The Long Game | Dr Alex

Bowel cancer in people under 50 is rising, and the numbers are genuinely striking. Someone born around 1990 has roughly double the risk of bowel cancer compared with someone born around 1950 at the same age, and the risk of rectal cancer specifically is even higher. At the same time, rates in older people are actually falling, which tells us something in the way we live has changed.

In this episode I go through what the research currently points to. That includes how inactivity affects insulin levels in a way that may encourage damaged cells to grow, how ultra processed food has pushed fibre out of our diets, and what that does to the good bacteria living in your gut. I also talk about a toxin called colibactin, made by certain strains of E. coli, which a 2025 study found far more often in bowel cancers diagnosed in people under 40 than in those diagnosed over 70.

I also cover alcohol, why the old idea that a glass of red wine is good for your heart doesn't hold up once you look closely at the research, and why regular drinking carries more risk than people often assume.

Most importantly, I talk through the warning signs you should never ignore, things like bleeding from your back passage, an unexplained change in bowel habit, weight loss you can't explain, or tummy pain that keeps coming back. If any of these apply to you, please get seen by a doctor.

The full list of research references for this episode is in the description of the YouTube version.

Disclaimer: This is not personal medical advice and does not override what your doctor says.

#dralex #boweldcancer #guthealth

There is a process ticking away in your body right now that sits behind pretty much every condition Dr Alex has treated in A&E, from heart attacks and strokes to type 2 diabetes, dementia, arthritis, kidney disease and several cancers. That process is low grade inflammation, and what you eat has a real influence on whether it stays switched off or keeps simmering away for years.

In this episode Dr Alex explains what inflammation actually is, why it sometimes fails to switch off, and the nine foods that help bring it back under control. These include tinned oily fish for the omega 3 fats that help end an inflammatory response, blackberries for their pigments called anthocyanins, broccoli for a compound called sulforaphane that switches on your own cell defences, and extra virgin olive oil, which contains a polyphenol that works a bit like a mild natural ibuprofen.

He also covers hemp seeds, mushrooms and their compound ergothioneine, turmeric and why cooking it with black pepper and oil matters more than taking a supplement, fermented foods like yoghurt, kefir, sauerkraut and kimchi for gut bacteria diversity, and dark chocolate at 80 percent cocoa or above for its flavanols.

Finally, Dr Alex talks through the three everyday habits that push inflammation back up: ultra processed food, not eating enough fibre, and alcohol, including why the old idea that a glass of red wine protects your heart does not hold up once you look at the research properly.

The full list of research references is in the description of the YouTube version of this episode.

Disclaimer: This is not personal medical advice and does not override what your doctor says.

#dralex #inflammation #guthealth

Big update today. I have been building something behind the scenes for months and I finally want to share where things are up to.

It is called The Long Game Kitchen, a recipe platform I have been working on with Steph. The idea came from so many of you after I first mentioned wanting to film cooking content. Rather than just show what we eat, we decided to build something bigger, a full database of the recipes we actually cook at home, alongside the reasoning behind why certain foods and combinations are good for you.

We are aiming for around 150 recipes at launch, a genuine mix of breakfasts, lunches, dinners and snacks. Nothing dogmatic, nothing restrictive. There is meat, there is chocolate, there are veggie and vegan options too. It is all whole food, cooked from scratch, with plenty of inspiration from the Mediterranean.

This has honestly been the hardest I have ever worked on anything, including medical school and ten years as a doctor. Early mornings, endless recipe testing, writing and photography, all in the hope of building something that genuinely helps people cook better and live longer.

We are planning to launch in the second half of November, with a discount for founding members and an extra discount for anyone who joins in the first week. If you want to be the first to hear when it goes live, the newsletter is the best place to find out, link in the description.

The full list of research references for my videos is always in the description of the YouTube version.

Disclaimer: This is not personal medical advice and does not override what your doctor says.

#dralex #thelonggame #longevity

Cardiovascular disease kills around 20 million people a year worldwide, about a third of all deaths on the planet. In the UK it accounts for more than a quarter of deaths, roughly 170,000 people a year, which works out to one person every three minutes. Someone is admitted to hospital with a heart attack roughly every five minutes. Up to 80 percent of heart attacks and strokes that happen before old age could be prevented.

