Episode 11: The Middle Lane: Moderation, Alcohol & Sustainable Performance with Stephen Radnedge

Stephen Radnedge is an Advanced Clinical Practitioner (ACP) in a GP practice with over 20 years’ experience in healthcare. He works autonomously assessing patients, diagnosing conditions, and prescribing treatment, and he’s also an endurance athlete training for long-distance events. Steve is passionate about sustainable performance, resilience, and a moderation-first approach to health—especially the role recovery, routine, and alcohol reduction can play in long-term wellbeing.

In this episode of The Next Chapter, Luke sits down with Stephen Radnedge to talk about what it really takes to balance a demanding healthcare career with endurance training—without burning out. Steve shares his journey from nursing and ward management into advanced clinical practice, the mindset shifts required when you step into a new environment, and why adaptability is a non-negotiable skill in both work and life.

They also get into the practical side of performance: building a routine that fits real life, staying flexible when work pressures hit, prioritising recovery, and taking a “middle lane” approach to alcohol—focusing on moderation and long-term sustainability rather than extremes. If you’re trying to level up your health while juggling responsibilities, this conversation will give you both perspective and tools you can actually use.

Chapters

00:00 Intro: Stephen Radnedge (ACP + endurance athlete)
00:49 From nurse to Advanced Clinical Practitioner: 20-year journey
01:54 Bristol to Glastonbury: change, routine, and work-life balance
03:18 What an ACP does (and how it compares to a GP)
03:55 Heart health fundamentals: reducing risk the simple way
05:05 Moderation & “middle lane” drinking: cutting down realistically
11:02 Career shift: secondary care to primary care learning curve
11:32 Snowboarding vs endurance: risk, resilience, and staying smart
18:41 Training mindset: time commitment, discomfort, and partner support
23:35 Alcohol, blood pressure & cholesterol—plain English breakdown
32:02 Cutting back benefits: sleep, HRV, recovery, performance
42:06 Steve’s next chapter: 50/60-mile ultras + finishing his MSc

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Stay real, stay relentless, and keep building your legacy—one choice at a time.

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Let’s be real: your next chapter starts now...

Transcript

SPEAKER_00 0:24

Hello everyone and welcome to today's show. So today's guest is someone very special. Today we've got Stephen Radnage. He's an advanced clinical practitioner, endurance athlete, and a good friend from primary school. He's recently moved from Bristol to Glastonbury, find love, and is training for two up-and-coming ultras, all while balancing a demanding health care, career, and a very healthy passion for snowboarding that we'll talk about later. So today we're going to go deep on change, endurance, health, and what drives us to keep pushing our limits. So let's dive in. So Steve, tell us a bit about your journey and how you worked your way up to being an ACP, please. Sure.

SPEAKER_01 1:12

So I qualified as a nurse 20 years ago this year. And kind of poetically, I'm hoping to complete my master's degree this year, 20 years on. Oh wow. So um it's been a the master's degree bit, it's been a slow process, kind of moved out of nursing and ward nursing and management to working as a nurse practitioner in the hospitals about 10-15 years ago. About 10 years ago. And yeah, started my postgraduate modules in uni to work towards my master's and enabled to me to examine patients, diagnose, order imaging, order tests, prescribe drugs, and yeah, kind of work at a more autonomous level. And now uh now I work uh about six years ago I moved from secondary care to primary care. So now I work in a GP practice as an in new title, it's advanced clinical practitioner. It used to be called advanced nurse practitioner, and the reason it's changed is because you don't have to be a nurse to do it. For example, in our practice, we've got a chap who is paramedic by background and he does a really similar job to me.

SPEAKER_00 2:16

Okay, so how did you move from Bristol down to Glastonbury? How did that come about? And what's it been like building a new life and career down in Glastonbury?

SPEAKER_01 2:26

Well, that was all for a girl, wasn't it? So um I was uh grew up in Bristol, as you know, uh did my undergraduate training to be a nurse in Bristol. And mostly worked in Bristol, hospitals and then in primary care. Uh but all the while um I uh met someone and yeah, we wanted to get a place together and I'd always lived in Bristol, fancied a change. She's from Somerset, so moved to Somerset. And I think about nursing is you can you can do it anywhere. Nursing is nursing, really, isn't it?

SPEAKER_00 2:55

Hmm. Yeah. Yeah, my wife's a nurse as well, as you well know, and she's always said that uh obviously our our move here to the Isle of Man was made very easy. Being a nurse, you can work pretty much wherever you want in the world.

SPEAKER_01 3:08

And my move my move was much easier than yours. It was much smaller. It's an hour down the road with good traffic. It doesn't take long to get up and see friends and family.

SPEAKER_00 3:18

Yeah, yeah, that's one problem about living on the Isle of Man. Yeah, it's not it's not living on Australia or New Zealand, you're not living on the other side of the world, but it is it is a pain in the ass to get on and off. And when ferries aren't running, and especially in the winter at the moment, it can be a bit of a pain. But obviously, you you you're only up the road from your family and friends anyway. So a bit of a nightmare there on that M5 in the summer. So your role as an ACP, Steve, yeah, how does that compare with being a GP? Just for context for my listeners, please.

SPEAKER_01 3:48

Um the best way I could answer that is just to tell you the way that we work. So we most of our requests for appointments or uh requests from patients to have something done, a problem solved, they go into a shared clinician's list, and a team of clinicians, be it GPs, trainee GPs, and ACPs like myself, we we work from the same list. So there's there's very few things that I would give to a GP because I can't do them. So one of them being sort of pregnancy-related problems, things like that.

