Begin Again with Davina McCall - Can Your Diet Reduce Risk of Alzheimer’s? The Truth About Alcohol & Brain Health With Dr. Federica Amati

Episode Date: March 13, 2025

In this episode of Begin Again, Davina McCall sits down with leading medical scientist Dr. Federica Amati to explore the fascinating link between alcohol and brain health. With Alzheimer’s on the rise, Federica unpacks the latest research on how certain drinking habits could protect against cognitive decline—while others may do more harm than we realize. She breaks down the science, busts common myths, and shares practical ways to make smarter choices for long-term health. Eye-opening, empowering, and packed with must-know insights—this is a conversation that could change the way you think about alcohol. 📢 Drop a comment: What’s your biggest takeaway? Have your views on alcohol changed? Follow me here: www.instagram.com/beginagain https://www.tiktok.com/@beginagainpod  Everybody should know this:  https://www.penguin.co.uk/books/458947/every-body-should-know-this-by-amati-dr-federica/9780241679616  (00:00) Intro (02:02) The Impact of Lifestyle on Chronic Illnesses (03:09) How Where You Live Impacts Your Diet (06:19) How Much of a Difference Can Lifestyle Change Make? (07:16) Diet as a Part of Culture (10:10) The Truth About Ultra-Processed Foods (13:38) Fear Around Food: Why Are We So Anxious About Eating? (16:04) Why Nutrition Advice Is So Confusing (18:35) How Much Fiber Should We Eat & What’s the Best Source? (23:58) Is Coffee Good for You? (32:18) Myths About Alcohol: What Science Says (37:30) Are Carbs Bad for Us? (38:35) Zoe Ad (39:57) Why Fruit Is Essential for a Healthy Diet (41:45) Are Oats Actually Healthy? (44:41) Do We Really Need Supplements? (52:13) Allergies & the Microbiome: Can We Train Our Gut for Prevention? (56:22) Does the Sequence of Food Matter? (57:55) Have We Lost Our Love of Eating? (1:02:06) Eating Mindfully: How to Build a Better Relationship With Food (1:04:59) Teaching Children About Food & Nutrition (1:08:01) Menopause & Food: What You Need to Know (1:15:04) How Much Protein Should We Consume? (1:20:01) How to Build Muscle as You Age (1:23:09) How Diet Impacts Lifespan & Longevity (1:25:41) Frederica's Book - "Every Body Should Know This" (1:27:36) Davina's Final Thoughts Sponsored by: Zoe - https://zoe.com and use code DAVINA10 Learn more about your ad choices. Visit megaphone.fm/adchoices

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You've got all of these nutritionists saying that the other doctors are wrong. You don't know who to trust. Please help me. We already have a nation that's fearful of food. It's important to note that it's never too late. You can actually add up to 11 years to their life with diet. Wait, what? Alcohol.

For a while, there was this idea that a small amount of alcohol might be protective. More recent studies have reviewed the data. But actually... That's amazing. What about coffee? Coffee is the most consumed psychoactive drug. Yeah. Right?

So three to four cups is like a good amount. But then these people, I would not recommend caffeinated drinks. And that's... Really? Yes. I'm always wondering, do people need to take supplements? My biggest thing is food is there to be your health ally. And so we have to remember a diet low is a direct contributor to poor health.

But we see that people who drink have a reduced. reduced risk of Parkinson disease and a reduced risk of Alzheimer's. You constantly blow my mind. Okay, I've got a favour to ask you. I was just wondering if you could just give us a follow. It costs absolutely nothing. It's completely free. And it really helps us to continue to bring you lots more episodes of Begin Again.

I'm so pleased you're enjoying it. Thanks. So Dr Federica Amati, very nice to have you here today. I'm going to call you Federica if that's okay. Yeah, you call me away. Okay, great. I mean, there's so much to get at with you. You're head nutritionist at Zoe.

And so you are all things food, but I know that you've done so much research into why, what, how we eat. And what is happening to us as a nation because of what we eat. So earlier on, you talked about the sort of several chronic illnesses that you you were looking into in public health that were being affected by our lifestyles. I was just wondering if you could just broadly go through what those illnesses are and what are we doing to make it worse for ourselves. Yes. So there's this concept, there's two concepts, right? There's one which is like the socio-demographic contributors to ill health. And it's a big diagram and it's got things like education,

and socioeconomic status, the things that are out of our control. Right. This is the time. It's important to note that when we talk about exposures that impact health, they're not all things we can control. And I think a lot of them are, which is really empowering, but some of them are just where we're born, what family we're born into. Really?

And so, yeah, so we need to also give ourselves some grace that whilst there's lots we can do, there's some things that we don't have control over. And so I think sometimes this culture of like self-improvement can be a bit toxic because we have to consider the context that people are living in. Can I just quickly ask you about you said where they live? Yes. Why would where somebody lives have an impact on their health? So I'll give you a really nice example of a study that was done in London.

So there's differences if you live in London or in Scotland or coast or, you know, in northeast, London and the city. So there's differences between city dwelling, country dwelling, coastal dwelling. And then different cities have different sort of prospective health. But the best way to think about this is the study that was done in London across the tube map. Okay. So some very clever researchers mapped out the average life expectancy per tube stop. So depending on where you live on the tube map, right? And it was a really cool piece of work, really interesting.

But what was shocking is that within London, there's an eight-year difference between the sort of most deprived area and the most wealthy area. So if you're living, if you're getting off the tube to go home at Green Park or at South Kensington, you can expect to live well into your 80s. Whereas if you're getting off the tube in a more deprived area of London, so now I'm trying to think, I can't remember the exact one that was like really low, but Apton or Myland, way less. So like 70s. And that's within London. So there's lots of contributors to that. So partly a socioeconomic status. So how much money do you have to do.

things like buy healthy food, go see your doctor or pay for things that will help you to live better. Partly it's education. So people who have more education tend to live longer. Then it's exposures like pollution, exposure to like pollutants in the environment, whether you're able to live in a comfortable home. There's so many factors that go into that. And but just within London, you get this huge variability. That's nuts, isn't it? Yes, it is. And so when you realize that then it I think it helps people to change the perspective on you know often you hear that

oh that person they just need to go to the gym and they just need to this no stop judging it's not that simple stop judging and there are factors outside of our control that still have an influence which we need to be aware of because we'll be kinder to each other and to ourselves and then we can focus on the things that we can change

so the things that we can change are often referred to us lifestyle medicine so lifestyle medicine is and it's a branch of medicine so it's what we teach medical students now. So my nutrition teaching sits within lifestyle medicine. Right. And it's, we're equipping healthcare providers with the knowledge of aside from surgery and interventions with medicines, what can you do for your patients to help advise them on their lifestyle that will help them live

longer, healthier lives? And that covers sleep, nutrition, exercise and sort of social and emotional well-being. So psychology is part of that. Those are the pillars, the four pillars. And having a good baseline knowledge of how those influence health outcomes is really powerful for the doctors themselves because they work really hard and for their patients. And that's where we have more actionable advice of what you can do to actually help your health, help your longevity, and just enjoy life a bit more, basically. How much of a difference can those lifestyle changes actually make really? Yeah. So they can make a massive difference. So can they? Nutrition is the one I know the most about, obviously. So if we look at nutrition, if you improve your

diet, say you're all improving your diet at age 40. You've decided that you've had enough and you want to change your diet. So some of the modelling studies that have been done looking at what happens if you just move your baseline dietary habits from what the average UK person eats, which is not great. Have we basically not got a very good diet in comparison to other European countries? Yeah. So on average we don't have a very good diet. It's not very diverse. It's high in ultra-processed foods and it's low in fresh fruits and vegetables.

So some of the markers of good diets we know. And if we just help people move from that baseline to a healthy dietary pattern, we can add up to 11 years to their life. Yeah. Wonderful. So that's a size of course. Yeah. How, how. So I know that for some people, you know, we were talking about the English breakfast and how we are.

We are attached in quite a big way to our food. Yeah. And I think every nationality is, but like fish and chips. Yeah. You know, battered fish and chips. Yeah. Part of our diet. You know, a curry, part of our culture.

Yeah. You know, pizzas, I guess nowadays. The English breakfast. It's like pies and stuff. Pies. Yeah. Yeah. Yeah.

Exactly. We are, we get a bit angry when people tell us to kind of make these changes. How easy is it to change a nation. diet. Diet. I mean... So I think those foods are like traditional

British foods. I don't think they're necessarily the issue, by the way, because they're occasional foods. People have fish and chips once a week if they do. And listen, you can make it a bit better by having mushy peas as well

and lots of vinegar on your chips. Oh, yeah? Sure. Wait, but just explain that because that's music to people's ears. Yeah, of course. So when you're having your fish and chips, so partly it's portion size.

