Food for Thought: Kimberley Wilson on the Science Behind a Healthy Brain & Mental Health

In this episode of Sound Living, Dr Mike Banna is joined by chartered psychologist and author Kimberley Wilson to explore the intricate connections between lifestyle, nutrition, and mental health. They discuss how this evidence-based conversation goes beyond simplistic notions of well-being, delving into the complex interplay between our dietary choices and brain function.

Drawing on insights from her book, How to Build a Healthy Brain, Kimberley explains how nutrition significantly influences behaviour and cognitive function, drawing on her experiences in high-pressure environments such as prisons as compelling examples. She also examines how societal structures and systemic barriers shape our dietary choices, advocating for both individual lifestyle adjustments and the development of compassionate, supportive public health policies.

Guest:

Kimberley Wilson (@foodandpsych)

Episode Transcript

Intro and Outro: Hello and welcome to Sound Living, a podcast by the British Society of Lifestyle Medicine. (00:05):
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Intro and Outro: Join me, your host, Dr. Mike Banna, as I chat to experts on various topics (00:10):
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Intro and Outro: related to health and well-being to figure out evidence-based approaches to (00:15):
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Intro and Outro: help people get the most out of lifestyle change. (00:19):
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Intro and Outro: I hope you enjoy listening to this episode as much as we enjoyed recording it. (00:40):
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Mike: Hello and welcome to this latest episode of the BSLM podcast, Sound Living. (00:48):
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Mike: Today I am joined by the incredible Kimberly Wilson. Hello, Kimberly. How are you? (00:55):
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Kimberley: Hi, I'm very good. How are you? (01:00):
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Mike: I'm really well, thank you. It's lovely to be here. It's lovely to catch up anyway. (01:03):
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Mike: I feel like I follow your content and the stuff that you put out on socials (01:07):
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Mike: and your lives and things so closely. (01:11):
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Mike: I feel like I speak to you all the time. (01:13):
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Mike: But today, this is a proper conversation. (01:15):
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Kimberley: Yeah, exactly. (01:18):
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Mike: Actual talking. I love it. Thank you so much for being here. (01:19):
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Mike: First of all, it's really lovely to have you here. (01:22):
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Mike: Like I said, I've been following your content for a long time. I've (01:25):
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Mike: really enjoyed your book how to build a healthy brain and I (01:29):
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Mike: thought it would just be really interesting to explore a few (01:32):
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Mike: of your ideas and sort of things that things that I've learned from you sort (01:36):
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Mike: of through social media I feel like you're an amazing voice on that platform (01:40):
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Mike: the way that you introduce concepts that might not be massively familiar to (01:44):
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Mike: everybody I think is really impressive I think you do it in a way that is very accessible to people, (01:48):
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Mike: And you're very good at making people think in a way that doesn't feel forced (01:55):
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Mike: or forceful, but that makes people actually like I often find myself changing (02:00):
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Mike: my mind quite a lot when I read this stuff. So I love that. I absolutely love it. (02:04):
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Mike: So thank you for that. But before we go further, I wonder if you might be able (02:10):
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Mike: to tell us and our listeners a little bit about yourself for those who may not yet know who you are. (02:15):
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Kimberley: Mm-hmm, sure. So I am a chartered psychologist, a chartered counselling psychologist, (02:20):
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Kimberley: so trained in working one-to-one with people around their mental health issues. (02:27):
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Kimberley: And part of my training, I worked with children and adolescents, (02:34):
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Kimberley: but for the most part, I work with adults. (02:38):
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Kimberley: And then I did a couple of extra master's degrees, (02:40):
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Kimberley: and one of those is in nutrition, and in that I specialised in the role of nutrition (02:45):
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Kimberley: and diet in brain health and really neurodegeneration, so brain ageing. (02:52):
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Kimberley: So looking at the relationship between the food that we eat and how that affects (02:57):
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Kimberley: the structure and function of our brains and how that might then impact how our brains age. (03:01):
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Kimberley: And so within part of that became, you know, because nutrition is a lifestyle (03:07):
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Kimberley: factor, you know, what are the other lifestyle factors that might have an influence (03:12):
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Kimberley: on how our brains are built and (03:15):
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Kimberley: how they function so um i kind of (03:18):
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Kimberley: integrate those ideas so (03:21):
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Kimberley: lifestyle nutrition i'm sleep assessment (03:24):
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Kimberley: trained as well so i can look at people's sleep um and (03:27):
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Kimberley: kind of stress management the kind of standard psychological things and bring (03:31):
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Kimberley: those together in my understanding of what's troubling my clients and patients (03:35):
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Kimberley: because my frustration with traditional psychological therapy training and practice (03:39):
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Kimberley: is that it largely ignores trauma. (03:49):
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Kimberley: Body and the outside world and their influence on the brain and i think we need to really work to. (03:51):
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Kimberley: Reintegrate the two so that's kind of what i do and uh sharing research and (03:58):
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Kimberley: information and occasionally political rants on social media is i think a a (04:03):
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Kimberley: side a side dish to all of that main main content. (04:09):
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Mike: And we will definitely explore that further as well i'm sort (04:12):
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Mike: of interested to know kind of how um i mean (04:16):
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Mike: obviously well not obviously we know really (04:19):
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Mike: from you know a lot from your content and from from what (04:21):
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Mike: we've sort of been seeing happening in the world over the last few years (04:25):
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Mike: um how much of an impact food has on people's psychology but what kind of prompted (04:28):
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Mike: you to to to want to delve into that side of things i mean you you're called (04:36):
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Mike: food and psych on social media and And so those two things are obviously really (04:40):
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Mike: huge parts of what you do. (04:45):
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Mike: And as you've mentioned, psychology was sort of the main part of your training (04:46):
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Mike: and the main part of your job. (04:50):
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Mike: What made you kind of want to bring nutrition into that? (04:52):
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Kimberley: It was, you know, I'm sure there are kind of lots of small things that happened (04:56):
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Kimberley: along the way that only really makes sense when you look back on them, (04:59):
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Kimberley: you know, little events in your life that had an effect, but probably on an unconscious level. (05:03):
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Kimberley: The thing that really sticks out for me that seems to make the most kind of (05:09):
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Kimberley: overt logical sense is my experience working in prisons. (05:14):
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Kimberley: And so I was working in prisons towards the end of my training and really the first part of my career. (05:18):
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Kimberley: And I was managing the primary care mental health service, so the therapy service (05:25):
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Kimberley: for the prison, which was a women's prison. (05:31):
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Kimberley: It was Europe's largest women's prison at the time. And essentially my job was (05:33):
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Kimberley: to run an assessment clinic, understanding what the psychological and psychotherapeutic (05:38):
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Kimberley: needs were for the women coming through the prison, (05:44):
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Kimberley: to have my own caseload and also to assign patients to my team of therapists. (05:46):
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Kimberley: And part of that work is about understanding risk. (05:53):
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Kimberley: So both the risk that people pose to themselves, the risk of perhaps missing (05:58):
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Kimberley: medication, you know, because sometimes it takes a little bit of a while to (06:04):
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Kimberley: get their external medication prescribed inside. (06:07):
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Kimberley: The risk that they might pose to each other within the prison system, within the building. (06:11):
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Kimberley: And understanding what their needs were in relation to those risks. (06:18):
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Kimberley: So part of my job was to sit with a team and look around, look at risk and security once a week. (06:22):
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Kimberley: And during that time that I was kind of thinking both about mental health and (06:28):
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Kimberley: both about risk and security and safety, a replication of a study was published. (06:33):
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Kimberley: And it was a prison study and it was a replication that was done in prisons in Holland, (06:38):
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Kimberley: the MOJ, and they found, and what's remarkable about it is that they found very (06:46):
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Kimberley: similar results and quite often when you're looking at RCTs, (06:52):
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Kimberley: there are kind of quite large variations in the magnitude of the effect depending (06:55):
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Kimberley: on where it's done and you sit down and you think, (07:01):
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Kimberley: well, is that because of expectation effects on (07:03):
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Kimberley: the on the part of the researchers or (07:06):
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Kimberley: is it about specific effect specific aspects of (07:09):
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Kimberley: the population that you're testing is it about baseline variables (07:12):
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Kimberley: that we have or haven't accounted for but these found very similar effects to (07:16):
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Kimberley: the original study and they found that when you improve nutritional status in (07:20):
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Kimberley: prisoners and in this case it was through supplementation rather than whole (07:25):
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Kimberley: food but when you improve nutritional (07:29):
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Kimberley: status in prisoners you reduce objective incidents of violence. (07:31):
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Kimberley: So the number of times someone gets punched in the face or barricades a cell (07:35):
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Kimberley: or starts a fight or harms themselves. (07:39):
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Kimberley: By about 30%, which is an extraordinary amount for something as small, (07:43):
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Kimberley: safe and innocuous as a vitamin pill. (07:52):
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Kimberley: I mean, these were fairly high dose, but essentially what they were doing was (07:55):
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Kimberley: getting people up back to the recommended daily amount of nutritional intake. (07:58):
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Kimberley: And so that had first been shown in 2002. And then this replication came out, (08:04):
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Kimberley: I think, somewhere around 2010, 2011. (08:09):
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Kimberley: And then since then there have been two more international replications RCTs (08:12):
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Kimberley: showing the same effect and but at the time what I (08:16):
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Kimberley: was thinking was well you know we have something we're thinking (08:19):
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Kimberley: about safety we're thinking about how to keep people well (08:22):
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Kimberley: we're thinking about how to reduce the costs of staffing and (08:25):
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Kimberley: reduce the amount of time that we have to go into lockdown because when there's (08:28):
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Kimberley: a big incident in a prison you go into lockdown either (08:30):
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Kimberley: the whole wing gets locked down no one's allowed to move or the whole prison gets locked (08:34):
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Kimberley: down which means you know staff can't go home nobody can (08:37):
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Kimberley: go in you have to kind of contain the situation before anything (08:39):
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Kimberley: moves again um and this was happening fairly frequently um and so you know we (08:43):
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Kimberley: had this incredible intervention and so i thought you know this is incredible (08:47):
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Kimberley: um it's effective it's cheap the only side effect is people get healthier um (08:52):
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Kimberley: why are we not doing this um and well that's a. (08:58):
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Kimberley: My kind of conscious understanding of the relationship between nutritional status, (09:07):
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Kimberley: behavior and brain function really sort of came together. (09:12):
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Mike: Amazing. And so then at what point did you then decide to, because you've written (09:16):
