4 ways your thoughts affect your metabolism, gut and longevity | Sarah Ann Macklin

Dr Rupy: What if I told you that two people could eat the exact same meal with the exact same calories and have completely different hormonal responses because of what they believed about what they were eating? Or that a group of women lost weight and dropped their blood pressure by 10% just by changing the way they thought about their daily activity. Well, these aren't fringe findings. The way we think about our health can meaningfully impact our biology. My guest today is nutritionist Sarah Ann Macklin, Sunday Times best-selling author of Healthy Shouldn't Be This Hard. And on this episode, we're going to unpack four ways in which our thoughts can either help or hinder our health. There's a body of evidence showing that the belief you hold about your food, your movement, and even your genes can rewire your biology, and why we all need to learn the art of self-compassion to truly shape our health for the better.

Sarah Ann Macklin, how is it possible that our thoughts can affect our hormones and our health?

Sarah Ann Macklin: So, my background is a nutritionist and I was always really aware about how important food is, right, for how we think and how we feel. And it is, there's so much to be said in that. But there is a massive missing ingredient here when it comes to how we look at ourselves with health information, how we relay health information and how we interpret health information. And so for me, yes, it's bidirectional. It's not just the food that affects our mind, it's bidirectional, our mind can also affect our entire physiology. And that to me was the missing, kind of the missing picture. And so I first started coming across this research by an incredible researcher at Stanford called Dr Alia Crum and she is someone who I have looked up to now for years. She did this fascinating study called the milkshake study. So what she did is she gave two participants, I would quite like to be in this actually, if I'm honest with you. Two participants, what she told them was milkshakes. And she said to one group, this has around 600 calories in, and she said to the other group, this has got around 180 calories in. She labelled one indulgent and one diet. So just think about how many times you're going out, maybe looking at drinks and ordering something that's diet or healthy or like, oh, I'm going to indulge tonight and have something a bit more delicious. And then she looked afterwards at the participants and how they responded with their hunger hormone. And the one that was indulgent, their hunger hormone actually decreased, which meant that they felt more fuller and they didn't want to eat anymore. The ones in the diet group, their hunger hormone didn't change. What was interesting is both of those milkshakes both contained 380 calories.

Dr Rupy: So they were identical.

Sarah Ann Macklin: They were identical.

Dr Rupy: Wow.

Sarah Ann Macklin: And so sometimes when you're relaying figures, it can be hard to catch up, but basically, neither was indulgent or diet. They were both exactly the same, but the perception that the participants had in that study thought actually changed the way that their hunger hormone related to what they thought and perceived that milkshake to be.

Dr Rupy: This is wild.

Sarah Ann Macklin: Isn't it wild? And so I'm thinking, hang on, for years, I've been seeing clients in clinic as a nutritionist and I'm like, this is really healthy. No, this is more indulgent. You shouldn't be having this this often. And if you're thinking about when you read in the news or when you're looking on Instagram, the way the linguistics of how food is is, you know, described and interpreted has the biggest effect, maybe more than the food itself. And so I'm like, wait, that should be the baseline of scaffolding when we're talking about health and food. And so that took me down an entire massive journey as a nutritionist to totally change the way that I kind of work with with clients, work with myself, but also really wanted to get this message out into the world that actually, before we start with all the external metrics, which can work and do work, sometimes people can be doing all the right things with health. I'm sure you've seen this, and I've been there myself. I'm doing all the right things and yet I'm still feeling terrible. I'm still not getting that result. And it's the mindset piece that's so important.

Dr Rupy: It's so important. I'm so glad you wrote the book and you're, you know, the book is littered with a whole bunch of these different examples that we're going to unpack today. There is another example in your book around this whole idea of how you can adjust your hormones with thoughts with another study from Ellen Langer about sugar labelling and blood glucose in actual people with type two diabetes. So those with a metabolic condition can still be primed by the way something is labelled on a drink.

Sarah Ann Macklin: Isn't this crazy? So Ellen Langer is, they work together quite well. So she is, she's a pioneer. She's the oldest scientist and first woman scientist at Harvard. And so just for that, I think she's a superwoman.

Dr Rupy: I didn't realise that. Oh, wow.

