5. How This Underrated Thing Can Transform Your Health

What if the secret to transforming your health isn't about discipline but understanding how your brain is wired? In this episode of Extend with Dr. Shah, I dive into the fascinating science of habit formation and uncover why routines like regular exercise and structured eating are the real keys to long-term health and longevity. As a physician, I break down how habits automate your actions, helping you conserve mental energy and sustain healthy changes without relying on willpower alone. Drawing inspiration from experts like Charles Duhigg, James Clear, and Malcolm Gladwell, I explore the habit loop—cue, routine, and reward—and how to redesign your environment to reinforce positive behaviors and so much more. I also discuss: (00:00) - Mastering the Science of Habit Formation (05:37) - Habit Formation Techniques and Tips (12:58) - Breaking Negative Habits Strategically To learn more about Dr. Darshan Shah: Website: https://www.drshah.com/ Clinic: https://www.next-health.com/ Instagram: https://www.instagram.com/darshanshahmd/

Speaker names marked ? are inferred from speaking time and the show’s known hosts — they are not voice-verified.

• 0:03Dr. Darshan Shah?

  Welcome to Extend with me, Dr. Darshan Shah, a podcast dedicated to cutting-edge science, research, tools, and protocols designed to help you extend your health span. Having become one of the youngest doctors in the country at the age of 21, and trained and board-certified at the Mayo Clinic, I've accumulated three decades of practice as a board-certified surgeon and longevity expert. Over that time, I've discovered that a mere 20% of health knowledge yields 80% of the results when it comes to your health span. We're living in a new era where we are creating a new healthcare system, no longer focused on disease management, but achieving optimal health and vitality. Join me as I interview world-renowned experts, offering you a step-by-step guide to proactively avoid disease, and most importantly, extend your health span.

• 0:50Dr. Darshan Shah?

  Today's solo sode, solo sode number three, is all about finishing up our discussion around the mindset of optimal health, focusing in on what I consider a key skill that one must master in their health journey, becoming adept at the science of habit formation. As a physician, I'm constantly asked, what's the one thing I can do to achieve lasting health? And honestly, I truly believe the most powerful tool at your disposal is to become an expert at habit formation. In fact, over time, the habits you build, or fail to build, are what shape your long-term health, well-being, and longevity. But here's the thing, habits aren't just about willpower or motivation. They're deeply rooted in science and psychology, and today, I'm going to break it all down for you. Your habits define your long-term success around health

• 1:35Dr. Darshan Shah?

  more than any quick-fix diet or exercise program ever could. Why? Two reasons. Habits create consistency, and consistency leads to results. A perfect example is working out at the gym. Did you know that lifting weights consistently, two times a week for 20 minutes without skipping weeks, is 50% more effective than an inconsistent four-times-a-week routine? The same is true for your diet. Eating at the same time every day, and virtually the same meal, will lead to long-term weight maintenance. Let's talk about your sleep. Getting into the habit of going to bed at almost exactly the same time every day will do more To improve your sleep than any other sleep hack ever could. The same could be said for all aspects of your health. Being able to form consistent, good habits will create long lasting health.

• 2:21Dr. Darshan Shah?

  The reason habits work is because they are your brain's attempt to conserve energy expenditure around thought. The brain is a powerhouse when it comes to energy consumption. Despite accounting for only 2% of body weight, the brain typically uses about 20% of the body's total energy. This energy is primarily derived from glucose, and it's needed to maintain various brain functions, including processing thoughts, maintaining basic bodily functions, and regulating the nervous system. Having stronger neuronal connections decreases this energy requirement. As you do something in the same time and the same pattern daily, your brain strengthens connections between neurons responsible for that habit. This is the reason you don't have to think about, for example, walking. It just happens.

• 3:03Dr. Darshan Shah?

  This is also a phenomenon that you see quite often in driving to work every day, for example. Many of us don't remember this drive or how we got there because the brain is rewired to basically do this drive automatically. So now let's talk about the concept of goals. It's important to shift our mindset around goals, in my opinion. Of course, it's fine to have goals, but I actually de-emphasize them when we discuss health with my patients. Having a goal implies there's a definite end to the process. In reality, we want habits to last way beyond the achievement of the goal. We want them to carry on forever. So think of habits as a machine that you are going to put into place in your life that will help you not only achieve your goals, but to create a lifelong pattern of behavior that will serve you for decades and beyond.

