Show Notes

• Dr Michael Mosley website 
• The Fast 800 website 
• Australia’s Sleep Revolution with Dr Michael Mosley on SBS 
• The Fast Diet Books 
• Allan Savoury Unstress podcast 
• Dr Peter Brukner Unstress Podcast
• Defeat Diabetes Website
• Australia’s Health Revolution with Dr Michael Mosley on SBS
• Fast Exercise Website 
• Dr James Muecke Unstress Podcast

Timestamps

[00:00:00] – Introduction and acknowledgment of traditional custodians.

[00:02:53] – Dr. Michael Mosley discusses his diagnosis of type 2 diabetes and his journey into intermittent fasting.

[00:04:11] – Explanation of intermittent fasting and its different forms, including time-restricted eating.

[00:06:37] – Discussion on human dietary history and the evolution of eating habits.

[00:08:50] – Dr. Mosley on metabolic health benefits from intermittent fasting and the switch from sugar to fat burning.

[00:09:47] – Challenges faced by medical practitioners in accepting new health paradigms.

[00:11:14] – Impact of Dr. Mosley’s work on public and professional perceptions of diet and diabetes.

[00:14:53] – The balance between calorie focus and the types of food consumed.

[00:16:51] – The shift from high-carb to low-carb diets and their implications.

[00:19:14] – Personal anecdotes from Dr. Mosley’s dietary experiments and their outcomes.

[00:23:38] – Discussion on processed foods and the vegan diet.

[00:26:36] – The importance of protein in the diet and misconceptions about plant-based proteins.

[00:30:36] – How Dr. Mosley incorporates intermittent fasting into his lifestyle.

[00:32:26] – Changes in public health policies and their impact on dietary guidelines.

[00:35:51] – The rise of low-carb diets and public health outcomes.

[00:37:45] – Benefits of high-intensity interval training and fast exercise.

[00:44:00] – Exploring the significance of sleep and its impact on health.

[00:47:08] – How Dr. Mosley addressed his own sleep issues through the Australian Sleep Revolution.

[00:55:40] – Detailed discussion on sleep disorders and effective treatments.

[01:00:06] – The complexities of sleep research and the influence of light on sleep patterns.

[01:02:05] – Reflecting on Dr. Mosley’s media career and the intersection of medicine and broadcasting.

[01:05:52] – Closing remarks and the importance of addressing systemic issues in public health.

Dr Michael Mosley: Fast 800, Fast Exercise & Sleep

Dr Ron Ehrlich [00:00:00] Hello and welcome to Unstress. My name is Dr Ron Ehrlich Now before I start, I would like to acknowledge the traditional custodians of the land on which I am recording this podcast. The Gadigal people of the Eora nation for over 65,000 years have been the custodians of this land on which we are recording. I’d like to pay my respect to the elders past, present and emerging. Well, today we explore a wide range of topics from dieting, diabetes, exercise and sleep. And even more than that, my guest is Dr Michael Mosley. Now Michael is a TV science presenter, known certainly in Australia and in the UK and I’m guessing round the world, and is co-founder of one of the world’s most popular diet and lifestyle programs, the fast 800. He’s also a bestselling author and after studying at Oxford University, then qualifying as a medical doctor at the Royal Free Hospital in London, Michael went on to pursue a very successful career as a science communicator after being diagnosed with type two diabetes in 2012. And like many doctors at that point, was determined to manage his condition through diet and lifestyle. Michael came across intermittent fasting and created the very well-known five two diet, enabling him to shed nine kilograms in eight weeks and successfully put his diabetes in remission. Now, alongside his dedicated team, Michael has impacted over 100,000 lives through that fast 800 programme, guiding members towards improved health and wellbeing. He’s also explored fast exercise, high intensity intermittent training, which we talk about as well, and I personally find and found rather empowering. More is less. You don’t have to go on a ten kilometre run to gain the benefit of doing exercise. We talk about that now. He’s also fascinated by sleep, a subject that we’ve covered on many occasions on this podcast. And he recently launched the three part series Australia’s Sleep Revolution, now available on SBS On Demand here in Australia. And we talk about that as well. I hope you enjoy this conversation I had with Doctor Michael Mosley. Welcome to the show, Michael. Brilliant to be with you. Thanks, Michael, and thank you so much for joining us. And thank you so much for everything you’ve done over the years. You’ve been particularly inspiring. I’ve been following your career for at least the last ten years, and it really kicked off with intermittent fasting, which a lot of people freak out about. But it’s really I mean, tell us about intermittent fasting. How did you get into it?

Dr Michael Mosley [00:02:53] Sure. So it actually was 12 years ago. And at that point, I’d just been told by my doctor through a random blood test that I had type two diabetes, which was a nasty shock because my dad had developed it around the same age, and he then died really quite young at the age of 74 from complications. My doctor said, look, you can start your medication, but I thought, no thanks, I’d like to see if I can find something else. And at the time, I was making television programmes for the BBC, and so I proposed to them that I go and make a television programme in which I would set out to cure myself with type two diabetes, which was pretty optimistic, because at that time it was regarded as a completely incurable disease. So I went off to the States and I met up with the professor, Mark Mattson at the National Institute on Ageing, and he introduced me to the whole idea of intermittent fasting, or what he called intermittent energy restriction. Now it comes in many different forms. The type that I discussed with him was cutting your calories down pretty drastically two days a week, and I started calling that the 52.. And the original idea was that you’d cut your calories to around 800 calories and do that two days a week. There are other forms which I also explored, including something called time restricted eating, which I’m sure you are familiar with.

Dr Ron Ehrlich [00:04:11] Yeah, no, I am, but just remind our listener of what that is.

Dr Michael Mosley [00:04:15] Short time restricted eating. What you do is you restrict the hours within which you eat rather than the calories. So, for example, you stop eating at 8:00 at night and you don’t eat again until 8:00 the next morning. That is a 12 hour overnight fast, and it’s known as 1212. You can go to 1410, where you extend that overnight fast or even 16 eight. Now, the research on this is based again on another American professor, Sachin Panda, in California. And he himself does 1410. So what he aims to do is to stop eating by about 6:00 in the evening. And then he doesn’t eat again until 8:00 the next morning. So when I originally did this program back in 2012, intermittent fasting was regarded as a bit mad. I mean, nobody else was really doing it or talking about it. Although it had formed the basis of many of the great religion. So all great religions really have advocated some form of fasting. And indeed a lot of the great thinkers of, people like Plato, philosophers, you know, you name it, they’ve all said, look, it clarifies the mind. It’s a good thing to do. Categories. A few days a week and see what happens. Anyway, I made this program. I came up with this thing I called the five to diet. I talked about time restricted eating. And over the course of eight weeks, I actually managed to lose about ten kilos. That’s about £22. And my blood sugars, which had been in that range, went down to normal, which is where they have stayed ever since. Though that was a kind of double whammy. And the program, when, it became very popular, I wrote a book, called The Fast Dot, and that popularised the idea of intermittent fasting. And since then, there’s been an absolute explosion of interest in intermittent fasting in its different forms. But as you say, there are different forms. It does sound a bit scary cutting your calories down to, you know, 800 calories, but it’s really not that drastic all that bad. And since I made that program, there have been numerous clinical trials showing the benefits and also loads and loads of clinical trials looking at the reasons and benefits for doing time restricted eating. So in many ways you can do both if you like, throw them together or you can do one or the other. It really depends on your lifestyle, your needs, the reasons why you want to do it in the first place.

Dr Ron Ehrlich [00:06:37] It’s interesting, isn’t it? Because, I don’t know. I mean, in human history, I’m not sure. There’s been many times in human history where three meals a day and two snacks were part of the human experience.

