3 Ways To Start Your Day For Less Stress, Balanced Energy, And Better Health

Hi, Doctors Pharmacy listeners. It's Dr. Mark here. If you've been following me, you know that I'm obsessed with understanding the latest research on longevity and how we can apply it to our daily lives. So I wrote a book about it. Think of it as a roadmap to optimal aging. It's called Young Forever, and it comes out February 21st, 2023. It's never too early or too late to take control of your health. And this book will show you how. Visit Young Forever book to learn more and pre-order now.

Coming up on this episode of the Doctor's Pharmacy.

What we crave and what we seek really can change, not just because it's better for us, but because our nervous system actually remodels itself where the good stimulus starts to evoke dopamine release.

Hey everyone, it's Dr. Mark. Now, I know a lot of you out there are healthcare practitioners like me, helping patients heal using real food and functional medicine as the framework for getting the root cause of the issues. Now, in my practice, this often means looking lots of internal variables to find the most effective path to optimize health and reverse disease. But up until now, that meant we were usually ordering tests for one patient from multiple labs. Now, I'm sure many of you can relate to how time consuming and complicated lab ordering can be for functional medicine practitioners like me and our patients. That's why I love using Rupa Health. With just a few clicks, I can order from 30 plus lab companies. That's over 3,000 tests for free in one single portal. That means one invoice for all labs paid online upfront. Plus, patients get practitioner pricing and receive full patient support. support through easier personalized collection instructions, automated follow-up, super bills, and answers to testing questions, and so much more. Just go to rupahelp.com, that's R-U-P-A-Health.com, to sign up for your free account today. Now something I get more and more excited about every year is personalized medicine. Now when I began practicing functional medicine over 20 years ago, it was clear to me we have to look at how unique each body is. Now with technology advancing in amazing ways, we can truly take that concept to the next level. One of the tools that I recently discovered that can help us all do this from home is InsideTracker. Founded in 2009 by top scientists in aging, genetics, and biometric data from MIT, Tufts, and Harvard, InsideTracker is a personalized health and wellness platform like no other. It's purpose-built to help you live a longer, more productive life. Their cutting-edge technology analyzes your blood, DNA, your lifestyle to give you highly personalized recommendations. Then using the app, you can track your progress every day. InsideTracker tells you what to do and why, so your health goals are clear and actionable and most importantly based on exactly what your body needs. And now you can connect InsideTracker with your Apple Watch to unlock deeper, more precise insights into your health. With real-time exercise, resting heart rate and sleep data synced with your InsideTracker plan, you can truly wear your health on your sleeve. My team took InsideTracker for a spin and really loved it. They discovered some important things about their health that led them to stop procrastinating when it comes to certain parts of their health, like, for example, finally taking a vitamin D supplement after seeing they were deficient, or eating more iron-rich foods due to low ferritin and hemoglobin, and making an effort to embrace stress reduction techniques after seeing high cortisol levels. Now, health is not black and white. Your wellness plan shouldn't be either. If you're curious about getting your own health program dialed in, to your unique needs, I highly recommend checking out InsideTracker. Right now they're offering my community 20% off at insideTracker.com/DrHyman. That's I-N-S-I-D-E-T-R-A-C-K-E-R.com/DrHyman. That's me, Dr. Hyman. And you'll see the discount code in your cart. Now let's get back to this week's episode of the Doctor's Pharmacy.

Hi, this is Lauren Fein, one of the producers of the Doctor's Pharmacy podcast. It's estimated that at least 80% of doctor's visits are due to illnesses related to stress. Through implementing intentional behaviors, routines, and lifestyle choices, especially in the morning, we can become more stress resilient, enjoy more balanced energy, and create overall better health. Our first actions of the day can make or break how we feel, and in today's episode we feature four conversations from the Doctor's Pharmacy on how we can start our day for better health. Dr. Hyman speaks with Dr. Andrew Huberman about how we can improve our sleep quality starting first thing in the morning and how to rewire our brains to crave the things that are good for us. He also speaks with Dr. Elizabeth Boham about the importance of avoiding foods that stress our bodies, especially in the morning, with Dr. Casey Means about what to eat for breakfast to minimize blood sugar swings, and with Dr. Rangan Chatterjee on developing a morning routine to help manage.

The effects of stress throughout the day.

Let's jump in.

Light exposure early in the day, getting bright light exposure, ideally from sunlight, within an hour, ideally within 30 minutes of waking up, is vitally important for getting sleep later that night. And the reason is, is it basically once every 24 hours you're going to have a spike in cortisol. It's non-negotiable. It's built in your genome. It's gonna happen.

So do people in like Arizona sleep better than people in Seattle?