• 3:47Dr. Darshan Shah?

  Many people ask me, so how long does it take to form a habit? The reality is the time it takes to form a habit can vary widely depending on the complexity of the behavior, the individual, and the environment. Research suggests that on average, it takes 66 days to form a new habit. This statistics comes from a 2009 study led by Philippe Allali, where participants were asked to adopt a new behavior, and it took between 18 to 254 days for the habits to become automatic, depending on the difficulty of the task. So, simple habits like drinking a glass of water in the morning might take only a couple of weeks. While more complex ones like exercising regularly or adopting a new diet might take several months. As you can see, it's a wide range of times, so don't get hyper-focused on how long it'll take.

• 4:30Dr. Darshan Shah?

  Instead, focus in on the consistency. The more consistent you are, the less time it will take for the habit to take root, focusing on the repetition of the action until it becomes second nature. With that background, let's dig into the science of habit formation for a bit. Let's start with the basics, the habit loop. This is a concept that is central to the work of Charles Dugan in his book, The Power of Habit, and is built around three components: cue, routine, and reward. The cue is what triggers the habit, the routine is the behavior itself, and the reward is the benefit that you get from completing the habit. Understanding this loop is crucial for both building good habits and breaking bad ones. So, for example, let's say you want to form the habit of going for a run each morning.

• 5:12Dr. Darshan Shah?

  The cue could be as simple as laying out your running shoes the night before. The routine is the run itself, and the reward might be the sense of accomplishment, or even the rush of endorphins that you feel afterwards. By identifying these three components, you can begin to engineer new habits or dismantle bad ones by disrupting the loop. So pause the podcast if you like here and write down three new habits you'd like to form. Next to the habit, make three columns labeled cue, routine, and reward. You can even do this in your head. Consider for each habit, what could be your cue for reminding yourself to start the habit loop? Then, write down the exact routine in the routine column of what is the exact thing that you want to do, and then finally consider how you can reward yourself for performing the habit.

• 5:56Dr. Darshan Shah?

  The reward can be as simple as a cup of coffee, or checking off the day on a habit tracker. This key exercise, breaking down the habits that you would like to form into this structure, makes it more psychologically tangible to achieve the new habit. So here's a few additional tips. With the actual routine you're trying to create, make it as small as possible. I'm talking, start off miniscule. For example, instead of saying, "Go to the gym and work out," say, "I want to do one set on three different machines." Building habits is all about small incremental wins. Trying to make huge changes overnight usually leads to burnout or Failure. Instead, focus on the 1% improvements, the tiny adjustments that you can make each day that compound into significant results over time. A 1% improvement done daily

• 6:41Dr. Darshan Shah?

  can lead to a massive 3,400% change over a year. So start small. Do one push up, two minutes of breath work, or eat one egg a day. Then, when your brain tells you it's ready, add a little more. On days you don't feel like doing it, still force yourself to do the most mini version of that habit that you started with. For example, say you're up to doing 50 pushups a day. Drop back down to five pushups on the days you don't feel like you can go the whole way. This will continue to reinforce the neural circuitry rather than having days in between where you're breaking down those connections. This ability to drop down into the mini version becomes easier to perform if you start off with the mini version of the early days of forming the habits. Now, let's talk about a powerful technique

• 7:24Dr. Darshan Shah?

  that James Clear emphasizes in his book, Atomic Habits, habit stacking. This is a method of habit development that involves attaching a new habit to an already established one. So why would you ever do this? Because your brain already has the neural pathways that have established for the original habit, making it easier to queue another behavior on top of it. So here's an example. If you already have a habit of drinking coffee every morning, stack a new habit like meditating for five minutes immediately after. By anchoring the new habit to a behavior that you're already doing, it becomes easier to integrate it into your routine. Over time, these small wins add up, and that's the key to sustained progress. This is exactly what I did to radically transform my own life. I started with my morning coffee,