In this episode I go through what heart disease actually is, how it starts in the lining of your arteries decades before any symptoms appear, and what the warning signs look like in A&E, including the ones that often get missed in women, older people and people with diabetes.

I also share my own dad's story. He had a heart attack at around 40, and it changed how my whole family thinks about prevention. Heart muscle that dies during a heart attack does not grow back, which is why the best treatment for a heart attack is never having one at all.

We also cover the habits that actually make a difference, eating mostly whole foods grown in the ground, cooking from scratch, walking more and checking your blood pressure, cholesterol and blood sugar regularly, since all three can quietly rise for years without causing any symptoms.

The full list of research references is in the description of the YouTube version.

Disclaimer: This is not personal medical advice and does not override what your doctor says.

#dralex #heartdisease #preventativehealth

Visceral fat is the fat packed around your liver, gut and pancreas, and it behaves like a gland, pumping out inflammatory chemicals around the clock. The good news is it is often one of the first types of fat to shift when you change two specific habits, sometimes within weeks.

The first is eating plenty of colourful, polyphenol rich plants such as blueberries, red cabbage, tomatoes, leafy greens, extra virgin olive oil and dark chocolate above 80%. In trials using MRI scans, people on a Mediterranean style diet with extra polyphenols lost roughly twice as much visceral fat as those on a standard Mediterranean diet, even though overall weight barely changed. The colour on your plate tends to come with more fibre, more antioxidants and more home cooked meals, and that whole pattern seems to be what does the work.

The second habit is interval training, short bursts of hard effort followed by easier recovery. It is one of the quickest ways to improve your fitness, helps your body handle sugar better, and builds muscle in your legs and core, often in far less time than a steady cardio session. It will not suit everyone, so if you have heart disease, chest pain, high blood pressure or any other significant medical condition, speak to your doctor before trying it.

The full list of research references is in the description of the YouTube version.

Disclaimer: This is not personal medical advice and does not override what your doctor says.

#dralex #visceralfat #inflammation

Four everyday foods sit in most weekly shops without a second thought, yet they are tied to some of the strongest links to cancer risk we have.

In this episode Dr Alex breaks down processed meat, sugary drinks, ultra processed snacks and alcohol, explaining why each one is so easy to overeat and what the research actually shows about the risk involved.

He also shares a simpler way to think about your plate, built around a rotation of meals you enjoy rather than restrictive dieting, and why the parts of the world with lower cancer rates tend to eat very differently.

The full list of research references is in the description of the YouTube version.

Disclaimer: This is not personal medical advice and does not override what your doctor says.

#dralex #preventativehealth #nhsdoctor

A supplement claim going around says taking bergamot extract can lower LDL cholesterol by 41% and put it on a level with a prescription statin. I wanted to look at the study behind that number properly.

The research came from 2011, ran for about 30 days, and included a couple of hundred people in southern Italy, where nearly all commercial bergamot is grown. The participants weren't average healthy adults. They were recruited because their cholesterol was already high, and some also had type 2 diabetes. The reductions reported ranged from the low twenties up to the high thirties as a percentage, and the very biggest figures, the ones close to that 40% mark, came from people who were taking a statin at the same time.

A percentage on its own doesn't tell you much without the starting number attached. If your LDL starts at 4.2, a 41% drop takes you to around 2.5. If it starts at 3, that same percentage only brings you to around 1.8. The higher your starting point, the easier it is to produce an impressive looking percentage.

There is some genuine chemistry behind bergamot. It contains flavonoids that can block the same enzyme in the liver that statins target, and that effect has been shown in lab and computer modelling. What hasn't been settled is how much of that actually reaches the liver once it's been through your gut and broken down by your gut bacteria.

We also know from a huge amount of research, across statins, other cholesterol lowering medications and people with genetically lower cholesterol, that bringing LDL down over years tends to protect the arteries. But that evidence is built on long term outcome data, not on a single 30 day blood test. Nobody has followed people taking bergamot for years and counted how many went on to have a heart attack.