Dr Michael Mosley [00:06:50] Absolutely not. I mean, most people, you know, they probably ate their breakfast and then they might eat something at lunchtime, and that was probably it. Roman soldiers famously were supposed to eat just one meal a day. And that’s why, there’s another variant of intermittent fasting, which I don’t recommend, but it’s called the Warrior diet and the Warrior diet. You just eat one meal. That’s it. As I said, to be based on what the Romans did, but, I’m not. I think that’s probably a bit too tough for most people, and I’m not sure the benefits really, you know, commensurate with the pain. But absolutely, throughout human history, the idea of three meals a day, it has not been one of the things that we’ve evolved to process. And indeed, professor Mark Mattson, when I was speaking to him, he said, look, we evolved basically for periods of feast and famine. And that’s why our bodies, if you like, evolved to do that as well. We were a bit like hybrid cars. He said to me, we run on a combination of petrol and electricity, or in our case, it’s a combination of fat and sugar. And your body generally prefers to run on sugar because that’s a fast access fuel. But when you you should get supplies to run down, then you start to run on fat. And that seems to be one of the benefits of intermittent fasting. It persuades your body, to move from, burning sugar to burning fat. You start to develop these or release these substances called ketone bodies. And, it’s known as flipping the metabolic switch, where you go from burning one fuel to another. And that seems to be a key part of why intermittent fasting is beneficial. But although we evolved to do it, and most of us never do, it will very rarely do it because we’re constantly snacking on sugary stuff from dawn until, you know, just before we go to bed. And so, we remain in sugar burning mode, throughout our lifetimes. And that’s not necessarily the healthiest thing for us.

Dr Ron Ehrlich [00:08:50] Well, I think the way we are eating, the way that’s you just described is a bit like, so much in our health care system. It’s a great economic model for driving industry, not just not a very good health model, but, I think interestingly, Michael, you were here you were in 2012 as a medical practitioner of some years experience. And it wasn’t until you yourself were faced with this type two diabetes. And presumably you’d seen many patients during your time, and it advised them it was in a irreversible as, as the common thoughts were of that and still are in many cases. It’s interesting how when medical practitioners reach a crisis themselves, the kind of become a lot more open to, what might not be mainstream evidence base to, I think, you know, evidence based approach.

Dr Michael Mosley [00:09:47] What you know, absolutely. I think, yeah. Because you’re suddenly immensely motivated to make change. And most of us, to be honest, are a little bit lazy, a bit complacent. We continue with whatever we believe, whatever we think. Habits are incredibly hard to break. And so yeah, you need motivation. And my wife is a GP and when I started, I wrote about the first, I started talking about that, that you can put, type two diabetes into remission by significant weight loss. She started to talk to her patients, but it was only really when they were approaching a crisis moment that they reached at that, for example. They might have had a heart attack. Or perhaps they are told they’ve got type two diabetes, or perhaps they’ve had diabetes for a while and they’re about to go on insulin. That is the moment where they are prepared to listen. And, you know, doctors are humans like everyone else, and we often need a giant boot up the arse to, be motivated to change. So, absolutely, that was, for me, a big moment. I hadn’t really been that interested in nutrition. And I don’t know about you, but I was taught almost nothing about nutrition. That medical school. I looked about beriberi, about all sorts of, you know, exotic diseases associated with severe malnutrition, but not really about the impact that food has on the body and brain. So I had to kind of re-educate myself at that point, you know, in a pretty rapid way.

Dr Ron Ehrlich [00:11:14] And how was that received? I mean, you are pretty high profile. Obviously, your media presence is well known. Was that received enthusiastically by the establishment without saying thank you, Michael, this is a major breakthrough in medicine. Thank you for your contribution.

Dr Michael Mosley [00:11:31] Not not so much. I have to say that. I mean, it amused me because years ago, I’d made a documentary with Professor Barry Marshall from Perth who you probably know. And for your listeners who don’t know, Barry was a gastroenterologist who proved back in the 1980s and early 90s, that stomach ulcers or stomach, you know, gastric ulcers are caused not so much, by stress, but by a previously unknown bacteria called Helicobacter pylori. And he swallowed it to induce gastritis in himself. So I made a film with him at a point where this regard is completely mad. And then he went and won the Nobel Prize for medicine, and suddenly it became universally accepted. So I had seen, close up, major medical revolution go by. So I was not at all surprised. When I read the book and it was greeted with a mixture of enthusiasm, more by the public than the medical profession. And a great deal of scepticism, I have to say, from medical colleagues, you know, because of the pressure, in a way, from the public, they started doing, clinical trials and people changed their minds in terms of the type two diabetes. It’s actually a, a Professor Roy Taylor up in Newcastle. He did the big clinical trials, which demonstrated for the first time that it was possible to put type two diabetes into remission through rapid weight loss. And he was actually advocating something which was, even if you like, more dramatic than what I was suggesting, because I was suggesting cutting your calories, you know, to 800 calories twice a week. He was saying, do it every day and do it for up to 12 weeks. Wow. And so that was seen as a crash diet. And he really did get a lot of, you know, flak for that. He when I interviewed him recently, he said, look, you know, I was gutted, completely crazy and dangerously crazy. But he was able to persuade, some charity to fund his research. Spent about $10 million on it, 300 patients randomly allocated, to either doing this rapid weight loss or continuing her normal. And he’s followed them now for seven years. And without a doubt, the ones who followed his diet, have improved dramatically to such a point that the British government are now rolling out the program across the UK, and more than 5000 people have already done it. So it moved from this is crazy stuff. To this is actually quite mainstream. And indeed, with Roy Taylor’s help and cooperation, I created an online program called the first 800, in Australia and in the UK, the people who are interested in rapid weight loss, for metabolic. PEPs is mainly suitable for everyone. Well, anyone who’s overweight or has a metabolic problem, they’ve got high blood pressure, high cholesterol, high blood sugars. Then, it’s an effective way to lose weight. And we’ve been tracking so far more than 25,000 people who’ve done the programme. And, we’ve seen some very dramatic changes. So I, for me, it’s been a huge revolution. And what’s been great is that, it has been supported by leading academics and that’s, I guess, which I tried to stick with the science. Right. So, along with the diet, I also recommend you try and eat a mediterranean style diet, because I think it’s not just about the calories, it’s about the quality of the food you’re eating as well.

Dr Ron Ehrlich [00:14:53] Yes. No, I was going to say that focusing on calories is one thing I know. A low carb is another approach where we are much less focussed on calories and far more focussed on fat and protein, as as the fuel source. And I guess the analogy is one of if we think of our metabolism, as long as a fire, we can either choose to throw kindling a newspaper on the fire, which requires our attention regularly, and we will be hungry. Or we could just throw a log onto the fire and walk away and know that it’s going to be burning all day.

Dr Michael Mosley [00:15:29] Yeah. That’s nice. I like that one. Yeah, absolutely. No, I, I’m really interested in low carb. I, I think that it can be quite difficult to stick to, but people who can stick to it, often do very well, particularly people who have problems with their blood sugar. So what I advocate is what I call a low club. I’m not necessarily, you know, keto or the keto can be a good way to kick off things, but in the long term, I think you’re better off with a low carb, Mediterranean style diet. So you’re trying to avoid, you know, perfectly well, all those unhealthy junky fats and carbs. That’s the stuff really, which comes in ultra processed food and eating healthy fats, olive oil, oily fish, nuts and things like that. And eating some whole grains as well. But not just piling your plate with pasta and then sticking a small piece of that’s a deep fried sausage on top. That is not going to be the way forward. Or indeed, you know, what people associate with the Mediterranean, which is kind of pizza, isn’t it? Again, a deep frozen pizza, stuffed with, you know, with cheese and all sorts of things is not necessarily the way to health. But I do think this this whole area is so fascinating. I absolutely love it. I love the fact the science is moving on. I love the debate, the discussion, the studies and things like that. It’s been, you know, an absolute rollercoaster, but a joy that last 12 years.