SPEAKER_00 4:22

Right, okay. What's one thing that people get so wrong about heart health? Because I know you specialise in heart health.

SPEAKER_01 4:29

Yeah. So I think it's m misconceptions about risk. So primary prevention of coronary artery disease, so that means preventing angina and heart attacks if you've never had one, is about risk reduction. I know no single action will mean that you don't have a heart attack, but being healthy across the board, weight loss, stopping smoking, cutting down alcohol, moderation, cutting down or moderating alcohol, regular exercise, it will greatly reduce your risk of a heart attack or stroke. Patients often quote something like, I'll be okay because my mum smoked all of her life and she didn't have a heart attack. And that's great. She beat the odds, doesn't mean you will.

SPEAKER_00 5:09

You mentioned moderation there. Uh lots of people that I speak to say it's a myth and you should either go one way or the other. What do you think about moderation? I mean, so many people that I speak to say everything in moderation, whether that's drink, whether that's food, you know, all of the bad stuff. So what's your take on moderation? Of alcohol? Yeah, well, alcohol, food, yeah.

SPEAKER_01 5:31

Well, it requires some willpower and discipline, which I think is why uh some people struggle. It it it is difficult, especially if you've fallen into the habit of drinking regularly. I mean, a lot of people who drink regularly they're not alcoholics, they don't get drunk every day. But it's just nice to come home from work and have a beer and a glass of wine, isn't it? It's so easy to do. Um but there comes a point in your life, usually, where you think I don't want to do this anymore, and you have to make a choice. Lots of people choose to give it up because for them that's the best way forward. I I chose to moderate. Actually, I haven't gone tea total. Uh autumn last year I drastically cut down the amount of alcohol I drink, and I I really look to do it by cutting down when I drink. So for me, since autumn last year it's been Christmas, birthdays, holidays. I haven't really drank much outside of that. I think it was um one of the podcasts you put me on to, actually, it was Andy Ramage. Um he talks a lot about middle lane drinkers. That's right. Um uh one of his podcasts, or he was a guest on somebody else's. He says, This is his advice, it isn't for alcoholics. If you are completely dependent on alcohol, this isn't for you. If you are uh an inside lane drinker um who only drinks a few times a year, this isn't for you. This is for people who drink regularly and want to quit, want to do something about it, but can't, and his advice is to stop, much like yours is. Um and it was listening to one of his podcasts, why can't I aim for left-hand lane and and try that? So it took me a few attempts to get it right, but yeah, at the moment I'm quite happy. I feel pretty good, and yeah, weeks go by. I don't drink, and I think the last time I had a drink was on holiday.

SPEAKER_00 7:14

Yeah, I think um so many people that I speak to that are into not just ultras, whether it's marathons, whether it's sort of endurance events, so many of them do say that alcohol affects the recovery, but I know we'll get on to that later. Um, a lot of people that I that I speak to, they've they've quit alcohol and they say, you know, it's really, really improved health-wise, whether that's in sport or whether that's in in endurance events, but we'll get uh we'll definitely get on to that later. Is there anything that you miss about Bristol or has Glastonbury worked its magic? So there's no magic in Glastonbury.

SPEAKER_01 7:49

There's plenty of witches and fairies, but I don't think there's any actual magic. And you can't throw a stone without hitting a crystal shop. I don't miss Bristol because it's not that far away. And like I said earlier, you can eat I can easily see my friends and family. It's not such a huge change in my life. Um I haven't really uprooted that much. I like living in a rural area, although I lived on the outskirts of Bristol before. Um there's a lot less traffic and it's just less busy here. Um and I work the practice I work in is in Glastonbury, so I can walk to work, which takes about 10 minutes. So good work-life balance at the moment.

SPEAKER_00 8:23

Yeah, I remember you saying when you first moved down that you could walk to work. And for me, moving to the Isle of Man where it's very raw, and just yesterday I where we actually hit some traffic in some roadworks, and it I and it had been seriously, it'd been months since I hit any real traffic, and I was stuck there for about five or ten minutes, and I was like, Oh my god. I used to I used to do this every day in Bristol, but yeah, you sort of get used to you get used to your surroundings, don't you, and you soon settle in. It's quite funny.

SPEAKER_01 8:53

I I drove up to uni uh on a Wednesday morning from Glastonbury uh a few weeks back, and I think I had to be there for about half past eight, and it took me two hours to get there from Glastonbury, and it's normally a one-hour journey, just because and and the the majority of that time was spent just getting into Bristol and getting to uni.

SPEAKER_00 9:12

Yeah, yeah, that's right. Yeah, that yeah, I don't miss that traffic, that is for sure. I know you love dogs as well, Steve. Uh, and we've recently just got a new puppy, which is driving all of us absolutely mad. It's one of those unteachable lessons I think you can never really prepare yourself for for getting a puppy. Uh have you got any tips for a new puppy owner, please?

SPEAKER_01 9:35

Don't compromise on basic training. Um, start training straight away. Peop some people advise you you don't need to, but you should. It will make for a better behaved dog in the future. And it it's not it's not learning for them, it's fun. You can make you can make training fun, you can make it rewarding, you can reward them with treats, with toys. And they're never too young to start learning, really. You start training them with um toileting as early as you can, so why not other things? Don't allow don't allow puppies to do things when they're small that you wouldn't want them to do when they're a big dog, because habits can really hang around, especially like jumping up on people. More relevant if you've got a big dog, but nobody really likes dogs jumping up on them. Training is is really good for stimulation and bonding as well helps improve your relationship with the dog, and if you've got a good relationship, they're more obedient. Consider socialization classes. We did that with ours, and it was really good just for getting them used to to other dogs from a young age, and it means there's less reactive later in life. That's it, man.

