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September 18, 2018

Filed under: #health4all — Dr. Phil @ 3:40 pm

Healthy Living Advice for the Whole Family.

Our health is our freedom to live a life that we have reason to value, and our ability to bounce back when our circumstances change and life kicks us in the teeth. Both of these elements of health are more likely to happen if we try to adopt daily habits that are fun, good for us and rewarding. One way to remember them is the acronym CLANGERS, which depicts 8 daily vitamins (and joys) of health.

Try to do your CLANGERS every day, as part of a regular routine 

  • Connect
  • Learn
  • (be) Active
  • Notice
  • Give back
  • Eat well
  • Relax
  • Sleep

In 2008, research by the New Economics Foundation and funded by the government, came up with five evidence-based steps we can all take to improve our mental wellbeing. Connect, Learn, be Active, Notice and Give back (CLANG). I built on this to come up with a plan for ‘whole-body wellbeing’ by adding Eat well, Relax and Sleep. These are the fundamentals of feeling good and, if you can do them at regular times to fit in with your body’s natural 24 hour rhythm (particularly eating, exercising and sleeping), it should improve how you feel and your energy levels.

CONNECT with the world around you. Human beings are social animals. We are leaves on a tree, needing to feel part of something bigger. Reach out to people, pets, plants, places and the planet.These connections are the cornerstones of our life. Take time and care to nurture them. Disconnection and loneliness may be as bad for us as smoking. And don’t forget to connect with yourself. Loving yourself may not always be easy, but are you happy in your skin? Do you enjoy your own company? Can you disappear inside your own head and not mind what you find there? People who like their own company like being on their own sometimes. You have space to think, reflect, explore and relax.

LEARN What do you want to do with your one wild and precious life? A purpose in life often stems from learning about what matters most to you, developing a passion for learning and keeping your curiosity alive. And there is good evidence that the more you learn, the better your health becomes. Try something new. Rediscover an old interest. Sign up for that course. Join a choir. Take on a different responsibility at work. Fix a bike. Learn to play an instrument or how to cook your favourite food. Develop new passions. Set a challenge you will enjoy achieving. Learning new things will make you more confident as well as being fun. And learning with others in your ‘circle’ often cements the skills and gives you confidence to use your new knowledge.

Be ACTIVE, in mind and body. Rediscover activities and passions you left behind, and have the courage to try new ones. Aim for five portions of fun a day, each different, at least one outdoors and one that involved getting pleasantly breathless. Being outdoors in the morning light wakes you up and helps you sleep well later. Gardening, dancing or singing in a choir are all excellent therapy. Physical activity is better for both mind and body than any drug, but keeps you awake if you do it too close to bed time. Choose activities that you enjoy, so you want to keep doing them. Park runs, dancing, singing, cycling and gardening are great examples. And let’s not forget the power of pets. They are usually happy to see you and . give you unconditional love when you are feeling at your lowest and least energized.

NOTICE, and be present in, the world around you. Try to be as still as you can be for fifteen minutes every day, preferably outside. Fill up your senses. Catch sight of the beautiful. Remark on the unusual. Enjoy the everyday. Savour the moment, and your place in it. Life is a balance and being and doing, and the older and wiser we get, we realise that most of the pleasure in life comes from just being. Notice how lovely your partner or children are without judging or diagnosing them. Simply slowing down and focusing on your breathing for ten minutes a day can pay huge dividends. Breathe in for 3, hold for 4 and out for 5. Feel those fabulous human air bags filling up to their fullest extent. Then slowly, slowly let it all out.

GIVE BACK. Helping and caring for friends, strangers and those less fortunate than ourselves is fundamental to good emotional health. It cements us as part of a community and develops more meaningful connections and insights. A friend of mine overheard a dad telling a waiter in the Glasgow hotel that is son was having chemotherapy in the nearby hospital, and that he was going to shave his head in solidarity so they would both be bald when they came down to breakfast in the morning. He wanted to warn the waiters so they didn’t feel uncomfortable. The head waiter said he would pass the message on. When the newly bald father walked into the restaurant with his son the following morning, they looked around and saw that every single waiter had shaved his head. The joy of being human is to be humane.