So like, you do now get an unusual amount of chips. Like no one can actually Does anyone finish their chips with the fish and chips If you get a portion Oh dear So any So partly it's portion size That's definitely changed over the years

It's kind of increased So think about that But also think about the fact that You can have your chips And you can have your fish But you can also have your mushy peas And your wally And these are like fibre

Wait, wait, Wally? Wally, you know the Gurkin Oh, the Gurkin Yeah, that's what they call it right? God, you're so cool Oh I mean my husband's just very British and his parents are very British So I've inherited some of their

culture. And then try not to sort of smother it in ketchup, if possible. That's more recent. Because that's got sugar in it? Yeah, it's fairly high in sugar, yes. But if you have your fish and chips with a wally, with mushy peas, vinegar is your main sort of way to flavour it up. And then a small portion, once a week, that is not what the problem is. So it's the same story when we think about a full English breakfast is not something that was designed to be eaten every day.

No. These are all occasional food. that we're talking about. It's the same, you know, we think about, oh, what about lasagna for Italians? Italians don't you lasagna every day? It's an occasional food. What we need to look at is what the majority of our diet is made up of. And the majority of our diet nowadays is made up of convenience foods. Right. Ultra-process snacks, grab and go, sandwiches, fizzy drinks. That's the problem. They're not traditional foods. They are modern, like a modern dietary pattern. Can I, because I'm in my 50s. Yeah.

my late 50s. Looking fab. I'll take that. So I'm in my late 50s. I was brought up in the 70s. I'm a child of the 70s. And the greatest thing happened to me as a child in the 70s. And that was fast, ultra-processed food.

And it got sweeter and sweeter and sweeter through my childhood. And I remember like literally, you will be so horrified by this. Federica, but my favorite tea was butoni-tined ravioli. Oh, yes. It was so full of sugar. Yeah. I'm not even sure the pasta was pasta. Like it was just, and the meat inside.

I mean, talk about ultra-process. It was like, I loved it. Yeah. Packet soups in a packet, not even in a tin. Like packet that you add water to and reconstruct it. You know, chicken noodle soup. Yeah. I mean, like, I know now to be awful for me, I was brought up on that.

And what is interesting is trying to change your diet when it's something that's been sort of entrenched in your childhood. There's like an attachment to it. How hard is it going to be to, does the government need to get involved to get these foods off the shelves? Yes, so definitely when we look at other countries. So, of course, these industrialised, like, these foods are available all over the world, right? But how available they are on supermarket shelves is very much decided by policy and a collaboration with the supermarkets and the food industry. And policy makers to be like, let's try to make this food environment not the worst possible version. Now, to date, the government hasn't had this angle of preserving a healthy food environment.

So in the UK. So whereas Italy, I'll take Italy as an example because I'm from there and we do a really good job. So like we Italians on average get about 14% of their energy from ultra-process foods in Italy. Of course they exist in supermarkets, but it's quite a small section of the supermarket that has these foods. And they're not super advertised and culturally they're not as acceptable. Like you just. Yes. And they're not fed to children in schools, right?

I'm half French. Yeah, so you have very similar. And France is one of the only countries, by the way, that has declining obesity rates. Declining, right? So important to note that. If we zoom out of there, France and Italy, go to the UK, over 60% of our calories come from ultra-processed foods. So it's a huge difference. 60%?

I didn't know that. That's amazing. So it's a massive difference. Wow. And the supermarket shelves are stacked with ultra-processed foods across every aisle. So it's actually hard to find. where the foods that are minimally processed or not processed are there. Now, the problem with the narrative around ultra-processed foods at the moment is that all ultra-processed

foods are lumped together into one bucket. But actually, we've seen with more recent research that some ultra-processed foods aren't that bad for you. Which ones? So things like high-fiber, low-sugar cereals, right? We can name it to name a brand, wheat of mix. They're not bad for you. So now we're at this point where we know that high consumption of ultra-processed foods is a problem.

But we also know that there's nuance between processing and what happens in that. Right. So we can't, unfortunately. Can't say all ultra-processed foods are bad. I think it's not helpful. Do you know what's happened, Davina, is that now people are aware of it. They're scared. Yes.

Now, we already have a nation that's fearful of food. Fearful of food because it's going to make me fat. It's going to do this. So there's such a fear around food. And now the ultra-process food conversation has driven more fear. And so where I am is, okay, look, we really need to try and reconnect with food as a helpful, enjoyable part of our lives that brings us memories and helps us to connect. And instead, we're in this really awful place at the moment where people are so scared of everything. And I really want to change that.

Like, that is a passion of mine. Like, I want to help people reconnect with the power of food as a force of good. not only our food choices can help the environment, but they also help us to connect with the loved ones, having dinner together, having lunch with your friends, or having breakfast with yourself and just taking a moment, something I love to do. So there's so much good, but the ultra-processed food narrative needs to change.

So we're doing a big piece of research at Zoe now, where we're actually saying, okay, how can we understand processed and ultra-processed foods, not just from a processing lens, but from a health-impact lens. Yes. We want to know, okay, we know these are ultra-processed, but actually what do we think they're going to do in terms of health impact? And then let's make that the tool that helps people shop because, yes, policy needs to change the way that foods marketed and advertised and the way how much of it is displayed.

But actually, we need to understand which foods to reduce based on their health impact, not just processing level. Because we do live in a world where processed foods are necessary for transportation, for. for like just making them last longer for affordability as well. They are more affordable. And so we need to... That's such a big problem. It is a massive problem. But we can't just say, oh, well, you should eat everything, you know, from scratch.

It's like, that's great if you have the means. Yes. But guess what? Like, a lot of people do not have the means. So to demonize ultra-process foods, if you're in a household that maybe doesn't have a kitchen, maybe all you have is a microwave. Then you're adding even more pressure on that family to make them feel really terrible. about what they're feeding their family.

So let's move forward. Let's evolve. Let's find a new way of looking at these foods through a lens of health impact on top of processing and on top of the basic nutrition knowledge we have. So that's what I'm really excited to be working on now. I think, you know, you were talking about the scaremongering

of the food industry. Social media is so brilliant for so many things. But in so many areas, especially in health and health, well-being. It's terrifying. And also what happens, what I do love about you and your social media presence is that you are always saying add. Don't be scared of this, just add some of that rather than taking things away. It's funny. And I know you know about this too because we've both worked in the menopause sphere. And I'd like to talk to you about menopause and food a bit later. But in the menopause sphere it's the same thing.

You've got all of these doctors saying that the other doctors are wrong. And then you don't know who to trust anymore. And rather than telling us, don't worry about all these mixed messages you're getting, this is a good thing to do, do this, do that. I don't know, it's just like nobody's on the same page. I wish, you know, like you were saying, nutritionists and dietitians come and they meet and they talk and they have seminars together. So you're all kind of on the same page.

Right. We are. Are you? Well, yeah. So everyone agrees on the basics. Everyone agrees on the foundations. Like, that's what I always say. If I hear, if you hear someone telling an audience on their social platform that vegetables are bad for you, that you should eat fruit and that beef tallow is better for you than virgin, than olive oil or seed oils,

they don't have a nutrition education because those are the fundamental things, right? So we all agree on those. Now, there is debate. Scientific debate is what makes science really cool because as a scientist, you know that what you know today might change tomorrow. Right. Now, most things won't change 180. But to give you a good example, 30 years ago, we thought that fibre was roughage, it bulked your stool and you pude it out. and that was the end of that, and that your colon was a tube, and that's it.

Yeah. It just now, now we know it's so much more than that. Fiber is broken down by gut microbes. There are trillions of gut microbes. Like, we know so much more now about that tube and what it does and how important it is for our immune system that 30 years ago, 40 years ago, you wouldn't have able to imagine it, but it's progressed and it's, but it's not 180 change. It's not like it's now.

You've just learned more. Yes. Now. Can I quickly ask you just while we're on the subject of fibre, can you quickly tell me how much fibre should we be eating? Yes. What's our best source of fibre? Yes. Because we don't eat enough in this country.

No. So the recommendation is 30 grams of fibre a day minimum. There isn't an upper limit to fibre as such. So some populations in the world get 50 grams a day and they're doing very well. But 30 grams recommended. And we currently get average UK adult gets 18 to 20 grams a day, which is the recommended amount for a four-year-old. So not doing very well. Good. And why is that? So high-fiber foods are nuts and seeds, which most people don't eat daily. And if you're allergic to nuts, of course,

you don't eat them, but seeds are a good option. Legumes, so chickpeas, beans, lentils, edamami beans, these lovely things that are really good for us, really satiating, really cheap. Can't say enough about how good legumes are. And whole grains. Your favourite is a lentil or something? No, I'm a big bean fan. Oh, I love lentils. I love lentils too, but beans for me are. But then I'm Roman. Also, you're Roman, yeah, exactly.

We love a bolotty bean. But what I didn't realize, and I love this fact, is that is it true that there's different types of fibre in every different bean? Oh, yeah. So every part. I thought that all beans have the same fibre and I realized that like you can have five beans in a tin, you know, those. The mixed beans, even cheaper. Yeah. Right.