Well, they do actually, and a lot of people in Seattle need light light boxes, because if you're living in an area where you can't get sunlight first thing in the day, feel free to flip on artificial lights. But you want, basically the rule is you want as much bright, ideally natural, but if you can't get natural, artificial light would be fine early in the day. And what that does is it basically times this cortisol spike to wake you up. That spike in cortisol isn't to stress you out, it's to wake you up. And then it sets a timer on your melatonin release. So 14 to 16 hours after your bright light exposure, you're going to get a pulse of melatonin, which is the hormone, of course, that promotes sleepiness and puts you to sleep independent of any supplementation of melatonin. Light inhibits melatonin through a direct pathway through the eyes to the brain stem and then up to the pineal. It's a well-established pathway. So, the number one thing is get bright light exposure to your eyes. So, no sunglasses, eyeglasses or contacts are fine early in the day. How long? well, it depends on how bright. So anywhere from two minutes to 10 minutes. Ideally, you're not looking at your phone during that time. Ideally, it's sunlight. But if you wake up before, you know, flip on a bunch of artificial lights and then get outside once the sunlight is out. I'm outside taking a walk. You're not looking at the sun, right? You're not looking directly into the sun. You don't want to burn your retinas out. Indirect exposure is fine. But there's a class of neurons called the melanopsin ganglion cells that reset your circadian clock and time things nicely. They time the cortisol all the time, the melatonin. So that's the number one. thing for, I wouldn't just say for sleep, but also for optimizing levels of alertness throughout the day. The other thing is that you really want to avoid bright light between the hours of 11 p.m. to 4 a.m. If you're on a standard schedule, shift workers is totally different. The reason is Samer's lab and a guy named David Berson at Brown University have shown that bright artificial light of any color Blue blockers or no? If there's bright artificial light, it activates a pathway in the brain involving this brain structure called the habenula. When I was an undergraduate, actually someone asked in neuroanatomy, what's the habenula do? No one knew. The habenula is involved actually in generating our feelings of disappointment. It suppresses dopamine release for several days afterward. Now, if you have to go to the bathroom or you have to pull an emergency trip, to the supermarket or something in the middle of the night, you don't have to worry about crushing your dopamine long term. It's a chronic thing, but you really want to dim the lights in the evening starting at about 10:00 p.m. And so you're saying those blue blocker things, that doesn't work? Well, the blue blockers will work, but if the lights are bright enough, it doesn't matter what wavelength they are. And this is because these melanopsin cells, these neurons in the eye, they do respond best to blue light, but they're very broad spectrum, the wavelengths that they will respond to. You can shine bright red light on one of these cells and it will signal to the brain time to wake up.

Amazing.

So it's really key to just dim things down. And I always say blue blockers are terrific, but you don't want to wear them during the morning and early part of the day because blue light is the optimal stimulus for this wake up signal. So we took the blue blocker thing is great in principle, but people kind of took it too far. So bright light when you want to be awake and alert and dim light when you want to be asleep.

So how many hours before bed? Because people are up on their TVs and their screens, computers and phones. Yeah, so the subtle things that people.

Can do are to start dimming the lights in the evening right about the time the sun goes down is when you want to say, oh, the sun is going down outside and if it's overcast, it's getting dark. Well, that's a time to dim the lights in your home. The other thing is because of the where these neurons are situated in the eye, overhead lights will activate this wake-up signal. much more readily than lights down low. So the Scandinavians have it right. In the evening, you want desk lamps. Most people aren't going to have floor lighting in their house. Desk lamps, early in the day and throughout the day, that's when you would want overhead lights. So those two things are going to be very beneficial. A lot of bright light, overhead light throughout the day, ideally from sunlight, and then in the evening, avoid bright lights of any color, any kind between 11 p.m. and 4 a.m. Don't get neurotic about it, but many people find that just making these changes.

You don't have to be off from like 6 o'clock at night.

No, no, no, no. And there's actually the third tool, which is also grounded in really nice work, a paper published in Scientific Report, shows that if you get some sunlight in your eyes in the evening, right about the time of sunset, if you can't get it from the actual sunset, just go outside. You don't have to see the sun setting. You just need the light, the ambient light, the outdoor light in the morning is sufficient. There's so many photons out there, even on a cloudy day, you'd be amazed. In the evening, if you see or get outside and get some sunlight or you get some light in your eyes, that has an effect of lowering the sensitivity of the retina, of the neural part of the eye. provides you a kind of insurance. It offsets a little bit of the late night bright light exposure. I call it sort of your Netflix inoculation. It kind of protects you against some of the ill effects. Now, if someone's schedule is really messed up, I mean, they're not sleeping, they're really screwed up. There's a study out of the University of Colorado that showed that this is a little extreme, but going camping for two days, reset these melatonin and cortisol rhythms for two weeks.

It's pretty incredible.

It's really incredible.

I noticed when I go camping or I go out in the wilderness or far away from technology, I just sleep way better. We had a storm my house last summer and we got power out for four or five days. We just had candles at night and it was unbelievable. I loved it and it felt so good to not have all that bright light at night and to go to sleep and sleep better. and deeper.

