Fibre is pretty potent, it's pretty powerful.
Even just a small amount on top of what you're already eating is related to significantly lower risk of type 2 diabetes, heart disease, colon cancer.
It's not about having to have the most perfect diet, but making small, practical changes for your health that make you feel better here and now but also support your health in the long term.
Hey guys, how you doing?
Hope you're having a good week so far.
My name is Dr. Rangan Chatterjee, and this is my podcast, Feel Better, Live More.
Research suggests that 96% of us are not getting enough fibre.
But why does this actually matter?
Well, that is the topic of this week's brand new episode with returning guest, Dr. Emily Leeming.
Emily is a dietician and researcher at King's College London who spent years studying the relationship between what we eat and the health of our gut microbiome.
And her brand new book, Fibre Power, makes the compelling case that fibre may be the most underrated nutrient in our diets.
National guidelines here in the UK are that adults need at least 30 grams a day, but most of us get 17 to 20 grams tops.
And when you hear everything that Emily has to say about what fiber is actually doing in the body, these statistics start to feel quite urgent and serious.
In our conversation we explore what fibre is where it's found and why it's so much more than a digestive aid.
Emily explains how it feeds the trillions of microbes living in your gut and why those microbes and the compounds they produce have a reach that extends to your immune system, your metabolism, your brain, your hormones and your risk of serious disease.
We also look at the evidence linking higher fiber intake to lower rates of type 2 diabetes, heart disease, bowel cancer and depression.
And Emily also shares findings from the major bowel cancer study that is currently running at King's, investigating why rates in the under 50s are on the rise.
Fibre is so much more than just a dull, functional food.
It's one of the most researched nutrients in existence.
So, whether you've never thought much about it or you already know that it matters, but keep falling short, I think this conversation will educate, inspire and motivate you to take action.
Emily, you highlight in your latest book that 96% of people are not getting enough fibre.
Why is this such a serious issue for our health?
I think there's so many ways to come across that.
I mean, fibre really has been seen as being this kind of dull bland, boring stodge that's simply there to help us do a nice poo.
It's not really something that's been on people's radar as something interesting and worthwhile having.
Yet so many of us are struggling to get the fiber we need.
And what's this fiber actually even doing?
There's so many things it's doing for our health.
It's actually one of the most researched nutrients in terms of having an impact on our health.
We're looking at things like your heart health.
So it helps to lower kind of bad cholesterol levels.
It helps to balance your blood sugar control.
So things like type 2 diabetes risk in later life, but also this kind of new science around the gut microbiome and really fiber being that key fuel that feeds your gut microbiome for a thriving microbiome that's going to make molecules for your health.
If I think back to when I was a kid.
I can't say this with 100 certainty, but I kind of feel people were talking about fibre.
What's different today?
What do we know now?
What does the latest science show us, which makes it even more important perhaps today that we actually think about this nutrient and how much of it we're eating?
So the gut microbiome science, for example, we're talking about the last 20 years.
Now a lot of the research that we have around fiber is really actually centered around heart health and the risk of heart disease.
So that's really where a lot of recommendations.
So that recommendation for 30 grams of fiber a day is kind of based mostly on kind of heart health recommendations, some kind of bowel cancer recommendations, also kind of type 2 diabetes risk.
But the recommendations that we have aren't actually centered around.
What does your gut microbiome need?
Because that has only been a lot more recent and a huge amount of science that's happened in that space since.
But I think that's really brought fibre to the front of hold on a second.
This is a whole other aspect of fibre that we hadn't fully even appreciated.
That is really essential for us to have this thriving gut microbiome.
These trillions of tiny living organisms that are a cornerstone of our health.
A forgotten organ, if you will, because we didn't even know it existed.
And yet now we really recognize that it is kind of foundational, not just for your digestion.
I think this is where again, fiber has really shifted from talking about, you know, talking about gut health, talking about the gut microbiome and talking about fiber collectively has moved from talking around okay, it's simply good for digestion, simply good for doing a nice, you know, smooth poo.
This is all a bit awkward, embarrassing to hold on.
This is foundational for our entire body health And this is something we need to be talking about.
And I think that's where really fibre has now stepped into the spotlight more and is finally getting the recognition it deserves.
In Fibre Power, you talk about at least...
10 different benefits of fibre when we're thinking about our health and wellbeing.
Cancer risk, brain power and memory healthy ageing.
I thought what might be quite fun is to go through each of the 10 and just get a little understanding of how fibre helps us with each one of those.
Because, as you say actually, if you want to live well for as long as you can, fibre is going to help you.
The first one I think you write about is it's fuel for your microbes.
I guess you've kind of just touched on that, but what is it we need to understand about fibre in that context?
I think what's key about fiber is the fact that it's almost this rebel nutrient.
And what I mean when I say that is that when we think about your digestion, your digestion starts in your mouth, then it goes down to your stomach where you've got this kind of swirling sack of acid.
And then it's your small intestine.
It's almost like this kind of garden hose pipe that is part of the next stage in your digestion.
Now, the small intestine is a bit of a misnomer.
It's actually pretty long.
And that's where 90% of the nutrients that you eat get absorbed.
So things like protein fats, simple carbohydrates that's really getting absorbed into your body for your body to use for energy and nutrition.
What's happening there that's different with fiber is that fiber is resisting being used by your body.
We don't have the enzymes.
Our body doesn't have the enzymes to break down fiber.
So actually what happens is that fiber then passes through to the lower intestine, which we previously only really thought of as this almost like sausage-packing factory getting ready for poo to kind of be shipped a bit further down and out into the toilet.
But actually, this is the home to your gut microbiome, these trillions of tiny living organisms.
And so this fiber is landing on their kitchen table, meaning that they then can feed on this fiber that helps them to grow, to multiply.
But actually what we really get excited about with a gut microbiome is them making molecules for your health and in particular a group of molecules called short-chain fatty acids.
And it's these short chain fatty acids which really help with the health of the cells that line your gut barrier lining.
They kind of act like battery chargers, you know, providing energy, but they also can be absorbed into your body and travel around to different sites and really support your health in that way.
One key example, just to show that how far reaching these short-chain fatty acids are they help to kind of support the blood-brain barrier, which is this kind of protective membrane that kind of stops toxins getting into your brain but also helps nutrients pass through.
So you've got many different actions that are happening around your body.
So that fiber is so key and instrumental for that thriving gut microbiome to do the job it needs to do for our health.
There's been this growing awareness over the past years of the importance of gut health, right?
And as you say, there are all kinds of benefits for the rest of the body.
And I guess you just shared one of the possible mechanisms there, which is the fiber that you eat interacts with the gut bugs And that makes short-chain fatty acids.
And we know those short-chain fatty acids go all around the body.
They can have positive effects on the immune system, be anti-inflammatory, et cetera, et cetera.
And as you say, can even impact the blood-brain barrier.
So really, it goes way beyond just the digestive tract, doesn't it?
Yeah, absolutely.
And I think what I really like to think about and I think you talk about this a lot in terms of health as well is thinking about how do I feel in the here and now and how do I feel kind of later in terms of disease risk.
And I think the gut microbiome is absolutely one piece of the puzzle in terms of linking that with disease risk later in life, but also in kind of thinking about how is it influencing how we feel day to day?
And I think We do talk a lot about fiber in the gut microbiome, but also fiber is doing so much without necessarily even feeding our gut microbes, because actually there's lots of different types of fiber and I'm sure we'll go into this.
Some types of fibre feed your microbes, some types of fibre don't, but they're also helping how you feel in the here and now and also later on.
So examples like that are balancing your blood sugars.
So when you have a meal...
You then have energy that lasts longer throughout the day and you kind of feel like you've got focus and you can kind of get on with what you need to be doing, because you're not kind of on this kind of roller coaster ride.
Same with helping you feel full and satisfied.
That's then going to help to, you know, mean that you're not kind of feeling really hungry and kind of scratching around for snacks during the day.
When many of us think about diet or food or how we might want to eat, a lot of us think about fat, protein and carbs.
We think about those three things and often talk about what we're doing with our diet relative to those three macronutrients.