Dr Ron Ehrlich [00:16:51] Yeah. I think it’s also a question when particularly when we’re talking about I mean, calories is pretty unequivocal. You measure it and you stick to it or you don’t. When we talk about carbs often, I think there’s a question of semantics here, because what’s low carb to one person is not low carb to another. For example, I think many dietitians recommend a well, we should be having around 300g of carbohydrate a day, or the USDA actually says 450 is fine, and so low carb would be 200 to 250. Yet if you went on the Atkins, it could start off on 20g and go to a mean a maintenance of 70 or 80g. What does low carb mean to you?

Dr Michael Mosley [00:17:33] I think really low carb, as you say, keto diet is one where you are down to around 20 to 30g. And when you are doing that, particularly if you combine it with a low calorie diet, then you will rapidly go into ketosis. And as I mentioned earlier, human beings, you know, like hybrid cars. We run on an analogy.

Dr Ron Ehrlich [00:17:55] I like that analogy.

Dr Michael Mosley [00:17:56] Thank you. And, we have, you know, a couple of tablespoons of sugar running around in a blood supply. But we have this big store of sugar in the form of glycogen stored in our muscles and our liver, and that takes about 12 to 14 hours to deplete when you completely cut out the carbs. Because obviously what carbs do is they just replenish the sugar supply. So one of the reasons for going on a very low carb diet is you’re going to drain the sugar out of your liver, and when that happens, you switch over to burning fat. And that’s kind of where, you know, people want to lose weight. What they want to do is burn fat. They don’t just want to lose weight. They want to get rid of the fat, particularly the fat around their gut. And that’s why a key to that can be an effective way to do that, because it rapidly switches switch of the metabolic switch, and turns you into a fat burning machine. And that also seems to have benefits for the brain, because the keto diet was originally created more than 100 years ago to help people with epilepsy, there was a lot of research going on in, particularly in Australia, but also in other countries looking at the benefits of the keto diet for things like depression, psychosis. Bipolar disease. And that’s really, really interesting. But it’s pretty tough to stick to long term. I don’t know if you tried keto.

Dr Ron Ehrlich [00:19:14] Well, I have been I think the 20 gram is, to me, unsustainable. I find 70 to 80g of Carb day very manageable and very, very doable. And and that’s why I like your hybrid analogy of switching over. And I guess the, the, the obesity epidemic. And I know we can’t say, what is it, causation? A causation doesn’t mean correlation or correlation doesn’t mean causation. I think we can say what you put in your mouth probably has an effect on the obesity. You know, I think we can make that kind of a stretch. And if if the evidence is anything to go by, we’re all eating too many carbs.

Dr Michael Mosley [00:19:53] I think I would agree with you particularly sort of poor quality carbs, because obviously what’s happened in the last few decades is the food manufacturers have started to pump out all sorts of rubbish, and we’re eating it in much higher quantities than ever before, particularly kids. In the UK, more than 60% of the calories come from ultra processed foods. In Australia, it’s about 50%. I was actually over in Australia a few years ago, making another series called The Australian Health Revolution, where, essentially I was looking to see if we could help Australians, reverse diabetes by doing what I did. And, as part of that, I put myself on an Australian diet, typical Australian diet, which is quite high in ultra processed foods. And within about two weeks, my blood pressure had shown up and my bloods had returned to the diabetic range. So, although I talk about myself having cured myself, really? It’s in remission. If I go back to my bad old ways, if I go back to eating a lot of junk food, I know it will return. So, like you, I think of low carb. It’s probably in that 70 to 80 cub’s a day, range. And, I do see, I sometimes say to people, you might want to start with keto because it’s a good way of kickstarting things. There is evidence that it will suppress hunger, that when you go into ketosis, it induces almost a euphoria. And there is evidence it also suppresses the production of ghrelin, the hunger hormone. And that’s why, you know, you lose weight fairly fast, but you also lose quite a lot of water to go to drink a lot of water. And I wrote a book called The Fast and Keto exactly about this. But it is a maintenance thing. I think you do need to be in the high range, because I think very few people can maintain, the keto diet long term. And that’s also what they found when, you know, with people with epilepsy, who were put on a keto diet, it was hard. So when the drugs came along, they kind of abandoned it. But it’s kind of coming back, particularly for people who the drugs at work on. I think the broad rule of thumb I have is try and eat more greens, a bit more healthy protein. Mix it up a bit and try and ensure you’re getting enough protein with every meal. And that’s probably, you know, in the range of that, you know, 25 to 30g of protein. Believe me, that will keep you fuller for longer. And the other thing I always say to people is try to drink a large glass of water with every meal because, you know, again, particularly if you’re losing weight, water is critical. So it’s been I have to say, I think we’re beginning to come to consensus about some of these dietary guidelines, but, I suspect there’s still a huge debate because the relatives obviously, there is still a lot of resistance to the idea of low carbon or even lowish carb. And, the standard recommendations still recommend, you know, you pile a third to half your plate should be full of nice starchy, grubs like pastor and, potatoes and things like that. This I’ve seen somehow is a good thing. Despite what I would regard as an overwhelming body of evidence would suggest that’s not really the best way to do it. You’d be better off piling it with, you know, veg or indeed with legumes. I’m a fan of legumes. They have clubs interest. They also come with a lot of, fibre. So I’m persuading myself to eat more lentils and things like that. My wife Claire, as well as being a GP, is a very successful recipe book writer and she actually does all the recipes for the book. So things like, the first 800 recipe book is hers, and she’s actually just writing one moment called the first 800 treats, which is a way of producing healthy treats which are low in sugar, but delicious. To try and wean people off the ultra processed junk was. The reality is, we all love a treat that we will.

Dr Ron Ehrlich [00:23:37] Yes, and.

Dr Michael Mosley [00:23:38] That’s how we look at challenges.

Dr Ron Ehrlich [00:23:40] I think one of the one of the things, when we’re talking about processed foods is, this big. The vegan movement at the moment, which I know is well-meaning because it’s about ethics, the ethics of animal, you know, animal welfare. And a regular guest on my podcast, Alan Savoury, has said, don’t blame the resource. Blame the way the resource is managed. And I can’t help but think that. Many vegans are becoming unwittingly footsoldiers for the ultra processed food industry. I mean, I was recently at a restaurant where they had plant based lamb plant based, beef plant based chicken and my God, it tasted just like all of those things. And in order to get it to taste like that, one only wonders what chemistry’s involved.