Yeah, you really reset. And you mentioned, I'm glad you mentioned candlelight. Candlelight in the evening is fine. Actually, not to turn people into geeky scientists, but there's a great app. I have no relationship to it, but it's completely free. It's called a light meter. And you can run this experiment. You can download the app. You go outside on an overcast day in Boston in January and press the little button on light meter in the morning, and it'll show you that even though you don't see the sun, it looks like dense cloud cover. It'll be something like 5,000 lux of light. You'll go inside, you'll point the thing at a really bright artificial light, and it'll say 300 lux. Close the window to the outside, and it reduces it by about 50 fold. So you don't want to do this through a window or a car window. And then you say, well, wait, you just said that there's very little light intensity coming from artificial lights. Why is it so bad at night? I should be able to turn on every light in the house, and it won't reset. Ah, but the clock and your eye get more sensitive as the day progresses. So you have to control it at both ends. And candlelight is fine, dim light in the evening is fine, but throughout the day you really want to try and get some bright light exposure. And for many people whose schedules are just really screwed up, anchoring to these two or three things of bright light exposure and avoiding bright light in the evening hours between 11:00 p.m. and 4:00 a.m. often not always can really reset people's ability. And once you're sleeping well, everything else gets better. So that was kind of the first question you had. The other one is that I'd be remiss if I didn't mention that there are things that people can take. I'm sure you're familiar with several of these as well. Obviously, well we have a doctor right here, so talk to a doctor. Obviously, I'm not a physician. I'm a professor, so I don't prescribe anything. the three things that have made a tremendous difference. You profess, you don't prescribe. I profess, I don't prescribe. That's right. That's how you usually say. Profess lots of things. The three things that I've certainly benefited from, and I know a number of other people have, and for which there's really good research, are apigenin, A-P-I-G-E-N-I-N, which is, it's very inexpensive, it's chamomile extract, and it basically turns on a chloride channel mechanism in the brain. It turns off thinking. It's kind of the equivalent of an alcoholic drink. It just turns off thinking. You could still drive on the stuff.

But it makes people drowsy.

You drink chamomile tea or you have to take a concentrated. Some people get that benefit from chamomile tea. Other people like the apigenin. And the other ones are the magnesium, magnesium and magnesium threonate and by glycinate in particular, threonate spelled T-H-R-E-O-N-A-T-E. And by glycinate, I won't spell out, but sort of just as it sounds, those cross the blood-brain barrier more readily because you're ingesting this obviously into the gut, and then that magnesium needs to get into the brain. And basically the magnesium seems to act as a precursor to GABA, the inhibitory neurotransmitter. And so for people who have a hard time turning off their thoughts, that can be very beneficial. So there's the kind of light, which is a kind of ancient mechanism by regulating alertness and getting into sleep. And then there's the modern thing, which is supplements. And there's something sort of in between worth mentioning, which is there's a great tool that was developed by my colleague who's our associate chair of psychiatry at Stanford. His name is David Spiegel. He's actually a clinical hypnotist. He's done a lot of work on pain management and even breast cancer outcomes from hypnosis. And he's developed a free app that's on Apple and on Android called Reverie, R-E-V-E-R-I. It's a 15-minute hypnosis that you do in waking, which trains the brain to sleep better. And I think that a lot of people hear hypnosis and get a little bit freaked out, but there are a lot of clinical data showing that this can help people to learn to turn off their thoughts and to relax and go to sleep. And there's some other nice hypnosis scripts in there as well. It's David's voice, and he kind of walks you through it. So those are, aside from the supplements, the light and the hypnosis are free resources that I think most everyone could benefit from. If I wake up in the middle of the night, oftentimes I will do one of these hypnosis scripts. And just one other thing about sleep. A lot of people wake up at 3 or 4 a.m. and can't fall back asleep. Okay. I never understood why that was. And then I talked to the folks in the sleep lab at Stanford, and I talked to the chronic. Here's probably the reason. Yeah. There's an asymmetry in this seesaw that we all equipped with internally, which is that. we can all push on and stay awake more easily than we can just force ourselves to sleep, right?

That's true, right?

At some point we fall asleep, but if you're waking up at 3:00 or 4:00 a.m., unless you're drinking too many fluids and that's the reason why, chances are you are running out of melatonin at that point. The levels of melatonin in your blood are dropping. And what it means is you stayed up too late and you probably are one of these people that should be going to bed at 8:30 and waking up about 3:30 or 4:00 a.m. And people don't like that answer because they think, no, but I want to be the person that goes to bed at 11. And there are ways to shift your circadian rhythm that we could talk about, but try and go to bed one hour earlier and chances are you will wake up feeling better at 3:00 or 4:00 a.m. Now, it's not exactly a solution, but if you're in an argument with your spouse or something about going to bed at one hour or the next, you can leverage biology or cite this discussion.

So.

Wow. So we really have this sleep epidemic problem, and people are struggling with figuring out how to deal with it. And your lab, and you have worked really a lot on how do we navigate the landscape of sleep? Because as we're having this conversation, whatever I ask you, you keep coming back to sleep, which is fascinating to me as a foundation. And we always think diets, the foundation, exercise, Foundation, meditation. But sleep is sort of that neglected fourth leg of the of the table.