You know, protein, of course, has been all the rage for a few years now.
People talking about how much protein you need.
Scientists and researchers arguing about how much protein you need.
Should you measure it at each meal or, you know, all kinds of things.
But do you think that we have over-prioritized other nutrients at the expense of fiber?
I think with protein in particular, I think we really went down kind of.
You know, protein was prom king.
He had the stage to himself.
There was no one else kind of invited to the table.
And yes, I think it's quite difficult.
We've got to have a nuanced conversation around this.
Protein, of course, is important.
And, you know, quite often most of us do need to be getting a bit more protein.
But I think with nutrition we become so hyper-focused, like a telescope lens, on one single thing.
That then means that there's just not room at the table to bring all these kind of other nutrients or other kind of dietary components to play.
With fiber, I think there's some concern.
Hold on, fiber's now the new kid on the block that we're all talking about.
And it's like, oh, we're going to have the same problem again.
And I actually think it's a very different case.
And the reason I say that is that protein foods, that most of us, if we're eating animal-based foods like chicken fish, eggs do not contain any fiber, but fiber-containing foods do tend to contain some protein.
So you're kind of already getting this mix and medley of yes, you're still supporting your protein levels in some way.
So I think there's less of a concern that we're going to end up just having a massive switch to another nutrient.
But I do think it means that we do need to just be thinking collectively.
Like in my book, for example, I very clearly have the recipes as both meeting protein needs and both meeting fiber needs, because I think we just need to stop having this.
You know one or the other.
Let's think of it all collectively and that's what's going to make you feel great, but really recognizing that, where's the spot that we're really, really struggling with?
And actually if you break down you know the kind of general nutrition guidelines, they often get kind of summarized into kind of nine key kind of recommendations for the UK dietary guidelines.
So things like Fruits and vegetables, you know, are you having your five a day?
Are you having, you know below, a certain amount of kind of free sugars, things like saturated fat and kind of processed and red meat?
Of all those nine, the one we're really doing the worst on.
So worse than sugar, worse than how many people are having fruit and vegetables, is fiber.
So that's, you know, 4% of people are meeting that recommendation.
25 of people still very low.
Amount of people are generally meeting their five fruit and veg a day.
So we need to be doing a lot more work across the board.
But that one key element where we can make a massive difference is is the gap that we have.
That's the biggest.
And that's where Fibra is.
Only 4% of us are meeting that recommendation.
I mean, that's staggering.
And then I think about the current state of population health, let's say here in the UK.
We know that many people I think in the UK it's around 60 or at least 60, but I know in America this is 90 of people have some degree of metabolic dysfunction.
And regular listeners of this podcast will know, but if anyone's tuning in for the first time, poor metabolic health is one of the root cause drivers of multiple chronic diseases heart attacks strokes Alzheimer's, even maybe up to 40 of cancers we think are related to some form of metabolic dysregulation.
Right,
So I think if a large part of the population are metabolically dysregulated and only 4 of the population are meeting the fiber guidelines, Is there a correlation there?
Should we put those things together and go?
Actually, you've already mentioned how fiber helps with blood sugar, but do you think, for example, that if we were, as a population, able to increase our fiber intake, that actually our metabolic health is also likely to improve?
Oh, absolutely.
I mean we have really strong evidence, the concrete kind of long term studies.
You know meta analyses of observational studies that show that there is an associated risk stepwise, of how much you increase your fibre by to a lower risk of type 2 diabetes, heart disease, colon cancer.
And even looking at things like, for example, your HbA1c, which is your kind of report card of your blood sugar control over kind of a three month period, you know lower levels of that with eating more fibre and I think You don't have to go from zero to hero.
I think ideally we want to be working our way up to that 30 grams, and if not perhaps a little bit beyond as well.
That's still kind of an area of unknown that we don't know much about in terms of...
How much more sizable are benefits at maybe 40 or 50 grams?
We don't necessarily have the research there yet.
But even just a small amount of fiber, just seven grams more on top of what you're already eating, is related to significantly lower risk.
That's the same as having a half a can of beans.
That's how much more we're adding.
That's not that much adding to your plate.
Yeah.
Just reading your book over the last few days actually has reminded me about the importance of fibre.
Again, it's not that I don't know that's right, but we all get stuck in certain patterns of eating, right?
And just reading the book reminded me to go.
You know what?
You could just add some nuts and seeds to this.
You know, like I used to do that, then maybe I was in a habit of not doing that.
Like last night, I had some coconut yogurt, blueberries and I added some nuts and seeds and pecans because of reading Fiber Power.
Again, it would have been a great meal or a great snack without that, but it was quite easy to just up my fiber intake by those two small things.
That's why I feel so strongly that there are small little changes that we can make.
And I think you know again the difference between us understanding about protein.
Most people will be able to say hey, can you just list some high protein foods?
They will list off eggs fish, maybe also beans and lentils.
That's very much kind of in our psyche, in our understanding of nutrition.
But if I say the same about fibre, you know the room goes quiet and i totally get that.
We think.
We think okay well, hold on, do i talk about all brand or kind of?
We talk about some kind of some high fiber cereal or something that we just associate as being quite brown and heavy, But actually fiber is found in an absolute wealth and range.
I mean, it's pretty much in every plant food.
But the key ones that are really kind of high in fiber are things like beans, whole grains and nuts and seeds.
So yes, fruits and vegetables fantastic sources of fibre as well, but just don't pack quite as much as those beans, whole grains and nuts and seeds.
And I think I feel so strongly about how can we break this down?
Like what could that look like on your day to day?
So I kind of talk about something called, which I call a kind of 4-3-2 method, which is when you're building your plate.
Let's just think of this like the starting point to your meal.
It doesn't have to be every meal.
It's just like if you're thinking about, you know, how you're putting your meal together and if you can make a quarter of your plate whole grain so that could be whole grain pasta that could be bulgur wheat that could be kind of you know brown rice what other kind of whole grain kind of grains that you have and then so that's you know four is a quarter quarter of your plate and then think about a can of beans if you can do a The three is a third.
So things like chickpeas, butter beans, cannellini beans.
There's so many beans out there and they're absolutely delicious.
If you could have, make sure that you're including in that meal somehow.
You could be cooking it into a sauce.
You could be blending it up into a dip.
But having that kind of quantity a third of a can onto your plate, and then having some nuts and seeds,
So, you know, the two comes from it being half a handful or just two tablespoons of seeds.
And just having that.
You can mix that all into a delicious salad.
Add in your chicken, add in your eggs, you know, add in some avocados, some healthy fat.
But just if you've got that kind of framework, you are automatically hitting 10 grams of fiber in that meal and you don't have to weigh anything.
And you're sort of...
Well, I guess aspirations for people is to go for 10 grams at each meal if you can.
So on three meals a day, that's your 30 gram target.
Is that right?
Yes.
And the reason I say let's split it across the three meals is that fiber is pretty potent.
It's pretty powerful.
If you eat too much too quickly and you're not used to it, your gut needs time to adapt and actually it's kind of like your gut microbes have been in kind of famine mode and you're suddenly throwing them a massive feast and they get a little bit kind of drunk on all the you know, the Kool-Aid of what's available.
And one of the things that we know our gut microbes do is yes, they make these molecules for our health, but they also make gas as a side effect.
So if you go, you know, straight from 0 to 100 and eat a tonne of fiber in one sitting, you can potentially end up with having a lot of discomfort in terms of your gut.
It's not harmful, but it's kind of like running a marathon if you've never run a marathon before.
Does that mean that, Emily?
Some people will say beans gives them gas and wind right, and that might be a reason for them to not continue eating it?
Are you basically saying look, give it time, build up slowly and after a month or so you won't feel that gassy and that windy?
Is that what you're saying?
Or will it always make gas to a certain degree?
So we haven't got that many clear, clear cut studies on this.
Surprisingly, maybe scientists don't want to research farts, but we do have some of the studies that I did find when I was looking into this.
And actually, funnily enough, we're building this into the study that we're running now, which is called the Eat Fibre Study at King's, where we're wanting to understand how your symptoms change on a week-by-week basis from eating more fibre.