Dr Michael Mosley [00:24:26] No, absolutely. The problem has always been that food manufacturers will jump on the latest trend because they know there’s money there. So way back in the day, the 70s and 80s, I’m sure you can remember it was all, you know, cholesterol free. It was all low fat. They produced all these horrible yoghurts and all sorts of margarines. Margarine is one of the, you know, quintessential ultra processed foods. Because if you’ve ever seen it produced in a factory, which I have, you would never eat this stuff again. But we were told, no, you got to eat it. You got to skip the butter, which is a natural food, and eat a lot more margarine because butter contains saturated fat. Saturated fat raises your LDL. That’s really bad for you. And the evidence is pretty strong. Now that this was all nonsense, that the saturated fats you get in dairy and nothing like that. And so they started churning out all this rubbish which we eat when I say we collectively and I swear you may be right. I, you know, I was talking to a friend of mine who specialises in this area, and he said, A lot of, you know, vegan food is now just ultra processed food with good PR. Yes. And, and, yeah, I met a, you know, somebody who described herself as a junk food, vegan because what she lives on is mainly stuff out of bright coloured packages. She’s not about to kind of cook from scratch herself. And so, you know, for her, it’s a clearing. It’s there, it’s bright, it’s vegan. It must be healthy. Whether, you know, the fact it’s got 67 ingredients on the side, it’s low in protein. It’s probably not got, you know, much in the way of the essential vitamins and nutrients is something that she’s not kind of educated to look out for. And so, yeah, I do think that is one of the risks of going vegan is, you know, unless you are very careful how you do it. And, and the same rules apply as would apply to anyone who’s not vegan. I try and cook from scratch, make sure that you know your ingredients are good quality, and make sure you’re getting enough of the protein and enough of the minerals and vitamins, because otherwise you could, you know, inadvertently, be inducing malnutrition in itself. Which would be kind of ironic, I think if you can substitute for health reasons.

Dr Ron Ehrlich [00:26:36] Yes, yes, I know the the other one is protein. You’ve mentioned it a few times, and I think the actual, suggestion or recommendation for protein is kind of gone up a little bit. It’s interesting as this vegan movement has emerged at the same time, they used to be the recommendation of 0.8 of a gram per kilogram. I always thought of 1g/kg because it was just easier to calculate, but 1g/kg of white of protein and, and more recently, talking to a gastroenterologist, you know, the suggestion is that it needs to be even higher than that 1.6 to even two and 2g/kg is really hard to achieve. What are your thoughts about getting enough protein? And I mean, I had a paediatrician on just recently who was talking about lentils, interestingly, and said to get enough protein from lentils, you need 100g of protein every meal. How are you going, Michael?

Dr Michael Mosley [00:27:33] I’m doing fine, but I’m.

Dr Ron Ehrlich [00:27:34] High on the little things.

Dr Michael Mosley [00:27:36] Oh, I’m doing fine levels. I’m not using that much. But I think for me, you know, and then also part of the story, I can’t live on lentils alone. So I like them for the fibre. I like them for the flavour I mix. It’s a matter of, you know, doing enough spicy it up and doing things that this is super convenient. But if you go, you know, you’re cooked lentils in the fridge, you can add it to a curry, you can make a soup out of it, whatever you want to do. Yeah, lots of fibre then decent amount of protein, but not anything spectacular. Which is broadly why, you know, if you actually need if you want to get enough protein in your diet. I do it through oily fish, meat and eggs and occasionally tofu or temper. If you are vegetarian or vegan, it’s going to be more of a struggle. You’re going to have to eat a lot more lentils, or you’re going to have to eat tofu, which is a perfectly, you know, valid substitute. And temper is an even higher protein source. So, yeah, I think, we’re moving towards a world now where it’s pretty obvious that government guidelines in Australia and the UK are really far too low. And this professor, Steve Simpson, Sydney University, who is a friend of mine and who has been doing quite little research in this area because he, is convinced that protein is one of the biggest drivers of hunger, that he has, what he calls the protein leverage hypothesis. And that suggests the reason why we put on so much weight, over the last few decades is because. The protein in a diet has been diluted by all the other rubbish. So you get these foods, which sort of look like they have protein in them, like beef flavoured crisps, you know, basically chips. And do they contain very little. There’s mainly fat and sugar because those are, the cheap things. And so you get quality protein is expensive. And so what is happening is the proportion of protein your diet’s kind of going down. And the levels that are recommended, certainly by the NHS, I think are spectacularly low. The 8.8 per, grams per kilogram is, I think, too low for most people. It’s certainly too low once you hit the age of 60. Because after the age of 60, you know, you don’t absorb or processed protein anything like, as well as you did before. And the same is true of women going through the menopause. And Professor Simpson is convinced that one of the reason women put on weight when they get through the menopause is because they haven’t upped the protein content of their food. So he’s looking to do a clinical trial about that. And so I do think, I do think one of the simplest things you can do if you want to avoid weight gain is to look at quality protein in your diet. And this has said for me that eggs in the morning, you know, it might be a bit of fish at lunchtime and it might be a bit more fish or possibly, some meat or indeed, tofu stir fry in the evening. So I do try and get in 20 to 30g per meal. And that means I’m consuming really at least 90g of protein a day, which I think is actually quite modest.

Dr Ron Ehrlich [00:30:36] And you. Yeah. And you use doing your. How does the intermittent fasting fit into your life now.

Dr Michael Mosley [00:30:42] Sure. So the main way I these days is I do the occasional, you know, five, two, particularly after Christmas or Easter where I’ve been guzzling Easter eggs or something like that. I go back, to five to, to get my weight. Then I, I wear a tight belt, so I know when I’m putting on weight around my waist because when I put on weight, that’s where it goes. It goes around my waist. It goes around my neck. So, that’s when there’s a danger that my blood sugars will creep up, my blood pressure will creep up, and I stop snoring, and my wife nudges me and goes, you’re snoring. Go back on two, five, two. And then I do it for a few weeks. I drop the weight. And, alternatively, I might, do something a bit more rapid, like the fast 800. I’m, you know, I obviously have access to the program, so I go back and I, and knock it on the head. I knock off a couple of kilos, and then my blood sugar and everything return to normal again. And I also try to practice 12, 12 time restricted eating. I try to stop, but 8 p.m. and not eat again till 8 a.m., but I do find 1410 a bit odd. You know, I like having breakfast and, I, you know, I feel like breakfast by 8:00. I normally up at about six, so I’ve already been awake and doing stuff for a couple of hours, and the thought of waiting till 10 a.m. is a bit difficult. And conversely, I think I would find it quite difficult to stop eating by six in the evening. It’s not terribly sociable. So, you know, and my, you know, I don’t think my wife would, but either, she is still slim. I’m a bit of a Labrador, you know, I put on quite readily and eat everything where she’s much more of a greyhound. She’s been, you know, I’ve known her since medical school. She’s always been the same size. She never struggles with her weight and that.

Dr Ron Ehrlich [00:32:26] Well, that’s a gift. That’s a gift. That’s a gift. And you’d be very interested to know very recent news in Australia, because we’ve had, Doctor Peter Brookner. Do you know, Peter, the sports position?

Dr Michael Mosley [00:32:39] I know of him, certainly.

Dr Ron Ehrlich [00:32:40] Yeah. Well, Peter, of course, has been the, Olympic sports physician. The Socceroos, the cricket team and the Liverpool Football Club has waned. Also his his play, some work, but he has put together defeat diabetes which I’m a very proud supporter of. But Peter similarly at the age of 60 was faced with the exactly what you were. He was given a diagnosis of, of type two diabetes. It was incurable. Had to go on medication. No, wait a minute. I’m going to use all of my medical knowledge and dig deep and came up and explored the low carb world and built defeat diabetes. Well guess what? Diabetes Australia and Defeat Diabetes have just signed an agreement to work together to bring low carb nutrition to Diabetes Australia. And literally five years ago, Diabetes Australia’s first rule was to ensure you had carbohydrates in every meal and stay on a low fat diet. So that’s quite a turnaround.

