Dr. Alia Crum: Science of Mindsets for Health & Performance

High-Level Overview

Andrew Huberman sits down with Dr. Alia Crum, a tenured Stanford psychology professor, trained clinical psychologist, former Division I ice hockey player and gymnast, and director of the Stanford Mind and Body Lab. Their subject is mindsets: the core beliefs we hold about whole categories of life, such as stress, food, exercise, illness and side effects, and how those beliefs shape not only motivation but physiology itself. Crum walks through the studies that made her lab known, from a milkshake experiment that changed people's hunger hormones to hotel housekeepers who got healthier simply by learning their work counted as exercise, and a stress intervention tested on bankers during the 2008 financial crisis.

The tone is warm, curious and quietly personal. Crum repeatedly connects her research to her own struggles with over-training, restrictive dieting and dissertation stress, while Huberman adds a neuroscientist's view of the hormones and brain circuits that might carry these effects. The conversation moves from definitions to landmark studies, then to practical tools for handling stress, the cultural sources of our beliefs about food, and how to teach better mindsets to children.

The Discussion Explores:

• What a mindset is, and why these simplifying beliefs matter even when they are neither fully right nor wrong
• The milkshake study, where believing a shake was indulgent made hunger hormones drop about three times more
• Placebo, nocebo and "belief effects," and why the total effect of any treatment includes what we think about it
• The hotel housekeepers study and research linking perceived exercise to death rates
• The "stress is enhancing" mindset, from UBS employees to Navy SEAL recruits
• A three-step approach to using stress instead of fighting it
• How movies and social media influencers shape our beliefs that healthy food is boring
• Reframing side effects in peanut allergy treatment, and how parents can build adaptive mindsets in kids

Deep Dive into Main Ideas

What a Mindset Is and Why It Matters

Crum defines mindsets as core beliefs or assumptions about a domain that orient us toward particular expectations, explanations and goals. She credits her colleague Carol Dweck, whose work began with "implicit theories" about whether intelligence is fixed or can grow. Crum points out that both views are oversimplifications of a complex reality, but humans need these shortcuts to make sense of the world, and the shortcuts have consequences. If you believe intelligence can grow, you work harder after a setback; if you believe it is fixed, there is little reason to try.

Her lab has widened the range of mindsets under study, focusing on health. Do you see stress as enhancing or debilitating? Healthy food as indulgent and delicious, or disgusting and depriving? Your exercise as enough or insufficient? Cancer as a catastrophe or as manageable, even an opportunity? Side effects as a sign of harm or a sign the treatment is working? Crum argues that these beliefs shape what we pay attention to, what we are motivated to do, and, as her lab has begun to show, what our bodies prioritize and prepare to do.

The Milkshake Study: Belief Changes Hunger Hormones

As a graduate student at Yale, working with Kelly Brownell and Peter Salovey, Crum asked a simple question: do beliefs about what we eat change the body's response, even when the nutrients stay the same? Participants came to the lab on two occasions a week apart. Once they were told they were drinking a 620-calorie, high-fat, indulgent shake; the other time, a low-fat, low-calorie "sensible" shake. In reality both were the same shake of about 300 calories. The researchers measured ghrelin, the so-called hunger hormone, which should fall after eating in proportion to the calories consumed.

When people believed they were drinking the indulgent shake, their ghrelin dropped at roughly three times the rate seen when they believed it was the diet shake. Their bodies responded as though they had eaten more. Crum says the result was counterintuitive and changed how she eats. She had expected that believing you are eating healthily would be the better mindset, but the "sensible" belief left people physiologically hungrier. Having spent years in a constant mindset of restraint, low-calorie and low-carb, she now aims to eat healthy foods based on the best science while approaching them in a mindset of indulgence, satisfaction and enjoyment.

Huberman asks whether mindset helps explain why every diet camp, from plant-based to carnivore, swears its approach works. Crum declines to referee the diet debates but agrees that belief contributes: "It does matter what it is and it matters what you think about that diet." She adds that people who feel they should eat a certain way and fall short may suffer from the stress and anxiety this creates.