Well, and it's the thing that we've been encouraged to push through. And, I mean, there are some elements, I mean, that we could get down into the fine science of it. We sleep in 90-minute cycles, ultradian cycles. Better to wake up after six hours than seven, right? For most people, for sake of alertness. So, waking up at the end of one of these 90-minute cycles, you're going to feel more alert than you would say if you slept into Seven hours would mean you weren't complete through your last ultradian cycle. But sleeping at 730 would be even better if you can. Getting the right amount of sleep is a process that you want to master on average. The one occasional all-nighter, you'll be okay. You drink coffee too late, you'll be fine. But on average, you want to be sleeping. Most people, it's going to be anywhere from five to eight hours a night. naps in the afternoon seem to be okay. The hypnosis script and the other things will really help people get centered around this. I think that the idea of breaking up one's sleep, there were these crazy sleep cycles that were promoted, not to be confused with Huberman, they called it the Uberman schedule. I just want to be very clear, not Huberman schedule. There was a study that came out recently that showed that it's incredibly detrimental to all sorts of inflammatory cytokine markers. To take a nap in it? Oh, no. To try and sleep two hours, wake up, sleep two hours, wake up, sleep to around the clock. There are people they found they could compress their total sleep time. This was kind of a Silicon Valley thing, like trying to master one, you know, you just have these human bodies. You got to actually. Yeah, you can't conquer that. But. But I think sleep is vitally important. Then I. I think. I do think that foundational diet and supplementation and from the literature I've seen, I'd love your thoughts on this, that the literature that impresses me the most in terms of diet and the brain and brain states are the studies that look at EPA, essential fatty acids, and the gut microbiome. Those are the two things that to me, it's undeniable. I don't understand how anyone nowadays could even question the idea that getting proper lipid intake, you know, essentially- Dr. Rain is fat. Yeah, these Omega-3s are so important. I mean, in a double, several double-blind placebo-controlled studies that I've read, it appears that getting a thousand milligrams or more per day of EPA. So not just taking a thousand milligrams of fish oil, but making sure that you're getting above that threshold of a thousand milligrams of EPA from quality sources. compares just with similar effect as SSRIs, prescription antidepressants, but without the side effects, which is incredible. And that if you are taking SSRIs, it allows you to take a much lower dose to still be effective. To me, incredible data. And then the other one is that ingesting fermented foods one or two servings.

A day SaUcrout for the brain.

Yeah, saUcrout for the brain or whatever given culture. Because what I learned, and this is very new and emerging data, there's a guy at Duke, he's incredible. He was a nutritionist, but then he has PhD nutrition, excuse me, and now he's a neuroscientist. His name is Diego Borges, not to be confused with the Argentine writer Borges. He's Ecuadorian, and he found that there are neurons in our gut of the vagus nerve. so these are neurons that live in the gut and endothelium, and they sense three things. They fire electrical signals to the dopamine centers of the brain in response to fatty acids, right? When fats are, you know, meats and things are broken down and the fatty acids, amino acids of other kinds, so from protein, and sugar.

Sure.

And so these neurons can easily be tricked into signaling the brain to release more dopamine. And because dopamine is really the molecule of craving, into craving more of whatever activated those neurons. And so if you give these neurons enough EPA or enough amino acids, so protein and essential fatty acids, the dopamine centers of the brain are just firing like clockwork, which is going to enhance mood, motivation, energy. I mean, dopamine in proper amounts is a beautiful thing.

Too high, obviously, you don't want.

But you're not going to get it too high.

Look, people don't get addicted to chicken.

Breast, but they get addicted to sugar.

Right.

And I think that's, I actually think that's because they're, they are, these neurons seem to be responding best to particular amino acids. They seem to want glutamine, of all things. They seem to want the omega threes. And what's interesting is that even if they numb the taste so that people can't taste sugar, if people ingest sugar, these neurons- Sugar receptors in your gut, right? And they crave more sugar. even if they can't taste the sugar. So I always thought that the dopamine release to sweet things was because it tastes so good. But the Borges lab results and some other work on dopamine more generally from my colleague Anna Lemke at Stanford shows that dopamine isn't so much about pleasure. We all, including myself, were taught it's about pleasure. Dopamine is about craving more of whatever it is triggered dopamine release.

Yeah, whether it's heroin or cocaine or sugar.

And so these neurons that trigger dopamine release, they are powerfully affected by these quality omega-3s and by amino acids. And then what's really interesting is that they trigger the release of dopamine, but then you say, well, okay, that should be pretty simple. Like you said, people don't get addicted to chicken breast. And I wonder whether or not that's either because omega-3s are too low, So these neurons are not, the full concert of these neurons is inactive. Or it could be that for some reason that the other things that people are ingesting has messed up these neurons. And so the whole brain-body relationship is disrupted. And it's, I guess Robert Lustig is his name at UCSF.

Yeah, yeah.

And others are now showing that some of the emulsifiers in foods and other things like that, what they do to the gut end of helium, I never really understood how the gut-brain thing works. But what I realize is that these microbiota, they don't care about us. What they do is they're trying to find conditions in the gut where the mucus is, pH of the mucus is just right. And that if people ingest emulsifiers and sugars, what happens is these neurons, and Boris Lab has shown this, that these neurons that are in the gut endothelium and can sense amino acids and can sense essential fatty acids, they actually start to retract their processes into the deeper layers of the gut. In other words, if you ingest the wrong things, pretty soon the neurons in the gut remodel, the bad kind of neuroplasticity, and you lose your gut brain sensing system. And so it's not just a matter of giving it the right things. It's really about, for many people, it's gonna be about repairing this system and allowing this portion of our nervous system to grow back. Now, the nice thing about peripheral neurons is that they grow back.