Yeah. Yes. Amazing. So every plant, there's dozens of types of fibre, which we're still understanding. Some of them have been studied specifically for their impact on the gut microbiome. But essentially, when you have a variety of plants, you get a variety of fibers, which your gut microbes stuff. Because each gut microbe likes to eat its own thing. But is it different colors as well? So like peppers, bell peppers, red, green, yellow, orange, all different types of fibre.

So they're not set. No, no, so they're not different types of fibre. they're different types of phytonutrients. So these are the chemicals that give them kind of. Yeah. But no, but you should because those phytonutrients also act as fuel for your gut microbes. So if you're having a variety of fibres, which they love to munch on and a variety of phytonutrients, which is like fuel for them, you're like superpowering them. Yeah.

So if you have like black beans and bolotti and a white bean, you know. So those three food groups, whole grains, nuts and seeds and legumes are really. really high in fibre. Most people don't eat them every day. No. So now vegetables and fruits do have fibre, but it's not as high. But not as high. So often I'll speak to people.

They'll say, I have lots of fibre. You know, I have carrots and cucumber and tomatoes every day. I have an apple. And then for dinner, I'll have some roasted, you know, some cabbage. And I'm like, that's great. That is nowhere near enough fiber. Right. So the understanding what foods are actually high in fiber can help us to get there.

And it's important, though, that when you're, increasing your fiber intake, you do it slowly because your gut microbes, if you don't feed them like any pet or any environment or ecosystem. Think of your gut microbiome as a tamagotchi. Little, little tamagotchi. If you don't feed them, they, and if you don't feed your gut microbes, the ones that are waiting to eat the lentil fibre tend to start dying off because they don't have any lentil fibre to eat.

Now, and then the problem is that when they start dying off, like any ecosystem, another another strain will grow. So if you're eating lots of chicken, lettuce and, I don't know, mayonnaise because that's your lunch, then your lentil microbes would be like, there's no lentils for me. But your chicken and your lettuce and your mayo fat microbes will flourish and take the place, like nudge their way into this ecosystem. Slowly introduce back the lentils. But do it slowly because at the beginning, you'll only have a few microbes that can break them down.

And if you eat, so if you go, one of my patients, Davina, he was brilliant. I'm Brazilian. I already eat lots of legumes. Great. So he had a chef and I said, make this for him, lots of this. He had a chef. Yes, he did. And so his chef was like making all these, she's a brilliant chef as well. She made all these amazing dishes. Federica. What's happened? I'm so gassy. Did you lie to me about how many legumes you eat? Okay, maybe, maybe you're exaggerated. So take it easy because your microbes need to just. dust to having food again to eat. Otherwise, the fibres will sit there for longer. And so just slowly, I always say, like, start with a spoonful. So add a spoonful of lentils to your tomato sauce or to a soup. Or bolognese.

I put lentils sometimes in bolognese. Yeah, it works really well. It's really nice. Add in, I mean, chickpeas to salad. I love chickpeas as well. I love chickpeas. And hummus, right? Everyone loves a hummus.

obsessed with hummus. you can make a hummus with any bean and then put some seeds on it. Wait. So it's just combining these things. Yeah. What did you just say? Put seeds on your hummus. No, you can make hummus.

You can make mixed chickpeak... I'm 57. First off, I've ever realized this. I'm such an absolute punker. It's delicious. Oh yeah, because it's just a like different flavor. So that's a good place to start at hummus. Everyone loves a hummus, right?

So while we're talking about foods. Yeah. I would love to go over some of the really crazy myths. Okay, love it. That we are told on social media. Now, I remember a while back, Tim Specter did a whole thing on coffee. Yes. And he was saying, coffee is good for you.

Polyphenols, that's what I remember him saying. But then I remember backlash. No, caffeine's too much. It's bad. Like, please help me. It's so hard being a normal person. And social media is such a confusing place. It's like red wine.

Red wine, great for you, one glass of-dial-old. Yeah, okay. Let's do both of those. I mean, I've got loads I will go to you with you. They're two of my faves. Okay, great, great. Coffee is the gift that keeps on giving for me because... Oh, it's a gift?

It's a gift. Because there's so much science on coffee now, Davina. It's like amazing. So it is, it's fair enough. because it is the most consumed psychoactive drug. Yeah. Right? People love it.

Most people drink coffee. More than like 80%. So we know two things about coffee. We know its effects because of caffeine. So caffeine is very well studied. Very well studied compound. We understand it very well. And then its effects as a beverage.

So like what is it about coffee that is so special? Because you find caffeine in tea. You find caffeine in chocolate. You also have added caffeine, of course, in energy drinks and sodas. Not good. Okay. Let's just park those. So we're talking about caffeine that's found in foods.

Caffeine is produced by tea leaves and by cocoa beans and by coffee beans as a protecting chemical. It stops insects from eating them. So it's a phytonutri. It's a phytochemical. Now, it has a very strong effect on our cognitive ability. So it helps us to think sharper, memories better. It's good for exercise. So it gives you a little bit of an oomph with exercise.

There was a fascinating study that looked at people random. assigned to drink caffeineated coffee or not. And on the weeks they were assigned caffeinated coffee, they walked an extra 1,000 steps a day. That's interesting, isn't it? Because you want to. You just have more energy, basically. So we understand caffeine very well.

Now, caffeine as a chemical, the way it works is it sort of attaches to adenosine receptors in your brain. Adenosine is a naturally produced compound that our body starts releasing as soon as we wake up. And it's almost like, you know, time sand. Yes. Like that. It's like from the moment you wake up, it sets.

And the adenosine starts dripping through basically to say how long you've been awake and therefore how long until you next need to sleep. Okay. Now by blocking the adenosine receptor, our brain is like, we've just spoken up. We've just spoken up because we don't have any adenosine filtering through. The caffeine is like not letting the adenosine bind. Right. But the adenic is still building up in your brain.

It's still going with the time sand. It's just that while if the caffeine is there, you won't get any sleepiness signals. How long does caffeine last? Now, that's the thing. It depends on your genetics. Your genes dictate how much of the enzyme you need to break caffeine down you make. Very, very variable.

So you have people who are very good caffeine metabolizers like me that can drink a coffee an hour before going to bed and sleep like a baby. That's me. Yeah, that's me too. Are we lucky? Very lucky. I think so. I think so.

And there are others who will have one card. up at 10 in the morning and might not sleep well that night. So caffeine is, it's important to know where you sit on that spectrum. If you're someone who's really sensitive, then maybe it's not for you because the problem is as well that once, so you have the adenosine receptors blocked, then if you have a bit more, if more caffeine is circulating, they bind to a different type of adenicine receptor, which can actually stimulate anxiety-like feelings. So if you're a slow metabolizer, then, and you actually makes you feel anxious, caffeine is not your, Not your drug of choice.

Don't do it because you're going to feel a bit rubbish. Yeah. And it's really important to let people know, listen to your body. If it doesn't agree with you, don't have it. Okay. Good news about decaf coffee coming later. So caffeine's well understood. And it also has a neuroprotective effect.

So we see that people who drink caffeinated coffee have a reduced risk of Parkinson's disease and a reduced risk of Alzheimer's. Really? Yeah. So it's something that people who have family histories will often adopt as a, as one of the things. I seem to remember, not sure if I'm right or not, Tim's saying four cups.

So three to four cups in most of the epidemiological studies is like a good amount. When we're talking cups, are we talking this big? Yeah. So say one espresso in your cappuccino or a cup of filter coffee like that is great. Milk doesn't make it less good. So have milk if you want.

Sugar, obviously, adding sugar to your beverages is not a good idea generally. Yeah. So that's coffee. Tea has way less caffeine. So tea is like 10 to 12 cups a day. Yeah. And then green tea even more. So it's really mostly coffee we think about caffeine.

Excuse me, miss. Yes. Sorry. You just say too much good stuff. I'm sorry, Fed's Freddie. I'm just like, I just need to know. Green tea. Yeah.

You said even better. I've always been nervous about drinking green tea. Yeah. How much caffeine is in green tea in comparison to coffee or tea? It's even less than black tea. Oh, okay. It's really low. Yeah, so it's really low amounts. You could have 18 cups of green tea. It's quite a lot. But this is great because green tea is so good for you. It is. And for different reasons. So all these plants have different impacts on your health for different. So black tea is good to drink for specific reasons, good for cardiovascular health. Green tea is good to drink. The catechins and green tea are good for metabolism.

Coffee has the most research because it's the most drunk. And we know it reduces the risk of cardiovascular disease and stroke. We're talking about, a reduction of about 15%. So it's a notable reduction. It's notable, right? And it's also helpful for neuroprotective effects. Now, decaf coffee has beneficial effects too, less on the neuroprotection because that seems to come from caffeine, but cardiovascular disease risk and gut microbiome composition. So we did a study with Zoe with 22,000 people and we found that we could tell if people

drank coffee by this one group of gut microbes called Lossanabata. who only eat coffee. And so there's this lovely, like, dozen of bacteria called Los Al-Odabaptas who only eat coffee fibers and coffee, because coffee does have fiber in it as well, a small amount but still contribution, and polyphenols from coffee.

