Dr. Alia Crum: Science of Mindsets for Health Performance | Huberman Lab Podcast #56 - 2022

Title : Dr. Alia Crum: Science of Mindsets for Health Performance | Huberman Lab Podcast #56 Author(s): Andrew Huberman Link(s) : https://www.youtube.com/watch?v=dFR_wFN23ZY

Dr. Alia's work focuses on mindsets - how what we think and what we believe shapes the way our physiology, biology, reacts to things like what we eat, stress, exercise etc. For e.g. what one believes about the nutritional content of the food they eat changes how that food impacts their brain and body - same with exercise, stress and medication.

As the podcast continues, keep the following in mind:

• What is my mindset about (food/stress/exercise/relationships/medicine/intelligence etc)

Dr. Alia (Allie) defines a mindset as "a core beliefs/assumptions about a domain or category of things that orient us to a particular set of expectations, explanations and goals" - or, just an assumption made about a domain. For e.g. viewing stress as enhancing/good or debilitating/bad orient our thinking and change what we expect will happen to us when we are stressed , how we explain the occurrences that happen when we are stressed, and the motivation for what we engage in when we are stressed. Another e.g. is growth mindset, i.e. if we are not proficient at something, thinking that we are not proficient yet, that we are on the path of proficiency.

Just thinking whether intelligence is malleable or not are consequential, they matter in shaping our motivation which eventually helps.

Allie's work is more on expanding the range of mindsets and the effects they have, specifically in health and health behaviours - e.g. thinking that healthy foods are disgusting vs. delicious.

Mindsets have an impact whether they are true or not, through physiological mechanisms, (by changing what our bodies prioritize and prepare to do) on top of the motivational mechanisms mentioned earlier.

Mindsets about illness - e.g. viewing cancer as an unmitigatable catastrophe, vs. viewing it as manageable, or viewing side-effects as a sign that treatment is harmful vs. viewing it as a sign its working.

A lot of these questions such as "does the belief about what a person is eating change the body's physiological response to that food, given the objective nutrients of the food are the same" may sound weird but from the perspective of placebo research it is not - in fact we have more evidence for placebo effects than any other drug.

The milkshake experiment: People were given milkshakes with vastly different nutrient concentrations designed to meet their needs. At one time point, they were told the milkshake is high in fat and sugar, is 620 calories. The other time point, they were told it was a diet shake low in fat and sugar and is 140 calories, while in reality they were both 300 the same milkshake with 300 calories. The ghrelin hormone (hunger hormone) which theoretically drops in proportion to the calories consumed. The high fat milkshake made the participants' ghrelin levels fall at a x3 rate stronger compared to the other milkshake, i.e. the high fat milkshake made the participants' respond as if they had more food, even though it was exactly the same milkshake in both cases. This shows that what you believe has a physiological effect (#TODO Check for reproducibility of results). A counter-intuitive result: Saying to oneself "I am healthy" may sound like a good mindset, however it was too simplistic way of thinking about it as it made them feeling hungry (they were not satiated) - so to maintain/lose weight the best mindset is to think that you are getting enough food.

On the other hand, when people are for e.g. told about side-effects, they are more likely to experience the side-effects. Not just physiology but also attention can also change, e.g. noticing fatigue, headaches etc. after taking some treatment which they are told has these as side-effects.

Hotel workers' study: Housekeepers who were doing a lot physical activity in comparison to the general public were asked how much exercise they do, a third replied 0 and the average response was 3/10 on the scale 10 being a lot of exercise. After randomizing them, into 2 groups, with 1 group being educated on the fact that they were doing a good amount of exercise. In 4 weeks, the educated group (which did not change their behaviour by exercising more/changing diet) had lost weight, decreased systolic blood pressure by 10 points on average and were feeling better (c.f. to the other group).

Think of mindset and being mindful as an extra on top of the exercise/eating etc. I.e. both the behaviour and the mindset about it matters, do them in a mindset of satisfaction and enjoyment.