EAT WELL. Food is above all a pleasure. Learn what’s good and enjoyable to eat, and in what quantities. Learn how to grow it, where to buy it and how to prepare it. Set time aside to sit and eat with friends and family. Your gut is like a garden. It contains trillions of healthy bacteria that are as fundamental to your health as your DNA. Many people with chronic diseases have a fairly narrow range of bacteria in the gut. Healthier people seem to have a wider range of bacteria fed from a wide variety of different foods. Eat plenty of plants – vegetables and fruits of many different types and colours, nuts, seeds, whole grains and olive oil. Add in a little bit of what you fancy.  Sustainable fish, lean meat, dark chocolate and  the odd beer or glass of wine (note: alcohol can improve your chat but seriously disrupt your sleep). You can have the odd Pringle but you wouldn’t plant too many in your garden.  Cutting down on sugary snacks and drinks, processed food is a good starting point. Learn to love water as your ‘go to’ drink. And try to do all your eating in a 12 hour period (say 7am-7pm) to fit in with your body clock, give your gut a break and improve your sleep. It also keeps you at a healthy weight

RELAX. Take time to rest and reflect on the day you’ve had, reliving and re-savouring the happy memories and having gratitude for friends and family. Learn to meditate. Be kind to your mind and let it wind down and de-clutter. My Uncle Ron used to have a sitting room that was just for sitting. At the end of the day, he would really happy little things that have happened during the day, and be grateful for the love he had in his life. I used to think he was crazy, but I now know he was practising positive psychology. Our brains are neuro plastic, which means what we focus on is what grows. So if we learn to relive happy moments and have gratitude for the good things, it can actually make us happier. And this happy end of day wind down can really improve your sleep.

SLEEP Good sleep is one of life’s great joys. It’s also essential for mental and physical health, helping you prevent and recover from a whole range of illnesses and improving your energy levels, creativity and performance. The flip side is that sleep deprivation prevents you from recovering from many illnesses, and it’s the first and most important thing to concentrate on. Adults work best on a regular 8 hours sleep a night, adolescents need nine hours if possible and children need more. Half the population in the UK have poor quality sleep and feel more tired, more stressed, less energized and more anxious as a result. If you’d like to find out more about the importance of a normal sleep pattern,  I would recommend Why We Sleep by Matthew Walker or the The Four Pillar Plan by Dr Ranjan Chatterjee. Dr Chatterjee also hosts some excellent podcasts on health.



 The CLANGERS you can do when you’re ill will be very different from the CLANGERS you do when you’re well, but they are equally important

Severe fatigue often happens to previously very active people. As one of my patients put it; ‘It’s like I used to have Duracell batteries but now I have Poundland batteries.’ If you overdo your activity, you can boom, bust, crash and take days to recover, which is why you have to use your energy wisely, and switch to rewarding activities that are less exhausting.

One young man played football for Bristol City but got severe fatigue after glandular fever and had to stop, which was a crushing disappointment. His Dad encouraged him to take up the guitar – a much less energy-draining hobby – and he gradually taught himself to play, finding the strumming very therapeutic. He has now fully recovered, formed a band, played a gig at the Fleece and Firkin in Bristol and made an EP. He sent me a lovely letter saying how much he loved his music and if he’d never have had severe fatigue, he’d never have picked up the guitar in the first place. Sometimes doors close in life, but another door opens.

Severe fatigue can be caused by many things, such as sleep deprivation, stress, anxiety, low mood or just about any illness, including Chronic Fatigue Syndrome/ME, which is a physical illness that may be triggered by an infection, or repeated infections, or other stressful events. Sometimes there is no apparent trigger, and there may just be a strong genetic predisposition to fatigue. A nutritious diet is essential for all of us but with severe fatigue you may find little and often is easier than eating big meals. Try to do your eating in a 12 hour window, and not late at night. It’s also important to try to optimise your sleep. As a teenager, this means trying to get 8-9 hours good quality sleep at the same time every night, including weekends, and trying to avoid oversleeping (you get no extra benefit unless you are sleep deprived) and afternoon catnaps (which, beyond half an hour, can interfere with the quality of your later sleep). Adults  of all ages function best after 8 hours sleep

Teenagers have it tough because their body clock shifts to make their natural going to be time later (11 PM onwards) but school demands that they get up early (often 6.30 am or before). So many are sleep deprived and stressed-out for no fault of their own. Severe fatigue on top of early school wakening is a double whammy.  It is far more important for your health and recovery to fiercely protect the 8-9 hours sleep and aim to get to school at morning break at the earliest, until you have fully recovered

A high quality sleep routine that fits in with your natural body clock is absolutely vital to recovery. Below are 25 tips for better sleep, not all of which may work for you, but they may start your journey to recovery. A normal sleep pattern can improve memory, energy, pain and many other unpleasant symptoms.