But effectively, what we know at the moment tends to be more based around fiber supplement studies.
And what we see in the first few weeks is an increase in farts when you're having those fiber supplements.
But actually, your gut microbes and your gut adapts.
And actually for those participants, their amount of farts went down to what they were before.
So I think, yes, you probably are going to be a bit more gassy, but I also think everybody farts.
If you can go for a walk after a meal, that's going to be great for your energy levels.
Let it rip.
You're outside, you know, maybe you can play some music and do it very silently, depending if you've got people around you, or maybe you don't have people around you and you can just really, you know, be as musical and fruity as you need to be.
But I think also the key thing is that they're not necessarily going to be smellier.
I think that's probably maybe something that people worry about, because the smelly parts of farts and it tends to be just, you know, a gas that makes up kind of 1 of the kind of gas volume um, of of your farts, of which most people are farting, you know, 20 times a day and don't even realize it.
Um, that's just very normal.
Uh, it's that 1% that has got that kind of rotten egg smell.
And that actually comes from kind of uh, certain amino acids that are kind of sulfur, sulfur based um, that tend to be um more in meat.
So if you're a big meat eater um, that tends to be more a reason of why that might be you've got more kind of stinky farts.
Though those compounds are also present in things like broccoli and cauliflower.
Obviously those are really good for your health.
It's not that we shouldn't eat them.
But little things like drinking enough water and fluid to get things moving through at a nice pace, making sure you're moving your body, all these things.
And I think that's another reason why in the book I don't just do a four week plan of slowly increasing your fiber.
There's also lifestyle changes that you make alongside that.
So, for example, week one is very focusing on drinking enough water, because fiber acts a bit like a sponge.
And then it's kind of moving your body, all these kind of different, and thinking about how can we, you know, look after our kind of mental well-being and that connection between our gut and our brain?
So all these things can help.
That's one thing I really enjoyed about the four-week plan in the book was that each week there was a food change and a non-food change, which I think is critically important, because There are so many factors that impact our health our gut microbiome yes food, but stress movement, how much we slept, you know, all kinds of things also play a role.
So I really appreciated the fact that it was quite a holistic approach to you know yes, increase your fibre, but also just generally improve your health and wellbeing.
I don't want us to go through these 10 benefits, and I know we've covered a couple of them.
We'll get back to that in just a minute.
One thing I think is really worth bringing up here is this idea that everyone is going to hear this message, but they could potentially be in a different state of health, right?
So I totally understand that if you are, you know, well, and you're, I don't know, teenager or in your 20s or 30s, you've never had any problems, you're just trying to look after yourself, yeah.
These are great recommendations you spoke about, whole grain pasta, right?
Let's say someone has got type two diabetes already, okay?
So the preventative element of eating fiber to prevent these problems in the future.
I wouldn't say it's out the window, but they're at a different point on their health journey.
And let's say they have found huge amounts of benefits from adopting a low carb diet.
Some people who do that may be thinking yeah, but on that sort of diet I don't eat whole grains and I don't have whole wheat breads.
I just think it's worth making sure we're keeping those people in mind.
Is every element of the recommendations for everyone, or in those particular individuals?
Might it be that hey listen, there's many ways to get fiber but yeah, maybe you're going to benefit from not having these types of fiber and increasing other types?
No, absolutely.
I mean, I think, as you say, like broadly generally, if you're well and healthy, then you know you can pretty much dive right in and kind of low and slow increase.
But of course, if you've got type 2 diabetes or you're on a low carb diet, it doesn't necessarily mean that it's completely kind of contradictory to eating more fiber.
I think what's so key is understanding that fibre is present in so many different foods.
So if there are certain foods you might have a food allergy, you might not be able to eat a can of nuts, for example.
So there are so many different options.
And I think, again, in the book, I have tables of different foods.
Yeah, you do. so that you can really kind of change and add in what you want.
And so I really want that to be a kind of flexible approach of also your own preferences.
Like this is how I eat, this is how I feel well.
How can I then adapt?
And I mean I used to work as a chef for five years and I worked a lot with people who had health problems and dietary preferences.
And for me, it was always like, what are you eating now that works for you?
What would you like to change?
But and how would you enjoy and how can I kind of move things that way?
I'm not going to come in and completely say you need to have this meal that you absolutely dislike, and it's going to make you feel rubbish.
Um, so very much what's going to work for you.
And I think this low carb and high fiber is.
Maybe they're going to be the kind of new talking point when we talk about um carbohydrate diets, because the same, very similar with IBS, for example.
That's been some benefit um.
For some people in a lower carbohydrate diet.
There's some evidence that has different dietary strategies.
But again like kind of just bringing in the language there of low carb, high fiber absolutely possible and not you know one or the other.
Those examples are really interesting because...
There's what's the right diet for you right now with your current state of health.
And then there's also, if we work on various aspects of your health, how might that change?
And so, you mentioned IBS there, right?
So for some people with Irritable Bowel Syndrome and there's many different types and each individual is unique and we'll need to find the right approach for them
But it could be that on a low carbohydrate or a low FODMAP diet, let's say for a few weeks, they feel really good.
They don't get the gas and the bloating and their symptoms are better, right?
So there's a temptation then to stay on that diet long term.
And I get that because they feel good.
So why would you want to change that, right?
But of course, over time, we want to see if we can broaden things out for you.
Another example which I think we touched on the first time you came on my podcast, but I think again it's worth talking about, because there are a lot of people who are experiencing relief from their autoimmune symptoms when they go in what's called the carnivore diet.
Right,
Or they go meat heavy and they're cutting out all plant food or virtually all plant foods.
And they're feeling better in themselves, right?
For someone like that.
What would you say to them when it comes to thinking about their fiber intake?
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I think we need to recognize that if you, you know, quite often, if you get to that stage, you know you're in a condition that perhaps you've seen multiple, multiple doctors and you are just at your absolute wits end to want to find a solution.
So I totally kind of understand why somebody might want to try a carnival diet, for example, and think, oh my goodness, I've just had relief for this significant period of time.
Yeah.
I think there's so many different individual factors that could be going there.
But I probably would say is that we know that long term in terms of you know if that's having short term relief, but long term that is not going to be ideal for your health and may end up just causing more problems later on.
And actually, if you can go to, for example, a dietician or clinician, you know, have some personalized structured support into you know introducing things back in, because it might be that there's some key elements there that you know haven't been picked up on before, that you're suddenly like oh, hold on, actually it was this bit but you've cut out and that absolute swathe of everything else that are probably fine and very great for your and supportive of your health.
And I think quite often what happens with these very restrictive diets is that they can feel you know better, but when and I think you know people are going to say this they they bring stuff back in, having not had it for a very long time.
Your body can suddenly go oh, hold on, What's that?
And so they're almost stuck in this trap of oh no, I can't eat anything now, which is completely debilitating as well.
And I think you've got to really recognize how that impacts your social life.
That impacts you know what can you at the supermarket, your time and what you're cooking, also kind of financially.
So I think...
If we could, you know, have a lot more support of people being able to connect with, getting that support from a dietician, for example, because and again I say this in the book I say if you have a gut health condition, you know you are probably very much in need of specific advice that is unique to you because it is very different from people.
It's all very much different. what's going to help you.
Yeah, I really like that approach.
So once you acknowledge that, in the short term, certain diets, certain restricted diets, may offer symptom relief to people, you're basically saying look, the research on fiber is pretty damn solid and pretty overwhelming okay.
If we can, let's see if we can help you over time by starting slowly and by recognizing that there are lots of different types of fiber.
Not just one thing you try that you go, I'm not good with fiber.
It's like, hold on a minute.
Why don't we just try it?
We'll start small.
We'll try some things you haven't tried yet.
And let's see if, over a period of months, we can, you know, increase the range of foods that you potentially have access to.
I think that's a really nice approach for people to take.
Let's go back to these benefits.
So we've done fuel for your microbes.
I think you also touched on the second one, which was more fiber helps us to lower inflammation.
Anything else you want to say on that?