Sarah Ann Macklin: Yeah, she's like pioneered and you know, I mean, she's a tough cookie. I've had her on the show. And you can see how she's pioneered. She is, she's a force of nature. And I think, you know, Alia Crum's kind of come up behind her and they work very, very closely together. Two of the most phenomenal scientists and they just look at the mind and body in a different unit. I mean, Ellen Langer will say it's not the mind and the body, it's mind-body. You know, we shouldn't be looking at this as two different things that are attached together. They are one set, they are one full unit. And I think that's where we've gone wrong. We're kind of treating everything from the body down as opposed to looking at it from the head up because all of our thoughts upstream is what's causing the inflammation, the chronic disease, all of these things, how our cells metabolise food. And so the one that you mentioned, so I actually got it here because it's one of the studies that I find really, really fascinating. But I'm going to look at it so I don't make sure I get my stats. But she basically conducted a study looking at food labelling. And so if you think about food labelling in the UK, think about all like the traffic light systems and the way that we again, we're interpreting food, right? And so automatically we're making a very snap judgment straight away by what we're being perceived. And the perception I think here is the biggest thing because that is changing how we're seeing things and it's also creating a memory bank. And so the brain is using all of our past memories to create our predictions. And I think that's another really interesting point that we need to remember. But she basically looked at drinks that were either high sugar or low sugar, but labelled. And 30 people with, so it was small, but with type two diabetes were given the same type of drink with labels, but suggested with the different types of sugar contents. And what was fascinating is that participants' blood glucose levels actually went up when they thought they were consuming a high sugar drink, even though again, similar to the milkshake study, all the drinks were the same.

Dr Rupy: Yeah.

Sarah Ann Macklin: So again, the perception, I always think about this with like, I don't like saying brand labels, but I always think about this with like Diet Coke and Coke Zero, right? And it's like, okay, is our blood glucose response literally responding to just the label and nothing else? And I think that is what's so important. Everything that, and I think about this now with GLP-1s coming out, if you look at the, you know, how restaurants have now consumed with menus, they're putting calories on the menu. And Alia Crum did a really interesting study again with the linguistics of food, that just how you describe a food will also change what you, what you decide that you're going to consume and also how your body responds to it. So if you think about a garden salad, okay, we know that's good for us, but our body will feel hungry because it's so bland in the labelling. But if it's then also being touted, you know, think about a juicy, delicious, crunchy hamburger, your body is like, oh my gosh, the signals are going off. And that is how we look at food on a label. Whenever do you get like a beautiful salad that is probably full of so much goodness and so much fibre and so much crunch and so much protein described in a really moreish way. It's normally the indulgent foods that are moreish. So even the descriptions on menus are affecting how we're metabolising and responding to food.

Dr Rupy: I'm so glad you brought up the the traffic light system because it's like one of my bugbears. Because when you see something that has got really nutritious ingredients in, nuts, seeds, really good quality high fibre ingredients, and you see a red on that wagon wheel, it immediately gives you this idea that it's unhealthy just because of the fat content, where we know, you know, monounsaturated fats, even different types of saturated fats can have different effects on your body. But that priming of, oh, it's red, ergo it's bad for me, is something that we need to really unpack for a lot of people. And it's it's hard because when you go into the supermarket, because of legislation, which probably has it, you know, their their mind in the right place of what they're trying to do at a population level for public health needs, it it it's still going to have that negative side effect if we don't take into account the fact that priming thoughts is going to have downstream effects.

Sarah Ann Macklin: Well, I look at this as well, and I don't want to get a lawsuit against me by saying this, so I maybe won't say what it is. But I write about this, I had to be, I had to take their name out of the book. My publisher was like, let's just be very careful with how we talk this. But you know, we have a lot of weight loss groups that are funded by the NHS. And there's parts of them that are incredible. It's a community-based, right? When you have community support and you get people kind of rallying in your group, that is obviously going to lead to part weight loss. But a lot of the foods that they do are on point systems and they're not nutritionally dense. And so we're already priming our brains on point systems, which I'm now kind of debunking in this entire book is the wrong way to go. Like we need to be consuming the nutritious food, all the things that you and I talk about, but also priming them in a really delicious way, not looking at foods that are diet foods that are full of hardly any nutritious foods and touting them as that's the way to lose weight. Like all of these perceptions are are fundamentally changing how we're consuming the food and and potentially leaving people hungrier afterwards and feeling more deprived and feeling less nourished. And I think that's such a such an important conversation that we're just not having.

Dr Rupy: Totally. I mean, like when we create recipes on the Doctor's Kitchen app, I'm always reading the copy and thinking, okay, this has got to sound nourishing, delicious, like something you want to look forward to when you're planning your meals for the week, because if it sounds bland or like, oh, this is kind of drab because it's more functional than flavour.

Sarah Ann Macklin: Functional is such a good way to describe it.

Dr Rupy: Yeah, it's just like it it it's not going to leave you with that satisfying feeling afterwards if you've had like, you know, bland kale salad or whatever it is, right? You know, we're always going into the the textures, the sort of heritage, the spice, the zing, the sort of like the citrus notes, all the all that kind of stuff. Like which is, you know, it's very onomatopoeic. It's you know, I I I really want that to come across in all the imagery as well as the recipe nomenclature.

Sarah Ann Macklin: Actually changing your customers' metabolism and how they're responding.

