Dr Louise Newson: [01:00:00] Sarah Ann Macklin is a guest on my podcast today. She's recently brought a book out called Healthy Shouldn't Be This Hard: a simple way to eat, think and feel well. We all often know what we should do, but actually putting it into practice can be difficult. We also talk about how the longevity and wellbeing space is worth a fortune, but are we really spending our money in the right ways? Sometimes making it very basic can really make the biggest difference. So we talk a lot about how we can improve our health in simple ways.  [01:00:34][34.6]
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Dr Louise Newson: [01:00:37] So you're in my podcast. Last time I was in your podcast and you've now written, and I love the cover.  [01:00:43][6.6]
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Sarah Ann Macklin: [01:00:44] Do you? [01:00:44][0.3]
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Dr Louise Newson: [01:00:45] It's really cool. So it's called Healthy Shouldn't Be This Hard. And what I really like is this, like you've got a list where everything's crossed out. And actually it says a simple way to eat, to think and feel well. And I really liked the think bit actually. I'm really controlled by my mind a lot. I like my mind and I don't like it because it just gets a bit overwhelming. So this is a really, really important book and I love it and it's very easy to read.  [01:01:13][28.6]
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Sarah Ann Macklin: [01:01:14] Thank you.  [01:01:14][0.3]
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Dr Louise Newson: [01:01:15] So welcome really. So for those of you that don't know you, just tell me a bit about you and your background.  [01:01:21][6.5]
Sarah Ann Macklin: [01:01:22] Okay, well, thanks for having me. It's nice that we have swapped seats. Yeah, and the cover, it's quite provocative, I think, the cover. My background is, all the way back to over 20 years ago, when I had a completely different world, a completely life. I was an international model for many years. I got spotted at 16 and at 18 when I finished my A-levels, moved to London, and I was very lucky that I had this amazing career. But, there's always a but, isn't there, at 23, I kind of had, I was admitted to hospital and my body basically stopped, it kind of, all the signals that were sending me over those years, I ignored and I ended up hospitalised with a whole host of things like urosepsis to E. coli to 10 burst cysts and, and yeah, it was life threatening. I mean, they had to helicopter the only antibiotic left from Scotland down to me within 12 hours or I would have passed. And so I think like that was quite a pivotal moment, quite young. And there's multiple diagnosis there and you have so many different consultants, but my diagnosis many years later was that I shut off every signal my body ever sent me because my mind was incredibly strong and overrode everything. And that sent me on like a huge path. And if you think, you'll know this, but you know, 20 years ago, health and nutrition was not mainstream. Mental health was massively stigmatised. It only really started changing in COVID when everyone started to realise that mental health isn't always a mental illness. It's everyone has mental health and we all need to kind of look after it. And so I kind of went down the road of, I'm not well, I need to figure out how I look after myself. And went back to school and studied nutritional science. Everyone thought I was mad. Totally mad.  [01:03:12][109.9]
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Dr Louise Newson: [01:03:13] Did they?  [01:03:13][0.0]
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Sarah Ann Macklin: [01:03:13] Yeah, because I was living the "dream", I would say, although obviously I wasn't because I was hospitalised. But you know, the word success is quite an interesting one to define, which you know the Oxford dictionary describes it as fame, wealth and social status. And so like, externally, I had that right, but internally, I have none of it. So I went back to school and everyone's like, what are you doing? Like you had all, you know making all this money living in New York, you kind of got this great life, but I was the unhappiest I ever was. And when I went back to school to study nutritional science, within six weeks, I went to drop out and my professor said, why do you want to leave? And I was like, I'm just not very smart. Like I'm really not smart. And I don't think that like I can do this. And she did something extraordinary, which I'll always remember. She looked at me and she said well why would you say that? I said, well, you want me to give a presentation in two weeks in biochemistry about this thing called the Krebs cycle that I don't even know what that is. And I was so overwhelmed in class. And she said, okay, well here's something that I've picked up within like you just starting uni. I think you're neurodivergent, I think that you have dyslexia. And I think once you can understand your brain, you will really enjoy this degree.  [01:04:28][75.0]
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Dr Louise Newson: [01:04:29] How wonderful, she said that.  [01:04:30][1.0]