You mentioned short-chain fatty acids.
Anything else that's worth commenting on?
Yeah, so I think, I mean, again, it's going back to that kind of whole body health.
And we know that you know low grade inflammation, which is kind of like this kind of background wear and tear that we might not even pick up in terms of how we feel.
But we you know, you might just be not feeling quite right or you might not kind of notice that's happening.
I talk about it a little bit like anxiety.
You're, you know, a train going around a track and if it's going too much at high speed, it you know that track might start kind of the wheels are going to start squeaking and you know, maybe some sparks happening and your body's just getting a little bit too much stress and pressure.
And so what we see is that people, in terms of like patterns and populations, that people who eat the most fibre versus people who eat the least fibre, tend to have lower levels of this kind of background inflammation.
And this inflammation is often, you know... connected with different disease states.
And so it's something that we kind of very much see as like a potential kind of early warning fire for what could happen later down the line.
When we think about the topic of gut health yes, fiber comes up, but so do things like fermented foods, for example.
And how would you say the benefits of fermented foods, for example, compare with the benefits of fiber?
There was an interesting study done by Stanford University that effectively compared the two.
They did a high fiber arm and they did a high fermented food arm.
People who were eating the fermented foods were eating about seven servings of fermented foods a day.
So that's quite a lot.
And they kind of, you know, looked and tracked them and looked at what happened towards the end.
And actually, funny enough, in that study they didn't necessarily see that there was inflammation kind of impact in terms of the fiber, but they did see that with the fermented foods now a lot of that might be like, oh hold on, that's completely opposite of what you've just said, but i think we've got to really program into, is it that fiber just needs that bit more, much more time.
This is, you know, so that when I talked about that pattern in the population, that's people who are already eating that diet, they probably be eating that way for years and years.
We tend to eat very similar, consistently in terms of the macronutrients that we eat, And this was a short-term intervention.
And I think that just plays back to hold on.
We know if we make changes for our health, we're not just doing it for a couple of weeks.
We want to make changes that are simple and practical and that we're going to keep up in the long term.
And I think, particularly understanding that fiber feeds the gut microbiome, and the microbiome is closely related to your immune system.
70% of your immune system lives in and around your gut.
And they are constantly interacting with each other.
Your gut microbiome from birth is helping to train and shape your immune system.
It's a kind of very kind of strong kind of hypothesis and connection in between that being kind of a likely influence.
Yeah, I remember that study.
I think it was Sonnenberg and Chris Garner, wasn't it, who did that.
And from recollection, it was only about 30 people in that study.
And I do remember, as you say, that the fermented food group had lower inflammatory markers.
And I think it was like 19 inflammatory markers they measured.
It was lower.
But I think, you know, we have to bear in mind that a lot of studies are short term.
And of course, there's many things that can show a short term benefits.
But what we're really looking for is long term changes.
You know, sustainable things that we can change that give us those long term benefits with our health.
So on that topic, are you a fan of fermented foods?
I absolutely am a fan of fermented foods.
And I think, again, a lot of fermented foods do naturally inherently contain fiber in them anyway.
They contain so many different phytonutrients for our health.
If you think about kimchi sauerkraut, all these fantastic fermented vegetables, they aren't just containing those kind of live microbes.
They've got... you know, this kind of plethora of other benefits that are within them.
And I think again, this is why science is so kind of fun for us scientists and clinicians is that we'll look at different studies and it's just pulling that overall body of evidence together and also, you know, taking.
Okay, can I just think about this through a nuanced understanding that background.
How can I then interpret the findings from that?
And I maybe I have to come back in a year when we've got the results from our eat fiber study, which is running all this year.
And that is effectively comparing people who are eating 30 grams of fiber to eating 40 grams of fiber, and looking at the gut microbiome, looking at inflammation, looking at lots of different other risk factors.
So yeah, very excited to hopefully see what the results of that are.
Is that eat fiber study also to try and assess bowel cancer risk in under 50s?
Yes, this is a kind of huge project and initiative, which is a £20 million funding which is fronted by Harvard.
And it's a Cancer Grand Challenges initiative.
And we are looking at why is bowel cancer rising in people under 50?
How long has it been rising for?
It's been rising consistently.
You know we've got each kind of batch of kind of what we call birth.
Cohorts are consistently kind of getting.
The risk is increasing.
So for example, in the UK in 2017, 5% of the cases of bowel cancer were people who were under 50.
Now that's Ten percent.
So that proportion has increased and there seems to be this increasing amount of people under 50 where those rates are increasing.
But people, this is traditionally a disease that is of people in their 70s.
It's, you know, it's been very much a cancer of of old people.
And yet levels seem to be stabilising in older adults.
And yet we've got these kind of rising risks.
So we're thinking that perhaps there's something that's happening consistently, maybe at an earlier point in life.
So maybe kind of. adult you know young being a young adult maybe earlier than that being a child or maybe it's you know antibiotics when you're when we're in babies and children so there's lots of different potential things is it microplastic is there dietary influence because we know with bowel cancer, that diet is probably one of the most central players in terms of the different cancers because your gut is directly interacting with the food.
You just mentioned an increase in rates from 2017, but were rates going up before that?
Yes, it's quite scary in a way of how the rates are increasing.
So if you're born in 1990 or afterwards, then your risk of getting rectal cancer is potentially quadrupled, and your risk of getting colon cancer has doubled versus if you're born in 1950.
So this has been happening for quite some time.
And so this eat fiber study you're basically trying to see if you can figure out what some of the causes of that might be.
We're looking at healthy participants, so they haven't got bowel cancer.
But what we're really wanting to understand is that preventative element.
So are there certain risk factors, certain signals that we start seeing in people's biology?
So that might be changes in their microbiome.
In their blood, in their urine.
There's lots of things that we're collecting and seeing, whether by changing their diet, by eating more fiber, but also looking at a variety of fiber.
So we're particularly giving lots of recommendations around carbohydrates.
Can you eat more whole grains?
Can you eat more beans?
Can you eat more nuts and seeds that aren't currently in the UK dietary guidelines to have specific quantities for those?
And seeing whether that is going to make a significant difference. in terms of those risk factors.
And I think really what's been so instrumental is that we've so wanted to design this study to have very simple, actual advice that can come from it.
So it's not something that you're like.
Okay well, this is interesting science, but what can I do about it?
The whole principle of the study is Can we really you know depending obviously, if we get you know, positive findings can we give people simple, actual advice based on this?
And we're comparing it to the current goal, standard practice advice, which is the UK dietary guidelines.
And so we really can see, is this necessarily better?
And therefore you know that give people that really kind of confidence that the changes they make are, you know, really kind of true to the science that we're seeing.
In the meantime, whilst that study is taking place, from your research can we convincingly say that people generally who have higher fiber diets tend to have a lower risk of certain types of cancer?
Yeah, absolutely.
So for every 10 grams of fiber that you eat, that's related to a 10% lower risk of bowel cancer.
But this tends to be that, you know, this is looking at all types of bowel cancer here.
And so one of the reasons for that is that, you know, we have all these different types of fibers.
There are certain types of fibers called insoluble fibers.
And these are kind of the ones that bulk out your poo and also get things moving through your gut at a timely pace.
You don't want things to stick around for too long.
So it's a little bit like a kind of sweeping broom.
It's kind of moving things along, getting things to move on.
And that is very important.
If we have potentially problematic kind of compounds that might just that's naturally just what happens maybe things that could end up being carcinogenic.
If they're hanging around.
Those compounds are hanging around in our gut and having too much contact with our gut for too long because you've got a very slow transit time.
You know things aren't moving.
Then that is potentially, you know, one of the factors that we think is kind of what's it could be kind of triggering cancer in some people with this.
So that's one of the key reasons that fiber can be really helpful in that sense, in terms of preventing.
Okay, so we've got so far.
The fiber is helping us because it's fuel for our microbes, our gut microbes, I should say.
It helps to decrease inflammation in the body, which can have all kinds of other benefits.
You mentioned how it can help balance blood sugar and reduce our risk of type two diabetes.
You just mentioned cancer.