Even if it does nudge your cholesterol down a little, I wouldn't take it instead of or alongside a statin without speaking to your doctor first. Bergamot is a citrus fruit, and citrus fruits can interfere with how your body processes certain medications, including some statins. Supplements like this also aren't standardised, so what's in the bottle can vary a lot between brands and batches.

If you're on a statin, please don't stop it or swap it for a supplement without talking to your doctor, who knows your history and your actual risk. The full list of research references for this episode is in the description of the YouTube version.

Disclaimer: This is not personal medical advice and does not override what your doctor says.

#dralex #cholesterol #supplements

Can you bring your blood sugar down without cutting out carbs altogether? Yes, and the answer comes down to which carbs you are actually eating.

Broccoli, lentils, oats and berries are all carbohydrates too, so when someone says they are cutting carbs, the real question is which ones. That answer decides whether the whole approach works long term or quietly falls apart within a fortnight.

In this episode I go through what actually decides how much your blood sugar rises after a meal, why milling and juicing change things so much, and why your muscles play a bigger role in all of this than most of the advice out there gives credit for. I also talk through insulin, where fat sitting in your liver and pancreas fits into type 2 diabetes, and why a diet built around beans, whole grains, fruit and vegetables can lower HbA1c even while increasing total carbohydrate intake.

Towards the end I share a few simple habits that have genuinely helped me and Steph, like giving your body a longer overnight break between dinner and breakfast, not snacking constantly between meals, and moving after you eat.

The full list of research references is in the description of the YouTube version.

Disclaimer: This is not personal medical advice and does not override what your doctor says.

#dralex #bloodsugar #guthealth

If you lined up two 60 year olds, one could have the heart, blood sugar and muscle of someone in their late 40s while the other is already heading towards the problems we see constantly in A&E.

The difference usually shows up years before anything actually goes wrong.

In this episode I talk through seven signs that tend to separate the two, starting with a couple of simple blood tests, then a scan of the heart, then how much you move and how fit you are, then your memory, and finally what actually happens in your kitchen.

A normal albumin level on a blood test is often one of the first things that tells you a lot about someone's overall health, reflecting muscle, nutrition and inflammation.

Staying physically active throughout most of the day, not just during one workout, matters because long unbroken stretches of sitting are linked with worse blood sugar and heart health even in people who exercise.

A normal echocardiogram in your sixties is a genuinely reassuring sign about how your heart muscle and valves have held up over the decades.

A healthy HbA1c shows how your blood sugar has behaved over the last few months and responds really well to lifestyle changes.

Good cardiovascular fitness for your age, something you can track with a simple watch or just by checking whether you can hold a conversation after climbing a couple of flights of stairs, is one of the strongest predictors we have of how long and how well someone lives.

Sharp conversational memory and the ability to multitask without slowing down a lot says a great deal about brain health as you get older.

And cooking most of your meals from scratch with plenty of colourful plants ties everything else together, supporting your blood sugar, your heart, your brain and your muscle all at once.

If you can say yes to all seven, you should feel genuinely proud. If you can't yet, remember these are patterns you can work on, not a verdict on your life.

The full list of research references is in the description of the YouTube version of this episode.

Disclaimer: This is not personal medical advice and does not override what your doctor says.

#dralex #healthyageing #preventativehealth

Every heartbeat needs your arteries to widen slightly, and the molecule that lets that happen is nitric oxide. When your body makes less of it, your arteries gradually stiffen and blood pressure can creep up, often without you noticing for years.

In this episode I go through seven everyday things that quietly lower your nitric oxide, including one habit plenty of people do every morning thinking it helps them.

We cover sitting still for long stretches, poor sleep, antiseptic mouthwash, smoking and vaping, low oxygen levels during sleep, low fitness, and ultra processed food. I also answer questions from the last nitric oxide video, including beetroot, arginine and citrulline supplements, and whether people with naturally low blood pressure need to worry.

The full list of research references is in the description of the YouTube version.

Disclaimer: This is not personal medical advice and does not override what your doctor says.

#dralex #nitricoxide #preventativehealth