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Sarah Ann Macklin: [01:04:30] She was amazing. And I just looked at her and I was like, what is dyslexia? I'd never heard of this. Anyway, so she sent me, she said promise me, please don't drop out. Just do this first. You don't have to do the presentation and then let's like kind of regroup. So she gave me a lot of compassion in that moment. And then two weeks later, they gave me the diagnosis of dyslexia, which sounds like a terminal illness when you're like I was diagnosed with, and it kind of feels like that at the time, right. And then the woman who diagnosed me said, this is going to ultimately be super power. And she really helped me understand my brain. And that gave me a huge connection to wanting to know more about the mind and nutrition. Because then for me, I was like, well, this is something that really affects me. And I'd realised that, you know, my mindset had also really affected me through modelling. And so that sent me down this like long path wanting to know everything about nutrition and the mind. And then once I got there, I wanted to know more about the mind and that sent down another long path. I started the podcast, Live Well, Be Well. And after five years, I kind of got to the emphasis of this book, which for many people, who listen to this, who I'm sure are English, will have the cringe when I say the word self-compassion. But I realised, one from that professor telling me to not give up, that was compassion mirrored to me, that ultimately I had no self- compassion. And actually we can have the healthiest diet in the entire world. But if you do it whilst you're hating yourself, you won't get the same result. And it's the same with everything. And so I had to learn the steps towards what self-compassion really meant. And especially being English, there was a huge kind of friction for me to have that word. The Americans love it, but the English really struggle. And, you know, what I realise is it's the antidote to so much of that, kind of controls us and to kind of makes us make the poor health choices or increases our stress hormones, which increases inflammation, turns on our threat response in our brain, which we know is like not healthy and we're always living in this chronic stress. And we know all of these things, but for me, it was like, how do we break that cycle. How do we actually look after us first and so that's where kind of my journey is today talking about this. [01:06:40][129.7]
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Dr Louise Newson: [01:06:41] It's incredible though, isn't it because it is so important and I'm, as you probably know, really interested in inflammation because it's the core of so much and how we can reduce inflammation will keep us healthier. And we've known for many decades that mental health is associated with inflammation in the brain, yet so often people are just given chemical drugs to help or not help, depending on how you look at the research. But I think, like you say, people are thinking about mental health differently and I was one of those doctors in the early 2000s that prescribed a lot of antidepressants because I was taught that's what you did. And I thought giving Prozac was the best thing ever until I realised the harms of some of these drugs. But we need to be thinking within how we can help because mental health is our brain. It's not an organ that works on its own. You know, once we discovered the connection of the gut and the brain, everything feeds into the brain. The brain tells our whole body what to do and a lot of people don't join the dots and I don't think doctors join the dots either which makes it even harder for laypeople to try and get help from a medical professional.  [01:07:49][68.5]
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Sarah Ann Macklin: [01:07:51] Yes, totally. I think there's a part of the book where I talk about SSRIs, it's very brief, but you know, there was a study, the first study that I came across that connected the mind and the body was Dr felice Jacka, the SMILES trial, which was like a renowned kind of pioneering study at the time, which actually showed that, and this is the food first step, that food can reverse clinical depression. So she put participants on a modified Mediterranean diet, which basically just means an extreme version of the Mediterranean diet, like five to eight portions of whole grains a day. So they had no room to eat anything else. And what they found is that after three months, 33% of the participants overcame clinical depression. And I was like, oh, wow. So the food really does influence the mind. That's the gut going up to the brain. Then there was this really interesting controlled group. And I've spoken to Felice Jacka on the show and we still didn't even speak about this, but 8% of the controlled group also overcame clinical depression, now this is people that had been in clinical depression for years. They went into remission. Now that 8% was the control group, but the only thing they had was a befriender. So it wasn't a therapist. It wasn't someone they went in and spoke about childhood traumas to, what went through their whole life. It was something that they did with a befriender that they enjoyed. Something that kind of took their mind off and allowed them to have some joy in their life. And I was like, that's interesting. Imagine if they put that group with the food