Okay, so I've ticked off four out of the 10.
Curbs, hunger and craving.
I think you sort of touched on this before, but anything else we need to know about how and why it curbs hunger and food cravings.
Yeah, so there's lots of different things happening, but mainly really is that fibre does tend to add bulk to the foods that you eat.
So it just makes you feel kind of, and that's why you feel kind of fuller is because that bulk is effectively stretching out your stomach and stretching your gut.
And that is then sending signals to your brain to say oh great, hold on, I think you've eaten enough, because I can sense it.
So that's one of the reasons why we have that.
But also it's the gut microbes that are also involved in this as well.
And they're really a player in every single aspect of the things that we're talking about.
So they're helping to influence the release of those kind of satiety hormones in your gut.
Again, sending messages to your brain saying, hello, this is time.
I feel good now.
The meal's over.
I've got what I need.
So the gut microbes are also playing a role in that as well.
Even if we think about curbing hunger and cravings through the lens of what you just said, right?
You're providing bulk and stretching out the stomach.
So it's sending messages to your brain that, hey, I'm full now.
The amount of people who struggle with their calorie intake, right?
I'm not saying necessarily to focus on calories.
I'm just simply saying that, you know, yes, as a population, we're putting on weight.
And, of course, a lot of people are trying to reduce their visceral fat levels and all kinds of other things related to weight.
It could be.
If you're trying to moderate how much you eat, maybe increasing your fibre intake is a very quick and easy win there.
I think also the biggest shift that I see, and I think you know I hope my mum doesn't mind me talking about here that in a sense that she's wanting to lose weight.
She's postmenopausal.
She has kind of gained a bit of weight in later life.
And she's of the generation where you know if you're wanting to lose weight, you make you know whatever's on your plate a tiny, tiny little kind of bird-sized amount of food.
And then she's absolutely ravenous.
She's so hungry.
And then she's kind of stressing about okay well, I just ended up having loads of biscuits because I was so hungry.
And I think this is such a different way of eating where, if you're putting loads of fiber on your plate, you are eating in abundance.
You're eating, you know, what feels like a very like almost indulgent amount of food.
It feels like so refreshing versus, particularly for women, where we're kind of almost institutionalized to, oh God, we've only got to have a small amount.
Um, this is, you know, eat to your fullness, eat, you know, and enjoy it.
And it's different, lots of different colors and lots of different flavors.
It's a very joyful way of eating that these foods that are high in fiber are naturally lower in calories.
They contain a lot of different micronutrients for your health, meaning that yes, you're eating more fiber, but reaching many of your other micronutrient needs as well without necessarily needing to think about it you feel full you feel energized and i think you know going through the day where you feel like you've able to focus you're able to do the things you want to do and you're taking care of both your body and your gut microbiome um it's and it doesn't feel restrictive Yeah.
You mentioned before how you used to be a chef.
I remember from our first conversation I didn't get around to asking you because I think was it you used to be a chef on yachts from recollection.
Yes.
What do you think that those years of being a chef people on yachts, what do you think that taught you about nutrition?
Oh, I think it taught me so much.
And I think I was quite shocked when I went and did.
So I did my undergrad in nutrition, worked as a chef for five years.
And then when I did my master's in dietetics.
I remembered it was me and one other person could chop an onion.
And I thought, how are you interested in nutrition but don't know how to cook?
Because it was so foundational to me that, of course, if you're interested in food and the impact that food has on your health, then you need to have a deep-rooted understanding of nutrition.
What flavors go together?
How can you make food joyful?
And also cooking for other people.
I think it constantly makes me think about that person likes to eat in this certain way or has these certain requirements.
And you can, you know, I think on super yachts, there's no such word as no.
You know, if somebody says they want to eat bread but they don't eat grains, you know, I think I had one.
I mean, it was a disaster and it was disgusting.
So please, no one try this.
But, you know, I made bread out of broccoli.
I was like, but, you know, we made it happen.
Bread without the grains.
Right.
And it was so you kind of, you know, where there's a will, there's a way.
And and I think it, I so sort play out time time again where you know quite often people would want to come in and have, you know, just a massive health kick and they wouldn't want to have anything that was sweet and delicious.
And yet they would then completely kind of fall into a pit and go and have a very indulgent meal, or just like be rifling through the snack cupboard.
And so it was just something where I just saw this pattern of yes, we need to think about things.
Most days,
I think that's something that's been really instrumental with how I think about nutrition.
It's?
Can we make changes for our health?
Most days that work for you, that you enjoy food that you enjoy and you'll eat, but of course still have those delicious little things here and there, because that's also part of a balanced lifestyle.
What do they think of your broccoli bread?
I think more the deckhands were irate because it crumbled all over the deck and I think they had to wash it all away.
What do you even put on broccoli bread?
Like how do you put jam on it or marmalade?
We were racing for a regatta and yeah, I think it was, you know, had all the kind of fillings, but it was just disintegrating as the poor man was trying to eat it.
I'm sure a valuable life experience, right?
Being in what many might regard as a privileged environment, but having to work and actually cook food and cater to people's tastes.
Do you think your experience on those yachts has helped you design recipes in this book?
Oh, absolutely.
Absolutely.
I was like, I know what I really set myself.
I was like I want all the nutrition targets that I want to meet, but mostly I want it to be affordable simple, practical.
I was making, we were doing the development only using one or two pans.
I was like, no, this is going to be simple.
But at the heart of it, it's always been, this has to be joyful.
This has to be delicious.
And yes, simple, easy.
Yes, hitting all the nutrients.
But this needs to just make you feel great.
Just when you're from that first mouthful or even just before the first mouthful, you see it.
I mean, the book is packed with color.
I was so felt so, so strongly about that.
I was like fiber.
No more of this brown, dull stodge.
You know, now this is, you know, fibre as it should be.
It's colourful, vibrant, and it's going to make you feel energised and fantastic.
What's your favourite recipe in the book?
Oh, there's some that have like an emotional connection.
For example, there's the carrot cake, which my mother always used to make.
And I've made for my brother's wedding and I've made for a friend's wedding.
That slightly had a few kind of tweaks to amp up the fibre.
So that's quite close to my heart.
But I love all the kind of salads.
There's a salmon salad which has got lots of kind of very spring, like kind of fresh green vegetables, kind of peas and mint, which is all kind of very delicious and very, I guess, of the spring that we're in now.
But lots of, yeah, lots of favourites in there.
They really are, I guess, a love letter to fibre.
It does very much feel to me that you're trying to make the case for fibre in quite an inspiring and aspirational way.
I think you've done a really good job with that actually.
As I say, it's helped me immediately just add a few tweaks.
And again, it's not that I don't know that more fiber is good for you, but we all need a reminder from time to time that, oh yeah, it's not that hard right.
So I think we've done five benefits so far out of your 10, and I think there's more than 10, but I wrote down 10 as I was going through the book.
I thought this would be quite good.
You say that more fiber helps us with healthy aging.
How does it help us do that?
So, in terms of healthy aging, I think quite clearly we talked about reducing risk later in life.
But there was really an interesting study, a large study done in Australia, where they tracked older adults for over a decade.
And what they found was the people who were having the higher fiber diets were 80 more likely to kind of just be living well in terms of having better kind of cognitive reserves, kind of moving ability, than people who were eating the least.
I think that really tracks quite nicely on top.
Quite often we see fiber as almost a signal of a general healthy dietary pattern.
So it's one of the kind of key ways, as nutrition researchers, that we tend to see if people eating more fiber, they tend to be eating more fruits and vegetables.
They tend to be eating more whole grains, more beans, nuts and seeds, obviously within what you choose within that.
So it's a kind of clear signal that fiber impactful, but also that kind of healthy diet throughout life as well.
Yeah, it's an interesting study, I guess.
Is there a downside to that sort of take in the sense that someone who's eating more fiber is likely to have other helpful components in their diet?
They're also, I guess, likely to have more helpful components outside their diets, like they're probably not drinking alcohol to excess.
Maybe they're not smoking as much.
And Is that not what the e-fibre study is trying to address in some ways?