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Mike: your book, How to Build a Healthy Brain. (09:20):
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Mike: I mean, that's pretty all encompassing about, you know, in terms of, (09:23):
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Mike: you know, brain health and all of the different things that impact it and how, (09:27):
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Mike: what we can do to try and improve on it. (09:31):
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Mike: Sort of at what point in the process was that that was presumably after you'd (09:35):
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Mike: done your master's and all that kind of. (09:38):
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Kimberley: Stuff as well yeah so that was a little while afterwards so i'd stopped working (09:40):
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Kimberley: in the prisons i was working in private practice at that point but i was um (09:45):
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Kimberley: the governor of a um an nhs mental health trust, (09:49):
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Kimberley: and uh again it was a kind it was a hospital trust specific to mental health (09:54):
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Kimberley: but it was a hospital trust and again we're thinking about safety and risk and (09:58):
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Kimberley: the things that we can do yes, there's provision of very excellent psychotherapeutic (10:02):
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Kimberley: care, but what are the other aspects of those people's lives? (10:06):
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Kimberley: You can give them therapy one hour a week, but then they go out into the world. (10:10):
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Kimberley: And what can you give them there to help support their mental health recovery (10:14):
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Kimberley: or safety or management? (10:19):
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Kimberley: And I remember talking to colleagues, another governor on the council, (10:21):
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Kimberley: and telling him about this research, you know, maybe we should think (10:28):
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Kimberley: about the quality of the nutrition and he laughed in my face and (10:31):
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Kimberley: I just thought isn't this extraordinary you (10:34):
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Kimberley: know we're in look at the setting that we're in we're in a set (10:38):
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Kimberley: we're in a therapeutic mental health setting and even my colleague cannot kind (10:40):
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Kimberley: of take in the possibility that nutrition has an impact on the structure and (10:48):
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Kimberley: function of the brain it was just extraordinary and so I thought you know if. (10:54):
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Kimberley: There's there's something quite wrong if we can't consider the idea that the (11:00):
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Kimberley: brain is an organ that might need good nutrition in order to function well and (11:04):
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Kimberley: it was at that point i thought i think i think this needs a little bit more (11:08):
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Kimberley: attention and i think it needs more advocates um and that if i can't get because (11:11):
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Kimberley: i couldn't get the prison on board, (11:17):
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Kimberley: I couldn't really get the council on board. I was like, well, fine. (11:19):
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Kimberley: Well, let me just, let me do what I can for my patients and let me then just (11:22):
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Kimberley: pop onto social media and let people know. (11:28):
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Kimberley: And, you know, I'll, I'll put the information out there and if people want to find it, they can. (11:31):
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Kimberley: But it really struck me then how, how little knowledge there was, (11:36):
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Kimberley: but also how entrenched this duality this dualism between mind and body was (11:41):
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Kimberley: that it just seemed inconceivable that was that what was happening in the body (11:48):
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Kimberley: might have an effect on the brain um thankfully uh minds are changing and people (11:52):
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Kimberley: are coming around but it was it was a bit of a slog to be honest but. (11:57):
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Mike: It and it kind of sounds like you know when you when you describe the study (12:01):
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Mike: and you describe the information it kind of sounds when you're saying it like (12:04):
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Mike: it's making me think why on earth don't we know this already why on earth isn't (12:08):
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Mike: this you know informing our practice like you say these are. (12:13):
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Kimberley: Simple things. (12:17):
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Mike: That are easy to implement on that sort of thing i mean obviously i'm not in (12:17):
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Mike: charge of running prison so i don't know how easy it is really but they're things that sound quite. (12:21):
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Kimberley: Straightforward it kind of is because i (12:26):
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Kimberley: think particularly for prison um it's not (12:30):
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Kimberley: like there aren't a lot of drugs going around prison you know kind of (12:32):
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Kimberley: prescribed and otherwise um there are very very clear mechanisms for the dispensing (12:35):
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Kimberley: of of pills in prison yeah so it's not like you would need to develop new strategies (12:41):
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Kimberley: or new protocols in order to be able to give out pills like we have these systems (12:47):
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Kimberley: in place it would simply be that one of the pills that you gave out, (12:51):
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Kimberley: was a multivitamin yeah so that was what was so astonishing about the unwillingness (12:56):
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Kimberley: to kind of engage with the research when i was at the prison at the time sorry i interrupted no. (13:00):
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Mike: No not at all I mean, I guess that sort of just brings me to my next question, (13:07):
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Mike: really, which is, I mean, like you alluded to earlier, you're quite open about, (13:12):
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Mike: I guess, the importance of understanding that in order to be vocal about things (13:16):
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Mike: like people's lifestyles and nutrition and all of those sorts of things, (13:22):
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Mike: we have to accept that we might also need to be vocal on a political level as well. (13:27):
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Mike: And that there is often quite a reluctance to do (13:31):
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Mike: this particularly in the public space particularly in health particularly (13:34):
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Mike: in social media um i guess for a (13:37):
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Mike: lot of people it's considered to be um overstepping (13:40):
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Mike: boundaries i guess you know people always say never talk about politics or religion (13:44):
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Mike: don't they but but there is just kind of this this apologism almost every time (13:47):
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Mike: anything political is brought into the conversation people say i don't normally (13:51):
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Mike: post anything political but i'm just gonna have to say this because it's about (13:55):
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Mike: something i feel strongly but we're often quite reluctant to do that. (13:58):
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Mike: A leading question do you. (14:03):
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Kimberley: Think it's possible to to. (14:05):
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Mike: You know improve people's lifestyles to actually change the health of our nation (14:08):
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Mike: without talking about politics. (14:12):
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Kimberley: Not in any sustainable or comprehensive way no I don't think so I think with (14:15):
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Kimberley: because essentially when we're talking about politics we're talking about policy (14:23):
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Kimberley: and if we're talking about population health then you're talking about policy (14:26):
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Kimberley: that affects the entire country. (14:33):
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Kimberley: If you're not engaging with policy, policymakers or politics, (14:35):
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Kimberley: then what really what you're doing is trying to get the information out to millions (14:40):
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Kimberley: of individuals one by one. (14:45):
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Kimberley: And if I mean, you and I will both know that behavior change on an individual (14:49):
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Kimberley: basis is incredibly hard, right? You have to sit down and counsel that person. (14:53):
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Kimberley: You have to understand what the barriers are to their individual opportunities. (15:00):
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Kimberley: You have to understand their motivation. (15:03):
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Kimberley: You have to understand the barriers or hurdles that might come up, (15:05):
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Kimberley: whether those are financial or cultural or geographical. (15:09):
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Kimberley: And you have to try to account for all of those one by one. We don't have enough (15:14):
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Kimberley: practitioners to do that. (15:18):
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Kimberley: It's just not a practical solution to what is a wide-scale problem. (15:20):
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Kimberley: And the wide-scale problem from my position is, (15:26):
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Kimberley: is that rates of mental health in the UK are dropping. They're bad at the moment (15:28):
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Kimberley: and they're getting worse. (15:33):
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Kimberley: And we've apparently had very successful medications, effective medication for 70 years. (15:35):
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Kimberley: And yet the rates of treatment-resistant depression, the rates of anxiety. (15:43):
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Kimberley: The rates of just low-grade misery are the same or worse. (15:47):
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Kimberley: And from that point, you have to say, well you can't lay the (15:53):
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Kimberley: blame and the responsibility of the individuals because psychology isn't (15:57):
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Kimberley: just personal people's psychology is affected by (16:01):
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Kimberley: their interactions with the environment you can't be (16:04):
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Kimberley: cheerful chipper and happy if you can barely pay your (16:07):
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Kimberley: bills or if you're staying up at night wondering when when (16:10):
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Kimberley: your money's going to come in so that you can pay your rent or pay (16:13):
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Kimberley: that bill pay that bill that's not about personal responsibility (16:16):
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Kimberley: that's about social inequality it's (16:19):
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Kimberley: about the cost of living it's about the (16:23):
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Kimberley: stagnation in wages those are the (16:26):
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Kimberley: things certainly psychologically which press on (16:29):
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Kimberley: people's minds and erode their mental health so you know my first book you know (16:32):
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Kimberley: a large part of it was about personal you know telling people what you can do (16:36):
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Kimberley: and I think particularly for things like neurodegeneration there is a general (16:40):
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Kimberley: belief that there isn't anything you can do and so there was an aspect in which (16:44):
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Kimberley: I wanted to be able to bust that particular myth. (16:47):
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Kimberley: But my last chapter was, are you a policymaker? If you're a policymaker reading (16:50):
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Kimberley: this, you need to understand that you have a responsibility to do something (16:54):
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Kimberley: to improve population health. (16:58):
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Kimberley: Because what we need is a cultural change in the way that we approach lifestyle and mental health. (17:00):
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Kimberley: And that cultural change can only happen through the enacting of policies designed (17:07):
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Kimberley: for the long-term improvement and betterment of people's health. (17:12):
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Kimberley: So i think no. (17:17):
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Mike: Yeah i mean i definitely i definitely (17:18):
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Mike: agree with you and i i think it is it's often quite frustrating (17:21):
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Mike: i think as a practitioner when you (17:24):
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Mike: are faced with a situation where you're speaking to a patient and (17:28):
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Mike: it feels like it feels like you're (17:31):
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Mike: often over medicalizing the problem in the sense (17:33):
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Mike: that yes the mental health is being eroded but it (17:36):
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Mike: is being eroded potentially by external factors and (17:39):
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Mike: external circumstances which you can't (17:42):
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Mike: treat with medication and you can't even necessarily treat with (17:45):
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Mike: with therapy but those are the things that you can offer (17:48):
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Mike: as a practitioner so in your you know in your desperation to make somebody feel (17:51):
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Mike: better of course that's what your those are the things that you're going to (17:54):
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Mike: resort to but it's it feels like such a pity that there aren't sort of processes (17:57):
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Mike: in place where you can go right you know let's refer you to a life management (18:02):
