Begin Again with Davina McCall - How Diet Affects Menopause Symptoms. Are We Eating Too Much Protein? With Professor Sarah Berry.

Episode Date: February 13, 2025

In this episode of Begin Again, Davina is joined by Professor Sarah Berry, a leading researcher in nutrition and menopause. Together, they unpack the myths surrounding diet and its true impact on menopausal symptoms. Sarah reveals how small, science-backed changes can lead to big improvements, helping you take control of your health with confidence. Whether you're navigating menopause yourself or want to better understand its effects, this conversation will challenge what you thought you knew—and leave you feeling empowered to make positive, lasting changes. Follow me here: www.instagram.com/beginagain https://www.tiktok.com/@beginagainpod  00:00 Intro (03:10) The Truth About Protein: How Much Do You Really Need? (06:49) The Hidden Impact of Processed Foods on Your Health (10:24) Rethinking Nutrition: A Balanced Approach (27:09) Understanding Inflammation & How to Reduce It (29:59) Sponsored: Zoe Ad (31:15) Sponsored: Adobe Ad (32:12) How You Eat Matters: The Key to a Healthy Diet (36:59) Home Cooking & Its Powerful Impact on Your Health (38:09) Menopause & Diet: What Really Helps? (50:47) Menowashing: What Is It & Why Should You Care? ZOE - https://zoe.com and use code DAVINA10  Adobe - https://www.adobe.com/uk/express/ Learn more about your ad choices. Visit megaphone.fm/adchoices

The ride that steals the spotlight every time it hits the road, that's the Volkswagen Tiguan. Its sleek exterior makes a first impression you can't ignore. Step inside to find available full leather seats and wood accents. Under the hood, the available 201 turbocharged horsepower engine gives it a fun to drive edge. The refined Tiguan, you deserve more style. Visit vw.ca to learn more. SuvW, German engineered for all. Presents Laura versus Fruit Flies.

Swarming your fruit and terrorizing your kitchen. These little freaks multiply at a rate that would make a rabbit say, yo. Chill. But Laura shopped on Amazon and saved on cleaning spray, countertop wipes, and fly traps. Hey, Fruit Flies, your baby boom ends here. Save the Everyday with Amazon. In the menopause, we have this massive range of symptoms, and we have been told so much that what we eat has such a massive effect.

I was like, look, as long as you take HRT, then that's it. But actually, what we found was people following healthy eating, they reduce their symptoms by that. It's enormous. What are you thinking of an unhealthy to a healthy? What would that look like? So an unhealthy diet, unfortunately, is the typical UK diet. We know they impact cancer risk.

We know they impact. impact cardiovascular disease risk. We know they increase our blood pressure. We know they increase our bad cholesterol. Can I ask you something? If that comes with a cancer risk, like I don't really understand how that's even on the shelf still. If we were to start eliminating any food that was bad for us or a carcinogen,

then... There'd be nothing left in the supermarket. They'd probably be about 30% left. It's quite mad. Give me the kind of headline changes that me as a menopausal woman could make to help me. So headline is... 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. I think what's amazing nowadays is that it's going to have such a massive impact, not just on obviously everybody's weight and well-being.

And we know that it's not just about your weight or your size or your health. It's also about your mental health. It's become so apparent that we are what we eat mentally as well. But for me in midlife and in terms of longevity and how best to look after our body, to live and prosper for as long as we possibly can. But for both men and women, I mean, often women have been just clumped together with men in terms of research and we're all just the same. But I know we're going to talk a little bit later about this amazing new research that you've got

that is such a game changer in terms of menopausal women and their symptoms and food. But in all the ways that women differ. from men, can you just tell me, in terms of like midlife, what big things have you learned that you think are takehomes for people in midlife, men and women, that are different? How are men and women different? Gosh, this is challenging me now. Yeah, good. This whole area of menopause is relatively new for me. I mean, you know, there's so much similarity between the, you know, men and women, just like there's so much similarity between what foods are good for you and what foods are bad for you for different people.

Well, could I ask you then very quickly, but for both sexes, what foods would you say? Because protein is so, well, it's quite a tricky area really because it's generally said that we should get most of our protein from our diet. And I do know that a lot of people either are too busy, they're not making the right choices, too much fast food, lots of people maybe aren't getting quite enough. But if you're young and you eat lots of meat, and you can also get enough protein quite easily plant-based, but you have got to be making the right decisions.

How important is protein as a building block for a mid-lifer? Because I really struggle getting protein into my diet. I really do. I can't eat a whole chicken breast. It's too much. Yeah, so I think protein has become one of these nutrients that's the hot topic at the moment. You know, I was in the States recently and you go to the kind of lunch restaurants and they say,

what protein do you want with that? I mean, that to me is just crazy. You know, we try and as good nutrition scientists think of food and in terms of food, not in terms of nutrients. I think there's too much of a focus on protein. I don't think it's a big problem. The majority of people are getting enough protein. Now, really, do you, like even if we're eating kind of, Even if you're eating plant-based, you know, exclusively vegan-style diet,

you do need to be more mindful of making sure you are eating protein-rich foods and getting kind of the right sort of protein-rich foods like pulses, etc., into your diet. The majority of people, certainly in the UK and the US, are getting enough protein. Some people aren't, and yes, at older ages, then we need to be a bit more mindful. I think when we think about how men and women differ, rather than thinking just because of the sex, we need to always think about not just sex, but the phase you are in your life.

So are you of a childbearing age? Are you an adolescence? Are you a pre- or post-menopausal women? For men, obviously those phases are less distinct like they are for women. So does their diet not really, do they not really need to think about changes or adapting as they get older?

