The simplicity of “cheating death”... 

Death anxiety has ramped up. We can’t seem to face it and just like putting off those inevitable tax returns we collectively are trying everything we can to delay illness, morbidity and death. 

Unfortunately, we might be looking for wins in all the wrong places; through green powders, cryotherapy chamber and coffee enemas... (if you’ve been reading this newsletter long enough, hopefully the latter isn’t you) 

Fortunately, the single most effective mortality-reduction tool requires no equipment beyond functional legs. Emerging from a mountain of pedometer data and mortality statistics comes a welcome truth – simply walking 1 hour and 20 minutes daily (8,700 steps) slashes all-cause death risk by 60%.  

To contextualise this biological hack: achieving the same risk reduction through pharmaceutical interventions would require a drug so profitable it’d make insulin look like pocket change. Yet here we are, ignoring this evolutionary birthright while debating whether turmeric lattes count as medicine... 

The step-mortality gradient: from potato couch crypt to delayed obituary 

Let’s autopsy the numbers: 

• 2,000 steps/day (20 minutes of shuffling between bed-coffee maker-car-office chair): Your mortality baseline. Congratulations – you’ve achieved the movement equivalent of a moderately active houseplant. 

• 8,700 steps/day (1h20m): Death’s customer service line puts you on hold. All-cause mortality drops 60% – comparable to quitting smoking while simultaneously fixing your sleep and diet. 

• 16,000 steps/day (2h40m): Gain an extra 5% protection. At this point, you’re essentially flicking off the Grim Reaper while he checks his step-counter app. 

The dose-response curve reveals walking’s brutal efficiency: every 500-step increment (≈5 minutes) decreases mortality risk like clockwork. This isn’t wellness – it’s statistical extortion. 

Why walking beats $100B wellness industrial complex 

While influencers hawk mitochondrial-boosting powders and “ancient longevity secrets,” consider these findings: 

1. Cardiovascular Protection: 7,126 steps/day halves cardiovascular disease (CVD) risk. For perspective, statins reduce CVD mortality by 30% over 5 years (you should still definitely take your statins if prescribed btw!) 

2. Metabolic mayhem prevention: Pedometer-based walking interventions yield 1.27kg average weight loss – outperforming most commercial diets without requiring kale proximity. 

3. Cancer risk reduction: Every 2,000 daily steps decrease cancer mortality 10% through mechanisms like improved immune surveillance and reduced inflammation. 

The bitter irony? Modern humans now walk 600% less than pre-industrial populations while spending 500% more on healthcare. We’ve engineered movement out of existence only to pill-supplement-exercise it back in! 

Your neurotic guide to step optimization 

1. The 500-step heist 

 
Steal steps in 5-minute increments – walk during calls, pace while reading, orbit your kitchen during coffee brewing. Each stolen 500 steps drops mortality risk 8-15%. Do this 4x daily and you’ve cheated death before dinner. 

2. Embrace inefficiency 

 
Park farther, take stairs, walk to colleagues instead of emailing. Medieval peasants hit 16,000 steps/day without trying; modern desk-jockeys must weaponise inconvenience. 

3. Postprandial pacings 

 
A 15-minute walk after meals blunts glucose spikes better than that wellness influencer plugging apple cider vinegar gummies. Your pancreas will thank you while your Apple Watch mocks your dessert. 

4. The Zombie apocalypse rule 

 
If you can walk 8,700 steps/day, you’ll outlive the pill-popping preppers. Survivalists stocking bunkers? They’ll die first from sedentary-induced thrombosis. 

Walking’s effectiveness torments us because it highlights modern health’s great paradox: we seek complexity to solve problems we created through oversimplification. We invented cars to avoid walking, then Pelotons to compensate. We demonize carbs while sitting 12 hours daily. The data screams that basic movement dwarfs most interventions, yet we dismiss it as “too simple” – as if survival must be earned through suffering and expense. 

The step-count studies reveal a terrible truth – health is not something you buy, but something you do. Continuously. Boringly. On purpose. The data’s clear – the road to longevity is literally paved with footsteps, not just protein bars. 

Why I’ve started berry maxxing.... 