Dr Michael Mosley [00:33:44] No, massive. And I know that very well because five years ago, well four years ago I was making this series, the Australian health revolution. And I had a quite a rigorous and vigorous debate with, Diabetes Australia, who are adamant, that the low carb approach was not the right approach. And it was also that diabetes is. Is an inevitably irreversible, incurable condition. So we had quite a, you know, quite a ding dong. And I was pointing at the research from Professor Roy Taylor. The fact that rapid weight loss is also a very effective way to put diabetes into remission. Anyway, at the time, I said it wasn’t a message that they were willing to hear, but, since then, I believe they have a new they have basically new people there. Yeah. And, one of my colleagues, Roy Taylor, sorry, Roy Ray Kelly, who is an Indigenous Australian and who’s been doing a sort of low carb program, with, Indigenous Australians. Right? That’s right. Having had a lot of kickback, suddenly he said, when the program when, no people came up to him looking for it, they’re funding his research. He’s getting a huge amount of support. So Australia has done a major, major turnaround. And so I was delighted to read that, because I’m also in contact with a lot of the great low carb groups here in the UK because we, we share this sort of common goal. And sometimes it’s seen as a sort of, you know, almost a sort of a difference of opinion. Is it low calorie? Is it low carb? The answer is both of them achieve similar goals, which is essentially to bring your blood sugars down and to allow you to lead a healthy lifestyle. And inevitably, if you’re doing, a low calorie approach like the first 800, you are going to be low carb. And I think we would all agree, that that is an approach which, is getting a lot of traction for good reasons. It’s not. But, I think there is quite a long legacy, from the Atkins diet, which, you know, had its point.

Dr Ron Ehrlich [00:35:50] Yeah.

Dr Michael Mosley [00:35:51] But equally, you know, when Atkins died, he was significantly overweight. And, it, you know, the fact that he died of heart failure was obviously not a great advert for the Atkins diet, and that’s one of the reasons it all collapsed. But also, I think Atkins at the time, he was telling people they could only, you know, heavy cream and as much bacon as they wanted and stuff like that. And I just don’t think that is true. I think whatever dirt you’re on, you should be aiming for a, you know, broadly healthy one which contains plenty of, you know, green veg and, you know, healthy proteins and, you know, yeah, I don’t think I don’t have anything against cream, but I would I much prefer a full fat yoghurt. And I think there are more benefits to say full fat. So I think there is still quite little nuance in this. But I do think some of the kick back against low carb is because of Atkins. And Atkins was obviously a monster in the sense that, you know, it it really worked. People lost a lot of weight. But, it turned out to be unsustainable for a lot of people as well, which is why it came. And it went.

Dr Ron Ehrlich [00:36:53] Yeah. And I think a lot of people were preoccupied with his initial phase of 20g, which was unsustainable. But that was that was seen as the Atkins diet. And yet the maintenance, I’m not quite sure, but I think the maintenance was a little bit higher than that. But but the interestingly, the, the, the development in Australia is probably one of the most optimistic things I’ve heard in health care in over 40 years. I know that’s a big statement to make. Good to, to have a public health, a public health message that is actually good for public health is quite unique. And I think that’s very encouraging. Your preoccupation with the word fast fascinates me, Michael. I mean, you’ve also done fast, exercise. And I found that very inspiring. I mean, tell us about fast exercising.

Dr Michael Mosley [00:37:45] Sure. So obviously the original fast was a play on the word fast. Fast? Yes. Exactly. Why? I if I’d had any sense, I’d probably have, called the book the 52., because that’s what became iconic. But at the time when I was writing the book, I thought, five, two, that no one’s going to know what on earth that means. So I’m going to call it the Fast diet because it does two things. It involves fasting, but it also means you’re going to lose weight pretty fast. So having done that, I also did a program about exercise called The Truth About Exercise, in which I discovered the benefits of high intensity interval training. And the professor I went to see said, look, you can get most of the benefits of exercise, certainly in terms of metabolic health, from three minutes a week. So I thought, I’m up for that.

Dr Ron Ehrlich [00:38:28] And that’s what I found so inspiring that Michael.

Dr Michael Mosley [00:38:32] Absolutely. Because he said, look, most people will say, I haven’t got time to exercise, but you’ve got three minutes a week. Surely you’ve got three minutes away. So I did this, program called, The Truth About Exercise, as part of which I put myself through this program along with other people. And the basis of it is you get on an exercise bike, you pedal a bit to warm up, and then you pedal like crazy against resistance for about 20s. And the resistance should be high enough to the end of the 20s you’re feeling. You know, this is hard work. Then you have a. A bit of a breather. You pedal slowly. Then you go again, and then you have a bit of a breather. And then you go again, and then you pedal away gently. The whole thing probably takes about five minutes. And in that time you have done basically one minute of intense exercise, three lots of 20s, and you do that three times a week and that is three minutes. And what clinical trials have shown is that can lead to significant improvements in your blood sugar levels. It burns. It doesn’t exactly burn a lot of calories, but what it does is it kind of revs up your system, releases adrenaline and things like that. And the other thing is, as I said, that it also improves your, what’s, what’s called your basically your, it’s your ability basically to, your VO2 max is without grappling for the, which is a measure of your aerobic fitness. It’s the amount of oxygen your body can take on. And it’s not only a measure of how thick you are, exercise wise, but it’s also probably the best predictor we have of longevity, because your VO2 max predicts things like your risk of dying from heart disease, cancer, neurodegenerative disease, you name it. So it’s a critical thing. And this super short form of exercise, high intensity interval training, is much more effective than most other forms of exercise, to, you know, improving your VO2 max. And that’s what we found in the trials. Since then, it’s become much more widely known and widely used. This was again back in 2012. I made this program and since then it has become a thing. And, HIIT it. Yeah. Hi. Hugs the training. Yeah. Hey, he’s quite a sexy word anyway. Yeah. So, so again, I think some of that was down to the success of the book I read called Fast Exercise, in which I described the science of high intensity interval training and why you might want to do it, and also why it’s not suitable for everyone. But since then again, because of the enthusiasm with which the book was, greeted, a lot of clinical trials were done showing the benefits of it, certainly compared to more, you know, conventional exercise. And what I would say is you don’t have to do it on an exercise bike, even if you’re going out for a walk. The clearances, if you put in little bursts where you, you know, going up a hill, you walk faster, you try and get up to, say, 120 paces a minute, or you put in a little jog and with joggers, when I see the my, you know, I want them spread because, the benefits really come from, you know, you’re jogging out there, but if you put in a little sprint for 20s, then that’s going to be an awful lot better for you than just a gentle jog around the block. And thirdly, you know, if you’re just cycling when I do a lot of cycling, I live on top of a steep hill. And when I’m going home, I often basically put in these little bursts. So I’m going up the hill, I go flat for about 20s, and then I have a bit of a breather, and by the time I get home, I’m pretty knackered. But I’ve managed to get in a decent hit workout. And that just going from the town back to my home, which is only a couple of kilometres. So, I do live. Well, I say, and my my, VO2 Max, is very good for my age, so, I do think that’s kind of one of those interesting measures, is it? There are indirect ways measuring it, which I go into in the book, because to do it properly, you need to go into a lab to have your VO2 max measured. But there are lots of simpler ways you can measure that at home. And that’s what I’m very keen on. I’m very keen on saying, look, there are simple things you can measure, and then there are simple things you can change because I’m somebody who likes numbers. So for me it doesn’t work for everyone. But I like, you know, I, I monitor my blood sugars for obvious reasons because I’m, you know, I don’t want to tip back into diabetes. I’m onto my blood pressure because huge numbers of Australians have hypertension and don’t know it. And I also occasionally test up my VO2 max. The simplest way is really to just feel your pulse. My pulse is normally in the 58 to 60 range, which is pretty good for my age. And the other measure I use is my ability to do press ups because I talked about we talked about it, rugby fitness. But even more important as you get older is, resistance, exercise muscles, because, you know, you use it, you lose it. So I and my wife, Claire, we get out of bed in the morning, and we, we do 20 to 30 press ups. I do about 50. She does about 2030, which is very good.

