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The United Kingdom represents on this episode, with Drs. Haroon and Sohaib leading a meaningful discussion on circadian nutrition with budding Dublin-based expert Alan Flanagan. Alan is an embodiment of holistic nutrition and well-being, and lends his advice into constructing a daily routine and optimizing your rhythm with nutrition.
Transcript
Dr. Haroon Kazem: Thank you guys for listening to another episode of the Body Clock podcast presented to you by Owaves. This is Haroon and I am joined today with Sohaib and a special guest for you guys today. As we mentioned in previous episodes, our goal here at Owaves and at the Body Clock podcast is to bring to light, experts and enthusiasts in the fields of science, technology, and any other pertinent industry that you can really think of that relates to circadian rhythms and body clocks and we are very privileged and pleased to bring to you today Alan Flanagan.
He is available for you to follow on Instagram, the handle “thenutritional_advocate.” He is a science based nutritionist for optimal health and performance as well as an attorney and a nutritional medicine master’s in science and a very very knowledgeable, intelligent dude. We are very happy to have him on today and we’re gonna pick his brain a little bit. I’m gonna go ahead and segway the microphone over and just so you know, we’re remote Alan and Sohaib both are across the pond in the UK I am on the complete opposite end over in San Diego. And so Alan, we’re just gonna go ahead and get right into it if that’s okay with you.
Alan Flanagan: Absolutely.
Dr. Sohaib Imtiaz: Yeah, so I was going to say, so Alan, I first came across Alan from this new lifestyle movement in the UK which has become quite prominent and a lot of doctors have been getting into this and being quite a young doctor, what I found was there’s a lot of lacking knowledge in this space and it was more of a kind of a movement where people were piggybacking on studies and things they’d heard on the media rather than having any kind of scientific robust evaluation of the evidence. So that’s where Allen stood out because we had a WhatsApp group, we had discussions, but whereas most doctors would jump on the bandwagon very easy of a concept, Allen would never be scared to voice his opinion. Also-
Dr. Haroon Kazem: Reign in if you wayward ideas that were getting thrown around.
Dr. Sohaib Imtiaz: Exactly which which is which is inspiring because, you know, you need to know the evidence. It’s very easy for a doctor to be like, “because I’ve studied certain things, I’m an expert in everything,” which is not not the case. So obviously I’ve been following Alan for a while and I mean, insane amount of knowledge on the topic and obviously is passionate about it and from what I used to kind of kind of feed my questions to and kind of increase my knowledge base. So yeah. So we’re gonna start with asking Alan a few general questions first about how you got interested in the space. So, Haroon, would you like to start?
Dr. Haroon Kazem: Yeah absolutely. So we typically want to go through like sort of like a standardized set of questions for special guests like yourself that we bring on and some of them are going to just be open ended so we’re going to probably start with one of those. And what what would you say gets you out of bed every day in the morning?
Alan Flanagan: For me I think that kind of depends on the phase of your life that you’re in, right? In terms of like what what you’re working towards at a particular time. So for the last, you know, certainly six months but in the last accelerated two months, up until the 10th of July when I submitted I was, you know, my dissertation was was front and center and everything that I was doing and that was getting me out of bed in the morning.
I guess for the last three years, what has mostly gotten me out of bed in the morning has been getting up an ATUS for more, you know, research and I spend my life buried in research: nutrition, science and that drives me. Hunger for obtaining as absolutely much knowledge as I can in this subject and thoroughly understanding it because it’s so nuanced and that’s why I fell in love with it,the shades of grey, the nothing being black and white. So really, you know, my my drive to get up in the morning is continually-in the broadest sense-a drive to keep learning and keep keep keep that brain ticking over.
Dr. Haroon Kazem: Absolutely. I mean, where would you say, right now your primary focus is? Because you’re very multidimensional in terms of like your professional background.
Alan Flanagan: Yeah, so law is my day job and always has been as a professional career. This was originally my kind of like side passion, you know, the way you might read history in your spare time or have a particular interest in something. And then-but I wanted to formalize the process because I found myself gravitating towards the science. I got frustrated that I felt like a lot of people I think when I first started trying to self learn about nutrition I was reading books and blogs and then I was kind of a bit skeptical of the type of information I was getting and I wanted to be able to verify whether it was true.
So I started turning to research but of course I had no formal training in that sense so that’s why I want to. And I have a balance in my life but it’s definitely a balance that requires certain sacrifices in terms of, you know, like the way you operate your week and the way you schedule things so, you know, my focus, it depends. I mean, professionally, my focus is to, you know, have a professional life that allows me to pursue my passion and I do believe you can have a profession and a passion and they don’t necessarily have to be the same thing. So I’m lucky in that sense. I’m lucky that I have a profession that I enjoy and that allows me to pursue my passion.
Now that said, you know, where a path to full time research to illuminate-and when I say illuminate, I’m trying to set the path on fire and make it illuminate. And, you know, if that’s to present itself, then I’ll then I’ll have a hard think about what I’m doing because the goal, you know, long term would be to get into nutrition research and the science. So right now I’m in the process of just trying to figure out the whys and wherefores of moving onto a PHD and looking for funding, potentially from the British Heart Foundation or whatever. But, you know, if that was to manifest, then I’d have a serious conversation with myself about, you know, going going full time into that but until that bridge or fork in the road presents itself then the status quo right now works for me and I’m lucky that it does.
Dr. Haroon Kazem: Absolutely. I am very eager to dive into your dissertation specifically because of a topic that it covers. Sohaib, is there any other general Q and A that you have for Alan or should we get right into it?
Dr. Sohaib Imtiaz: I think there’s so many questions we could be asking him but I think we really want get into the whole science of it and the value it can really add to listeners. I think before we start, so Alan, obviously Owaves is a concept of trying to optimize your daily plan which most people struggle with. You’re someone from from following you, it seems you’re quite good at finding that balance between, you know, learning, exercise, you know, making the right food choices, you know, still social connection, the whole kind of lifestyle medicine spectrum to be able to kind of calculate. You even have a day without your phone. So you seem to have found a balance. So just about what’s helped you do not have always been like that or is this something-
Alan Flanagan: No, I have always been fortunate to be one of those people who is organized. That’s at least one thing that I’ve always had. I do have a touch of, you know, kind of an obsessive element to my organization but I’ve always been organized so that’s been helpful. But in the last couple of years I read a lot of, you know, some excellent books about, you know, optimizing performance and in a general sense, in a life sense, possibly the most impactful was Cal Newport’s Deep Work and then Tony Schwartz’s The Way We’re Working isn’t Working, which was just a real rubbish of like the manner in which we’re kind of like the 9 to 5 work day etc.