The humble berry – nature's middle finger to people who talk about superfoods but don’t consume berries! 

These tiny, unassuming fruits are the closest thing we have to edible cheat codes for the human body. Berries have been quietly outperforming most of modern medicine's supplements and quick fixes. Let me explain how and why... 

Brain boost: cognitive function on steroids (except it's just fruit) 

Berries, particularly blueberries, have shown remarkable effects on cognitive function. Studies demonstrate that daily consumption of blueberries can improve memory and slow cognitive decline.

Who needs expensive nootropics when you can just pop a handful of nature's brain candy? 

Heart health: cardiovascular system's secret admirer 

Your heart, that tireless muscle keeping you alive despite your best efforts to sabotage it, absolutely adores berries. 

Regular berry consumption has been linked to reduced risk of cardiovascular disease, improved blood pressure, and better vascular function... those berries whispering sweet nothings to your endothelial cells. 

Gut reaction: microbiome's mosh pit 

Berries are the rockstars of the gut world. They come packed with both soluble and insoluble fiber, making them the ultimate party favor for your gut bacteria. These fibers act as VIP passes for beneficial microbes, promoting diversity and health in your intestinal ecosystem. It's a rave down there, and berries are supplying the good stuff. 

The antioxidant arsenal 

Berries are loaded with antioxidants and phytochemicals, making them the special forces of the fruit world. These compounds wage war on oxidative stress and inflammation, protecting everything from your liver to your eyeballs. It's like having an army of tiny, delicious bodyguards patrolling your bloodstream. Neve thought I’d use that phrase... 

Fiber fiesta: more bang for your nutritional buck 

Berries pack a serious fiber punch. For instance, raspberries boast a whopping 8 grams of fiber per cup. That's 29% of your daily value in a single serving. Compare that to the fiber content of that sad, wilted lettuce leaf on your sandwich, and you'll see why berries are the overachievers of the plant world. 

Incorporating nature's candy into your life 

1. Berry breakfast: Mix a variety of berries into Greek yogurt and oats. It's like a protein-fiber party in a bowl, with antioxidants as the welcome guests. 

2. Smoothie sensation: Blend frozen berries with spinach, Greek yogurt, and a splash of whatever milk you like. It's basically a multivitamin you can drink, minus the gag reflex. 

3. Salad savior: Toss some berries into your green salad. Suddenly, that pile of leaves becomes infinitely more interesting (and nutritious). 

4. Dessert deception: Use berries as a topping for healthier desserts. It's like putting a halo on your indulgence. 

5. Snack attack: Keep a mix of berries in your fridge for easy snacking. It's nature's version of those addictive, colorful candies, but without the subsequent shame spiral (not that the occasional sweets are anything to be ashamed of...I have a box of sour patch kids on standby in my kitchen) 

How to advocate for yourself in healthcare

(without feeling like you’re starting a war)... 

I’ve been a doctor for over 11 years and I’ve come to realise that advocacy in medicine isn’t about "fighting" your doctor—it’s about making sure you get the best care possible. It’s not combat, it’s collaboration.

But if you don’t speak up, your health decisions can get made for you, rather than with you. 

Medicine has (thankfully) moved away from the paternalistic "doctor knows best, don’t ask questions" model, but let’s be honest - some remnants still exist. 

Sometimes, if you want to ensure you get the right tests, the right treatment, and leave a healthcare appointment actually understanding what’s happening to you, you need to advocate for yourself (that doesn’t mean demanding tests, but simply being more informed) 

Not because your doctor is evil. Not because healthcare professionals don’t care. 
But because you know your body better than anyone else. 

As a doctor and a patient, I’ve been on both sides of the system. I’ve seen what happens when patients are empowered, and I’ve seen what happens when they walk away confused, unheard, and sometimes - undiagnosed. 

First, what is patient advocacy? 

Patient advocacy is not: 
- Challenging everything your doctor says just to be difficult. 
- Googling one study and deciding you know more than the entire medical profession. 
- Shouting "Big Pharma" every time someone prescribes you medication (I see you social media misinformers) 

Patient advocacy IS: 
- Asking questions so you fully understand your diagnosis and treatment options. 
- Ensuring your lived experience is taken into account. 
- Making sure you leave an appointment feeling informed, not confused. 

