Stay ConnectedDr Ayan Panja puts health into context. A lifestyle medicine expert, author and family physician with over 25 years of experience, his unique blend of candour, perspective and knowledge make for a mind-expanding essential weekly bite-sized listen.
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Copyright: © Dr Ayan Panja
Triage is increasingly being used in healthcare outside the emergency setting to help filter urgent from non-urgent.
With the growing use of artificial intelligence, triage algorithms are becoming more reliable. I look at the pros and cons of triage from the view point of both patient and practitioner.
Links:
Triage and it’s background: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5649292/
Continuity of care: https://www.bmj.com/content/375/bmj.n2468
And article on the ethics of triage:
Sample triage protocol: https://www.medicalprotection.org/ireland/practice-matters/may-2014/example-triage-protocol-for-non-clinical-staff
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In this episode I look at symptoms affecting the gut. They are one of the most common presentations in
general practice.
Most of us experience some kind of gastrointestinal symptom at some point in our lives. I delve into my understanding on how the gut works and how and why things can go wrong and what we can do to help ourselves.
Links:
Mintel gastrointestinal problems data: https://www.mintel.com/press-centre/beauty-and-personal-care/86-of-brits-have-suffered-from-a-gastrointestinal-problem-in-the-past-year/amp
Mintel article on gut health determinants: https://www.mintel.com/blog/food-market-news/gut-health-goes-beyond-digestion/amp
Ultra-processed foods: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7399967/
Aryl-hydrocarbon receptor: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5777317/
Short chain fatty acids: https://www.frontiersin.org/articles/10.3389/fendo.2020.00025/full
Diet and reflux disease: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6702398/
H. pylori infection and reflux disease: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6502218/
Low FODMAP diets: https://pubmed.ncbi.nlm.nih.gov/33585949/
Probiotics and their potential role in reflux disease: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7019778/
SIBO and IBS - is there a link?: https://pubmed.ncbi.nlm.nih.gov/29761234/
Gallstones and SIBO:
https://pubmed.ncbi.nlm.nih.gov/29392773/
A review of inflammatory bowel disease (Crohns and Ulcerative colitis): https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6685307/
‘Red flag’ gut symptoms needing medical assessment: https://bowelinterestgroup.co.uk/resources/red-flag-symptoms-in-gi-conditions/
Diverticulitis: Diverticulitis: Symptoms, Causes, Diagnosis, Treatment, Surgery (healthline.com)
The popular ‘4 R’s of gut health’: https://thenutritionalinstitute.com/resources/blog/292-the-4-r-s-of-gut-health
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*TW* Today’s episode is on a topic which affects us all.
Prejudice, bias and inclusion are all ongoing hot topics which can affect our wellbeing, how we feel about ourselves and our experience of the world.
Here I look at the reasons why it is such a complex area to navigate and not as simple as it should be.
There are some anecdotes on this episode that might be difficult to listen to.
Links:
Protected characteristics: https://www.equalityhumanrights.com/en/equality-act/protected-characteristics
A paper on similarities and differences in people and their perceptions: https://www.frontiersin.org/articles/10.3389/fpsyg.2018.00849/full
Health inequalities and gender: https://eurohealthnet.eu/publication/gender-health-and-inequalities-before-and-after-the-pandemic-where-we-go-from-here/
Microsoft video training on bias and inclusion: https://www.microsoft.com/en-us/inclusion-journey/learn
Medical regulators and racism: https://blogs.bmj.com/bmj/2021/06/29/racism-and-the-general-medical-council/
The 2004 film Crash that cleverly gets under the belly of prejudice and bias: https://youtu.be/DEJH0hEoHc4
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This framework that I have created helps turn what is in your mind into action.
IDEAL:
Identify, Define, Engage, Activate and Look Back
One of the hardest things can be to turn intentions into reality. This simple framework along with the work of known behavioural theory experts can help implement your behaviour change intentions.
Links:
BJ Fogg behaviour model: https://behaviormodel.org/
Susan Michie and COM-B: https://implementationscience.biomedcentral.com/articles/10.1186/1748-5908-6-42
Pre-order your copy of The Health Fix now: https://www.amazon.co.uk/Health-Fix-Ayan-Panja-ebook/dp/B0B2VTFFVS/ref=mp_s_a_1_1?qid=1655897648&refinements=p_27%3AAyan+Panja&s=books&sr=1-1
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*TW*
This is such a trenchant topic and I wanted to cover it for so many reasons.
Most of us get some kind of brain symptom at times but it is short lived, but that is not the case for many people. Alzheimer’s Disease is the commonest form of dementia affecting over 60% of all dementia sufferers worldwide.
This episode looks at the determinants of brain health and the aetiology of Alzheimer’s Disease.