And they munch it up and they love it and they make metabolites from the coffee that help your metabolic health. So a lot of the effects of coffee that are beneficial come from the polyphenols and the fiber not the caffeine, which is why decaf coffee, decaf tea are very valid drinks to have. And especially, so there's one population in which I would not recommend caffeinated drinks, and that's pregnancy.

So actually, the first population is if you're somebody who really doesn't tolerate it. So, great. And then in pregnancy, it's not worth, like, don't have it in pregnancy. The studies are, you know, people are saying, oh, you know, it's not definitive. We can't do randomised control trials on pregnant women for obvious reasons. but there is the effect that caffeine has on vasoconstriction, so it does that to your blood vessels. When you think about that in the context of the placenta,

probably not great, and it does cross the placental barrier. So whilst your baby's developing, you know, just I recommend to my patients, and for myself, I didn't have caffeinated drinks. I didn't either. I quickly want to say something. I love the way you explain everything

because it's so accessible to me as a normal, person that's not a scientist. And it constantly blows my mind how brilliant food is for us and how we ignore that so often. And I find talking to you so inspiring. Anyway, thank you. I want to go through some more myths. Myths. So alcohol. Let's just talk about alcohol generally. So alcohol generally, there's lots of studies that I've done on this as well. And for a while there was this idea that a small amount of alcohol might be protective. Now, more recent studies have reviewed the data and there was a major flaw in the way alcohol studies were done in that when people looked at, so you take these populations and you say, do you drink,

yes or no, and then follow them up. In the yes or no category, if you're a non-drinker, there are usually two types of non-drinkers, people who have never really drunk and it's just not nothing, and the people who had to give up drinking because it became a problem. And they were grouped in the same group. And so what happened when you put these people together is that it looked as though moderate drinking, so one to two glasses or sometimes three to four, was a bit protective. Like they did a little bit better than the non-drinkers. But this is just the way that the data was put together wasn't appropriate because

people who had to stop drinking because their drinking became a problem tended to have health consequences from the heavy drinker. Right. So when you separate forever non-drinkers to those who had to give up and you rerun the data, there is no benefit to alcohol. So it was just the way that the data analysis was made. So no one who's read the recent meta-analyses would suggest that any amount of alcohol is healthy. Now, it's not saying don't drink because you can enjoy it. It's important to caveat that our bodies are very well equipped at dealing with some toxins. So if you're somebody, but if you're somebody...

When you say occasionally, what do you mean by that? What I really mean by that is no more than two or three times a week, no more than a glass. Yeah, a glass. So two or two or two glasses a week. Yeah. But spread out. So you also want to try and avoid in the three glasses in one night. So like binge drinking patterns are not helpful.

I think that's a lot less than most people drink. would imagine. 100%, but the recommendations are still above that. 14 units. Which is. And I think people kind of think, well, I need to get to my 14 units because that's what I can have. Yes. Oh, great, tonight.

I can have five units. Yes. It's a skewif way of looking at it. And they haven't been updated for a while, or since the new meta-analysis have been published. And also, they're supposed to be upper limits, but I think people treat them as targets. Targets, yeah. So we're moving away from the, you know, so we're moving away from the, this narrative of alcohol is good because it's legal.

And of course, I'm not recommended anyone does it. It's still illegal here. But we need to reframe the way with our relationship with alcohol, especially in this country, isn't great. So if you go to France, go to Italy, no one just goes for drinks. No. You don't just go to drink. That's a very British thing.

And it's funny that when you say it out loud, it's like, oh, that is a bit odd. Having a glass of wine with your meal is much more. And when I say a glass wine, you know, a tumbler like this, a red wine in a meal in Italy is what we would do. And, but you would never just go out to meet people just to drink alcohol. It's really unusual. Well, like the French, if you, we have pubs. Yes. But you don't really have a coffee in a pub.

The French would have a cafe where you could get a drink. Yes. But it's a food. Yeah. Yeah. Really, where you can have like a coffee and a croissant or something. Yeah. So it is, it's a cultural thing as well.

It's in bread in us, isn't it? And then you have to wonder, you know, I'm very lucky. I have a good relationship with alcohol. I drink very occasionally if I'm going to a dinner or a party. But I'm lucky in that. If you're finding yourself having to drink a lot, what is it that you're trying to heal or trying to suppress? What is it that you're trying to cover? Because really, that is the problem.

So when we think about, people just need to drink less, it's like, well, no, but why are they drinking? what's happening in society that means that that is what people go to. So we do have to, again, be kind to ourselves and then ask the hard questions. Okay, if it's so hard to give this thing up that we know is bad for us, that doesn't make you feel great the next day, that doesn't enable you to act as the best parent, partner, or whatever job you're doing. No one does a good job when they're drunk, let's be honest. So what is it that, why are you relying on it?

Why is it there for you? Why do you have this relationship? And then that's usually where you get answers. Yeah. What about things like, I'm just trying to think of other things that have recently been kind of vilified. I thought, you know, everybody was going, you know, get off the dairy, go to nut milks or pea milk or whatever. But was it almond milk that got the bad rap? Oat milk.

Yeah. Oat milk suddenly was like, don't drink. Because everybody was like terrified of a carb. Yes. Carbs have been a bit of, oh, let's talk carbs. And oat milk. Yes, okay. Oatmilk is easy.

Okay, let's do it with milk in a minute. Still carbs. Carbs have been, okay. First of all, carbs is this term that's used, but it covers a huge spectrum of food from your table sugar to your radishes. Like, carbohydrates cover a massive amount of foods. And when we thought, talk about whole carbohydrates, complex carbohydrates, talking about fiber. We've just touched on how

important fiber is. So if anyone's like, Carl's a bad for me, I'm like, next, because you've just misunderstood. So carbohydrates include fiber. Some carbohydrates are complex. Some of them we can't break down at all like fiber. We need the gut microbes. And some of them, we can break some down and use some, but not all, so like whole grains, where there's some sugars we can, use some starch as we can, some we can't. And then right at the other end of the spectrum, we have the refined to carbohydrates that like the simple sugar. So the table sugar. So are they seen as not as good?

Like refined carbs are not as good for us as the other types of carbs. Yes. But there's a lot of reasons. It's not just because of their glycemic index, not just because they have more simple sugars ready to absorb. It's because they're lacking other nutrients. So let's talk about Zoe who sponsor this podcast. Okay, so you're in the supermarket.

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Track sales, handle inventory, manage staff, send invoices, and keep up with finances all in one place. Apply through orders with zero mistakes. Get the data you need and keep everything working together. So you're ready for whatever's next. Learn more about their customizable plans at squareup.com. Fruit's been a vitified, which is horrendous because it's such an important. Yeah, that's really sad, isn't it?

It's so sad. It's such an important part of a healthy diet. Like a diet low in fruit is a direct contributor to poor health. So the fact that we're vilifying fruit is you're actively doing public health harm if you're vilifying fruit, basically. So take a whole apple, right? It's got quite a lot of fructose in it. It's got fiber in it, it's got water in it, mostly water, to be honest. And when you're eating that, you're not just getting the water, the sugar and the fibre.

You're getting vitamins, you're getting minerals, you're getting polyphenols, especially if you eat the skin. If you eat the call and the pips, which I do, you're getting some microbes. Do you? Yeah. Wait. What? Yeah, I eat the whole thing. I just have the little wooden thing left.

Really? Yeah. Wait, isn't the core like? Crunchy. But I like crunchy. It's good? Yeah. And Pips are good?

They're fine, yeah. And apple cheese is not going to grow in my stomach. No, but I like the idea. I used to get told that too. And actually, that's where the microbes live from when it was a flower. So you can not have a heart. Wait, what was that? Well, when fruits grow or when vegetables grow, the microbes from the environment live on the skin.

And if you think about the apple blossom, which is what an apple is beforehand. So it's like exposed to the bees and everything. And then when it becomes an apple, like the apple, the apple, blossom goes in and the seeds form from the apple. So it's part of the goodness. Seeds. Yeah. So. Great.

I'm doing that from now on. Now you've got lots from that apple, haven't you? Yes. Much more than just a teaspoon of simple sugar, which just has sugar. So refined carbs, it's not just that their sugar is readily available. It's that they're actually lacking in anything like the other things. Another example I love to use is oats. The whole grain of the oat is this like seed-like structure.

Very hard shell outside for what it is. And they look like little seeds. So have you ever bought steel cut oats? They're harder to find in the supermarket now. It's amazing. You can get them in a little spot. So you see the steel cut oats and they look like little seeds, right? Great for you.

They have loads of fibre, healthy fats. You take that and you roll them out, steam them. Remove some of the brand. So remove some of the fibre. Wait, what do you mean roll them out? So with machines. Well, no, like in an industrial processing. Oh, I see.