Dr Rupy: Well, now I know after reading your book.

Sarah Ann Macklin: Yeah, now you know. I mean, you're literally making a change not just because you're getting them to eat delicious food and nourishing recipes, but you're literally changing their mindset towards food unknowingly. You're doing that, but you have literally done that.

Dr Rupy: Yeah, yeah. Let's move from from thoughts and and food to thoughts and movement, because this is a really real big eye opener for me about how your beliefs around how you move your body can literally change body composition without changing the movement itself. This is wild to me.

Sarah Ann Macklin: This is wild, and I actually relate this in the book to busy mums.

Dr Rupy: Oh, great. Yeah, yeah.

Sarah Ann Macklin: Because I do a lot of case studies in the book from people that I've been seeing over the last 10 years. And if you if you're a busy mum listening to this, or if you're somebody who, I don't know, is on construction or is on their feet all day or is a waiter or anything like that, somebody who just moves. I mean, sadly, a lot of us sit at desks, but if you are someone who is up up and down the whole day, this will really, really relate to you. So again, Dr. Ellen Langer, she did this, this is one of her first studies and it was called the chambermaid study. And she went to the chambermaids and she said, how often do you exercise? And they all looked at her in despair and were like, never. Like I never have time. I'm working all day on my shifts. So she took half the participants and she said to them, okay, this is how much energy that you expend when you're literally taking the laundry, walking up and down the stairs, changing the bed, hoovering all the hotel rooms. This is how much energy that you expend.

Dr Rupy: So these are ladies working in hotels.

Sarah Ann Macklin: In hotels.

Dr Rupy: Okay, got you.

Sarah Ann Macklin: And so a month later, she went back and she said to the other part of the group, nothing. So half of the group then had that perception of mindset of, wow, every time I do this hoovering or change the beds and do my 10-hour shift, this is how much energy I am expending. The other group weren't told anything, so they just carried on as normal. A month later, the ones that had done the perception mindset exercise of, wow, this is how much I'm burning, they lost 10% of their body weight, but around their visceral fat, around their stomach, which we know is the most important determinant of where to lose weight because that's linked to chronic disease and metabolic disorder. So if we want to lose weight, we want it to be around our waist. Their blood pressure dropped by 10%, which you know this is a doctor.

Dr Rupy: That's wild. Yeah, that is wild.

Sarah Ann Macklin: They had so many different health metrics change, but the funny thing was, nothing else changed. They didn't do more exercise. They didn't increase their hours at work. The other group, which was the control group, nothing changed. They didn't lose any weight, their blood pressure didn't change. And so none of their metrics that were measured had any effect, they just stayed the same.

Dr Rupy: Wow.

Sarah Ann Macklin: So the perception of what they were telling themselves. And then I thought, when I was interpreting all this research, I thought, think of the busy mums. I always think about the mums that come and see me in clinic who sit down to me and they're like, I just don't have any time to do exercise. All of my friends who don't have children, you know, they're still going to the gym in the morning, they still have their lives. You know, I used to run marathons, I don't have any time to train anymore. It's always like this depleted mindset that they're never doing enough. Yeah, I think mums are the biggest superheroes out there because they're doing everything. And you know this because you've just had a child and I can imagine with your partner, you see her like never sitting down. It's like she's probably more exhausted now than she's ever been. And she's like running around, grabbing toys, like constantly on the go. And I relate that to the chambermaid study. I'm like, we should be distilling this information to the busy mums where it's like, you might not be going to the gym and doing a 45-minute session, but you're doing way more than that probably because you're up and down the whole time. And when we think about exercise, it's not about standing in a gym and doing so many reps. It's about the constant movement of your body. And I think we've misaligned. Like you look at the blue zones, they didn't go to the gym the whole time. You know, the people in Sardinia are walking up and down these hills, they're carrying their bags of shopping, they're constantly moving their body. They're not running at their their, you know, at speed on a treadmill. Doesn't say that doesn't work, but it's just saying like we need to be looking at this in a different way. And so I really hope that, you know, with all these studies in the book and what I'm trying to present is that if we can change our mindset towards actually how much we might be doing, it could have actually a massive effect on our health.

Dr Rupy: I I completely agree and I think again, there is this mismatch between public health messaging around 150 minutes of moderate to vigorous activity every single week, plus a couple of strength training sessions. And if you don't hit that, then, you know, you're not doing as best as you can for your cardiorespiratory health and reduction of metabolic disease and all the rest of it. Whereas actually, if you tot up all the little incidental things that we do during our day, you know, walking to the train station, picking up toys, going to nursery, you know, doing the hoovering. This morning, literally, like my wife had to go early for work, so I was I was dealing with Rafs and his breakfast and all that kind of stuff. I had him in my on my hip and I'm doing the porridge at the same time. So it's like a kettlebell. He's 12 kilos. It's heavy, you know. So I'm like on one side and then I've got to switch him because he's like doing something else and then I've got to throw him in the air because like got to keep him like active, like happy and like and I'm just I've just tot all these things up. And one of the one of the things that I think I'm finding myself um in a negative self-talk spiral with at the moment is the fact that I don't go to the gym nowhere near as much as I was doing pre-Raphael. Whereas actually, if I tot up all those little like kettlebell swings I'm doing with a 12k.