So I had my organization and I usually always put a structure on my day and then I read these books and I decided, “Okay, there is really valuable lessons here that I can put in place things like giving yourself, you know, I do one day a week with just no no social media and no e-mails and stuff like that. But even in the morning now-the way I kind of organized my day is, I’m an early bed person. Like I’m pretty much in bed by about 9 p.m. most nights. Yeah. And that’s because I figured out that for the most part, our waking time is relatively non-negotiable. That’s the thing. And if you’re a nine hour person sleep a night which I am, I’m not one I’m not, but when I’m training hard, which I do because I compete in powerlifting.
So I’m training hard, I’m also exerting a lot of mental output during the day and I actually find that cognitive exertion is more fatiguing than physical exertion, to be honest. When you combine the two, I am one of those people that needs pretty much nine hours a night in order to really be on, firing on all cylinders. So that’s what dictates that. I tend to wake up naturally any time between six and half 7 am. And so if I want to get that in then, you know, getting into bed at 9:00, reading for 20 to 30 minutes, fall asleep.
I put my phone on airplane mode before I go to bed. And then the first two hours of my day is a sanctuary where that phone doesn’t come on. So I’m cut off from the outside world for the first two hours of my day when I’ll get up, the first thing I’ll do is well down a glass of water, I’ll meditate for 15 minutes, I’ll stretch and do some yoga poses to loosen up, I’ll make coffee, I’ll read for 20 minutes and then I attack whatever particular thing I really want to do with that day and I’ll attack it for about 90 minutes, totally undistracted. And depending on the day or what commitments I have, that could that could go on. But usually it’s that average of like just doing that 90 minutes or two hours in the morning and then I might turn on my phone connect with the world. I might have to go into work, into my desk and take care of stuff in there or whatever. So my day can be really really variable.
It’s never the same, for the most part. And so having certain rules and structures around that really helps and for the most part then, by the evening, by about 8:00 o’clock, I’m trying to check out of my phone and I’m thinking more to, you know, starting to kind of wind down and go to bed again. But basically anytime from that first two hours of my day to kind of going to bed can be relatively variable. From a circadian perspective, I figured out that I’m best training anytime between say, 3:00 and 7:00 but even 7:00 is getting kind of late. So on the on the main I train at about 4:00 p.m. till about 5:30.
Dr. Sohaib Imtiaz: Okay, wow. I mean, that’s very insightful so it’s very-so it seems like you’ve got these structures in place but then you’ve got the flexibility to adapt to external cues and situations because-
Alan Flanagan: Absolutely, yeah.
Dr. Sohaib Imtiaz: Life doesn’t run how we want it to.
Alan Flanagan: No, exactly.
Dr. Sohaib Imtiaz: Amazing. And before we go into the kind of, well I’m sure all the listeners will be waiting for, any elite performers or anyone you’ve looked to as kind of inspiration, or is it just, you know, you’ve read a lot of books?
Alan Flanagan: Yeah, it’s more it’s more of a collection and an accumulation, I think, of of, you know, different sources and different bits of knowledge that you pick up along the way. So yeah it’s definitely-there’s no one in particular that like I kind of have us as a kind of, you know, kind of an uber role model in any sense. It’s-I’m always drawing from from different stuff.
Dr. Sohaib Imtiaz: Yeah, trying to create the best. I mean, interesting, when we when Royan does do an Owaves daily plan of yours, we’re looking forward to posting that, actually.
Alan Flanagan: Yeah.
Dr. Sohaib Imtiaz: So now I think it’s time to deep dive into some topics that, I mean, I’m looking forward to learning. So we’ll start with time restricted feeding. So what what what can you tell us about the whole concept of time restricted feeding and the lengths of time?
Alan Flanagan: Yeah. So the first thing I think that is good to clarify for listeners is that time restricted feeding is often conflated with intermittent fasting and they certainly are related but they’re more like cousins than brother and sister. And what I mean by that is most of the intermittent fasting regimes were simply concerned with one thing and one thing only and that was an extended period without food and then an eating window but that eating window when you look at different intermittent fasting regimes, that eating window is random.
You know, you have some paradigms that they might eat between for four hours and it might be in the evening or they might skip a whole day of food and kind of do alternate day fast so intermittent fasting is very much solely concerned with restriction of energy for typical periods, 16 hours or as being a minimum or more. But it’s not really considering time of day dependent eating. People eat whatever the hell they like with an intermittent fasting regime, awesome. You know, just once it’s in the window.
Time restricted feeding was born out of circadian research and so it is distinctly circadian in nature and it factors in what we have accumulated over the years from animal model data and also from what are known as, you know, constant routine studies which are lab based work in humans where their light cues are manipulated or, for example, all of the external light cues or timing cues are removed, so that is a little longer than the 24 hour day, which is why we have these external cues. We’ll get into that. But the basic premise of time restricted feeding was from that body of mechanistic studies, shall we say, and animal data, a couple of features emerged.
One was that, for example, our insulin sensitivity peaks in the earlier part of the day and kind of declines as the day goes on. We have rhythms in circulating triglycerides-which for listeners it’s a technical term. It just means the circulating fat in your blood and that can come in through the diet or it can be released from stored energy from fat tissue.-We have peaks in obviously different hormones that are involved in blood sugar management, cortisol in the morning that’s typically associated with what they call the “cortisol awakening response,” you get out of that.
So all of this all of this data accumulated and using different constant routine studies it was identified that, well if you give people a glucose infusion at 9 p.m., you know, they’re fairly-their response is fairly impaired, their tissue insulin sensitivity is poor. If you give them even a snack a 200 calorie snack at 11:00 p.m., you know, they’ll have decreased fat oxidation and all of these negative metabolic consequences. So from time restricted feeding, kind of, was was very much born with these parameters in mind and so it has certain principles at play in it which for example would be that-an earlier timing of more-of the greater bulk of one’s energy intake should come relatively earlier in the day and do not eat late into the biological night which really I think if you tease it out in the literature, it’s from about 8 p.m. onwards.
And the ultimate goal of a time restricted feeding approach is to, because our circadian rhythms are cyclical our-the primary drivers are obviously light exposure. But as well as the cycle of light and darkness is our cycles of wake and sleep and there are cycles of activity and rest. There also are cycles of feeding and fasting so time restricted feeding is very much about aligning all of those circadian variables together so that your food intake is coming during the period of light activity and waking and your giving your body distinct cycles of feeding and fasting, light and darkness, et cetera, in that respect.
Dr. Sohaib Imtiaz: Oh wow. So this seems to be-so you have to kind of synchronize your cycles. Is that what you’re saying?
Alan Flanagan: Yeah and that’s-we need to do that because, so, I mentioned there that the free running human circadian cycle is a little longer. It’s about 24 hours and 20 minutes or 24 hours and 30 minutes, give or take.
Dr. Sohaib Imtiaz: Okay.
