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Interview: Emma Short, doctor, personal trainer

14 October 2022

‘A healthy and well-balanced diet is a fundamental aspect of well-being’

As a junior doctor, I rotated through general medicine and general surgery, before completing my basic surgical training (A&E, ENT, breast surgery, and orthopaedics). I started my histopathology training in 2008, which took me a long time to complete, as I had two maternity leaves during this time, and did a Ph.D.

I started my first consultant post in April this year, specialising in soft tissue and gastro-intestinal pathology. I’m a consultant histologist now, working part-time in a hospital.

I really enjoyed surgery. It’s not that unusual for women to do surgery these days. But I was always attracted to pathology. A lot of people discouraged me from that specialty because I’m a people person, and it’s very academic and lab-based, but I love the scientific, academic side of things. It’s true that I don’t see live patients.

Most of what I do is examining tissue samples from live patients to diagnose disease, but, having made the diagnosis, I go to everyone’s multi-disciplinary meeting to discuss patients and their care with the whole medical team; so I’m heavily involved in patient care that way.

I really like medical education. When I was a registrar, I was doing a Ph.D. in cancer genetics, and spent a lot of time at conferences. It was clear that lots of time and money is being spent in early diagnosis and treatment, which is really important, but there’s a big gap in preventing cancer and other diseases. I wanted to spend time preventing the onset of disease.

Yes, a significant proportion of high blood pressure, obesity, and related disease can be prevented, or reduced in their severity, and lifestyle medicine can also affect how we respond to treatment. Even simple things like walking more, and not being so sedentary, or eating more fibre, if you sleep well, have a big impact on preventing diseases. The rates of chronic diseases are so high, and there’s so much we can do to prevent them.

Health education can sometimes feel overwhelming, and there’s lots of contradictory advice, as well as some really wacky stuff on social media. The NHS is incredible. The treatments are evidence-based for patient safety and for their clinical effectiveness. Health-care professionals deliver care in a holistic way, taking into consideration each individual patient’s circumstances, beliefs, and needs.

I run a community running group, which aims to get people active while having fun. Being active is one of the best ways to stay healthy.

Changing people’s nutritional habits is really tricky. They know they need to eat more fruit and veg, for instance, but translating their knowledge into action is the difficult thing. There are lots of different factors that make it difficult. Unhealthy foods, highly processed and sugary food, give us a dopamine hit, and we don’t get the same response from eating a piece of wholegrain toast.

If you’ve grown up eating unhealthy food, you see it as the norm. Finances are a big part of it, too. If you’re living in poverty, don’t have time or the facilities to cook, or you haven’t had a good education — all that, and the combination of advertising and media, and getting that dopamine hit. . . We seek out that instant hit as humans rather than think about long-term consequences. Health is poorer in poorer communities; so as long as there’s social inequalities there’s going to be health inequalities.

If you go for a run, you feel the rewards immediately; but with diet and nutritional changes, you generally don’t feel that immediate hit, though a lot of people say they do feel better, sleep better, have more energy.

The secret is to make small changes. Just make a start with a five-minute walk a day, and it becomes a habit. Our willpower fatigues — at least, most people’s does — so we can’t keep that up, but, when what we’re doing becomes a habit, we do it automatically. For example, a lot of people have a biscuit with their morning coffee. Change the biscuit for a banana, and you do it without thinking in a couple weeks.

I think that it’s vital to have a holistic approach to preventing diseases and promoting health. I wanted to learn more about nutrition, and spending time in nature, to understand the impact they can have on our well-being.

I was inspired to take up running by my good friend Lou. She was always out running or going to the gym, and one day I decided to join her. We decided we’d run a half-marathon together, and, from the moment I started training for it, I caught the running bug and I haven’t stopped. To try and stay injury-free, I make sure I get enough sleep and stay hydrated and well-nourished; and I mix running with other activities, like body combat, walking, and strength training.

I teach mindful nutrition, which is a broad category covering everything to do with how we think about food — how and where it’s grown and brought to us, and applying the principles of mindfulness to eating — enjoying the sight of food, its textures, smell, and how it feels when you’re eating it, and the effects it has on your body.

I also like shinrin-yoku, or forest bathing — bathing in nature rather than water, walking slowly through a green area, ideally a forest. A lot of Japanese research shows that this habit raises NK blood cells (the cells that fight viral infections) and reduces stress levels — measured subjectively and in lab readings of cortisol and adrenaline.

Just spending time in the natural environment is important for health, and most people did, before there was so much screen time and social media. During the pandemic, people spent more time appreciating being outside, but, sadly, I get the impression that people are going back to their old habits.

A healthy and balanced diet is a fundamental aspect of health and well-being. It is important that every individual finds a healthy diet which works for them, and which is sustainable in the long term. Some of the general principles are to maximise your fruit and vegetable intake, to eat a variety of different coloured plant-based products — eat the rainbow of colours — to increase your fibre consumption, to reduce your intake of highly processed foods, and not to have too much sugar.

The great thing about smoothies is that they can contain several portions of fruit and vegetables, and many have a high fibre content. It is important to be aware of the sugar content of smoothies: to reduce the sugar content, you could choose the vegetable or nutty recipes.

It’s hard to say which is my favourite recipe. I love them all, and my favourite changes all the time. At the moment, I’m really enjoying pink chocolate milkshake (beetroot, Greek yogurt, raw cacao powder, and milk).

There’s a tremendous movement around the world to encourage lifestyle medicine to improve health and well-being. My first book, A Prescription for Healthy Living: A guide to lifestyle medicine, got a hugely positive response from other doctors. The six pillars of lifestyle medicine are: promoting movement and physical activity, reducing stress, prioritising sleep, reducing the use of harmful substances, improving nutrition, and nurturing social connections. I also like to focus on spending time in nature.

I grew up knowing God, and he’s always been with me. God is all the good in the world.

I’m from Devon originally, which is beautiful, in Newton Abbot. My husband and I lived in New Zealand for six months, and we settled in Cardiff in 2008, where he’s a GP.

I love spending time with my family. We enjoy walking by our local river and baking together. I run and go to the gym, and I’ve recently started to learn how to make silver jewellery.

I don’t often get angry, but when I do it’s usually in situations which involve unjustness, unfairness, discrimination, narrow-mindedness, or a lack of kindness or compassion.

Lots of things make me happy: being with my family, frothy coffee, being in a forest or by the sea, and running are just a few.

I love listening to the birdsong as I run on the trails.

My prayers are usually simple: I thank God for all that we have, and ask him to be with anyone in need.

Dr Short was talking to Terence Handley MacMath.

Smoothie Doctors: Delicious, nutritious recipes for a healthier, happier life is published by DLT at £14.99 (Church Times Bookshop £13.49); 978-0-23253-448-1.

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