Sarah Ann Macklin: You're probably doing more.

Dr Rupy: I'm probably doing more. Yeah. So I need to like put this into practice myself. And I think again, to your point, if we relay this at a public health level, think about all those incidental things that you're doing during the day, that counts, that's actually helping your health. We know that it's it's literally having an effect on people's physiology.

Sarah Ann Macklin: It's changing our physiology. And one of my best lines ever is Audrey Hepburn where she says, I never went to the gym, but I always took the stairs.

Dr Rupy: Nice.

Sarah Ann Macklin: And I'm like, it's true. And I to get here, I walked up two flights of stairs. You know, I got the train here. I was walking up three flights of stairs at the train station. Like I'm moving all day. And I I think about that. I walk up the stairs and I'm like, think about Audrey Hepburn. She always looked, she was always in shape. And she always took the stairs. And so it's those things I think that we've got to start relaying in our mind of, you know, I haven't, I've been on a book promo now for like three weeks. I haven't managed to go to the gym. But I am on the go 24/7. And I'm I'm like relaying and rewiring the thoughts that I'm telling myself, whereas a couple of years ago before I wrote this book, I would have been like, gosh, I'm I have no time for myself. I'm literally not going to the gym. I'm not stretching. I'm not lifting my weights. And I would have put myself into a negative spiral. And I think it's so important to change that that self-talk is is one of the most powerful ingredients we have for our health.

Dr Rupy: Totally. And if people are listening to this and thinking, oh, well, that's one example of chambermaids, like how is this actually relatable to the general public as we're alluding to now? There is actually research looking at the NHANES data of like 60,000 participants, I think it was, who if they perceived themselves as less active, they actually had higher mortality rates. And the reverse is true of those who perceived themselves as being more active, whether or not they are or not. It's just that perception that actually has a literal effect that we can see in the epidemiological data.

Sarah Ann Macklin: Absolutely. Like I look at my dad and he was, he started off as a builder and he built a construction company. And you know, I think about, I mean, my dad now goes to the gym. He's 71. He now goes to the gym because he obviously he's not a builder anymore because he's 71. But you know, he was on a building site every single day and he was so in shape. And he would be doing physical activity all the time. I just don't think we think about people that are literally going out every day and doing physical work and we just don't put it down to exercise sometimes.

Dr Rupy: Totally.

Sarah Ann Macklin: I think it's so important. And I and I think a way as you said, messaging public health data, all of this like we should be doing this much a week getting our heart rate up. It's helpful to an extent, but I think we're not including everyone in how we're relaying that. And you know, I'm not going to the gym this week, but my heart rate's definitely been up because I've been running around in between things. I mean, I literally went to the wrong studio this morning. And I literally was like running from the station. And I mean, I've not got trainers on, but like all of this counts. But I wouldn't have thought about it in that way before. And as you said, that's a massive, that's a massive group, 60,000 people. And you know, and I think, you know, the the research that that we cite as well, you know, they're all very accredited, you know, Harvard, Stanford, they do a lot of RCTs, these are placebo control trials. And I think when I started uncovering all of this research, I don't know, I felt like I'd had a secret that I'd been holding on to because I was like, why is this not being spoken about? And you mentioned something really important at the beginning because when I wrote, started writing this book, I started writing it into the rise of bro science and the optimization culture because I was getting overwhelmed with it. I was feeling like I was depleting. I was like, I can't do all of these things. I'm not getting up at 5:00 a.m. and taking a cold shower. And also I was like putting on a cold shower and I was like, I don't know if I want to get under that cold shower. But everyone's telling me I need to because it's going to increase my HRV and blah, blah, blah, blah, blah. And then I should be intermittent fasting and obviously through the show I've learned that that's not what women should be doing. But I had all these should, should, should, should, should. And so the should, should, should, should, should leads to a massive lack of like depletion because you can't keep up with all the shoulds in life. Like there's so much that we have to think about today, literally to survive. And then we're trying to add on all of these things. And the sadness that I found with myself, but also with my with my clients, was that the ultimate goal is that we all just really want to feel good. We just want to feel well. Like we're that's what we're trying to do. But we're putting ourselves at the bottom of the list with all the things that we're not doing to get there. And the rise of this optimization culture, the the rise of the bro science culture is helpful to a degree and before it then it shifts and goes unhealthful.