together. Imagine if there was a study that could see, would we even get better results. And I think about that. And then I thought about Dr ellen Langer, and I don't know if you've heard of her. She's the kind of pioneering woman at Harvard. She's like the first ever woman to come out of Harvard. And she did this incredible study called the Chambermaid study, which then really changed my perspective. So I was only looking at food and mental health for such a long time. And then when I spoke to her, she told me this really interesting study about chambermaids. Where she asked, you know, how often do you exercise? And they all just looked at her and they were like, well, obviously never. I never have any time. And she said, okay, well, I'm going to split them in half. I'm gonna tell one half of that group that this is how much energy they expend from mopping the floors, changing the bedding, hoovering, all of the things that they do on their feet all day and I'm actually going to show them how much exercise they're doing. The other group, she said nothing. And said, Okay cool, just carry on. One month later, the ones that had been told that they were doing a lot of energy expenditure. They lost weight around their waist circumference, which we know is the most important metric for our health. Their blood pressure reduced by 10%. They had so many different changes to their overall health just from telling themselves that they were actually doing enough. That they were actually doing as much as somebody who was going to a gym class. And that made me then think, oh, I wonder what that happens if we relate to our health? I wonder if our mindset also influences the food we consume? And then the next study that came along was Alia Crum and this kind of takes me to like the connection with the mind and body where she did the milkshake study and that was small. There was only 46 participants, but I found it really fascinating because I would always go and order like a skinny hot chocolate. That was always my natural order. I could never go, I'm going to go and have like the delicious, luxurious, full fat, all sugar hot chocolate, I was like absolutely not. And I read this study and she basically gave two groups a milkshake and she said one was indulgent and one was diet. And she said, this one has over 600 calories. This one has around 160 calories in the diet. Then when they drunk the milkshake, they both hormonally responded completely differently. The hunger hormone actually went down in the one that was indulgent, which meant they felt fuller and the one was that diet that hunger hormone didn't, yet the milkshakes were both 300 calories. They hadn't, they hadn't had the differences of 600 to 160 calories.  [01:11:46][234.8]
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Dr Louise Newson: [01:11:46] They had just been told that.  [01:11:47][0.8]
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Sarah Ann Macklin: [01:11:47] Exactly. So it was their perception, their mindset with the food. So when I started to put all these studies together, I was like, well, we do know food influences mental health, but that can't be the only connection. Our mindset is also bi-directional. We know it changes our gut microbiome, but it's also changing how we respond to food, the choices that we make, how we see that, how even full we feel it's changing. And so I thought, I feel like we've got a bit of this backward. I feel like before we put food on a pedestal, we also need to put the mindset there as the foundation because I was seeing clients come in and just taking their biomarkers and looking at a food diary, for me, I felt like I was banging my head against a wall a little bit. I was like, what if we reverse that? Start with the mindset and then we add the diet on top. Surely that's a much stronger foundation for long-term change and how they see themselves than just the food itself. And so I think, you know, the connection between the mind and body is, you know, the gut as you said, has exploded off over the last 10 years. And I think this is where it's going to be going with the mindset, the mind and the body connection. And we know it's so important, but we haven't quite created the tools. And now we live in what is predicted to be next year, which I find mind boggling, the wellness industry is predicted be $8.5 trillion.  [01:13:07][79.5]
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Dr Louise Newson: [01:13:08] I read that! [01:13:08][0.2]
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Sarah Ann Macklin: [01:13:09] Isn't that wild! [01:13:10][1.0]
