Dr. Akil mindset

Transcript

1. incredible effects of mindset Akil Palanisamy, MD march 16, 2024
2. outline • your beliefs and thoughts… • about diet, sleep, exercise, stress & aging matter… • and impact your physical body… • & biochemistry/physiology in significant ways Presentation title 2
3. milkshake study a low-calorie option • Half of the bottles labeled as a low-calorie drink called Sensishake — stated as having zero percent fat, zero added sugar and only 140 calories. a rich treat • The other half was put into bottles that were labeled as containing an incredibly rich treat called Indulgence, including enough sugar and fat to account for 620 calories. • In truth, the shakes had 300 calories each. what was tested • levels of ghrelin before and after (in same person) Presentation title 20XX 3
4. milkshake study background • Old model – calories in/calories out – does not account for beliefs about food. • Ghrelin is a hormone secreted in the gut – “the hunger hormone". • When ghrelin levels in the stomach rise, that signals the brain that it's time to seek out food. When they drop, hunger subsides old thinking • Scientists thought ghrelin levels fluctuated only in response to nutrients in the stomach. • i.e. put in a big meal, ghrelin responds one way; put in a small snack and it responds another way. Presentation title 20XX 4
5. ghrelin positive response • Usually after a big meal, your ghrelin levels drop which is tied to increased satiety and lower appetite in addition to a boost in metabolism. negative response • If you only have a small meal, your ghrelin levels don't drop much, appetite stays the same and metabolism doesn't get boosted – you might get hungry again sooner. Presentation title 20XX 5
6. surprising results Presentation title The ghrelin levels dropped around three times more when people were consuming the ‘indulgent’ shake compared to when the same people drank the ‘sensible’ shake (even though both shakes were identical) 20XX 6
7. implications If you believed you were drinking the indulgent shake, your body responded as if you had actually consumed much more and were more satiated/less hungry – better hormonally and metabolically! Presentation title 20XX 7
8. takeaways the insight • food labels are not just labels; they evoke a set of beliefs and actually affect the body's physiological processing of the nutrients that are consumed the paradox • what should you believe to maximize the benefit of “eating healthy”? • believing that you are consuming a nutrient-rich, indulgent meal is actually better for you metabolically, making you more full/less hungry • thinking that you are limiting yourself to a restricted, low-calorie meal actually may be counterproductive Presentation title 20XX 8
9. food choices don’t matter? Presentation title • Beliefs & mindset matter • But choices do matter, in terms of which foods you choose to eat – try to make the best choices you can • Not either/or but both/and – avoid dualistic trap 20XX 9
10. beliefs about food Presentation title 20XX 10 … should be centered around satisfaction and indulgence rather than deprivation
11. is exercise a placebo? Crum AJ, Langer EJ. Mind-set matters: exercise and the placebo effect. Psychol Sci. 2007 Feb;18(2):165-71 11
12. beliefs about exercise population • 84 female housekeeping attendants working in seven different hotels, measured on physiological health variables affected by exercise. intervention • Those in the intervention group were told that the work they do (cleaning hotel rooms) is good exercise and satisfies the Surgeon General's recommendations for an active lifestyle. • Examples of how their work was exercise were provided. Subjects in the control group were not given this information. Presentation title 20XX 12
13. baseline beliefs • While they exceeded the Surgeon General’s recommendations for physical activity, the women were not aware that their work was good exercise at the start of the study. • 66% reported not exercising regularly and 36% reported not exercising at all. Presentation title 20XX 13
14. study findings perception matters • Although actual workload and activity levels did not change, 4 weeks after the intervention, the informed group perceived themselves to be getting significantly more exercise than before (they did nothing different) and translates to results • As a result, compared with the control group, they showed a significant decrease in weight, blood pressure, body fat, waist-to-hip ratio, and body mass index. Presentation title 20XX 14
15. is exercise all about perception? Presentation title 20XX 15 ↑ perceived exercise without any changes in actual exercise results in physiological improvement – e.g. wt loss + ↓ SBP 10 pts without increasing exercise or decreasing calories – public health implications education is needed about how being physically active throughout the day “counts”
16. exercise affects health in part via the placebo effect Presentation title 20XX 16
17. beliefs about sleep Do your beliefs about how well you slept impact the way you feel each day (regardless of how you actually slept)? 20XX 17
18. testing sleep perception study design • 63 participants were randomized to receive next-day sham feedback on sleep quality ("positive" vs. "negative") regardless of what was measured on actigraphy device. • Participants completed symptom reports and tests of sleep-related attentional bias and cognition Results • Those randomized to negative feedback had impaired daytime function (decreased alertness, increased sleepiness & fatigue) in the evening compared with those given positive feedback, independent of actual sleep quality. Presentation title 20XX 18
19. testing sleep perception positive feedback • The positive-feedback group displayed a significantly greater increase in positive mood and alert state of mind, and significantly greater decrease in sleepiness/fatigue, independent of actual sleep quality. conclusions • feedback about sleep changes the experience of daytime somnolence, mood, energy, and alertness, in a way that is decoupled from actual sleep quality. Presentation title 20XX 19 Gavriloff D et al. Sham sleep feedback delivered via actigraphy biases daytime symptom reports in people with insomnia: Implications for insomnia disorder and wearable devices. J Sleep Res. 2018 Dec;27(6):e12726
20. wearable devices that claim to measure sleep metrics may provide inaccurate data and cause harm Presentation title 20XX 20
21. shift your mindset Do people with more positive beliefs about aging live longer? 20XX 21 beliefs about aging
22. testing beliefs about aging study population • 660 individuals age >50 in the Ohio Longitudinal Study of Aging and Retirement • Beliefs assessed by validated questionnaire that measures agreement with statements such as “As you get older, you are less useful” hypothesis • Those with more positive attitudes and beliefs about aging will live longer (controlled for age, gender, socioeconomic status, loneliness, and functional health) Presentation title 20XX 22
23. results • median survival for the more positive self-perceptions group was 22.6 years past baseline, whereas median survival for those in the more negative self-perceptions group was 15 years conclusion • older individuals with more positive perceptions of aging lived 7.6 years longer than those with less positive beliefs Presentation title 20XX 23 testing beliefs about aging Levy BR, Slade MD, Kunkel SR, Kasl SV. Longevity increased by positive self-perceptions of aging. J Pers Soc Psychol. 2002 Aug;83(2):261-70
24. beliefs about stress Presentation title 20XX 24 Do your beliefs about stress impact your body’s physiological response in a stressful situation?