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Mike: service where we can you know well i guess there There are. (18:07):
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Mike: I mean, with social prescribing and things like that, there are some improvements (18:10):
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Mike: being made in terms of that from an NHS perspective. (18:13):
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Mike: And I think things are a little bit moving in the right direction. (18:17):
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Mike: But then it feels like what's now coming with that is then a cost of living (18:21):
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Mike: crisis, which then is then setting it back several steps as well. (18:24):
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Mike: So it is really frustrating. (18:27):
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Mike: And I guess that's something else I sort of wanted to touch on with this. (18:29):
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Mike: It's slightly off topic to what we're speaking about at the moment. (18:34):
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Mike: But, you know, there's so much more awareness about things like mental health, (18:36):
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Mike: about people talking about psychology, about people talking about how people (18:39):
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Mike: are in terms of their mental well-being. (18:45):
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Mike: Um and there's also all (18:46):
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Mike: of this clunky terminology like the fact that people (18:50):
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Mike: use anxiety to describe an emotion but they also use it to describe a clinical (18:53):
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Mike: disorder do you think that that um we're also seeing a little bit of over diagnosis (18:57):
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Mike: of medical problems when actually the problems are more social or political or lifestyle related i. (19:03):
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Kimberley: Think i'm not sure if it's over diagnosis because I don't think it's the clinicians. (19:11):
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Kimberley: An overgeneralization of psychological terms, I think, is an issue. (19:16):
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Kimberley: And I think it comes up in a few ways. (19:22):
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Kimberley: So to kind of take off from your first point, there is such a responsibility, (19:25):
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Kimberley: I think, especially as a psychologist, when you are presented with someone and (19:31):
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Kimberley: their despair or their distress is, (19:36):
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Kimberley: to not just try to make someone well enough to stay in a dysfunctional system, right? (19:40):
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Kimberley: Or at least to let them know that they're in a dysfunctional system. (19:49):
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Kimberley: So if someone is coming to me and saying. (19:52):
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Kimberley: You know, I'm depressed, but also then they describe a kind of hellish work (19:56):
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Kimberley: environment where nothing is predictable or where their boss is a bully, (20:01):
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Kimberley: well, then your distress is a reasonable response (20:07):
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Kimberley: to these horrible environmental factors and (20:10):
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Kimberley: my responsibility isn't just to try to make (20:13):
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Kimberley: you cope better with mistreatment ideally my (20:16):
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Kimberley: my my task then that i see for myself (20:20):
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Kimberley: is to either help you to advocate for yourself or to help you get (20:23):
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Kimberley: out because actually the treatment then is to get out of a (20:26):
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Kimberley: harmful environment um that's not (20:29):
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Kimberley: always possible but it's it's that kind of holding the (20:32):
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Kimberley: tension between what is internal and what is external um and (20:35):
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Kimberley: not making people responsible or making them feel guilty for (20:38):
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Kimberley: not coping with situations that (20:41):
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Kimberley: they shouldn't really be expected to cope with um i (20:44):
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Kimberley: think in terms of this kind of over generalization i think (20:48):
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Kimberley: at least a couple of things happen one is (20:51):
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Kimberley: that people i think well-intentioned um have (20:54):
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Kimberley: their own good experience perhaps or of (20:59):
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Kimberley: therapy of psychology or (21:02):
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Kimberley: of their own reading around what they felt their experience to (21:05):
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Kimberley: be and they want to kind of proselytize or (21:08):
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Kimberley: be an advocate for that and then they go on social media and do (21:11):
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Kimberley: so um the problem (21:13):
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Kimberley: with that is that (21:17):
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Kimberley: well first of all um if. (21:20):
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Kimberley: You're not an experienced practitioner you can't offer the (21:25):
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Kimberley: kind of nuance and the understanding of what your (21:28):
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Kimberley: symptoms were and what the treatment was (21:31):
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Kimberley: for you and how that might work for (21:33):
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Kimberley: somebody else um also you (21:37):
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Kimberley: you don't know anything about contagion and expectation effects now this is (21:41):
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Kimberley: one of the things that really worries me quite a lot um because we know that (21:46):
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Kimberley: the more that someone reads or engages with symptom lists so i'm thinking particularly about those um. (21:51):
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Kimberley: Posts that say five signs that you were traumatized in childhood, (22:00):
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Kimberley: or five signs that you are a high functioning neurotic, or five signs that you have anxiety disorder. (22:04):
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Kimberley: The more you engage with that kind of material, actually, what psychologists (22:11):
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Kimberley: know is that you build an expectation effect, or what you might call a nocebo effect. (22:16):
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Kimberley: And you can end up increasing the likelihood that someone will experience those (22:21):
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Kimberley: symptoms or that distress simply because they're engaging with that material. (22:27):
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Kimberley: So there's a problem with people posting that kind of material, (22:32):
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Kimberley: but then there's a problem with the algorithm that once you've already engaged (22:34):
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Kimberley: with that material, you're going to see more of it. (22:37):
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Kimberley: So there's a way in which we might be at risk of really spreading mental health (22:40):
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Kimberley: contagion through social media. (22:45):
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Kimberley: And then the other problem is about not understanding, (22:48):
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Kimberley: again, the impact of the political environment on (22:53):
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Kimberley: mental health so for example what the (22:56):
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Kimberley: research tells us is that mental health (23:00):
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Kimberley: is worse in more unequal societies right (23:03):
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Kimberley: so that and the UK is one (23:07):
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Kimberley: of the most unequal societies in Europe probably the (23:10):
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Kimberley: well I think I think we're kind of bested by Bulgaria (23:13):
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Kimberley: or something like that you know but we're up there in the in the top worst (23:17):
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Kimberley: and of the OECD countries the US (23:20):
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Kimberley: is the most unequal and the reason (23:24):
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Kimberley: that this is really important to understand is that the more unequal a society (23:27):
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Kimberley: is right so the more that a big chunk of the wealth sits with a few people at (23:32):
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Kimberley: one end of the spectrum and then you have a group of people who are utterly (23:37):
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Kimberley: destitute you know the big the gap the widening gap between those two sets of people, (23:40):
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Kimberley: the more anxious and distrusting your society. (23:46):
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Kimberley: And the more anxious and distrusting your society, and the more you have these (23:51):
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Kimberley: kind of hierarchies of haves and have-nots and the steepness of that hierarchy, (23:56):
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Kimberley: the more people are imbued with a sense of inferiority. (24:00):
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Kimberley: You know, I'm not good enough. There are some people at the top who have all (24:05):
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Kimberley: the money, all the power, all the generational wealth. (24:08):
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Kimberley: They are the ones that are considered to be valuable human beings and they are worthy. (24:12):
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Kimberley: And every level beneath that, people have worse and worse mental health outcomes (24:16):
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Kimberley: and a worse sense of their own value and self-worth. (24:21):
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Kimberley: And then within that, in order to make yourself feel better, (24:25):
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Kimberley: markers of status become much more important. (24:29):
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Kimberley: So markers of status around body image or accumulation of expensive items, (24:32):
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Kimberley: but also things like imposter syndrome. (24:37):
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Kimberley: So if you're walking around in a world where actually people are judging you (24:42):
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Kimberley: and people are comparing and people are making these judgments about their superiority (24:46):
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Kimberley: and your inferiority, you (24:51):
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Kimberley: Do you have anxiety? Do you have imposter syndrome? (24:54):
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Kimberley: Or are you actually responding in an accurate way to the social environment? (24:57):
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Kimberley: And so there's a real complex that needs to be understood which cannot be gotten (25:03):
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Kimberley: at by simply throwing around words like anxiety, high-functioning anxiety, imposter syndrome. (25:11):
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Kimberley: And that's one of the frustrations about the overgeneralization of psychological terminology yeah. (25:17):
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Mike: I i see i didn't you know i didn't know that about the about the data about (25:26):
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Mike: people being being exposed to that that really makes me feel really uncomfortable (25:31):
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Mike: about a lot of the you know spreading awareness on social media which actually (25:36):
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Mike: is potentially harmful in those sorts of. (25:40):
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Kimberley: Situations why i don't do any of those posts those five signs that you because (25:42):
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Kimberley: you know they're very popular they get a lot of engagement but ethically i can't (25:47):
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Kimberley: engage with that kind of material that's. (25:52):
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Mike: Absolutely fascinating what makes us because i also did not know that about (25:55):
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Mike: us being one of the most um like different societies what makes what what makes (25:59):
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Mike: us have that what are the statistics that that that mean, (26:04):
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Mike: that is there just is it the is it from a poverty perspective particularly or (26:07):
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Mike: from like a class perspective or. (26:12):
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Kimberley: A little bit of both but often often (26:13):
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Kimberley: class is is kind of there's a crossover between class (26:17):
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Kimberley: and markers of poverty right but it's largely about poverty (26:20):
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Kimberley: and the policies that mean that (26:24):
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Kimberley: people end up staying in poverty or not so we have (26:26):
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Kimberley: basically no social mobility in the UK anymore (26:29):
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Kimberley: and again this is one of the the the things that undermines this idea of meritocracy (26:32):
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Kimberley: the idea that if you just try hard enough which is the kind of general message (26:38):
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Kimberley: that you'll see everywhere if you hustle hard enough if you try hard enough (26:42):
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Kimberley: if you want it enough you can make it and sure absolutely there are going to be some outliers, (26:46):
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Kimberley: that we'll be able against the odds to get to the top. (26:52):
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Kimberley: The problem with that is that we then have this kind of survivorship bias where (26:55):
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Kimberley: we see those people up on a pedestal and think, well, if they did it, everybody else can. (26:59):
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Kimberley: And they even start to think, well, if I did it, everybody else can. (27:03):
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Kimberley: And they exclude or miss or ignore the aspects of luck that helped them on their way. (27:06):
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Kimberley: Yes, they worked hard, but they (27:14):