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Dr Louise Newson: [01:13:09] It's just crazy. But then isn't that people making money out of people who just want to feel well. And I felt really sad because I read it and I thought maybe it's a misprint and it was billion not trillion. And then I read this again and I think what I'm really very sad about as a healthcare professional is that a lot of healthcare professionals are letting down their patients. So they're going elsewhere. But often in medicine and in life, it's the basics. You know, we need to look after ourselves and I think there's so much words that scare people or means that something different, even longevity means different things to different people. Self-compassion, people think, oh, that's a bit woo-woo. But actually, let's just put ourselves first. If we're healthier, we can look after other people better. My oldest daughter, many people know has chronic migraine and I'm constantly going down to the flat that she lives in in London and I'm cleaning and tidying and cooking for her. If I'm not well, I can't do that. And I have to be able to look after her because it's not fair, you know, on others. So it's my incentive, but I should be doing that anyway because I've got two other children and I want to be healthy for work and everything else. But somehow if I call it self-compassion, I feel like it's really selfish. But if I'm there saying, no, I've got to be well for my children, it feels like I can say that. But I shouldn't have to justify it to anyone.  [01:14:33][83.4]
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Sarah Ann Macklin: [01:14:33] It's interesting, right. [01:14:34][0.5]
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Dr Louise Newson: [01:14:35] We all know that when we do really basic things that don't cost lots of money, eat healthily, sleep, you know, reset in a better way, have a positive outlook, it makes a big difference. And I feel sad that people are spending so much money and they're not doing the basics.  [01:14:51][15.6]
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Sarah Ann Macklin: [01:14:53] Well I think that what that dissects right, is it's going to be $8.5 trillion, well predicted to be in the next year. I think it's since I've written the book even gone up now to $9 trillion. But I think what that says is that ultimately we all want to be healthy, right. Ultimately, I wanted when I was 23 to have the glowing skin and I probably didn't. I just didn't see myself in that way. So I would buy everything under the sun to make myself feel better. And that is where health's come to now. We're all kind of trying to pedal like the optimisation culture. What does optimal even mean. Like we don't even have a measure for it. And as you said, longevity is a massive buzzword. And I think when it comes to self-compassion, it's so, I find it so fascinating because Oliver Burkeman always said, if you feel the cringe, lean into the cringe. That's where you're work is. And, I remember him saying that to me in a podcast and it's when I was writing this book and I was like, because I feel it as I'm writing it, right. I feel the cringe. I don't feel it anymore. I mean, I still always have work to do, but I think the interesting thing is that it's not about like loving yourself. It's not about putting yourself above anyone else, it's actually the complete opposite. It's about treating yourself with kindness that you would as a friend. So when someone comes to you and asks for advice, we all seem to be very wise in those moments, right. We can all like extend it really easily. But when we flip it back to ourselves, it's really difficult. And that isn't selfish. Like actually reducing friction and reducing like the heavy mental load and the rumination and the thought loops and the negative self-criticism actually isn't helpful. It's actually, you know, it's not... If you did that to friends, you wouldn't have any friends. There's no-one would want to be around you yet when it's in your head, it seems to be completely justifiable. And I think that's the most important thing about self-compassion is that it's about stepping into the uncomfortable moments. That is what self- compassion is. Because you know the thing that I have around positive thinking when I started to uncover all of this research, because for me, self-compassion was, was Buddhism, it was very Eastern philosophy, I was like, beautiful to read about, but not very scientific. And at the end of this book, there was a meta analysis of 113 studies that came out to say that self-compassion is one of the most protective factors for psychological wellbeing. And I was like, why do we not speak about this because it's free. You know, it's free to do. It's harder to do because you have to do a little bit of mindset work, but it's free. And ultimately treating yourself as you would a best friend is so essential for our long-term health and wellbeing. And that's kind of what this meta analysis showed. I was so annoyed that I finished the book and couldn't put it in there. But it just kind of, for me, with all the research that I did, it kind of really brought everything together just to go, actually, there is so much research behind how it increases your motivation, how it helps you reach your goals better, how it help you sustain long-term healthy habits, how it massively reduces your stress response. Like there's so many incredible outcomes to using self-compassion. It doesn't mean it's going to be easy, but I think we've got to change the relationship and if it feels really uncomfortable, there's a reason that that feels uncomfortable. And I think it's also important that I speak a lot about compassion fatigue in there. And you saw this with doctors in COVID, where they were extending themselves so much that actually they really struggled and found it even harder to give themselves self- compassion. So I think it's about meeting yourself where you're at with your capacity. The more uncomfortable it is normally means the more work there that needs to