Dr Claire: we give so much of our day to other people and caring for others that we often forget to look out for ourselves and ways to keep us well. And I think, you know, to be able to treat people we need to first be able to treat ourselves well.
Dr Rupy: Welcome to the Doctor's Kitchen podcast with me, Dr Rupy. And today we're going to be talking about yoga for health. Now in my second book, Eat to Beat Illness, I not only blend together the science with delicious recipes inspired by cuisines from across the world, I also talk about the intersection of lifestyle and how that improves health outcomes. Things like yoga, mindfulness therapies, sleep, as well as a sense of purpose, community and other forms of exercise. Today, we're going to be talking about yoga as a method of restorative practice and exercise and even a way of life. It's a practice I talk a lot about in the new book, Eat to Beat Illness. And today, Dr Claire Henegan, who is a fully qualified GP and a trainer in Ashtanga and Vinyasa yoga, is going to talk to us about why yoga can be thought of as a therapy. She actually took out some time from her GP training to travel to India and become a yoga teacher, completing 200 hours. She also did another 40 hours of training and mentoring and does therapeutic yoga at levels one and two. She now teaches publicly alongside working as a general practitioner and has also been able to teach yoga to other doctors at conferences and seminars and with the Royal College of GPs. Claire is fascinated by the health benefits of yoga, including help with mental health, musculoskeletal issues and chronic disease. Stick around to the end of the podcast where I sum up some of the benefits of yoga and we go through some of your rapid-fire questions that I put to Dr Claire.
Dr Rupy: Dr Claire.
Dr Claire: Hello.
Dr Rupy: You made it.
Dr Claire: Thank you for having me.
Dr Rupy: Thank you. Thank you so much for coming. For those who don't know, I've known Dr Claire for a couple of years now, I think. Yeah, yeah. I reached out to you whilst you were training. You were doing the Masters in Nutritional Medicine at the University of Surrey, which is what I'm currently doing. And I remember you sharing some of your slides with me so I could get an idea of just how in-depth it is, and it's pretty in-depth.
Dr Claire: It is quite intense. But really interesting.
Dr Rupy: Super interesting, yeah. And I remember you came down to my practice and we had a coffee and I was just fascinated by, you know, the work you're doing, which is combining the science and the art, I suppose, of yoga and yoga therapy for lots of different issues and how you're also interested in nutrition and stuff. Basically, someone after my own heart. It's amazing. So why don't you give us a little bit of background to how you got into yoga and nutrition and what was your journey been?
Dr Claire: Yes, of course. So I guess from a young age, I was always interested a lot in exercise. I used to dance quite frequently. Um, so that was something that, you know, movement, exercise was very important to me.
Dr Rupy: What kind of dancing?
Dr Claire: So ballet dancing mainly. So used to be a big, big passion of mine. Um, and then obviously went to medical school and I found yoga really in the probably last year of medical school. So it was when I was studying for my finals. Um, I came across the, so it was at Newcastle University and I came across the um yoga society and they were holding classes um in the local church hall. Um and I started going along with one of my friends and um just made it a regular part of our schedule. Um, and I really enjoyed learning about yoga, learning about the postures and then I started to notice that that had benefits in my everyday life and helped kind of my feelings of stress and helped with my studies in the end of medical school really.
Dr Rupy: Final year of medical school, I've got horrific memories. It's not a pleasant experience.
Dr Claire: Yeah.
Dr Rupy: I actually remember during my final year, I got back into meditation quite a bit.
Dr Claire: Did you?
Dr Rupy: Yeah, I started, it's going to sound a bit weird, but I started recording a mantra to myself. I think I used GarageBand or something on my Mac. And it would be like 15 minutes long and it would just be simple things like breathe in, breathe out, um breathe in white light, breathe out negative energy. I don't want to get into too much detail. Uh, and then I would listen to that recording once a day whilst I was uh doing my studies, um because I remember it being absolutely stress-inducing, just the sheer volume of stuff that we had to to to remember. Um, but I imagine like yoga has some similarities in that, right? Because um, I mean, I know from my practice and stuff, but the whole breath and the concentration on your breath as well as it being a physical activity. It's quite an amazing combination.
Dr Claire: Absolutely. And the postures in yoga themselves, they're quite challenging. And when we go into the postures, we always bring our attention back to our breath and that helps ease the postures and focus the mind. And I think that's what we try and take off the mat to bring to when we get challenges in everyday life, kind of using those techniques to help relax and deal with those stressful situations.
Dr Rupy: Amazing. And so, so you started in your final year of medical school and and then where did it take you? Is this something you did during your foundation years?
Dr Claire: So it was when I could. I think you remember from foundation.
Dr Rupy: Yeah, where did you do your foundation training?
Dr Claire: So I trained up in Edinburgh. So, um, I was at one of the big hospitals in Edinburgh for my first two years. So that's um our junior doctor training. Um, so I'm sure you remember long hours, stress. Um, so I did, I did definitely keep up my yoga when I could. Um, I was doing a lot of shift work, so I was managing to go to kind of random morning, evening classes when I could. Um, and then I came down to London to do my GP training. Um, and it was about after my first job in in GP training, I think going straight into it, um, continuing with the long hours, you know, not eating well, the stress of the job itself. And there was some personal stress as well that was happening at the time. I was really reaching a point that I was burning out and I was really close to leaving medicine actually at that point. Um, but actually my GP training scheme were really, really open with me and they said, you know, you can have some time off and see how you feel after that. And if you want to come back to GP training, you can. So I used that as an opportunity and during that time, that's when I went off to India, um, and did my teacher training.