Dr Ron Ehrlich [00:43:40] For a woman. Well that’s it’s good for both of you. Really. And, and I was going to say that it wasn’t just hit high intensity interval training, but it was also that anaerobic. And throwing a little bit of anaerobic exercise in as well was a message that I got out of your whole program there too, which was which is good. Yeah.

Dr Michael Mosley [00:44:00] Absolutely. So as you can see, I’m really intrigued. When I get into things, I get really, really. In them. And plastic size was another thing. Like the first thought which was at it wasn’t greeted with scepticism, but there was some, you know, people were worried that people would damage themselves and become that sort of thing. And one of, famous broadcasters, said he’d actually had a stroke after doing high intensity interval training on a, on, rowing machine. And so that, you know, put a considerable damper on the idea, for obvious reasons. I spoke to him about it, and it turned out it was nothing like that at all. What had happened is that he had had a tia, 3 or 4 days beforehand. Basically what the transient ischaemic attack, what had happened is that he had lost the power of speech for about five minutes now. He should have recognised that is a really bad thing. I should go into hospital. But he ignored it. His speech came back. He had another tia. A couple of days later. He ignored that. And so at that point, he was a ticking time bomb. And if he could have triggered it in his case, it was, when he was, you know, doing getting kind of hard on the, rowing machine. And he had a major stroke. So the warning, I would say that is if you have, you know, again, it’s the word fast, which I’m sure you’re familiar with, that if you have any of these warning signs, suddenly your face, your face droops, you know, you have problems with your speech. Then it’s time to go to hospital pretty fast. Because, you may well be having to. I and I talked about this on the radio, and, a few years later, I met somebody, and she said she’d heard me. She had experienced exactly that in hotel room the night before she went off to hospital. She had had a tia. She was treated, so she never had a stroke. But if she hadn’t had radio program, she would have ignored it. And she would almost certainly have had a catastrophic stroke some point further down the line. So I would say, you know, and I emphasise in the book and indeed the, the exercise is part of, the first 800 program. Is that, you know, you should ease into it. And if you have any anxieties about your health, do go and talk to your doctor, though. You know, to be honest, most doctors don’t know much about this, so I’m not sure entirely how helpful that is, but, ease into it. But since then, there have been a lot of studies showing that doing this form of high intensity interval training, is safe for people who’ve had heart attacks, who’ve had strokes, and indeed, they’re using it now for people with cancer. There’s a trial going on in Cambridge where you do it while you’re having the chemotherapy. So while you are being infused with chemotherapy, you are on an exercise bike pedalling like crazy. So, this is there is, without a doubt, some really good evidence that if you have cancer, you’re having cancer treatment. Then things like, high intensity interval training are actually a good way to go. But as I said, like any form of exercise, you got to ease into it because otherwise you’re, you know, you you might damage yourself. So a good bit gently work up to it and see if it works for you I guess.

Dr Ron Ehrlich [00:47:08] So the the limiting factor is our own human experience. You know, being humans there is a self limiting factor about not necessarily overdoing it and just listening to your body a good a good message there. Another area that you’ve become very interested in. I know you were in Australia doing research and we were just talking about it before we came in is sleep, and sleep has been an issue for you in your life. Tell us a little bit about that.

Dr Michael Mosley [00:47:34] Absolutely. I would say to people, there are four great pillars of a healthy body. Like one is maintaining a healthy weight, which will hopefully mean that your blood sugar is healthy and your blood pressure is healthy. And that meets eating a and rudimentary low carb diet. The second thing I’d say is do exercise activity. If you can do it, then that’s great. But the third thing is do try and ensure you’re getting decent sleep, which is easier said than done. So I did this a straight series in Australia, which is just come out on SBS called The Australian Sleep Revolution. I mentioned earlier I’d done the Australian Health Revolution, which went down a storm. So you can see why that title, proved to be, a winner as well. And the idea here was, we coupled up with, Flinders University. They have a brilliant sleep lab, and we took 30 people who all suffered from chronic, sleep problems. And I was one of them. And we were put through a battery test. And the idea was to see if these people, including me, could be cured, within eight weeks. That was the design of the trial. And I’m delighted to say that just about 80%, were. And the other 20% saw a significant improvement. And indeed, I’ve written a book called Four Weeks to Better Sleep, which is kind of based on that which is also available in Australia. So the idea of it was that we’d start off by getting the sleep conditions diagnosed, because there’s lots of really quite. Bland advice out there about how you can improve your sleep, and it’s sort of quite good. Goodness comes under the title of sleep Hygiene. And essentially it says things like keep your bedroom dark and quiet and try to go to bed same time every evening and get up at same time, do exercise. And this is sort of the generic advice, and it’s well-meaning but on the whole useless, particularly if you have a significant sleep problem, it’s not going to touch the side of it. And that’s why a lot of people have tried these things, and in desperation, they’ve gone off to aromatherapy or, you know, whale sounds or things like that, or they swear by, you know, eating cranberry juice or something like that, none of which really has been shown to be at all helpful, in clinical trials. And that’s because you’re not really addressing the fundamental problem, which is why are you sleeping badly? So what we identified in the trial is that people had essentially two significant problems. One was, around half of them, slightly more had sleep apnoea, which was undiagnosed. So it turns out you’re very familiar to sleep apnoea, but essentially snoring is. And sleep apnoea is more like. What happens if you’re choking. And what happens is it’s at night. You’re probably lying on your back. You’re probably a bit overweight. And when your muscles relax, your tongue come full back. Blocks your airways and cuts off your supply of oxygen to your brain. So, not surprisingly, your brain goes, hey, wake up. And so you make those funny snoring noises, and then you partially wake. And this can happen if you have sleep apnoea can happen 20, 30, 40 times an hour throughout the night. So you probably don’t know. You got it. And indeed, less than 5% of Australians or you know, with sleep apnoea know they have sleep apnoea. And let alone being treated. And so they just go through the day feeling completely shattered. And they try all the aromatherapy and the sleep hygiene. And none of it makes any difference. And the reason it makes no difference is that they are missing out on the reason why their sleep is so poor. So that was one of the things we discovered. I was surprised to discover I have sleep apnoea. And that was a bit of a shocker. So the treatment for it is, if you can, weight loss, because a lot of it is about weight gain, particularly around the stomach. And the neck typically happens with blokes, after, you know, who aren’t middle aged, but also women going through the menopause, because when they put on fat, they put it on round the neck, and that constricts the airways. And that, in combination with this floppy tongue falling back is kind of what causes it. So lying on your back is one of the major causes. So one of the simplest things you can do is, sew a tennis ball into your pyjamas. If you wear pyjamas or put a bra on backwards with a tennis ball in it. And that means that you’re less likely to sleep on your back because it’s when you’re sleeping on your back that you snore and get sleep apnoea because the tongue is blocking, right? So that would be stage one. Stage two might be a device, which you can put round your neck. We tested that at, which gives you it detects when you’re lying on your back and it gives you a little shock. So that kind of jolts you into lying on your side again. And, if that’s not working, then you probably will need something like a CPAp machine. Which, you know, you go into a sleep physician and they’ll probably prescribe it, and that’s like a Darth Vader mask, which is linked to a tank, which, you know, basically produces an air pressure which keeps your airways open. The thing that I actually found most useful, was something called a med device mandibular advancement device, which is kind of a method you put in. It makes your lower jaw move forward. And because your tongue is attached to your jaw, then, basically that means the tongue is unable to fall back with your airways. So I kind of we did all this in the program, and I also wrote all about it in the four weeks about sleep, but it’s quite a lot to take on. And, as I said, that was just one element to do. A lot of people who, it turned out, had sleep apnoea. And then there were lots of people who had insomnia and, insomnia just basically means you struggle either to get to sleep or to stay asleep so that onset insomnia or maintenance insomnia. And, we had a mix of that. So I’m more of a maintenance insomnia person. I typically wake up at 3 or 4 in the morning, and then I struggle to go back to sleep. Whereas some of the people, other people on the trial, they struggled to go to sleep. So they get a better day, 10 or 11 at night. And then they were still awake 2 or 3 in the morning, and then the alarm would go off at six in the morning, but had to get up. And so many of them were getting by on 3 or 4 hours sleep. And not surprisingly, they were shattered. And as I said, otherwise, there were people more like me, which is incredibly common, where you wake up at three in the morning, you’re worried about life or something like that, something rattling through your brain, and you lie there worrying about the fact that you’re not going to sleep and what terrible things that’s going to do. Your brain, and then you struggle to get back to sleep. So that’s the second form of insomnia. So again, we divided people up into two different forms. But there are very different treatments depending on which type of insomnia you are. So for example, with the people who, who, were, if you like, serious owls, people who would go to bed at ten but couldn’t go to sleep until two, the treatment for them was bright light therapy first thing in the morning, exposure to bright light, because that would reset the internal clock, the circadian clock that clocks were running too slow. So what we actually did is we got them to swallow a pill which measures their core body temperature. And typically that should be at its lowest at about four in the morning. But what these devices picked up in these people was it was lowest at six in the morning. So just at the moment the alarm clock is going off. They really want to go to sleep. Their body screaming at them go to sleep. And conversely, you know, it’s ten 11:00 at night, but their body is saying, hey, it’s time to party. So understandably, they struggle to sleep. So for them, it. Was a combination of bright light and something I called bedroom restriction therapy. I’ll speak about it in the moment, whereas for me, it turned out that the best treatment was bright light at the end of the day. So because I have maintenance problems, I actually need to expose myself to really bright light at about 10:00 at night. But now that for you.

