If you go on social media, CEDAWS are toxic, CEDAWS are going to give you Alzheimer's, CEDAWS are going to give you cancer.
But I've done lots of research and there is absolutely no evidence to show CEDAWS are harmful.
Actually, they're beneficial for our health.
And I'll come back to that, but the problem is that there is so much misinformation out there about what we eat, how we eat, and how it affects our health.
So let's go into all of that.
Dr. Sarah Berry is a renowned nutrition scientist and professor.
with over 20 years of research her work has reshaped how we think about food metabolism and gut health dr sarah berry we have a lot to get through yes so let's start with the food matrix that's so important because you can have two foods with identical labeling same nutrients and calorie value it can have entirely
different impacts in terms of how you metabolize our food and how it impacts downstream health effects depending on how that food has been processed now we also know the timing of when we eat is really important for example we found that snacking after nine o 'clock was associated with unfavorable health
outcomes the worst kind of fat around your belly for example this was even if you were snacking on healthy snacks really we also know on average if you change the speed in which you eat your food by 20 you reduce your calorie intake by about 15 but where it gets really interesting is there's evidence
to show if you chew your food 40 times versus 15 times it can result in and then there's the menopause we've conducted lots of research and one of the most exciting things is that there is the principles which can reduce symptoms by about 35 percent and so they are this has always blown my mind a little
bit 53 percent of you that listen to this show regularly haven't yet subscribed to this show so could i ask you for a favor before we start if you like the show and you like what we do here and you want to support us the free simple way that you can do just that is by hitting the subscribe button and my
commitment to you is if you do that then i'll do everything in my power me and my team to make sure that this show is better for you every single week we'll listen to your feedback we'll find the guests that you want me to speak to and we'll continue to do what we do thank you so much dr sarah berry
can you give me a little bit of an overview over what you've spent the last sort of 25 years of your career focusing on and understanding yeah so i've spent 25 years starting out in quite a specific area looking at how diet impacts our cardiometabolic health So by this, I mean lots of factors related
to cardiovascular disease, like type 2 diabetes, our cholesterol, our blood pressure, our inflammation.
And then more recently, I've been looking at how actually we piece together all the complexity of who we are, what we eat, how we eat, into how that actually impacts how we respond to food and the helpfulness of a food.
Most of my work's been done through running clinical trials.
so randomized control clinical trials where I recruit various people get them to eat various things do loads and loads of different measurements and look at how a food or a nutrient or a diet might impact a particular health outcome.
And how many of these individual pieces of our sort of health and lifestyle are you trying to piece together to form this picture what are those pieces?
The key pieces are who you are so that's one of the key pieces so by that I mean your genetics, your microbiome, your age, your sex, your menopause status, all of those kind of things.
The other is the food that you eat.
And when we think about food, we need to think about it beyond the traditional way that we thought about food in terms of nutrients, you know, back -to -back labelling, fat, protein, fibre, carbohydrate, but actually thinking about food in terms of the fact that on average, each food has 70 ,000 different
chemicals. And these are contained within a very complex food structure which we call food matrix that modulates the impact that those chemicals and nutrients have so that's the second thing that we need to think about so we've got who you are the food that you're eating but the complexity of that food
and then how you eat your food and by how you eat your food i'm thinking about your lifestyle i'm thinking about are you jet lagged how much sleep did you have last night you know what's the order in which you're eating your food within a meal or over the day?
How stressed are you feeling?
When did you do physical activity?
All of that also impacts how you will respond to food.
And then I think the last piece of the puzzle is so important that as nutritional scientists, I don't think we think about enough.
Why do you make the dietary choices that you make?
So why do you choose to have that for breakfast, for lunch, for dinner?
Is it because it's part of your culture?
Is it because that's how you're just feeling emotionally?
Is it because you're sitting with friends and it's part of that social experience I think we're at a really exciting time in nutritional research because we're now able to collect data at a scale breadth depth and precision that we've never been able to before that's allowing us to put together all
of those pieces of the puzzle to start to see a clearer picture.
So let's go into all of that let's start with the subject of the food matrix which is a term I hadn't actually heard before until today what is the food matrix and why do I need to know about that so the food matrix simply put as a structure of food and it's really important because we know that food
is so much more than just the nutrients and chemicals it contains so we know that food contains nutrients that people are very familiar with like protein fat fiber carbohydrate we know that food also contains thousands of other chemicals many of these we call bioactives that you have heard of like polyphenols
you know vitamins minerals etc but they're all encapsulated within the structure of a food to think of an apple versus apple puree versus apple juice they're all coming from the same food but they have a different structure and the reason it's important is because we know that food structure modulates
the healthfulness of the chemicals and nutrients within the food and it's really really relevant now it's really relevant now because our food landscape has changed almost unrecognisably to 50, 100, 200 years ago.
We're now eating a lot of food where the food matrix, the structure of the food has changed.
And this is because we use multiple different processing techniques.
So in simple terms, if I were to zoom in on a piece of food on a microscope, the way that the molecule of the food is put together is now different to what it used to be and that's having an impact on my health?
So in simple terms it's that we are changing often through processing the structure of the food.
Now by processing it could be our own processing when we chew a food we change the structure.
Take a nut for example you have a whole nut you chew it you break up the nut it goes into your gastrointestinal tract it's broken down further.
We also change it using manual industrial techniques as well.
So we use techniques like grinding, or we might use pasteurization for dairy or, you know, extrusion for some carbohydrate -rich foods.
We use all of these different techniques that also change the food matrix.
For better or for worse?
It's a double -edged sword.
Right. And I think this is what we need to remember, that everyone's demonizing at the moment.
Old processed food, you know, it's killing the nation.
60 % of our energy is coming from old processed food yes we are eating too much unhealthy food much of which has been heavily processed but processing can also be used to our benefit and we have to think why do we even process food in the first place well we process it to make edible I don't want to
go and eat a rice grain that's not been cooked we make it safe I want to drink pasteurized milk because I know it's safer.
We want to make it stable.
I think how long a can can last for unfrozen vegetables versus fresh.
So you're saving food waste.
We want to make it taste good and we want to make it convenient.
So there's all of these different reasons that we use food processing.
But when we think about the healthfulness of a food, we need to think about it in terms of the processing techniques that have been used as well as the nutrient composition.
and we can't look at them in isolation, in my opinion.
And this is what I've done a lot of research looking into.
And what has processing gone bad?
I think processing gone bad is when you've changed the nutrient profile of a food such that it is unhealthy, so in simple terms it's too much saturated fat, too much salt, too little fibre, too little bioactives like polyphenols, a food that is very energy dense so you eat it really really quickly so you're
eating too many calories you're eating it before your hunger signals have got your brain to say well Stephen you've had enough and there's great research that has been looking at how processing can affect your eating rate the energy density of food the nutrient profile of a food and that's where it
can go wrong but where it can go right is you can improve all of those things as I've said, the stability, the safety of the food.
You can also increase what we call bioaccessibility, so the availability of some of the nutrients within a food as well.
Okay, so I've got some snacks over in the corner of the room here, which I guess have been processed differently to have a different impact on me as the consumer.
Gosh, these look delicious.
I hope they're salt and vinegar Pringles.
How are you going to eat them?
Look at this. Oh, my gosh.
So I've got some mixed nuts here.
Yeah. And I've got some cookies, some little pieces of chocolate and some crisps.
So you were talking about this processing something so that I eat it faster and that it doesn't sort of satiate me or make me feel hungry.
Crisps. We're a nation of crisp lovers.
When you were saying that about something that makes you eat faster and not realize that you've even eaten it all, Well, crisps were the first thing that came to mind for me.
I love a crisp. You love a crisp.
We all love a crisp.
So I think all of these first three foods, the crisps, the chocolate, the cookies, you know, if compared to what would be a healthy food, they've all got less fibre.
They've all got, well, certainly the chocolate and the cookie has got more sugar.
They won't have all of the wonderful bioactives in them.
and then with the crisps depending on the type of crisp it's probably quite high in salt but the chances are with those three is that they are quite energy dense so they have quite a lot of calories per gram which is partly because of the processing techniques yet if you take a whole food like a nut now
they're actually very energy dense so they're very high in fat fat they're high in calories but actually because they're in their original food matrix how your body handles them is quite different to if for example they had been processed.
You mentioned something about my brain takes a little while to figure out that I've started eating.
Yep. So if I started smashing these crisps down now how long would it take my brain to realize that I'd started eating to sort of catch up and make me feel hungry?
Yeah, so there's loads, lots of different mechanisms that impact how full we feel, how hungry we feel related to a food.
There's different hormones that are released from different areas of our gut, for example, that feedback signals to say either you're full or you're hungry.
On average, I would say it takes about 10 to 20 minutes for the fullness to really properly kick in.
Now you could easily have got through those.
well I could easily have got through all of these in under that 20 minutes.
I wasn't aware that there was a delay but it does make sense because there's certain foods that I used to eat like Pringles and snacks and crisps and things like that where I feel like I could eat two tubes of the thing before my body even realized what was going on and are they in some way designed
to encourage that speed of eating?
So there are many people who will say the food industry has specifically designed these to make them firstly what we call hyper palatable so to have the right mix of fat sugar you know carbohydrate etc to make them really tasty and in this case salt as well.
I don't think the food industry is out there to get us.
I think that what the food industry were doing 50 years ago versus what they're doing now is quite different but some people will say i'm very naive i do believe the food industry ultimately want to produce food that's safe but also healthy for us that's probably an unpopular opinion but based on my
interactions with the food industry i believe that however i do believe that these crisps are there have been made to be flavorsome to be palatable to you so that you do enjoy them now whether that's that you then go and overeat them, I think is, yes, a byproduct of that.
Now, it doesn't take 20 minutes for all of the fullness signals to kick in because as soon as you start chewing something, you start to release different hormones and different sensory characteristics of the food will also trigger some sort of fullness.
But what we do know is that you have more of these fullness receptors saying, hey, you're full, lower down in your gastrointestinal tract.
and so if you can get food to the lower gastroenterostinal tract that's when it says hey Stephen you're full now and these heavily processed snacks that you've got here would be typically absorbed higher up the gastroenterostinal tract because kind of the hard work's been done and yet when you've got
something like a whole grain or a nut typically that would be absorbed lower down the gastroenterostinal tract where you've got more of these fullness signals so giving you that greater feeling of fullness.
My girlfriend has said to me for many many a year that i need to eat slower yeah and i thought it was like a spiritual thing that she's into um to do with like giving the food gratitude etc etc but upon reading your work and having this conversation today now i'm starting to believe that she was right
all along unsurprisingly once again um and that there is a a scientific basis for slowing down how fast i eat absolutely we now know that eating weight is important there's some fantastic work that's being done by a professor kieran ford who's dedicated many years into researching this and looking at how
changing the structure and texture of a food can modulate your eating rate and how also your eating rate can modulate how you metabolize the food and how many calories you go on to eat and so it's a great example you know i talked about all of these different pieces of the puzzle that's one of those
pieces so when we talk about how you eat changing your eating rate so how quickly you have your breakfast your lunch or dinner or any of these snacks will also without you consciously thinking about it change how many calories you eat might change how quickly you metabolize the food as well what's the sort
of knock -on effects there so the research that's been done by karen ford shows that on average if you change the speed in which you eat your food by about 20%, you reduce your calorie intake by about 15%.