Dr Rupy: Amazing. Which part of India did you go to?
Dr Claire: Um, so it was in Goa, which is quite a relaxed part of India compared to the rest of India, but it was a gorgeous place. Yeah.
Dr Rupy: Yeah. You know, that story really resonates with me quite a bit. I remember my first year of foundation training, um, three months in, that's when I discovered I had my own heart condition, atrial fibrillation with an irregular fast heartbeat. And that picture of stress, poor sleep, eating on the go, you know, a new job that you're learning so much. I remember that that um steep learning curve of just learning the sorts of uh basics of how to be a hospital doctor. Um, whilst not forgetting, but almost like the uh the knowledge that you gained in medical school is kind of like to the side. It was more about like, you know, how do you sell this CT to a radiologist in a hospital? You're like, please, let me CT the head. This is what I'm meant to be doing. Um, but yeah, no, it was all that that sort of like the new sort of experience. Um, and when I started looking at my own lifestyle and recognizing, taking a step back and recognizing where those stressful points are, one of the things apart from nutrition, obviously, and getting better sleep was a meditation sort of practice that I started doing a lot more often. Um, and I think yoga is a nice way to sort of get yourself into that. But so so you've had a practice since the final year of medical school and going to into actually doing it as a teacher.
Dr Claire: Yes, absolutely. So it's been for about the last five years now. Yeah, I've been solid.
Dr Rupy: Yeah. And Goa, uh, so how long were you out there for?
Dr Claire: So I did a month intensive course. So there's a few different types of yoga teacher trainings you can do. Um, there's month intensives or sometimes, um, they're over a period of years or weekends, weeks, depending. Um, so it's a very intensive four weeks. Um, 6:00 a.m. starts and sometimes 8:00 p.m. finishes.
Dr Rupy: Oh, wow.
Dr Claire: Um, so it's not a yoga retreat. It's not a holiday retreat. It sounds quite military. It is, but yeah, really interesting. So you start with, um, always start the day with kind of meditation, breathing exercises, your practice, and then you delve into the philosophy, some anatomy, which is a helpful recap. Um, but yeah, fantastic.
Dr Rupy: Where did you do your training?
Dr Claire: Um, so it was in Goa in in India.
Dr Rupy: What, do you know what school it was?
Dr Claire: Oh, yes, it was Sampoorna.
Dr Rupy: Oh, Sampoorna. I've actually been there.
Dr Claire: I think I remember you saying that that you went to a class, a drop-in class there. Yeah.
Dr Rupy: Yeah, I did. So I was out at my friend's wedding in Mumbai a couple of years ago. Um, I remember that's when I started my gratitude exercise, gratefulness every day exercise. Yeah, like 2016 now. Um, and yes, my friend, uh, was getting married in Mumbai. We, as a like a whole group of us, like, uh, medical students, um, we all went to, um, uh, to Goa just to chill out for like four days. And then I was there and then somebody from Sampoorna who was following me on social media reached out to me and said, come to a class. And I remember that that that, um, school is amazing. It's like this huge sort of like central, sounds like a big advert for them, but this huge sort of like forum.
Dr Claire: There are other yoga schools. There are other yoga schools available.
Dr Rupy: Yeah, this huge like central sort of, um, studio with like mosquito nets, everything's open. Um, you have these little huts around it and people like lived in the neighboring villages and stuff. It's right by the beach. So amazing.
Dr Claire: And Agonda is gorgeous. Absolutely gorgeous. My favourite beach in Goa, definitely.
Dr Rupy: Yeah, that's gorgeous. Um, but I can't imagine doing 6:00 a.m. to 8:00 p.m. every day. Wow, that's, uh, that's proper intense. So who's that course for? Is that for people who are looking to become a teacher or can just anyone go?
Dr Claire: Yeah, I think people go with different attitudes. Some people are definitely wanting to teach at the end of it. Um, I have to say, I wasn't sure that I definitely wanted to teach at the end of it. I just knew that I really enjoyed yoga and I wanted to learn more about it. Um, and I think a yoga teacher training is definitely the way to go. Um, there's also workshops and things that you can do, but if you want to really understand yoga, it's a really good way to learn more about it, definitely.
Dr Rupy: That's fantastic. So when you came back, all refreshed and replenished.
Dr Claire: I know, I know. So yeah, it was, it was, it was amazing. I wasn't sure if I would come back to training, but at the end of the six months, I definitely actually felt ready and I've, it's definitely built me a lot of skills that, um, I've taken with me for the rest of my training and, yeah, finally managed to complete my GP training this week.
Dr Rupy: Yeah, congratulations. That was a couple of weeks ago. You're now a fully-fledged general practitioner.
Dr Claire: Yeah, starting the life of salary and locum GP.
Dr Rupy: Yes, salary and locum GP. Yeah. But, um, we were recently at a conference where you actually took a whole bunch of GPs as part of the Royal College of GPs sort of like wellness day. Um, uh, through a yoga session. How was that?
Dr Claire: That, that was really cool. That was, um, so yeah, the RCGP launched a new kind of well-being conference for GPs, which is obviously so important. It was the first of its kind and it was free for GPs to attend because I think, you know, obviously we give so much of our day to other people and caring for others that we often forget to look out for ourselves and ways to keep us well. And I think, you know, to be able to treat people, we need to first be able to treat ourselves well. Um, and yeah, it was a fantastic conference. You were speaking as well. Um, and yeah, I was able to teach two kind of workshop sessions and introduce people to yoga and I think people really enjoyed it. It's cool.