Hey everyone, it's Dr. Mark. Now time and again I've had my patients tell me they're too busy to eat as healthy as they like. And that's when I ask them how much time they spend on email or social media. I like to tell them if they have time to scroll, they have time to shop online for healthy foods. With Thrive Market you can order all your favorite healthy pantry staples, snacks, household and body care goods and so much more and have it delivered right to your door. Thrive Market is an online membership based grocery store that makes eating well convenient and more affordable. They've got everything from ethically sourced cabinet essentials to sustainable meat and seafood, non-toxic cleaning products, personal care items, and lots more. And they make it super easy to search by category like paleo, vegan, low sugar, or gluten free. You can get a monthly or annual Thrive Market membership to find the perfect fit for your family. Even with a crazy schedule and tons of travel, I'm always able to have what I need when I get home, thanks to Thrive Market. Right now, if you go to thrive market.com, forward slash Hymen, you can get $80 worth of groceries free. That's t-h-r-i-v-e-market.com/hymen. Did you know that 80% of people are deficient in omega-3 fats? Omega-3s impact every cell in your body and help support your brain, your skin, your heart, your immune system, and lots more. And that's why I recommend eating at least two servings of wild or sustainably raised cold water fish per week to get sufficient amounts of omega-3s. But I also know how hard it is to get enough fish on your plate day in and day out, which is why I rely on Nordic Naturals to help. Nordic Natural Omegas are pure concentrated Omega-3 fish oil made from 100% wild caught fish. Their top selling Ultimate Omega products are available in soft gels, liquid, and new zero sugar gummy chews. One of the best things about Nordic Naturals is that their products are grounded in science. Everything is non-GMO, third party tested, formulated with care, and responsibly sourced. Nordic Naturals is a great company with great products. I personally love using Nordic Naturals Ultimate Omega Fish Oil to shore up my Omega-3 intake. And I know you will too. Shop today at nordic.com and save 20% using the code FARMACY. That's F-A-R-M-A-C-Y. These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, or cure or prevent any disease. And now let's get back to this week's episode of the Doctor's Pharmacy. By the way, I just gotta unpack that because what you said was just so profound right there. basically you're talking about uncoupling the natural ability of our body to sense its environment and to self-regulate in the right way to create health when we eat processed food that contains ingredients that screw up the gut microbiome or the lining. And all of a sudden that the brain in the gut, or whatever you want to call it, the neurons in the gut, start to change as a result of the crappy food we're eating and make us less able to seek out and want the foods that are good for us and tend to make us seek out and want the foods that are bad for us.

Exactly.

That is a massive brain state shift for me because I never really understood the mechanics of how that happens. But it's clearly true when people or eating bad foods, they want more bad foods and they keep eating more and more of them. And there are many reasons for that, but the gut story is just fascinating.

Yeah, these neurons and really, you know, I tip my hat to the Borreslab. It's cool, you know, science as you know can get really entrenched and then someone comes from a completely different perspective of, you know, his background in nutrition. And he described, it actually, it's a relevant story here. He had a friend who was, she was very overweight. and she ended up having a gastric bypass surgery. And she lost a lot of weight and her diabetes went away. But she also started craving runny eggs, you know, easy over runny eggs. But previously, just the thought of runny eggs made her nauseous, made her want to vomit. And he heard that story and he realized that cravings themselves are modified by the conditions of the gut. How could this be? So he started exploring, what are these neurons in the gut? What brain areas are they talking to? It's very clear that these neurons that innervate the gut, they're part of the vagus nerve, connect to the brain areas that release dopamine and create craving. And so the health of these neurons in your gut is strongly going to impact what you want. And so what I love about the literature, and I haven't had anything to do with the research I'm describing, but I've spent a lot of time with that work. What I love about the work that he's doing and others are doing is that it really points to A, the brain-body connection is mediated by neurons. B, that what we crave and what we seek really can change. I think that a lot of people that are having a hard time shifting towards healthier eating or healthier relationship to light, so we talked about a few moments ago, it starts becoming reflexive, not just because it's better for us, but because our nervous system actually remodels itself in ways where the good stimulus starts to evoke dopamine release.

Yeah, I find that for so true. If I go off track, I just want more of the bad stuff. If I stay on track, I want more of the good stuff. Like I naturally will crave the things that are good for me. But I think what's happened through our radical dietary changes is we've gotten so far away from our natural sort of ability to seek out things that nourish us and we've lost that. Animals have that. They're not going to be running around eating things that are going to make them sick and gain weight and cause damage to their gut microbiome or whatever. But they're not thinking about it. Their body naturally will seek out, oh, I want this plant because it's got this nutrition in it or this one has this phytochemical. They're not thinking that, but their body is telling them where to go, where to look and what to eat. We've sort of really decoupled our ability to be in touch with our natural healthy cravings and have been hijacked by the food industry to desire all these foods that are driving us into worse and worse states of dysfunction, poor health and poor brain states and poor brain function.