SPEAKER_00 10:29

Yeah, we were um we're looking into puppy classes at the moment, but we're just waiting for the injections to clear. But yeah, we're we're in that sort of limbo stage at the moment where we we can't go out, she can only go out in the back garden. So it is it is tough at the moment, but uh yeah, it's a it's a long-term investment, right? It's um it will be worth it in the end.

SPEAKER_01 10:50

I've never I've never had a dog before, and uh Vicki, my wife, has always had dogs, and a little while after we got together, she said, I'd like to get a dog, and I was like, Great, I've always wanted one, never really been in a position to have one because I lived alone, worked shifts. Um and yeah, I haven't never looked back. I can't imagine not having one there.

SPEAKER_00 11:09

We've both gone through some big changes. Me obviously moving to the Isle of Man and going alcal-free, and yourself with uh moving down to Glastonbury. How's the transition been for you? I know you've just said, you know, we've just covered quite a lot of this, and you've said it's only half an hour down the road, but how have you settled into Glastonbury?

SPEAKER_01 11:27

Fine, yeah. Um I mean it's not been much of a transition in geographically for me. I just moved to the next county. Bigger transition for me was moving from hospital-based care where I've kind of worked for 10-15 years, into general practice. That was a really steep learning curve. And it felt like all of the experience I'd gained in secondary care didn't count for much, and I had to learn everything again. Um and a frequent but I do frequently find occasions where my acute experience is useful.

SPEAKER_00 11:54

Yeah, my it's been a big change for me, obviously, geographically moving over here, um, definitely a lot more so than yourself. I mentioned earlier on snowboarding. Me and you have got a big passion for snowboarding. We've just been away snowboarding for the for the half term. What has been your favourite snowboarding trip and why?

SPEAKER_01 12:13

Probably your stag do. Because it was so long ago that I was much younger and everything was a bit easier.

SPEAKER_00 12:20

God, you're not that old, mate. Don't write yourself off, yeah. So what um what do snowboarding and the endurance uh events that we've been speaking about? Like, what what do they teach us about resilience and risk? Now, for me, I've always said to you, obviously, I've got a physical job. I'm a gas engineer by trade, so I'm always a bit, you know, I'm I'm a bit wary about breaking bones and coming off and stuff like that. So I'm always a bit yeah, I I hold back a bit. What does it is there any link? What does it teach you? And uh yeah, what is it what does it teach us about resilience?

SPEAKER_01 12:54

Well, like you said, I think the obvious risk with winter sports is injury, and it's a big deal for most people, but even bigger deal if you um if you fit uh of a physical job like yourself, or more so if you're self-employed as well. Like one of our friends broke his wrist snowboarding a few years back, and he was quite frustrated about that, not so much because his wrist was broken or because it was hurt, because he was worried about how it would affect his work.

SPEAKER_00 13:16

Yeah. Yeah, that's right. I remember. Um E Fun, wasn't it? Was it E Fun? That's it, Chris.

SPEAKER_01 13:23

I suppose you know, we went away, I'm sure you don't mind me saying on the podcast where we went skiing a few weeks ago in France, and on that trip there was the best snow we've had in years. And but you can have too much of a good thing, and it increases the avalanche risk. And that was much more apparent on on that trip than any other trip we've been on, I think, to the point that they're you're hearing in the media about people that have have died in your resort in the last couple of weeks, and you when you're out skiing, you wouldn't have known it. But um, yeah, it's just it really kind of brings home the kind of the power of nature and how you have to respect it. And yeah, I mean the key thing with winter sports is going off piste, isn't it? If you stay on the piste, you're pretty safe with avalanches.

SPEAKER_00 14:05

My wife kept on saying to me, like literally every night that we were back in the in our cabin there, she was saying, Have you seen that someone's died in the next resort and some you know they've had another avalanche in so-and-so? And I'd be like, What, really? But yeah, it really, it really, really bought it home because there was so much snow in the Alps while we were there. I think it's the best season that we've ever seen, for sure.

SPEAKER_01 14:29

And with endurance sports, I think you get less risk, especially of traumatic injury. But yeah, you can if you overtrain, you can get stress fractures, other trainer injuries or possi training injuries are possibilities, but they're usually less traumatic, things like tendonitis, pulled tendons, pulled muscles, achy joints, especially as we get a bit older, your your joint pain is going to take a little bit longer to resolve after longer runs or faster runs. Endurance sports teach us more about dedication and time management, I would say. Both help us to believe that we can achieve more in sports or in our family and professional lives, just like learning a new skill like skiing or boarding or pushing yourself to do the next distance in a in a running event or a triathlon. Um and a distance is relative as well. So, like a non-runner will get the same sense of achievement from completing their first 10k or half marathon as I will from my next Ultra because it's a new distance to them. And if they don't have any running fitness, they may need to invest the same amount of time training for it as well.

SPEAKER_00 15:25

Yeah, yeah, yeah. No, it is a brilliant point. Uh why do you think ultras, I like ultras, Iron Man, why do you think these events have taken off so much in the last 10 years?