Dr Rupy: Yeah, it's fantastic. I'm really gutted that I didn't get to do the actual session. I had to run off. But, um, it looked amazing and the feedback was incredible. And it's quite interesting to see a lot more yoga creeping into the NHS. So not only for the well-being perspective for, um, the doctors, but also from a social prescribing perspective.
Dr Claire: Definitely.
Dr Rupy: So Dr Michael Dixon, who's the founder of, um, the College of Medicine, has done some fascinating stuff on this. Um, have you, you come across some of the work?
Dr Claire: Yes, the, um, yeah, Dr Michael Dixon and I know recently as well that they held the, um, yoga and health conference. I think it was just last week. So it's quite a topical.
Dr Rupy: I didn't know that.
Dr Claire: Yeah, so, um, there was a big yoga and health conference and I think Prince Charles did the kind of opening address at the conference as well. Um, so it's quite topical that we're speaking about it this week. Um, linking obviously all the benefits of of yoga and health and, um, certainly, um, there was a lot of promise that potentially more money will be spent on yoga in the NHS and it could be part of kind of social prescribing for us actually to be able to to give to our patients.
Dr Rupy: To patients. Yeah, yeah. Do you have experience of discussing yoga with your your patients? I'm sure you have.
Dr Claire: Yeah. So it's something I do try and bring up very frequently. And um, I was listening to your podcast with um Dr John Sykes recently as well on exercise and I have to say a lot of that resonated with me when he said where he kind of brings in exercise to his patients. And I do think that as well with yoga, it tends to be, I do tend to bring it in more with the patients that are maybe suffering from conditions such as anxiety and depression. Um, certainly as part of that, I would talk about, you know, have you thought about yoga, meditation, exercise with that and see obviously how how they get on if they're open to, you know, trying things and and seeing the benefits, definitely.
Dr Rupy: How do you broach that topic? Because I imagine a lot of people have some a perception of yoga being a bit middle class, of being a bit woo-woo. Um, but I I I mean, I personally don't have that opinion. I I find the practice uh phenomenal and the science behind it, which we'll go into in a little bit, is is really, really convincing. But for a lot of lay people who haven't even heard of yoga before or just think it's something that's for the sort of upper class or like, you know, the the wellness warriors. How do you, how do you start that conversation?
Dr Claire: Yeah, um, so I think it's about changing people's perspectives to yoga and, um, so yoga essentially is for for everyone. Absolutely. I think, especially the world of Instagram, you see that you think yoga is just for these middle-class people, sports bras, you know, very, yeah, absolutely. Those leggings doing handstands. But in essence, that isn't yoga. Um, anyone can do yoga. If you can breathe, you can do yoga. Um, and I think it's, um, just explaining that to patients, um, to potentially them to having an open mind, going through the different types of yoga and what really yoga is. So kind of starting to explain that. So yoga really means, um, union. And so we link our body, our breath, and our mind together.
Dr Rupy: That's fantastic. Yeah, I love that sort of analogy of or that that saying, if you can breathe, you can do yoga. Um, and that union of mind, body, um, and uh, breath.
Dr Claire: Breath.
Dr Rupy: That's it. Mind, body, and breath. Um, that is something that I think can be uh separated when you're just doing regular exercise and actually having that sort of uh connection is is is really important. It might explain some of the benefits that we see.
Dr Claire: Absolutely. Absolutely. Um, and yeah. Yeah. So, um, so having that conversation and and starting uh people on their journey, how do you do that? Do you point people in the direction of certain online materials or are you aware of sort of like local church groups, for example, like church halls where they they actually do yoga?
Dr Claire: I mean, obviously the ideal would be if we had somewhere as GPs that we could ideally, um, you know, say, oh, this is a yoga class that would be beneficial for you and we could prescribe it on the NHS. I think obviously that would be the ideal. And in certain, I think certainly in some areas of the country that is starting to happen. Um, but in my kind of practice, unfortunately, we don't really have um that available. Um, so certainly it depends how the person is and and why they're kind of maybe seeking yoga. Um, obviously some people are quite isolated or find it very difficult to go to classes and want to start practicing by themselves. Um, certainly, I think there's some great online stuff. One that I particularly use, although there is others, um, is um Yoga with Adriene on YouTube, just because it's, I mean, it's something I used years ago, but I just think she's got so much material out there. There's so many classes. They can be 10 minutes, 15 minutes. There's yoga for anxiety, yoga for back pain, yoga for, um, you know, stress, anything that she's got it. And I think it's quite a nice way to get an introduction to it by yourself that you can do at home. It's free, it's quick, you can add it into your day.
Dr Rupy: I'm glad you recommend that because I've been recommending that for a number of years.
Dr Claire: I know. Everyone keeps asking me if there's other sources and there is other stuff out there, but I think it's that's just such a great free resource there and I think she's fantastic.
Dr Rupy: Yeah, it's a huge library of information there.
Dr Claire: Exactly, exactly. I even saw some interesting ones that yoga for heartbreak and and things. Yeah, that are quite good. Yeah. So there's got a lot of good content there. Um, certainly as well, I would encourage GPs. So, um, in my, in my area, we've got a few yoga studios nearby and certainly what I do recommend to patients is, um, a lot of the yoga studios have community classes. So I mean, again, this stigma of it being for the middle class is quite often yoga studios in London, it is 20 pounds a class. Um, but these community classes are kind of pay what you feel, donation-based classes and they're often raising money for charities and you can go along, drop in and try yoga. And it tends to be a variety of different people that are going, not just those in sports bras and things. So it's a more comfortable environment generally. Yeah. Um, but obviously and just letting patients as well know about all the different types of yoga because I mean, it's overwhelming, isn't it?