I don't have to do that. You're not doing it. Somebody else is doing that. Someone is doing it. Okay, great. And you get your, you get your jumbo rolled oats. Right. Right.

So they've just been flattened, yeah. Steemed and flattened. But we've removed some of the fiber. Right. And then you go to your local health shop and you buy oat bran. Yes? Yes. To increase your fiber intake.

They've just taken the fiber off the oat and then sold it to you as a supplement. which is genius. So then you have this rolled jumbo. Still relatively high in fibre, less, much less than the whole grain, but still there. And it still has some of the healthy fats, but they've been steamed and flattened so a bit less.

So it's a different, different mutine profile. It's slightly processed. Slightly. So yeah. And then you move to like quick cook, flavored, microwave, syrupeatts. All the fibre's been stripped out, again, salty. And added sugars and quickly.

So they have all kinds of. carbohydrates. But this whole grain carbohydrate over here is a powerhouse of nutrition. And this quick cook over here is not offering you much. You see, this is what annoys me because when you have people going oats, you know, it's not, it's not what you think it is. They don't explain. I feel like menopause, nutrition, things are. It's so nuanced. You can't just blanket vilify something. No. You have to have it explained properly. And then never seems to be time enough in an Instagram post to properly explain. That's why it's so nice to be able to do something long form with you.

To get the kind of gritty bits, get the brown out. Obviously, oats can be amazing for you on one hand as a whole food, but not so good when they've been ultra-processed. And this is why, you know, the recent announcement by the government that they're going to start banning the adverts on these sweetened quick-cooked. There was national outrage. We thought porridge was good for you. Yes, it is. What they're proposing is not to advertise the maple syrup flavored. Yes.

Because they're not as good. No. So I think an overarching thing to think about when we think about food and it really helps to sort through the sort of noise online is that with almost everything, carbohydrates, proteins, fats, with almost everything, quality is actually what we need to be looking for. Oh, that's something I wanted to talk to you about. I've been thinking a lot about quality.

So things like some supplements as you get older. So I'm going to tell you what I take. I take magnesium and cod liver oil. Those are the two. I take magnesium at night and cod liver oil twice a day with a meal. And I'm always wondering. Oh, and vitamin D. Okay.

And I'm always wondering, how do you know if a vitamin company is good? I hear so many people that these tests have been done on various supplements. And some supplements have got exactly what you need in them. And some appear to have nothing. Yeah. It's completely unregulated. So unfortunately, the supplements industry. So why is it unregulated?

That's insane. It's a huge industry. So back in back in, I want to say the 40s, the US decided that to speed up progress in the space of supplements and nutrition, they would allow supplements to be unregulated because regulatory process is so long. So to get a drug to market takes over a decade. You have the idea. You test the molecule.

You test it in the lab. You test it in the animal. You test it in humans. If it takes a decade. So at least, right? So what they decided was that to help with progress and to help with speeding up the industry, let's say, they were just unregulate it, disregulate it. And this created a boom, of course. Now, that still persists.

So there's no, I could, tomorrow, I could be like, I want to retire. So I'm going to bring out a supplement. Yeah. And I'm going to market it as like the best supplement that you can have. It's got all the essential micronutrients in the correct dose for the day. And I'm going to put it on the market, right? No one, like, the only thing I have to, I have to check is what health claims I make on the packet. That's the regulated bit.

So what I can say it helps you with, the regulatory body has to agree that I've got enough micronutrient amounts to make that claim. So if I want to say, great for hair growth, I have to show that it has a certain amount of biotin and some other micronutrients that have pegged. research to them. Yes. And the research can be decades old. It doesn't matter. Right. But there's this way you make a health claim. That's the only thing that's regulated. So how do we know then? I mean, that's a nightmare. It is a bit of a nightmare. And it's also why we have to have a level of trust in the manufacturer.

So like, who makes it? Do you trust them? That's part one. Yeah. There is third party testing. So some manufacturers of supplements will now third party test their supplement. So an independent company will take it, run a test to see if it's got what it says in it and if it does what we wanted to do. And then they'll be able to say third party tested, great. That's good. Oh, third party. So you can look up third party tested vitamin companies. Yes. And there are some that do that. And then there's a company that you see this like tick certification on the side. That often means that at least they've checked that if you're buying magnesium, there's actually magnesium in it. Because you're right, in some in some tests,

some random consumer testing. Some of the supplements don't have any of the thing they've got on the label. So it says magnesium and then you check it and there's no magnesium. The other thing that's quite interesting with magnesium was that I was talking to my daughter about it. He was a dietitian. She's qualified now. And she, I said, what should I take if I want to kind of sleep and relax?

And she said glycinate. But there are so many different types of magnesium there isn't. So with all vitamins, it really is worth checking with someone or getting an appointment with somebody and making sure that this would be something good for you. For you. Because mostly do people need to take supplements? No, and this is the real crux of supplements is they have a place when you're trying to correct something that's not quite right. So if somebody comes to me and they say that the iron levels are, I'm like, okay, we definitely need to get some iron in you right now. But then let's find out why are your iron levels low.

That's the key, right? So for me, supplements do have a place. I'm not saying that you should never take them. But they have a place for a specific outcome. Another example is folic acid. We know that folic acid reduces the risk of spina bifida in babies. So if you're trying to conceive or you're pregnant in the first trimester, take it daily. But otherwise, just taking supplements doesn't actually do the thing.

Now, here's the problem with it. taking supplements is easier than changing your diet. So often the problem I find is that people take supplements, right? And then they think, okay, I've done my bit and carry on with having really poor lifestyle choices, poor diet, you know, extra alcohol consumption, not getting enough sleep, not moving throughout the day. That supplement in the grand scheme of things, it's going to have a very marginal effect on your health. Even the best supplements that have data behind them, that have been produced with love and care and attention and they have the thing they say they do

will have a fractional improvement to your health compared to what you can do by changing the four pillars. So what I, listen, I have patients who are like, well, I just love taking the supplement. I don't care that it costs £120 £120, I'm like, fine. I mean, the money. It's incredible. I'm like, fine, if that's your choice,

but I just want to make sure you're clear that that is not going to have the effect on your health. health that you're coming here to see me for. That isn't going to deliver it. So my, that's my main bone of contention with supplements is that people spend a lot of money and time and effort to like get them and take them. And they think that it's going to have this profound impact or this really sizable effect. And there is no evidence to support. Even omega three supplementation, right? there's a really good long-running clinical trial that has looked at whether omega-3 supplementation

helps with health outcomes such as reduction in risk of cancers, heart disease, death. It doesn't do it. It doesn't do it in the same way that eating fish does. Yes. So if you don't eat fish... No, I've started eating oily fish three times a week. Great.

You'll get much more benefit for that. I am absolutely, like, really deathly serious about that. I've started doing that kind of as part of my regular... And if you don't eat fish, you know, we know that chia seeds, flax seeds and walnuts and seaweed, critically, fish get their omega-3 from seaweed. They don't make it. It's an essential fatty acid. So they get it from seaweed. So if you don't want to eat fish, shellfish is also a really good source.

So people often forget that muscles and clams. Oh, you do. I love them. And they're a bit more sustainable. But, you know, if you're eating fatty fish and shellfish, great. If you want to get plant-based alas, you can from seaweed and from walnuts, chia and flax. So there's other ways of getting it in. And from the epidemiology, we have getting dietary omega-3s has very measurable health effects and better improvement.

Whereas supplementing, even with a really good quality. Doesn't have the same. Thank you. That was very helpful for me, for a start. And the other thing I wanted to talk to you about was so my son, Chester, who's 18 now. When he was born, I could see he was getting allergies. He was getting kind of slightly red around the eyes. There was something.

He was scratching his face a lot. And it turns out he was allergic to, I think, pine nuts and cashews. So I couldn't give him kind of tin pastos. I was making. But what was interesting when I went to see, the allergist and this was 18 years ago so quite a long time ago really but she said look this could be an allergic march so i was like how do i stop him from getting a full on nut allergy yeah and she said there are two um kind of ideas at the moment either you give him a bit of peanut butter every day

yeah or you don't give him any yeah and i said i don't know why but i feel like giving him a little bit every day might be a good idea. Turns out, that was the right approach. That's the right approach. So talk me through that. So yes, this is what part of the microbiome, this is where the microbiome comes in and goes, ta-da, I'm helping you with this. Allergy is caused by when a protein from a food, it's usually protein mediated, basically triggers your immune response to think that there's a pathogen. So it's like, it reacts in a way that you have just touched or ingested. or inhaled something, which is going to harm you. So it's a full-blown immune response to something that's harmless.

Right. Now, historically, people used to think, well, if we just avoid the allergens, then the immune system won't respond to it in a harmful way. However, it turns out that our gut microbiome is part of the process in presenting these proteins to the immune system. So if you imagine, like, when you eat anything or anything, you know, our gut is this surface. that comes into contact with our environment and gives our body information about what's going on because our body doesn't know what's going on outside.