SPEAKER_01 15:39

So I think that endurance events have become more popular over the last 10 years because of increased awareness of events being put on. Uh, more people share their challenges and achievements on social media. People take a lot of inspiration from things that they see of other people doing stuff on social media, whatever your interest is, whether it's running, baking, motorsport, it doesn't really matter. It's a source of inspiration for loads of people. Um, running does well in growing new interest due to its simplicity and ease of access. So anyone can get a pair of trainers and go for a run. I mean, parkrun has generated massive amounts of interest in in people new to running. Parkrun, I think they've celebrated their 20-year anniversary recently. Um but for the first two years that they're in existence, there was only one parkrun in the country. Uh and now there are 850, 850,000 odd. Uh like four million registered runners for parun. So it's just grown huge. And when you front load a sport like running with loads of grassroots programs like part run, inevitably some of these new runners are gonna progress on to do the longer distances. You'll see an uptake in running events across the board, on-road, off-road, long, short obstacles, muddy ones, team events.

SPEAKER_00 16:55

Yeah, it it it's it really has boomed so much in um in the last couple of years. Do you not think it's because we're becoming a lot more comfortable now with technology and we're sort of thinking we're not we're not getting out into nature and we're not getting out enough, and we're we're wanting to push ourselves, push our limits.

SPEAKER_01 17:15

Oh depends on your school of thought. Depends on your school of thought that you go with, because depending, you could ask different people that question and get a different answer. I think lots of people will say that technology is is making us too comfortable and we don't go out as much, especially the younger generations, whereas years ago we'd be out more. But on the flip side, it's much easier for me to find my next run with a PC in front of me and the internet and like running databases. Um but interestingly, I think Iron Man, especially the branded Ironmans, they haven't expanded as much. There are less full Iron Man events in the UK now than there were 10 years ago. Um Iron Man races. They used to have uh full Iron Man in Bolton, they've stopped that one. There was one in Weymouth, that one stopped. I think in the U in Great Britain, at least it's only Wales, I think, where you can get a full Iron Man. In days you have to go further afield if you if you want to do a full Iron Man and you don't want to go to Wales or if you've already done Wales. Um But I mean remember, Iron Man is just one brand that hosts a long-distance triathlon. There are others, it's it's just been such a successful brand that most people associate it with the distance now. It's just becomes synonymous with a long-distance triathlon. And um, I think triathlon as a sport, aside from Iron Man, is growing in popularity um and availability. But unlike running, triathlon requires a bit more investment. You can't, it's not just trainers and shorts and a vest. You need a bike, it's the most expensive part. Wetsuits aren't cheap, tri-suits, all the rest of it. Um so yeah, you've just got to be a bit more committed to want to get into triathlon, I think.

SPEAKER_00 18:46

It's the time as well. Everyone I speak to who do triathlons, they always say the bike, you've got to invest so much time in going out with a bike.

SPEAKER_01 18:55

You know, especially for the longer ones, and you've got three disciplines to train for. So, I mean, put simply, it's three times as much training as just training for a run.

SPEAKER_00 19:03

What is your own relationship with pain and discomfort in training light then, Steve?

SPEAKER_01 19:10

My relationship with pain and and discomfort in training. Well, you have to stop me prattling on for too long about this. I absolutely love it. Um I mean my my limiting factor in training is I work full-time. Uh of course I've got the usual life commitments other people have too, but the real thing that stops me investing more time in training is I've got to go to work. Um I would do it almost every day. I'm so happy running, cycling, swimming. Um training for Iron Man takes a lot of hours out of your week for many months. When when I've done Iron Man's, I think I allocated around 15 hours a week for six months leading up to the race. Wow. And for that reason, I I was putting off doing a second Iron Man for a while. We moved to Glastonbury, as you said earlier, and we were working on the house, so like I said, uh the same pressures and stresses and things that take up your time that everybody else has. And it's I mean on that subject, it's it's quite important to discuss a commitment of training with your partner as well, because um, it's a good idea to get them on board with it because you're going to be less available during that time. And I think it absolutely should be a shared decision. One, because it's the right thing to do, one, because it's the right thing to do, and two, because it's just makes your life easier.

SPEAKER_00 20:28

Yeah, my brother-in-law's done a couple of full distance triflons, iron Iron Man's, and my sister's always saying, Yeah, he's always training. Um, but he can juggle it quite well with his job. He works from home and he does a lot of his bike stuff in his garage. But I know it just takes uh it really can take over your life, can't it?

SPEAKER_01 20:47

Yeah, I um I try and alternate year on year, so if I've got uni work to do one year, um I I won't sign up to any major events. Like last year I was doing my dissertation, so that took that took me eight months to do that, so I didn't didn't sign up to any races or triathlons. I mean I can hand on heart say that one of my only regrets is that I didn't get into one of the core triathlon sports at a young age, which might have given me a chance to making a career out of it. Uh if you read about Alistair or Jonathan Brownlee or Lucy Charles Barclay, she's um she's a professional British triathlon, and she's also I'm Man World Champion. And uh they they talk about their teeny teenage years spent in swim clubs and cycle clubs. And uh I've never come across a good elite runner or triathlete who was good at their hobby and turned it into a career. You've got to really kind of you need those pushy parents to get you into it at a young age.

SPEAKER_00 21:42

Yeah, yeah, yeah. It's going back to discipline, isn't it? You've got to be very, very disciplined, and there's levels to everything in there.

SPEAKER_01 21:49

But because you you don't just do it in childhood, you've then got to have the discipline to choose to do it in your adult years as well.

SPEAKER_00 21:55

Yeah, yeah. It is definitely a lifelong commitment. Have you got any advice for anyone that's struggling with any type of training, man? How do you do you keep going when things are tough? I really want to tap into that mindset because so many people, the normal person like Joe blogs on the street, mate, they would do a run, they would do any sort, yeah, whether that's a swim or a bike ride, and they'd be like, Sod that and give up. What what makes you what makes you Guys, different and why do you push through?