For example, if you’ve lived with hyperthyroidism for 20 years, you know your body better than any doctor seeing you for the first time. If you have IBS and know exactly which foods trigger a flare, that’s valid information. A good healthcare provider wants to collaborate with you. 

10 actionable tips for advocating for yourself in healthcare: 

1. Prepare Before Your Appointment 

Your doctor may have 10-15 minutes with you (thanks, modern healthcare systems). Make them count. 

• Write down your symptoms, concerns, and any major questions in advance. 

• If it’s a complex issue, keep a symptom diary—dates, triggers, severity. 

• Bring a brief medical history if relevant (surgeries, medications, family history). 

Why? Because the "Oh, I forgot to mention…" moment happens to everyone, and sometimes it’s the detail you forget that can change everything. 

2. Bring someone with you (or write down key questions) 

When my cousin had major surgery, I couldn’t attend his pre-op appointment, but I wanted to make sure he left feeling knowledgeable and confident. 
So I did what any overbearing but well-intentioned family member would do—I wrote him a list of 20 questions to ask his surgeon. (which I’ve expanded on and you can download using the link at the end of the newsletter!) 

• Having someone with you can help you process information. 

• If you can’t bring someone, write your key questions down so you don’t forget. 

• If your doctor says something unclear? Ask them to clarify. 

Why? Because stress affects memory - especially when discussing surgery, cancer, or a major diagnosis. A second set of ears is invaluable. 

3. Ask: "What are the alternatives?" 

If a treatment is recommended, ask what else is available. 

• Is there a non-surgical option? 

• Are there medications with fewer side effects? 

• What happens if I do nothing? 

Why? Because medicine isn’t always a single-answer game - there are often multiple options, each with pros and cons. 

4. Repeat information back (a.k.a. the teach-back method) 

Doctor: "You need to take this antibiotic twice a day for 10 days." 
You: "So, I take it every 12 hours for 10 days?" 

• Rephrasing what your doctor says makes sure you actually understand it. 

• It also forces them to explain things more clearly if they’ve been too vague. 

Why? Because medical jargon can sound deceptively simple - but clarity saves lives and peace of mind. 

5. Ask: "What’s the worst-case scenario?" 

Doctors are trained to talk about benefits and risks, but sometimes the risks can be downplayed unless you specifically ask. 

• What’s the worst thing that could happen if I take this medication? 

• What’s the risk of complications from this surgery? 

• What are the red flag symptoms that mean I need emergency care? 

Why? Because informed consent isn’t just saying "yes" to a treatment - it’s understanding what you’re saying yes to. 

6. Know that you can ask for a second opinion 

• If you feel unheard, dismissed, or unsure, you can see another doctor. 

• A good healthcare provider won’t be offended. 

Why? Because medicine isn’t infallible. Different doctors have different experience levels and biases. 

7. Ask: "Can you explain that in plain english?" 

Some doctors speak entirely in medical jargon (this used to be me); not because they’re trying to confuse you, but because it’s second nature to them. 

• If something doesn’t make sense, ask for clarification. 

•  "Can you explain this as if I were a 10-year-old?" 

• If it’s a complex diagnosis, ask for a printed summary. 

Why? Because you can’t make informed decisions about something you don’t understand. 

8. Know that "normal" bloodwork doesn’t always mean "no problem" 

• If your symptoms persist despite "normal" test results, ask about further investigations. 
   

• Some conditions (like thyroid disease, autoimmune disorders, functional gut or neurological issues, chronic pain) don’t always show up on standard tests. 

Why? Because lab results aren’t always the whole picture - your symptoms matter too. 

9. Don’t Be Afraid to Challenge Dismissal 

• If you’re told "it’s just stress" or "it’s in your head", and you know something is wrong, push back on clarifying the diagnostic process 

• "What tests would you run if this wasn’t anxiety?" 

• "Can we explore other possibilities before assuming it’s stress?" 

Why? Because many people (especially women and people of color) are dismissed more often in medical settings. 

10. Be respectful, but firm 

• Healthcare professionals want to help you, but they’re also human. 

• You can advocate for yourself without being confrontational. 