So it takes proteins from your food and from other things you ingest because when you breathe and talk and swallow, you'll send anything down. It presents it to the immune system. Like 80% of our immune system cells sit just outside the gut waiting for information. So imagine these like waiting there to see, is something wrong, are we okay? And they receive these proteins presented to them. And at that moment, if your gut microbiome is healthy and happy, it will present the protein as not a problem. It'll be, okay, look, this protein's here all good as part of food.

And your immune system goes, check, not a problem. And then it goes into the memory of your immune system, and your immune system memory cells go, great. Noted as not problematic. So if you have repeated exposure early in life where your gut microbiome is training. Because when we're born, we don't have one, then depending on how. how you're born, you either seed initially from your mother's vaginal microbiome or from the skin cells and the air cells in the cesarean section room. Yeah. And that's where the training begins. Then the next big factor is, are you breastfed or are you formula fed? That trains your

microbiome some more. So these early years, the exposure in your early years, helps to train the gut microbiome to know what's harmful, what's not, what's food, what's not. Do you have pets? Okay, great. So then pet hair doesn't become. Yes. So these things. And so if you think about it like boxes, they're in there and they're training to their opponent or they're letting go the other things. Repeated exposure to allergens is now understood as being one of the best ways to minimise risk. But it's important to say repeated exposure.

So just giving your baby peanut butter once. No. It's got to be like repeated exposure. Yeah, we did it. We did it several times a week. Yeah. And it worked for Chester. Yeah.

And actually he grew out of his allergy. Amazing. We were very lucky. That's really good, yeah. But, you know, I was very grateful to that doctor because I felt like she changed his life in such a massive way. Also, I wanted to talk to you about, we were talking earlier about adding in. Yes. Positive nutrition.

Why I love you because you're always saying, look, you can eat that, but add the mushy peas. Yes. It makes it less scary. And I feel like we will react better to adding things. Or how important is the order of things? The order is that. This morning. So, for example, I tried to eat some yoghurt and fruit before I ate the croissant.

Yeah. So that's the sequence of food is important if you have. diabetes, for example, so type 2 diabetes. If your metabolism is struggling a bit, you can give it a helping hand by ordering food. Otherwise, it's not really worth it. For most people, ordering food is just an extra cognitive load that frankly we don't need. So, as I said, we're trying to make food your friend and something that's pleasurable and that you can actually trust.

And I think ordering, it adds a bit of cognitive load that most of us don't need. So is this a problem with food enjoyment? Are you finding fewer people? I mean, as an Italian, you have grown up. And as a French person, I went once. I was very lucky I went to, I was working in Clarages and I went to go and sit on my own at the chef's table. They said, let us cook you lunch.

I sat on my own and they bought me food. And I was weeping because it was such a pleasurable experience. Yeah. Sat my own crying. But I feel like we've slightly lost. our love of eating. Are you seeing that? Yes. I mean, it's so sad to see the amount of people now that are drinking their lunch at their desk from a bottle. Wow. The amount of people who are actively avoiding meals. So there is, and this is again, there's a conflation of time

research at eating research is great. But it's never enough if it costs you the pleasure of connecting socially with food. So we, I do, I see a lot. And people just, also people just saying I just don't know what to eat anymore. So I'm just, I'm done. I'm going to eat the same thing every day or I'm going to order from the same place or, you know, and so people have, and I don't blame them. I mean, you're right. The noise online is like, eat this, don't eat this, eat that, don't eat that. Fast, don't fast. Snack, have protein. It's a nightmare, right? And we need to, in my opinion, strip it right back from what we know from the evidence. So you're completely right. Positive nutrition is this idea of if you help people to understand

understand what to eat more of. It's more sustainable and more enjoyable. So if you look at the evidence for nutrition interventions, when you ask people to calorie restrict, when you ask them to, like, cut out an entire meal, when you ask them to change their way, that means they have to remove food from their life or remove entire food groups, most of the time it doesn't last. Some people might do it for a few weeks, a few more, like a few less people will do it for a few months. A minority people will be able to do it for a couple of years. But as a general, rule, it's not sustainable. Not only is it not sustainable, but you run into the risk of missing out on essential nutrients that are found in varieties of food. So your dietary diversity

is a major way of measuring your dietary quality. We all need a bit of food from each food group to have the nutrients we need. Okay. And we come to this country where we have more food than we need and everyone's trying to restrict it. It's like backwards. I'm like, what are we What are we doing, isn't it? What are we doing? Yeah. And so we have to remember to keep that in. So positive nutrition says, let's focus on the things we need to add back in. There's a wonderful study that I always quote, 195 countries. They looked at all the data of dietary components and health outcomes. And they made this beautiful graph that showed what are the main dietary factors that are contributing to ill health across the globe, right? And they broke it down by diets high in or diets low in. So diets high in sodium, hypertension is biggest risk. factor in the world for heart disease, so big risk factor. That's up the top. Then we have underneath diets low in whole grains, diets low in nuts and seeds, diets low in fruit, diets low in omega three factor. So the top contributors to poor health are the diets that are lacking in food. Yes. Then you go down towards like towards the bottom, diets high in red meat, diets high in processed

meat, diets high in trans fats. So that's underneath lacking legumes and yes. Yes. So we need to think about what are we lacking? We talked earlier about nuts and seeds, whole grains and legumes, as three clear groups that people don't get every day. And it's not shaming people into like, oh, I can't believe you didn't eat your beans today. But it's like, okay, we know that's really going to help your health. So let's get that back in. Once people start adding these foods back on their plates and in their snacks, then the things that maybe we want, we do want to eat less of. So like less processed meat, less red meat, less ultra-processed unhealthy foods, they start falling off because you feel satiated, you feel energetic, you feel better when you eat these kinds of

foods. And so we don't need to focus on what you need to get rid of. We can focus on what do we need more of. And it's much more sustainable. I think the other interesting thing is that people often eat those foods because they're quick. It's easy to cook. It's just, I've just got to heat up a can of something, you know, heat up a hot dog, put it in a brioche bun full of sugar. you know, it's like a quick tomato ketchup, mayo. These are all things that are seen as quick. But if you think about a packet of lentils can last you a week. Holly, we're talking about my daughter.

She does meal prepping. So they're meal prep. Lots of different meals. And she will just add legumes to whatever she's doing. And they don't even need to be cooked because you can get cooked lentils, cook chickpeas, beans. It's this convenience culture, I call it. It's like this idea.

we've been sold this idea that convenience is king. And when we think about the way we've evolved, right, so we'd go back 10,000, 20,000 years. We were foraging and gathering food, and then that would take us all day. And then we'd come back to our tribe and we'd prepare it, mill it, share it, and then we'd write about it on caves.

Our entire lives revolved around foraging and providing food. And now, fast forward to it today, and we're expected to just not think about what we're eating. This idea that we shouldn't spend any time preparing food at all. Yes, it's for me, isn't it? We don't have time. It's too much faff. Too much faff.

But actually the social aspect of eating with somebody or the mindful aspect of eating alone. Yes. And really thinking about what you're eating, turning it into a pleasurable experience again. 100%. So what does it taste like? What are the smells? What's your favourite part? Really savouring food.

Not looking at your phone, not watching TV. Just really savouring that food. it transforms the experience of eating. And I think I would love people to feel like they can claim back that, hang on a minute. Since when am I not supposed to think about what I'm going to eat, prepare it and eat it, like eat it slowly, eat it by myself, eat it and enjoy it. We've been sold that.

That's not how we evolved. People are like, oh, you don't want to be thinking about your food. Just get it delivered. It's like, no, actually. I want to take my lunch break back. I want to sit down and enjoy a meal and it can be quick. I love bold bean company. They make the most delicious canned.

So actually jarred beans, they taste so good. Anyone who doesn't like beans, I'm like to try that. Because they just cook them really well. Bold bean company. Bold bean company. Yeah, it's a British female founded, Amelia, is brilliant. And they are delicious. And you can eat them cold out of the jar.

That's how good they are. Or you just pop them on a plate. So classic meal for me, pop that on a plate, some whole grains, which I either batch cook, or you know you can get spelt in a packet now. That's parboiled, that you just microwave. Put that there, some greens, maybe some tin sardines.

I love them. I love tinned fish. Can I tell you something? It's going to fry your brain. You were going to be so upset with me. Oh, go on. When I was a little girl, and I lived in Paris for a bit, or when I used to go and visit my mum in Paris.

We used to eat tin sardines with a knob of butter on it. Yeah. Could you believe that? We'd mash the butter in it, into the sardines. And then put it on bread? But that's delicious. If people ate, if I'm honest, like my, my little one, Isabella, four and a half, she's got her in mind, she likes to take tinned fish, including smoked spraps, which I would argue are an adult palate. Sprats? Yeah, sprats. Wow, I love that. They're really good. And she'll just go, oh, that's it, snack, done. And I did not teach her that.