And that's due to where you're releasing your hunger hormones, how many fullness hormones you're releasing, etc.
So it's a really simple strategy.
And we see this play out as well, even in our own evidence, when we look in our Zoopradiq studies at fast eaters versus slow eaters.
We see that once we adjust for lots of other confounders, there's a difference of 120 calories between what fast eaters have over a day versus slow eaters, with the fast eaters eating more calories compared to slow eaters.
And there's even been clinical trials where they get groups of individuals and say, okay, slow down the rate at which you eat your food over the next, you know, three, four, five weeks.
They have another group, they say, just eat at your normal rate.
Those people who are intentionally slowing down the rate at which they eat their food lose more weight than those people who continue to eat at their normal rate.
see I always made this like weird unfounded evolutionary argument to her I was like well you know in the wild you gotta eat what you can so people eat quick but um we're not in the wild anymore and the food choices that we have are drastically different now so yeah and also the food that is available
to many of us is the kind of food that can be eaten really quickly so there's some great research that's been conducted that shows that heavily processed soft textured type food can be eaten 50 % more quickly than the unprocessed harder textured equivalent.
So the kind of food that we're eating now is quite different.
So you're eating it really quickly.
You're overeating because your hunger signals haven't got there, but it's that rate at which you're eating.
What's an example of a soft textured food versus like a hard textured food?
So we can use an example from a study that was actually conducted in 1977, and this was published in the lancet it was one of the first nutrition studies published in the lancet and it's one of the first studies to show the importance of the food matrix and it kind of got buried for many years and it's
a study by the scientist called haber where he fed individuals whole apples he fed individuals the equivalent amount of carbohydrate from apple puree it was exactly the same ie same nutrients same fiber same everything else in it all that's different is the apples are hard, the puree is soft.
And what he found was that those people who were given the puree, even though they were given exactly the same amount of calories, ate that puree or rather drank that puree three to four times more quickly than when they had the apples, the equivalent amount of calories.
So they were eating the same amount of calories, but three to four times more quickly.
That's like 300%, 400 % faster.
Okay. They felt less full.
So when they measured their fullness and they monitored that for quite a few hours so going up to quite a few hours those that were having the apples continue to feel full for longer those who are having the puree didn't feel full this long and what also happened interestingly is those that were having
the puree had what we call a blood sugar dip so about two to four hours after having a high carbohydrate meal we know that some people have a dip in their circulating blood sugar and we know from our own story predict research that actually this can really increase your hunger levels yeah and so we
know from our research if you are a dipper I'm a dipper hence I get hungry quite often so in about two hours I'm going to be if you're a dipper you know your your blood glucose is going below your baseline levels and so you get hungry you go on to eat 180 calories on average more at your next meal because of that and so I
mean this research from 1977 I think is fascinating it's that first research really demonstrating the importance of food matrix.
And then since then, I've now over the last 10 years done lots of studies with nuts, with oats, for example, that demonstrate you can have two foods that have identical backup pack labelling, identical nutrients, identical calorie value, if you were to look at the backup pack labelling, but can have entirely
different impacts in terms of how much energy you absorb, how you metabolise that food, how it impacts your hunger, how it impacts downstream health effects.
And you've done some research on walnuts, right?
So we've done work on walnuts, but particularly on almonds.
So we've done lots of work with almonds using it as a kind of proof in principle of the importance of the food matrix.
Now, you just took a bite of that and I could hear the crunch.
The reason I could hear the crunch is because in almonds, like most nuts, So like many plant -based products, there is a very rigid cell wall.
Okay, so that almond that you're holding there has thousands and thousands and thousands of cells.
These cells are tiny, they're about 50 microns.
Okay, you can't see them with the human eye.
I can show you a micrograph.
But there's thousands in there.
Now, each of those cells is smaller than a grain of sand.
and each of those cells is encapsulate cell walls is encapsulating the fat so we know that in most of these nuts it's about 50 % they're about 50 % fat hence people say oh my gosh I can't eat nuts they're high fat they're high calorie now in all of those nuts the fat's encapsulated in this rigid cell
wall when you bit that you fractured some of those cell walls when you swallow it you chewed it you chewed it a little bit I assume a little bit Yeah, yeah, I didn't swallow it.
When people chew it, we know from these lovely chew and spit studies or mastication studies that we do that at the point at which you swallow a nut, the particles, i .e.
the size of the bits that you're swallowing that you've chewed, are about maybe half a millimetre to one millimetre in size.
Now, given that the cell of an almond nut is about 50 microns, that means when you're swallowing, within that, what we call a macro particle you've still got thousands of cells they're intact where you've got this lovely cell wall containing all of this fat and so you're swallowing these intact cells
containing encapsulating the fat so they're what we call very low by accessibility they're not very accessible to us this fat now what happens is this passes through your gastrointestinal tract some of the enzymes can break down the cells a little bit but actually a lot just comes out the other end
so I don't know whether you've ever eaten a bag of nuts and looked at your poo after none of your business I'm joking go and do that but you should see some almond particles really you know like when I'm you know being a mum when I've I've looked at a lot of poo in my life through my work but also through
being a mum you can see whole nut particles in the poo so nuts they just is it they just don't break down fully?
So they break down partially so you break down about 10 % in the mouth before you swallow so about 10 % of the calories become available because the calories are contained from the fat etc and then you probably break down about another 60 to 70 % as it passes through your stomach your small intestine your
large intestine okay but you have loads of material arriving at your colon which is your large intestine that's undigested which is good for two reasons one because you're giving all of this food to your microbiome which we know is great for your health your microbiome's having a party with these nuts
but also if you are worried about eating nuts because of their high calorie value actually 20 to 30 percent of the calories are just coming out the other end but where it gets really interesting is if we then take exactly that nut that you're holding there and if i was to industrially grind it so that i
broke all of those cells walls yeah so we're breaking it down to less than 50 microns so that you're releasing all of the fat so it becomes a hundred percent bioaccessible ie you absorb a hundred percent of it but they could have two identical back and back labels yeah because if they're the same ingredient
all that's happened is you've ground that nut to such an extent that you've released everything and so having that in its whole form is beneficial because if you are concerned about energy intake it's reducing the energy it's providing this amazing food for your gut microbiome it's changing also how
you your blood changes metabolically in that about eight hours after eating it and this is what I've done lots of work on looking at how your blood fat increases and decreases in that immediate period after eating either groundnuts or wholenuts but once you grind it I'm not saying it's necessarily bad
because the upside of that is all of the other good nutrients contained within that cell like the vitamin E and some of the other components also become available so it's this double -edged sword.
Interesting. But that's what I think is so fascinating about processing and about food matrix and why we have to move beyond thinking about food just in terms of the nutrients, because you can have two foods with identical backpack labeling that have different effects.
And we've seen the same with oats.
We've been doing studies as well where we feed people large oats, so kind of like the steel -cut sort of old -fashioned porridge, or you feed people finely ground oats.
And so we've done clinical trials where on one occasion people come in and they'll have 50 grams carbohydrate for breakfast of these large oats then they'll come in another day and they'll have exactly the same oats but where we ground them literally we've got students just grinding them down so they're
more like a powder and the difference in the metabolic response in that following six hours after having either the large traditional oats or these finely ground oats is enormous and that's because of gut absorption speed yes so with the nuts what we're seeing here is a difference in the amount as well
as the speed. With the oats, what we're seeing is a difference in the speed.
So we're seeing a difference in the rate because we know that the food matrix impacts the amount, i .e.
with the nuts, the rate, i .e.
with the oats, and as well as where the food's absorbed in the gut.
And so you see about a 40 % difference in the postprandial glucose response so this is the increase in circulating blood glucose after you've had these oats we see about a 50 percent higher response from the ground oats versus the large oats and that has subsequent impacts on hunger hormones fullness
hormones insulin release etc etc and what role does fiber play in this because fiber is becoming quite popular now they're like putting it in drinks and stuff like that and i there's some candy in america when we're recording over in New York, which had like, it said like 15 grams of fiber added to
this like candy. So fiber is a really interesting one.
And it's a really interesting one because we know we're not getting enough fiber.
So we should be getting at least 30 grams of fiber in the UK.
And it's similar in the US, we get on average about 20 grams of fiber.
95 % of us are not having enough fiber.
Fiber is the one nutrient that we know consistently is associated with beneficial health effects, reduction in many cancers, reduction in cardiovascular disease, reduction in levels of obesity, type 2 diabetes, etc.
You know, it's an amazing nutrient fiber and we don't get enough of it.
Just to pause there then, why is it so good for us?
Because, I mean, it sounds like a super molecule the way you just described it.
So it's good for us for many different reasons and there's loads and loads of different types of fiber and the different types of fiber are good for us for slightly different reasons.
really simply put we've got soluble fiber and that's great for us because it impacts things like cholesterol absorption as well as other factors related to how quickly we metabolize food etc then you've got insoluble fiber which is the kind of fiber that for example are in those nuts because fiber in those
nuts is actually the cell wall so most cell walls of plants are just fiber that's great for us because it's food for our microbiome it helps bulk out our store so it reduces our transit time how quickly the our poo basically passes through our colon reduced the risk of colon cancer and so forth but largely
because it is the food upon which our microbiomes have their party produce all of these wonderful molecules that we know impact so much related to our health but we don't get enough of it and we don't get enough of it because we're not eating the right types of food that we have in high amounts so having
any kind of fiber is going going to improve our health having fiber that's added artificially back into food is going to be better than having no fiber so the kind of bars that you're talking about that say are added fiber great having fiber though from the whole food is always going to be better and so with nuts
fiber is essentially the cell walls of the nuts so it's having that role in reducing that bioaccessibility that we talk about at slowing those nuts down so that's always going to be better having that fiber in the whole food in its original structure in the way nature intended but having any kind of fiber
is better than having none and in a nation or or you know many nations where we're not having enough if we can get some in our diet even if it is processed fiber it's better than no fiber in my opinion one of the um big revelations in my household has been just getting some of these bad snacks just
out the house and replacing it with um healthier whole snacks and i say that because the sort of the very definition the very like sort of use case where we snack is when we typically don't have a lot of time where the hunger kind of crept up on us in between a meal um and so we make fast decisions
it's not a very considered decision um and i was reading that there's been some studies done where they took sort of two groups and gave them typical snacks versus healthy snacks and they found a pretty significant reduction in cardiovascular disease?
Yeah so this is one of my studies and we looked at how changing people's snacks can impact their health and the reason we're interested in this is because we're a nation of snackers in the UK as in many countries so we know that about 25 % of our energy comes from snacks that's phenomenal and so what we
wanted to do is look at if we do a really simple snack swap can we improve people's health and so we asked people to change 20 of their energy from either having typical uk snacks or having 20 of their energy from almond nuts for six weeks and then we looked at various health outcomes at the beginning
of that six weeks and then at the end of that six weeks we said keep everything else the same we provided all of these snacks to them we provided the typical uk snacks we spent a lot of time designing these so we did lots of research where we looked in the uk and it's the set very similar in the us
what are the typical snacks so basically we designed these muffins that ultimately were having a bit of a potato chip or crisp a bit of a chocolate biscuit a bit of a cake just like imagine all put in one muffin i mean we didn't go and get those and just stick them in one muffin.
But we worked out what's the nutrient profile in the U .K., in the U .S.
that comes from snacks, and then we designed a snack product that was quite highly processed that reflected that nutrient profile.