Yeah, it's interesting because the discussion about light and the discussion about food are remarkably similar from the perspective of these neurons in our eye, they don't think. They'll respond to light at 1:00 AM when you're watching Netflix, just as well as they'll respond to sunlight because of their sensitivity at that time of night. They don't care. They'll work for you or they'll work against you. They don't have a mind of their own. They're just cells. These cells in your gut are the same. And so I think that what's exciting as more and more of the neuroscience emerges and these other fields like nutrition start to really infiltrate neuroscience in a positive way, we're starting to realize that Giving the brain and the body the proper stimulus. And there is a proper stimulus. There is a right time of day to get sunlight and light in your eyes. And there's a wrong time of day. There's a right set of nutrients, amino acids and fatty acids are what your body really craves. But we've been giving it decoys, right? Sugar is a decoy. It really is a decoy. These neurons, unfortunately, respond to sugar, connect to the dopamine centers of the brain. and as I mentioned before, even if we don't taste the sugars, they're triggering these mechanisms. So I think that neurons are both beautiful and remarkable, but they're also dumb. They'll send these signals to your brain to a variety of things that you give it. So you wanna know what is the proper input? Like, what do I need to give these neurons? When do I need to give it sunlight or amino acids, essential fatty acids? 'Cause that's really what we crave. There's no essential carbohydrate, and I'm not an anti-carbohydrate person, I eat starches. I actually find them very useful for falling asleep at night. They really help. Well, it's not only what to eat.

It'S what to eat when, right? We are totally flipped in this country. We eat all of our sugar and starch and carbs in the morning, not so much at night.

Yeah, I tend to do it the opposite. I'll fast in the early part of the day and then I eat meat.

And vegetables throughout the day and then starches at night. There are certain foods that actually cause stress in the body, independent of your thoughts. and there are certain foods that reduce stress in the body, independent of what you're thinking, right? So it's actually food can be a stressor or a relaxer, depending on what you're eating. Can you talk about the foods that tend to cause more cortisol, adrenaline, and stress in the body? And then some of the foods that we would be thinking about that might help reduce that.

That's such a great point. If we eat a donut with coffee and sugar, I'm going to an extreme here for breakfast.

It's not that extreme. It's probably the breakfast of most Americans. Americans. Dunkin' Donuts, yeah.

It's really stressful on the body, right? Why? Because it causes this spike in our blood sugar, because it gets digested and absorbed really quickly, our blood sugar goes up quickly, and the body goes, oh no, right? It gets stressful for the body. The body produces a bunch of insulin to help lower it, and then what happens is the blood sugar drops afterwards. And so those ups and downs in blood sugar like that are really stressful for the body. And when the blood sugar is dropping.

It'S a life-threatening emergency.

You gotta go get food. Right, right. So those, you know, if you're eating a lot of foods that cause your blood sugar to go up and then drop with, you know, those easily to digest and absorb, you know, you have a can of soda. I mean, we're, you know, those things really are stressful for the body. They create this stress, they create the cortisol response. It's one of the reasons we get a lot of weight gain around the belly when we eat those kind of foods because they are stressful for the body. and so instead we want to be really balancing our blood sugar.

And before you get to how to fix it, I just want to point out this study that was just so mind blowing when I read it years ago by a friend of ours, Dr. David Ludwig from Harvard. And he took kids that were overweight and fed them three different breakfasts, right? Oatmeal, steel cut oats, and an omelet. Same calories, okay? Same calories, but different carbohydrate, protein, different fat. What he found was that the kids who had the regular oatmeal, like the quickly absorbed oatmeal, we think oatmeal is healthy, right? It's not like they're having a donut. Their insulin went up, obviously their blood sugar went up, but their cortisol went up, their adrenaline went up. So the body perceived it as a stress. Whereas the kids who ate the omelet didn't happen. And then the kids who ate the oatmeal were hungrier and wanted more food. So we know that starch and sugar create a biological stress response in the body. And that's bad. In addition to the fact that the sugar causes a problem, your brain chemistry and your neurotransmitters are talking to your fat cells and they're telling them when they're under stress to store more fat. So literally stress makes you gain weight independent of what you're eating. So it's really, it's fasting when you look at weight and other issues. It's so connected.

It's so connected. It's fascinating. So, I mean, so really balancing blood sugar is so powerful. It's, you know, I mean, people sometimes we say these things again and again, like, you know, balance your blood sugar, have a good source of protein, healthy fat and fiber at each meal. And sometimes we say it so much that I wonder people just, oh, yeah, it's the same thing. They're just saying eat healthy. But it's really critical to have a good source of protein, healthy fat and great source of fiber at every meal because it's, It is not allowing for that stress response to happen in the body. It's nourishing the body and that's exactly what the body needs.

Yeah, and so I think using food and having the right quality fats, low glycemic diet, lots of fiber, phytochemicals, these are all messenger molecules that help reduce the stress in the body.

Yes. So we always start with food first and this is a great place to start in this area, really working to balance the blood sugar, preventing those spikes in blood sugar, preventing that stress.