Dr Rupy: It is, yeah.
Dr Claire: What all the different types are.
Dr Rupy: I'm often asked like what I practice and I'll be honest, I don't know. I don't know whether it's Asana or Vinyasa. I just kind of move and do warrior one, warrior two and then a few other movements. And you know, I I I like to uh I dip in and out of classes. Um and I find classes useful because they're quite challenging. They usually explore other poses that I haven't done before. But I find them most relaxing is when I actually do yoga on my own on the carpet or on on a mat that I've got at home in my own time, 20, 25 minutes, like I did this morning. And I don't have to kind of like crook my neck to look at the instructor to make sure I'm doing it right. And if I fall over, it's not that embarrassing. So like I think, you know, dipping in and out of classes, getting a few movements and then practicing at home is a really good way to start.
Dr Claire: Absolutely. Absolutely. And I guess the benefits of classes is that you've got someone there that's that's watching you while you're starting to learn and making sure that you're doing the poses correctly. Um, because if they're practiced safely, then, you know, yoga is a very safe practice. Um, but, you know, there's that worry if you're trying quite challenging poses by yourself that you might, you know, injure yourself.
Dr Rupy: I'm definitely guilty of that.
Dr Claire: But then absolutely bringing it to that daily practice by yourself is obviously the essence of yoga and getting that connection with yourself is what it's all about where you get the most benefits.
Dr Rupy: Absolutely, yeah. With regard to like chronic stress, I think there's an obvious sort of intersection there with why yoga might be beneficial. Um, I was doing some research for the the new book, Eat to Beat Illness, and yoga just kept on coming up for so many different topics. And that's why I cover yoga in the brain section, in the immunity section, in the inflammation section. Um, but specifically for chronic stress, we know that that can change the structural anatomy of of your brain. And when you practice uh things like deep breathing, you actually lower those uh inflammation signals that are related to chronic stress amongst other physical things as well. Um, have you come across some of that kind of stuff in the past or is that something that you were taught uh during your training or something that you've you've developed an interest in afterwards?
Dr Claire: Yeah, so I mean, obviously it's something that I've found in myself, but also you are taught throughout the training and I guess the training is kind of based on, you know, people's experiences of yoga and, um, and and they've kind of done it from experience rather than necessarily evidence-based. I would say a lot of the evidence of yoga is quite is quite difficult. There's quite only quite a few studies. They're very small sample sizes, um, with not kind of adequate controlled. It's hard to double blind, for example, the yoga. Um, and there's large variations of the practices of yoga. Therefore, it's really hard to kind of correlate that well across the studies. But I think there's a lot of obviously good small bits of work that are out there that are, um, certainly showing the benefits and some of them are psychological. So kind of how we perceive stress that they find that through practicing yoga, um, you've actually got a kind of a lower perception of stress. Um, also through yoga, you get a, um, more of a self-awareness and, you know, able to have more self-care, recognize, you know, when things aren't feeling right in your body and your mind and, you know, starting early to change those things. And then there's obviously the physiological components of kind of, um, proposed kind of decrease of the hypocretin axis, um, less sympathetic, um, nerve innovation. Um, and then, you know, there are some studies showing that there might be decreased cortisol and catecholamines. Um, and then there's some work, um, about kind of gene expression, which you mentioned as well, actually.
Dr Rupy: Yeah. I I I find that kind of stuff fascinating. And and going back to how hard it is to do these kind of studies. A, the funding's not there. B, like you said, it's you can't blind. Um, what I'd like to see actually is a study that teases out whether it's purely the exercise component of yoga or whether it's the exercise and breathing component that leads to those extra benefits if they're seen at all. So, you know, in in the podcast that I did with Dr John, for example, we talked about the benefits of exercise in general. So the benefits of uh gene expression, positive gene expression, uh reducing uh inflammation signals, IL-6, for example, um mitochondrial biogenesis, as well as um reducing the inflammatory signals. Um, uh, it's it's hard to tease out whether the the effects on chronic stress from yoga are from the exercise component or is is actually the breathing. And I think that combination is quite interesting.
Dr Claire: I think it is, yeah.
Dr Rupy: Yeah, because it's almost like you're combining the um benefits of the exercise as well as meditation. And there's lots of research looking at meditation. This is kind of like a form of meditation in itself.
Dr Claire: Absolutely. Meditation is an essence of yoga. It's part of yoga. And I would agree. I think there must be some extra benefits that are from that being linked into the exercise component as well.
Dr Rupy: Yeah, it's kind of like, you know, the diet and exercise component. Yes, there is like diet that certainly has effects that benefits, but when you combine that and the synergistic effect of diet and exercise, it's no wonder you see so many uh benefits to to well-being and health outcomes.
Dr Claire: Absolutely. Yeah.
