The Long Game | Dr Alex

Magnesium has become one of the most heavily marketed supplements out there, promising to fix your sleep overnight. So in this episode I went through what the research actually says.

The honest answer is that the evidence is pretty thin. A lot of it comes from small studies, often funded by companies selling the product, and frequently without a proper placebo group. There is one small trial in elderly people with insomnia that gets quoted a lot, and it showed only modest improvement in a low quality study. When you pull together the better evidence, magnesium might nudge sleep very slightly in some people, but the effect is small and the certainty is low.

A chunk of what people feel when they take it is likely the placebo effect, and I talk through why that matters so much with sleep specifically.

There is one group it can genuinely help though, and that is people who are actually deficient. Certain people are more likely to run low, including those with poorly controlled diabetes, gut conditions that affect absorption, heavy drinkers, and people on certain long term medications. A standard blood test can be misleading here too, since less than one percent of your body's magnesium is in your blood. For someone eating a reasonably varied diet, true deficiency is not that common, since magnesium is already in foods like leafy greens, nuts, seeds, beans and whole grains.

The bigger question I wanted to get into is why you are not sleeping properly in the first place, because a supplement can only ever paper over a cause. I cover the real drivers I see time and again, caffeine too late in the day, alcohol quietly wrecking your deep sleep, an inconsistent wake time, a bedroom that is too warm or bright, and a stressed mind that will not switch off.

I also share a bit of my own experience with this during a rough patch with George's sleep, and what actually helped me get through it.

Then I walk through the free changes that genuinely shift sleep long term, anchoring your wake time every day, getting outside in daylight soon after waking, cutting caffeine off by midday, keeping alcohol away from bedtime, keeping your room cool and dark, and getting your phone out of the bedroom.

The full list of research references I mention is in the description of the YouTube version of this video.

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

#dralex #sleephealth #preventativemedicine

If you take a statin like atorvastatin, simvastatin or rosuvastatin, this episode is for you.

I go through seven things that often get missed in a rushed appointment, including why so many of the aches people blame on statins may not actually be coming from the drug, why grapefruit can genuinely change how much of the tablet ends up in your blood, whether the time of day you take it actually matters, and the difference between relative risk and absolute risk, which is one of the most confusing parts of this whole conversation.

I also talk through the small rise in type 2 diabetes risk linked to statins, why that risk is concentrated in people whose blood sugar was already creeping up, and the daily habits that work on your heart and blood vessels from angles a statin simply cannot reach.

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 #statins #heartdisease

There is a sign your liver might be struggling that you would probably never connect to your liver at all. It does not hurt. It will not turn your eyes yellow. Most of the people who have it just put it down to being tired, stressed or getting older, and they carry on like that for years while their liver quietly clogs up with fat underneath.

In this video I talk about that quiet sign, what is actually happening inside the liver to cause it, and how to reverse it, because the liver is one of the most forgiving organs we have.

Fatty liver disease is now the most common chronic liver condition in the world, and research suggests it affects around a third of adults, so the chances are a good number of you watching this have it without knowing.

I explain the flat, stubborn tiredness that doctors sometimes call TATT, the skin changes to look out for in places like the neck, armpits and groin, and why these signs often get missed because the liver is not even on the list of things being considered.

I also break down what is happening inside the liver when it turns fatty, why liquid sugar and refined carbs play such a big role, and the order I would personally go in to start reversing it, from cutting sugary drinks to walking after meals and building a bit of muscle.

None of this is about quick fixes or crash diets. It is about changes you can actually keep up for the next thirty years, because the same habits that protect your liver also protect your heart, your blood sugar and your brain.

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

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

#dralex #liverhealth #fattyliver

I came across a piece of research a couple of weeks ago that genuinely stopped me in my tracks. It points to a habit linked with living around 7 and a half years longer, and it costs nothing. No supplement, no fasting window, no cold plunge. Just what you believe about getting older.

I know how that sounds, and I was sceptical too. But this comes from decades of work led by a Yale researcher called Becca Levy. In one long running study, people who held more positive beliefs about ageing went on to live around 7 and a half years longer than those with more negative beliefs, even after accounting for age, sex, wealth, loneliness and baseline health. A newer study from her team followed nearly 4,000 older adults for over a decade and found that close to half of adults over 65 actually improved their memory or walking speed at later checkups, and those improvements were more common in people who started out with more positive beliefs about ageing.

Here is the catch though. The belief does not do anything on its own. What it seems to do is shape your behaviour. If you believe getting older means inevitable decline, you are less likely to bother with strength training, trying something new, or staying socially connected. If you believe later life can still be active and full, you keep doing the things that protect you. The belief drives the behaviour, and the behaviour drives the biology.

This is largely observational research, so it shows a strong link rather than definite proof of cause and effect. But the mechanism makes sense, and it is the kind of thing worth building into how you think about the years ahead.