SPEAKER_01 22:25

I think you have if you want one, you've got to want to do it, to start the process of finding motivation to do it. And then I think you need to give thought to what's going to help you. So we're all different. I mean, some of us do better in groups or clubs, some do better alone. If you're the latter, would you benefit from having some one-to-one coaching sessions to get advice on your training? I'm quite basic with my approach. I recently read a book called Science of Running. It's really helped me to make some further marginal gains in my ultra training, and I've been doing it for years. One of my best gains recently is just really simple, just including some leg strength work in the gym. So this year, this time round, I've been including that. It doesn't really make you go any faster or further, but what it really does is it massively improves your recovery from the longer runs. So you can you can knock out a 20-mile training run and you're not going down the stairs sideways for four days afterwards. I find that's the real benefit.

SPEAKER_00 23:19

Yeah, yeah, definitely. Oh yeah. I remember those long runs uh back in the day when I was running marathons and uh yeah, uh walking the next day is an absolute killer, those stairs.

SPEAKER_01 23:31

It's so cool, man. And I I would know it's so simple, and I would never have really thought of doing it. I I didn't think doing strength exercises or weights on the legs in the gym would really help with running, but um yeah, it's it's really, really been a game changer for me. Been a game changer in terms of recovery. You can recover quicker and get it. Exactly, that's it. So yeah, I didn't say that, but if you um if you can recover quicker, you can train more, and then that improves your speed and your endurance and distance.

SPEAKER_00 23:58

It's just compounding your training better. Yeah. Steve, can you break down what alcohol does to your blood pressure and cholesterol in plain English, please?

SPEAKER_01 24:08

Yeah, sure. So I suppose if we're talking about the effect on your blood pressure, I'd break it down into the acute phase and chronic phase. Acute phase meaning when you when you drink, say, three or more drinks in one session, it starts to affect the nervous system. It causes vasoconstriction of your blood vessels. So your blood vessels become smaller, tighter. This increases your blood pressure short term. And remember that I think according to the National Institute of Alcohol Abuse and Alcoholism, four drinks or more in a short period of time is the definition of binge drinking. So is have we all been guilty guilty of that at some point? Probably. Um so that's the short term. It just makes your your arteries more so than your veins constrict, so that it raises your blood pressure. And then you've got the the chronic consumption of alcohol. So if you have alcohol regularly, if you're one of these middle lane drinkers who's drinking every day or every other day, and you're just you're not getting pissed, but you're drinking enough, and um it inhibits the brain, the brain receptors that regulate your blood pressure. So throughout your body, not throughout your body, but in various places of your body, like your heart and your aorta, you've got these little um pressure sensors, but like a sense for barometric changes, and they send signals to the brain, um, and then the brain regulates the blood pressure through constriction and dilatation of your blood vessels, and the alcohol inhibits that um that nerve pathway. So it's it doesn't work correctly, and and basically your blood pressure is higher as a result of it. So therefore, reducing your alcohol intake or quitting drinking allows your body's nervous system to return to a natural status quo. You can see positive effects of this after just three to four weeks of quitting drinking. So if you're if you're having a conversation with your GP about having high blood pressure and you think you drink too much, then you probably do. And quitting drinking, you you'd only have to wait three or four weeks to see improvements in your blood pressure.

SPEAKER_00 26:03

One of our close friends, I was I was talking to him recently and and he uh he was taking a break from booze. I know a lot of people have been recently, especially with dry January, and he said it's it massively changes recovery. I said, Oh, why aren't you drinking? He said he said it's simply because I'm training for this event, and I know when I don't drink I can get a lot fitter faster and I can recover, like you just said.

SPEAKER_01 26:27

Well yeah, I can tell you more about that after I've answered the other part of your um your question about the effects on cholesterol. Okay.

SPEAKER_00 26:35

Um yeah, so so on the cholesterol side as well, Steve.

SPEAKER_01 26:38

Yeah, yeah. So I mean alcohol puts your cholesterol. And I suppose it's worth just saying that most of the time when I'm having conversations with patients about about their drinking, it's not because they've come to see me because they're an alcoholic and they want to get into AA or the local alcohol um alcohol abstinence so it's it's just because it's come up in conversation because they've got another health problem, like they've had a health check and their blood pressure's high, or their BMI is high, or they've got diabetes, or their cholesterol's high. And that's our kind of one of our bread and butter health promotion conversations that we have with patients. And yeah, cholesterol is a really common feature in it. People always ask what their cholesterol is, and most people know it should be five or below, but your total cholesterol in your blood test is calculated from three different results. So when we review your cholesterol, we look at the whole lipid profile. So in that you've got total cholesterol, you've got HDL cholesterol, which is the one people call good cholesterol, and your LDL cholesterol, which is the one people call bad cholesterol, and triglycerides, which is a different type of fat. Um, like I said, ideally it should be less than five, but it's a ballpark goal depending on which of those other fats is high. Because if it's only your HDL cholesterol, which is high, this is the good cholesterol, it doesn't really matter if your your total cholesterol is a little bit over five. But if it's because your triglycerides and your LDL are high, that's bad. Because those are the ones that will actually do you harm. So it's I don't want to go on too much about the kind of science of it and that I don't want to get bogged down with medical jargon, but that's that's the crux of it. Of the the different fats I mentioned, triglycerides are the are the one commonly affected by alcohol, so it's alcohol, increases your triglycerides, they will then increase your total cholesterol. And the reason that's bad for you is like most things we consume food, drugs, alcohol, they're metabolized, which means broken down uh by the liver, and then they're later excreted by the kidney. And the liver liver breaks down alcohol into fatty acids. These then combine with glycerol to form triglycerides. The reason we have these is triglycerides are one method of the body storing energy for use later. And again, unfortunately, you can have too much of a good thing, excessive triglyceride levels that contribute to buildup of fatty plaques in your coronary arteries, so it's putting you at risk of a heart attack essentially, or angina or a stroke, which is pretty much the same pathology.