So it's quite high in saturated fat, high in sugar, high in refined carbohydrate, low in fiber.
People had to eat 20 % of their energy from these muffins, which my kids loved, or 20 % from the almond nuts.
At the end of that, we measured lots of health outcomes.
one of which was a particular measure that we do to look at people's vascular functions, their blood vessel function.
It's a measure called flow -mediated dilation.
It tells us in really simple terms kind of how healthy the blood vessels are.
And what we found was the improvement in blood vessel function following having almond nuts versus having typical UK snacks equated to a 30 % reduction in cardiovascular disease.
That's crazy. And in what period of time?
Six weeks. In six weeks.
And do you know what I think's really interesting about this is it's one simple, single dietary strategy.
And snacks are under our own control, typically.
What I have as a snack isn't determined by my fussy kids.
What I have as a snack quite often isn't determined where I am at that point in time because I can bring my snacks with me.
It's a really simple, single dietary strategy that can have a big size effect.
And I think that that's really important it is really important though Stephen at this point that I do say that I have actually had funding from the Alma Board of California and they did fund that study although the way we conduct our RCTs the funders have no impact over the study design or you know
they don't get to see the raw data or the paper before we're publishing it but I just think it's always important to declare conflicts of interest we've seen this though play out in other studies with other nuts or other snack substitutes so it's not unique just to almonds it's a great illustrator of how
changing our snacks can improve our health and we we really are a nation of snackers um you highlighted one of the stats there that in the uk and in the us about 25 of our energy comes from snacks 75 of the energy that's coming from those snacks is coming from unhealthy snacks this was taken from the zodiac
podcast in meditation in mediterranean countries only 14 of energy comes from snacks, which is half of the UK.
And 85 % of British people report snacking compared to 10 % in France.
And in the UK, we have 2 .5 to 3 snacks per day, which translates to six or seven eating events a day.
And this has massive impacts on our glucose spikes and drops throughout the day causing metabolic chaos.
And that's part of what I was thinking as I was thinking about this is if I'm eating that muffin that you made, which resembles the sort of typical British composition of a snack it's not necessarily just that that snack is going to impact me it's that my next food choice because I ate that snack is going
to be different because I'm on that I might be on a glucose roller coaster here so I might end up making a worse food choice thereafter which then might impact my maybe my sleep because I've got a little bit of sugar in me when I'm settling down to go to sleep and is there the sort of downstream domino effect
because of that one snack choice so i wouldn't say that you've made about one bad snack choice and that's it your day's over damn it you know your stuff i think that you highlight an important point though that what we choose as a meal does have knock -on effects on what might happen later in the day
so for example if you have a really refined carbohydrate breakfast or snack then you're more likely to have a blood sugar dip which we know from our research is more likely to make you more hungry eat more calories have lower mood have lower energy and be less alert but i think you know snacking can be
used to our advantage snacking can be used to our advantage because we know it accounts for such a huge proportion of our energy intake because we know on average that you know 70 75 percent the snacks that we do currently in the uk and the us are not helpful snacks and because we know that actually
just transitioning from those to healthy snacks can have a big impact but I think it's really important to be thinking about not just the type of snacks you're having but the time of day that you're having the snacks and we published some research recently where we looked in a thousand individuals at people's
snacking habits because it's not actually been looked at much I mean you think everyone snacks you think there'd be loads of science out there about snacking there's lots of science out there about the different you know foods that we might snack on but not really much looking at snacking habits and there's
a lot of controversy out there about whether we should be grazers and we are a nation of grazers you know we well I certainly graze but many people we know like you said you know 80 to 90 percent of people do have multiple eating events throughout the day are you taking these away from you for self
-control i am a little bit yeah i think uh the smell of the chocolate and the cookies is testing me and in general i'm not trying to be tested there we go um and what we have never really fully understood is is snacking per se bad are you having multiple eating events so eating six times a day which we
nearly do in the uk and the us or is it about the type of food we're snacking on.
So should we revert back to having the three main meals, the breakfast, the lunch, the dinner?
Or is it okay to have multiple meals as long as it's healthy food?
So we looked at this in our cohort of a thousand individuals where we take lots of measures related to what they're eating, when they're eating, how they're eating it, as well as lots of different health outcomes.
And what we found was that the frequency of eating within reason was not a problem.
So if people were grazing having multiple eating events as long as they were eating healthy foods it didn't matter having multiple eating events so snacking per se wasn't a problem as long as they were healthy foods okay because there's been a long i guess raging debate about how many meals you should have a day
some people just eat one meal a day some people probably five or six meals a day and you're saying it doesn't necessarily matter as long as what you're eating is healthy yeah i I mean, I will always, as a cautious scientist, caveat it within reason.
But our research showed people having six eating events a day, I, you know, six different occasions that they're eating food or three eating events, as long as they were eating or snacking on healthy foods, it did not impact their health outcomes.
And this is, I guess, controlled for extreme cases where someone's maybe eating at 1am in the morning or 2am in the morning.
Yeah, so we also looked at timing, because I think that's something that we haven't given enough attention to in nutrition science and it's a really exciting new area of research that we're starting to understand the timing of when we eat is really important and what we found was interestingly 30 percent
of people were snacking after nine at night and we found that if you snack late at night I feel attacked and this is a lot in line with you know other published research from very tightly controlled clinical trials we found that if you snack late at night that that was associated with unfavorable health
outcomes so uh worse adiposity so worse kind of fat around your belly for example um higher levels of inflammation worse levels of blood lipids so you know cholesterol that sort of thing and we found that this was even if you were snacking unhealthy snacks really and this isn't especially surprising
because there's this whole new area in nutrition called chrononutrition which is all about the timing of eating and we now are really starting to understand that every cell in our body has its little body has a clock every cell has a clock and that clock is shaped by when we eat as well as the light
day cycle and if we're eating out of sync with those clocks those millions and trillions of clocks in our body we know that we process the food slightly differently we metabolize it slightly differently it may have a different impact on our health and that's what our research showed as well so eating
after nine o 'clock isn't great for your health.
Just to double down on that I have had a long standing hypothesis that when I eat later at night it is making is it is basically increasing my belly fat.
Now I don't have any science to support this but there's a and also the way that I feel when I wake up is radically different.
If I've eaten close to my sleep time so I had this weird hypothesis that I'm basically putting food into the machine and then I'm like turning the machine off while it's processing so it's kind of like not processed it properly yeah i mean that's kind of a simple terms what's sort of happening you know
our body needs to rest overnight just like our mind does our cells our metabolism needs to rest overnight and if you're not giving your body your cells your metabolism your gut microbiome etc that time to rest things get disturbed a little bit and what's really interesting is you said that you'll feel
different the next day if you eat late at night there's some really fascinating research that came out about one or two years ago where they looked at giving exactly the same calories and foods over the day within the same time period but in one group of individuals having most of the calories earlier
and in another group having most of them later in the day now those that were having them later in the day woke up feeling more hungry which is kind of like counterintuitive isn't it but it fits in with what you just said yet those people who are eating the calories earlier in the day woke up feeling
less hungry and this is why as well the evidence shows early time -restricted eating so time -restricted eating where you're eating within a particular time window those people who are practicing earlier in the day tend to do better in terms of the health outcomes whether it's weight, inflammation, cholesterol
than those practising a later time of strict eating when they have their last eating event later in the day and that's because they're eating in time with their body clocks with these millions and billions of little cell clocks I have had a weird observation which is sometimes sort of quite rare these
days I have to wake up super early to get on a flight and it means that I'm disrupting my sleep maybe getting up at four or five in the morning.
And for some bizarre reason, if I wake up at say four in the morning to go and get a flight, I am starving.
But if I woke up at nine that same day, I would not be, I would probably not get hungry till about 2 p .m.
And I've never managed to sort of really figure out why disrupting my sleep causes me to be ridiculously hungry.
Whereas typically I don't honestly eat breakfast I typically eat about midday or 2pm so I think there's probably a lot going on there it's getting a little bit outside my expertise but I can certainly comment from work that we've done and I'm familiar with so what we know is that sleep duration sleep
efficiency what we also call sleep midpoint so the midpoint in which you sleep impacts your hunger levels we know that your hunger and your fullness hormones change as you sleep so we know that short sleepers people who you know are getting up too early so when you're getting up for your flight then
your hunger and fullness hormones might be perturbed and we know that short sleepers or if you've had a poor night's sleep you tend to wake up more hungry than if you've had a good night's sleep this isn't from my own research i always have to caveat that but this is what some of the research is showing
but that also if you've had a poor night's sleep you reach for less healthy food and there's a study that was conducted at king's college london by my colleagues called the slumber study and this really nicely illustrates how just changing how much you sleep can change your dietary choices and in the slumber
study they asked people who were short sleepers to practice sleep hygiene they gave them no dietary advice they just said practice good sleep hygiene i you know no screens late at night no physical activity caffeine alcohol etc late at night darkened room and then they just monitored lots of different
things in these individuals and what they found was that those who were able to extend their sleep actually made healthier choices such that they reduced without being told to their intake of sugar by about 10 grams oh really without being given any advice so they slept better they ate less sugar they
made the decision to eat less sugar without being told to that correlates it's it's been such a revelation i think in my my life over the last i'd say two to three years is realizing the downstream impact of sleep and a bad night's sleep because it was one of the things i think growing up especially
as an entrepreneur when you're like consuming a lot of like hustle printer you know culture and it's all like sacrifice to sleep work seven days that you assume is um take it or leave it like it like you assume it's often the first thing you think that you can sacrifice in the pursuit of productivity
yeah but this is what i thought growing up and then in the last couple years or i think all 20 30 year olds think that yeah do you not think yeah and anyone that's like has i think probably an involuntary amount of i say involuntary but i I mean, just because of the decisions they've made, amount of professional
pressure or like shift workers or anybody or even parents, I guess, they probably see sleep as secondary to some other kind of priority in their life.
And when I shifted that and I made adjustments to my calendar and my schedule to try and prioritize sleep, the downstream impact of it has been profound in a way that I could never measure or articulate fully, but just everything seems to be better.
So like my relationships with my partner, my ability to think straight, my motivation to go to the gym that day, the work that I do, everything.
So there's been this big sort of radical adjustment where I now see sleep as actually the starting point for all these other choices that I make, good or bad.
And that's kind of what your work is highlighting.
Yeah, I think it's that we have to think of these four pillars together of health.
We can't look at diet on its own, can't look at sleep on its own, can't look at stress on its own, we can't look at physical activity on its own.
So if we want to improve our health through diet, I think we must be looking at our sleep habits, which we can to a certain extent control, not always.
I know some people have to work shifts, some people don't have a choice, they're woken up by their kids etc.
We need to look at our stress, I know that's one of the hardest things to change.
We need to look at our physical activity and our diet, and they are all so interconnected.
And the PREDICT studies that were done at Zoe found that sleep affected metabolic responses as much as the macronutrient content of the meal.
What is that saying?
So this is some research that we published where we looked at people when they'd had a good night's sleep, and we looked at people when they'd had a bad night's sleep.