Placebo, Nocebo and Belief Effects

Crum explains that the standard drug trial is a good test of whether a drug has a specific effect, but a poor measure of its total effect. In real life, any treatment's result is a combination of its chemistry and what is going on in the placebo effect, which she breaks into three parts: social context, mindsets or beliefs, and the body's natural ability to produce the outcome. Because her milkshake study did not involve a sugar pill, she prefers the broader term "belief effects."

The darker side is the nocebo effect, which she calls "the placebo's ugly step sister": negative beliefs producing negative outcomes. People told about side effects are far more likely to experience them. Some of this is attention, noticing the everyday fatigue and headaches we always have and blaming the drug, and some is genuine change in physiology. Huberman mentions a paper on psychogenic fever, in which believing you are sick can raise body temperature by one to three degrees Fahrenheit.

They also discuss sleep. Crum cites a study that gave people sham feedback about their sleep quality; those told they had slept poorly showed deficits on cognitive tasks, largely decoupled from how they actually slept. Huberman admits he prefers to rate his sleep subjectively each morning rather than see a number from a tracker.

The Hotel Housekeepers and the Power of Feeling You Get Enough Exercise

This study began with a provocative remark from Harvard's Ellen Langer, who told Crum, then a college hockey player, "the benefit of exercises, just a placebo." To test the idea, they found a group getting plenty of exercise without realizing it: hotel housekeepers who pushed carts, changed linens, climbed stairs and vacuumed all day, easily exceeding the Surgeon General's guideline of 30 minutes of moderate activity per day. Yet a third of them said they got no exercise at all, and the average rating was about three out of ten.

Half the women were told, accurately, that their work was good exercise and what benefits they should expect. Four weeks later, with no detectable change in workload or diet, that group had lost weight, lowered systolic blood pressure by about ten points on average, and felt better about their bodies and their work. Crum's graduate student Octavia Zahrt later analyzed three nationally representative datasets that asked people how active they were compared with others and tracked deaths over the next 21 years. Perceived activity correlated only weakly with measured activity, yet it predicted mortality even after controlling for actual activity; in one sample, people who felt less active than their peers had a 71% higher risk of death.

The lesson, Crum says, is not that exercise is all placebo. Exercise is good for us, but public health guidelines do not motivate people and may leave those falling short feeling worse. She recalls her own unhealthy athlete mindset, adding elliptical sessions after two-hour practices and weightlifting because she never felt she had done enough. "It's a sense of enoughness that really matters."

Rethinking Stress: From Debilitating to Enhancing

When Crum turned to stress, she found a public health message that treated it as uniformly harmful, while the research was more mixed. Stress can narrow focus and speed up information processing; stress hormones can recruit growth-promoting anabolic hormones, a process called physiological toughening; and research on post-traumatic growth shows that even severe adversity can deepen people's values, relationships and passion for life. Her aim is not to claim stress is purely good but to show its true nature is a paradox, and to ask what role our mindset plays.

With Peter Salovey and Shawn Achor, she built a scale using statements such as "stress enhances my performance and productivity" and found that an enhancing mindset correlated with better health, well-being and performance. Then, after the 2008 financial crisis, they worked with employees at UBS facing layoffs. Some watched no videos, some watched films framing stress as crushing, and some watched equally factual films framing it as enhancing, featuring examples like LeBron James making a last-minute free throw. Just nine minutes of video over a week shifted mindsets, and the enhancing group reported fewer backaches, less muscle tension, less insomnia and racing heart, and better performance at work. The debilitating videos did not make anyone worse, because that message was already everywhere.

Navy SEAL recruits were the one group Crum found whose average leaned toward stress being enhancing. Within that group, a stronger enhancing mindset at the start of BUD/S training predicted graduating, faster obstacle course times and better peer ratings. Crum stresses that an enhancing mindset does not mean the stressor itself is good; combat, a cancer diagnosis or poverty are not good things, but the experience of stress can still lead to growth.