Dr Ron Ehrlich [00:55:40] Let me just stop you there. Because when you’re talking about light, I mean, this is a subject that we’re exploring quite a bit on the podcast. You know, this is a question because light is part of the problem in general with our sleep, whether because we are bathed in blue light. I’m I, I should actually, Michael, at this point in time put on my blue light blockers. Right. And because this is a problem, I’m sitting here now at 7:00 in the evening in front of a computer, which I normally wouldn’t do. And I’ve got some lights here which are all blue light. And that is part of the problem when you say being exposed to light. What light?

Dr Michael Mosley [00:56:20] Okay. So this is a complex story. And I’d say this is one area I would disagree with you about was I don’t actually think blue light is the problem. And I get this from the horse’s mouth. Because the professor at Oxford University who discovered the receptors in the eye which respond to blue light, which are linked to your circadian clock, so that actually things like the blue light you get from your phone or your computer or your laptop are way too low to have any impact on your sleep. He says it’s complete nonsense. And this is an idea that’s been perpetuated by the people who float devices to block out blue light. So there have been surprising number of studies which have shown it makes no difference at all. It it has a placebo effect at best. So there you and I. Anyway, we could debate it, but that’s okay. Absolutely. So what I would say is that, the spectrum is less important than the intensity. The. If you actually want to have an impact, you need 10,000 lux. That is equivalent to going out in the early morning. And, the devices like laptops, computers that producing about maybe 102 hundred lux. So an order of magnitude 50 times lower than actually is needed to, you know, alter your circadian clock. And, so to get 10,000 lux, if you’re a, Night-Time person, the easiest way to do it is you go out, in the morning and just, you know, stand outside in the night or go for a run or go for a walk, something like that, because then you’ll get all the light you need. If, however, your problem is the other one, which is maintenance insomnia, which is my problem, then you need a device because obviously there is no bright light available at 10:00 at night. So in my case, I use something called the sad lamp. And these are devices intended for people with seasonal affective disorder. And that is about 10,000 lux. Though I bathe myself in bright light lasting at night. And so it entirely depends on your problem. So if your problem is that you’re an owl, then you want to avoid bright light in the evening. But if your problem is that you are a lock that you struggle to stay awake at night, then you need light, lasting at night. So I’ll say it again. It very much depends on what your situation is, which is why one piece of advice absolutely does not apply. And indeed, if you’re a, shift worker, you’re a doctor or something like that, your best bet is bright light during the shift because brought in lots of caffeine. The way to make yourself more alert is to expose yourself to bright light. And indeed, you know, I spoke to light experts in Australia while making the series and they said, this is really interesting and really complicated, brother, because it entirely depends, as I said, on your personal genetics. And and so again, one, that’s the big problem. The biggest problem with computers and laptops is not the light. The biggest problem is they’re distracting. If you’re on your laptop, last thing at night or you, looking at your phone, then it is designed to hook you. It is designed to keep your brain firing at full amplitude, which is exact opposite of what you want if you want to go to sleep. So I looked up on Google Trends, what time of day people are most likely to search the word insomnia and it is at 3 a.m.. So there they are. They’re awake at 3 a.m. they’re on their phones looking at the wedding some night, which is the worst thing you can possibly do. So I think actually the message is, you know, try to avoid your devices within a couple of hours of bedtime. Try and put your phone on the other side of the room. Not really because of the light, but primarily because they are immensely distracting. And that’s what the prophet Prof. In Oxford said.

Dr Ron Ehrlich [01:00:06] Yeah. No, no, I totally agree. I mean, I think this is it’s no time to connect with the world. It’s time to think about connecting with your pillow. And, and I agree with you that the main thing is the distraction that it that it causes. But, so interesting to hear you say that, Michael. I’m just intrigued because, you know, we were saying before we came in with similar ages and you’ve been in the media for many years, with your own journey. I mean, I should have asked you this is beginning, but, you know, you were where have you been in clinical practice? And how did you move? From clinical to medium.

Dr Michael Mosley [01:00:39] Oh, I was originally, you know, intending to become a psychiatrist. I was very interested in how the mind works. But I got, you know, disillusioned with psychiatry, didn’t go very far along that line. I in a moment of sort of flat madness, I saw an advert in the papers to go and join the BBC. I went off and joined the BBC, with the intention of going back into medicine. And then I never did. So, I got one of those slightly random things I have to say. So I actually spent a while working in current affairs. I worked in different areas, but, naturally enough, I ended up, making science programmes. And then I ended up as a presenter again through a complete chance. So I wasn’t in front of the cameras behind the camera for a while. But I was always interested in, you know, health and science and stuff like that, but in the broadest terms. But it’s only recently, in a way that I’ve in the last 10 to 12 years, I’ve become a television presenter. And that’s also when I started writing kind of books inspired by what I was discovering about, you know, health and things like that. So I’ve had this slightly weird journey, but.

Dr Ron Ehrlich [01:01:42] Yeah.

Dr Michael Mosley [01:01:43] It’s been very enjoyable.

Dr Ron Ehrlich [01:01:44] Yes. Well, I mean, it’s been enjoyable watching it. Listen, I must say, and I just want to finish up with this last question because putting aside your role as a, as a presenter, a journalist, a researcher, writer and author, we are all on a health journey as individuals in this modern world. What do you think the biggest challenges for us as individuals on that journey?