And we looked at their post meal postprandial glucose response so that basically means after having your breakfast that's got some carbohydrate in it how much does your blood glucose increase we call this the postprandial glucose response because postprandial is greek for postmeal and so it's a term
we use a lot in the science and we looked at individuals postmeal glucose response when they'd had a good night's sleep and when they'd had a bad night's sleep and what we found was within the same individual if they'd had a bad night's sleep their post -meal glucose response so after breakfast was a lot
higher than if they'd had a good night's sleep so what this shows i think quite nicely if we think back to what you said about how you wake up more hungry when you've not had enough sleep we know that people make poorer dietary choices for example from the slumber study and then we know that the metabolic
responses to those are worse it just shows how you're kind of creating this perfect storm and how you can't think of it in isolation because firstly you're waking up and like bloody hell i'm hungry secondly it's like i'm not having that healthy breakfast i want that pano chocolate or you know whatever
that's you know giving you that quick fix and then you have it and you're going to have this massive blood sugar peak compared to if you'd had a good night's sleep and and made a healthy choice for less hungry etc etc so it's like creating this perfect storm and it's all started with your sleep and that's
why i don't think we can look at things in isolation more which is how i have spent the previous 20 years of my research looking at things in isolation but that's because i've not been had the luxury of being able to collect the kind of data that we're now collecting i get a lot of messages from parents
so uh because i'm not one yet i don't fully understand what it is to be a parent and the demands of parenthood So I'm going to defer to you on this.
My children never slept.
They never slept? They did, obviously, but oh my Lord.
How did you survive that as a parent?
Was there any strategies or tactics you put in place to defend against exactly what you just described, the downstream consequences of sleep deprivation?
No, because the first four years of my children's lives, I was also I lost my father when my daughter a few weeks after my daughter was born my sister and I became full -time carers for my mother who lived around the corner I took a career break looked after my mum with my sister had two young children
they weren't sleeping I had to show up I had to show up to help my sister look after my mum it was about survival I didn't think about what I ate when I ate that was irrelevant and it was about survival, to be there for my mum, to be there for my kids and whether it was because the sleep deprivation was also so bad
that it was just like driving bad choices, I don't know.
But there's points in time in anyone's life that we go through that are about survival, aren't there?
And I think everything goes out of the window and I'm not saying it should but I think that when you're in the depths of whether it's sleep deprivation because your children keeping you awake or what I was going through, you know, my mother had a degenerative neurological condition, and seeing someone
daily deteriorate like that, what you're doing physical activity -wise, well, I didn't have time to do that, what you're eating quite often doesn't become a priority.
Now it's probably a time it should be even more of a priority because we know that what you eat impacts your mental health.
you know there's great research now showing how important it is but when you're in that fog of whether it's that you're depressed or you're dealing with you know trauma whatever i think food is one of the last things that you think about making a priority and i think it's okay you know when we talk
about the health situation in the us and the uk with obesity on the rise and things like that people are now pointing at things like a zen as the cure for that.
But when you speak about the role there that stress and our lifestyles are having on us, and I was thinking about some of the stats that have emerged around anxiety in young people and them being more in depression rates globally.
Maybe there's something else that we should be thinking about, which is like the mental health mindfulness piece of how that overlays with food choices.
Because, you know, even the food, the ultra processed unhealthy foods that are being attacked a lot these days, i mean to some degree they are a consequence also of demand oh absolutely so they wouldn't be making these things if people didn't want them no and didn't buy them so maybe if we focused more
on some of the mindfulness mental health challenges we have in society people would have more of a um a greater ability to make better choices themselves as well because i certainly know in my life that if I'm highly stressed or if things are difficult then my ability to make better food choices is significantly
impaired yeah absolutely and you know again this is what the research shows the sleep the stress it impacts your ability to make choices about lots of things but equally your food choices you know what you're talking about I think is so complex it's where where's the responsibility for the government
where's the responsibility for the food industry where's the responsibility for us as individuals where's the responsibility for schools for example for us as parents educating our children we need to take into account all of those different areas in order to improve the foods that we're eating.
There is a problem that these three dishes so the chocolate the biscuits the crisps they are more tasty or rather our taste buds our brains are tricking us into thinking they're more palatable and that's a problem do we say to our children you can never ever have them now I've certainly never taken
that approach I think it's all about balance and enabling people to make the choices that they make but I recognize if I'm sitting there in the evening I'm a bit stressed I've got a work deadline I don't want to eat nuts I want to eat those biscuits or those crisps and I want a glass of wine with it
I know that's not the right decision I know it's 10 o 'clock at night But in the moment, that's the choice I probably will make.
Do you get frustrated with yourself because you know more about nutrition than most people on planet Earth, yet you still find yourself making, at times, suboptimal nutritional choices?
No, I don't because I think that it's really quite simple when we think about the food that we eat.
I think we're making it so complicated and I think that do you know what if we eat a good amount of fruits vegetables pulses if we try not to eat too much heavily processed foods if we try and get a bit of diversity in our diet we're doing okay so what if I go and have you know a bar of chocolate as
long as I'm not doing all day every day and I think this kind of health optimisation around diet, I think is taking away the pleasure of food.
And, you know, I often say if a food is too healthy to be enjoyed, it's just not healthy at all.
Food is there to bring us joy, it's to bring us pleasure, it's part of our emotions, it's part of our culture, it's part of, you know, our social connections.
And I worry that now there's a certain proportion of society so hyper focused on that one percent gain in terms of the food that they're eating that they forget all of that pleasure so I think I have quite a balanced approach because I know that ultimately if you get the foundations right the rest will follow
but that makes up 95 percent of what makes a food or a diet and that's how we need to think about what we eat healthy what do you think of diets because there's so many bloody diets isn't there i think that there's so much nutrabollocks out there nutrabollocks there is so much misinformation out there
what you see on social media versus what the evidence shows is like night and day i mean seriously and so when i think about diets my view on diets i mean there are some that there's some good evidence you know eat plenty eat 30 plants a week yeah that's great um go on a low calorie diet to lose weight
great but how are you going to maintain that weight that's a whole other question great for losing not for maintenance um then you've got the alkaline diet i mean i i don't understand that eat alkaline foods but your stomach is acidic so got no idea how that works the blood type diet i don't actually know
what half of these diets do because i do not understand the physiological theory behind them and so you know what so stephen i think if it works for you as an individual fine do it but if it works for you at the expense of the pleasure of food, at the expense of enjoying life to the fullness.
That's what I think is a shame.
Like time -restricted eating, I think there's great evidence around time -restricted eating.
Now, much of it comes from very tightly and metabolically controlled studies, you know, that are done in clinic where people, you know, eat within a five or six hour window.
So they have their first meal at 10, their last meal at four in the evening, reduces inflammation, reduces body weight, improves blood cholesterol, et cetera, et cetera, et cetera.
I don't want to only eat six hours a day.
I want to have dinner with my family.
I want to have dinner with my friends.
I want to go to the pub in the evening, not every evening.
I want to live life.
So what can we do that takes that principle of that diet, but we still benefit from it?
And this is what's great, again, about the research that we're doing.
So we've done this study called the Big If Study, the Big Intermittent Fasting Study.
We had 150 ,000 people sign up.
And we said, look, we want to see if what we find in tightly controlled clinical studies plays out in the real world.
Because we always have to think, how does all of this evidence play out in the real world?
Does it matter? And we said, just limit your eating window, so the time from your first to your last meal, to 10 hours.
So that means if you're having your first meal at 10, in the morning you're having your last meal at 8 in the evening.
That's correct, isn't it?
Sure. My perimenoportal brain cannot do maths.
That's quite doable for most people.
I can have my breakfast at 10.
I can finish my last meal at eight.
I mean, yeah, I do like munching on my chocolate late at night.
I could probably still live a happy enough life doing that.
And we found people could do it.
We found as well that people who practiced it within two weeks, they felt better.
They had better energy, better mood.
You know, they were feeling a lot better.
They also lost weight.
Many people wanted to do this because they wanted to lose weight.
And we actually see from evidence that people practicing time -restricted eating, even if they're told not to change their calorie intake, just by limiting their eating window on average, reduce their energy intake by about 300 calories on average.
There's been a big debate around this conversation around fasting and calorie restriction.
And some people say that it's basically the same thing.
And you've kind of proven that to some degree.
So we know that in most instances, if you practice time -restricted eating, you unintentionally reduce your energy intake.
And the data shows that on average from the studies that are published, it's about 300 calories.
Obviously depends on the duration.
The reduction in body weight also we know is dependent on the eating window.
So the smaller the eating window, the greater the reduction in body weight.
but there have been some studies that actually control the amount of calories that people eat but have some people having in a bigger eating window some in a smaller eating window and what these studies have shown that if you have the same amount of calories but you change the period and time in which you're
eating your food there is an additional benefit on metabolic health there is a benefit in terms of blood lipids in terms of inflammation independent of calories.
Okay, so time -restricted eating has some benefit independent of calories consumption?
Yes, but the bulk of the benefit is due to a reduction in calories.
So there's some benefit independent to calorie restriction, but the bulk of the benefit that we see is due to a subconscious or unintentional reduction in calories.
And I think this is when we're thinking about diets, I think we need to think about how easy is it to implement?
Is there any evidence behind it?
And 99 % there isn't.
For the ones that there is evidence, like time -restricted eating, can we do it in a way that still enables us to live our life that's sustainable?
And the sustainable point, I think, is really important because there's now some new evidence emerging around consistency and the importance of consistent eating patterns.
And I think this is fascinating.
So there's research showing that if one day you're having three meals and then the next day you're having nine meals and the next day you're having six meals and the next day you're having four meals, that troubles your body.
It's like, whoa, hold on, I'm used to having, you know, four eating events a day.
And this is important to bear in mind when we think about snacking.
If you're typically a snacker, then fine, carry on snacking as long as it's unhealthy food and as long as you have your last snack before nine at night.
If you're not a snacker, having me just vouch for the great benefits of snacking don't start snacking because you don't want to be inconsistent and this new evidence emerging around the consistency of eating and there's some research done actually quite some time ago that started this idea i think is really
fascinating so try and have a consistent eating pattern same applies to sleep try and go to bed at the same time get up at the same time we've done some work around social jet lag don't know if you've heard of that term I think I've heard of it.
What does it mean? So social jet lag is where you have an inconsistent sleeping pattern throughout the week.
So for example, for many maybe 20 year olds or students, they might go to bed at a sensible time in the week and go partying and crazy at the weekend.
Or for someone like myself, I go to bed late at night because I'm late night working, parenting, etc.
And then at the weekend, I catch up.
So if you have more than about a one and a half hour increase or decrease in sleep between your work days or weekend days, etc., that's called social jet lag.
So it's a bit like jet lag going from one country to the other.
And what we know is, and we've published on this from our own Zoe Predict Research, people who experience social jet lag, so have this inconsistent sleeping pattern, make poorer dietary choices.
They have more inflammation.
they have a different gut microbiome composition now it might be because of the dietary choices but again it just plays into this whole idea that we're talking about that we can't just think about the food in isolation we need to think about how we're eating our lifestyle etc what else is on your Nutribolics
list? what things bring to mind that a lot of people believe I mean there's a big debate raging at the moment about seed oils because we had an incoming American i guess he's a politician um rfk junior say recently seed oils are one of the most unhealthy ingredients that we have in foods and the reason they're
in foods is because they're heavily subsidized they're very cheap but they are associated with all kinds of very serious illnesses including body -wide inflammation which affects all of our health it's one of the worst things you can eat and it's almost impossible to avoid if you eat any processed foods
sorry i'm having to last this is like Nutribolics beyond Nutribolics but please that's basically it he said if you're going to eat processed foods you're going to be eating seed oils and he advocates for replacing seed oils with beef tallow which is in the UK is referred to as dripping which is pure
beef fat and is a saturated fat and he's actually selling t -shirts um rfk junior at the moment that say make frying oil tallow again so what so seed oils what is this weird debate that i've seen raging on on my instagram about seed oils i've like managed to avoid it like i've just not paid attention to
it but i see the word seed oils all of a sudden everywhere okay so seed oils i think is at the top of the neutral bollocks list it blows my mind what you've just read me it seriously who blows my mind, I've done lots of research on seed oils so I can talk from my own research as well as all the evidence
bases out there. There is absolutely no evidence that is credible evidence when interpreted in the correct way to show seed oils are harmful.
