favor. And it might be that the listeners might think about the things that they can do from each of those domains first and pick at the low hanging fruit that's easier and then lean into it. And when we're talking about easier, I think it's sort of then boils down to things that we talked about very briefly about habit formation. So if you do find it very difficult to get yourself motivated to go for that walk or that run, make it just slightly easier to do it. So in the UK, we know it's raining all the time, and you might wake up, say, I can't be bothered. Well, if you've got your gear sorted out the day before, there's one less sort of roadblock or mentally to actually doing it. So I think it's important to then try to say, okay, can I get an accountability buddy to do it together? Or you then say, okay, have I packed all my gear to go to the gym? Or have I bought the latest, I don't know, racket that you feel very happy and you invested it. And you think, God, if I don't use it, God, that's a waste of money. You can sort of lean into all of these that just makes you more likely to do it. I think that the Nike slogan, I know there's copyright is just do it. ⁓ And I think it's important to, to, yeah, just do it. Whether that's the exercise, the physical activities, the movement side of things. There are various services, of course, on NHS, when we talk about sort of, sort of ties into people who struggle with losing weight. ⁓ But also in terms of lifestyle medicine side of things, I think there are going to be community services that sort of type into just general exercise. Or if not, you might want to go on a communal walk. So I know last week we were talking very briefly again, over the previous weeks we were talking about the Oxford Longevity Project that I'm involved with. We've started doing walks, community walks. And again, that's exercise. And it's got that social component as well, because we can make friends. So Wafaa and Elliot in the background, I'm looking forward to seeing you guys on the next walk at the Oxford Longevity Project. But I think it's very... I think we can try to ways to...
Dr Wafaa: Yes, I hope so too. Yeah.
Dr Paul Ch'en: Nudge yourselves to do a bit more. So Wafaa anything else in the mix?
Dr Wafaa: Yeah, it reminds me when you mentioned the Oxford Longevity Project and then there was the Oxford Summit that ⁓ I attended last year and then I saw Angela Rippon. So Angela Rippon as far as I ⁓ remember, she's like an English broadcaster, former newsreader, journalist, et cetera, but she was a dancer. And she gave this amazing lecture about dancing and how it optimizes your
Dr Paul Ch'en: ⁓ yes. Mmm.
Dr Wafaa: She didn't mention the hope molecules, but I'm sure if she knew it, she would have mentioned it definitely because this was what she was aiming at. And she talked to us about this clinical study about people exercising in the gym for six months versus people exercising in the, dancing for six months and how it differs that dancing with the happiness. So the component of happiness whilst exercising is more important than.
Dr Paul Ch'en: No.
Dr Wafaa: just exercising alone. I'm sure that people going to the gym are actually benefiting big time. But the thing is that when you do mindful exercise versus mindless exercise, and if we combine both, maybe, maybe the listeners in the gym can listen to our podcasts. So it would be a mindful exercise for them. But and then she mentioned also the the power of dancing with improving the ⁓ the tremors for Parkinson's patients. And that was for me, it was mind blowing and I loved it. And I think, and you can talk about this more, that she has implemented dancing at the NHS. She mentioned that at the end of the talk.
Dr Paul Ch'en: Hmm. Yes, I think there are places where they're incorporating dance. And Dennis Noble, for instance, my other colleague, I mean, he started dancing during the COVID pandemic and he's now turning 90. And he just said it's been a huge change for him. And I think it's, mean, whatever little helps. I mean, even talking about this is quite funny because once you mentioned about serotonin, I can just see the image of Wafaa dancing with Angela Rippon. ⁓ it just puts a smile. puts a smile on my face. So already my serotonin, dopamine, the endorphins, oxytocin, even just thinking about it and watching, I remember you on you dancing and everyone dancing and having a laugh.
Dr Wafaa: Yes, but they caught me on camera. ⁓
Dr Paul Ch'en: We just blasted it on our media platform. Yes.
Dr Wafaa: Yeah, it was amazing. Yeah, bottom line, Paul, I would love everyone, like as we discussed in our earlier episodes, like walking is a very nice habit to start exercising because you cannot ask someone who is overweight or who is depressed, like go to the gym and lift weights. So you start by implementing everything together that we discussed about. You find someone that you like, you walk every day with.