Why the Mindset Works, and How to Use Stress

People with a debilitating mindset tend to react in one of two ways: "they freak out or they check out." An enhancing mindset changes motivation toward using the stress to learn and grow, brings more positive affect (though not necessarily less negative affect), and some studies show more moderate cortisol responses and higher DHEA. Huberman adds that Duncan French's research showed an adrenaline spike, as in a first skydive, could raise testosterone, and notes that adrenaline is made from dopamine, so it makes sense that stress can be steered toward growth. Crum describes mindsets as "kind of a portal between conscious and subconscious processes": a default setting that quietly guides the body, yet one we can bring into awareness and reprogram.

Her first practical step is to redefine stress as neutral: the experience or anticipation of adversity in pursuit of goals that matter to you. "As humans we stress because we care and we don't stress about things we don't care about." Her three-step approach follows: acknowledge the stress, welcome it because it points to something you care about, and utilize the stress response to achieve that goal rather than spending time and energy trying to get rid of it. Checking out of stress, she warns, can lead to depression and anhedonia, because you also check out from what you care about, and Huberman connects this to substance abuse.

Where Mindsets Come From: Food, Media and Influencers

Crum names four sources of mindsets: upbringing, culture and media, influential others like doctors and peers, and our own conscious choice. Her former student Brad Turnwald analyzed the top-grossing movies of the past 20 years and the Instagram accounts of the most influential people. Depending on the study, 70 to 90 percent of the food shown would fail UK legal standards for advertising to children. Unhealthy food is described with words of excitement, fun, indulgence and even danger, while healthy food, when it appears at all, is framed as bland, boring or a post-holiday recovery.

Surprisingly, more than 90 percent of this content was not paid or branded, so creators have a lot of freedom to portray healthy food differently. The audience plays a part too, since posts about unhealthy food get more likes. Crum's goal is not to make her three-year-old hate ice cream but to help her see vegetables and fruit as delicious as well.

Reframing Side Effects and Teaching Better Mindsets

Crum's current focus is bringing mindset work back into medicine. With Kari Nadeau of the Stanford Allergy Center, her lab studied children in oral immunotherapy for peanut allergies, a treatment that often causes itchy mouths, stomach upset and vomiting. Half the children learned that these symptoms signaled their bodies were building tolerance. That group had less anxiety, fewer symptoms at the highest doses and better immune markers of tolerance. The lab is doing similar work on cancer treatment and COVID-19 vaccine side effects. When Huberman asks if belief can amplify a drug's benefits, Crum says it depends on which mindset is evoked, such as the sense that you are in good hands.

For changing mindsets deliberately, a project she calls meta-mindset, the steps are to recognize that you hold mindsets, examine whether each one helps or harms you rather than whether it is right or wrong, and seek more useful ones. As a parent, she resists forcing her daughter to finish dinner to earn dessert, because that teaches that dessert is the prize and dinner the punishment. She also warns against becoming dogmatic about having the "right" mindset, advising people to "treat yourself like a scientist." She calls her work "research is me search," rooted in her own experiences as a gymnast, hockey player, dieter and stressed doctoral student, and in growing up with a father who taught martial arts and meditation. Her lab's materials, including a Rethink Stress toolkit, are at mbl.stanford.edu and through Stanford SPARQ.

Conclusion

Dr. Alia Crum's central message is that outcomes come from both what we do and what we believe about what we do. The same milkshake satisfies more when we believe it is indulgent, the same workday improves health when we see it as exercise, the same stress can build us up when we see it as a sign of what we care about, and the same side effects become easier to bear when understood as signs of healing. None of this replaces good food, exercise, sleep or medicine, but mindsets are the part of the puzzle we can reach and change. Huberman's takeaway is a simple habit worth borrowing: keep asking what is the effect of my mindset about X, whether X is stress, food, exercise, relationships or yourself, and trade the unhelpful beliefs for more useful ones.

This is a summary of "Dr. Alia Crum: Science of Mindsets for Health & Performance" from Huberman Lab, giving you the GIST so you can decide if you want the REST. Listen to the full episode.