  1. Try to go to bed at the same time and – most importantly – wake up at the same time each day, including weekends, even if you have had a bad night. This may not always be possible. Aim for a ‘non-negotiable’ 8 hours sleep every night as an adult, 9 hours as an adolescent. This isn’t easy, so decide which timing works best for you and your daily functioning. You will need to ensure 8.5-9.5 hours in bed to give you adequate nodding off time. Keep a sleep diary if this helps.
  2. If this routine goes wrong, don’t beat yourself up. If you don’t get good, refreshing sleep you will build up a sleep debt that has to be paid off on days off. And if your red (high) energy allowance is set too high, you will sleep longer or more deeply to try to recover
  3. If you are asleep all day and awake at night, treat this like jetlag and cut back your going to bed time and your waking up time by 1 hour each day. Day One: 6 am sleep 3 pm wake Day Two: 5 am sleep, 2 pm wake Day Three:4am sleep – 1 pm wake etc until you wake at the desired time.
  4. Have the right sunlight exposure. Daylight is key to regulating daily sleep patterns. Try to get outside in natural sunlight for at least thirty minutes each day. If you aren’t sensitive to light wake up with the sun or use bright lights in the morning. If you have problems falling asleep, you should get an hour of exposure to morning sunlight and turn down the lights before bedtime.
  5. Enforce a strict ‘no caffeine after noon’ rule. Coffee, colas, certain teas, and chocolate contain the stimulant caffeine, and its effects can take as long as twelve hours to wear off fully. Nicotine in cigarettes and e-cigarettes, and alcohol also severely disrupts your sleep, as can some medications. Check with your pharmacist.
  6. Come off close-up screens and games 60-90 minutes before bed. The blue light and excitement they give off boosts cortisol and blocks melatonin release.
  7. Set an alarm to tell you when it’s time for bed, and stick to it. Alarm clocks in the morning freak out your heart and are best avoided if possible.
  8. Fit blackout blinds in your bedroom. The darker your room for sleep, the better. A black-out mask is a cheaper option
  9. Remove ALL screens from your bedroom, so temptation is avoided.
  10. Consider opening the bedroom window. The perfect temperature for sleeping is around 17ºC/ 65ºF. A cooler room is much better for sleeping than a hot one
  11. Eat earlier in the day, before 7 pm if possible. Don’t snack at night.
  12. Exercise earlier in the day, and outdoors when you can. Exercising 2 hours before sleep time raises your metabolic rate and temperature, and makes it hard to sleep
  13. Socializing is important but don’t do it late at night except on special occasions.
  14. Consider red lights for night-time illumination
  15. Consider amber glasses to filter blue light from screens
  16. Don’t use your phone as an alarm clock
  17. Install f:lux on your e-devices, or switch on ‘night-time mode’ from 6pm
  18. Don’t take catnaps after 3 pm and keep them short, ideally less than 30 minutes. And keep the curtains open. You are not trying to fall into deep sleep as this disrupts the next night’s sleep, but trying to have a quick refresh.
  19. Relax before bed. Don’t overschedule your evening so that no time is left for unwinding. A relaxing activity, such as reading, listening to music, chatting through the day with friends or family or stroking a pet should be part of your bedtime ritual.
  20. Take a hot bath before bed. The drop in body temperature after getting out of the bath may help you feel sleepy, and the bath can help you relax and slow down so you’re more ready to sleep.
  21. If you can’t sleep, counting sheep isn’t as effective as repeating the same word over and over (the, the, the, the…) or filling your mind with peaceful music
  22. Don’t lie in bed awake. If you find yourself still awake after staying in bed for more than twenty minutes or if you are starting to feel anxious or worried, get up and do some relaxing activity until you feel sleepy. The anxiety of not being able to sleep can make it harder to fall asleep.
  23. Keep trying to improve your sleep, little by little. It’s about quality as much as quantity
  24. We all have bad runs of sleep, particularly in stressful times, but if we allow ourselves to get back in synch with our body clock, we may rediscover the joy of a good night’s sleep
  25. Some drugs may appear to help you sleep but your sleep quality will be better if you can manage without them, so try these tips first, keep a sleep diary and ask your doctor or nurse to review your progress.