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Kimberley: all say they probably got lucky somewhere along the line, as we all do. (27:15):
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Kimberley: Um but it's it's really these it's (27:20):
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Kimberley: the policies which mean for example that (27:25):
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Kimberley: wealth can accumulate at the top and (27:28):
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Kimberley: it doesn't trickle down we know that trickle down economics doesn't work (27:31):
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Kimberley: when people get money they don't share it out they (27:34):
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Kimberley: hoard it they keep it or they (27:37):
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Kimberley: spend it on themselves like that's what happens and and (27:40):
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Kimberley: it doesn't trickle down um and so (27:44):
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Kimberley: it's the economic policies around austerity (27:47):
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Kimberley: reductions in benefits the quality of state funded education those sorts of (27:50):
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Kimberley: things which end up keeping people at the bottom of of income or kind of wealth trapped there. (27:56):
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Kimberley: And also feeling worthless because they don't have those markers of status, (28:08):
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Kimberley: which means they could, you know, fit in in different environments or feel like (28:12):
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Kimberley: they could move their way up the ladder. (28:16):
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Kimberley: And other things like, you know, social housing costs. (28:18):
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Kimberley: One of the things that we consider to be a marker of adult achievement in the (28:21):
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Kimberley: UK, which isn't the same on the continent, is house home ownership, right? (28:26):
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Kimberley: If you own a home, you've made it as a sensible, reasonable (28:30):
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Kimberley: adult we can take you seriously but the (28:34):
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Kimberley: fact is that it costs so (28:37):
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Kimberley: there's so much good social housing stock and our policies around private rents (28:41):
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Kimberley: mean that people can charge extortionate rents as private landlords which means (28:46):
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Kimberley: that people can't save which means they have to you know and so they kept paying (28:51):
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Kimberley: huge proportions 60 70 80 percent of their income, (28:57):
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Kimberley: on their rent on the continent there is more social housing there are more there (29:01):
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Kimberley: are better protections for renters which means people can have more disposable (29:05):
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Kimberley: income they can invest more in education they can have hobbies and time off (29:09):
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Kimberley: and all of these things will have an impact on on mental well-being. (29:14):
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Mike: Blimey so we are we're fighting a tough battle here aren't we yeah, (29:17):
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Mike: i guess like before i move on because i've got a couple of slightly i think (29:25):
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Mike: meaty questions which I think are going to they're not sort of two second answers (29:30):
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Mike: before I just get into those, (29:33):
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Mike: and I don't want you to I mean you've written a whole book on this so (29:36):
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Mike: I don't I don't want you to kind of give us any spoilers but (29:39):
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Mike: kind of as a general kind of overview what can (29:42):
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Mike: we do day to day if we want to be if we want to be supporting our brain health (29:45):
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Mike: for example what are the kind of what's the low-hanging fruit what are the simple (29:51):
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Mike: kind of general things that we can do to make sure that we are supporting our (29:56):
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Mike: own brain health for now and for the future so. (30:01):
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Kimberley: Kind of quick and dirty the most robust (30:05):
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Kimberley: evidence base is exercise um and they come so regular and consistent exercise (30:08):
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Kimberley: not necessarily your weekend warrior type kind of beast mode for two days but (30:14):
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Kimberley: regular consistent exercise a combination of both aerobic and resistance training (30:19):
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Kimberley: because they do slightly different things in terms of brain health. (30:24):
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Kimberley: Aerobic helps to maintain the health of your blood vessels and obviously there (30:28):
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Kimberley: are miles and miles of blood vessels in your brain and making sure they stay (30:33):
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Kimberley: healthy and flexible in order to feed your brain the nutrients and oxygen it (30:36):
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Kimberley: requires for metabolism is really important. (30:40):
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Kimberley: But also when you do resistance training, essentially those growth factors, (30:42):
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Kimberley: your BDNF and your IGF-1 that help your muscles to grow also cross over into (30:48):
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Kimberley: the brain and can protect your neurons both and the ones you have at the moment (30:53):
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Kimberley: and also help the support the survival of any new connections that are made. (30:58):
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Kimberley: Cognitive challenge also comes up as something really really (31:02):
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Kimberley: important so what we know is that people who have more years of education have (31:06):
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Kimberley: a reduced risk of depression of Alzheimer's disease and that seems to be because (31:11):
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Kimberley: they have this more opportunity the more you learn so cognitive challenge basically (31:16):
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Kimberley: just means learning the more you learn, (31:20):
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Kimberley: the harder your brain has to work, the more connections it builds between one area to another. (31:23):
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Kimberley: And this building of additional kind of spare bonus connections is the principle (31:29):
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Kimberley: of cognitive reserve, which I call the pension plan for your brain. (31:34):
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Kimberley: Because as you get older, your brain starts to shrink. It's terrifying. (31:39):
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Kimberley: But as you get older, your brain starts to shrink. (31:43):
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Kimberley: Essentially, people who have built a bigger brain bank balance will have a greater (31:45):
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Kimberley: chance of maintaining their cognitive functions as they get older. (31:50):
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Kimberley: Nutritionally the big one that I'm always going to come back to is omega-3 (31:56):
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Kimberley: fatty acid but in conjunction with (31:59):
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Kimberley: sufficient choline so some of the new evidence that's coming (32:02):
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Kimberley: through is that DHA kind (32:05):
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Kimberley: of requires choline to help its bioavailability so (32:09):
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Kimberley: in making sure you are getting those two servings of (32:13):
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Kimberley: fish a week of which one should be oily or getting an (32:16):
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Kimberley: adequate supplement an algae-based supplement but (32:19):
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Kimberley: also eating your egg yolks as well you'll find (32:24):
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Kimberley: choline in most meat foods it's really kind of vegetarians and vegans you (32:27):
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Kimberley: have to be careful about making sure they get both of those and then kind of (32:30):
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Kimberley: leafy green vegetables particularly because they have vitamin k and lots of (32:34):
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Kimberley: other really important phytonutrients that have been shown to slow the rate (32:38):
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Kimberley: at which your brain ages and don't skimp on sleep sleep is hugely important for brain health, (32:42):
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Kimberley: if you don't get enough, if you are chronically underslept, (32:49):
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Kimberley: your brain starts to cannibalize itself, which as you imagine, we do not want. (32:52):
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Kimberley: So we do not want. So don't take your sleep for granted. (32:58):
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Kimberley: If you have any sleep issues, do try to address those as quickly as possible. (33:04):
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Kimberley: And a game changer for me was earplugs. (33:07):
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Kimberley: I thought, oh my God, do I have a sleep disorder? I can't get to sleep. (33:11):
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Kimberley: My sleep latency was really long. It took me ages to get to sleep. I was really worried. (33:16):
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Kimberley: And what I hadn't realized, because I've been a Londoner all my life, (33:21):
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Kimberley: I can take it. It's all right. But actually, I'm really sensitive to noise. (33:24):
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Kimberley: And it was really impairing my ability to drop off to sleep and the quality (33:28):
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Kimberley: of my sleep. But earplugs changed my life. (33:32):
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Mike: That's really interesting. And I find, And again, sleep is something that I (33:35):
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Mike: think, again, as a practitioner is so difficult to manage because sleep hygiene (33:39):
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Mike: is incredibly complex, isn't it? (33:44):
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Mike: There are so many different things that affect sleep and it's such an individual issue. (33:46):
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Mike: So I often find myself in the space of my 10-minute consultation, (33:50):
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Mike: giving people advice like, oh yeah, just turn your devices off and all of those (33:54):
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Mike: sorts of things. And they're like, I don't actually have any devices. (33:59):
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Mike: And oh, I just assumed that you did. I just assumed it was fully devices. (34:01):
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Kimberley: Um but it's actually. (34:05):
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Mike: It can be quite difficult to get in you know to get to the bottom of the reason (34:06):
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Mike: why people struggle to sleep can't it. (34:10):
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Kimberley: Yeah and i think the thing that we often miss (34:12):
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Kimberley: you know sleep hygiene is really important and making sure (34:15):
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Kimberley: that you're you have a an environment that is conduces (34:18):
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Kimberley: to sleep but the thing that keeps most people up the (34:21):
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Kimberley: thing that is responsible for most cases of either (34:24):
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Kimberley: chronic or transient insomnia is (34:27):
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Kimberley: anxiety it's psychological issues it's (34:31):
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Kimberley: the worries about what's going to happen tomorrow morning or (34:34):
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Kimberley: what's going to happen next week and i think there is both an (34:37):
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Kimberley: under appreciation i think in both uh the (34:40):
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Kimberley: general public but also practitioners that that is the (34:43):
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Kimberley: case you know our frontline treatments for sleep (34:46):
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Kimberley: disorders isn't sleeping pills it's cbti (34:49):
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Kimberley: cbt for insomnia so i suppose that's quite maybe a helpful thing for people (34:52):
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Kimberley: to know is that the thing that's keeping you awake is probably what you're thinking (34:58):
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Kimberley: about um the worries that you have and to address those as quickly and and as (35:01):
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Kimberley: effectively as possible yeah. (35:07):
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Mike: Exactly and it's a bit like what we were talking about before that when you (35:09):
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Mike: know people are feeling anxious or people are having sort of symptoms of mental (35:13):
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Mike: health problems sometimes the um the temptation is to try and solve the symptom (35:16):
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Mike: rather than solving the underlying disorder isn't it. (35:23):
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Kimberley: And we. (35:25):
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Mike: Can sometimes be led by our clientele in that sense i often have people come (35:26):
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Mike: to see me to ask for sleeping tablets but. (35:31):
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Kimberley: Not to. (35:33):
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Mike: Ask for trying to help fix what what is stopping. (35:34):
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Kimberley: Them from sleeping and sometimes. (35:37):
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Mike: It can be quite difficult to to reframe it with people because again sometimes (35:39):
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Mike: addressing that underlying, (35:44):
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Mike: issue is is much more challenging and. (35:45):
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Kimberley: You know both for the yeah. (35:48):
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Mike: For the practitioner and for the patient as well. (35:49):
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Kimberley: It's really tough and you need time you (35:51):
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Kimberley: know you need time to be able to sit down and say okay i hear (35:54):
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Kimberley: that you want sleeping pills how long have you had trouble (35:57):
undefined