• "I appreciate your time, but I feel like this concern hasn’t been fully addressed. Can we look into it further?" 

Why? Because kindness gets you further than aggression. 

Being an advocate means being a participant in your health; ask, listen, and make informed choices. 

3 gut health hacks: the science-backed edition 

Embarking on the quest for optimal gut health can feel like navigating a labyrinth of dietary advice, each twist and turn more perplexing than the last. But in one corner of the internet...i.e here there is still hope: 

1. Flaxseeds: Nature's cholesterol busters 

The Claim: Consuming 2 tablespoons of flaxseeds daily can reduce cholesterol levels as effectively as some statin medications?! 

The Science: A study focusing on patients with peripheral artery disease revealed that daily intake of milled flaxseed led to a 15% reduction in LDL cholesterol within just one month. This effect was comparable to the cholesterol-lowering capabilities observed with certain statins. PMID: 25694068 

The Mechanism: Flaxseeds are rich in alpha-linolenic acid (ALA) and lignans, which have been shown to reduce cholesterol levels. These compounds may decrease the absorption of cholesterol in the intestines and increase the excretion of bile acids, leading to lower circulating cholesterol levels. 

Who knew that the humble flaxseed, often relegated to the back of the pantry, could give pharmaceutical giants a run for their money? Perhaps it's time to sprinkle a little rebellion onto your morning yogurt. (P.S to caveat, if you’re on cholesterol lowering medication, this is not a call to arms to bin them and make eating flaxseeds your new personality!) 

2. Spice up your life: mixed spices and microbiota diversity 

The Claim: Incorporating 1 tablespoon of mixed spices into your daily diet can enhance the diversity of your gut microbiota. 

The Science: Research indicates that a blend of spices, including cinnamon, ginger, and turmeric, can positively influence gut microbiota composition. These spices possess antimicrobial properties that may selectively inhibit pathogenic bacteria, allowing beneficial microbes to flourish. PMID 34050197, 31242596 

The Mechanism: The bioactive compounds in these spices, such as curcumin in turmeric and cinnamaldehyde in cinnamon, exhibit prebiotic-like effects. They serve as substrates for beneficial bacteria, promoting their growth and, consequently, enhancing microbial diversity. 

Imagine your gut as a bustling metropolis. Without spices, it's a monotonous landscape. Add a dash of turmeric and a sprinkle of cinnamon, and suddenly, it's a vibrant carnival of microbial life. Who knew your spice rack held the keys to biological urban planning? 

3. Psyllium husk: The Fiber Superhero 

The Claim: Psyllium husk can alleviate bloating and promote regular bowel movements. 

The Science: A recent study highlighted that psyllium supplementation improved symptoms of bloating and increased stool frequency in individuals with chronic constipation. PMID: 37979710 

The Mechanism: Psyllium is a soluble fiber that absorbs water, forming a gel-like substance in the gut. This action softens stools, making them easier to pass, and can help regulate bowel movements. Additionally, psyllium fermentation by gut bacteria produces short-chain fatty acids, which have anti-inflammatory effects. 

Consider psyllium husk the janitor of your intestinal tract, sweeping away debris and keeping the halls clear. Just be sure to hydrate, or this custodian might leave things a bit too clean. 

In the grand theater of gut health, these dietary interventions play starring roles, each bringing unique talents to the stage. But remember... gut health still relies on some of those boring foundational basics of general health – sleep, exercise, stress reduction etc! 

P.S learn more about gut health and other health hacks in my book here:

Vitamin D & painful periods... 

The monthly blood sacrifice ritual that turns uteruses into torture chambers – primary dysmenorrhea.

But fear not, for science has stumbled upon a potential savior in the most unexpected of places: vitamin D.  

Now this is not a panacea for health but there is some mechanistic madness behind this potential menstrual mediator.  

Vitamin D, in its active form calcitriol, plays the role of a prostaglandin puppeteer (you know that sneaky chemical which causes pain). It represses the enzymes responsible for prostaglandin synthesis while simultaneously upregulating the enzymes that break them down [PMID: 32512697].

The result? Fewer of those pain-inducing prostaglandins floating around, theoretically leading to less uterine agony. 

