The Long Game | Dr Alex

Dementia affects around one in three of us over our lifetime, and it is one of the diagnoses people fear most. But a landmark 2024 Lancet Commission review found that around 45% of dementia cases could potentially be prevented or delayed by tackling risk factors that are within our control.

In this episode I go through five simple exercises, three for your body and two for your mind, that can help protect your brain as you get older. None of them need a gym or expensive equipment. We cover dual task walking, dancing, strength training, active thinking like reading and writing, and staying socially connected with a real sense of purpose.

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 #braincare #healthyageing

There is a tiny muscle deep in your calf called the soleus that most of you will never have heard of, and it turns out to be surprisingly useful for controlling blood sugar.

Researchers at the University of Houston found that gently activating this muscle while sitting down, by doing slow repeated heel raises, could cut the blood sugar spike after a sugary drink by around 52%, with the insulin needed falling by up to 60%.

Here is why that matters. When sugar floods into your blood too fast, it irritates the lining of your blood vessels and forces your pancreas to release a big surge of insulin. Do that enough times over the years and it can wear your pancreas out and push you towards insulin resistance.

Muscles have a clever trick though. When they contract, they can pull sugar straight out of the blood without needing much insulin at all. The soleus is especially good at this because it is built almost entirely from slow, enduring fibres that can keep working for hours without getting tired.

I want to be honest about the limits here too. This was a small lab study using a pure sugar drink rather than a normal meal, and it does not mean heel raises beat a proper walk or going to the gym. It will not undo a poor diet or reverse diabetes on its own.

But the bigger lesson is the one that matters most to me. If isolating one small muscle can do this much, imagine what a short walk after eating can do when you are using your calves, thighs, glutes and core all at once. And imagine what staying gently active throughout the entire day could add up to over years and decades.

So the simple version is this. Try not to sit completely still the moment you finish eating. A ten to fifteen minute walk after meals is ideal, but if that is not possible, a few minutes of heel raises, some squats, or even pottering about doing chores all help keep your muscles working and your blood sugar in check.

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 #bloodsugar #preventativehealth

A bad night's sleep does more than leave you groggy. Within days it can make your body more resistant to insulin, which means blood sugar stays higher for longer and slowly starts to damage your blood vessels, heart, brain and kidneys.

This matters most if your sleep isn't really in your control. Shift workers, nurses, doctors and new parents all fall into this group, and the research shows a real difference in long term risk compared with people who sleep normally.

In this episode I go through what poor sleep actually does to your blood sugar and why, then explain the exercise that the research suggests can blunt some of that damage. Short, hard interval sessions seem to let your muscles pull sugar out of the blood without needing insulin at all, which is exactly the process that bad sleep interferes with.

This is not a way to undo years of poor sleep and it is not a replacement for fixing your sleep where you can. It is a practical tool for the nights you cannot avoid being short on rest.

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 #sleep #health

America and Britain run their healthcare in almost opposite directions. One treats care as a public service funded through tax. The other runs largely on private insurance where what you get depends on what you can afford.

America spends roughly double what Britain does per person on healthcare. You would expect that kind of money to buy a far healthier nation, yet when you look at life expectancy and the overall burden of disease, the two countries end up remarkably close.

In this video I walk through how the two systems differ on prevention, on the thresholds doctors use to decide who counts as sick, and on the food and lifestyle environment each population actually lives in. I also look at what each system does brilliantly, where each one fails, and why neither has solved the real problem.

The short version is that both countries are good at rescuing you once you are already in crisis, and both are surprisingly poor at stopping you from ever needing that rescue. That gap between treating disease and preventing it is where this whole conversation lives.

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 #healthcare #prevention

The strength you build in your 60s could decide whether you stay independent later in life or become frail. Your body has been on a slow downward curve since your 30s or 40s, and the goal is to get ahead of it before it gets ahead of you.

In this video I walk through six simple movements that mirror the exact things an 80 year old needs to be able to do. Standing up from a chair without using your hands. Getting up off the floor on your own. Climbing the stairs with confidence. Walking briskly. Carrying shopping in both hands. Balancing on one leg.

These aren't about building a beach body. They're about rehearsing the movements you already know you'll need for the rest of your life, the same way doctors rehearse the procedures and conversations they know they'll face one day.

A broken hip is one of the worst things that can happen to an older body. As many as one in four to one in three older people who break their hip will die within the following year, and plenty more never make it back home. Training these six movements now is one of the simplest ways to protect against that.