I remember when I was filming the movie Fed Up. Yes. And one of the scenes was where the mother was like trying to get her kids to lose weight and her family to lose weight. And she's like, well, what I really focused on is healthy breakfast cereals. And she pulls out these cereals that are marketed as, quote, health foods. I mean, Kellogg, who invented breakfast cereal as a breakfast food, which wasn't a thing, right? These are basically Desert for breakfast, it's 75% sugar and it's bad as having a soda with breakfast. So, I think people need to get that cereal and starch for breakfast is a huge no-no. If you can do one thing to change your biology quickly, it's get rid of any starch or sugar for breakfast.

Yes, yes. You said that it's like eating sugar for breakfast. I will up the ante here. It's much worse. When eating dessert for breakfast, peach pie has an average glucose spike of 46 milligrams per deciliter. Cinnamon toast crunch is 59. It's, you know, and they both have, of course, the refined seed oils and the flour.

It's worse.

So, okay, give me the peach pie. I love peach pie. I know, exactly. Exactly. So you mentioned, you know, breakfast, getting rid of the breakfast foods that, have the refined starches. This has been one of the most fascinating things we've seen because All the common American breakfast foods are in the worst 100 foods that score. And these, just to run through them really quick, we're talking about, this is in our worst 50 foods, egg McMuffin, bagel with cream cheese, French toast, Pop-Tarts, cereal, English muffin, blueberry scone, cinnamon roll, Cheerios, croissant, toast with jam. Those are all above a 40 milligram per deciliter spike. So that's a lot of big spikes.

It's a lot.

If you look at then the best foods in our data set, like very little glucose spike, you also see a handful of breakfast foods. And so these are the ones we want to eat.

Like what?

We see frittata, we see avocado and egg, avocado and greens, chia pudding, Greek yogurt and berries. And we actually see this, a lot of people log this, I think because Kelly LeVeque is sort of close in our network, but we get a lot of logs for the Fab 4 Smoothie, which is a smoothie that she has popularized, which is really balanced. It has very minimal fruit, a lot of protein, fiber, fat and greens. And all of those that I just mentioned all score below 20 milligrams per deciliter. So you want to get, I mean, it's basically, Mark, it's the Pegan diet. People can read your book and it's the beautiful nutrient-dense foods that none of those have refined carbs. And I think people sometimes assume that, oh, if I'm gonna have a keto breakfast or a low carb breakfast, I need to eat the animal products. That's not true. Half of those things I just mentioned don't have animal products. The Fab Four Smoothie, the Chia Pudding, you could do non-dairy yogurt with some berries, some avocado with, you know, and so, so that's just something important to remember that breakfast is this one straightforward. Don't eat those first things.

Eat those things. So fat and protein for breakfast. Get rid of the starch and sugar. You talked about the importance of a morning routine? Because yes, we know the harm of stress and we can go into that more, but I think people get it. What are the three M's you talk about that you can practice every morning to start your day and actually kind of get ahead of the stress?

Yeah, so I call these the three M's of a morning routine. The first M is mindfulness, the second M is movement, and the third M is mindset. So I say, look, I'm a huge fan of morning routines because they give you a period of calm in the morning that's just going to make you a bit more resilient to cope with those stresses that will come up in your day. It's not if they're going to come up, they will come up. But I think the 3Ms provides a very valuable structure to help you think about what are you going to put into your morning routine. And it works. If you have an hour in the morning, it works beautifully well. If you only have 5 minutes, like some of my patients, it can still work really well. So the first term, mindfulness, can be meditation, it can be breathing, you know, it can be a practice of mindfulness. Whatever you want can go under that umbrella of mindfulness. I personally, currently I'm doing the Calm Meditation app. So first thing when I get up in the morning, I'm plugging into the Calm Meditation app. I put my phone on airplane mode so I can't see any of the incoming noise that might be on there. And I do 10 or 15 minutes meditation. Some days, Mark, I hit the zone and I feel really, really calm. Other days, I just go through my to-do list. But what I've learned to do is not beat myself up about it on those days where I'm going through my to-do list. I'm accepting that, hey, you know what? My mind's a little bit busy today. That's okay. Whereas even 18 months ago, I would get slightly frustrated, oh, I can't switch my mind off. I can't clear my mind. So I think that's a great practice.

For people to do.