Dr Rupy: I think there's a real lovely balance to be struck between the interest and like genuine excitement that we both have for some of these things like cold water therapy and intermittent fasting and, you know, certain modes of exercise that could be beneficial particularly as we age, whilst mitigating ourselves against the overwhelm of all this information. And it's like choosing which path you want and at what stage of life as well. And as you were talking about your dad, I was thinking about my dad as well, who's also in the construction industry. He's been in the bathroom business for 40 years now. He never sits down. He's always behind the trade counter, dealing with customers, running into the back of the warehouse, grabbing like little elbows and radiators and boilers and all that kind of stuff. So he's literally in the gym pretty much the whole day. And like he's stick thin. And he eats like a horse. And it's, you know, I I I had to remind myself to actually remind him that he's basically doing wonders for his heart health and wonders for his his brain because he is constantly moving all the time. And I think there is, if anyone's listening to this or watching this, there's probably someone in your life that needs to be told that. You know, what you're doing every day is actually phenomenally good for your health.

Sarah Ann Macklin: And what I love, you've just said one of the biggest parts of my book without even realising that you've just said it. So there's a part, so the the book is, so when I got all of this research, I was like, okay, what do I do with this? Like, how do I turn this into something actionable? And it's not about positive thinking because sometimes things aren't positive and that's really also important to recognise because I also get very frustrated if I'm not feeling positive and someone goes, oh, just, you know, just cheer up, just think positively. And I'm like, well, if I could, I would. Like that's really unhelpful advice right now. Um, and I'm a massive believer in, you know, the positive thinking leads to positive results, but we also have to be that we're human and if we don't experience all the different emotions, then we're basically becoming an AI robot. So it's important to feel the sadness and the joy and the grief and all of those emotions together. So I was thinking, okay, so our mindset is really integral. How do I get people to connect to this and change and help rewire and work with neuroplasticity? And what I was thinking is, okay, well, if we're stuck in the self-criticism loop, which we know, and we can go into the science and that in a minute, increases the stress response and we know that stress is like one of the leading factors of mortality here, um, because stress increases inflammation and we're now living in more chronic stress than ever, ever before. What's the antidote? And it took me a long time to get there, but the antidote to me was the cringe word of an English person who is probably listening to this too when I say it, and I say that with love, is self-compassion. The Americans have this down to a T. They they love it. Like whenever I say it in America, they're like, yes, self-compassion. And I say it to an English audience and they just look at me like I've got the death stare. And I'm like, I know we feel very uncomfortable with that word here, but as Oliver Burkeman once said to me, if you feel the cringe, lean into the cringe because that's where the work is. And I was like, that's such a good point. And so the reason why self-compassion is such a protective factor for mental health is you said something there really interesting. We should always tell someone in our life if, you know, if they're doing that, we should relay this information. It's a very compassionate approach. It's like, I see you and I see how much you're doing and how incredible you are and what you're doing for your health. You're giving massive compassion and encouragement and you're connecting them with empathy. It's flipping it. It's literally the external compassion back inwards. So rather than telling yourself, God, I haven't gone to the gym since I've had my child and I'm exhausted and I'm running all of these different things and the depletion mindset, you're giving yourself a compassionate friend filter. And you're basically not telling you that you love yourself. It is not that at all because that's what I couldn't connect with. I was like, I don't know if I love myself. Like I find that really hard to connect to. It's actually respecting yourself. It's giving yourself a bit of compassion. So you don't go to your friend and say, I love you so much every day. You're like, this is great what you've done. This is amazing. If someone was to come to you feeling like, actually, I've had a really hard month. I haven't connected any of my health goals. I've gone off, I've had a pizza nearly every other night and I've ordered in and I had no time. Are you going to tell them they're a loser? Are you going to tell them they're a failure? Are you going to tell them, well, you might as well just give up because, you know, there's no point going forward in any health goal because, yeah, the whole month's now destroyed. Like that's not what you're going to say to that person, right? And I think that's the most important part when it comes to compassion. It's honoring what you're feeling without it fully consuming you. And then it's like stepping into action. Okay, so like what can I change here? What is like the most supportive mechanism now for me to move forward? And that's the most courageous step with compassion. There's so much research as well that also shows that it increases motivation. And so, you know, a lot of us talk about willpower and the lack of willpower. And actually, it hasn't got anything to do with the willpower. And I debunk a lot of this in the book. One of the most important things was when it comes to self-compassion is that we know it actually increases your motivation. It is one of the most strengthening things that you can do to help support motivation and behavioral change. And when I finished writing this book, an incredible meta-analysis came out of 113 studies that showed self-compassion is the most protective factor for psychological well-being.