But wait, there's more! A meta-analysis of 8 clinical trials showed that vitamin D supplementation could significantly reduce pain intensity, the number of days with pain, and even the need for pain medications in women with primary dysmenorrhea [PMID: 33803407].  

However, before you start mainlining vitamin D like it's liquid sunshine, remember that more isn't always better. This potential period panacea seems to work best for those deficient in vitamin D. So, if you're already basking in a vitamin D surplus, don't expect miracles. It's not a "more D, less pain" linear relationship – it's more of a "just right" Goldilocks scenario. 

Beyond Vitamin D, my delve into researching other evidence based actionables to combat the monthly monster has churned out these: 

1. NSAIDs: The old reliable. They work by blocking prostaglandin production, much like our vitamin D hero [PMID: 35313770]. 

2. Hormonal contraceptives: If indicated for your specific condition and prescribed by a doctor, sometimes the best way to deal with your period is to ghost it entirely [PMID: 35313770]. 

3. Heat therapy: Wrap yourself in warmth like a human burrito. It's surprisingly effective [PMID: 30716460]. 

4. Exercise: Yes, moving when you feel like a stabbed potato can help. The endorphins are worth it [PMID: 30716460]. 

But let's not get too carried away. While vitamin D shows promise, it's not a silver bullet. It's more like a bronze arrow in the quiver of period pain management.  

In the end, managing primary dysmenorrhea is about finding what works for you and as I’ve said before – excessively painful periods is not “normal” and it’s worth getting checked up if you experience debilitating periods on a regular basis. 

P.S I just want to ask you a teeny tiny favour. If you want more deep dives into health topics, press subscribe to the Dr Karan Explores podcast on Apple Podcasts or Spotify: That is the best thing you could do for me! And since most people still discover podcasts from recommendations.. feel free to share an episode with a friend, family member or enemy! 

Something I wish I knew before my 30s... 

For years, I thought talent was everything. That if you were good enough, skilled enough, naturally gifted enough, success would just… happen. 

It took me way too long to realize that’s absolute nonsense. 

Because the cold, unflinching truth is that there is someone out there living the life you want, achieving the things you dream about, not because they’re smarter, not because they’re more talented, but because they had the courage to act when you didn’t. 

And that stings. It stings because it means the only thing standing between me and everything I wanted… was me. 

The worst prison in the world? Wasted potential. 

For most of my teens and 20s, I was stuck in a self-constructed mental prison - a cocktail of overthinking, self-doubt, and grand excuses. 

"I’ll start when I feel ready." (You never feel ready.) 
"I need more experience first." (You get experience by starting.) 
"I don’t have the right connections." (Neither did the people who built them.) 

And while I was busy waiting for the stars to align, someone with half my ability but twice my courage was out there taking my opportunities. 

Because the world doesn’t reward talent that stays inside your head. It rewards action. 

Why your brain keeps you stuck 

Your brain hates uncertainty - it’s wired for survival, not success. The second you step outside your comfort zone, your amygdala (your brain’s alarm system) freaks out: What if you fail? / What will people think / You’ll look stupid... 

This is evolutionary biology trying to protect you from social rejection, which, in ancient times, meant exile from the tribe (and probably death). 

But you’re not in a tribe anymore. You’re in a world where courage is the currency of opportunity. 

The people who succeed aren’t fearless. They just act despite the fear. 

The ancient stoics had a saying: We suffer more in imagination than in reality – Seneca 

Most of the things we fear? Never actually happen. The rejection? Not as painful as you think. The failure? Not as catastrophic. The embarrassment? Fades in days (unless you soiled your pants at school...that might take a bit longer) 

But what doesn’t fade? The regret of never trying and the realization that you were the one keeping yourself small. 

If you take one thing away from this, let it be this: Courage matters more than talent and there is no perfect time because action beats overthinking every time. 

The worst prison isn’t failure - it’s being smart enough to know you could do something great, but too afraid to try. So whatever you’ve been waiting to do… just start. Because somewhere out there, someone with half your talent but twice your courage already did. 

Oh and before I forget here is your free PDF of questions to ask a surgeon (based on what I sent to my cousin!):