Dr Paul Ch'en: Yes, sir.
Dr Wafaa: and you finish the walking by having a ⁓ meal, like a breakfast that is high in protein, good fat, et cetera. So you will have like your social connection, your exercising, you will be happy being with that friend. And so I think that would be the perfect thing, like ⁓ a very good habit. You will not have that friend available every day, but you can build a community. You start with one friend and then it depends. So are you like a mother like me who drops her children and go walking? Or are you a retired person who actually have the time and you can do it any time of the day? Or are you, well, when it comes to children, and this is something very important because I have seen a lot of mothers pushing their kids into doing like three types of trainings per day. And when I look at the diets that the kids are eating these days, the chicken strips, burgers, no vegetables, French fries, how the hell are they going to build their muscles, good muscles in order to give them those hormones and in order to help them during their growth spurt as well. So it is very important that from a very early age you teach your children to eat the broccoli, to have the avocados, to have the walnuts rather than the cashews, because cashews, like everybody loves cashews, but to have the...
Dr Paul Ch'en: you
Dr Wafaa: to just implement the good things, not to give them the candies that turns your tongue blue. But instead they can have the apple, they can have the mangoes, they can have the ⁓ acai. Now there is like a trend in Egypt, like the acai ice cream. We know of course the power of the acai as being like an antioxidant, et cetera. Well, a trend or not, it's healthy and I'm happy that it's there. But we have to be very mindful about who is exercising.
Dr Paul Ch'en: Yeah.
Dr Wafaa: their physical status, their age, if they have any other comorbidities. And then us as doctors can actually ⁓ personalize that training to the person that we are talking with. And I hope that our listeners who are having excellent doctors and they can also reach out to us whenever they want for advice. And we will have that exercise expert in our next season. So it's not me.
Dr Paul Ch'en: Absolutely. Absolutely. I mean, I'm on I'm just on another basic level at the moment for for where I am. But I think what you say, it totally resonates and makes a lot of sense. And I think it's also important to make sure that whilst the hormones will help itself as you do it, make sure to enjoy it. So it shouldn't be a chore, it shouldn't be a task. So surround yourself with the people that you like, or make it a fun thing, because no habits are sustainable, if it's not very fun.
Dr Wafaa: Yes. Yes.
Dr Paul Ch'en: And you can put fear in the mix as your initiator, but fear is not sustainable either. So I think it's important to then find ways that make it fun at the end of the day. Okay, well on that note, I know that we usually have our normal, what are we gonna do? I know what I'm gonna do. So what I'm gonna do is, well, I'm just gonna tell what Wafaa just says. So I'm looking forward to our next Oxford Longevity Project walk. I know Wafaa and Elliot in the background, you'll both be there. And then we'll then go for a long walk, we'll chat away, that's the social connections. And then we can have a nice English British tea afterwards for Wafaa who loves Oxford, to then have the dietary side of things with good stuff. That's what I'm to do. And yourself, what are you going to plan to do?
Dr Wafaa: So Paul, for me, I think I'm going to start going to the gym gently and slowly because I don't want to hurt myself. But it's very important for me if I'm going to, how do you say, make your dreams come true about me being a professional pedal player. So it's all the, but we have to take it gently so that I wouldn't hurt myself because if I don't start working out gently, I might actually end up hurting myself in a paddle game, et cetera. And the more like you feel good about your muscular structure, you don't have lower back pain from sitting in front of the laptop all day, et cetera, you will feel happy. And you will do the next step. So I'm just looking forward into implementing that gently and slowly. And I just have to admit one thing that I hate to go to the gym. is one thing. so maybe in the Oxford Longevity Walk we can get those, you know, like weights around our wrists and ankles ⁓ while we're walking we'll be having weights while walking as well, maybe.
Dr Paul Ch'en: I have got this. I can dig it out from the upstairs, I've got some of those. ⁓ But yes, promise me, Wafa, that try not to overdo the paddle.
Dr Wafaa: Yes. I promise you. I promise you.
Dr Paul Ch'en: Well on that note listeners, hope you guys can also have a bit of a think what you might be able to do in terms of exercise or physical activities or movement. And then on that note, I think we're quarter of the day. So thank you as always and we look forward to seeing you soon. Bye for now.
Dr Wafaa: Bye!