SPEAKER_00 29:01

So, how does this relate to heart attacks and strokes then, Steve? Especially for dads and people in their 30s to sixties, like most most of my coaching clients.

SPEAKER_01 29:11

So if you have a buildup of fatty plaques in your coronary arteries, and let's say you also have a high blood pressure, you're far more likely to have an undino or heart attack. Um strokes are really similar in pathology to heart attacks, where most strokes are because strokes come in two forms. So if it's an ischemic stroke, which means blocked arteries, pretty much the same pathology as a heart attack. Um you can also have a stroke which is a bleed called a hemorrhagic stroke, and they're usually more severe, but thankfully less common, um, but not really related to um not really related to drinking in the same way. The pathology is a bit different.

SPEAKER_00 29:52

What are the early warning signs that men should look out for then Steve?

SPEAKER_01 29:57

Yeah, um well with both blood pressure and high cholesterol, unfortunately, there there aren't loads well there aren't many at all for for early warning signs that hypertension is known as a silent killer. Most of the symptoms don't present until your blood pressure's severely raised or has been raised for a very long time. That said, when that happens, you can get headaches, changes in your vision, nosebleeds, tinnitus, just to mention a few. So the best tactic with blood pressure is really to check it. When you're over 40, it's not a bad idea. When you're over 50, you really should. You need to start knowing whether your blood pressure is high or low as early as possible so you can do something about it. And it's not necessarily pills. Lifestyle changes are best, especially at a younger age. Um you can easily check your blood pressure in many places. Uh the waiting room in the practice where I work has a monitor that people can just walk in and use. Most high street pharmacies offer a blood pressure check. Or you can easily buy a blood pressure monitor online from Amazon. They're about 12 quid or get you the same kind of one we use in the practice. Um and I think some well some libraries lend them. Uh so if we don't have any to lend out, we have patients to borrow one from the library.

SPEAKER_00 31:09

About five years ago, I think it was, I was suffering with high blood pressure. And I remember obviously my wife's a nurse, and and we just bought a a blood pressure machine for our house, and and um, and we just had it at home. And I don't think it was that expensive either, so you can do it from home as well. So it's not it's not such a big deal. And we've spoken about your two ultras and how uh alcohol impacts your training, muscle recovery, and performance. Have you got any stories or science about booze, sleep, and injury risk, Steve?

SPEAKER_01 31:42

Stories not so much, but I mean tendon injuries and tendonitis are more common in people who drink alcohol often. This is related to the acetaldehyde. It's a uh a pro-inflammatory agent. Uh it comes from alcohol through two different methods. It's in the alcohol because it's part of the fermentation process. Um, and you also get some in the metabolism of alcohol in your liver.

SPEAKER_00 32:01

What changes have you noticed in your own performance since coming back from booze then, Steve? Uh you've mentioned before recovery. Are there any other things? Is your sleep better, maybe? Um, does it what I found when I cut back on booze is my diet became a lot better because I used to eat a lot of crap as well when I was drinking. Yeah. How how has it helped you since quitting um since cutting back last year?

SPEAKER_01 32:24

So, yeah, I sleep better. I mean, one of the reasons I wanted to cut down drinking is because um as I get older, the alcohol disagrees with me much more. Um, gives me a headache before we've even gone to bed. Red wine as much as I loved it, it would give me um bad tummy if I drank more than two glasses. So sleeping better for that reason, just because you don't have a headache or a bellyache. But as you know, if you if you can go weeks and months without alcohol, your s your sleep pattern just improves. It's really good for your sleep hygiene, is a phrase that we use a lot in work because sleep hygiene refers to all the things you can do to improve your sleep, and removing alcohol is one of them. Um other things I've noticed. I think my last year my my garmin was telling me that my uh heart rate variability was actually quite low, which I thought was odd for the amount of exercise I do, but since I packed in drinking, it's almost doubled. I was down in the twenties before, and now I'm in the forties.

SPEAKER_00 33:19

Yeah, that was a big thing for me when I quit and obviously I've got my health watch now, and my heart rate variability has changed so much. And I was the same as you, mate. I absolutely loved red wine. And whenever I um I used to drink red wine most of the day, every Sunday. My Sunday roast. Starts with communion. Roast beef, mate. Roast beef and uh a bottle of red wine. Oh god. But uh yeah, and my heart rate variability was just yeah, it was off the chart. It made a really, really big difference when I quit drinking my sleep. And obviously, when you sleep better, you've got more energy and you can think clearer. It it um I think sleep has been prob probably the biggest thing for me since quitting quitting the booze when you when you have a good night's sleep. And it's the and again it goes back to consistency. When you consistently sleep well, then it's gonna fall it's gonna build and affect everything else in your life, isn't it? It's a big lifestyle change.