Kimberley: sleeping when did it start often people it's really (36:00):
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Kimberley: interesting because that can be one of the the most profound questions (36:03):
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Kimberley: that you ask someone which is like when did (36:07):
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Kimberley: this start because actually often people (36:09):
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Kimberley: can pinpoint it and then just that question they (36:12):
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Kimberley: go oh oh i know exactly what it was but just having the opportunity to sit down (36:15):
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Kimberley: and have someone ask the question and give you the time to think about it suddenly (36:20):
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Kimberley: you've you found a solution but what we don't have the luxury of in a lot of (36:25):
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Kimberley: our healthcare settings is time and that's an enormous enormous shame yeah. (36:29):
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Mike: Absolutely um it's interesting to (36:34):
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Mike: hear you talk about kind of the nutritional side of um (36:36):
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Mike: brain health as well and actually that the fact that (36:40):
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Mike: I guess from what you're saying it sounds obviously this is (36:42):
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Mike: a slight over generalization but it almost sounds like the impact of physical (36:46):
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Mike: activity might be even greater than the impact of nutrition in in many cases (36:50):
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Mike: or you know the negative impact of the of that lack of physical activity and (36:55):
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Mike: and sort of other lifestyle factors out with nutrition um is that fair to say. (36:59):
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Kimberley: The most robust evidence base is certainly on the exercise and that might be (37:05):
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Kimberley: because exercise interventions are much more easier to manage. (37:10):
undefined