Alan Flanagan: Our day is not-our day is 24 hours flat. What that means is that we consistently, every day need external cues to synchronize our cells and what goes on in our body to our external environment. The primary driver of that synchronization is light, particularly light of a wavelength 460 to 480 nanometres. Now your listeners are going, “what the hell? Nanometres? What does that even look like?”
Well it’s very simple, particularly if you’ve got people in San Diego go outside and look up-because the color 400-the reason the sky is what we perceive it to be as blue, short wave blue light, that is exactly what you are looking at when you see a blue sky. It’s the wavelength that gives us the-what we perceive as color and that wavelength of the blue sky is 460 to 480 nanometres. We have specialized cells in our eyes that have nothing to do with vision in the sense of creating images from what we perceive. And those cells relay information about light to a particular part of our brain. And that is the most potent time cue to the human circadian system.
That then feeds down information to the rest of the body to signal its daytime, but if light is the primary driver of synchronization to our external environment on a daily basis, probably the second one is meal timing because meal timing consistently resets the circadian clock and we can offset our circadian clock by shifting meal timing and having erratic meal timing or late meal timing and stuff like that. The rhythms in our liver, in our pancreas, in our kidneys and in all of these organs, in our digestive system, even now they’re looking at-there’s rhythms in the microbiome, basically the composition of gut bacteria that we have in our colon that’s really important.
So everything that’s involved in metabolism, in the taking in of energy that we eat, the breaking down, the digestion, assimilation, absorption of it and the utilization of it is under circadian control. And in order for us to have really optimal health, what we want to have is synchronization between our primary light driven synchronization cues with our meal timing cues so that our peripheral tissues in our liver and our pancreas and our digestive system synchronize with the primary-what they call the central master clock in the brain.
And when that all syncs up together, we have optimal circadian synchronicity. But actually when you disconnect any of them then we’re into circadian misalignment and that obviously now is something that we’re starting to realize has really profoundly negative effects for metabolic health for neurological health, cardiovascular health and otherwise.
Dr. Sohaib Imtiaz: Okay, so so would you-for a listener, which would they be better placed to be having a lunch at one o’clock or a certain time every day? Would it vary by person or is it just about being consistent?
Alan Flanagan: It’s about consistency for the most part. Not only that, it-here’s what I will say does vary by person. We have largely arbitrary concepts about breakfast, lunch and dinner. So I always make this point when I talk about circadian stuff. Breakfast, lunch and dinner, if you think about it, breakfast is largely dictated to by someone’s work start time and whenever they then get out of bed. So breakfast is largely arbitrary.
Breakfast, if you’re a kid, is dictated to you by your school start time and time you get out of bed in order to make that and have breakfast in between. Dinner can be relatively arbitrary as well, although what we see in circadian, kind of, literature now, if there’s any one part of the day that is really getting messed about, it’s evening eating and eating habits and meal timing in the evening. It’s one of the effects of extended evening illumination, is people are simply up later and they’re eating later and they snack a lot. Like, they might have dinner at 8 p.m. but then there’s a lot of discretionary snack intake that comes between say 8 and 11, before they go to bed which is problematic. So the reason I say this is this, when I say things like, “your insulin sensitivity or your response to glucose peaks in the early part of the day,”
I’m saying early part of the day that’s quite a broad definition. I’m not saying breakfast. So you’ll have internal rhythm certainty that are your own. And that’s where taking an intuitive approach to your food intake can come into play. So I’ll give myself as an example. I tend to wake up anytime between six and half seven, give or take. And I am not hungry in the morning. I don’t want to eat. I’ll get up and I’ll drink water or black coffee or some green tea but I won’t eat eating food and then I get hungry at 10 a.m. so it’s so 10 a.m. is my breakfast. Even though it’s not breakfast time in the traditional sense.
But it’s my first meal and I’ll typically eat again at about 2, 1 to 2 and I’ll typically have dinner at about 7. And that’s kind of my-and then you get people that wake up and they are ready to eat as soon as they get out of bed. They are, you know, they’re obviously hungry and they know they’re hungry so they should eat when they’re hungry and when they’re up. General rules, trying to be practical for people, I do think that a time restriction on feeding is beneficial. It does not have to be extreme. I think even aiming for an 11 hour window is-and you’re you’re doing fine and that gives people in the real world something to work with.
You know, you could have breakfast at 8 and finish at 7:00 p.m. It’s easy to do in that context. One thing I would say, though, is trying to have the bulk of your energy certainly in the early or part of the day overall, so that could come across your first two meals and maybe a snack if you wanted. They did a really interesting study in Spain, control trialed humans. I always qualify that because so much of the research in this area is in mice and rats and there’s a lot of overreach based on that kind of data. But this was in lean, metabolically healthy women that controls breakfast and dinner and they had breakfast and dinner at the same time. But the only difference was the timing of lunch.
And so what that meant is that the group eating lunch at 4:30 was having 70 percent of their daily energy late in the day. So they had lunch at 4:30 but they still had that dinner at 8 o’clock. And after, I think it was four weeks, the impact on their metabolic health was was was quite profound. Decreased glucose tolerance, decreased fat oxidation and this shifting in the rhythms, you know, of their kind of metabolism the circadian rhythms of their peripheral organs and tissues.
So that was was actually really interesting because it corroborated a lot of what we’d seen in mechanistic studies and free running studies and stuff like that. And fundamentally, it shows consistent with a few other studies in humans that really from a kind of more, you know, viewing this from a circadian time restricted feeding perspective, we are definitely better off consuming more or a greater proportion of our total energy intake in the earlier part of the day and maybe that’s in your first two meals or something. But when I say early part of the day, I mean anytime between when you wake up and 3:00 p.m.
Dr. Sohaib Imtiaz: Okay. I mean, that’s that’s something that Dr. Satchin Panda seems to discuss as well. But it’s a perfect time to ask you about your perspective on him because a lot of his studies are in rats.
Alan Flanagan: So Satchin Panda is brilliant, an amazing scientist and has done incredible work in this area with the Salk Institute and I think they are really kind of on the cutting edge of this stuff. It’s not Satchin Panda that’s the issue, it’s people that take his rodent model studies and overreach on what the conclusions might be in relation to humans. And there are some people in this space that I really respect. But, you know, they’re constantly referring to that. I think people fell in love with that graph. I remember they published that study on cell metabolism and they had the cute info graphic of the fat mice that did different time restricted feeding and some of them did only weekend TRF and it protected them from obesity and then-.
Dr. Sohaib Imtiaz: I saw that.
Alan Flanagan: People just, I think it’s just a really nice info graphic and so people just throw it about the place and so you like, you know, “this is what time restricting feeding does,” it’s like, “nah. No, they’re rats.” So.
Dr. Sohaib Imtiaz: Yeah, why do you think nutrition is something that people seem to like having a belief system or grabbing for making-above and beyond?