Dr Rupy: Really? Wow.

Sarah Ann Macklin: And it I don't know, it was just this moment when I finished it and I was like, damn, that's not in my book. But then I was like, yes, it's true. And I think we need to really reframe our connection and understanding to what self-compassion means. It is literally treating yourself like you would a friend. Which is really, really important. Like it is not, it is not giving yourself, it's not self-pity, it is not self-esteem. And I can go into why these are really bad metrics. Self-esteem is not a good metric to use. It's not self-pity, it's not weakness. It's actually a very courageous strength. You are stepping in and acknowledging suffering, you're connecting to common humanity, that lots of other people also feel this way, but you're actually going to make a step to make a change. And that is so important. That is like you're being your own best friend, your own ally. And and I kind of say you're your own CEO of your health by that point. And that's what happens with the optimization culture is that we feel we get completely lost and we're looking at all of these other things that other people are doing. That increases our comparison. Comparison is one of the most demotivating things you can do because you're trying to keep up with everyone else's life. You completely forget your internal life and your internal world and what you're feeling. And then you're working with wearables, which to an extent can be really helpful, giving you like weekly data, monthly data, recording your menstrual cycle, but allowing your wearable to dictate how you feel every single day, you're losing your interception, your internal signals that are saying, hey, this is how I feel today. You're externally outsourcing that to a to a metric by saying, actually, no, you feel like this today. And that changes your physiology because you're perceiving what something's told you rather than taking the autonomy and saying, this is how I feel. And so it's really, really important that compassionate mindset to use, like your body is like an incredible wisdom machine. It's it's literally working with you to say, hey, today we feel X, but we are so smart in our minds that it overrides all of our signals in our body.

Dr Rupy: Absolutely.

Sarah Ann Macklin: So compassion just brings you back. It brings you back to you.

Dr Rupy: On this pod, we we talk a lot about food and diet and we have a a bias towards physical activity and all that kind of stuff. And I think what I've learned from your work and the book that you've written is our thoughts can be powerful medicine. And it's definitely something that I'm trying to practice more so in my personal life. Like I mean, I went on a silent retreat very recently and I think, honestly, it's I I bang on about it all the time. So my listeners are probably like really bored of me constantly talking about it. And I don't think it's for everyone. I think for certain people, you want to microdose before, so go for like 30 minutes like without any stimulation and just sitting on a bench in nature and actually experiencing boredom just to see what that's like, because then you actually recognise that your brain is really powerful and you've got this working memory and it's like you can start piecing things together. And I spent a lot of those first three days that I was there just unpacking my childhood and earliest memories and just going through it very methodically, whereas if you ask me to do that during a working day, I wouldn't be able to, I wouldn't have the attention span. It would be a lot like slimmer because of all the pulls on our time. And so more and more in my personal life, I'm realising that thoughts are medicine. And I think the framework for your book, and obviously you're going to a lot more other subjects and ones that we've talked about today, is just giving me the impetus to really think critically about how I talk to myself and just the power of that thought insertion when I'm thinking about my diet or thinking about my exercise or, you know, what my the analysis of my blood results looks like and actually, you know, what those initial sort of visceral feelings are and how that's going to have a physiological effect.

Sarah Ann Macklin: Massive. And I think, you know, like the third part of the book is all tools. And it's interesting because I think you just I just displayed a lot of research and case studies in the book, but then I'm like, the tools was the hardest part to write because I'm like, how do you write self-compassionate tools? Like honestly, I rewrote that section like three times. Um, and I'm proud of that section now because I think there's we're also so different. And I'm sure you had this, but you know, when I went to my publisher, they were like, it needs to be a 30-day plan and it needs to be this. And I was like screaming, I was like, this is the opposite of what I'm writing about. And they were amazing. They were like, okay, well, what what would you do? Like, how can we get people connected to this? So I literally start the third part of the book by saying, my publisher wanted me to write a 30-day plan. And for me, the most important health message that I've always stuck to is that health is so individual and there's not a formula for every single person. Some people are much more cerebral, much more in their minds. Other people are much more in their bodies. And so we need different tools and techniques to support different individuals. And so from those three stages that I wrote, I ask each person to pick two of the 10 tools that are in each of those 10 in each of those three stages. So at the end, you get six tools and every person who reads the book will have a different toolkit at the end of it. And it's important that you try all the different tools because you're going to see, well, that doesn't resonate with me. Just as you said, for some people is incredible and life-changing. Like Mo Gawdat said he does it for like 60 days.

Dr Rupy: 60 days?