Then I move on to movement. Again, movement can be anything depending on what you like. I do a lot of hip stretches, maybe some yoga moves, maybe some workouts on a step, maybe some press ups, whatever I feel like for five or 10 minutes. That is all I do. And then I'll move on to mindset. So, mindset can be anything to put you in a positive frame of mind. So, it could be reading a book that you find very uplifting for a few minutes with a cup of tea in the morning. It could be doing affirmations. And actually, you know, like many people listening, I've got young kids, right? so my daughter, who's currently six, has a sixth sense when daddy is up, right? So I try and get up before them and get my morning routine done, but she can sense when I'm downstairs doing it. And often she'll. She'll creep down in. Often it's in my second end in my movement, which is fine because she just does the movement with me. But if she's there with me for the third end, which is mindset, I'll do affirmations with her. So we'll sit there together. I'll hold her hand. She'll hold my hand. and we will say for about two minutes, I'm happy, I'm calm, I'm stress-free. I'm happy, I'm calm, I'm stress-free. And we'll just repeat that for two minutes. And at the end of those two minutes, she's got the most beautiful smile on her face. I feel totally relaxed and calm. And that calm continues throughout the day. That's the beauty of it. It's not just in the moment. I'm more resilient to the stressors in my life. Now, for people who are thinking, I don't have time for that. 'cause I've got a lot of patients who are single mums who might be working two jobs. I managed to persuade them to give it a go even for five minutes. And one of my patients simply does this. She does her morning routine with those 3Ms in just five minutes. She gets up and for one minute she will do deep breathing. She does a breath that I taught her called the 3-4-5 breath. When you breathe in for three, hold for four and breathe out for five. Okay, she does that for one minute. Then she does two minutes of some yoga moves that she learned on YouTube. Right, so this is super accessible. She didn't have to go to a class even though I recommend yoga classes. She learned some moves on YouTube, which she likes. And then for the final two minutes, she's got about three or four books that make her feel good. And she literally for two minutes, she reads three or four pages from that book. And she has reported back that actually that has really, really helped her. In fact, she thinks it's helped her eczema get better, which is remarkable because There are many things that can cause eczema. Eczema we know ultimately is a slight dysfunction of the immune system, stress impacts the immune system. So for her, doing that morning routine, she feels is helping her with her skin. For somebody else, it may not do that, right? But I just want to really get across how powerful these small intentional moments of calm are. So again, I hope people listening think, you know, maybe I'll try that 3:00 a.m. morning routine for about seven days or so and see how you feel.

Yeah, I know it's so powerful. It's just building the structure of that into your day. And I think when I do it, it makes a huge difference. And like yesterday again, I was preparing for my show and I'm like, oh, I got 300 emails, I want this to do and that to do. And I'm like, no, no, I'm just gonna stop. I'm gonna do a little meditation in the morning. I went to work out a little bit. I went to the beach and just sat on the beach, went in the ocean for a little bit. And my mind was clear. I felt calm. It was like. And it set me up for an amazing day, which, you know, often don't give myself that. I mean, I. I usually meditate in the morning for 20 minutes and we'll exercise when I can.

Can I. Can I ask a question, Mark? Do you ever feel you know how important meditation is for you in the morning, but do you, like many of us, sometimes feel, oh, I'm too busy today. I don't have that 20 minutes. I just want to get ahead with my emails. And if you do that, I think it would be interesting for people to hear that is, do you fall prey to the same pressures that we fall prey to?

Absolutely. I've got the stuff I got to prepare for. I don't have time. I've got to finish this. I got to do that. And yeah, but I'll usually fit it in somewhere else. And I think it's probably a false notion. It's probably not even true that if I did it, I'd feel better. And when I do it, especially when I do it regularly, like twice a day, I don't feel stressed.

About anything.

Like, I'm resilient, I'm calm, I'm more productive, I'm more focused. And it's like, well, how do you have that much time every day to meditate? Well, turns out I don't have the time not to because of the impact it has on the quality of my life, the quality of my happiness, the quality of my experience, the quality of my relationships, and my overall well-being and my productivity. So I think it's, I've learned that it's something that's essential. and it's not just an add-on it's as important as eating well and exercising.

Yeah. Now thank you for that. I mean, I find that when I don't do my morning routine, when I think that I'm too busy, I feel it later.

Yeah.

You know, I get stressed at things. Things take me longer than they would have done. And I've, you know, I'm not perfect, but I've certainly trained myself to actually do it. And I find, you know, the more you can do it at the same time every day, the easier it is to create that new habit. And if again, if people are listening to this, I'd say the last few months I've been really delving into behavior science in terms of what does all the best science and behavior change say about how we create new behavior?

Yeah.

And, you know, research from Duke University suggests that over 50%, I think it was 56% of what we do in any given day is habits. Yeah. It's not conscious thought, it's habits. So the way to create new behavior is to stick it on to an existing habit that you are already doing without thinking. So for example, in the UK, I don't know if it's the same here, but a lot of people like to put the kettle on in the morning and make themselves a hot drink, whether it's a coffee or a cup of tea. So with many of my patients, I start simply that. I say, look, how about when the kettle's on, what do you do? Oh, I normally flick emails or go on social media. I say, okay, why not when the kettle's boiling? Why not for that one minute do some deep breathing? and it's amazing how powerful that is because they don't need to find time in their day because many people say they don't have time. They're already going to be boiling that kettle. So they're using that time productively.

Yeah.

To get that one minute of deep breathing in.

Yeah.

And again, breathing is one of the simplest and fastest ways to switch off your stress response. Breathing is information for your brain. It's information for your body.

It's true. You know, we were talking earlier about BJ Fogg, who's a behavioral scientist, and he talks about behavior change having to be broken down in something that's you have an intention to do, you have a desire to do, you have the ability to do, and you have a trigger to do it.

Exactly.

And so, for example, I really wanted to do more push-ups because I'm getting older, I don't want to lose muscle. It's important. And I'm like, oh, I'm so busy, but I know it takes, like, 30 seconds or a minute for my shower to heat up in the morning. So I basically have a trigger, which is I turn the shower on and I drop down on the bathroom floor and I do my 30-50 push-ups and then I'm good. And it's so simple and at that time, I don't know what else I would be doing there. They're just sitting there waiting or looking at my phone, but it's a simple behavior change habits that you can integrate.

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