Peter Cox is a London-based clinical nutritionist and physiologist and has worked in healthcare since the early 1980’s. He’s worked with both conventional medical clinics developing and delivering lifestyle programs to clients attending health assessments.
Peter has appeared in numerous publications and TV programmes on issues relating to nutrition and health and he frequently gives seminars workshops to a wide range of organizations about aspects of nutrition and health, including numerous investment banks, consulting firms, law firms and health organizations.
Edge7: Peter, you’ve worked a lot with corporations and clinics. In this mostly urban and professional population, what are the most common ailments you see?
Peter: There are three things that I see routinely in my corporate clinics. The first is fatigue-related -chronic fatigue or chronic fatigue syndrome. Secondly, I see people for gut-related issues, like IBS - a stressed gut condition. There are a lot of conditions within that, including bacterial infections, parasitic infections, food intolerances, food allergies, which all fall under that same umbrella. I also see weight problems, like weight loss, or weight gain.
Depending on a person’s background, being in any relatively stressful environment - corporate or otherwise - exploits the more distorted patterns of eating they may have. If they have a problem with retaining weight or they have an eating disorder, then they tend to lose weight with stress. If it's the other way around, they gain weight.
Edge7: Why does stress affect behavioral patterns like this?
Peter: Stress exploits our Achilles heel, whatever that may be. When we're pushed to make decisions very quickly, we resort to a default pattern of behavior. We see it in a variety of different ways. Sometimes it's excessive exercise, for example. If it's about exercise as a means to relaxation, then people just do it more and more, and that becomes a problem. Sometimes it's poor patterns of eating. Sometimes it's anxiety and that then drives these distorted patterns of behavior.
Edge7: In light of this, what would you say are some of the simpler steps people can take to improve their well-being?
Peter: I think to get into the habit of eating well and having a balanced pattern of behavior. That's an alien concept to most people who have no idea how to do this - especially in a more distorted work environment where the norm is to have a relatively unbalanced pattern of behavior.
We try to help people redress balance by understanding what balance actually means. What's an appropriate amount of sleep? What's an appropriate amount of down time and rest? How much work is good? At what point are they likely to lose efficiency let alone their performance and productivity?
For me, the dietary and nutritional side is key. Having regular meals is part of having a balanced pattern of behavior and part of that is about optimizing digestion. But beyond that, it's about eating a nurturing and nourishing diet. It varies from individual to individual, but broadly it's about eating regular, routine meals, which are broadly nutritious.
...we live our lives very much out of balance in the West. But the key pillars would be eating well, having regular meals, having sufficient good, quality restorative sleep, having enough downtime.
Edge7: When you say ‘balanced’ what are the core pillars of a balanced lifestyle within the professional setting? How do you get to be balanced working in Central London?
Peter: I think for the most part, we live our lives very much out of balance in the West. But the key pillars would be eating well, having regular meals, having sufficient good, quality restorative sleep, having enough downtime. I think exercise plays a part, as do good relationships. For many people, having good relationships and the time and ability to relate to other people is something that's easily lost.
Edge7: Obviously since the financial crisis in 2008, London’s financial sector has been under a lot of strain. Have you observed increased stress in the people you see?
Peter: Absolutely. I think it's always been there but now people are working in increasingly competitive, hostile, regulated, and stressful environments. If I go back half a generation or perhaps a little bit longer, the workplace was a much more fun place to be.
When I came into the industry in the early 80s, more people were working regular hours. The 9-5, or 9-6 was fairly typical. If people were working until 7, that was unusual. Now, the vast majority of people across many industries are working extraordinarily long hours and this has become the norm.
That means whatever people do - exercise, eat, socialize - it's all done in a much more compressed period of time. And that's where the problem lies. The loss of balance is fundamentally about the kind of merited time people have available to them.
There’s also a much more profound sense of insecurity these days, because there's no loyalty any longer and certainly not in the way it used to be, where people would remain in one place for the entire duration of their career. That doesn't happen any longer. There's no loyalty on either side now.
Edge7: I imagine that many times when people come and see you, the answers you give them are not really what they expect? They probably want a pill to solve it all.
Peter: Absolutely. People come and say, "What should I eat?" but they don't give me the context.