Sarah Ann Macklin: 60 days he did it. And he goes and I'm like, well, I don't know if I could do that. And then you start to feel a bit more shame, right? You're like, I don't know if I could do that. But I think that's the most important part of this book is that I don't want anyone to feel like they can't connect to a tool. I literally say there will be tools in here that you will not connect to. And there will be tools in here that will be life-changing for you that you'll really resonate with. And so I want you to make your own formula at the end with your toolkit that you have six tools that you can take with you that are free, that don't cost any money, that you can use to support the self-criticism thought loops and making them more compassionate for yourself going forward in life. And I think that's the most important part that we're so individual. We all have our own memory banks. We all have our own past experiences. We all have our own insecurities. Um, but being able to like use a compassionate lens with them in your own way, I think is the most powerful.

Dr Rupy: Yeah, absolutely. I mean, I'm not going to ask you to do a 30-day plan or suggest like one tool that people should do after listening to this pod, whether they're listening in the car or in the AirPods and putting that down. But if there is like a process or an exercise or a framework that you want to leave people with, what where do you think people could start?

Sarah Ann Macklin: So I think there's a couple of things. So we haven't spoke about the chocolate bar test yet.

Dr Rupy: Okay.

Sarah Ann Macklin: So that's the very start of the book. And this is how I get people to resonate with self-compassion in relation to food. So it's called the chocolate bar test. And I, when I was thinking about this, I was thinking, okay, how can we resonate this directly to food, but also how we see ourselves? So I think you're going to resonate to this a lot because you have a child. So your child comes to you, we're going to do this in real time, okay? Okay, so Raf comes to you when he can speak and says, Daddy, I really want a chocolate bar. And it's a Saturday. What do you say?

Dr Rupy: Uh, I say, well, I've got plenty of 85% plus dark chocolate in the in the store cupboard if you want.

Sarah Ann Macklin: I love this. This changes depending on who's sat across from me. And I knew that was going to come out. I'm just going to go 90, so you're a little bit kinder.

Dr Rupy: No, in all honesty, I'd probably say, I'd probably think about whether he's had lunch or whether he's had breakfast or, and then I think, okay, how am I going to like ensure that this behaviour is not just, you know, habitual. I'm like very much in my parenting era right now. So I'm constantly thinking about the psychological impact I'm having on my child. And so I'd probably have a reasonable stab at like whether I give him a little bit or whether I say, look, you know what, we're going to wait until after your meal, which is coming up, so you don't ruin your appetite.

Sarah Ann Macklin: Amazing. So I love that answer. That's the best best answer. And then after he's had his chocolate, after he's had his meal and his three years healthy protein and his fibre and all of his water. It's going to be such a such a healthy child. Um, and you give him his 85% piece of square. He comes back and he goes, Daddy, I want more. Can I have another one? What do you then say?

Dr Rupy: I say, well, why do you want more?

Sarah Ann Macklin: And he goes, because I do, it's so good. I really want another one. What do you say then?

Dr Rupy: I'm probably going to say, well, we're going to hold off until maybe a bit later, maybe tomorrow, because you don't want to overindulge, do you?

Sarah Ann Macklin: Uh-huh. And he goes, but Daddy, I want another one. Can I not have another one? What do you say then? I'm probably getting into an argument with my kid. I'm being really honest.

Sarah Ann Macklin: I love it. I love it. And why do you get into an argument with your child? Why?

Dr Rupy: Because I'm trying to enforce some sort of boundaries and an idea that he can't just expect to have everything all at once and he's got to, you know, um, not necessarily earn it, but he's got to understand the ramifications of overconsumption of certain foods, even if it is healthy, like 85% plus dark chocolate.

Sarah Ann Macklin: And that's not because you're mean, right? That's not because you hate him. That's not because you want to make him sad.

Dr Rupy: It's coming from love.

Sarah Ann Macklin: It's coming from love. It's because you love him.

Dr Rupy: Yeah.

Sarah Ann Macklin: So let's reflect the chocolate bar test back to ourselves.

Dr Rupy: Okay. Yeah, yeah, yeah.

Sarah Ann Macklin: This is the moment when it clicks for people. Because it's like, okay, so you've already thought about the first moment of when you're going to give your child that chocolate. Has he had his meals? He's not going to eat it before. He's not going to snack before. Like he can have a treat. Absolutely. I'm not going to like deprive my child of ever having a chocolate in his entire life. But when's the best time to give it to him? Because I care about how he's going to react to that. And I actually want him to have nourishing food first, and then I'm going to give him some chocolate. But when he comes back to me again, it's like, well, actually, I'm not thinking this is the best thing for you. It all comes from a place of care. And you know what you're doing. And I think most parents listening to this would probably abide by very similar rules. They know that having chocolate before a main meal is probably not the best. Having chocolate at 10:00 p.m. at night is not going to be the best. But they also do want to give chocolate to that child because they know that, you know, on a weekend, they they want to give them a square of chocolate. The flipping of it is really difficult because that's when people go, I don't use that same analogy in my brain with myself.