Alan Flanagan: Yeah, nutrition for me is unique amongst health sciences because other health sciences or any science really is typically just more objective. But we all eat. We will engage with food, more than any other variable in our life. I mean, you will sleep once a day, you’ll buy a car twice in your life, you’ll buy a house once, you’ll do all these things through your life that are really kind of impactful and and significant, very rarely.
But every single day, you will eat multiple times and you will make multiple cognitive decisions in that day. So it’s very much tied to being human at a very deep level and obviously because, you know, if you look at it from a kind of anthropological point of view and why we’re here and there are humanoid species died out and why we have a prefrontal cortex and, you know, those rats we study don’t. It’s very much tied to nutrition in our evolution.
So I think that at a very deep rooted level, nutrition is something that becomes part of someone’s identity. The choices that they make reflect their moral values, reflect their ethical values, and then reflect their nutritional beliefs. And it’s really not the moral or ethical values that get us in trouble. It’s when people take their nutritional beliefs and internalize that as part of their self-construct, that we end up in serious problem. And that’s really where we’re at now, really with all the noise and nutrition is people just can’t separate nutrition from their self.
Dr. Sohaib Imtiaz: Exactly. And I think being into quite conscientious statistics and data and I think, as we evolve into more of a technological society that is slightly more intellectually robust, I think people like you who kind of have more of a kind of look at the evidence for nutrition, I think there is there’ll be an increasing awareness because you do hear from, I mean, being a medical student, I was so confused. You would hear so many different things and then you then you’d make no choice because behavioral economics tells us that when we have too much choice, we don’t make a choice. So when you’re hearing low carb, low fat, you’re hearing all these different ways, vegan, etc. I mean you’re just like, “you know what, screw it.”.
Alan Flanagan: Yeah.
Dr. Haroon Kazem: Yeah I’ll get a cheeseburger.
Dr. Sohaib Imtiaz: Yeah. You look at that. So you’re quite well-I’m quite interested in public health. So you look at the kind of population health paradigm. So a lot of these principles are quite good for population health but say I’m say say, for example, I’m setting my Owaves plan. And say I’m-like you’re a powerlifter, say I’m a tennis player or endurance athlete of or something-and I have my training later in the day. Would I be better off starting my time restrict-if, say if I’m applying the principles of time restricted feeding later on due to that adjustment?
Alan Flanagan: Yes. There’s two ways of looking at that. One is that you could just start a, kind of, later, you know, window, it really would be dependent on when exactly that evening training session is coming in and it really would be dependent on the energetic demands of that session. So if I was telling someone who-I was discussing this on on a podcast two weeks ago with a group of guys here in Ireland that they’re all strength and conditioning coaches.
So they’re working with people who are coming in and doing very demanding going home and getting home at 9 and they were like, “well what’s your advice for someone like that?” And my advice is typically to probably have more of a kind of liquid based meal. So like a blended smoothie in the blender and typically keep the dietary fat content of it lower. That’s nothing against dietary fat. It’s simply a reflection of the circadian peaks in triglycerides that occur and they occur in the evening. So you don’t necessarily want to dump a really high fat meal in on top of that, late in the night because you just exacerbate the digestive post absorptive circulation of fat in the blood, which isn’t great when you’re just going to sleep. So typically what I’d say to someone is, you know, if it was it was a tennis match, you know, depends like, I mean, if you played three sets in the evening and a bit of heat, you’re sweating like your primary goal is to replenish those fluids first and foremost.
Your primary kind of nutrients that would be optimal at that point in time would be protein and some carbohydrates and keeping fat relatively lower. So I would say to someone if they did have to eat later in the night would be try and keep it something like protein based. Some some maybe some kind of you know some carbohydrate with that if they had a kind of training session that warranted replacing carbohydrates that they’ve lost. So what I would say to someone, if that is their case and they have to train at 7:30 p.m., your your nutrition during the day is going to be what what dictates, you know, the outcome of that session.
So make sure that you get all your energy intake in during the day that you need. You’re going to be fueled for that session. If you’ve had enough protein over the course of the day, you’re likely going to be fine for like a response afterwards so just have something very light on a kind of like a shake in the blender with a banana and some frozen berries and keep it light and go to bed and get off and just have a big breakfast the next day.
Dr. Sohaib Imtiaz: So I think everyone needs a personal Alan to personalize their days.
Dr. Haroon Kazem: Seriously.
Dr. Sohaib Imtiaz: That’s what at Owaves, we’re trying to make it actionable. Yeah, Haroon so I think that dissertation brings us nicely onto that. So.
Dr. Haroon Kazem: Absolutely. Yeah, that’s a that’s a very popular topic note is that I’m seeing more and more on the Internet, in terms of like what your dissertation specifically covered with regards the nurses and working night shift.
Alan Flanagan: Shift work.
Dr. Sohaib Imtiaz: Yeah.
Dr. Haroon Kazem: Yeah, I guess that’s becoming-they’re shedding light on the fact that that is actually very unhealthy.
Alan Flanagan: It takes ten years off your life.
Dr. Sohaib Imtiaz: Yeah. Finding out everything I do is suddenly taken another decade off so I feel like I’ve got a week left at this point but-.
Alan Flanagan: It’s a difficult one because the nature of the societies that we’ve evolved means that shift work isn’t going anywhere. So it’s really imperative that we develop the research and the evidence base to be able to have it be less impactful on people. I think that part of the reason why we see such strong associations now with adverse health outcomes, particularly it seems to be dose dependent as well, like you can get away with it for a while but when you-certainly, in relation to, you know, the long term effects of people who work shifts over say 20 years.
That seems to be really where you see some pretty early onset cardiovascular disease and stuff like that. But it’s not going anywhere so it’s really important that, you know, particularly for our health care professionals, we grow the evidence base so we’re able to give people better advice on-actually I can tell you what I’m hoping to pitch for my PHD but-.
Dr. Sohaib Imtiaz: That’s interesting.
Alan Flanagan: So it is important. One of the really interesting observations from shift work and as it relates to, kind of, chrononutrition. I love that term because, what is that? I’m like, “oh, new thing.”.
Dr. Haroon Kazem: Sounds pretty cool.
Alan Flanagan: Yeah, it does sound cool. But but one of the really interesting things was the original assumption was that well the reason why shift workers are at increased risk of cardiovascular disease, diabetes, etc., cardio metabolic disease, generally is probably because they’ve been up all day and then they eat more in the evenings, blah blah blah. We actually know that not to be the case.
People who work shifts don’t actually consume any more total daily energy than someone just works during the day. So it really started pointing the finger at, kind of, time in which they’re easing being really important. If they’re not consuming any extra energy, this really isn’t so much about calories as much as it’s about when they’re eating. There’s a couple of interesting things that that when we sleep and during our biological night, we’ll have two peaks in circulation blood fats.