• 8:08Dr. Darshan Shah?

  adding a special journal called The Five Minute Journal by a company called Intelligent Change that someone had bought me. This journal uses the concepts of visualization and gratitude to create a mindset of positivity first thing in the morning. Then, recognizing I needed to start doing some form of physical activity, I added five pushups and five situps. Then I added five minutes of breath work. Over time, this morning routine expanded to one hour a day of self-care that ultimately led to a complete transformation in my personal health. This is a concept of the morning routine. By the way, Which is detailed by Hal Elron in his book, The Miracle Morning, which is about a powerful morning routine called savers. Silence, affirmation, visualization, exercise, reading, inscribing.

• 8:52Dr. Darshan Shah?

  This is designed to help you transform your personal and professional life by starting the day with intention and purpose. Next, let's dive into one of the most overlooked aspects of habit formation, your environment. Your surroundings have a profound impact on the habits you form. In fact, studies have shown that our environment can dictate up to 90% of our behavior. So what do I mean about our environment? Well, it's where you find yourself throughout your day. Your bedroom, your office at work, your car, your kitchen, are all environments that we find ourselves in day after day after day. So let me give you an example of modifying your environment to support your habits. If you want to eat healthier, start by cleaning out your kitchen. Get a big box and literally open every drawer and cabinet

• 9:36Dr. Darshan Shah?

  and removed all ultra-processed food, seed oils, bread, junk foods, and sugary snacks. This simple environmental shift makes it easier to make better food choices. If the stuff is not around, you won't be able to access it. This is the concept highlighted in The Power of Context from Malcolm Gladwell's The Tipping Point. When the environment supports the behavior you want to develop, you're setting yourself up for success. Design your environment so that it supports the habits that you're trying to build. If your goal is to work out more, set up a space in your home for exercise or keep your gym bag in your car. The easier the environment makes it for you to follow through, the more likely the habit will stick. Exercise number two. Write down three places you spend the most time.

• 10:20Dr. Darshan Shah?

  Next, make two columns, one labeled add and one labeled remove. Think about the three items in each of these places you want to add that will serve you in forming new habits. And then three items that you should probably remove to make it harder to sink back into negative habits. Okay, so we've talked about building good habits, but what about getting rid of the negative ones? This can be challenging because bad habits often immediate rewards, even if they're harmful in the long run. We all know that momentary pleasures can lead to a lifetime of pain. And this is especially true when it comes to our health. The key realization here is that negative habits have formed using the same neuronal circuitry that you use to create the good habits. So you just have to do the opposite to unwind them. Here's your strategy.

• 11:04Dr. Darshan Shah?

  First, identify the cue that triggers the bad habit. Let's say you have snacking late at night as a bad habit. What's triggering it? Stress, boredom? Once you understand the cue, replace the routine with a better alternative. So if you're snacking out of stress, try swapping it with a relaxing activity like reading or meditating. Additionally, reducing exposure to the triggers helps. If having unhealthy snacks in the house is a cue, just remove them. As James Clear says in Atomic Habits, making the bad habit harder to do and the good habits easier to perform leads to success. Success in eliminating these depends on the amount of friction put into place as well. And by friction, I mean making it hard to do the negative habit in the first place.

• 11:47Dr. Darshan Shah?

  Do this for one negative habit over time, and over time you'll see all your negative habits fade away. So to sum it up, forming good habits and breaking bad ones is a science. It is not about willpower, motivation, or goals. By understanding the habit loop, stacking new habits onto existing ones, designing the right environment, and tackling bad habits strategically, you can truly transform your health over time. Remember, small, consistent changes lead to the biggest results over time.

• 12:21Dr. Darshan Shah?

  Thank you so much for listening to the podcast today. Please remember to subscribe if you liked this episode and give us a good review and share a link with your friends. It really helps to support all of our efforts. I also want to remind you that the information shared on this podcast is for educational purposes only and is not intended to replace professional medical advice, diagnosis, or treatment. Please consult with your healthcare provider or physician before making any decisions or taking any action based on what you hear today, especially if you have any underlying health conditions or on any medications. Your doctor knows your personal health situation the best, and it's always important to seek their guidance.