be done. And I think that's really important because a lot of people now will not label things like self-esteem as a good metric for psychological wellbeing because self-esteem will put you, your self-esteem will rise if you do better than others and your self esteem will lower if you feel like you're beneath someone else. So for instance, releasing this book, if my book smashes other books, my self-esteem goes way up. If my book plummets under loads of other books, my self-esteem goes way down. So it's a really unhealthy metric because you're basically always pitching yourself towards external things in society, whereas self-compassion is inward. It's more about kind of like acceptance of how you're feeling in that moment. Whether it's pain, whether it's happiness, like whatever it is, it's about having the acceptance of where you are and then taking the next step. As you would say to a friend, this is what I would do to support you. And that is always a really hard shift, but I think it's a really important one to speak about because it's not, go and love yourself. Because it's the opposite. [01:19:20][266.8]
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Dr Louise Newson: [01:19:20] No, it's different isn't it? But it is very difficult because most of us have got insecurities. Most of us don't see the things that other people will see in us as well. I'm a very negative, inward looking person and I don't do it because I want support from people, but I find it really hard to like myself in the right way. And it's quite, it's a very difficult, I'm happy to look after myself, but I'm not happy to think about myself in a positive way and it is the way I've always been, but it's, a big mind shift for a lot of people, isn't it? [01:19:52][31.6]
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Sarah Ann Macklin: [01:19:52] It's really big and I think it's also different to positivity because when I'm sad, I'm sad. When someone goes, oh just think positive. I want to slap them. I'm like, I haven't thought about that. Like, of course we all want to be positive, but that's also not the natural way to be. That's not the human existence. You can't always just be positive you're also missing out on a range of amazing emotions. So I think like compassion is about acceptance. That's kind of what it comes down to. It's about the acceptance of like, sometimes I am really critical, but it's about taking the step, what can I do to make myself feel less critical. What can I to not beat myself up every day like what is going to be the best thing for me. And it's like the advice you would then extend to a friend, like what you would say to a friend of like well, why am I always so critical? We'd probably be like, have a conversation about it. And that's self-compassion. It's kind of giving yourself a bit of flack, like, okay, I've been like this for a really long time. Like, no wonder why I'm still stuck in this cycle. You know, it's kind of like acknowledging where you're at.  [01:20:56][64.2]
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Dr Louise Newson: [01:20:57] So then you can do something about it as well.  [01:20:58][1.4]
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Sarah Ann Macklin: [01:21:00] So then you can do something about it rather than just being like, well, I'm always going to be this way. Because then you kind of don't move forward. You kind of, don't take any action. But also if you just like push it off, it just suppresses it. So compassion is about like nurturing and moving.  [01:21:13][13.0]
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Dr Louise Newson: [01:21:14] Which is so important. So what have people, the feedback that you've had so far from the book, obviously it's doing well, but what feedback have you had? How have people changed or improved?  [01:21:24][10.0]
Sarah Ann Macklin: [01:21:25]  Well, I think a big thing, one, I think people resonate with the title, Healthy Shouldn't Be This Hard. I think people are exhausted right now. I think I felt exhausted writing this as someone in the healthcare industry, you know, as someone who talks about this all the time. I was like, why is this so difficult? So I think one, people have like connected to a little bit of like relief around there's like not another protocol that needs to be done. Secondly, I think for many people, they've also connected to their own negative self-taught that they've had in their mind that they're very unconscious of so there's the third part of the book, which is all the tools that you create your own formula at the end of it. So there's lots of different ones and I never believe that there's one right way to do anything. I think sometimes you need more somatic work. I think sometimes need more cerebral work and you should kind of mix and match on what feels right. And so you're meant to pick two from each section and some will work for some, some will not work for others. And I think it's really important that you go through the stages to figure out actually what's right for you and the tools. And people have said that that's been like transformative for them. They've got their like own kind of, their own individual, because you know, it's like, you can't see everybody in clinic. So they've kind of created their own toolkit, but even similar to the food diary that