Now if you’re asleep and you’re you’re fasting and you’re not eating, that’s fine and it’s going to create some energy availability to be able to get up and start the day. The other effect is you-when you sleep, obviously before sleep, you’ll have an increase in melatonin. Well once you’re not staring at a 60 inch plasma, spitting out at the same wavelength of life, the blue lights the blue sky is showing you-but you will have an increase in melatonin, you go to bed and melatonin remains elevated during the biological night and will start to come down towards the morning. The issue is that melatonin was once considered like the sleep hormone.
That’s being fairly disparaging to melatonin. It has an incredibly wide array of physiological effects, one of which is an interaction with the pancreas. There’s melatonin receptors in the pancreas. Melatonin basically, in conditions of high melatonin levels like when you’re asleep. If you consume carbohydrates, your insulin response is going to be so exaggerated and you’re gonna basically have peripheral insulin resistance and your blood glucose response that meal is gonna be all over the place.
So even-and they’ve done research on this-you know, a 200 calorie snack at 11 o’clock has really negative metabolic effects over a couple of weeks. A 200 calorie snack at 4 a.m. will result in the highest peak in triglycerides, in circulation even more than a meal containing 750 calories at 1 a.m.. Part of the reason for that is all of the the fat from the meal that was consumed earlier gets stored in cells in your intestines and then when the previous snack comes in it get to be bumped out into circulation and that means that even small snack type calorie intake, if it’s taken in at the wrong time can have a lot of negative effects on someone’s metabolic health. So we’re starting to gather an understanding of what, you know, is going on in terms of the underlying metabolic issues and why eating during our biological night is such a problem.
But one of the things that really hadn’t been teased out that well in the research, there’s one or two studies looking at it. One very good one from last year that kind of was the genesis for my idea but it hasn’t really looked at the distribution of energy, no one works-typically no one works one night, acutely. It’s certainly in health care, the standard is internal rotation shift patterns, where someone works three nights in a row, has an off day and works three day shifts or something like that. Very little research has looked at well if someone’s working a couple of nights in a row, how do they distribute their energy?
If they’re not consuming any more than the person that just works during the day and goes home and sleeps during the biological night, what’s the pattern? So what I wanted to do was look at-specifically look at the manner in which energy intake in nurses was redistributed to the night phase and what we ended up finding was that between certainly night one and night two, on night-the first night they work shifts, they won’t consume any huge amount of their total daily energy intake during that night phase. And that’s because they’ve been awake for the day and they’ve kind of eaten their normal daily pattern, so they might snack a bit and they might have maybe 10 or 15 percent of their of their energy intake comes during between say 9 p.m. and 7 a.m.
But by night two, they had-the spread was was wide enough in terms of the different-but up to 40 percent of their total daily energy had been redistributed to that night phase. And the reason this is really important is because we know from everything that we know about circadian rhythms that one nights, two nights, three nights worked is not enough to have a circadian realignment to that night phase. So your biological processes are still tied to the day but you’re eating all of this energy intake during what internally and in your circadian rhythms is your biological night. So that can only have negative effects on someone’s cardio metabolic health over the long term.
And what what seems to be the most pronounced negative effect is in relation to your glucose tolerance. So, carbohydrate intake and your triglycerides, dietary fat and so one thing-and this is where what I’m hoping to kind of maybe pitch as a PHD- The one thing-piece of feedback you get from people who do work shifts is they’re saying, “well look, I know that the best thing I could do is not eat at all, but that’s just not feasible. Like I’m I’m running around,” you know, they’re nurses or something they’re stressed or they’re doctors, you’re dealing with stuff going on. So not eating doesn’t seem pragmatic for people who work shifts, particularly in kind of demanding environments. What I’m kind of interested in is looking at the effects of protein feeding as opposed to carbohydrate and fat because protein metabolism is relatively unique.
It’s certainly different for carbohydrate and fat and it doesn’t seem that anyone has actually looked at the effects of, kind of, intermittent protein feedings during a biological night and what impact that has on, you know, blood glucose responses and stuff like that. And if that could be something that is less impactful then it might give us some strategies to be able to tell people who do work shifts some better advice on how to eat. So you might have a nonfat Greek yogurt, you know, at-what-1:00 a.m. or something like that and we may be able to optimize when we tell people to eat during during nights. So.
Dr. Haroon Kazem: I think that’s a really good point you bring up that the quality of the calories is just as vital as the quantity, right? So I think too many times we get caught up with sticking to that 2000 calorie number per day here in the United States. And, you know, I kept it under that and I should have had a good day. But are you eating you know healthy lean meats, grass fed beef, things like that or are you picking up like a piece of processed baloney or are you eating like a pop tart?
Alan Flanagan: Yeah. And the thing about the thing about our are our circadian rhythms is that if that was coming during the biological night, there’s a question over whether that even, you know, that the quality thing would matter. It’s the it’s the effect of the meal itself. So you could sit down to quite a high quality meal. I mean, you could sit down into a grass fed steak and some sweet-roast sweet potato at 1:00 a.m. Yeah there’s, you know, it’s if your response certainly to the sweet potato would be would be just as-
Dr. Haroon Kazem: Poor? So on the flip side, could I have a pop tart instead and it’s the same thing?
Alan Flanagan: Probably.
Dr. Haroon Kazem: Don’t do that to me, Alan. You don’t know what you’re gonna do to me if you say that.
Alan Flanagan: Yeah yeah.
Dr. Sohaib Imtiaz: I’m looking forward to this PHD. I’m hoping you get it.
Alan Flanagan: Thanks, dude. Yeah.
Dr. Sohaib Imtiaz: Unfortunately I only have four months of nights left.
Alan Flanagan: Right.
Dr. Sohaib Imtiaz: With the surgery so, as someone who’s having four night shifts in a row coming up and then you switch to days and then weekend nights, it’s pretty brutal, 13 hour shifts.
Alan Flanagan: Yeah.
Dr. Sohaib Imtiaz: So would you say-you kind of-you’re hypothesizing the protein content. So with things like protein shakes if they have a low sugar-
Alan Flanagan: Yeah, I just it’s a hypothesis I have that protein typically doesn’t have, you know, certainly you can get an-you will get an insulin response to protein intake but it depends on the type of protein as well. I’m kind of of the opinion that if you’re going to set up your eating during the biological night, then yeah, a protein shake or a non fat Greek yogurt or, you know, some-I don’t know-even sashimi or something like that, you know, so light snacks, I would say avoid eating at certainly 4:00 a.m. because that seems to be-that is the point of peak triglyceride circulation a lot of the time so.
Dr. Sohaib Imtiaz: That is also the point that most people eat on the night shift, it’s in the middle.