Dr Rupy: Um, there was uh a bunch of studies that I looked at, um, when I was writing the immune section for Eat to Beat Illness. And again, research is demonstrating that with some, uh, some practices like Qigong and uh Tai Chi as well as yoga, you know, you can positively uh improve your immune cell function. Um, there was a a a podcast that I did with Dr Jenna Macciochi, um, that if you haven't uh listened to at home, you should definitely listen to. It's all about immune health. And um, how the uh the notion of boosting your immune system is is quite misleading. It's more about like supporting your immune system. But, um, what these researchers demonstrated with the yoga practice is that it can express the impact the expression of your genes that positively improves your immune cells, essentially, like uh increasing the number of natural killer cells, increasing, um, or reducing the likelihood of you suffering things like common colds and viruses. Fascinating stuff. Is this something that you've come across yourself?
Dr Claire: Absolutely. I think I've read the similar study. Absolutely. Um, I think that one was quite a, it was a relatively quite quick intervention. I think it was part of kind of a yoga retreat. So it was these changes came on quite quickly. So it was recorded, I think within two hours of the activity actually being done. And absolutely, it was showing that, um, potentially they could, um, increase the action of natural killer cells, which is quite an interesting theory because, um, it's noted in chronic stress that actually the activity of natural killer cells is reduced. So that's would be quite an interesting link and something to certainly take forward into more research would be quite interesting. Um, and it's also shown that it can increase the expression of megakaryocyte maturation and also platelet production itself. And obviously this is a very small study with very short, short intervention, but certainly something that would be interesting to to see more of.
Dr Rupy: Yeah, it mirrors some of the other stuff that I read on not not to do with yoga, but I think it was um to do with meditation practice. So they looked at a cohort of people who uh were taken on a retreat. So it's a very unnatural situation. There's so many confounders. But they're taken on a retreat and taught a whole meditation practice. Um, and they demonstrated uh lengthening of the telomeres. So not just reduction of the um uh the degradation of telomeres, which are the repeating bits of material at the end of your chromosomes that are essentially a biological marker of aging. But they they demonstrated that they could actually lengthen the telomeres, which literally had an anti-aging effect. And whilst we can't prescribe retreats for everyone, you know, having a little mini retreat in your own house, I think is something that I try and do. So, you know, a five-minute uh meditation in the morning, an intention that I do at the end of my bed every day I get out of bed, I I you know, I have this little mantra that I say to myself, the world is going to be, the world is beautiful. Today is going to be very productive. You're going to have a happy day, you're going to have a positive day. And having that sort of like intention for the rest of the day, I think is really useful. And then doing a movement exercise. So whether that be hit training, whether it be yoga, whether it be something quite restorative and relaxing like Qigong or Tai Chi. Um, actually for a lot of people, I don't think they've come across Tai Chi or Qigong. Is that something that you've had experience of yourself or?
Dr Claire: It's interesting. I've read a lot of stuff about um both of those, but I've not actually practiced them myself. Have you done much?
Dr Rupy: I've done Tai Chi before and I've got to be honest, a little bit too slow for me. Um, but um, yeah, it's it's it's very um, it's quite intense. For something that is very slow, almost like tortoise-like movements, it is quite intense because you you you give intense focus, uh whole focus to every little brush stroke of your hand and stuff like that. Um, which I I think I I struggled with.
Dr Claire: I was going to say is it more the mental focus rather than the physical posture itself?
Dr Rupy: Yes, yeah. And the kind of slowing of of the mind.
Dr Claire: Yeah.
Dr Rupy: I I've certainly watched a lot of people, um, uh, in San Francisco in the morning doing Tai Chi and stuff. Yeah, in the parks, yeah. And I've joined in a couple of times, a handful of times. Um, but yeah, no, I found it quite, I I think I'm easily distracted. But it's something to, you know, it's a challenge. It's something to try.
Dr Claire: Exactly, exactly. And I think, you know, and quite often in in yoga, we always talk about kind of Yang and and Yin. And quite a lot of us practice a lot of, we call them more Yang classes, which are more the vigorous classes and dynamic classes, but we're also in our private lives living very busy and stressful lives. And then we're going into these busy and classes that are stressful on the body. And actually, should we be doing more of the kind of more Yin style of yoga, which is slower and more time to focus and and relax and that balance.
Dr Rupy: Yeah.
Dr Claire: Is what, yeah.
Dr Rupy: That's fantastic. Yeah. Have you come across some some patients that you've um uh recommended yoga to? Yeah. And with some some benefits? Do you have any stories or anecdotes?
Dr Claire: Yeah, um, I think, um, definitely like I said, um, kind of using the yoga more in kind of depression, anxiety. I had one patient who was suffering from really bad anxiety. Um, and had never done any yoga at all. And recommended to go along to kind of local community classes and, um, started, I think she ended up getting a kind of induction pass and going along most days for the month and found it was really helpful. Particularly she needed a, she was very, um, suffering very bad anxiety and she needed a period of time off work and it was actually a nice focus for her to do while while being off and and, um, helped certainly her anxiety symptoms alongside medication and things as well.
Dr Rupy: That's fascinating. Yeah, that's really good. It's almost like there's there's so many different avenues that we could help patients, whether it be cold water swimming, for example. I know some people try that on TV as well. I've seen some people try that. I don't think it's as accessible as as the other things.
Dr Claire: Feel it by the sea.
Dr Rupy: Yeah, if you live by the sea, maybe. Um, but certainly, you know, uh, park run, walking practices. Um, there's walking groups that I think that a lot of GPs have gotten into now. And the whole culinary aspect as well. Yes, you can. I do, um, a lot of work with, uh, Made in Hackney, one of the ambassadors there. I'm actually doing something tomorrow, um, at the Bart's Hospital. We're doing a day where we we're doing a little demo for children, um, to highlight the, it sounds terrible to talk about it, but highlight the record rates of constipation, uh, that are leading to, it's some severe like interventions. I mean, some of these kids are having to have surgery because of chronic constipation. Um, so yeah, that that whole practice of, you know, getting into an environment with random people you've never met before and cooking or doing an exercise class or something. You know, there there is something again, very intangible about that experience, but certainly very, very refreshing and and incredible for well-being and and sense of purpose.
