Dr. Alia Crum on How Mindsets Shape Your Response to Food, Exercise, Stress, and Medicine

High-Level Overview

Andrew Huberman sits down with Dr. Alia Crum, a tenured professor of psychology at Stanford and director of the Stanford Mind and Body Lab, to explore how mindsets, our core beliefs about things like food, exercise, stress, and medicine, shape not only our motivation but our actual physiology. Crum walks through some of the best-known studies in the field, many from her own lab: a milkshake experiment in which belief changed hunger hormones, a study of hotel housekeepers whose health improved after learning their work counted as exercise, research linking perceived activity to death rates, and a series of studies showing that viewing stress as enhancing leads to better health and performance. She also describes newer work on reframing side effects in children undergoing peanut allergy treatment.

The tone is warm, curious, and science-driven, with Huberman frequently adding the neuroscience behind Crum's findings. Crum brings an unusual mix of experience as a researcher, a trained clinical psychologist, and a former Division I ice hockey player and gymnast, and she repeatedly stresses that mindset is a piece of the puzzle, not everything. The conversation flows from definitions to landmark studies, then to practical frameworks for stress, the cultural sources of our beliefs, and how to change mindsets deliberately, including as a parent.

The Discussion Explores:

• What a mindset is and how it differs from a simple expectation
• The milkshake study: how believing a shake was indulgent changed ghrelin responses
• Placebo, nocebo, and belief effects, and why the drug-versus-placebo model is oversimplified
• How exercise mindsets changed weight and blood pressure in hotel housekeepers, and predicted death rates
• Sleep, sleep trackers, and the power of feedback about how well you slept
• The stress-is-enhancing mindset, the UBS and Navy SEAL studies, and a three-step approach to stress
• Where mindsets come from, including movies and social media influencers
• Reframing side effects in medicine, and how to deliberately change mindsets in ourselves and our kids

Deep Dive into Main Ideas

What a Mindset Is

Crum defines mindsets as core beliefs or assumptions about a domain or category of things that orient us to a particular set of expectations, explanations, and goals. Take stress: do you see it as enhancing and good for you, or as debilitating and bad for you? That core belief changes what you expect to happen when you're stressed, how you explain what unfolds, and what you are motivated to do about it. People hold mindsets about intelligence, food, medicine, illness, symptoms, and much more.

She credits her colleague Carol Dweck's work on fixed versus growth mindsets about intelligence, noting it originated from implicit theories about whether ability is static or malleable. Reality is always more complex, but humans need simplifying systems to make sense of it, and these simplifications are not inconsequential. Crum's lab has expanded this into health: Western culture tends to see stress as debilitating and healthy food as disgusting and depriving. Her lab's contribution is showing that such mindsets work not only through motivation, but also through physiology, by changing what our bodies prioritize and prepare to do.

The Milkshake Study and Eating With a Mindset of Indulgence

As a graduate student at Yale working with Kelly Brownell and Peter Salovey, Crum asked whether our beliefs about what we're eating change the body's response to it, holding the nutrients constant. Participants came to the Yale Center for Clinical and Translational Research 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 diet shake. In reality it was the same shake both times, about 300 calories. When people believed the shake was indulgent, their levels of ghrelin, the hunger hormone, dropped about three times more steeply than when they believed it was sensible. Their bodies responded as if they had eaten more food.

Crum calls the result counterintuitive: she had expected that thinking you were eating healthily would be the better mindset, but believing they were eating sensibly left participants physiologically hungrier. For anyone trying to maintain or lose weight, the more adaptive mindset appears to be that you are eating indulgently and getting enough. On a personal level, the study changed how she eats. She had been constantly restraining her diet, and she realized that mindset of restraint might be working against any benefit. Her approach now is to eat healthy foods based on the latest science, but with a mindset of indulgence, satisfaction, and enjoyment.

Huberman asks whether mindset effects might explain why people in every diet camp, from plant-based to carnivore to intermittent fasting, report feeling great. Crum declines to weigh in on the diet debate but says she believes mindset contributes 100 percent. She argues that the total effect of any diet, like any drug, is a combined product of what it actually is and what you and the people around you believe about it. Falling short of a diet you believe you should follow may even backfire through stress and anxiety.

Placebo, Nocebo, and Belief Effects

Crum explains that the standard clinical trial compares a drug to a placebo, which is a good test of a drug's specific efficacy but not of its total impact. She breaks the placebo effect into three ingredients: social context, mindsets or beliefs, and the body's natural physiological processes that can produce the outcome. Since beliefs trigger those processes and are shaped by social context, calling these belief effects makes sense, especially in behavioral health where no actual placebo is given.