I will, I put in here too, there's also a thought diary and I get people to write down all their thoughts they have in a day that are negative just to see how often and how frequent they are because I think when someone comes in with the food diary, sometimes they're like, I didn't realise how little or how much or these things, it's the awareness part. And I think the thought loops are also a really, really big part that people just sit for a moment and go, wow, I didn't realise how often I spoke to myself negatively. I think we all know we do, but you know, research shows it's between three and five positive comments to balance one negative. Yet we outweigh our negative comments way more because from evolution, our brain is evolved to be more negative. We've got a huge negativity bias. And that's kind of taught us to survive. It's there as a safety metric, but now in the world of 2026, we are constantly on the whole time. We don't live like how we used to with our ancestors. And so our negativity bias is much, much more strong. And so having a tool to help you assess that and be aware of it, people have found to be really, really helpful.  [01:23:43][138.8]
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Dr Louise Newson: [01:23:45] Which is great.  [01:23:45][0.1]
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Sarah Ann Macklin: [01:23:45] Which is great. And I think it's just kind of. I don't know, for me, I wanted to give people autonomy back. I feel like sometimes we are so overwhelmed by everyone else, always doing something on social media, always looking like their best selves always. If I see another thing on X where it's like the 10 best things to get, you know, most productive, best in the gym, best diet, this like longevity protocol, I think we just kind of go I haven't got enough time in the day!  [01:24:09][24.1]
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Dr Louise Newson: [01:24:10] I think then you freeze into doing nothing because it's too scary.  [01:24:14][3.9]
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Sarah Ann Macklin: [01:24:15] So this helps people to take the step forward. And that's what people have said to me. They're like, I actually feel like I have, I can actually take action. [01:24:22][6.8]
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Dr Louise Newson: [01:24:22] Well, I think the thing is about the book is that it's very simple, it's very basic and it is going back to those ways. There's nothing in it that you go, oh, I didn't know that, but it's all there for you and it's empowering people. And I think that's what is working so well really and it's not unachievable, which is really important. So it's great. I hope more and more people read and learn and change the way that they are because, like we said at the start, eating and feeling well is one thing but thinking well is really so important. So I'm very grateful for you because I know you're so busy at the minute. But before we finish, I always ask for three take home tips. So this is a really easy thing for you, hopefully for you to answer. Three reasons why people should read your book.  [01:25:08][46.0]
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Sarah Ann Macklin: [01:25:09] Okay, so one, this is gonna be your best friend. Two, you're gonna feel better about yourself at the end of it, which is really important. You're not gonna feel deflated, you're going to feel empowered.  [01:25:18][9.4]
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Dr Louise Newson: [01:25:19] Great.  [01:25:19][0.0]
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Sarah Ann Macklin: [01:25:20] And three, I think it's one of those books that it will teach you a lot about your mind and your body together as a whole mechanism, not separate mechanisms. It will help you make your own toolkit. But I also think it is one of the best gifts to give someone that you love after you've read it. I think it's just that book that has a lot of heart to it. And it's one of those books that I wanted to write a book that was going to try and change people's lives in a mindset way. And I really believe like this book does.  [01:25:51][31.4]
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Dr Louise Newson: [01:25:52] Great.  [01:25:52][0.0]
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Sarah Ann Macklin: [01:25:53] So that's the third one.  [01:25:53][0.3]
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Dr Louise Newson: [01:25:54] Yeah, brilliant, bring it on. So everybody should buy one for themselves and another one for someone else because gifting is so important. And, you know, if we can all be healthier for longer, that's more important. I think thinking more about healthspan than longevity in my mind is key. So thank you so much for coming. It's been great. Thank you.  [01:26:17][23.0]
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Sarah Ann Macklin: [01:26:17] Thanks Louise.  [01:26:17][0.0]
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Dr Louise Newson: [01:26:21] So just a quick one. It would be really great if you could follow or subscribe to this podcast. This will really help me reach more people with evidence-based information about hormones and their future health, and also means you never miss a future episode. Thank you.  [01:26:21][0.0]