Dr Claire: Absolutely. And I think particularly the stories from Parkrun are really nice of the differences that they've made to patients, outcomes and, you know, patients coming off their antidepressants or depression medications are really interesting. Our practice has recently linked up with our local park run in Peckham as well, actually, which has been great. And it was a great incentive even just for the staff to get everyone to to go along as well. And, you know, some people walked it, but it was fine. Um, I think that's what's fantastic about Parkrun is there's always a volunteer at the end and some, you know, chatting, encouraging everyone to complete it.
Dr Rupy: Yeah. Your patients must love you in that area. You know, you're talking to them about yoga, you've got a nutrition masters. I know you just started on like your GP journey, but yeah. Must be getting loads of thank you cards. For those who don't know, thank you cards are a really good gesture of goodwill and that you can upload them onto your portfolio, take to your appraisal.
Dr Claire: They are the nicest thing to get.
Dr Rupy: They are. Yeah.
Dr Claire: They mean so much. They really do. When someone actually takes the time to write a thank you card to us, I think.
Dr Rupy: Exactly. Yeah. I I like, I cherish all the thank you cards that I've had in the past couple of years. Unfortunately, it's not like a daily. I wish it was a daily occurrence. But when you do, it's like, oh wow, you know, you've really feel like you've done something.
Dr Claire: Absolutely. That's those little snippets, don't they make us realize why we do what we do. I think.
Dr Rupy: Definitely. It's kind of like why I I still practice my gratitude exercise. I stopped recording it on Instagram, but you know, um, sharing it and actually encouraging other people to do it. There there is something quite special about just remembering those little positive accents at the end of your day. Um, whether it be a thank you card, whether it be bumping into someone, whether it be something as simple as, you know, the bus driver smiling at you or welcoming you onto the bus instead of just ignoring you. You know, those those little things that you would otherwise just completely forget about, you bring it back to the the forefront of your memory and it's it's very um replenishing, I find.
Dr Claire: Absolutely. I think even on my journey here this morning, I was packed into this, um, you know, packed into the train, squished amongst everyone and the as we were pulling into London Bridge, the driver just said a few really nice words and wished us all a really nice day. And I was just like, that's really actually really set me off nicely for the day and something I'll really, you know, be thankful for today.
Dr Rupy: It's a new yoga practice, isn't it?
Dr Claire: It's a new, very cheery. And also the nice weather today is really helping.
Dr Rupy: Yeah, yeah, absolutely. So where do you see the future of yoga going uh in the NHS? Have you had any thoughts about this or?
Dr Claire: Absolutely. I mean, I think that it would be fantastic if we had somewhere that we as GPs could, um, advise, well, prescribe for our patients and dedicated classes potentially to whether that's set up to, you know, as whole classes or set up to different conditions. So yoga for back pain, yoga for, you know, anxiety, yoga for, you know, well-being, whatever that is. Um, and have dedicated teachers that, you know, are interested in that particular niche that can deliver, you know, a safe and effective, you know, yoga class for the patient.
Dr Rupy: Yeah, absolutely. Yeah. I think if something is recommended by your GP, you're more likely to listen to it as well. And I suppose, you know, the events that you've done, um, with the Royal College of GPs is just heightening everyone's awareness, um, of what the evidence base is saying and how effective yoga can be as a treatment.
Dr Claire: Absolutely. Absolutely. And I think it's it's also really nice as well if if us ourselves, like you with obviously, you know, the culinary medicine, if if you're saying, you know, this is what what I do and I try and practice this as well and it it that passion comes across and I think our patients are more likely to start doing it if we're, you know, very enthusiastic about it, have had that experience rather than saying, you know, I think you should do yoga, but I I don't need, I don't need to do yoga.
Dr Rupy: Yeah, yeah, exactly. And, um, if you there are any people out there who have tried yoga before or perhaps they're completely new to it, what kind of tips do you have for them to get started?
Dr Claire: Absolutely. So I think, because I find the whole Instagram world very overwhelming when it comes to like, you know, the positions and stuff. I'm like, oh God.
Dr Claire: Absolutely. And I think, um, you know, you know, handstand isn't necessarily yoga. Absolutely. Yoga is moving and breathing. Um, in essence. And I think, you know, I would tell you to be open. Certainly. So there's there's such a wide variation in the types of yoga, the yoga teachers. And I think even if you've you've tried it once and it's it's you haven't quite enjoyed it, be aware that there's so many different other styles out there, so many different teachers. And I'm sure within that you'll be able to find someone that, you know, you like going to, that you, you know, have resonate with and and a practice that you enjoy. Um, I mean, obviously there's lots of different types. There's, you know, quite commonly, I think there's the Vinyasa types, which are kind of quite flowing and dynamic classes, but there's also some really nice slower classes such as, um, the Yin yoga and restorative yoga. I don't know if you've ever tried any of those.
Dr Rupy: I don't think I've done Yin, no, no.
Dr Claire: No, it's a really nice class. It's, um, where you hold postures for quite a long period of time and and, um, yeah, so they're much kind of slower-paced classes and, um, they talk quite a lot more about philosophy maybe in those classes because you've got a bit more time to kind of relax, depending on who you go to.