The negative counterpart is the nocebo effect, which she describes as "the placebo's ugly step sister": being told about side effects makes people far more likely to experience them. Part of this is attention, since we all experience fatigue, headaches, and upset stomachs regularly and then attribute them to the drug, and part is real physiological change. Huberman mentions a paper in Science on brain regions involved in psychogenic fever, in which believing one is sick raised body temperature by one to three degrees Fahrenheit. He later adds that he now throws away the long list of side effects that comes with his prescriptions and simply takes the medication as recommended.

Exercise Mindsets: Hotel Housekeepers and a Sense of Enoughness

Crum's exercise research started with a provocative comment from Harvard psychologist Ellen Langer, who told her, when Crum was an undergraduate hockey player training constantly, that the benefits of exercise were just a placebo. To test the idea, they studied hotel housekeepers who were clearly getting more than the Surgeon General's recommendation of 30 minutes of moderate activity per day, yet a third said they got no exercise at all and the average rating was about three out of ten. Half were randomly told, truthfully, that their work was good exercise and what benefits they should expect. Four weeks later, with no detectable change in their work or diet, that group had lost weight, lowered systolic blood pressure by about ten points on average, and felt better about themselves, their bodies, and their work.

Crum argues that public health guidelines telling people what they need to get are not motivating and may leave people worse off by convincing them they are not doing enough. Her graduate student Octavia Zahrt analyzed three nationally representative datasets that asked people how much exercise they got relative to others and tracked deaths over 21 years. Those perceptions correlated poorly with actual activity measured by accelerometers, yet they predicted mortality even after controlling for actual activity; in one sample, people who felt less active than their peers had a 71 percent higher risk of death. Crum notes the study was not experimental, but says the lesson is to get people active without making them feel terrible. As a college athlete she never felt she was doing enough, adding elliptical sessions after two-hour practices and weightlifting. "It's a sense of enoughness that really matters," she says. Huberman sums up the message as communicating the potency of food and exercise, and Crum agrees.

Sleep Mindsets and Sleep Trackers

Huberman asks whether believing you can handle a poor night's sleep might reduce its effects. Crum points to one study by Draganich and colleagues in which participants were given sham feedback about their sleep quality from a fake test. Those told they had slept poorly performed worse on a range of cognitive tasks, largely independent of how they reported actually sleeping. She says she would bet that mindsets can shift the cognitive and physiological effects of sleep, while stressing that sleep has real, important benefits and how far mindset can push them is an open question.

Huberman connects this to sleep trackers. People who see a poor sleep score may expect little of themselves that day. He admits he may lose a few friends for saying so, but he prefers to simply decide each morning, subjectively, whether he slept well, rather than looking at a number from a device, while acknowledging that many people find trackers useful.

Rethinking Stress: From Debilitating to Enhancing

Crum found that the public message about stress was overwhelmingly that it harms health, productivity, relationships, fertility, and cognition. The research, however, shows that stress can narrow focus, increase attention, and speed information processing; that catabolic stress hormones can recruit anabolic hormones, a process called physiological toughening; and that post-traumatic growth can lead to deeper connection with values, others, and life. Her view is that "the true nature of stress is a paradox", and her research asks what role our mindset about stress plays. With Peter Salovey and Shawn Achor she built a measure with statements like stress enhances my performance and productivity, and found that a more enhancing mindset was linked to better health, well-being, and performance.

In a study at UBS after the 2008 financial crisis, employees facing layoffs were randomized to watch no videos, videos framing stress as debilitating, or videos framing stress as enhancing, all with true information, such as examples of LeBron James making or missing a final free throw. Just nine minutes of video over a week shifted mindsets, and those who saw the enhancing films reported fewer backaches, less muscle tension, insomnia, and racing heart, and better work performance. The debilitating videos did not make anyone worse, likely because that message was already everywhere. Among Navy SEAL recruits, the only group Crum had measured with an average stress-is-enhancing mindset, those with more enhancing mindsets were more likely to complete training, had faster obstacle course times, and were rated more positively by peers. Crum emphasizes that this doesn't mean stressors like combat, cancer, or poverty are good things, but that the experience of stress can lead to enhancing outcomes.

She explains that a debilitating mindset pushes people to either freak out or check out, while an enhancing mindset shifts motivation toward using stress to learn and grow, bringing more positive affect, though not necessarily less negative affect. Some of her studies show more moderate cortisol and higher DHEA responses in people encouraged to adopt the enhancing mindset. Huberman adds supporting mechanisms: Duncan French's research showing that a sharp adrenaline spike, as in a first skydive, can raise testosterone, and the fact that adrenaline is made from dopamine. Crum describes mindsets as "a portal between conscious and subconscious processes": they run in the background as default settings, but we can bring them into awareness and reprogram them.