Links:
Facts, figures and information on dementia: https://www.who.int/news-room/fact-sheets/detail/dementia
Food and brain health: https://www.healthline.com/nutrition/11-brain-foods (did not focus on this in the episode but in case you want to know more).
Brain health and food chat with @Doctors_Kitchen: https://www.listennotes.com/podcasts/the-doctors/8-eat-to-boost-your-brain-W4eh8cIyNHf/
The hippocampus and memory: https://alz-journals.onlinelibrary.wiley.com/doi/full/10.1002/alz.12009
Association between diabetes and Alzheimer's Disease: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4265876/
The ApoE gene: https://www.frontiersin.org/articles/10.3389/fnins.2021.630502/full
Cognitive stimulation therapy: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5639131/
Alzheimer’s support: https://www.alzheimers.org.uk/
101 on Alzheimer’s Disease - what it is and it’s pathology: https://www.nia.nih.gov/health/what-happens-brain-alzheimers-disease
Treatment of Alzheimer’s Disease: https://www.alzheimersresearchuk.org/dementia-information/types-of-dementia/alzheimers-disease/treatments/
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Sometimes in order to get to the underlying reason behind symptoms that may arise from your lifestyle and environment.
It is a way of dissecting an area that may need more focus, for instance: diet, environment, movement, sunlight exposure, sleep, historic infections and your family history.
They are good tools to use if you are not making huge progress with conventional habit changes.
Links:
Some benefits of a health diary: https://blog.vantagefit.io/health-diary/
Caffeine overload? https://www.healthline.com/nutrition/caffeine-side-effects
Fish in your diet - risks and benefits: https://www.bbc.co.uk/news/av/health-35884051
Methylisothiazolinone and skin: https://mi-free.com/
Back pain and posture: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3828513/
Foot shapes: https://www.healthline.com/health/types-of-feet#pronation-and-supination
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Self talk is something we all do. It’s how communicate with ourselves and it can have a significant
impact on our health.
In this episode I give examples of cognitive distortions which can lead to poor self esteem, false beliefs and negative thinking.
Links:
Cognitive distortions and CBT: https://positivepsychology.com/cognitive-distortions/
Monkey brain: https://www.forbes.com/sites/alicegwalton/2017/02/28/8-science-based-tricks-for-quieting-the-monkey-mind/?sh=699868ec1af6
Self help therapies and mental health apps: https://www.nhs.uk/mental-health/talking-therapies-medicine-treatments/talking-therapies-and-counselling/self-help-therapies/
There are many mental health apps which may be of benefit and there is also scope for doing CBT online. Disclosure: I am medical adviser to a web-based app called Leafyard which is AI driven and based on CBT: Leafyard.com/actnow
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This week I cover the topic of overwhelm, suggested by a listener.
It’s a feeling we all know and dislike. I try to get under its belly and look at the causes behind it as well
as solutions to minimise the chance of it arising.
Links:
Overhelm and burnout: https://careerpivot.com/2020/overwhelm-and-burnout-whats-the-difference-guest-post/
Saying no: https://tinybuddha.com/blog/stop-saying-yes-want-say-no/
Perfectionism and its pitfalls: https://www.bbc.com/future/article/20180219-toxic-perfectionism-is-on-the-rise
Anxiety and overwhelm: https://www.calmclinic.com/anxiety/symptoms/feeling-overwhelmed
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This week I discuss supplements. It’s a veritable minefield.
How do you know the quality of what you are taking?
Are there some supplements that are essential and others that should be avoided?
I give you my take on all this and more in this episode.
Links:
Vitamin D NICE guidance: https://www.guidelines.co.uk/nutrition/nice-vitamin-d-guideline/252552.article
Types of vitamin D: https://www.healthline.com/nutrition/vitamin-d2-vs-d3
B12 deficiency symptoms: https://www.healthline.com/nutrition/vitamin-b12-deficiency-symptoms
Do probiotics work? https://www.scientificamerican.com/article/do-probiotics-really-work/
Digestive enzymes: https://www.hopkinsmedicine.org/health/wellness-and-prevention/digestive-enzymes-and-digestive-enzyme-supplements
Antioxidants: https://www.frontiersin.org/articles/10.3389/fphys.2020.00694/full
A great go to resource for truly independent analyses and views on supplementation: https://examine.com/supplements/
Signs of nutrient deficiency: https://www.rush.edu/news/6-signs-nutrient-deficiency
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The How, What and When of our habits can have significant effects on our health.
Here are some papers on related topics. The abstracts make interesting reading.
Time restricted eating - changing when you eat: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7262456/
Sleep - the how and when: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3174832/
Morning exercise: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7492403/
Weblink for exercise: https://www.healthline.com/health/fitness-exercise/best-time-to-workout#The-Case-for-Sweating-in-the-Afternoon,-or-Night
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