She just, well, she's seen me eat them, of course. And she's like, I want that one. But no, wait, Feddy, that. is teaching her. Exactly. She's watching you. I think that's why it's so important. I didn't do this enough with my kids, but I didn't know then, what I know now. And it's hard. But I didn't do that enough with my children.

I wish I could go back and parent them again, although, you know, Holly has become a dietitian and is so into her food. So I guess that's a good thing. But it's that watching by example. That's why children do things. I grew up in France, so I'm very into. lots of French types of food that other people are like, you know. Yeah.

And it's interesting you say because one of the biggest pieces of work I do with the parents I work with is actually saying to, you know, often I'll get parents who say to me, I'm really worried my child is not eating enough foods and I'm worried I'm not getting enough in and they're just like to drink their milk. And I said, okay. And I used to do home visits for these families. And often these children were sort of placed to eat by themselves in a high chair with their bibs. and the food's a little popped or like a little Tupperware

and then they're expected to just eat it. But we learn how to eat. It's a learnt skill. So one of the things that I encourage, and I want to do more of it with my children, it's hard if you're working and travelling, but sit down and enjoy food with them, even if it's a different time.

So if they've had their dinner maybe and you're coming in and you're having your dinner, sit down with them, let them sit on your lap. One of the most annoying things is when toddlers try to feed you and they get it all over your face. But let them do it. Yeah. Because it's part of them learning what you eat and that will help to educate them on what food is.

And they might not eat it yet. But it is a learned behavior. And the damage I think that I'm seeing now with children who are very good at opening packets, they can grab and go snacks, pouches. We need children to interact with actual food. I'm not suggesting you will never use a pouch again or you will never get promised. But children is so crazy. critical that they're exposed to whole food. They squish the broccoli with the hands.

They throw it on the floor. Yes. They take some of the sweet potato, pop it in the mouth, spit it out. It's all part of the learning curve. And the later we leave that, the harder it is. Because it's the early years that really sets that. So share food with them. Let them make a mess.

I know that's really hard for a lot of parents, like really struggle with that. Let them make a mess. Let them feel the food. Let them smell it. Let them eat it. Let them spit it out. Let them play. They're not trying to annoy you.

It's part of the learning process. And if we can, and that's part of the social aspect of eating. So convenience is not king. We need to carve this time out again. I'd love to talk to you as well because I know there's been incredible research done on the menopause and food. Yes. So tell me what that is. So the first study we did looked at this impact of the menopausal metabolism.

So all of how women who were premenopausal compared to peri, compared to post, how their metabolic responses varied. That was groundbreaking at the time because it hadn't been done before. And so the next logical step from that was, okay, so we know there's this fundamental shift in the way that we respond to food and the way that we use it. So how can we help women to navigate the perimenopause and menopause transition with food that will support them? And the first step was to look at how different women with different levels of symptoms,

how they ate. And we found there was a really clear trend. There was a really clear association between women who ate a variety of plant food, so high plant diet and better menopause symptoms. So like a reduced risk of having as many and a reduced risk of having as much of an impact on their quality of life. And that was irrespective of their BMI, which is a well understood risk factor for severity of menopause symptoms. So that was really important. And what it just reinforces is the fact that women going through the perimenopause transition and menopause, we have so many tools now that are evidence-based, right? H-R-T, if it's right for you, balanced and personalized to your levels. We have diet. We know you can make a difference with diet.

We know you can. You can actually improve things with diet. And now we have the hard data to show it. We know you can improve things with exercise. You can improve your bone mineral density, your mental health and you can improve how well you maintain your muscle mass, which is so important for independent living later in life, right? And so that this is just this toolbox, which is growing. We also know that the gut microbiome changes significantly in the menopause. It was one of the things that we found in the original study was we saw metabolism changed, but then also the gut microbiome composition was completely different. So there's a whole group of gut microbes that love estrogen, estrabolome sometimes is called as a group. And when we have less circled,

eating estrogen, they have less to eat. And so they start to die off. And what happens when, as we said, an ecosystem, when they start to shrink, the microbes that take their place can either be health promoting or they can be less helpful. And so we want to encourage women, we think this is one of the reasons why a very high plant diet helps. It's because if you have a high plant, high fibre diet, you're encouraging the good guys to take that space. Yes. And one last thing on the menopause research, which I was really surprised. by and I think is really important is postmenopause, so women who are fully menopausal, they still have symptoms and they're still reporting them.

I think this is so interesting because a lot of women think, oh, postmenopausally, if my periods are stopped, I'm done. Yeah. But that's not the case. No, and we need to serve this population better. Yes, totally. I see, you know, it's interesting. When I think about women's life course, we have, you know, we're born, we have adolescents.

If we have children, we have matressents. then we have menopause. And then postmenopause is this really brilliant period of time where we are our hormones stabilise again, right? We have this new being, we're this new woman, right? And we have 20 or so years to absolutely power our health up in the best way possible before we start to think about older age and then there's new challenges that.

So there's this like lovely, I don't know what we should call it, essence because menopause means the end of something. It's like a... But it's like the... It's like almost like the woman essence where it's like you're just yourself. There are no hormonal fluctuations that are changing your mood or all the things that they can impact. And you're just this new being. Well, it's quite interesting because you're talking about physically there's a new being.

But I have found most menopausely that mentally I'm a new person. I'm going to try not to try not. cry. Okay. Because I've found that I am a lot more balanced, a lot calmer, a lot more forgiving, a lot less controlling. It's a really nice time in my life. I'm really enjoying it. And I often think that it's a time women fear because they think, oh, it's going to be, but you're right, it is a time. It is a time. where you can think, oh, I've got to a lovely space where I'm fit, I'm healthy, I'm me. That's, because so many things are pegged to our ability to procreate, essentially. And then actually, what's this bit, it's just for us.

But when you can't anymore and you know that's off the table, it's immensely liberating. Yes. I was grieving the idea of that. Yeah. I can't have children anymore. And I grieved it. for a bit. Yeah. And then I was like, oh, can't have kids anymore. Wow. Done. But it's like, it's so exciting to me to have this time and to get to know yourself again in a new way.

And I think we need to, this is this population now that we're not really serving. And I will go as far as to say that, you know, we need to do more research for this space because there is so much potential. We think in 30 or 40 years time, the majority of the population is going to be over 65. That's just the way that the world is going. So we need to think, okay, what do we want to see for ourselves in this space where a senescence is like aging, right? But it's got negative connotations because a senescent cell is one that's old and senescence. But actually, we've got the opportunity to make it something that we can look forward to again. And if we focus really hard on this postmenopausal period, we can impact the health, vitality, independent living.

for 30 years, 40 years down the line. I'll be your poster girl. I love it. Yes. You already are. I'm offering myself. It's a huge opportunity. Oh, it's massive.

Yeah. And I'm seeing a lot more around, because we're talking a lot more about perimenopause and menopause. I am seeing a new positivity around growing older. And I like to thank Aris Apul, rest her soul, God bless her soul. She was amazing. I'd like to thank Aris Aptop for God bless her soul because she was so amazing and so inspiring. and a fashion icon and still living her best life.

And we can all get better and still have lots of fun and live our best lives. Exactly that. Into old age. Can I ask you one final parting question? Yes. Because it is, I don't know any supplement that is more kind of tricky to discuss with people than protein. Yeah. And I do sometimes supplement protein, but I don't do it every day.

Yeah. And I feel like I kind of know when I haven't had enough protein. Yeah. But what is the amount of protein that we should be consuming? Just once and for all. I'm just going to just put it out there. I think it's really nuanced. So this is where I've had, it is.

But I've had so many conversations, discussions about this. And every time I bring this up, the comment section, and it's something to behold. So let's do it again. So essentially there's a big debate about protein. And this is where in science you have the science, the nutrition professionals that are sort of sports and performance leading, and they have one opinion.

And then you have the nutrition professionals that are like public health leaning and then longevity leaning, very different opinions. Oh, really? Very different. So longevity-leaning scientists like Valtolongo, actually he believes a low-protein diet is best best for long term, for survival and long-term health. Then you have the more professional

sort of sports scientists, professionals and they're like, whoa, the recommendations are way too low. We are like underserving. And then there's people like me. So the public health, and for me, it's about longevity and functional aging. So you like Goldie Lox. You're in the middle.

I tend to, yeah, I'm like in the middle. And I think actually the recommendations made by the WHO, the World Health Organization, you know, 0.8 grams per kilogram, 1.83. it's a really nice place to land for adults. So when I say adults, I mean 18 to about 65. This is a nice number that's got lots of research. How we got there is not just for maintenance.

It's not just not to be deficient. It's actually more than enough for the majority of people. So I just want to be really clear about that because people often say, oh, that's the minimum cutoff. It's not. Minimum cut off is more around 0.7. And the 0.83 is there to make sure that pretty much 97% of the population will get more than enough.