A Three-Step Approach to Using Stress

Crum says the first step is redefining stress, which people now confuse with its negative consequences. She defines it as a neutral, yet-to-be-determined effect of experiencing or anticipating adversity in your goal-related efforts. The key is the last part: we only stress about things we care about. Her example is that Johnny failing school wouldn't stress you out unless Johnny were your son, or you were Johnny, or you cared about educating the Johnnys of the world. As she puts it, "we stress because we care", so trying to fight, avoid, or merely cope with stress through vacations and massages means fighting the things that matter to us.

Her three steps are: acknowledge the stress and own it; welcome it, because it points to something you care about; and utilize the stress response to achieve that goal rather than spending energy trying to get rid of it. Huberman praises the framework, noting that stress narrows visual attention, which helps parse time more finely and process information faster, almost like a superpower, and that unlike relaxation we don't have to train the stress response. Crum cites Hans Selye's view of stress as a non-specific response, and they agree that stressing about stress amplifies it, while checking out leads to depression, anhedonia, and, as Huberman notes from his conversation with Anna Lembke, substance abuse.

Where Mindsets Come From: Culture, Movies, and Influencers

Crum identifies four sources of mindsets: upbringing, culture and media, influential others such as doctors and peers, and our own conscious choice. Her former graduate student Brad Turnwald studied top-grossing movies from the last 20 years and the most influential Instagram accounts, finding that, depending on the study, 70 to 90 percent of the food shown would fail the UK legal standards for food advertising. Unhealthy foods are described with language of excitement, fun, sexiness, danger, and indulgence, while healthy foods rarely appear and, when they do, come across as nutritious but boring and depriving.

Huberman suggests that packaged foods get promoted because they can be commoditized, but Crum says over 90 percent of the foods shown were not promoted or branded, so creators have lots of freedom to showcase healthy, delicious food. The public is also responsible, since unhealthy food posts get more likes. She says it doesn't have to be a competition: she doesn't need her three-year-old to hate ice cream in order to love broccoli.

Reframing Side Effects in Medicine

Crum is now bringing mindset work back into medicine. With Kari Nadeau, head of the Stanford allergy center, and graduate student Lauren Howe, her lab studied children in oral immunotherapy for peanut allergies, who eat gradually increasing doses of peanut over six or seven months and suffer itchy mouths, upset stomachs, and vomiting. Children were typically told these were unfortunate byproducts to endure. Because the symptoms are actually linked mechanistically to the body learning to tolerate the allergen, half the children were taught that symptoms were a positive signal that the treatment was working and their bodies were getting stronger. That group had less anxiety, fewer symptoms at the highest doses, and better immune markers of tolerance. Her lab is extending this to cancer treatment and COVID-19 vaccine side effects.

Asked whether hearing that a drug is effective could amplify its effect, Crum says it may, but warns that simple expectancy is less useful than understanding the specific mindset involved. Believing you are in good hands and that an illness won't kill you, for example, suggests mechanisms such as reduced anxiety through which blood pressure might improve.

Changing Mindsets on Purpose, and Crum's Own Path

Through what her lab calls meta-mindset work, Crum outlines how to change mindsets deliberately. First, recognize that you have them and that beliefs are filtered interpretations of reality. Second, play out their effects and ask not whether a mindset is right or wrong, since you can find evidence either way, but whether it is helpful or harmful. Third, seek out more useful mindsets. It is easiest where people have little prior experience, such as the allergy kids, and harder with baggage-laden topics like healthy food. As a parent, her advice is to lighten up on forcing behaviors. Making her daughter eat dinner to earn dessert, she realized, only teaches that dessert is the exciting thing and dinner is something horrible. She warns against getting dogmatic about having the right mindset and says to "treat yourself like a scientist."

She says that for her, "research is me search": her exercise, eating, and stress research all grew out of her own struggles, including writing a dissertation on stress while stressed about her dissertation. Her gymnastics taught her that you can't perform on the balance beam if you can't see it in your mind, and her father was a martial artist and meditation teacher. She is driven by how little we have done to consciously use the power of the mind, for example to leverage the placebo effect in medicine. Her lab's papers and toolkits, including a Rethink Stress toolkit, are available through mbl.stanford.edu and Stanford SPARQ, and she invites listeners to share stories or propose collaborations.

Conclusion

Dr. Alia Crum's research makes a compelling case that what we believe about food, exercise, sleep, stress, and treatment is not just commentary on reality but an active ingredient in it. Believing a shake is indulgent reduces hunger hormones more, learning that your work counts as exercise can lower blood pressure, seeing stress as enhancing improves health and performance, and viewing side effects as signs of progress can improve treatment outcomes. Her practical advice is to eat healthy foods with a mindset of indulgence, cultivate a sense of enoughness about exercise, acknowledge, welcome, and use stress because it signals what we care about, and regularly ask whether our mindsets help or harm us. Throughout, she insists that both the behavior and the belief matter, making mindset a powerful, accessible piece of the health puzzle rather than a replacement for the rest of it.

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