SPEAKER_01 34:14

Yeah, absolutely. You feel you feel better, faster for having better sleep. Um I think another thing, another motivator for me to to to cut down on drinking was the effect of alcohol on um sports and performance and muscle recovery. Yeah, when you uh alcohol can affect you at your muscles and performance really quickly. So even the the day after you've drank alcohol, your your maximum heart rate's limited. So if it's normally 180, it can be limited to 160, which immediately affects your performance. Alcohol causes dehydration the next day as well. The dehydration symptoms that most people experience that they associate with dehydration, part of the hangover, is is often called by acetaldehyde. It's like a nasty chemical that I mentioned earlier that you get from alcohol. But it's a pro-inflammatory, so it slows the heal healing of soft tissue. So if you've got tendon injuries, if you've got muscle pains, if your muscles are just healing and rebuilding after your training, whatever it is, whether it's weights, sports, running, cycling, is it's all going to be inhibited by by alcohol because it suppresses a pathway um which is associated with muscle recovery and adaptation. Um and it's the the cellular signalling cascade that acts as a regulator for your metabolism and growth and energy levels. The way your body uses nutrients and and proteins. And if you drink alcohol, even once, actually, not even regularly, but if you drink alcohol, uh say you have a couple of beers after your first half marathon, your your muscle recovery won't be as good as a result of that. Um up to 13, 5% inhibited, like delayed because of because of alcohol, just in in low amounts.

SPEAKER_00 35:50

When I was running marathons back in the day, I was drinking quite heavy, and especially to celebrate as well. So uh yeah, maybe maybe it took me four attempts to get a a sub-4 hour marathon because I was drinking so much. Who knows? I might have been uh uh I might have half my time if I was uh if I wasn't drinking. That's my excuse anyway. You could have been a more far. Okay, so uh the what are the biggest myths around alcohol and health uh that you see in your clinic that we haven't uh mentioned already, Steve?

SPEAKER_01 36:23

Yeah, so again, really common conversation we have with patients often comes up because of other health problems. But I suppose one of the common myths is that is that regular alcohol consumption does not cause you harm if you only drink a little. So um classically the conversations that I've had with patients are not because they're alcoholics, but because other health problems have been picked up during investigations. So if they are over 40 or over 50, they come in for a health check. That's how you often detect people's cholesterols are a little bit high earlier in their life. But when we drill down into their lifestyles and routines, uh small but regular amounts of alcohol are often present.

SPEAKER_00 37:01

Yeah, and like I said earlier, it affects your eating habits as well. Definitely. And what I've been really surprised with since quitting as well is how much sugar is in alcohol that I never knew about before. I've had a hell of a lot, uh not so much now. I'm I'm sort of I've sort of dealing with my sugar cravings now, but when I first give up, I was craving sweet sugary stuff all the time. And that w and many people told me that that is because you're craving sugar because your body's been so used to having all the sugar from the alcohol.

SPEAKER_01 37:33

So you also tell yourself that you're allowed a treat because you've given up alcohol, so it's okay. Of course.

SPEAKER_00 37:40

Of course, yeah. Smash in a whole chocolate bar on an evening whilst watching TV. Yeah, that's it. Yeah. Well, you just you swap the addiction from one to the other. So for busy dads juggling work, family, and fitness, what advice have you got for protecting your heart health and performing better?

SPEAKER_01 37:57

Cut down or have a break from alcohol together. I agree with the recommendations that you and Andy Ramage have made. Three months is best, especially if you want to see real improvements. That's when you really feel the benefit in your sleep routines and in your concentration during the day as well. I'm saying three months is a good aim to aim for. And things like dry January and Stoctober, they're they're good. But I I think we could aim for better. And a lot of people I know who do dry January, they've they're already stocking their fridge with alcohol and ready for the first of February, like before January's over. And it really undermines all their hard work that they put in in January. So I think my advice would be do dry January, roll it into February and March. And then if you if you want to completely quit drinking, then you you've got the foundations there to do that. If you don't, then it's going to be easier to really limit your drinking of alcohol when you've had three months off rather than just plowing through a case of wine because it's the first of February. Other advice is there's no substitute for regular exercise. It doesn't have to be running, it can be anything, whatever you wherever flips your switch, swimming, classes, spin classes, going to the gym, anything really. Make sure you maintain a healthy weight. And you will you will do that if you do regular exercise and and cut and stop drinking, your your weight will improve anyway if you're overweight. And I think finally, I would eat healthy. Uh balanced diet, plenty of plant-based foods. Don't need to be a vegetarian, but make sure you're getting plenty of fruit and veg in your diet. It's good for your weight, it's good for your cholesterol, it's good for your blood pressure, and also it's really good for gut health, which will also make you feel better in in your your newfound boost of health.

SPEAKER_00 39:37

Going back to exercise, Steve, I was reading a post the other day and uh they were saying about if if you could buy a drug that increased your mood, helped with anxiety, helped with depression, boosted your self-esteem, boosted your brain function, help you sleep better, and help you live longer, would you buy it? And of course, everyone's 100% yeah, and that is exercise. It is literally the best thing for you, and it's crazy, isn't it? But but people and people would rather escape and and not exercise, put it off, justify, you know, reel out all these excuses and say, I haven't got time, I haven't got this, I haven't got that, I can't do it. And they and they won't go to the gym. But like you said earlier, running is free is free. I run every morning now, and my mood and being so upbeat and being so positive, I put so much of that down to that exercise in the morning. I I think it is the wonder drug, definitely.