What is a seed oil?
So a seed oil is an oil from a seed.
So the most common seed oils in the UK is rapeseed oil, which is also known as canola oil in the US and many other countries, followed by sunflower oil.
The most common seed oils in the US are soybean oil, followed by rapeseed or canola oil, followed by sunflower seed oil.
And there's about three or four arguments that people use to say that seed oils are bad for us.
And if you go onto social media, I mean, this is a perfect example of night and day between scientific evidence and what's on social media.
If you go on social media, CEDAWs are toxic.
CEDAWs are going to give you Alzheimer's.
CEDAWs are going to give you cancer.
CEDAWs are going to kill you.
You look at the evidence, it's totally the reverse.
Now you can have sensible, boring scientists like me say CEDAWs are really good for you.
You could put that as one of your assets or whatever you call it or adverts for this.
So we could say, seed oils are really good for you, Stephen.
Or I could tell you, seed oils are toxic, they're going to kill you.
Everyone's trying to kill us with seed oils.
What's going to get more clicks?
Probably the toxic seed oil narrative.
And so the sensible science, there's no silver bullet.
There's no, like, you know, crazy inflammatory argument.
The sensible science isn't going to get the clicks.
So unfortunately, the voices of reason, and often it comes from boring academics like myself not saying other academics are boring but sensible academics like myself that give the you know the balance we we don't get a voice we're not being heard which is one of the reasons that you know I wanted to
come on this show because of the misinformation and we have to get the voice of reason out there we have to get the voice of reason so things like that to do with CEDAWS are not what's dominating the headlines so what people say in terms of seed oils is firstly our intake of seed oils has increased
100 fold the last 20 30 40 50 years and with that increase in seed oil intake so has cancer increased so has cardiovascular disease increased so has obesity increased so has alzheimer's etc etc so it must be to do the seed oils well what else has changed in that 50 years we're more sedentary we eat loads
of these other these heavily processed foods that got all of these other ingredients in, you know, the sugar, the this, the that, so much else has changed.
You know, you can't put it all down to the fact that at that point in time, CEDAWS were also changing.
We also know that about 60 % of the CEDAWS that we eat is actually in these heavily processed unhealthy foods.
So it's the first argument they say, and you see these beautiful figures that they put out where you see on one axis, the intake of CEDAO.
You see on the other axis, you know, over time you'll see for example like rates of cancer and you see rates of cancer, rates of cardiovascular disease going up linearly with the intake of CEDAO.
But we have to think what else has changed in that time.
The other arguments that they use are theoretical arguments based on biochemical pathways and I spend an hour teaching this to our undergraduates and I'm not going to bore you with that biochemical part to me but they talk about the ratio of a particular fatty acid which is omega -6 which is found in high
levels of seed oils and omega -3 which is another fatty acid and they talk about how having lots of seed oils changes this ratio makes this pro -inflammatory state because it increases a particular downstream chemicals etc etc what we know from kind of theoretical biochemical pathways and enzymes etc
doesn't actually play out in humans we're so clever we have all of these mechanisms in place to control inflammation to control oxidative stress to control downstream impacts of foods and so this argument that is also used to say that omega -6 Atlantic's fatty acids, so the main fat that's found in many of these
CDOIs is pro -inflammatory, is not supported by any evidence.
It's not supported by tightly controlled clinical trials.
If anything, it's shown to be anti -inflammatory, that levels of inflammatory circulating molecules actually reduce.
And yet they use this kind of theoretical argument, or what they've seen in a Petri dish, for example, or in a test tube.
So where has this narrative come from?
Where did it originate from that cedar oils were toxic?
Was it just one of those things that just snowballed?
I think it's one of those things that snowballed.
And I think it does fit in with the whole argument that people are using against auto -processed food.
It does fit in with other narratives that are going on.
I think some people can be very clever in cherry -picking research.
so there's a study called the sydney heart study and in this study this was done in the 70s and this is a study that's used often to advocate for the toxic effects of seed oils and in this study males that had had a heart event or a heart attack of sorts were randomly allocated to either to increase their
omega -6, so this particular type of fatty acid that is in seed oils, in their diet by having lots of seed oil, or they were asked to just follow their normal diet, which is quite high in saturated fat.
And what they found is those that increased their seed oil intake went on to have worse health outcomes.
now the problem with that is is that in those days the majority of seed oils underwent an industrial process called partial hydrogenation and partial hydrogenation produces a very harmful fat called trans fats you might have heard of trans fats and so they were eating this seed oil in the form of a margarine
or fat spread that had undergone partial hydrogenation and therefore was full of trans fats trans fats increase cholesterol trans fats increase inflammation trans fats are bad less that's why they are not in our food supply anymore and so of course that seed oil was going to cause worse health outcomes
but it's not how seed oil is consumed now and so it's that clever cherry picking of evidence that often supports a lot of the nutriabolics that's out there yeah and you know people you know with all these studies out there and with some studies having less rigor and studies that aren't don't have sort
of the randomized control element or what's the other term for a study where they do um they look at like 50 studies at once so they're meta -analysis so we do randomized control trials so these will be trials where there's always a control arm we'll randomly allocate some people to an intervention like
seed oils and some people to a control could be saturated fat, could be beef tallow, that's been done.
And then we look at different health outcomes, we follow them over a period of time.
Or it could be that I ask you for a month to have seed oils and then next month have beef tallow, for example.
And then we'll look at different health outcomes, compare how you responded to one versus the other.
And then what we do as scientists is if there's enough of these clinical trials, these randomized control trials, we put them all together into what's called a meta -analysis and we look what does the meta -analysis show so for example for seed oils there's meta -analysis for example of about 42 randomized
control trials where they can play seed oils to other fats showing consistently that there is no harmful benefit that actually there's a reduction in cardiovascular disease because the particular fat that's in seed oil has a really potent cholesterol lowering effect so it's actually beneficial for our
health Yet beef tallow is full of saturated fat.
It's full of palmitic acid, which is a particular type of saturated fat that we know is bad for us.
There has been studies, and these studies were done many years ago when beef tallow was actually used, comparing seed oils with beef tallow.
Seed oils always came out better.
Seed oils always reduced cholesterol compared to beef tallow, reduced inflammation, et cetera, reduced cardiovascular risk factors.
You're very passionate about this.
I am, because I've researched.
And as a research active scientist where I've run randomized controlled trials and I tell you what, you sweat blood and tears.
I love my research, but it's flimmin' hard work doing a clinical trial.
You know, getting ethical approval, recruiting people, changing people's diet.
Running dietary studies is really hard because it's not a case of giving them a pill.
If I'm going to give you CEDAWL, I've got to think, well, how am I going to do that?
What am I, instead of what, what am I taking out of your diet to give you that?
How am I going to make sure the rest of your diet is controlled?
So once you've run studies yourself and you've sweated that blood and tears and then you see this neutral bollocks, this misinformation out there, it's really bloody frustrating.
But it's a good thing that people like yourself are leaning into the mediums now of like podcasting because it's worth saying that as it relates to the sort of transfer of information, It's typically people who have either a platform or who are great public speakers or great salespeople that are ultimately
going to like resonate the most, reach the furthest with their information, irrespective of whether that information is credible.
So it's good to see more and more people that are in the research now sort of stepping away from their research laboratory and coming into environments where they can provide counteracting information.
And as someone that's on my own journey to figure, to sort of weave through all of this information to find out what's right for me, it's difficult.
And for a lot of people, it's super difficult.
I mean, the way that I kind of, my own framework for this is I listen to things and then I don't necessarily trust one source to be true.
But I almost like weight the authority experience and the rigor behind how they've arrived at that information.
and then I guess I perform my own meta -analysis across lots of different people that I speak to and guests and information that I get to find the sweet spots where the sweet spot for me is many people have said it that I think have a lot of sort of rigour and authority and experience in that subject
matter so then I accept it to be true whereas I'm not going to go on Instagram and see a real pop -up and it says that I don't know, putting sugar in your eyeballs is good And I'm not going to crack on with it just because the person's got charisma.
And I think in the world we live in where there is now this decentralization of information, which has its upsides and its downsides, we all need to have our own decision framework to decide what is true.
But I think yours is more rigorous than most.
Many people get their information from one source.
Many people trust one source.
and you're right that us academics we're rarely given a platform yeah and this is what I valued most actually about what I've done at Zoe well being able to do the kind of trials that we're doing but being able to have a platform not just for me but for us to invite other credible scientists onto the Zoe
podcast or for me to come on to this kind of podcast we're not trained as academics how to communicate we're trained how to you know run good studies in my case you know run clinical trials interpret the evidence evaluate the evidence critique the evidence and you know i'm self -taught to present the evidence
to other academics but we're not taught to communicate it to the general public so for me it's been a journey working at zoe of trying to communicate really complex stuff like i would have loved to have spent an hour telling you about the biochemical pathway of why seed oils don't impact inflammation But
I know that really you're not interested, the listeners aren't interested.
But, you know, I'm hoping that by informing them that I've done these studies and that these are the results, there's trust that actually what we found is true.
But we're the smallest voice out there, the research active scientists, partly because of time.
You know, I'm still in, you know, running trials, running, you know, different interventions.
but also i think many of the big platforms aren't giving us the opportunity necessarily because we haven't got the most exciting things to say because at the end of the day you know we'll present the evidence we'll present it with caveats we'll present it with caution and you know i will always say
on as i were to students i'm teaching what i'm telling you now is based on what the evidence shows now.
In 10 years time, I might be totally wrong.
All of these trials showing CEDAWS are fine.
I might be wrong in 10 years time.
I mean, I doubt it, I doubt it, because there's enough research.
But as scientists, that's something else, you know, we always caveat with.
And I think sometimes that's difficult for the general public, maybe.
I mean, I might be doing a disservice, I don't know, that you have the non -active sign or non -active influences science influences i don't know what you call them that speak with such certainty now i will if it's my study so i'll talk with certainty over the cedar study because i've done them i've been
there in the lab analyzing it or i'll speak with certainty over snacking data because i've you know sweated blood and tears over you know running the stats etc but i won't talk with certainty about anything else that i haven't done myself and yet you have other people talk with such certainty and I
think that's what instills confidence in maybe listeners and that's why they get more viewers.
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There's a lot of NutriBollocks around dairy, right?
Yep. I think the prevailing NutriBollocks is that dairy is bad for you?
Yep. So there's lots of NutriBollocks around dairy, and it's related to the NutriBollocks also around saturated fat.
So as a whole, we know saturated fat is bad for us.
Dairy contributes to most of the saturated fat intake in the UK.
So therefore, we could say all dairy is bad for us.
But no, there is a diverse food group.
You've got cheese, you've got yogurt, you've got butter, you've got milk.