Alan Flanagan: Right. Yeah.
Dr. Sohaib Imtiaz: That’s very insightful.
Alan Flanagan: Trying to eat maybe it’s say, like I would say like, have a big dinner certainly at like, say 9:00 p.m. and then a snack at 3:00 and then, you know, maybe a protein shake at 7:00 or something like that. But yeah.
Dr. Sohaib Imtiaz: When you come back in the morning and you go about sleep, is it good to eat like a breakfast?
Alan Flanagan: Well yes but again I would say to keep that to a, kind of like, protein and fat type breakfast because your your your your insulin sensitivity after a night of no sleep or impaired sleep is that of a pre diabetic. So come home and have some scrambled eggs and some avocado and then get into bed.
Dr. Sohaib Imtiaz: I’ve written all that down.
Dr. Haroon Kazem: Yeah, same.
Alan Flanagan: And then when you get up, even though it’s counterintuitive because you’re working more nights, just get out and go for like 30 minutes to forty five minutes to an hour, just walk in a natural light. The other thing you can try and do is get the amber wear blue light blocking glasses.
Dr. Sohaib Imtiaz: I’ve seen you wear them.
Alan Flanagan: Yeah. So you can get-so I’ve got I’ve got the swanis, which are extreme because they’re really dark orange. Now they block everything but there are companies that are doing blue light blocking glasses that will block up to 440 nano meters so they don’t block all blue light, but they’re clear glasses so they just look like you’re wearing normal reading glasses. But it’s just enough, kind of-if you’re wearing them during the night shift, you’re still able to obviously see and everything. But it’s it’s just enough blue light blockage that you might be able to keep some integrity in your in your circadian rhythms even though you’re pulling an all nighter.
Dr. Sohaib Imtiaz: Okay. I’m going to write that down as well. Okay. I hadn’t heard of these, actually. So, are they available commercially?
Alan Flanagan: Yes they’re-Amber wear, they’re good. They’re nice. I have a pair coming to me now. So they’re the ones because the-the ones with that are really orange tinted, I’ve worn them out publicly sometimes.
Dr. Sohaib Imtiaz: Yeah, I’ve seen you.
Dr. Haroon Kazem: “My circadian rhythm, dude.”
Alan Flanagan: These are a little easier for socializing and stuff.
Dr. Sohaib Imtiaz: Yeah. I don’t think I’ll be socializing too much in the hospital.
Alan Flanagan: No you aren’t. Exactly. Exactly.
Dr. Sohaib Imtiaz: Glasses sounds good.
Alan Flanagan: Yeah. Yeah.
Dr. Haroon Kazem: Alan, so I had a quick question for you because I was thinking about what-I was thinking about what you were talking about earlier with regards to just like, normalizing our patterns-right-when it comes to us being creatures of light and that ultimately, you know, evolutionary wise, like probably being the reason why we are the way we are today. What are your thoughts on, you know, some of those more outlier populations of people who are, you know, more light exposed in certain geographic areas and also with regards to that as well as like the comment you made-a little bit of a tangent-but the concept of like eating protein being better.
Would you attribute that in any way to like our evolutionary, you know, sort of development where, you know, at a point, you know, when we’re early hominids you know more than likely we were probably getting our nutrition and calories from-what-like, plant sources, animal animal proteins and it probably wasn’t until, like the industrial revolution that, you know, suddenly processed foods came about and that became like a very normal thing.
Alan Flanagan: Actually, it was the Second World War, really, what we know as the processed food industry now. Yeah. And it was born out of the, obviously, the best intentions in the world. It’s like, “well, how do we create foods that can survive and travel to feed an army in the South Pacific and France?” So a lot of what we know about like, you know, processing and packaging and stuff like that-and all that kind of stuff was actually born out of the Second World War, yeah.
Dr. Haroon Kazem: Sure, makes sense.
Alan Flanagan: So, no. My idea about protein feeding is actually just much more metabolic. It’s just-it’s looking at the way that we digest protein. Doesn’t, kind of, necessarily because it’s typically just it’s a building block, obviously, so we we use proteins slightly differently in the body to the way that we use, you know, we don’t typically convert a lot of protein into fat, we don’t typically convert a lot of protein, we can do-in different conditions-into glucose.
We can convert protein into glucose easier than we would kind of convert it into fat. And it’s just really more to do with the metabolic response to protein intake that I’m interested in, perhaps has less negative impacts on your, you know, on your, kind of, insulin and on your tissue insulin sensitivity and on your triglycerides, if one was to consume it in the biological night. And again, that is purely a hypothesis and I don’t know. Is it based on evolution? No, not necessarily.
It’s based on metabolic responses and what potentially could be a different metabolic response if someone just has, kind of, protein based snacks during the night. But you touched on that really interesting point about light. Our circadian rhythms are flexible because they respond to time cues. But there is some-there is some interesting kind of, you know, data on, for example-and Matthew Walker talks about this in his book-
Dr. Haroon Kazem: I love that guy, by the way.
Alan Flanagan: Yeah. And he talks about the increase in heart attacks that occurs with daylight savings. It’s really scary stuff. You know, we we fairly arbitrary, come up with daylight savings, for the purposes of creating an extra hour of light in the morning for agriculture and that’s typically the historical purpose of daylight savings is to allow, you know, agricultural industry to have an extra hour of light because you’re not going to have it in the evening.
There’s question marks over whether that’s even necessary in the modern world and I agree with those question marks. You interestingly, you also have political interventions that can mess with people’s circadian rhythms and probably the most famous one there is Spain. So we all know Spain for late night eating and the siesta in the in the afternoon and then people go out for dinner. But if you’re Irish or from the U.K., for example, you go to Spain and you know it’s just direct south you’re flying but you get there and it’s an hour ahead, but then you go into Portugal and you’re back on Irish and UK time. Why? And the reason is, during the rise of fascism and into the Second World War, Franco wanted Spain to be on the same time zone as Germany.
Germany is one is GMT plus plus 1. So Spain ended up changing, for political reasons, its time and suddenly everyone’s daily routines that were so established over the years were shifted by an hour. And there’s a lot of really good circadian research comes out of that of a group in Spain and there’s some quite strong calls to basically just shift their clocks back. Not 9:30, ten o’clock. And then there’s obviously the region of the world you can be in just based on geography and the Scandinavian countries of Europe and Alaska, if you’re in northern Canada, you’re gonna go through periods of the year with extreme swings in how light it is and how dark it is.
And yes our circadian rhythms are adaptable but certainly there is, you know, in the Scandinavian countries there was quite a high prevalence of suicide in the winter months. One of the big pushes in Scandinavia has been to get people getting artificial blue light exposure in the winter months. And I do recommend that for anyone that lives in a climate where for the first couple of hours of their day in the winter months it’s dark out. You can buy them freely available on Amazon. Phillips do a good range.