SPEAKER_01 40:35

It's a great way to start the day. I mean it like you say, it doesn't matter what exercise you're doing. Vicky and I were talking the other day about doing something different. Uh once a week we get up early before work and both go to the gym. And too. We don't do anything too too intense, but it's more about spending time together and just doing something together before work. So it just feels like you've got more out of your day, you're in a better mood when you get to work. But we were yeah, we were talking about could we try something different? Because I think we're both getting a bit bored of that. So yeah, we're just um yeah, might do some different exercise, might go for a jog together or a bike ride in the summer when it's a bit lighter, or just take the dog for a much longer walk and come back via the bakery and get some pastries and have a coffee.

SPEAKER_00 41:16

What keeps you motivated then, Steve? Because I know it's hard through tough training and stressful times, which inevitably, if we keep on doing using endurance, events, ultras, etc., that you're gonna come up against.

SPEAKER_01 41:29

Yeah, so I like to find new challenges. And I like to find what's achievable for me. So when I first got into running, I entered lots of 10Ks and half marathons. I think half was my favourite distance for a long time, and I love just trying to better my PB every time. But as you get older and fatter, this becomes harder to achieve. So I find it motivating to look for new challenges. So that's how I got into triathlon, that's where I bought my first road bike. Um ultra marathons. I mean, my my best times for 10k and a half marathon, I set them 10 years and eight kilos ago. So it's it's gonna be hard to beat those now. So it's easier to move away from time as a metric and move towards something new. So for me, it's for me and I often consider how much further could I run? So I've done a marathon, I've done something that's a bit longer than a marathon. If I can run 26 miles, could I run 30? And if I could run 30 miles, could I run 40? And just kind of build on that.

SPEAKER_00 42:26

You're just pushing, you're pushing your limits all the time. And you feel like you can progress then, don't you? Yeah. What does success look like for you now then, Steve? Uh moving forward with your own next chapter.

SPEAKER_01 42:41

So the longest run I've completed to date is a 47-mile ultra. So the two ultras that I've entered this year will be the first time I've broken either of those distances. So the first one is in April, it's 50 miles. Uh I entered this one in 2020, but it was cancelled because of COVID, and I've been keen to go back and do it ever since. And then the second race is in Wales, and that's 60 miles. So the other good thing about 60 miles is it's considered a bit of a milestone in the ultra ultramarathon world. So it's it's 100k. So it's a good good milestone to to uh to achieve in uh ultra worlds. I think that was that'll scratch that itch for a long time. Uh professionally, I'm really close to completing my MSc, which is a master's degree in advanced practice in healthcare. And it's been in the pipeline for a long time, and I'll I'll be really chuffed when I've completed that and all being well when I've completed this module that I'm doing now should be this year.

SPEAKER_00 43:35

Brilliant. Fair play. Congratulations. Is there any one book or a podcast? We mentioned a couple of different podcasts, or a habit that you find really helped that has helped you?

SPEAKER_01 43:46

Yeah, I think a book, definitely. So um I think one of the first books I read about running was called Born to Run by Chris McDougall. So it was published in 2010, and I think the book starts in the early 90s, and it's this uh it's about uh I think it was like a an Indian from a tribe in Mexico called the Tara Humara, and he was in his 50s, and he entered and he won a prestigious hundred mile ultramarathon in America wearing only sandals and a toga. So no fancy trainers, no fancy kit. And it it tri this happening triggered the author, Chris McCoy. McDougall, who's a sports journalist by background, and a small group of elite runners to seek out the tribes, spend time with them, learn about their story and history of history of running. And the book contains other stuff too: history of running, science of running. It's one of my top five books of all time. Not just running books, it's just fascinating and inspirational. The people that are in it, I didn't know who they were at the time, but then when I came to know more about ultras who kind of recognize the names and think, ah, they were in that book. They went to Mexico, they ran with the Tara Humara Indians. It was really cool. And I I took a lot of inspiration from that book. And it's just really well well written. It's just a really good book.

SPEAKER_00 45:02

Knowing everything that you do now, Steve, have you got any advice or would you give any advice to your younger self?

SPEAKER_01 45:10

Yeah, well, like I said earlier, one of my only regrets is is not getting into like a core triathlon sport at a young age, so my advice would be forget about drinking cider and chasing after girls in the local village disco and go join a cycling club.

SPEAKER_00 45:26

Start younger. Easier said than done when you're that age, though, Steve, right?

SPEAKER_01 45:29

Yeah, I don't think young Speed would have listened.

SPEAKER_00 45:31

No, no, nor do I. Have you got uh any final words uh for dads or blokes facing big changes, Steve?

SPEAKER_01 45:39

Yeah. I think I touched on this earlier, but I would just discuss your goals with your partner. They might have similar goals, in which case you can share that journey together, and then you've got somebody on board to you can support each other. More often they don't want to do the same things you do, but it's still good to get their support if you're taking on large volumes of training. If you're a single parent, reach out to other support networks that might be available to you if you've got family or friends, and they can they can be a good resource in in uh enabling you to take on new challenges and to give you a bit of support.

SPEAKER_00 46:12

Well said. So thank you so much for coming on today, Steve, and giving up your time and sharing your real honest story that you've been building up for, you know, it's it's years of health, knowledge, and experience. You didn't have to do this either. You know, you've got nothing to sell or anything to promote. So you've done it purely for the love and helping others, Steve. So I really appreciate it, mate. So big up yourself. I know this episode is going to be valuable to a lot of my listeners, and I've learned a ton as well. So thank you again, and I'm certain your insights and help are gonna um help a lot of people moving forward with their own next chapter.

SPEAKER_01 46:51

You're very welcome. I've enjoyed it, it's been fun.

SPEAKER_00 46:54

Thanks, Steve. Thanks, Lou.