And how they impact our health is vastly different depending on whether it's a liquid a solid it's fermented it's non -fermented etc etc and grouping them all together is as ridiculous as grouping all these snacks together in terms of the health effects and what we now know is that some dairy is actually
good for us so some dairy like cheese like yogurt and i don't mean this really kind of heavily sweetened sugary yogurt i mean like your greek yogurts your kaffirs those sorts of things you'll play in yogurts they've undergone a process called fermentation and that changes the food matrix so again we're
coming back to that whole importance of the structure of the food and by changing the food matrix changes how our body handles it how our bodies how the health effect of that cheese we don't fully understand how there's some great research being undertaken at reading university really diving into this uh
but what we know is if you have cheese, within reason, if you have yogurt, within reason, it does not increase your cholesterol despite being high in saturated fat.
Now, I have to caution that I'm not saying people should go and have, you know, 300 grams of cheese every day.
But within normal kind of intakes of a few portions a day, it does not increase people's cholesterol having cheese or having, you know, good yogurt.
Butter, on the other hand, we do know does increase your cholesterol.
Now, if you're having it at the kind of level that you would maybe just putting it on a bit of toast, I wouldn't worry so much.
But we do know that if you were to compare cheese versus butter, which has almost the same fat composition, and this has been shown in randomized control trials, the butter will increase your cholesterol, but the cheese will not.
And nuts. A lot of people say that nuts cause weight gain?
No the evidence does not support that so we know that people who consume nuts based on the totality of the evidence do not gain weight we know this from epidemiological data i .e people who consume more nuts tend to quite often have a lower BMI now that could be confounded by the fact that nut consumers
and only about 10 percent in the UK and even less about 7 percent in the US even consume nuts.
Nut consumers tend to have a healthier overall diet.
So there is that confounding but clinical trials show that if you add nuts to your diet, ours included, you do not gain weight.
Now that might be partly because of the mechanisms that we've talked about to do with the food matrix that 20 to 30 % of the calories are being excreted.
So the back -of -pack labeling shows that per portion of nut is 170 calories but actually on average you only absorb 130 calories.
So lots of it's coming out.
It might be because, you know, they're feeding the microbiome that's helping, you know, reduce adiposity.
It's also nuts are satiating, so they make you feel more full.
They also blunt your blood sugar response.
They have so many other benefits that counterbalance any potential for weight gain.
And is there anything else on the Nutribollocs list that is worth highlighting?
I would say that I think there's still lots of confusion around saturated fat and around cholesterol.
So cholesterol, I went and did a blood test and the doctor said to me that one of my cholesterol was a little bit on the higher side.
This was last year.
So I think it was the, is it the HDL cholesterol?
I don't know. The way that I experienced it was there's this good cholesterol and this bad cholesterol.
And like my bad one was like a little bit, you know, behave, like it's getting a little bit into the region where he might have more of a stern talk with me.
That was last year i think i've done better this year but what is cholesterol and my simplified explanation of it is that is that flawed in some way a good bad no it's always a little bit more nuanced a little bit more complex um but there are two ways that we can look at cholesterol we can look at cholesterol
in terms of the cholesterol that we eat right and that's where i think there's a lot of misinformation and we can look at cholesterol in terms of the cholesterol that our body produces so our liver is constantly churning out cholesterol when the liver churns out cholesterol it packages cholesterol into
do two different kind of packages or two different types of parcels and the labeling so to say on these parcels determines the health effects of that cholesterol so you've got your hdl cholesterol which we call our good cholesterol you've got your ldl cholesterol which we call your bad cholesterol okay
so l is bad yes h is good yes they're actually the same in terms of the cholesterol but it's the label that's on the parcel the label in terms of which is directing where they go which is different so in really simple terms LDL is directed posted to your peripheral tissues to your blood vessels where it
can be taken up and in the right environment where there's inflammation also stress etc can result in atherosclerosis, which is that kind of furring of the arteries, which over time can build up and can lead to a heart attack, et cetera, et cetera.
HDL, in very simple terms, has a label on it that actually enables the reverse cholesterol transport.
So it actually almost kind of cleans up some of the cholesterol.
This is kind of in very simple terms.
So if any lipidologists are listening, they might be a bit frustrated.
But in very simple terms and kind of brings it back to the liver for disposal.
So that's why it's considered good.
What we know is that the amount of LDL cholesterol that's circulating is really important in terms of our cardiovascular disease risk.
There are some cholesterol deniers.
And I know you've had on your show a cholesterol denier.
I don't believe in the evidence he presents.
I think that the totality of the evidence is very, very clear that as your LDL cholesterol increases, your risk of cardiovascular disease, your risk of all -cause mortality increases.
Where there is misinformation is around dietary cholesterol, that there was this perception years ago that if you have foods high in dietary cholesterol, like eggs, that it will increase your circulating cholesterol and therefore increase your risk of heart disease.
And therefore, there was a limit years ago put on how many eggs we should eat, how much cholesterol we should consume.
we now know within certain limits so within the limits that we typically eat our food containing cholesterol that dietary cholesterol does not impact our circulating cholesterol obviously at extremes it does but if you're having one to two eggs a day that's an intake of cholesterol that's not going
to negatively for most people impact your circulating levels of this ldl bad cholesterol.
If you're having 10 eggs a day, then I would be worried.
Okay. Okay. But yeah, cholesterol is another area of NutriBolix.
And then, you know, on this whole area of cholesterol, heart disease, I think a really frustrating area of NutriBolix is saturated fat.
So we'll talk about saturated fats, but just so I'm super clear on the cholesterol point, what foods have really high levels of LDL circulating cholesterol in them?
OK, so you've got dietary cholesterol, which is just the cholesterol that's in the food.
Yeah. And that has very little impact on circulating cholesterol.
OK. Then you have cholesterol that the liver produces.
And the liver produces that from scratch.
And it's how diet impacts the liver production that determines how diet impacts our circulating cholesterol.
So saturated fat increases the production of cholesterol by our liver and reduces the removal of cholesterol by our liver.
Highly refined carbohydrates can also increase the production of cholesterol by our liver.
So when we're thinking about how diet impacts our cholesterol, particularly our LDLs, our bad cholesterol, we don't need to worry so much about dietary cholesterol, i .e.
how much cholesterol is in a food because unless it's extreme it will have a minimal impact we need to think about how much saturated fat for example we're having because that's one of the main dietary determinants of our cholesterol level.
Okay and what is a saturated fat versus like a normal fat like is there good and bad fats?
Yes there are good and bad fats.
All of the fats that we eat or 98 % of the fat that we eat comes in the form of a molecule called a triglyceride.
And a triglyceride has within it three fatty acids.
And it's the mix of these fatty acids that determine the health properties of that triglyceride, the melt profile of that triglyceride, etc, etc.
And there's lots of different types of fatty acids.
So you're probably familiar with amino acids, which are types of protein.
And in the way that amino acids are what make up protein fatty acids are what make up a fat and the quality of that fat and we typically separate them into three main classes saturated monounsaturated and polyunsaturated and you might have heard of those terms yeah loosely yeah and saturated fatty acids
differ in terms of their biochemistry and i won't bore you with that um to monounsaturated fatty acids they also differ in terms of their melt profiles so like how hard they are or liquid they are most tend to be hard hence why most hard fats like butter you know most animal fats which are hard at room
temperature tend to be high in saturated fats.
Mono and polyunsaturated fatty acids differ from saturated fatty acids in terms of their biochemistry in terms of their melt profile they tend to be liquid and polyunsaturated fatty acids are a very special type of fatty acid because they're actually essential for us our body can't make them and so they're
essential fatty acids and one of those is omega -6 which is the fatty acid found in seed oils which is what people say is why seed oils are bad for us which hopefully we've debunked that and saturated fat as a whole we know is linked to increased risk of cardiovascular disease increased risk of all cause
mortality. But there's lots of people that say you know we've got it wrong as nutritional scientists we don't know what we're talking about it because actually there's this meta -analysis that showed that actually saturated fat isn't bad for us and that's because when we think about the health effects
of food we have to always think of that instead of what.
So there was some work that was carried out looking at hundreds and hundreds of different clinical trials where they've replaced saturated fat in the diet with carbohydrates or trans fats or polyunsaturated fats or monoun saturated fats.
And what this research showed is that if you replace saturated fats with whole grain carbohydrates, you have an improvement in health.
If you replace saturated fats with poly or monounsaturated fats, you have an improvement in health.
If you replace saturated fats with refined carbohydrates there's no difference so you could take that study and you could say and this is of hundreds of different studies and say saturated fats are really bad for us because we know that if you replace them with whole grain or polyamonyl unsaturated
fats you have a beneficial effect or i could take the same analysis and say oh saturated fats are fine nutritionists have got it all wrong because actually there's no detrimental effect if you compare it with refined carbohydrates.
And this is exactly what happened when this meta -analysis came out about probably about 15 years ago.
I remember looking at the headlines of two different papers.
I won't say what the papers are, but one I would say is a little bit more evidence -based and one is a good example of clickbait headlines.
They had totally different headlines.
One said nutrition scientist have got it all wrong we've been lied to saturated fats are fine the other said research again consistently shows saturated fats are detrimental to our health obviously that one's right and they're talking about the same study talking about the same study because it's that instead
of what and that's really important when we think about the health effects the other thing that does complicate things a little bit with saturated fats is there's lots of different types of saturated fats.
We know that the type of saturated fat matters, but we know the food matrix that it's in matters.
And the dairy is a great example.
So you have cheese and butter, exactly the same, almost identical fat composition, two entirely different effects on our cholesterol.
So it is a little bit more nuanced than saying all saturated fats bad.
It depends on the type and the food it's in.
And what types of food have saturated fats that have a less than healthy food matrix?
So I would say the type of saturated fats that we want to avoid are the saturated fats that are found in most animal products, except fermented dairy, except cheese, except yogurt.
So beef tallow, I would say the evidence consistently shows is not favorable for our health.
Lard, butter in large amounts.
you know and then the meat that's the fat that's intrinsic to the meat take salami you can see the fat in there take steak for example you know cut off the visible bits of the fat it's okay in small amounts i'm not saying we should avoid it and totally but if you have the option of kind of cutting off
trimming the fat then i would and then there are some tropical oils that are very high in saturated fat palm oil for example coconut oil although the jury's out on the health effects of coconut oil but palm oil for example is very high in saturated fat we know it increases our cholesterol if you had to give
me some principles for eating based on everything we've talked about today just like and i and i had to force you to just give me five principles for eating what would those five principles be?
Five. Okay. I would say, first and foremost, find a food or dietary pattern that you enjoy, that brings you pleasure.
Cookies. Okay. But we are not, these aren't exclusive to each other, Stephen, okay?
Okay, fine. That brings me pleasure.
Okay. That's really important.
These not exclusive.
Okay, so a dietary pattern that brings you pleasure.
Because? Because food is there to be enjoyed.
And it will be a sustainable dietary pattern.
And because we know that consistency and sustainability is really important in how you eat.
Okay. Second, I would say, think about how you eat.
Think about how fast you're eating.
Slow down. Chew more.
Chew more. Don't eat late at night.
Try and eat within a 10 or 12 hour eating window.
And just on this chew more point, before we started recording, you were saying that you wouldn't mind if I chewed some nuts and spat them out so you could look at them.
Why does chewing more have an impact again?
Just so I'm clear. So chewing can impact how you break the food down, obviously.