Kimberley: You know, you can make people do exercise, you can RCT them into exercise in (37:15):
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Kimberley: the way that you can't RCT them into nutrition. (37:19):
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Kimberley: So the robustness, you know, our ability to say prevent when it comes to exercise (37:23):
undefined

Kimberley: and depression is much stronger than our ability to say prevent when it comes (37:29):
undefined

Kimberley: to nutrition and depression, for example. (37:32):
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Kimberley: But that might be because simply we haven't had that many studies. (37:34):
undefined

Kimberley: You know, we have the first RCT on nutrition and depression only in 2017. (37:37):
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Kimberley: Since then, there have been a couple more which have found the same magnitude (37:42):
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Kimberley: of effect, which is essentially a 30% remission in depression in people who (37:45):
undefined

Kimberley: have nutritional improvement. (37:50):
undefined

Kimberley: And in this case, it was a whole food diet rather than supplements that we saw in the prison study. (37:51):
undefined

Kimberley: And then that joins the observational data and the lab data that say, (37:56):
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Kimberley: actually, this makes sense in terms of what these nutrients might be doing for (38:01):
undefined

Kimberley: neurotransmitters or cell signaling or clearance of amyloid beta or just in terms of, (38:05):
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Kimberley: uh you know reducing inflammation and things like that so it may be that the (38:17):
undefined

Kimberley: influence of nutrition is bigger but we don't quite have all of the of the evidence base in just yet. (38:22):
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Mike: Super interesting one of the things that i wanted to ask about this especially (38:28):
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Mike: as somebody who i know spends a lot of time in the wellness space we often see (38:33):
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Mike: quite a lot of um i guess not necessarily misinformation but perhaps over optimism when it comes to the. (38:38):
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Kimberley: Benefits of. (38:45):
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Mike: Doing certain things or. (38:45):
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Kimberley: Over pessimism. (38:47):
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Mike: When it comes to the dangers of doing certain things what are kind of the biggest (38:48):
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Mike: myths that you might like to bust about um lifestyle and brain health and their (38:51):
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Mike: interactions with one another that are there particular themes that you see (38:58):
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Mike: around that sort of space about things that that frustrate you or. (39:02):
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Kimberley: I suppose one question that i get a lot is what food can boost mood um which (39:06):
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Kimberley: slightly wants me makes me want to pull my hair out because it's, (39:13):
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Kimberley: that kind like i get the question yeah but partly (39:17):
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Kimberley: it's a disservice to depression to say well if you just have a salad (39:21):
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Kimberley: you'll be all right um and and actually what the evidence says is not that a (39:24):
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Kimberley: single food will do it but that an overall dietary intake of whole foods of (39:29):
undefined

Kimberley: fresh produce will improve your chances or improve your outcome so it's not (39:35):
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Kimberley: simply the case that you can you know eat, (39:41):
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Kimberley: mostly chocolate and then have some salmon (39:45):
undefined

Kimberley: and everything will be hunky-dory it's not it's not like that (39:48):
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Kimberley: i'm so sorry devastated um so there's no one food you know nutrients work in (39:51):
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Kimberley: concert and it's overall nutritional intake that will do it and I suppose from that. (39:59):
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Kimberley: It's a partial myth around how easy it is to improve your diet you know it's (40:10):
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Kimberley: just about the choices that you make is something gets thrown around quite a (40:16):
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Kimberley: lot and again I can understand why it seems simplistic on the surface to say (40:20):
undefined

Kimberley: well you choose the food that you eat you choose what you put into your mouth. (40:25):
undefined

Kimberley: But the psychology of food choice is so complex. (40:29):
undefined

Kimberley: That it's almost hard to fathom and (40:36):
undefined

Kimberley: it starts in utero right so (40:39):
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Kimberley: let's not even begin with oh you know what you (40:42):
undefined

Kimberley: pick up in the supermarket because actually the supermarket are nudging (40:45):
undefined