It's like a direct intervention on increasing fibre to see prospectively what happens?
Yeah, exactly.
I mean, it's something, so my background is this, what we call epidemiology.
Right.
Kind of, as you say, looking at patterns and populations and, as much as you try, and you know, effectively adjust your analysis to account for these other factors because, as you say, people tend to eat healthier foods, tend to perhaps be of a slightly higher income and tend to spend more time exercising, tend to sleep better.
So it's like, how can we account for these other factors?
So we do in our analyses, tend to adjust as much as we can, But within that there's still an absolute recognition that that could be a signal of you know other things within that, which is why I'm always quite keen to say you know, fiber is such a great one for saying we need to get more of.
And naturally then around that you'll get all the other wonderful things that come with fiber from this whole foods industry.
But it's also, they're all playing, you know, it's not just one instrument.
We're looking, we're talking about the orchestra, really.
Yeah, that's a beautiful way of looking at it.
And I think if we have populations who've been eating high fibre and have been healthy and living with great health spans for multiple decades...
You know, it gives us a great degree of confidence, doesn't it to go, this is likely to be a helpful recommendation.
Yeah, and they all layer on top of each other.
And I think again the fact that all these studies again have been pulled together and then people have done what we call almost like an umbrella.
You pull everyone under an umbrella and then you look at what's the general overview.
And I think we are.
This is what's so fantastic about talking about fibre is that it's not just a handful of a study here and there for most things.
It's really that there is just this overwhelming amount of evidence and yet it just hasn't really played out in terms of what the public are hearing.
Yeah.
You mentioned heart health before, so I'm going to give that a tick.
Mood and mental wellbeing, how does fibre help us here?
So this is one where there is, this is like newer research into how we're looking at it.
What we see in terms of mood and kind of memory is again stepping back to that.
What is a general dietary pattern that is healthy?
And that does tend to be higher in fiber, but of course, recognizing that there are other components that are important for brain health.
In that
So we know, for example, in the SMILES trial, which was a Mediterranean dietary pattern, high fiber, full of beans lentils, nuts and seeds, whole grains.
What they saw was that, after that intervention in people with depression, that 30 of people at the end of it still doing their therapy, still taking their medication but we're not seen as falling into that bracket of what is clinically defined as depression in comparison to the group who were effectively doing what was called a befriending protocol, which is like social interactions.
Just so people are not thinking that was a vegan diet.
There was fatty fish and lean meats in it, I'm pretty sure in the SMILES trial.
Yeah, absolutely.
As well as those things, there was these rich, diverse arrays of fibre, weren't there?
Yeah.
Yeah.
And I think that's you know, all these foods, lots of different colours, lots of different textures.
You're getting an absolute variety of different types of fibres in that that are supporting health.
So we think, and again, if we think, about brain health being effectively very similar in terms of how we look after our heart health.
We need to be thinking about supplying nutrients through our kind of blood flow to our brain.
And the same is for our heart.
We want to make sure that we're not clogging arteries.
So things like blood pressure, blood sugar management, looking after your cholesterol levels.
Those are things that fiber are really helpful for, but also really important for your brain health.
Also looking at some kind of early supplement studies that have looked at prebiotic fibers.
Now, these are particular types of fibers that feed a select group of microbes in your gut to then have a health effect.
What colleagues at King's College London found with certain prebiotics is that these were kind of, you know, generally well slightly kind of, I mean, I think, average kind of 60 years old, kind of females.
After, I think, a couple of months of taking these prebiotics.
Versus the placebo, they were performing better on cognitive tests that are often used as early checkings for signs of Alzheimer's and dementia.
So some kind of cognition benefit there.
And we do see in terms of emotional frameworks again studies from Oxford University, not necessarily seeing people report better mood, because that's kind of quite subjective.
It's quite hard to see.
But actually seeing that perhaps there's some kind of underlying kind of automatic response that's happening, that's making them more drawn towards positive items versus, and spending less time and less attention on, things that are kind of negative.
Wow.
You mentioned the term prebiotic there.
For people who don't know what that means, can you explain what it is and give some examples?
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So prebiotics, so you have types of.
I'm going to talk about it in terms of fibre, because a prebiotic can also not be fibre.
If we talk about it, you have fermentable fibres, which are really the group of fibres that feed your gut microbes.
These aren't necessarily what we call prebiotic fibres.
They're actually slightly different.
That's because those fermentable fibres as a whole are just generally supporting your gut microbiome.
They're generally feeding them.
The slight unique difference there is that prebiotic fibers are feeding a specific group or specific number of bacteria in your gut.
And so and then having a health benefit that we kind of know about.
So these tend to be things like inulin, galactooligosaccharides.
And they, you know yes, we talk about supplements and I think there's so many, you know, on the shelves these days.
But really, they're found in everyday foods.
So things like garlic onions leeks asparagus, lots of different probiotics just naturally embedded in the foods that we eat.
And these are all helping to support your gut health.
Yeah, what I think is really great about the probiotic research and how we apply it in our own lives is that You know food has got more and more expensive, right.
But onions, garlics, leeks are cheaper foods, aren't they?
Yeah.
And I think that's what I think we are so bombarded with.
Take this expensive supplement, buy this amazing product and it's essential for your gut health and it's going to make all these huge differences.
I really, really think the benefit you're going to get for most of these unless it's something that's clinically you had a clinician really recommend it for a certain problem you know so small and yet you're spending a lot of money on it.
Yet those going back to that foundation, you know, building a kind of healthy balance plate, making fiber, kind of central for your gut microbes um, that is affordable.
It is delicious.
It doesn't have to be some, you know, um, very fancy, uh, super, super great.
Um, you know, it's just you know those, those everyday delicious um things that we enjoy and and just recognizing i think you know, maybe onions need to be the the superfood of the year.
Um, they don't ever seem to register on anyone's um you know health list, but they're very good for you.
I love cooking with red onions.
Yeah like, i absolutely love it, And they make any dish better.
I'm always like the base of any dish, onions, garlic, you know, you're already on a flying start.
So someone's heard up to this point, Emily, and they're like, right, that's me.
I'm going to get on my fibre game now.
And they come and see you.
What do you say to them?
I think there's key things.
It's like how can we recognize which foods are the highest in fiber, so that we can make it easy when you go shopping?
So no, I think I talked about this last time around the podcast.
Let's do it again.
I'm going to do it again.
But I talk about the BGBGs.
B, G, B, G. S. S. So these stand for, so B, berries.
Now, when I'm highlighting berries in particular is because any fruit that has some seeds in it are going to be naturally higher in fibre than other types of fruits.
So this is obviously a kind of bit of a rough and ready approach, but we're thinking about things like raspberries blackberries, but also some things that may be won't fall necessarily into the berry category, but things like passion fruit, for example, if you think about those seeds.
So that's just a really kind of useful way of okay.
If I'm thinking about fruit, the ones that are high in fiber are going to be the berries.
Then we're talking about greens.
This is basically thinking about green vegetables.
Again, just a kind of rough and ready, kind of easy way to think about which vegetables are higher in fibre.
So thinking about things like garden peas. thinking about green beans, thinking about broccoli.
You've got kale, a lot of different kind of green vegetables.
I might also.
I know that technically avocado is a fruit, but I always seem to.
I'm just going to put it in the vegetable category.
Avocado, surprisingly high in fiber.
And I think again, this is where we've got to shift away from thinking that anything that is crunchy is high in fiber, because that's not really the case.
That's one thing I remember from our first conversation very well is that avocado has got quite a high amount of fiber in it, which I don't think I knew up until that point.
I think, like many people associate it with, you know so-called healthy fats, but it's also rich in fibre.
It's one of the highest.
I mean again if you put it in the vegetable category, it's one of the highest ones in fibre in terms of vegetables.
For this acronym, you've gone for berries and green veg.
If we broaden out beyond berries, other types of fruit, of course, have fiber in them as well.
The reason you've gone for berries is to highlight that actually, if you're looking across the category of fruit, berries tend to be higher in fiber.