But we also know chewing impacts your hunger and your fullness signals.
So there's some evidence to show if you chew your food 40 times versus 15 times, it can result in a difference in how full that food makes you feel.
OK, so the chewing effect is sending some kind of signal to my brain.
Yeah. Again, this isn't an area that I have expertise in, but that's what the evidence is showing.
So as well as your gut sending signals to your brain, receptors on your gut saying whether you're full, there's something going on when you're chewing your food as well that's important.
OK. And chewing your food also changes the rate, therefore, at which you're eating.
So it changes your eating speed.
OK, makes sense. So on that second point, I've got slow down, chew more, don't eat late at night.
and eat within a 10 to 12 hour eating window 10 to 12 hour eating window then the third would be go back to basics yeah have a good amount of fiber have a good amount of healthy oils that's your olive oils and your olive oil dare I say it seed oils but olive oil I would say is the king and queen of the oils and you
know have that balanced plate rather than obsessing over a single food.
Okay. Number four? Don't think of food in isolation.
Okay. Think about your diet in relation to or alongside your sleep, your stress, your physical activity.
And number five? Can you remind me of what I've done?
Yes. I'm 48, I'm in the depths of perimenopause.
I'm one of those, like, 90 % of people that have brain fog and memory loss.
So number one was food that brings you pleasure, which is sustainable and allows you to be consistent.
Number two is really thinking about how you eat.
So slowing down, chewing more, not eating late at night and trying to have a shorter eating window of 10 to 12 hours.
Number three was go back to basics, which is high fiber, whole grains, fruits, healthy oils and overall just a balanced plate.
And number four is don't think of your nutrition in isolation.
So think of it in the context of your exercise, your sleep, and all of these other lifestyle factors.
And number five. Don't deny yourself anything.
Think about what you can add in rather than what you take away.
Don't deny yourself anything.
So cookies are still on the menu.
Occasionally, yes. You mentioned the perimenopause.
You said you're in perimenopause currently.
How does that factor into everything we've talked about today?
And what is the – because I've got this graph here that I've found about the menopause transition, which talks about how different sort of things are happening inside the body.
You've probably seen this quite a few times before, which I'll put on the screen and link below for anybody.
But what is the relationship between my diet and my menopause journey?
Is there anything to be aware of?
There is. I mean, you know, the menopause has a huge impact on how we respond to food.
it has a huge impact generally on all of these pillars of health that we've talked about our sleep our stress our physical activity you know and diet and I think it's something we're talking about a lot more now and we should be talking about it a lot more now you know 50 % of the population at some
point are going to go through the menopause and it's a transitional period of great disturbance great disruption and of great burden to many women and we've conducted lots of research at zoe on the menopause and what we know is that prior to the menopause which is basically the point one year after your
last menstrual cycle you have this perimenopausal transition period where your estrogen and other hormones are fluctuating day to day so it's like this roller coaster which I think your graph shows really nicely you've got this roller coaster of hormones and so what's happening is is your estrogen isn't
just slowly declining as you reach perimenopause so that transitional period before your menopause but you're on this roller coaster and it becomes more regulated after the menopause but you're still in that point where you're having less estrogen so less of the hormone that we know has such wide -reaching effects
and the reason that the perimenopause transition as well as postmenopause period in a woman's life is so important is because estrogen the hormone that fluctuates during the perimenopause and then reduces and declines in postmenopause has effects all over our body nearly every cell in our body has oestrogen
receptors. So our brain, our blood vessels, nearly everywhere.
So this rollercoaster of oestrogen during the perimenopausal phase and also the reduction postmenopausally has far reaching health effects.
So for example, postmenopausally, women are five times greater risk of having a heart attack.
Now some of that's due to age, but it's also due to the loss in oestrogen.
Women are five times more likely to have abdominal obesity, which is fat around the tummy and that's because of estrogen's role in fat tissue deposition so where fat tissue is deposited we see in our own zoopradic research pre -menopause women are doing well compared to men in terms of many of these
what we call intermediary risk factors of cardiovascular disease blood pressure cholesterol glucose insulin etc as soon as they hit the menopause suddenly they catch up with men and it gets worse and so suddenly their blood pressure is higher than men or their cholesterol is the same level as men.
So we see this as well in our zoopradic research that post -menopausally and perimenopausally, people's cholesterol and their bad cholesterol, their LDL cholesterol, increases by 25%.
And this is all related to the wide -reaching role that oestrogen has in our body.
We also see that oestrogen impacts and therefore the perimenopause and postmenopause, how we metabolize food.
So we see bigger excursions in post -meal glucose and post -meal fat after the menopause.
Again, it's all linked to the role that oestrogen plays in our metabolism.
And then I think what's most important to be aware of regarding the perimenopause and post -menopause phase is the symptoms that women experience.
and we've done some research in 70 ,000 individuals where we've looked at how prevalent these symptoms are.
We see that 99 % of perimenopausal women experience at least one menopausal symptom.
We see that 66 % of perimenopausal women have 12 symptoms or more and this has a huge burden.
We know from other surveys 10 % of women leave the workforce during the perimenopause and postmenopausal phase because of the burden that these symptoms have on their quality of life.
And what age does this typically occur, the perimenopausal symptoms?
So typically people become menopausal, as in postmenopausal, stop their menstrual cycles at 51.
The menopausal transition period can be anything from 2 to 10 years.
Typically people would say maybe around the ages of 47 many women start to experience perimenopausal symptoms and these include symptoms like brain fog, anxiety, memory loss, irritability, low libido, change in metabolism and now I'm in that perimenopausal phase and I've forgotten all of the others
but there's about 50 symptoms that are recognized and we see in our own research that the amount of women experiencing symptoms is really high so we see that 85 percent of women are saying they have brain fog they have anxiety they have memory loss it's really high the amount of women experiencing these
symptoms and what's really interesting is we know yes hrt so hormone replacement therapy therapy or mht can help reduce many of these symptoms.
But we also know that diet can help as well.
And I think actually, Stephen, one of the most interesting things from our research, looking at menopause and symptoms, is that typically when we think of menopausal symptoms, we think about hot flushes.
And if I was to ask you, actually I wished I'd have asked you before I said that, but if I was to ask you, if you were to think of a menopause symptom, what would come to your mind first?
I would say hot flushes, because that seems to be the only time that people talk about hot flushes is when they're talking about menopause in my world.
And then I'd say brain fog.
Yeah. And what's really interesting is hot flushes are one of the least common symptoms.
About 40 % of women in our research have hot flushes.
85 % have brain fog.
85 % have all of the other brain -related symptoms and yet typically we always think about hot flushes and this is because there just hasn't been loads of research on menopause and so I think what's really exciting is there is now a lot more research on menopause so I think the future is really exciting
but I think what comes with this is yet more neutropologs and that's because I think there's this whole area of what we call meno washing i don't know if you heard of i've never stick meno for menopause in front of any product you can charge 10 times as much i could call this a menopause tea it's actually
yorkshire tea and it's a very good cup of tea i could call this menno tea and charge 10 times as much for that tea bag without any evidence because women are desperate 45 percent of women say their symptoms are so burdensome they'll try anything 10 % leaving the workforce because of their symptoms and so we
have to be really careful that we are only selling evidence -based supplements for which there isn't much evidence at the moment and I think that the evidence that an overall healthier dietary pattern can reduce symptoms is the best way forward for now alongside for those who choose to hormone replacement
therapy. A recent survey showed that 30 % of menopause women are trying herbal remedies, 30 % are trying vitamins and 51 % are trying any kind of dietary therapy as an alternative to HRT.
That was in iNews, which kind of supports what you're saying, that there's lots of people searching for, because I think from the experiences that I've had with people talking to me about menopause, it seems to be an incredibly confusing period of life where you can't make sense of what's happening
and all the old rules of just you know hit the gym and eat a bit healthier seem to go out the window because there's something deeper at play in your body so it's not that you're not eating right or it's not that you're not sleeping right it's a deeper hormonal fluctuation that you've actually never
experienced before so of course you're going to be really confused and um quite easily uh gaslit as well I imagine because you know I've had someone say to me that they felt like they were going crazy and then people started thinking they were just like kind of going crazy a little bit um yeah i think
you know fortunately i think it's changing but historically we didn't talk about it you know i vaguely remember my mum saying i'm really hot i'm having hot flush but we didn't talk about menopause we didn't talk about periods we just didn't talk about it in that you know when i was growing up and unfortunately
my mother's no longer alive so i don't really know what she did go through and i want to talk about it people are talking about it we have people like davina mccall who are amazing because they're getting women talking about it so we're no longer ashamed so i think the tide is really turning but menopause
is this perfect storm because you have these burdensome symptoms and then you have alongside it which i don't think we talk about enough is these health effects that i talked about so women going for the menopause aren't sleeping I mean my sleep is all over the place honestly when I get a good night's
sleep Stephen I feel like superwoman it I'm almost it reminds me of the state I'm in at the moment is like how I was when I had kids where you know I'm getting four or five hours sleep then I wake up if I'm lucky I might get back to sleep so you've got women they're not getting enough sleep you've got
women who often are feeling a bit depressed or anxious or you know are losing their confidence because of their brain fog, because of their memory loss, because of, you know, their anxiety.
You've got the hormones changing your body composition.
Suddenly you're eating and doing everything the same, but all the fat's being directed to your tummy.
Your hunger signals are mucked up.
Your desire to eat different food changes.
And we see this again in our own research that post -menopausal women tend to eat a lot more sugary foods than pre -menopausal so you've got this perfect storm of things going on and then in amongst that do you really want to do some physical activity are you really motivated to start eating healthier
and you know when you're exhausted and it goes back again to that importance of sleep and that interaction of sleep with our food choices and how we respond to food there's so many things to think about and I think it's really tough in that perian post -menopausal phase when your body's changing when you're
tired when you're feeling a bit rubbish to also take control of your diet but it's the most important time because it's when your cholesterol increases it's when your blood pressure increases it's when all of this fat tissue around your belly is releasing harmful inflammatory chemicals etc.
So it's when unfortunately we really do need to take stock of our physical activity of what we're eating and our stress levels but it's probably one of the most challenging times to do it as well.
you must be incredibly stressed through that period but also just thinking about your relationships if you if you're in a relationship in a heterosexual marriage with a with a husband who isn't going through that at that period of their life and you said there was a libido issue that's symptomatic of menopause
as well to navigate all of that and for the people around you to understand what's going on in your head must be incredibly stressful incredibly stressful I'm very, I feel very, I don't know what the right words are here, but I feel very sympathetic because I can't imagine, I don't think there's a point
in the man's life where we go through such a profound change in our hormones in such a confusing way all of a sudden.
So it's like. but i think even if we raise awareness so that men are aware and they can support their partners and you know libido for you know it's an example we see in our own research whilst it might not be the most common women rate it as the most burdensome really so we monitor not just the prevalence
so how common the symptoms are we also ask people how much impacts their quality of life and the peri and postmenopausal women rate that as their what their symptom that has the most burden on their life because if I'm not slept and I'm not feeling sexy I'm not gonna I'm independent of whether there's
like a chemical impact on my hormone levels that causes my lowering of libido I'm not trying to have sex you want to go to sleep I want to go to sleep yeah exactly so even if you know and especially I don't feel good I don't feel sexy and probably my mood might be altered and yeah your tummy's suddenly
grown yeah it's not going to be so what do what advice do you give to those the women going through that you said that you're on hormone replacement therapy yourself previously um and that's had a i guess a positive impact on your menopause journey yes i still sleep really badly yeah um i don't think
hrt is the answer for everyone and some people can't take it if they're contraindicated with certain risk related to cancer.