Kimberley: your choices there as well below your level (40:48):
undefined

Kimberley: of consciousness but your food preferences begin (40:51):
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Kimberley: in utero with the food that your (40:55):
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Kimberley: mother is eating and so and that's going to be affected by what she's been exposed (40:58):
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Kimberley: to and her cultural traditions and her income and all of that sort of stuff (41:01):
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Kimberley: and essentially the patterns of the food that we eat start to get bedded in (41:05):
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Kimberley: in utero and early life you know the patterns of foods that we we eat in childhood (41:10):
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Kimberley: tend to be the ones that we'll eat in adulthood. (41:15):
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Kimberley: Yes of course some people can change but largely we follow (41:18):
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Kimberley: the same pattern of dietary intake the same spectrum (41:21):
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Kimberley: of flavors and textures that we ate in childhood and (41:24):
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Kimberley: you know and that's even without thinking about the emotional associations (41:28):
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Kimberley: that we make with those things or you know (41:32):
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Kimberley: the the cost of them and their availability in the area that (41:34):
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Kimberley: we live so we we (41:37):
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Kimberley: need to understand that food choice is actually incredibly complex and therefore (41:42):
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Kimberley: again this kind of comes back to policy if we're saying to people in order to (41:47):
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Kimberley: have a healthier brain in order to be less depressed in order to reduce your (41:51):
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Kimberley: risk of Alzheimer's disease, (41:56):
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Kimberley: you need to change your habitual diet. (41:58):
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Kimberley: Actually, that starts in childhood. That starts with policy. (42:01):
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Kimberley: That starts with making sure that all children have access to adequate nutrition (42:04):
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Kimberley: in nursery schools and primary schools and secondary schools, (42:09):
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Kimberley: making sure that their families have enough money or whether that comes from (42:13):
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Kimberley: vouchers to ensure that they have availability of food at home, (42:17):
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Kimberley: that they have the money to pay for fuels food banks are saying that they are (42:20):
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Kimberley: getting requests for food that doesn't need to be cooked because people are (42:25):
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Kimberley: trying to save money on fuel, (42:28):
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Kimberley: Now, this is going to affect, you know, there are 2.6 million children living in food insecurity. (42:31):
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Kimberley: That's going to affect the food that's available to them. That's going to affect (42:36):
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Kimberley: the food choices that they make in the future. (42:40):
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Kimberley: And it will have started decades before, you know, they were in a position to (42:41):
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Kimberley: make choices for themselves. (42:47):
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Mike: I think it is so fascinating. And it is, you did a really good post on this (42:49):
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Mike: when we were talking about calories on menus and things like that. (42:54):
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Mike: Because actually it's this illusion of choice, isn't it? (42:59):
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Mike: And I think something you said earlier that really struck a chord with me was (43:02):
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Mike: talking about that survivorship bias of people who managed to change. (43:06):
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Mike: And we see that a lot in the wellness space, don't we? And actually, (43:10):
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Mike: I will very happily admit that I was that person when I lost loads of weight. (43:13):
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Mike: I was like, well, yeah, look, I did it. If I can do it, anybody can. (43:18):
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Mike: It's really straightforward. (43:22):
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Mike: And then completely paying no attention to all of the privileges that I had in that process. (43:23):
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Mike: The fact that had I wanted to, which I did, I could hire a personal trainer, (43:29):
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Mike: join a gym, have access to exercise, have access to food, have the education (43:33):
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Mike: to know what is and isn't healthy foods to choose in the first place. (43:38):
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Mike: So all of those things go out the window, I think, when people are being praised (43:42):
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Mike: for making choices that they think have given them a positive impact. (43:47):
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Mike: And they think that everything that they've done is down to down (43:51):
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Mike: to those things rather than the luck that they've experienced (43:54):
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Mike: along the way um and i think that really reinforces (43:57):
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Mike: that and i find it so commonly among you (44:01):
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Mike: know in the fitness industry and that sort of side of (44:04):
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Mike: things because i think when you've always had that natural tendency i had a (44:07):
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Mike: really interesting conversation with somebody the other day about how um actually (44:12):
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Mike: i have a really good friend of mine who really loves alcohol and um he will (44:17):
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Mike: not really want to go to the pub if he's not drinking, for example. (44:22):
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Mike: So I'm like, why would you not want to go to the pub? Because there's all of (44:26):
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Mike: these other great things about going to the pub, like I'm having a Diet Coke (44:29):
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Mike: at the pub because I'm driving. (44:33):
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Mike: And that doesn't bother me because I don't have a strong affinity to alcohol. (44:34):
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Mike: Whereas if we were perhaps going out to a cafe for coffee in the afternoon, (44:38):
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Mike: I would really want to order some cake. (44:42):
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Mike: Whereas he would I have no interest in the cake whatsoever. And it's fascinating (44:45):
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Mike: that it's not because he's a better person than I am or a worse person for wanting (44:49):
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Mike: alcohol or any of those things. (44:54):
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Mike: It's just because he's developed a preference for one thing and I've developed (44:57):
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Mike: a preference for another. (45:00):
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Mike: And if you have somebody who has a preference for alcohol, (45:01):
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Mike: exercise and uh nutritious vegetables and (45:04):
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Mike: lean proteins then they're gonna find it easy (45:07):
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Mike: to maintain this lifestyle and you know (45:10):
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Mike: i i think it is i'm sure there are lots of people who you (45:13):
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Mike: know who use a decent amount of willpower in in terms of (45:16):
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Mike: those lifestyles and all of those sorts of things but i i think we underestimate (45:19):
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Mike: the amount that preference has an impact on those things (45:22):
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Mike: and and and we sort of use it against other (45:25):
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Mike: people and i always think about that alcohol example because (45:28):
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Mike: i have no problems not not drinking at all (45:31):
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Mike: and i think that must be the way that (45:34):
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Mike: i feel about trying to avoid eating cake or (45:37):
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Mike: bread or all of the foods that i love must be how people who love alcohol think (45:40):
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Mike: about avoiding alcohol i mean obviously it's different processes and there's (45:45):
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Mike: addiction with that sort of stuff as well but you know there are really complex (45:48):
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Mike: um factors at play and i think that we don't have a great a great understanding of those at all no. (45:52):
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Kimberley: We don't and And on that idea, on the notion of preference, (45:58):
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Kimberley: it's also that neurologically, if we come back to the idea of food and the idea (46:02):
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Kimberley: of willpower and you should just try to avoid eating in order to kind of shift (46:07):
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Kimberley: your body composition or whatever the goal might be. (46:14):
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Kimberley: Well, you know, the idea of willpower is that you have to try to resist something (46:17):
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Kimberley: that's available in the environment, which brings us back to the interaction (46:21):
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Kimberley: between the individual and the environment. (46:25):
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Kimberley: If the environment wasn't so conducive to eating delicious things, (46:27):
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Kimberley: then you wouldn't need to use as much willpower. (46:31):
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Kimberley: Humans have an evolved tendency to try to capitalize on every opportunity to (46:36):
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Kimberley: eat as is possible because your brain is convinced that there's a famine coming. (46:41):
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Kimberley: But then on an individual level different (46:45):
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Kimberley: people neurologically will have a different (46:48):
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Kimberley: response to food cues some people (46:52):
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Kimberley: have a heightened response to food cues they will see an (46:55):
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Kimberley: advert for cornflakes and be like i could do some cornflakes (46:58):
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Kimberley: right now whereas other people will see an advert for (47:01):
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Kimberley: cornflakes and be like oh no i'm okay and that is a (47:04):
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Kimberley: genetically driven response to external (47:07):
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Kimberley: environmental cues and again people won't realize (47:10):
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Kimberley: that some people will have higher natural (47:13):
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Kimberley: resting ghrelin levels they will just naturally be (47:16):
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Kimberley: hungrier and again that's not a problem in an environment where the foods you're (47:20):
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Kimberley: eating are largely whole and nutrient dense and never you know moderately palatable (47:25):
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Kimberley: but in an environment where you're hungrier all the time and the food that you (47:29):
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Kimberley: have access to is is calorie dense that's going to have an impact on your health outcomes. (47:34):
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Kimberley: So yeah, it's enormously complex. And I, (47:39):
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Kimberley: which is why people just say you need to try harder. They just, (47:43):
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Kimberley: they belie that they don't really know what they're talking about. (47:46):
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Mike: Yeah, no, a hundred percent. And I'm glad we clarified that. (47:50):
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Mike: So I suppose now that we've talked about all of these problems and obstacles (47:54):
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Mike: and all of the things that are almost unchangeable, what do you think that the (48:00):
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Mike: BSLM can do as an organization? (48:06):
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Mike: You know if we're sort of sitting here as an organization saying that we we (48:09):
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Mike: are keen on improving the health of the nation through lifestyle change where (48:13):
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Mike: should we be focusing our energies what should we be doing. (48:18):
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Kimberley: I think the bslm should (48:20):
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Kimberley: capitalize on its (48:23):
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Kimberley: leverage right doctors have power (48:27):
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Kimberley: you know whether it's simply it's from the title which (48:31):
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Kimberley: means you have influence which means people think you (48:34):
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Kimberley: know what you're talking about or through (48:37):
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Kimberley: connections either through your training institutions or (48:41):
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Kimberley: where you practice or simply you know just (48:44):
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Kimberley: the the the authority that comes (48:47):
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Kimberley: with the title I think the (48:50):
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Kimberley: organization should use that leverage politically we are a group of doctors (48:53):
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Kimberley: who understand the importance of lifestyle but we also understand that individual (48:59):
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Kimberley: changes in lifestyle are ineffective (49:05):
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Kimberley: in the context of an environment that is not conducive to that. (49:09):
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Kimberley: So we call on the government too, or we think the best way to improve, (49:12):
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Kimberley: Public health would be to do this one thing, choose a campaign and leverage (49:18):
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Kimberley: your authority and your membership behind that campaign. (49:23):
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Kimberley: Advocate for people. Advocate for people who don't have the authority, (49:28):
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Kimberley: who don't have the connections, who don't have the power to have the people (49:32):
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Kimberley: higher up, listen to them and take them seriously. (49:36):
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Mike: I like that. And I think that we are trying to do that. And I hope that that carries forward. (49:40):
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Mike: And I hope that it does improve things I think that I've seen definite (49:44):
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Mike: a definite focus and understanding as (49:47):
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Mike: as the as the society has grown (49:50):
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Mike: on kind of you know a greater understanding of that (49:53):
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Mike: sort of political thing that political side of of things (49:56):
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Mike: and how important the the public health sort of (49:59):
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Mike: aspect of it is um and I think that (50:02):
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Mike: again that's something in the wellness space we see so much of (50:05):
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Mike: you know encouraging individual change encouraging you know (50:07):
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Mike: personal responsibility and all those sorts of things which obviously as (50:10):
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Mike: we know do do play a significant role as well particularly in (50:13):
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Mike: a society that for a lot of the society is quite (50:17):
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Mike: privileged and can you know can do certain (50:20):
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Mike: things to improve stuff but again we (50:23):
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Mike: need top-down change don't we um but (50:26):
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Mike: then again the other question is then from a (50:30):
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Mike: from an individual clinical perspective when (50:33):
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Mike: people come to see us and we think that their their lives (50:37):
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Mike: could be improved by improving their lifestyle what (50:41):
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Mike: do you think the best approach is for us to have what are the best (50:43):
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Mike: things that we can be advising them to do or particularly in the context of (50:46):
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Mike: people who might have less privilege who might have less choice and who might (50:50):
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Mike: be being impacted by things like poverty and all of the other the other things (50:54):
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Mike: that we've been talking about which impacts their lifestyle negatively how can they change. (50:59):
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Kimberley: I think, to come back to your example about sleep, when you might say, (51:06):
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Kimberley: oh, turn off your devices, and your patient says, I don't have any in my room, actually, thanks, doc. (51:10):
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Kimberley: Is to, (51:15):
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Kimberley: is to understand that most people know what they need in they know what will help them, (51:18):
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Kimberley: most often right so if you were to ask your underslept patient what what do (51:27):
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Kimberley: you need i know you're saying that you need sleeping pills but what is the thing (51:35):
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Kimberley: that's keeping you up what is the thing that is you know stopping you from sleeping (51:39):
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Kimberley: giving the person the opportunity to, (51:43):
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Kimberley: to think might be very helpful and then even if you can't personally direct (51:47):
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Kimberley: them to social services or you know whatever it might be then you've given them. (51:52):
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Kimberley: Perhaps more opportunity to get to the the core kind of causative issue than applying, (51:58):
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Kimberley: you know a band-aid for for the moment um you know but saying that you know (52:07):
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Kimberley: it is it is difficult And I suppose I have much more time with my patients, (52:14):
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Kimberley: so it's a different thing. (52:20):
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Kimberley: I do have the luxury of time to stop and sit and think. (52:22):
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Kimberley: But I wonder whether there's, find out what the patients in your area need. (52:25):
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Kimberley: Maybe, you know, you put a suggestion box down in the surgery and say, (52:31):
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Kimberley: what is it in the local area that you think could do with improvement or would (52:35):
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Kimberley: help you most? And then again, you know, you're the doctor's surgery. (52:42):
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Kimberley: How do you leverage that authority and those connections to advocate for the (52:46):
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Kimberley: thing that the people in your local area and the streets around the surgery (52:50):
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Kimberley: say they need the most? Is it the tidying up of the playground? (52:56):
undefined