The Go Light Blue is a good one and you spend 30 minutes with this blue light box on your face just just on and your eyes will pick up on it in the morning. And people really notice a difference in their energy levels, in their moods, and all of these variables. And it’s important to note the mood thing isn’t random. Light is physiologically arousing to humans and that’s why we get up and go when we respond to it.
That’s why in the summer people are like, “oh my God, everyone’s in such a great mood, the sun’s out,” and that’s not random. You know, we didn’t lick that off the ground. So it is difficult. For me, I notice, I actually kind of-because I am typically quite stringent with regulating my light environment, I struggle during the summer months here because, you know, right now it’s kind of 8:30 here and it’s beautiful outside.
Dr. Haroon Kazem: Yeah, I know.
Alan Flanagan: I want to I want to go outside, you know? So I typically, you know, and it’s like, “I don’t want to put on the blue light blockers because it’s such a nice day.” But, you know, I will eventually. You know, typically I do-in the summer I’m less I’m less militant on that because it is light outside so but but some of the experiments they’ve done over the years and the circadian with humans have been interesting.
I mean, the pioneers, I mean, him, the professor took his postdoc and they basically went down into a cave for two weeks or three weeks and measured. So they were the ones that really discovered that the human circadian rhythm was free running because they removed all light cues. They lived in pitch black for weeks and they were the ones that kind of started to-and they were they were recording and taking data and blood measures and stuff and they realized that-and the term “circadian,” the rhythm is defined by it running independently of of other stuff. So you’ll-those peaks and triglycerides or your insulin sensitivity and all that stuff. And so it’s about synchronizing what we do with them, trying to impose onto them because that’s when we lose. And that’s fairly reflective of how we’re living now with getting up in the morning.
People in industrialized countries spend 88 percent of their time in enclosed buildings. That’s a really scary stat. And what it effect means is that even though you might think your room is brightly lit, it does not compare to the intensity of light that we get from natural light exposure. So people might get up in the morning and it’s dark out. They might commute in a car to a poorly lit office, from a circadian perspective, poorly lit.
They don’t get any light signals that stimulate circadian entrainment and then they come home in the evening and they’re lying on the TV with a 60 inch plasma on and their iPhone 6 inches in front of their face and they’re getting all of this light exposure that is signaling to them, “finally, it’s daytime, it’s arousal, it’s awake,” but it’s 7 p.m. and then they’re going to bed and they’re waking up and they’re tired and they’re fatigued.
And this idea that has emerged in this term of “social jetlag” and that is what so many people are walking around experiencing on a daily basis because their light cues are all over the place. They’re still trying to have a pattern according to, you know, the time zone that they’re in and go to bed at say 11:00 and they think, “well it’s 11:00, it’s late,” but really all of the signals that they’ve given themselves have offset their their synchronization.
Dr. Haroon Kazem: I love that you just tied that social jet lag concept in because we actually just covered that on our last episode. So.
Alan Flanagan: Nice.
Dr. Haroon Kazem: That was beautifully done.
Alan Flanagan: Psychic too.
Dr. Sohaib Imtiaz: I mean, there’s so many topics we could discuss with you, Alan. I think we’ll have to have you back on a further podcast to discuss nutrition and brain health, traveling, readjustment, circadian rhythm, to talk genes and genomics, that’s an area I’m interested in. There’s just so much weight management, diets, etc.
There’s only so much we can discuss on one podcast. But I mean we’ve tried to focus this around kind of the whole timing of nutrition-interest in finding out a little bit more about you. I mean, I’ve heard you talk about some of these topics previously but I mean, every time, I learn something new. Because there’s so many facets to this, you know?
Alan Flanagan: There really is.
Dr. Sohaib Imtiaz: This space, I mean, it’s very interesting.
Alan Flanagan: Yeah.
Dr. Sohaib Imtiaz: I mean, it’s been great having you on the podcast.
Alan Flanagan: Awesome, lads. It’s great to geek out on just purely circadian stuff.
Dr. Haroon Kazem: I’m just sitting here, like, you’ve shattered my reality, my friend-in a good way.
Dr. Sohaib Imtiaz: No more no more late nights. So, a question I want to ask is, what would you say is your kryptonite in terms of-what would you struggle with in terms of nutrition? What would be your weakness? And do you encourage people to have a balance?
Alan Flanagan: Oh, of course. So, I’ve come from a place of always being interested in my nutrition. But I guess, like, a lot of people-I started because there wasn’t a lot of information in the general space. When I first started getting interested in training and nutrition, it was basically body building magazines I was getting information from and, you know, talk about the garbage that comes out of that kind of space about nutrition.
I would eat a kind of tuna without daring to put any mayonnaise on it because, you know, that, you know, I was eating clean and it was all this, this is like, you know, 15 years ago and I was 18, 19 and so I came from this, you know, plain chicken breast, protein shakes, tuna out of a can, bodybuilding lore and I hated that. And so I just I rail on on that whole health and fitness industry now for the kind of crap that they give out. And then-
Dr. Haroon Kazem: Sorry to interrupt you but I think the technical term is bro science.
Alan Flanagan: Bro science, fact. And now, you know, I go through phases. I will track sometimes, if I’ve got a competition coming up and like I’ve kind of, you know, weight is I need to just kind of drop a bit but to be honest, where I’m at now is a place of intuitive eating and I think that’s the holy grail for everyone to get through. And, you know, we’ve so many rules and restrictions. I do not have food rules. I’ve got rid of them all because they cause more trouble than it’s worth.
It’s like creating this big red button to not press and you’re gonna press it because we’re humans. I’ve also fought really hard, you know, certainly on social media to get people beyond a lot of the garbage that I think from the 2000s on, we had this real rise of like movements based in total speculation. You know, the paleo buzz and, you know, gluten is the devil and because it was hybridized in the 60s and most of these-the only thing they have in common is they’ve got a really good narrative behind them and people love a story so they buy into it.
But, you know, the idea of any food being uniquely harmful, you know, is is farcical and just not supported by any science. So I’m at a place now where I don’t have any food rules. If I have a kryptonite, it’s something that I will eat without guilt. Do-what would my Kryptonite be? Like, what do I not have an off switch for? Probably mince pies around Christmas. That’s-
Dr. Haroon Kazem: Makes sense.
Alan Flanagan: Yeah. Mince pies at Christmas time. I know, they’re not big on mince pies in the States. So.
Dr. Haroon Kazem: Yeah. Could you explain for listeners would a mince pie is?
Alan Flanagan: So a mince pie is not beef mince. It is a it is a mix of kind of, you know, sultanas and raisins and a kind of brandy sauce so the inner filling is quite sweet and spicy. It’ll have some kind of nutmeg and cinnamon and so yeah. So, you know, very kind of Thanksgiving style spices and it’s all mixed together but then it’s in this really buttery doughy pastry. So you’ve got this amazing combination of like sweets and then savory in the one. And it’s just it’s there were real Christmas tradition in Europe and I just don’t have an off switch, like.