If you don't currently exercise, run through these daily. If you already train regularly, use them on your rest days to keep the most important movements ticking over. Either way, treat these as your floor, not your ceiling, and keep nudging yourself a little further as you go.

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 #healthyageing #strengthtraining

We've all been trained to watch our cholesterol, our blood pressure, our blood sugar and our weight as if those are the only numbers that matter for how long we live.

In this episode I talk about a number that almost nobody gets checked, your VO2 max, and why the research suggests it may tell you more about your lifespan than any of those familiar markers.

I walk through what the big trials actually show for cholesterol, blood pressure, blood sugar and weight, then compare those gains to what a large Cleveland Clinic study found when it tracked over 122,000 people through a treadmill fitness test. The difference in risk between the least fit and the most fit group was dramatic, and the researchers found no point where the benefit of getting fitter stopped.

None of this means your other numbers don't matter. The habits that improve your cholesterol, blood pressure, blood sugar and weight genuinely help each other. But raising your fitness is the one lever that reaches your lungs, heart, blood vessels, muscles and the cellular machinery inside them all at once, and it is something almost entirely within your own control.

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 #VO2max #heartdisease

Some of the most normal looking things in your kitchen could be quietly keeping your body inflamed. In this one I go through 7 foods that the evidence links to higher inflammation and worse metabolic health, from cereals you thought were a healthy start to the day through to sugary drinks, sweets, pastries, crisps, processed meat and the truth about seed oils.

I also give you 7 foods to eat instead so you finish this with something practical you can actually do tomorrow, not just another list of things to feel guilty about.

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 #inflammation #guthealth

A large Danish study followed nearly 3,000 men and women for over a decade and found that people with the smallest thighs had a substantially higher risk of heart disease and early death, regardless of weight or belly fat.

The threshold seemed to sit around 60cm of thigh circumference. Below that, risk climbed steeply, even after accounting for body fat, smoking, blood pressure, cholesterol and activity levels.

The researchers believe this comes down to muscle. A small thigh is often a sign of low muscle mass across the whole body, and your legs hold the biggest muscle group you have. That muscle is where your body parks the sugar you eat, it releases signalling molecules that calm inflammation throughout your body, and it is what lets you catch yourself if you stumble.

The good news is that this is one of the most changeable numbers in health. Resistance training for your lower body a couple of times a week, enough protein at each meal and staying consistent over months and years is what builds the kind of legs that keep you strong and independent for decades.

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 #longevity #healthtips

10 years in emergency medicine. Somewhere between 50 and 60,000 patient encounters. And the same preventable problems keep arriving on the same trolleys.

In this episode I share the 10 lessons I will carry with me for the rest of my career, things that I believe genuinely stack the odds in favour of a longer, healthier life.

We cover recognising the warning signs of a heart attack, a stroke and a perforated bowel, why only air should ever go into your lungs, how ultra processed food quietly pushes your blood pressure and blood sugar in the wrong direction, and why muscle matters so much more than people realise as you age.

I also talk about why a mind that stays challenged tends to stay sharper for longer, why hearing loss should never be ignored, why new dizziness always deserves checking out, why seat belts and attention on the road save lives, why checking your blood pressure at home from your thirties onwards matters, and why you should always trust your gut and seek a second opinion when something does not sit right.

None of this guarantees anything. Life is uncertain and anything can happen. But these are the patterns I have watched play out again and again, and I believe taking even a few of them seriously could add real years to your life.

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 #emergencymedicine

I want to give you a 12 minute routine you can start tomorrow morning, and if you stick with it for 30 days it could genuinely change how you feel, sleep and move.

Here it is. The moment you wake up, put your socks and shoes on, drink a large glass of water, and head straight out the door. Walk briskly for 12 minutes, and every couple of minutes stop for 20 squats or 20 walking lunges before carrying on.

That is the whole thing.

In those 12 minutes you get morning light into your eyes, which helps set your body clock and can improve your sleep and mood later in the day. You rehydrate after a night without fluids. You get a brisk cardio session that works your heart. And the squats and lunges build the muscle and balance that matter more and more as we get older, while also helping your body handle the blood sugar from your breakfast better.

Doing it first thing, before life gets in the way, is what makes it stick.

This is not meant to replace whatever exercise you already do. Think of it as the foundation you lay down before your day even starts.

Give it an honest 30 days and pay attention to your sleep, mood and energy along the way.

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

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

#dralex #morningroutine #healthyaging