Yeah, these are really like your high-fiber heroes that I just kind of want to make them regular features on your plate.
When you're going to the supermarket you can think okay well, I'm going to make sure I have some of these around because it's going to make me hitting my fiber requirements that much easier.
But of course, all vegetables, all fruit, fantastic source of fiber.
This is more just a kind of quick hit list.
Like for example, with fruit, pears, really fantastic source of fiber.
This is why at the back of my book, I have a whole section of the list of the different fruits.
I have a list of the different vegetables.
So you can see yourself, okay, well, that's that.
That's got.
Do you know if hard pears are different in fiber content in any way than when it's sort of super ripe?
There is this change and I think particularly most of the research has been around bananas actually.
And if we think about a banana, obviously it has a bit of a life course, doesn't it?
We buy it and maybe it's still got that little tinge of green on it and we might start eating it when that skin turns yellow.
And then it might hang around in our fruit bowl and get kind of brown and spotty and, you know, slightly change shape a little bit.
So they've looked at actually the resistant starch content of that banana at different kind of phases of the banana's life.
And resistant starch is kind of newly added into the fiber family.
And you can tell from its name resistant being kind of rebelling against being digested by your body and therefore kind of passing through to your gut microbes.
And what those kind of just right bananas You can tell when you taste them, they're less sweet.
They actually have kind of higher amounts of resistant starch.
But that then kind of transforms into kind of simpler, kind of more sweet sugary flavors as that banana ripens.
So that kind of level of overall fiber is getting a little bit less, which of course, in terms of your health isn't really it doesn't make that huge difference.
It's just an occasional banana here and there.
But I did kind of cheekily use that as an excuse in my book for the banana recipe.
I always want to make banana bread when I don't happen to have lovely, you know very brown, ripe bananas which you're meant to use.
You know the very spotty kind.
And so I purposely made the banana bread recipe with the, you know, more high resistant starch bananas.
Of course you can use what you want, but I think I'm always like I want to make banana bread, so I'll buy the bananas, and then they're never quite at that stage.
So...
But potentially has a little bit more fiber.
Yeah, exactly.
So win-win.
So it's win-win.
So it totally fits the book, right?
I love it.
Okay.
We've got B for berries, G for green veg, then there's another B. What's that?
And then, so now we're in like the big fiber hitters.
Okay, so...
Wow, so we've just had like a warm up.
We've had this been the warm up.
Like the opening act.
Yeah, the opening act.
Because as wonderful as fruits and vegetables are, we need to be eating more of them.
They often don't tend to contain as much fibre as beans.
And also the next one is grains and whole grains.
And then S is seeds as in nuts and seeds.
So these are the three that you know.
Really, if you're getting those regularly in on a day-to-day basis, it's going to make it that much easier to reach your 30 grams of fibre.
Of course, these are all things that...
Listen to what works for you, your tastes.
You know, if you don't like, you know, nuts and seeds, you can shift to something else.
But I really like it.
It's just easy tools to be like.
OK well, actually I'm going to have some more beans, and beans can be things like
It doesn't have to be adding physical beans into things all the time.
It could be that you're blending it into pasta sauces.
I think this is like an absolute kind of trick that we could all be doing.
For example, like a tomato sauce.
If you blend in some white beans, like butter beans or cannellini beans, It's going to make it that lovely creamy, almost like mascarpone-like sauce.
And you're automatically boosting that fiber content.
Really great for kids who maybe might feel a bit kind of unsure about trying kind of whole beans.
And I also have a recipe where I make a kind of mac and cheese and it's actually a lot quicker and easier to thicken the sauce with blended beans.
You can't taste it at all.
It's still deliciously rich and cheesy, but it just kind of adds a bit of extra oomph without you realising it.
The thing I get from your book mostly is in terms of practical take-home.
Is it's really not that hard?
If you are aware of the foods that are rich in fiber and if you start looking at your diet through the lens of fiber.
Whatever your dietary choice is right.
Vegan omnivore, Mediterranean.
Actually it sort of doesn't matter, unless you're kind of super strict carnivore and not having any plants at all.
And we've covered that earlier on in the podcast.
I think pretty much for anyone else, it's not that hard once you know where these foods live.
Absolutely.
And I really felt so strongly that I was like, I wanted this to be a practical guide.
I mean, the whole beginning of the book, that first page says, this is for you.
Yeah.
Because I wanted to just give everybody the simple simple, enjoyable tools that you could then make work for your life.
I mean even yes, it's got kind of over 60 recipes, but it's also got what I call the food combos.
You know, each week there's a whole list of ideas of how you could throw ingredients together.
That aren't necessarily recipes, they're just five things that will help you meet your fiber and your protein.
So that could just be making a bagel that's a BLT.
What do you need to add and what do you need to think about for that?
Or it could be that it's a breakfast or a dinner or like sometimes I just like to have a sweet potato with some chicken and some broccoli, and what do I need?
To maybe just have a little bit with that.
So just really simple practical, because we are so time poor and, as you say quite often, you just happen to have these things in the fridge and not, you know, a full recipe itself For people who perhaps are trying to keep on top of their blood sugar.
So I, for example, will wear a CGM
Every so often, I have found it to be one of the most powerful behavioral change tools I've ever seen.
I'm not saying it's everything, but I think understanding what foods spike your blood sugar, give you rapid drops in blood sugar, which foods keep them relatively more stable, I think can be very helpful, certainly for me and many patients in the past.
What would you say to someone who's also trying to look at their blood sugar and think yeah, but some of these foods Emily, may really send my blood sugar soaring high.
I think this is really like we just need to bring fiber into the conversation when we're talking about carbohydrates, because really carbohydrates are things like sugar.
And really that particularly the type of fiber that's called soluble fiber and effectively it dissolves.
You might not even see it sometimes.
It's kind of fiber that dissolves into water and liquid.
But some of these types of soluble fibers also make a gel.
And so they can act a bit like slowing down that sugar release into your bloodstream, because they're acting a little bit like a kind of fishing net.
They're slowing things down.
And so all these foods if we're talking about things like berries, which naturally contain, you know, more kind of sugar in them, but it's a natural sugar that's encased within a structure, so it's going to naturally slow that down all these things have fibre in them.
So I think It's not to say that any of these things are going to necessarily be problematic for your blood sugar control if we're bringing fiber into the conversation with it.
I think Emily, you've really made the case well for fiber, both in your book and on the podcast today.
Just for that person who's thinking about getting involved now and increasing that fiber in their diets.
What are the key things that we need to remember?
I would say let's.
Yes, fiber is powerful, but let's just really remember that we need to start low and go slow.
And I think that also could be very individual to that person.
Somebody who's maybe got more of a sensitive gut.
It may mean that you need to go a little bit more slowly in terms of how quickly you're introducing more fiber into your diet than someone else.
If you are currently on a low-fiber diet, is going to 30 grams a day too much?
Would you say go slower than that, basically?
So the whole four-week plan is about taking four weeks to get to 30 grams.
Got it.
The first week is just making changes to your breakfast.
Second week, you then start making changes to your lunch and you keep up those breakfast changes.
And then we start moving to dinner and then we start moving to snacks.
So it's a small stepwise changes that's giving your gut time to adapt.
And that's going to make you feel better, much better in terms of your microbes adapting to the new amount of fiber.
But also you're going to notice all these fantastic changes on the way to your digestion energy levels.
The other thing I really liked in your plan was that each week, you're helping people build awareness through tracking, which I think is so, so important.
It's not just blindly following a plan.
It's also like paying attention to how was this impacting me?
Can you tell us a little bit about that?
Yeah, I kind of wanted to bring people on the journey of being a scientist with me.
So I kind of say this is your kind of own individual science projects where you're the participant in your own little study.
And so I kind of have, of how you know, fun ways to kind of fill out and keep an eye on.
How did you feel on all these different metrics when you started it?
You know, how's your poos as well?
Like how often are you going, you know, are they kind of healthy size and shape?
Are your energy, your mood, your stress, your sleep, all these things that maybe you don't necessarily think are all related, but very much are.