Dr Michael Mosley [01:02:06] I think it is, you know, the forces of darkness out there, the food manufacturers, the people who are essentially out there to make a buck, to make a dollar, and who don’t seem to be that bothered about the social consequences. So once upon a time, they were the manufacturers of tobacco, when that market started to dry up, they jumped into food manufacturing instead. So they promote all sorts of unhealthy messages, they fund strange sounding, research laboratories, which, surprisingly enough, always come out showing that, you know, these unhealthy foods are actually not bad at all. They help to fund researchers who sit on government bodies, who help to advise us. So I think that is the real danger. I don’t want to be too paranoid about it, but that is my experience. The there are quite a lot of I recently made a series for, channel four in the UK who called Who Made Britain Fat? And the answer was, yeah, it was pretty much that was the food manufacturers producing the ultra processed junk food and sending out lots of conflicting messages. It’s exactly like smoking. Once upon a time, you know, doctors used to smoke back in the 50s. You know, it was completely normal. My father in law spoke like crazy. You know, he was a doctor. His wife, psychiatrist. She smoked like crazy 40 a day. And it was really. It took a long, long time, to convince people that smoking is bad for you. And, you know, even when I was a medical student, half the population in the UK smoked. Now it’s down to about 15%. But that took years of concerted effort. It took government intervention. It took the, you know, banning advertising, making cigarettes more expensive and things like that. And I think that’s probably what we’re going to have to do if we’re going to take on the food manufacturers, because they’re not going to do it voluntarily. And indeed, the good one said to me, in the course of making that program, you know, we would love to reformulate the food and make it healthier, but, it would be more expensive and we will lose market sales. So I know, for example, a famous manufacturer, tinned tomato soup, did a trial where they put out two tins of tomato soup, one of which said low in salt and the other which said normal and the low in salt. Nobody bought it because I thought it. So it’s going to taste terrible. So I do think in the end it comes down to government intervention. And even as you were describing there also people like the Australian Diabetes Association getting into bed with, you know, the diabetes prevention teams, because that way you reach a lot more people. I write a lot of books, I produce a lot of programs, but in the end it’s about educating the doctors. But it is also about getting government to reinforce the message and to make it easier for people to be good. But at the moment, you know, we are surrounded by junk food, junk food, advertising and things that. So it’s not at all surprising, that people, you know, eat badly because that’s what they’re saying all around them. It’s cheap. They it’s convenient. And they know they don’t know better. And, eating healthily is more time consuming. It requires more knowledge. It can be more expensive. So, does one thing knowing the stuff. And the second thing is put it into operation and it’s like exercise, you know, we all know that it’s good for us. Most people don’t do it. And that’s partly because it’s so much more convenient to jump in the car and drive down to the shops. So we have to find ways of redesigning our cities so that it is more convenient to walk than it is to jump into the car. And I do think probably. And then that’s the only way we’re going to actually, you know, people who listen to your podcasts, they’re really well in. Formed, I’m sure, and I imagine they’re already doing a lot of the the right things, if you like to maintain good health. But if you’re going to do it nationally, you’re going to do it internationally. Then I think the only way of doing it is, bringing governments on board. And so said changing the built environment.

Dr Ron Ehrlich [01:05:52] Well, Michael, that’s a great note for us to finish on. And thank you so much for joining me tonight. I’ve been really looking forward to this conversation, and thank you for everything you’ve been doing over the years and continue to do pleasure. Well, it’s, it’s great to catch up with Michael, to meet him and talk to him as he. I’ve certainly been following his career, for the last 12 years and, was fascinated by the intermittent fasting and the 5 to 5 also his focus on calories. And, I did I did forget to ask him, on the program, but I connected with him afterwards. One thing that I think is an important thing, and that is this focus on calories. This has been something that many dietitians, globally, have focussed on this whole idea of calories in, calories out being the secret to losing weight. And, and the, the alternative being to low calories is low carbohydrate. And the big factor there is hunger. And I asked him, you know, the problem with a low calorie diet is that people get hungry, whereas on a low carb diet where the focus is to eat, proteins and healthy fats, it’s, as I said, a bit like putting a log on the fire rather than just adding kindling. You know, if you think of our metabolism like that, where we’re trying to fuel the fire that drives us on a daily basis. Well, the the food pyramid encourages us to eat three meals a day and and, snack in between so that we keep our blood sugar level even. That was the traditional approach. That is, it found its way into the Australian Healthy Eating Guidelines, which was formulated by the Australian Dietitians Association. So this idea of calorie focus was has been very popular. But the problem is that hunger is the problem, whereas low carb is a different approach and and encourages you to keep your carbohydrates low. And what that means we discussed in the program, for me personally, I think 70 to 80g of carbohydrate a day is sustainable, achievable and effective. And it’s doable. So so that’s what I call low carb. And I think Michael agreed with that. And when I asked him what his comment was, does a low carb, mean less hunger than low cal? And he said, yes. I would agree that one of the advantages of low carb is you get suppression of hunger. But, he added, you get a similar thing on a low calorie diet, like the direct, remission clinical trial. This is the direct study, the direct, study in the UK, which is diabetes remission clinical trial. They found that on an 850 calorie diet, people soon stopped feeling hungry within a few days. And I know that they have just issued the five you follow up there. It’s, we’ll have links to that on our show notes to the, direct study, the diabetes remission clinical trial. So you’ll find links to that on our show notes. You will also find links to defeat diabetes, which is an Australian initiative and most recently defeat diabetes has it’s bit. It’s a world first where a public health organisation like Diabetes Australia, which for the last 70 years has been advocating to include carbohydrates in every meal and focus on a low fat diet. And, I think if the evidence is anything to go by, the increasing, type two diabetes is a testament to the failure of that public health message. But still, it is the message that the diabetes Australia have had for many years. But in a world first, Diabetes Australia has pivoted. And I congratulate them for this because they looked at the evidence, which was the rising, the shockingly rising rate of type two diabetes, which actually used to be called late onset diabetes, but is now being seen in young children as as young as five. So late onset is no longer an applicable term. But type two diabetes can be put into remission, and it’s so interesting to see doctors when faced with this diagnosis themselves. Go on to explore the role of diet and exercise and particularly. Low carb. And in Michael’s case, the low calorie, approach. And and I definitely am very proud to have supported defeat diabetes I make no I’m proud of that. And I’m inviting actually it’s CEO and founder doctor Peter Brookner, one of the world’s leading sports physicians, who he himself win at the age of 60, was was diagnosed with type two diabetes, decided to explore alternatives. And the alternative he explored was a low carb approach. And that was the beginning of defeat diabetes. And I’m also going to be inviting on Opthamologist and 2020s Australian of the year doctor James McKee, who similarly has championed the low carb approach. Back on the program to talk about this exciting and extremely promising public health initiative. And that is that partnership. Look, it’s great to connect with people like Michael, who is truly a source of inspiration with his popularising of intermittent fasting, of fast exercise and of the focus on sleep. It was interesting to hear him, get his most relief for his, I’m assuming, his diagnosis of obstructive sleep apnoea, which is we observed in 80 to 90% of cases, goes undiagnosed. So if you are not waking up feeling refreshed, you need to take that seriously. And I would encourage you to look at his program. Australian. Sleep read the Australian sleep revolution, and get tested. Find out whether you have obstructive sleep apnoea. Michael found relief in, a mandibular advancement splint, which we’ve talked about on this program a few times before. I hope this finds you. Well, until next time. This is doctor Ron Erlich. Hey. Well, this podcast provides general information and discussion about medicine, health, and related subjects. The content is not intended and should not be construed as medical advice, or as a substitute for care by a qualified medical practitioner. If you or any other person has a medical concern, he or she should consult with an appropriately qualified medical practitioner. Guests who speak in this podcast express their own opinions, experiences and conclusions.