Dr Rupy: Right. Depending on how how aggressive they are.
Dr Claire: And your teachers, yeah.
Dr Rupy: Yeah. And what about those who have tried yoga and they haven't found any benefits or anything? Like, you know, is it, do you think like experimenting with different types or?
Dr Claire: Yeah, definitely. So I think, um, if there's a, you know, if you've gone to a Vinyasa class and you you haven't quite enjoyed it, try try something else. So there's there's, you know, Hatha yoga, Ashtanga yoga, maybe there's yoga for sleep yoga, yoga nidra, try something else that works. And even doing meditation every day is part of yoga and that's still doing yoga, I would say.
Dr Rupy: I like that. Yeah, even breathing is still yoga.
Dr Claire: Absolutely.
Dr Rupy: We're doing yoga right now.
Dr Claire: Absolutely.
Dr Rupy: Um, I'm going to ask you a few rapid questions. I put out uh a call to uh everyone on social media. And a whole bunch of people came back and they all have loads of questions about different types of yoga and stuff. So this is our opportunity to uh try and extract as much knowledge as we can about yoga from the expert. Okay. Hot yoga thoughts.
Dr Claire: Oh, okay. Um, that's quite an interesting topic. I think people either love or hate hot yoga. Um, and I'm a bit wary about, um, yeah, discussing some because because of necessarily the evidence behind it. But, um, I think, um, yeah, hot yoga personally, I actually very enjoy practicing hot yoga. I quite like the way it makes you feel. The classes are, um, if you don't particularly like hot, um, environments, then I probably wouldn't recommend it. They're very sweaty classes. But I quite enjoy the time that you take in each posture, um, and the way you can really feel into the different yoga poses and the way that you feel when you leave a class. But I would say you have to be quite cautious because it's a hot environment, you are more relaxed and your muscles are more relaxed. So there are, there is is an increased, um, possibility of injury in those types of classes.
Dr Rupy: Yeah.
Dr Claire: So I would say, you know, if you enjoy it, then great, but just be aware of the potential problems with them as well.
Dr Rupy: Yeah, yeah. It can be quite intense, I've found. Um, it depends on how hot the hot yoga is. Um, I actually went to a class, I think my first hot yoga class in LA and it was literally like being in a sauna. And I, you know what, I I there are, I think there are some benefits. Obviously, you have to be mindful of the fact that you're more injury prone, your muscles are more relaxed, so you can overstretch. Um, but there are some really interesting studies looking at the benefits of sauna in general. Um, if you combine that with exercise, you know, maybe there's some additional benefits, who who knows? I don't think the study's been done on hot yoga specifically. But certainly upregulating heat shock proteins and how that has an effect on sirtuins and longevity. Um, that is something I think warrants more discussion. There's some really interesting studies that I found out about, uh, via listening to Rhonda Patrick, um, who's a a scientist in America. And, um, she's fascinated with the idea of regular sauna goers. So I think it's three times a week at a temperature above, oh, I'm going to get this wrong now. I think it was, uh, above 90 or 100 degrees. Um, not degrees centigrade. Um, was it 100 degrees? Actually, no, I've I've definitely got that wrong. I'm going to have to double check what what it actually was. But, uh, yeah, there there are some, uh, there's reduction in the in the incidence of Alzheimer's, dementia, and, um, increasing longevity as well and reduction in all cause mortality, all cause mortality. So I found that super interesting. Maybe it extends to hot yoga. I don't know. So this isn't rapid at all. We're just talking about. Does Pilates have the same benefits as yoga? I'm more of a Pilates girl than a yoga girl.
Dr Claire: Um, I think there's certainly some of the same, um, benefits of Pilates. I guess with the Pilates, there's not as much of kind of the the yoga philosophy and relaxation component to it, but it's certainly doing mindful movements. And I think with the Pilates, it's more kind of core-based, more, um, more kind of, um, isolated types of movements, whereas, um, and some people obviously find that more beneficial than the yoga, which is, you know, the more dynamic movements as well. So I think there's definitely some benefit, um, there's definitely overlap between both of them, definitely.
Dr Rupy: I think the whole concept of mindful movements extends throughout all the different practices you can find. And whatever suits you.
Dr Claire: Absolutely. Then do it. Exactly.
Dr Rupy: Yeah. One of my, one of my really good friends in Miami, she's addicted to Pilates. And she, shout out to Amy. Uh, she, um, she loves it. She literally does like five times a week. And, uh, I, yeah, I I can't see her going to anything else, but that that works for her and that's her practice.
Dr Claire: Absolutely. Absolutely.
Dr Rupy: Um, yoga in pregnancy thoughts.
Dr Claire: Yeah. Um, so I mean, definitely if if you're someone that practices, um, yoga normally and and become pregnant, then, you know, it's definitely we recommend, you know, you can still continue doing that. I would say it's it's definitely beneficial to find a pregnancy class, um, that's local to you because obviously as the pregnancy progresses, um, can be quite dangerous in the first trimester. And then obviously as the pregnancy grows, you need to be obviously mindful of that and you won't be able to do the same postures that you could do in a public class. So absolutely, yoga is great for pregnancy, but, um, just go to a pregnancy class.