Dr Rupy: Yeah.

Sarah Ann Macklin: And that's the tool that I want to leave people with to start with. That moment of connecting back to, do I do that with myself? Is that my relationship that I have with my health? It's really important. You can do that with exercise, you can do that with your sleep. Like you probably wouldn't allow your child to go to sleep with a phone in their hand. But how often do we go to bed with a phone in our hand? You probably would say to the child like, let's switch off from screens because it's not going to help your sleep. But do we do that?

Dr Rupy: Totally.

Sarah Ann Macklin: So the chocolate bar test is a really powerful way to connect to the self-compassion experiment that I start with in the book.

Dr Rupy: I love that. I love that. So, I mean, that's definitely something I'm going to be taking away for myself. I feel like I do have like good sort of like, um, uh, frameworks and and a foundation of like, you know, keeping myself in the straight and narrow when it comes to like exercise. But the one thing I've learned from our conversation, obviously, loads of other things in your book is, um, the thought diary.

Sarah Ann Macklin: Yeah, the thought diary.

Dr Rupy: The thought diary for me, I'm definitely going to do that because I think I'm I'm I'm awash with negative self-thoughts, even though I've got quite a positive disposition. But I'm definitely awash with negative thoughts, whether it's when I'm driving or when I'm commuting on the train or whether I'm doing something online or whether I'm, you know, doing a pod, like thoughts coming in everywhere.

Sarah Ann Macklin: Yeah. Yeah.

Dr Rupy: And I think it's like, I've never done a a thought diary in the same way I've done a food diary or an exercise diary, you know?

Sarah Ann Macklin: Or a supplement stack like review, you know?

Dr Rupy: When I give my clients a food diary, there's also a thought column within it. So how are you thinking and feeling when you're having this food? What's coming into your mind? What are your thoughts just before? Because, you know, if you even like dial it back to not even what's in my my book, but just general, you know, when you look at people that have gut problems, there's so much amazing research now that it's maybe not just potentially food, there's also like the mindfulness techniques and all the kind of the rewiring that, you know, it is bidirectional, which is where we started our our conversation. And I think a lot of people feel like they go through all of these different types of diets and fodmaps and, you know, restrictions and exclusion diets and putting it back in and they're still in this state of like, what is going on? Why do I not feel better? And we don't ever think about what we're thinking, feeling or doing in that moment. Are you eating alone? Are you eating with people? How are you feeling? What shaped your day? That to me is one of the most profound things that happens to me when I work with a client. Because it's like we're matching the two. Like there's a whole there's a whole chapter on mindful eating, solo eating versus eating with a community versus how you can do it properly. Like all of these different, you know, I've lived alone most of my 20s and into my 30s. Um, you know, and I've lived with partners in that time, but I've always basically had my own lifestyle because I've travelled a lot with my work. And the impact of solo eating can be helpful and detrimental, but there's a really good way to do it properly. And I think all of these factors massively play in. And I think also understanding who you are, like the start of the book, I I talk about two different types of people that I see that both share the same connection, optimizers and lapsers. The optimization, you and I, we're the optimizers, right? We're always like, what can I do to keep going with my health? And then you have the lapsers who are constantly like falling off the wagon per se and then trying to go back onto the next diet and just always feeling in this like same loop. But the importance of the connection at the bottom of it is the self-compassion element. They're two different extreme sets of people, but they both share this common denominator of self-compassion. And so like when we can work on that, and I've seen it with the two different, I've had massively high performers that have come and worked with me and I've had the complete opposite. But when we work on this part, all the other health behaviours like start tipping into place.

Dr Rupy: I love that. Sarah, you are an inspiration. Your book's awesome. Thank you. And uh, I'm super excited and congrats. Sunday Times bestseller already. Amazing. Amazing. For a good reason as well. Thank you. But I've got so many tips and things that I'm definitely be putting into practice and I'm sure our listeners are going to absolutely love the book and and everything that you talked about today. So thank you. Really appreciate you coming in.

Sarah Ann Macklin: Thank you. Thank you so much.

Dr Rupy: Thanks so much for listening to this episode of the Doctor's Kitchen podcast. Remember, you can support the pod by rating on Apple, follow along by hitting the subscribe button on Spotify, and you can catch all of our podcasts on YouTube if you enjoy seeing our smiley faces. Review show notes on the doctorskitchen.com website and sign up to our free weekly newsletters where we do deep dives into ingredients, the latest nutrition news, and of course, lots of recipes by subscribing to the Eat, Listen, Read newsletter by going to thedoctorskitchen.com/newsletter. And if you're looking to take your health further, why not download the Doctor's Kitchen app for free from the App Store. I will see you here next time.