And some people choose not to take it and it certainly doesn't solve everything.
I do think the evidence is very compelling for reduction in many symptoms.
I think the evidence is compelling or increasing and building for the beneficial effects it also has on some of these health effects that happen during menopause like blood pressure, cholesterol, tummy fat.
so I've chosen to take it for both health and for symptoms but there's reasonable evidence now showing that diet can help reduce symptoms there isn't a one -size -fits -all there isn't a silver bullet but an overall healthier dietary pattern I believe can reduce menopause symptoms this comes from other
published research as well as our own research that we've done at Zoe where we've looked in a subgroup of individuals over 12 to 18 week period and looked at those who transitioned to a healthier diet they're actually following the Zoe program but the underlying principles are the same for all individuals
to follow a healthy diet so increased plant diversity increased fiber a very kind of Mediterranean style diet and what we see in those people who are improving their diet they have a 35 % reduction in symptoms now that's huge I do have to caveat that to say though that there wasn't a control arm so it's
not a clinical an rcts we call it it's a study where we followed people at one point in time and collected data another point in time what we now need to do is repeat this with a control arm to see if we see the same size effect but there are other studies that have in a randomized control trial ask
people to follow the Mediterranean diet or a older and they see a similar magnitude of around 30 % reduction in symptoms which is huge and promising I think.
But I think where we have to be really careful with menopause because we are desperate because we're struggling I think we're really susceptible to marketing to this menowashing and I think there are so many supplements that are being sold as the silver bullet you know and I see it on social media and I
think firstly okay if it works for you great If you can afford it, great.
But what worries me is people who are spending a lot of money that they could be using for a healthier dietary pattern or, you know, a gym membership or whatever on a supplement that there is no evidence to support.
And the evidence is very, very weak.
Except for a supplement called soy isoflavones, there is very weak evidence that any other supplements will work consistently.
They might work for some people, but consistently.
So soy isoflavones are a particular chemical that are found in some foods.
It's a chemical that has a structure very similar to oestrogen, so it actually binds to the oestrogen receptors in the body, which is why it has a beneficial effect on many symptoms.
Now, soy isoflavones are consumed in quite small amounts.
In the UK and the US, we consume probably about one milligram a day on average.
in the far east like china they consume about 70 milligrams a day as part of the natural diet so in those kind of countries they actually have a really low prevalence of menopause symptoms compared to us they still have menopause symptoms but it's a bit lower than us what we know is that if you supplement
people with soy isoflavones for the vast majority of people but not everyone it will reduce symptoms a little bit not totally but it can reduce symptoms and is your underlying health a predictive factor of the amount of symptoms you'll experience if i was if i'm obese and then i go into perimenopause
are my symptoms going to be more significant so that's a good question we've looked at how living with obesity can impact your symptoms and we do see that if you're living with obesity you have a higher prevalent number of symptoms okay we see that if you have an unhealthy diet to start with you have a higher
number of symptoms we see that if you have low physical activity you smoke etc yes it's associated with high symptoms this is all association data though it doesn't show causality and it's really important to say that for quite a while I ignored my gut I ignored the role it plays when it comes to my
overall health and it wasn't until the team from Zoe came onto my podcast that I realized I couldn't ignore it anymore I was so impressed by professor tim specter and professor sarah berry that i ended up investing in zoe and then our sponsor of this podcast they helped me to view my gut as the gateway
to better health that when in balance my microbiome could strengthen my immunity elevate my mood and fight off disease which i now know to be true i trust zoe because they have one of the largest microbiome databases in the world and when you sign up you'll get one of the most scientifically advanced
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talked about professor that's a formal way to trust me I think we've covered an awful lot and I think the thing that I would emphasise when people are thinking about their health, thinking about their diet is firstly find what works for you find something you enjoy but I think I would say be really
really careful of the misinformation that's out there, really careful and I would say also if you're going to make a change make sure it has a big enough size impact to warrant the change you're making because there's a lot of advocates for this health optimization you know make this change and it will have this impact
well if you're making a change that disrupts your life significantly but only has a one percent impact on whatever health outcome you're interested in whether it's your cholesterol you're your overall energy or whatever is it really worth disrupting your life that much for that small change and i think
that's really important i hear so many times when i'm talking to other mums at the school gate or that sort of thing oh my gosh i read this and i'm going to do this and you know it's going to be really hard but they've said it will help with this and it's like oh you're taking away pleasure and actually
what is the gain and if the world is to move forward in a way that is positive in your estimation how does the world change and improve as it relates to all the subjects we've talked about today what is that change you wish to see in the world in which you operate I would love to see a world where scientists
food industry and policy makers work together I'd love to see a world where we encourage evidence -based science, but scientists aren't scared of working with food industry, for example.
A lot of people think that food industry is bad.
Like it's this sort of evil guy who sat in this boardroom who's just counting money and just pushing whatever these little innocent children will put in their mouths to make them addicted and give them neurodivergence and all kinds of other issues, potentially.
A lot of people feel that the food industry has become this sort of singular entity people think about in the sort of conspiracy theory internet.
And you kind of imagine it is like a guy in a boardroom in a suit who's just like cackling and laughing and stuff like that.
I think that I can't comment on their motivations for profit.
I don't think I'm informed enough to comment on that.
But I do believe that the food industry needs to work with academia in order to solve the problem of the kind of foods that are out there.
We need impact from government, though, as well.
We need impact from policymakers.
We need to go back to grassroots.
We need to be educating our children how to cook.
We need to be giving healthy school meals.
We need to be educating them in schools.
What is a healthy meal?
What isn't a healthy meal?
What is a healthy food?
But I think that something that's so important is this current state of fear.
I think we're in a perilous state at the moment of there are some people making a lot of noise in the media about scientists working with industry, how any research funded by industry is therefore biased, is corrupt, can't be trusted.
That's certainly not my experience.
It's not what I have ever seen from any other colleagues taking money from food industry in order to do studies.
We as nutrition scientists need to do studies, we need to run clinical trials in order to look at how we can improve the food to make it healthier.
The amount of funding we get from independent government bodies is tiny.
To get funding, the amount of time we have to spend as academics writing grants to be rejected and rejected because the government invests so little in nutrition research.
We need to be able to get funding to be able to run studies to answer important questions the money and the experience I've had from those around me when we receive funding from research when we receive funding from industry there is very limited involvement that they are allowed to have with what we
do and the university ensure that we conduct the research, we do the analysis, we publish the paper the industry funders cannot get involved in that process so I still see it as independent now there is discussion about are they setting the agenda of that research you know there's something we could talk
about for days and days but I think this narrative that's out there that just because a study is being funded by the food industry is biased is wrong and I think it's unhelpful and it's putting these exposés that certain media personalities are putting forward that if an academic has taken money from a food
industry that therefore they they cannot be advising us on food they cannot be trusted for their research I think that that's a real problem for us as nutrition scientists because it's creating a time of fear yeah I mean of course So yeah, when you explain it through how these studies get funded, then
it makes a ton of sense.
And actually, part of what I was thinking is that government should be doing a little bit more to fund these kinds of studies.
Because I can't, I don't really believe that you're going to get the food industry to work together.
Because again, thinking about incentives, if there's one cereal company here and the other here, and they say there's 10 of them.
Yeah, how can you get all of them to agree to take Coke or Pops off?
Yeah, the two that don't win, and then they keep their jobs, their companies are successful, they get the pats on the back.
So when we think about health interventions that the government have made over the years that have been super effective, they've come from like policy.
Smoking is a good example that I always think about, like the change in smoking in our society because they banned smoking indoors and put things on the packaging and just changed the sort of social narrative.
And all smoking companies, tobacco companies had to sort of comply at once.
And that's why I think all three have to work together.
Government need to take big responsibility.
now and but i think that there has to be an acceptance that academics scientists can work with food industry and it doesn't mean that you're corrupt or our results are biased in any way we have a closing tradition on this podcast where the last guest leaves a question for the next guest not knowing
who they're leaving it for and the question that's been left for you is what is something that you believe that smart people you care about disagree with do you know i believe i believe that life can be simple that actually all that matters is that you have good relationships that you're finding joy
in life and that we shouldn't over complicate things and if on my gravestone i have written sarah was a nice person i would be very happy with that but a lot of the clever people i interactive i think wouldn't agree that that's necessarily a good achievement in life but i see that as a great achievement
what do you think they might want written on their gravestone instead you're smirking nervously i am is it they're too obsessed with like impact and ego and those kinds of things is that what you're saying i don't know because the people i care about i don't think are egotistical i think we live in a society
certainly in a society where we're mixing with successful people where there is a lot of ambition where there is a lot of um emphasis put on your achievements where there's a lot of striving for the next goal striving for the next achievement and maybe it's having had four years where i took a career
break where i was care of my mom and together with the rest of my family we looked after my mum we kept her at home through a degenerative neurological condition and seeing someone change seeing someone lose the power to talk lose the power to eat lose the power to interact lose the power to do everything
that we take for granted I think has enabled me to not sweat the small stuff it's enabled me to find joy in most things pleasure in most things and not strive for things that maybe in the past i would have perspective i think it's given me a perspective now don't get me wrong you know i you know i was nervous
before coming on here so i sweated about that and you know i'm not saying that i'm always like horizontally laid back by any means but i think it's given me a perspective on what matters to me and what matters to me and I think the greatest achievement in my whole life has been actually not becoming
professor which I'm incredibly proud of I'm from a working class family you know I was the first person in our family to ever go to university my mum and dad didn't have the privilege of staying at school beyond 14 and I mean it saddens me that they haven't seen this success saddens me very much and whilst
the pride I felt yesterday at the ceremony was phenomenal actually what I'm most proud of is the four years that I cared for my mum and to me that's what matters and so that's why when I'm with lots of smart people and I think they're doing amazing things I don't have the same perspective sometimes
I probably don't care as much as long as I'm having fun and do you know what and I think I said this at the beginning I'm so privileged I get to do my hobby every day I love what I do I'm not doing this necessarily because I'm such a selfless person that I want to improve everyone's health yes if that's
a by -product great but I get up and I love what I do I'm so excited by the science that we do and what drives me to do it is having been through that situation of realising how delicate life is so just seize the moment enjoy what you're doing at that point in time thank you so much um professor congratulations
on the professor didn't realise it was uh you had the ceremony yesterday that's an incredible achievement i know that we're not we're not prioritising the achievements as much anymore but um it's incredible yeah it's no it's an incredible thing and it's a it's a credit to the work that you've done and how
you've done it over the last 25 years and the broader impact I think you've had on so many millions of people's lives now through now the content you produce but also all of the research that you've done firsthand so thank you so much for doing the work that you do thank you for illuminating so many
of these subjects to me today I actually said a message to my team before saying that I've had lots of conversations about nutrition and stuff but the the primary research you've done and the research you're continuing to do is so much of it's completely new to me and that's quite hard when I sit here
doing this every day so it's been an absolute joy speaking to you and also not just from the information standpoint but from the broader philosophical idea of how one should approach their life and how one can approach their life has been incredibly inspiring so thank you.
Thank you it's been a real pleasure to talk about so many things I'm passionate about.
We shall do it again sometime, thank you.
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