25. poll • choose A or B – which statement you identify with more: • A – stress is debilitating and disruptive, and can lead to multiple negative effects on health • B – stress is enhancing and can have positive effects such as improved creativity and performance Presentation title 20XX 25
26. testing stress mindset the training • In the stress-is-debilitating group, 164 employees watched videos that portrayed stress as harmful, causing illness and mistakes at work. • In the stress-is-enhancing group, 163 people watched videos that portrayed stress as useful, improving immunity, creativity, and work quality under pressure. shift in mindset • After a week, people who had watched the stress-is-enhancing videos believed that stress has more positive effects. • In contrast, people who had watched the stress-is-debilitating videos thought stress has more harmful effects. Crum, A. J. (2013). Rethinking stress: The role of mindsets in determining the stress response. Journal of Personality and Social Psychology,104(4), 716-733. 20XX 26
27. effects of stress mindset grace under pressure • During a public speaking task, people with positive stress mindsets had more adaptive physiological responses than people with the stress- is-debilitating mindset, as indicated by changes in output of the stress hormone cortisol. openness to feedback • People with the stress-is-enhancing mindset were also more open to feedback — a necessary step toward improving. Presentation title 20XX 27
28. stress mindset and cortisol Presentation title 20XX 28 Study evaluated effect of stress mindset on cortisol awakening response (CAR) via saliva testing Negative perspectives about stress linked to higher cortisol reactivity to awakening demands, indicating that stress mindsets influence the HPA axis & the stress response Fernanda Carini Silva, Stress-is-debilitating mindset is linked to higher cortisol awakening response in women, Psychoneuroendocrinology, Volume 153, 2023, 106228
29. what is stress • stress is the experience of anticipating or encountering adversity in one’s goal- related efforts • only occurs in situations that matter to us Presentation title 20XX 29
30. stress is enhancing Presentation title • stress is usually thought of as negative • but stress can instead fuel physiological thriving by positively influencing the biological processes of hormones & immunity 20XX 30
31. stress is enhancing Presentation title • stress elicits anabolic hormones that rebuild cells, synthesize proteins, and enhance immunity, leaving the body stronger and healthier than it was prior to the stressful experience • does not mean that you have to like stress or find it pleasant or comfortable – but you can leverage it (rather than just trying to reduce or escape from it) 20XX 31
32. shift your mindset people can shift to a more stress is enhancing mindset, which can have positive consequences & improve health and work performance Presentation title 20XX 32
33. Presentation title • Stress can enhance creativity, give new perspective, improve relationships, strengthen priorities, lead to post-traumatic growth • Stress can lead to skilled performance at risky moments: athletes succeeding at “clutch” moments, doctors performing life-saving surgery, fighter pilots in action • Examples of historical leaders making remarkable decisions and actions in the face of stress: Lincoln, Gandhi, Churchill, etc. 20XX 33 stress is enhancing
34. stress is… Presentation title 20XX 34 INEVITABLE NATURAL STRENGTHENING GOOD FOR CREATIVITY USEFUL
35. summary • your mindset impacts your body’s response to… • diet • exercise • sleep • aging • stress Presentation title 20XX 35 not either/or but both/and
36. placebo Presentation title • any effect not attributed to an actual treatment, but rather to the individual’s mind-set, beliefs and expectations • therapeutic benefit of the placebo effect is widely accepted and accounting for it has become a standard in drug trials 20XX 36
37. placebos in action skin • subjects exposed to fake poison ivy developed real rashes (Blakeslee, 1998) heart • people consuming placebo caffeine experienced increased motor performance and heart rate (Kirsch & Sapirstein, 1998) joints • patients given anesthesia and a fake knee operation experienced reduced pain and swelling equivalent to patients getting actual arthroscopy • body will get better if it believes that it should (e.g. after surgery) Presentation title 20XX 37
38. CNS • placebo alcohol caused a slower reaction time in adults even when alcohol was not consumed • participants who believed they were intoxicated had similar motor performance (post-error slowing) to those of intoxicated participants Galindo MN. The Influence of Placebo Effect. Front Psychiatry. 2020 Aug 26;11:849 20XX 38 placebos in action
39. placebo effect size • in a study of patients with Parkinson’s disease, people were told they would receive either an expensive or a cheap new IV “medication” • patients who were told they were receiving the expensive treatment had greater improvement in tremor and muscle stiffness • studies show that placebo treatment causes a release in endogenous compounds called endorphins (runner’s high) – placebos change physiology Presentation title 20XX 39
40. TIGER Protocol Toxins Infections Gut Eating Rest mindset – in context Further reading with 35+ recipes
41. questions? Akil Palanisamy doctorakil.com @doctorakil Presentation title 20XX 41