Dr. Sohaib Imtiaz: They’re very tasty.
Alan Flanagan: The thing is, when you go to Portugal, the pastel de natas?
Dr. Sohaib Imtiaz: Oh yes.
Alan Flanagan: Like, I’ve no off switch.
Dr. Sohaib Imtiaz: Definitely. My friend brought some back. Difficult to resist.
Alan Flanagan: They’re insane. So I just, I love food like and I think that we should all be back in that place where-eating diversity in food as well, which I think is a huge issue and, you know, like the idea-imagine with where nutrition is at now, with how dogmatic people are, like, imagine being like, “oh, I’m really low carb,” and then you go to Italy and are sitting there and it’s like, “well what are you gonna do now?”.
Dr. Haroon Kazem: Good luck buddy.
Alan Flanagan: Yeah.
Dr. Sohaib Imtiaz: You absolutely should. I love that about travel is like, I think, you know, you know, a culture speaks through its food. And so like why not when you travel just like immerse yourself in whatever that place is? Like, “oh sorry, does this pizza have gluten,” it’s like “gosh.”
Dr. Sohaib Imtiaz: I love it.
Alan Flanagan: I’ve abandoned all that crap because it simply doesn’t serve your health and your mental health is probably just as important with diet as what the food is gonna do for you. So I have a real balance-and I’ll fast, sometimes more, sometimes less-that’s also intuitive thing-and I do that-not for weight loss. I do it for the potential underlying kind of metabolic and neurological highlights and just giving giving the system a break. I like the, kind of, the practice of it as it kind of resets. And fasting may be good for resetting the circadian clock. There’s-I think I think it’s useful for like jetlag and stuff like that and getting over that but we can talk about that another time.
Dr. Sohaib Imtiaz: Yeah, I think we talk about longevity as well because you just brought me onto that as well.
Alan Flanagan: Yeah.
Dr. Sohaib Imtiaz: I mean, there’s so much so I think, Haroon what time are we on?
Dr. Haroon Kazem: We’re pushing about an hour and twenty minutes, so.
Alan Flanagan: Wow.
Dr. Haroon Kazem: Yeah, this is awesome.
Dr. Sohaib Imtiaz: Longest longest episode yet.
Dr. Haroon Kazem: So I could keep going but I feel like we’re keeping Alan and this is-.
Alan Flanagan: I mean, I’m fine.
Dr. Haroon Kazem: Good, man.
Alan Flanagan: It’s up to your listeners, to be honest.
Dr. Sohaib Imtiaz: He’s so engaging and I can’t wait until this episode is released because, I mean, you can extract so much actionable, kind of, behavior from this. And I mean, it proves you’re human as well.
Alan Flanagan: Yes absolutely.
Dr. Sohaib Imtiaz: And you know, you have to like food as well. It’s not just-
Alan Flanagan: It has to be something that gives you, you know, emotional and kind of spiritual nourishing and that’s what it’s there for. So I I’m a big believer in the kind of-I think when-look at the Mediterranean diet, for example, which is getting so much press now in nutrition sciences, you know, this really optimal kind of diet pattern.
But the one thing that no one talks-everyone’s, again, lost arguing over the kind of nutrients in it and stuff but the one thing people don’t talk about is the social aspect to us and the fact that people sit down and eat a meal and I love cooking, so for me, you know, the idea of, you know, putting on a spread and getting, you know, your friends over is just it’s, you know, it’s amazing. Crack open a nice bottle of wine, get a glass, have some foods, get some conversations going, put the fucking phone on silent.
Dr. Sohaib Imtiaz: Social connection. That’s part of lifestyle medicine, social connection.
Dr. Haroon Kazem: Absolutely.
Alan Flanagan: And food food is a big part of that. And I think it’s also important to remember that we are fortunate that we are kids that were afforded opportunities in life. And when you look at health research and nutrition research, you know, sometimes we need to stop arguing over diet crap because all of the issues that face us in society now are, you know, obesity, diabetes, lifestyle disease.
These are socioeconomic issues, you know? We’re lucky. We’re we’re we’re normal weight, healthy, we have access to good food and, you know, that’s not the reality for a lot of people in low socioeconomic areas in the United Kingdom or the United States. And my brother lives in Chicago. He works in some pretty poor neighborhoods on the south side and like, there is there’s nothing there, like there’s, so-and it’s the same in the UK if you’re, you know, you go through an area of London or you go up north further and like, say you’ll see this in Manchester if you go through. There’s some areas-.
Dr. Sohaib Imtiaz: Massive disparity. Massive.
Alan Flanagan: Massive disparity. And so, you know, we’re arguing over like, “oh that’s to eat oily fish” and then like people poor socio economic areas of life-there’s a massive disconnect. That’s the big kind of bee in my bonnet at the minute now, is like, we need to start getting real about how we help the people who need help the most. And Instagram is often, you know, a kind of, an echo chamber of like well-educated, middle class kids posting their chickpea curry and it’s like, “wait, Okay. I’m glad you found health. But, you know, that’s not the problem on the ground and it’s not a criticism of that, you know, I’m obviously part of that machinery.
I’m conscious of it, but I’m saying we need to acknowledge where we’re at and our fortune and maybe start having a conversation about how to get people’s diets at a population level better. And I think we need to be comfortable with the fact that “better” will not be “optimal.” You know, from from from various perspectives, we’re not going to please everyone. You know, the planet’s not going vegan. So, you know, how do we press on and improve population health in a manner that is also sustainable for the planet and achieves what we need to achieve at a population level in terms of reducing lifestyle disease risk? And it’s like, I mean, these are big questions, like we’re not going to answer that today.
Dr. Sohaib Imtiaz: That’s a brilliant ending. And the narrative-a very logical narrative. Dissociating emotions from it. So-
Alan Flanagan: Yeah.
Dr. Sohaib Imtiaz: I think, perfect way to end the podcast. Haroon, take it away.
Dr. Haroon Kazem: Alan, it was a pleasure, my friend. We’re gonna definitely have to do this again. We have so much more to discuss.
Alan Flanagan: Absolutely you guys. That was really enjoyable.
Dr. Haroon Kazem: Yeah, this is gonna be excellent. I think everyone’s gonna really benefit from listening to this episode.
Dr. Sohaib Imtiaz: Yeah.
Dr. Haroon Kazem: I look forward to your your future work and on your road to getting your PHD and hopefully we can have you on during that ride and you can tell us some more about it.
Alan Flanagan: Anytime, guys.
Dr. Haroon Kazem: Thank you Alan.