If they're working 16-18 hour days - which is very often the case, then the first thing is that they need to be able to fuel that length of day, and they need to be able to nourish themselves for that long. There are consequences as well. So we need to then mitigate against some of the consequences of working too much or being too stressed.
There's a sense always of context firstly. Yes, of course I can provide dietary and nutritional information to help better nourish them - but I need to know what the objectives are, what's the context. Do they already have a health condition? Is it short-term stress? Are they training for a marathon?
Fundamentally there's no indefinite diet and no single diet that's going to work for any one of us all of the time. It has to evolve. My job is to match the two.
...sports and exercise have a place but it shouldn’t be to the exclusion of everything else. I see people who exercise to the exclusion of either eating, or sleeping, or deep resting. The sport has to fit in. There has to be sufficient recovery. There's no point in exercising unless you can recover from it.
Edge7: In terms of sport and exercise, what is a sensible approach to training, if you’re already in a high-performance, highly demanding job?
Peter: I think sports and exercise have a place but it shouldn’t be to the exclusion of everything else. I see people who exercise to the exclusion of either eating, or sleeping, or deep resting. The sport has to fit in. There has to be sufficient recovery. There's no point in exercising unless you can recover from it.
Exercise is a form of stress - and potentially a very damaging one. For a lot of people, it's their main means to relaxation and stress management. So when things get more stressful they exercise too much and end up over exercising.
My early research, going back 30 odd years, was around overtraining syndrome. Today, I see a lot of people exercise excessively or in a way which is unremitting.
Edge7: Moving on to another key factor in living with balance – in a nutshell, what are the things people can do to improve their sleep quality?
Peter: It's dependent on several things. But the concept that we talk about is sleep hygiene – which is about preparing for sleep - winding down effectively in the evening, and not doing things which are essentially stressful.
I talk to people about their sleep, and a lot are worrying last thing at night. They're looking at their phones, or they're on the computer, they’re worrying about what they're having for breakfast, or whether someone’s going to break in, or whether they're going to have a job in the morning.
Of course, you have worries, but there should be a time for it. It should not impact sleep. I think one of the enormously important points is having emotional security - and part of that is using the concept of gratitude, being grateful for the roof over your head, having enough to eat, having people who love you.
...we massively overuse alcohol and caffeine. And I think that taking either or both in the evening is potentially very, very counterproductive.
Edge7: People today want fast solutions. But is there any real ‘quick fix’ to feeling better?
Peter: I think in our culture we massively overuse alcohol and caffeine. And I think that taking either or both in the evening is potentially very, very counterproductive.
Edge7: Because they affect sleep?
Peter: Absolutely. I think the other thing which has absolutely been lost in so many of the clients I see, is the regularity of eating and the time and space to do so. I’d love to see the return of the regular meal - a standard, regular lunch hour where people not only get enough time to eat but enough time to actually digest some of it and enjoy some down time. Essentially, to engage a little bit and switch off from the workplace. What we need are blocks of down time, and preferably around food.
Edge7: So you’re talking about psychological effects?
Peter: Ultimately, whether it's psychological or physiological - the end result is always physiological. I think getting people to think in the right way is important. From a purely dietary point of view, discouraging people from having caffeine, over-stimulating food, and alcohol last thing at night, or even during the evening, is often very important. But creating the right environment is equally so.
Sometimes there are distractions or stresses in the bedroom - the computer, the TV, even reminders of the things that stress us - like the photo of the ex we still worry about. There are things we can physically remove from the bedroom to make it a more comfortable environment.
There are also things like open windows and doors. Does that create a sense of insecurity? We don't want to watch a horror movie last thing at night and then leave the window open, worrying if the Boogeyman going to come inside. These are the types of things we can change.
Edge7: Is there any online resource or book that would be useful for people to access the kind of information we’ve discussed?
Peter: The honest answer is no. I think there have been a number of attempts and I've been involved in a couple where people want to have both a diagnostic and treatment process online. And it just doesn't exist because the risks are great and it's too complicated with too much individual variability to be able to do that easily and well.
As far as a book, I think of The Optimum Nutrition Bible by Patrick Holford. It's a nice, broad overview, which outlines some of the dietary and nutritional contributors to certain health conditions. It makes a really nice starting point.
Edge7: Peter, thank you for the interview.
More information on Peter's practise can be found on his website: www.petercoxnutrition.co.uk