In the general public sphere, stress is treated as unequivocally a bad thing. However in the literature, encountering stress i.e. encountering adversity or challenge in one's goal related efforts does not have to be debilitating, in many cases it narrows our focus, increases attention, speeds up rate that we can process information, gives physiological toughening where the release catabolic hormones and the stress response recruit and activate anabolic hormones which help build muscles, build neurons to help us learn, in addition to post-traumatic growth leading to a sense of joy and passion for living. In short, the true nature of stress is a paradox.

Viewing stressors more as a challenge than a threat leads the brain and body to respond more adaptively. Going one step above, we can think about the nature of stress, viewing stress as something that is bad and should be avoid vs. something that is natural and will enhance. This higher-order mindset about stress is quite important - the enhancing mindset correlates with better well-being and higher performance. The RCT to test this hypothesis involved dividing participants into 3 groups, one group is not shown anything, other 2 are shown 2 types of documentaries on stress with differing mindsets albeit both having factual information - the question here is does orienting people to different mindsets change how they respond to stress. Results indicate that 9 minutes of videos over a week led to changes in physiological symptoms associated with stress, with people who watched the enhancing films had fewer back aches, muscle tension, racing heart, insomnia, and reported performing better at work. Interestingly, no one was made worse by the debilitating films.

Having a "stress is enhancing" mindset does not mean the stressor is a good thing. It means that the experience related to the stress could lead to enhancing outcomes with respect to our cognition, health, performance and well-being.

People inspired to adopt more enhancing mindsets have more moderate cortisol (stress) response, and higher levels of DHA in response to stress.

Allie thinks of mindsets as a portal between conscious and subconscious processes.

Clarify our definition of stress. Decouple stress from negative consequences, and think of stress as a neutral effect of experiencing/anticipating adversity/challenges in goal-related efforts. We only stress about things that matter to us, which is an important thing to notice.

The most adaptive way to deal with stress/leverage stress to our advantage (in contrast to fighting against it) is to:

• Acknowledge you are stressed, be mindful of it.
• Welcome the stress.
• Utilize the stress response to achieve what you care about instead of spending effort to get rid of the stress.

When stressed, do not:

• Try to stress about the stress.
• Attempt to check out from the stress.

Mindsets are influenced by:

• Upbringing, e.g. via how our parents taught us to manage stress.
• Culture and Media e.g. movies, podcast, social media etc.
• Influential others e.g. doctors, friends.
• Conscious choice - we have the ability to change our mindsets.

Peanut allergy treatment experiment: Telling the children about the positive mindset that the negative symptoms and side-effects were a positive signal that the treatment is working and their bodies were getting stronger had led to reduction in anxiety, fewer symptoms and also better outcomes.

Effects of placebo were thought to be expectancy based (i.e. expecting to get a benefit then getting it), but the mindset approach is more powerful since it helps us understand the mechanisms better.

Best way to learn and teach mindsets: Focus more on helping to adopt more adaptive mindsets than making them do certain things. Communicating that stress is natural, and going through stressful experiences can help them grow and be a more connected and happier individual.

How to change mindsets:

• Be aware that we have them, that our beliefs are not unmitigated reflections of reality as it objectively is, that they are filtered through our interpretations, expectations, frameworks and simplifications of that reality.
• Start to think about the effects of those mindsets are (i.e. play out the story) e.g. if one has the mindset that stress is debilitating, how does it make you feel? What does it lead you to do? Is it helpful or harmful? Then seek out ways to adopt more useful mindsets.

Ask yourself: What is my mindset about _? Think of the mindset as just one piece of the puzzle, and find the mindset that suits you for the task.

What drives Allie is the burning question "What is going on here (with placebo etc) and what more can I do with the power of my mind?".

Mindsets are powerful to the extent that it motivates us that engage in behaviours that make stressful situations manageable.