So it's really been well calculated. Yes. It's not, you know, just to be clear. And it's per kilogram. Per kilogram, yes. Now, why is that problematic? Because I can't even do it in my head. If I had to work out how many grams of protein that would be for me a day.

You need a calculator. And then, if I then had to work out how much every food ate, how much protein it has and then added up, my mental load is like, no, I'm not doing that. So where I worry about protein being prescriptive is. is that people then spend a lot of time and effort reaching that one goal at the expense of everything we've spoken about today. Enjoyment. Yes. Dietary diversity. Getting enough fiber.

Yes. Getting a variety of plants. Getting enough polyphenols in. Good quality fats. If you hyper index on protein, a lot of the other stuff gets missed out. And listen, it's true. There's lots of lovely science to show that, you know, if you eat more protein and you're on a weight loss journey, you'll better maintain your muscle.

There's not, so we, I'm not, at all suggesting protein is not important. Protein is important. But what I would love people to understand more is that pretty much most foods contain protein. All plant foods do. All plant foods have all amino acids. So you're not going to be deficient in amino acids if you're eating variety of plants. Good quality meat. So there's very clear evidence to show that eggs, fermented dairy, so yoghets and kheifers,

and some lean meats, like so some chicken, some turkey. oily fish and shellfish, great sources of animal protein, that you can eat regularly. Great. So if you like those and you eat them, it's going to be very easy for you to get enough protein. Okay. If you are vegan, getting enough protein is something to think about a bit more, not because plants don't have protein, but they're just because you have to eat quite a lot of different plants in good amount to get enough protein, especially if you're looking to build muscle or if you're an athlete.

There are very successful vegan athletes. it's totally doable. It just needs a bit more work. And let me, I have to say this, most of us sitting at home are not athletes. So I also encounter people who are like, well, you know, I go to the gym every day. I'm like, that doesn't make you an athlete. I don't even go to the gym every day and people are always like, you must have loads of protein. I was like, no, I go three or four days a week. I don't need. This is the thing, Davina, is we got to a place where we're so sedentary that just being active, people are like, oh, I must, I must get more because I'm an athlete. It's like, no, let's be super clear. There's a very small amount of people.

people on the earth are athletes who train four or five hours a day, who are constantly, you know, damaging and rebuilding muscle. Very, very few. Then I have got another question for you. What about our aging population? Because it's harder to build good quality muscle then. What can we do about that? So 65, so this is the sort of age group. If you're eating enough good quality food, you'll be getting good protein. As we reach 65, 70, our ability to absorb protein goes down. Our hunger-sunk signals go down. So we actually forget to eat less. Yeah.

And our bodies are a bit less efficient at building the new muscle and preserving it. So in those populations, now, if you're independent living and you're quite healthy, it's not an issue. Most of the studies looking at this population are in care homes and people who are assisted living. Who are sitting down a lot. Sildenry. And unfortunately, not so well. And they do tend to have not enough protein in their diet. But that's also because the quality of their diet isn't great.

Yes. So it goes down to it. It's not that they have to be protein deficient or that they suddenly have a massive increase. You know, some recommendations suggest that after age 65, 17, it might need to be like one gram per kilogram or one point two. So it's not a huge shift, but it's just that we need to make sure that we're looking after people who are older by making sure they have access to nutritious foods. Yes. And I often say this, that if you're in a supermarket and you think about somebody who's maybe in their 80s and they're shopping, can they even reach? the lentils and the beans. They're often at the bottom or the top shelf.

Is the packaging created so it's easy for them to eat nutritious foods, right? If you buy a packet of biscuits, it's very easy to open. Or tins or jars or something that's quite difficult. Tins or jails are really hard to open. Yeah, yeah. We need to make it easier for people who are older. Thought about that. This is the kind of thing.

So I love this space. Well, yeah, and geriatrics, geriatric medicine, like, it's an underserved. It's a really important space. It's honestly, we have to. think about this dentition, do you have all your teeth? So when I say, oh, eating nuts is really good for you. Fantastic. But if you go and buy your grandma who has false teeth nuts might not work so nut butters are a better option. But we need to start thinking how... And that butter's okay. Yeah, yes, yeah, absolutely. And especially the crunchy nut but again, we're thinking

about older people, they're less able to absorb nutrients. So a nut butter where the nutrients are much easier to absorb is a good thing. Right. So we have to be protein, is a really good example where I can't tell you and all the listeners of this episode, this is the way you should have protein. It depends. How old you are? Do you eat enough food? Really important, especially for women who are dieting? Eat enough food. Do you, are you an athlete, in which case, please crack on with your sports nutritionist? And we can get enough protein before having plenty of diverse high quality foods and don't stress about it is my main message. Now, if you occasionally feel like, gosh, I actually went to gym, worked out quite hard and didn't eat enough breakfast, I'm going to have a protein supplement. Fine. But just that's not the problem. The problem is when people think that they have to get, you know, chicken fillets at breakfast, salmon for dinner. Well, it becomes a stress.

Oh, and you don't feel great if you're having too much of one thing, of anything is too much, right? And remember we talked about the study where if you change your diet at age 40, you could add 11 years, right? That same study looked at what happens if you change your diet, 870. So I also like to think later in life, is it too late for me? I get the question a lot. There was a study that came out last year that showed that your diet aged 48 was very predictive of your risk of dementia age 69. And everyone was like, oh my gosh, I'm 53. What does this mean for me?

And it's like, you know, this is just that study was a rough age. It's a good example of a study that looked at compound effective diet. The study that looked at the improvement in lifespan with diet with 70-year-olds age 70 if you elevate your diet from standard diet to something that's more Mediterranean diet longevity pattern so plenty of oily fish extra virgin olive oil and legumes and nuts and seeds and veggies you can add six years to your life so it's never too late any change you make at any age is going to be good for you and going to make a difference to how you feel today and tomorrow and for your long-term health and it's not about perfection it's about consistency find something that you can

add in every day that you can keep up over time. And there'll be the odd day where you go to a birthday party and all you eat is canapes and cake. And that's fine because you're consistently looking after yourself. And that moving away from perfection also makes it more achievable and more pleasurable. Because gosh, perfection is a hill that everyone will know. It's not, it's not the way to go. Would you say, Fedi, that that is the message overall that you want to convey? Don't stress. Yes. Health, you know, my biggest thing is food is there to be your health ally.

It's there to help you. So it takes a bit of work, a bit of interest, a bit of investment in learning how to cook. Become your own health, your own health architect. Make your home full of delicious, healthy nourishing foods. Because outside, at the moment, policy and the food environment isn't great. So create a nurturing environment for yourself at home. be consistent with your choices and learn to enjoy food again, be social with it, take time to eat it, be mindful when you're eating, like really enjoy it, savour it.

And I think often I see this when that switch happens and people start to enjoy their food again and they explore with new ingredients and they go to the like farmer's market and they buy this really random looking radish and they try. The joy it can bring is just so worth it. And then once you're there, your relationship with food. your relationship with your body will change as well, because you've really learned to appreciate what your body is doing for you in extracting all the wonderful nutrients and making you feel great. Talk to me about this. So this came out last year, didn't it? Everybody should know this.

Little shout out from Tim. Tim actually liked it, which is good. Wow. Can I also thank you for the quite large type, just as a middle-aged woman. Can I tell you that I asked for that? I'm so great. Because originally it was time. And I said, listen, I'm hoping that people will read this for the entire life course. There's a good chunky section on midlife and after. I was like, can we make it readable?

Because I really hate it. Well, can I just say it's one of the first things that I noticed about the book. So I really appreciate that. But also that it's like through your whole life. Yeah. You know, it's from. Conception. Cradle to grave.

Yeah. So thank you very much for that. I've obviously got my copy of this. So that is absolutely brilliant. But I just wanted to say, thank you. I love the way you can communicate about food without people feeling stressed or guilty. It makes it sound fun again. And actually what I didn't realise whilst I was kind of looking into you and everything that you've done is that how I had lost my life.

of preparing food, that it had become a bit of a chore. And I want to get that back. And I think that's what I'm going to work on. I'm definitely going to do a cooking course. I think we should all go to Italy. There's some really good ones. I bet they're on. Yeah, yeah, it would be really fun.

And it's so nice to like, and if you get to pick, go to the field and pick them. Yes, I mean, amazing. It's really fun, yeah. Yeah, great. Well, I've loved this. Thanks. Thank you for having me. It's absolutely brilliant to have you on.

Thank you. Always love chatting to you. That's easy peas, is it? For hours. Yeah. I loved talking to Federica today and I think probably my favorite message of all was enjoy food. I mean, I think the messaging sometimes that sent to us is kind of scary and I know that's a bit clickbaity, but it's sort of avoid this, don't eat that. You know, this is bad for you. You should only have this much of that. And what I like about what Federica was saying, enjoy what you have.

add things in, eat with people, make it a social thing, de-stress by preparing food. I really like this idea of make it an enjoyable thing again. It's essential to us being alive, so we may as well enjoy it, right?