And then each week you kind of check in and you know, keep track of how you've been feeling and then you can see, you know has there been shifts and what those shifts are across that four weeks.
And I think in particularly for moments where you know we all have them and maybe you're like oh, just feeling a bit kind of rubbish today or something.
You can think well actually overall wow, I really have made this amazing change and I can keep it up as well.
Yeah, I think building that self-awareness is one of the most important components of change.
I just think, if you don't do that, you're constantly following other people's plans and recommendations.
At some point it has to change from being someone else's plan to being something that you know helps you and supports your well-being.
And that comes through this kind of tracking of, oh, wow, my gut is better.
I've got more energy.
I'm sleeping better.
Wow.
And that really locks it in.
So you're more likely then to continue.
Whereas if you're blind to that, it's like, oh, I tried that.
I don't know, I'll just go back to the way I was eating before.
So I think that's really, really important.
Emily, gut health is always a popular topic with my audience and we let people know that you were coming back on the show.
And there's quite a few questions that have come in.
So is it okay if I put a few of these questions to you and get your sort of take on them?
Okay, Sarah has asked, Emily, what is the impact of menopause on our gut biome?
And what can women do to optimize this?
So we see that the gut microbiome can change and shift.
If you think about this as a kind of living ecosystem in our gut, what we tend to see in that, with the difference between boys and girls when they hit puberty, is women's microbiome or girls kind of newly pubescent microbiome will kind of shift and change.
And we think this is all relation between oestrogen, that sex hormone, and also the microbes having this kind of interaction back and forth.
When we go through menopause, of course, we then start having these kind of fluctuating levels and fluctuating decline of oestrogen.
And we think then, that this is one of the reasons why we see a shift in the gut microbiome and it starts to become a little bit more similar to a man's microbiome in terms of like what microbes are around.
So how much that might play in terms of how you feel day to day, we're still not really sure.
I think one of the most frustrating things about women's research is particularly the lack of funding and lack of evidence that we have in menopausal research and particularly with actionable strategies that we can take to manage symptoms.
What might happen is that, because there is this shift in the microbes, it could be a kind of key opportunity to think okay well, how can I just be more in tune with my gut?
I think a lot of people say that they notice they have changes to their digestion.
They might think that kind of bowel movements shift.
There's kind of things happening where they feel that the body is different from what it was before.
So can we then use that as a way to be like okay well, can I then pay more attention to my gut health?
Maybe you know, start putting some of these kind of dietary strategies in place, because we do see that from some evidence.
Again, these are patterns in studies, so we don't know that they're kind of causal or not.
But people who tend to have a kind of higher fiber, more plant rich, kind of healthy dietary pattern tend to experience less menopausal symptoms.
But again, that is something that we just still need to tease out and understand a lot more.
And I really hope that we get some more research in this space, because it's shocking the lack of funding that it gets.
Gemma has asked Emily how can I test my gut health, especially if I don't have the funds for very expensive tests?
So I always say, can we just look in the toilet every day whenever you go?
This is really giving you a clear sign of the health of your gut.
And when I talk about the health of your gut, it's not just about your gut microbiome.
I'm talking about the entire kind of system going from your mouth all the way down to your bum.
So what are you really looking for?
You're keeping out for the fact that it's a smooth sausage or a sausage with cracks in it.
It's a brown colour.
You're going to the loo very easily.
Everything's coming out.
And also that you're going between a frequency of three times a day to three times a week.
I know that gut microbiome testing is all the rage at the moment, but we actually had a consensus review by 69 experts in the microbiome space.
And they effectively put together a number of statements that they kind of agreed on.
And what they said was that the microbiome testing is really not there yet in terms of the science to give any specific, actual advice when it's from a company directly to the customer.
So where does that kind of land?
If you are wanting and you've got the money to and you just want to know who's there, then great, but don't feel like it's something you have to do, that you think it's an essential thing to understand about your gut health, to do a gut health test If you're having issues with your gut health, it's much cheaper to just go and see a clinician who's going to help, to help you directly with your diet if you are experiencing problems.
Charlotte has asked what causes people to become intolerant to garlic, gluten or onions when they've previously eaten it all their lives and not had any issues.
That tends to be something that we see with irritable bowel syndrome, in terms of those key foods containing something called FODMAPs.
And these are kind of fermentable, kind of carbohydrates and sugars that, some of them of which are types of fiber that for some people can cause some problems.
And that might, as this person said, happen when they haven't had any issues before.
For example, that could be that someone's picked up a bug on holiday, had a dodgy stomach.
You can then suddenly get IBS.
Why does that happen?
We don't actually really know why exactly we're happening.
We think the microbiome is one key component in, for example, IBS and why, if you've then had food poisoning dodgy stomach abroad, that's then disrupted your gut microbiome?
It hasn't been able to kind of... make it back.
And then it's just meant that you're more sensitive.
So it's not necessarily those foods are harming you, but it could be then that you've got more kind of sensitive signals from nerve endings, kind of sending pain signals back and forth, that you're getting more bloating because you're getting more gas produced from certain types of microbes.
There's still a lot of fun of, and again, this gut brain connection as well.
Paola has asked you to comment on the sauerkrauts and kimchis that are sold in supermarkets.
He or she is saying.
It would appear that most brands pasteurize their products and, as such, aren't the beneficial probiotics eradicated by pasteurizing?
A lot of these products are pasteurized, because it makes them more shelf-stable, they're less likely to explode.
They're easier to transport from location to location.
So we do see from some of the studies that, particularly looking at things like kefir for example, that making kefir at home you're going to have a whole kind of wider range of microbes than perhaps a handful of number of strains that are kind of put in a bottle.
There's no official kind of requirements and then put the label on.
But I would say that...
I having previously, you know, spent a lot of my life making fermented foods.
I tend to buy them because I just think you've got to really recognise how much time and effort you've got at hand and you're still getting some microbes.
And I think also...
We have microbes all around us.
It's not just in these fermented foods.
They're on every surface.
We talked about this last time.
We're interacting with microbes.
We have a microbial cloud all around us.
So we are getting microbes from many different sources as well.
Emily, you're such a wealth of information on all things gut health and nutrition.
We've, of course, spent a lot of time today covering fiber and its impact on various aspects of our health.
But of course you write a sub stack where you cover all kinds of things relating to all kinds of things, right?
You kind of, was it?
Was it last week you were talking about the impact that nurseries have on our gut health?
You're talking about the impact that certain medications have on our microbiome and how that impact can last for several years.
For people who want to go deeper with you.
What kind of things are they going to get if they go to your Substack?
Oh, absolutely.
So I write every week and I'm very big on breaking down not only the latest science.
So if I get very excited that there's a study that just came out last week or a few days ago, then I'll break down what that evidence says, especially with a microbiome.
It's so fast paced.
So, yeah, keeping on top of the latest microbiome scientists.
But I also do.
You know my background as a dietitian and you know also kind of researching nutrition.
You know I very much tackle those key nutrition topics as well.
So I think a recent one was.
You know is the advice and sort out data and actually understanding you know that kind of key advice behind that.
And lots of other kind of different kind of nutrition and things for your health.
That's hopefully very you know, excuse the pun easily digestible.
But yes, every week and it's something I really enjoy sharing with people.
Yeah, brilliant.
Of course, the new book is called Fibre Power, Transform Your Energy and Feel Amazing.
It's out now.
So for people who are interested, check it out.
All those delicious recipes he's talking about are in there.
To finish off, Emily.
For that person who's listening, who has really not taken care of their health for a variety of different reasons, and they've recognized today through this conversation that actually you know what.
It's time to change things.
It's time to put themselves first.
And they decided to make increasing fiber the first step on their health journey.
What are your final words to them?
I would say welcome.
You're in the fiber family now.
And you know this is something that I want you to have fun with and to enjoy and find delicious, and understand that it's not about having to have the most perfect quote unquote diet, but making small practical changes for your health that make you feel better here and now but also support your health in the long run, and that's really the key things that matter.
Yeah Emily, fantastically empowering message.
Thank you so much for coming back on the show.
Thank you so much for having me.
Really hope you enjoyed that conversation.
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