Dr Rupy: Yeah, there are specific pregnancy class that I I obviously have not been to. But, um, I I think those are, yeah, no, they're fantastic. There are lots of different options to maintain a practice or exercise as well throughout pregnancy. So this whole concept of like, if you're pregnant, you just stay still. Uh, is just, yeah, a myth and we shouldn't be encouraging that. There are lots of benefits of maintaining movement during, uh, pregnancy. Um, reduction of gestational diabetes incidence and and lots of other things, lots of other benefits. Uh, is it good for sciatica? I think we've pretty much answered this. Yeah, yeah, for back pain. There's lots of good research.
Dr Claire: Yeah.
Dr Rupy: Yeah, it'd be interesting your concept of like, you know, yoga for back pain, yoga for mood, yoga for cardiovascular disease, you know.
Dr Claire: And I think there was there was an interesting study as well that, um, looking at, um, yoga for back pain, chronic back pain specifically compared to, um, either a control or just exercise on its own. And actually the yoga came out higher. And I think that's probably what we were talking about with the mind-body aspect as well as the exercise itself for the chronic pain.
Dr Rupy: Absolutely. Yeah, no, that's fantastic. Is it okay to do a yoga practice daily or do we need to have a few rest days?
Dr Claire: Oh, that's an interesting question. I mean, I think it's certainly, um, I think yoga absolutely can be a daily practice and should be a daily practice, whether that's meditation or movement. Obviously, if you have a very vigorous class and and you're doing kind of, you know, 90 minutes and, you know, you might benefit from having some rest, but certainly, um, yoga is is that it's set as a practice and something that we should live our lives by. So having a bit of yoga every day is definitely worthwhile.
Dr Rupy: Yeah, I think so. I think it's about being intuitive about your body as well. You know, I I mix up my exercise regime. A lot of people ask me what I do to keep fit. You know, I do a mixture of endurance, um, hit training, strength training, and yoga as well. And you know, I I try and move every day, but if I know that I'm sore from whatever I've done the night before, um, or the day before, that came out wrong. Um, yeah, I I I chill out. I have a rest day. So, yeah, it's I think there's a lot of pressure these days to maintain consistency and routine and stuff, but you also have to be more in tune with how your body's feeling.
Dr Claire: And actually yoga helps with that.
Dr Rupy: Yeah.
Dr Claire: Exactly. It helps you be aware of of how you're feeling and yourself and recognizing that. That's one of the great benefits of it. So if it's just that, you know, actually I need just to do meditation today, that's perfect. That's that's yoga. That's going to help. That's going to, you know, help you grow and practice.
Dr Rupy: I like that. I like often at the start of practices, at the start of classes, um, you know, the teacher usually asks, how are you feeling? Check in with yourself. Have you noticed how you're feeling today or your bones are, what your mood is like? Are you stressed? And that kind of gives you that benchmark at the start to figure out, okay, how am I going to feel at the end of the session and what's your intention as well?
Dr Claire: Absolutely. Absolutely.
Dr Rupy: These are like specific questions. Okay, good, good. Are there benefits of practicing yoga dependent on the length or frequency of sessions or does any time and effort provide health benefits?
Dr Claire: I think from what we've discussed certainly that, you know, any time and effort, you're going to get some benefit from yoga. I don't think, you know, in the long run, you know, having a longer session than a shorter session. I think it's about finding something that incorporates into your life that you can do for a long period of time. Absolutely. I think it's more about how you bring it into your life as a whole rather than one-off sessions of longevity.
Dr Rupy: Absolutely, yeah. And when it comes to specific health benefits, we have discussed actually previously on the podcast with Dr Anita about the benefits of, um, yoga for things like endometriosis, menorrhagia, painful periods, as well as, um, PCOS as well. And I think those benefits may be extended to the fact that yoga is an exercise and we know that exercise is beneficial for a lot of things. But particularly when you add that with the meditation element, you know, there are probably some synergistic effects.
Dr Claire: Definitely.
Dr Rupy: Which I I personally find fascinating. I think it's something that we need to explore a lot more and hopefully with some funding, we can actually demonstrate that in some proper research.
Dr Claire: Proper evidence, exactly.
Dr Rupy: Fascinating stuff there from Dr Claire. You can catch Dr Claire at realyogadoc on Instagram and make sure you check out her website realyogadoc.com as well. Today we talked about how yoga can be thought of as a therapy for things like chronic stress, something that we see as general practitioners super, super commonly. And it's very, very clear to us that loneliness is becoming an absolute epidemic. As a stress-relieving strategy, yoga is a perfect exercise, but others exist like Pilates and Qigong. These can be just as effective. We also talked about how yoga can balance inflammation as well as positively impact the expression of your genes. I've also linked some of the research that we talked about in the show notes on the doctorskitchen.com. So make sure you check that out. Some small-scale research has demonstrated that yoga can improve your immune health as well by increasing the availability of certain cells that are responsible for maintaining your fighting ability against infection. And let's not forget the community aspect of yoga. Not only can you do this as an individual practice, but it's also encouraged, especially in the early stages of your practice, to do this as part of a group and go to a few classes, of which there are many available in the most high-end of studios, but also in simple church halls that are available to a lot of people up and down the country. Check out the doctorskitchen.com for more tips on how to get involved with yoga as well as other mindfulness-based therapies. The new book, The Doctor's Kitchen: Eat to Beat Illness is out now and it will have lots more tips on how to improve lifestyle practices as well as delicious meals to help you on your wellness journey. Make sure you give the podcast a five-star review if you enjoyed it. It really does help other people find the information that will help them and subscribe to the doctorskitchen.com. I will catch you next time.