Kimberley: Is it a cycle path? (52:59):
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Kimberley: Is it, you know, an opportunity, you know, a greengrocer's or something, (53:01):
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Kimberley: you know, what is it going, what is the one thing that's going to make the difference (53:06):
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Kimberley: for your local population? (53:09):
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Kimberley: And and and I think sometimes simply asking (53:11):
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Kimberley: the question can help empower people (53:14):
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Kimberley: it can help them to think actually maybe there is something (53:17):
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Kimberley: that I can do and you get this kind of virtuous cycle of someone cares enough (53:20):
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Kimberley: to ask me but also maybe I can do this for myself and and that I suppose brings (53:23):
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Kimberley: into the idea the idea of community which is one of the most important things (53:30):
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Kimberley: for mental well-being is a sense of community of community engagement coming (53:34):
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Kimberley: back to this the impact of inequality, (53:37):
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Kimberley: which is kind of shredding and atomizing communities into individuals who are (53:40):
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Kimberley: competing with one another. (53:45):
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Kimberley: If you can do something to foster a sense of community, then actually you're (53:46):
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Kimberley: going to have beneficial and positive effects on your local area and your patients' lives. (53:50):
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Mike: I love that. I think that's one of the things that's probably missing, (53:56):
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Mike: I think, in a lot of aspects of what we all do is that collaboration with people (53:59):
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Mike: who work in different services and kind of sort of individualistic approach (54:05):
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Mike: of all of these different bits. (54:10):
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Mike: And again, I think that's another thing that is hopefully improving, (54:11):
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Mike: but I think there's definite work to do. (54:15):
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Mike: Now, we are approaching the end of our time, but I don't think that I can do (54:17):
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Mike: a podcast with you without talking a little bit about cake and baking. (54:22):
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Kimberley: Cake. Yeah. (54:27):
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Mike: Um i and the reason that (54:30):
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Mike: i that i um the reason that i want to (54:32):
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Mike: talk about this is not just because you have an awesome journey when (54:35):
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Mike: it comes to that and also you've you've provided me with some (54:38):
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Mike: excellent recipes and you've created some great things that (54:41):
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Mike: have that have that have given me joy in terms of just (54:44):
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Mike: watching what you've what you've made yourself but also (54:47):
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Mike: i think that one of the things that is neglected in (54:51):
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Mike: the lifestyle discussion is the importance of food (54:54):
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Mike: outside of nutrition and I (54:57):
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Mike: just wanted to touch on that a little bit because I think it's very (55:01):
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Mike: easy when we're having these lifestyle conversations with people and (55:04):
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Mike: we're encouraging people about what they should or perhaps shouldn't be (55:06):
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Mike: eating to forget that food is a little bit more than just nutrition and again (55:09):
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Mike: we could probably do a whole podcast on that but so I'm just going to ask you (55:15):
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Mike: that that sort of one this one question really which is what does what does baking mean to you. (55:20):
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Kimberley: Um i sometimes it depends on the day sometimes baking means nothing to me at all, (55:30):
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Kimberley: um which i know sounds a bit odd but part of the thing about bakeable was i (55:40):
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Kimberley: was kind of watching it and thinking I could do that and it was partly about (55:47):
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Kimberley: I'm the kind of person that quite likes a challenge. (55:54):
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Mike: Yeah um. (55:56):
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Kimberley: So it was it's partly about the challenge but that said um I do um, (55:57):
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Kimberley: have what I call kitchen time, which is when I'm, when I'm done with the world. (56:04):
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Kimberley: This week, um, I will take myself to my kitchen and I will have some kitchen (56:10):
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Kimberley: time and it will often be preparing something that isn't necessary, right? (56:15):
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Kimberley: So it's often I will make pickles or I'll make jam or I'll make something that (56:22):
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Kimberley: needs a little bit of stirring or I will bake something. (56:28):
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Kimberley: Um and so it's partly about (56:31):
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Kimberley: a time out from the (56:34):
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Kimberley: world and I think it's also about (56:38):
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Kimberley: um a creative outlet you (56:41):
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Kimberley: know what's lovely about baking is you know (56:44):
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Kimberley: if you're if you're not a carpenter if you can't draw very well (56:47):
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Kimberley: if you can't paint actually in a (56:50):
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Kimberley: very short amount of time you can take these crude raw (56:53):
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Kimberley: ingredients to something that is beautiful and delicious (56:56):
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Kimberley: and there's an alchemy and a science and a beauty too which i (56:59):
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Kimberley: really enjoy um but the (57:02):
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Kimberley: lovely thing about baking the which you found during lockdown (57:05):
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Kimberley: is that other people love it (57:09):
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Kimberley: and it's it's a lovely thing to (57:12):
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Kimberley: do um and um i'm (57:15):
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Kimberley: a member of a choir and every year every year (57:18):
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Kimberley: every week a different a different section of the choir makes cakes for our (57:21):
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Kimberley: break and it's just it's a lovely act of generosity tea it's a lovely act of (57:25):
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Kimberley: giving and there i think there are a few things that say i care about you than (57:31):
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Kimberley: cooking for someone and so i think it's just it's a lovely thing to do i. (57:36):
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Mike: Love that i love that description and i love that you also said that sometimes (57:40):
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Mike: it means nothing to you because i think that sometimes we overestimate like (57:44):
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Mike: sometimes we underestimate it and we just think of food as just nutrition but (57:48):
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Mike: sometimes we overestimate the importance of like you said that sometimes, (57:51):
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Mike: evolutionarily we're always looking to maximize every single food experience (57:55):
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Mike: that we can have and sometimes that doesn't that doesn't have positive outcomes (57:59):
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Mike: either so i think that's a really important aspect to add so, (58:02):
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Mike: On that note, I think that we've come to the end of our time. (58:06):
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Mike: And thank you so much for joining me. (58:10):
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Mike: Before we go, can you just tell our listeners where they can find you and tell (58:12):
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Mike: us about your book very quickly before we go? (58:18):
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Mike: Because I have read your book and I think it's amazing and that everybody should (58:22):
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Mike: read it. But obviously, I am biased. (58:25):
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Kimberley: Thank you. Thank you so much. Well, yes. (58:28):
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Kimberley: So you can find me on mostly Instagram. I mean technically I'm on Twitter but (58:32):
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Kimberley: I don't really I try to spend as little time there as it's humanly possible (58:36):
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Kimberley: so mostly on Instagram where I am food and psych so f-d-o-d-a-n-d-p-s-y-c-h, (58:40):
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Kimberley: how to build a healthy brain has been endorsed by the (58:54):
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Kimberley: NHS as a source of trusted health information so (58:57):
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Kimberley: i'm delighted about that um fantastic (59:00):
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Kimberley: congratulations thank you very much so yeah i'm (59:04):
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Kimberley: really really thrilled because again there's (59:07):
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Kimberley: a lot of either misinformation or over (59:10):
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Kimberley: generalization of health information not (59:13):
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Kimberley: just on social media but also in books and i worked really hard (59:17):
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Kimberley: to you know as much as i care about these things to try to be accurate with (59:20):
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Kimberley: the information that i was putting out and so it's it's lovely it's really it's (59:24):
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Kimberley: a really lovely feeling to know that a panel of 60 people in the nhs have agreed (59:29):
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Kimberley: that it's a good quality you know source of information so i'm thrilled about that oh. (59:35):
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Mike: That's amazing news and i agree so with that thank you so much for your time we really. (59:40):
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Kimberley: Appreciate it and. (59:44):
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Mike: To all our listeners thank you very much for listening and we will see you next (59:45):
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Mike: time on sound living goodbye. (59:48):
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Intro and Outro: Thanks for listening to this episode of Sound Living, and we'll see you next time. (59:54):
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Intro and Outro: Don't forget to subscribe to the podcast. And if you enjoyed this episode, (59:58):
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Intro and Outro: leave us a review and make sure you share it to social media. (01:00:02):
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