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 #longevity #healthyaging

Memory loss isn't just genetics or bad luck. Research suggests a huge share of dementia cases could be prevented or delayed by things we actually have control over.

In this episode I walk through three mistakes people commonly make in their 50s and 60s that quietly stack the odds against their brain, from ignoring a slowly rising blood sugar to letting life get too comfortable and understimulating.

Then I share the one factor that surprises almost everyone I tell it to, and the one I would fix first in my own family.

None of these habits work alone. It's the combination, kept up over years, that really shifts your long term brain health.

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 #braintips #preventativehealth

You cannot unclog an artery the way you unblock a drain, but there is a lot you can do over years and decades to protect your heart and your blood vessels.

In this episode I count down my top three vegetables for artery health, based on the physiology and on studies that actually measured hard outcomes like heart attacks and deaths rather than just a vibe.

Cruciferous veg like broccoli, cauliflower, cabbage and kale are linked to less calcium building up and hardening inside artery walls, partly thanks to vitamin K and partly thanks to compounds that support the lining of your blood vessels.

Beans and lentils are the surprise entry. In trials they lower LDL cholesterol by an amount that is genuinely meaningful, largely through their soluble fibre, and they barely move your blood sugar at all.

Right at the top is the humble leafy green. Spinach, rocket, chard and kale are loaded with natural nitrates that your body converts into nitric oxide, the same molecule we use in hospital to widen blood vessels in people having a heart attack or severe heart failure. Through food you get a slow, steady version of that effect running quietly in the background all day.

I also talk through two honest cautions, including a note for anyone on warfarin, and why these vegetables work alongside your medication rather than instead of it.

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

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

#dralex #hearthealth #nutrition

Should you be taking omega 3 capsules? I get asked this constantly, and the honest answer might surprise you.

For a healthy person, the big randomised trials (one following around 25,000 people, another around 15,000 people with diabetes) show that standard dose fish oil capsules do not meaningfully reduce heart attacks, strokes or deaths compared with a placebo. The label might say it supports heart health, but the best evidence we have does not back that up.

There is one specific situation where a high dose prescription only form of omega 3 showed a reduction in major cardiac events in a trial called REDUCE IT, though the picture gets complicated once you look at the placebo used and other trials testing combined EPA and DHA that found no benefit at all. I go through all of this properly in the video, along with a consistent finding across these trials that omega 3 supplements raised the risk of a heart rhythm problem called atrial fibrillation, with higher doses carrying a bigger risk.

None of this applies to eating oily fish itself. Mackerel, sardines, salmon and herring are linked with lower rates of heart disease in large population studies, and you get far more than omega 3 from the whole food. Vitamin D, protein, selenium, iodine, B12 and calcium from the bones all come along with it. A capsule isolates one ingredient and hopes it does the whole job alone.

My honest view for most healthy people is to save the money on the capsules and eat oily fish a couple of times a week instead.

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 #omega3 #hearthealth

I had a conversation recently that left me so frustrated I had to make a video about it.

Someone close to me has lived with obesity for over a decade. After years of struggling, he finally found the courage to go to his GP and ask for help. He got roughly five minutes. Nobody asked about his diet, his sleep, his stress, his past attempts or what had actually failed before. He walked out with a prescription for a weight loss tablet and nothing else. No counselling, no follow up, no lifestyle advice.

In this episode I explain how that tablet actually works, why handing it over on its own was never going to solve the real problem, and why I think this happens far too often across the system rather than being the fault of one doctor.

I also talk about what I would have done differently with the same five or ten minutes, and why small, specific, sustainable changes matter so much more than a quick fix.

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 #preventativehealth #nhs

If I could give one gift to everyone over 50, it would be more muscle. It protects you from falls, keeps your blood sugar steady, lifts your mood and is closely linked to a longer, healthier life. Yet it is something your doctor will almost never mention.

In this episode I walk through seven proven ways to build muscle faster, covering how to train, how to eat, how often to do it and how to recover properly, all aimed at building real strength for the decades ahead.

We cover progressive overload, why compound movements give you the biggest return on your time, how much protein you actually need and why it should be spread across the day, eating enough overall to support growth, training each muscle group regularly, respecting recovery and sleep, and listening to your own body for the long haul.

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 #buildmuscle #healthyaging

The carnivore diet promises weight loss, better energy and even reversed autoimmune conditions, but as an NHS doctor I wanted to look properly at what the evidence actually shows.

In this episode I go through what the diet actually involves, why people genuinely do feel better when they start it, the real problems with eating this way long term, the argument about whether humans evolved to eat only meat, and the way of eating I would recommend instead, which gives you nearly all the same benefits without the downsides.

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

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

#dralex #carnivorediet #nutrition