So as you get older, your body composition naturally changes. your metabolism naturally changes. It's a natural part of the ageing process. So because of that, I think that you need to be more mindful of the types of food that you're eating. And I think that you also need to bear in mind that at any age, adapting a healthy diet, whether you're 40, 50, 60, there's really good evidence to show transition from an unhealthy

diet to a healthy diet, whether you're male or female, at any age has significant health benefits. When you're saying, what are you thinking of an unhealthy to a healthy? What would that look like? So an unhealthy diet, unfortunately, is the typical UK diet for the average person. So I'm talking about a diet that contains maybe 60% of heavily processed unhealthy foods, which is the average UK diet, has lots of refined carbohydrates, white red, white rice, white pasta, has too much red meat in it, doesn't have enough fibre. And then when I think of a healthy diet, I think of a healthy diet in one that is kind of a little bit more traditional. So a diet where we are cooking from scratch that can have some red meat, but limited red meat, has a wide

diversity of plant-based foods, has plenty of fibre in it. Being someone who, you know, I'm in midlife and I'm thinking to myself, I grew up on red meat. I, you know, I think people generally thought that it was really good for us. Yeah. Iron, sorry. solid, you know, and it is quite hard to wean yourself off that. Why should we only be consuming a bit of red meat? So there's really good evidence to show that if it's processed red meat, so your hams, your salamis, etc. It's like the best.

I know. And often this is a problem with processed food. I mean, we can come onto that. But unfortunately, a lot of heavily processed food has that magic mix of the salt, the fat, the carbohydrate to hit those reward centres in the brain, that is why, like you're saying, it's the yummy stuff. But there's really good evidence to show that this heavily processed meats are bad for us. We know they impact cancer risk.

We know they impact cardiovascular disease risk. We know they increase our blood pressure. We know they increase our, you know, bad cholesterol or LDL cholesterol. Can I ask you something? If that comes with a cancer risk, I mean, the World Health Organization actually says processed meat is a carcinogen. I don't really understand how that's even on the shelf still. How come we're allowed to eat that?

Gosh, you need to get the government in here. Yes. It feels kind of quite a crazy thing that we are eating. It's the power of the consumer, I think. I mean, this is kind of going outside my kind of research area, but my view on this is the consumers, very powerful. And what the consumer wants is what manufacturers will give to a certain extent. There is a duty of care. I think food manufacturers have, but at the end of the day,

they're business, they have products to sell. Our whole food landscape has changed. And so if we were to start eliminating any food that was bad for us or carcinogen, then... There'd be nothing left in the supermarket. There would be very little. There'd probably be about 30% left. It's quite mad. But having said that, you know I like to caveat everything. It's all about balance. So I'm not saying that 70% of the food is going to kill us. Well, I do, I'm half French.

And my love for sausage sauce and ham and mortadella and all the processed meats that are now, I know, not great for me. I don't understand how France, Italy, Spain. You know, the Spanish, literally you get served tapas, and it's like meat and an artichoke. Why are they well? So I think that is a great example of how we need to try and not take what we call a reductionist view of nutrition, of food and health. Because we can't just look at single foods. Yes, we know some single foods aren't the best of us, but we have to look at the entire diet. And the Mediterranean is a great example.

the healthiest diet out there, but yes, they still have like the French sun salami. But we need to think, what else are they having in addition to that? So rather than focusing on kind of what's bad for us, I think it's a really good approach to use these kind of countries to say, okay, what's good in their diet? The extra virgin olive oil, they have loads of that, they have loads of healthy fats. They still have lots of fibre rich foods. But also, I think they are a great example of how we need to think about food, about diet, beyond the food. So if you take the Mediterranean, for example, they don't snack as much as the UK and the US.

Yes. The way they eat their food, they eat it more slowly. And I mean, there's fantastic research, even that we've been doing about eating weight, so the speed at which you eat it and how that impacts your health. Also, the distribution of how they eat their food. So in most of the Mediterranean, the main meals,

the majority of their calories come from their lunchtime meal. In the UK, the majority of our calories come from our lunchtime meal. late our kind of evening meal. Right. And actually 35% of people in the UK snack after nine in the evening. Yes. And we know that that's not good for you.

There's this whole new area called chrono nutrition about the time that you eat. And so when we look at countries like that, it's not a case of, oh, well, they have loads of salami, but look, they're living these wonderful, long, healthy lives. It's okay, what else are they doing? How are they eating?

And this is a real exciting area of research, as well as what else is in their diet. I mean, this is why, I found intermittent fasting so interesting for me because the first and biggest thing I noticed was in the evening I was depressed because I'd eat my meal. I'd finish at about seven

because I'd know that I'd want to eat after I'd worked out so I'd want to eat about nine. Yep. The next morning. So I'd finish about 7, 7.30. And then we'd say, okay, let's watch something on the telly. And then it would be, the boys would be like, oh, okay, let's go in snack cupboard.

I mean, we've got a snack cupboard for the love of God. And it's full of the worst things you've ever seen. You know, wafers and crisps and, you know, and they come with their snacks and they open their crisps and everybody's co-sharing and a toffee bonbon or something. Oh, that's a bit mean and you're there. And I'm there sitting on my hands. But after three or four days, again,

I didn't want a snack after dinner. I didn't miss it. It didn't take me very long. but it is interesting. It's part of our culture. Yep. To sit down in front of the telly and have a snack. It is a thing.

But it wasn't like 30, 40 years ago. No. It's a snacking has become very different now to how it was. What was the percentage again that you said that we got our nutrition from snacks? So on average we get 25% of our calories in the UK for snacks. That's a quarter of our calories. But do you know what? I think rather than worrying about it.

it. Yeah. I think we should see snacking is one of the eating events, as we call it, that's kind of under our self-control. Because typically when you snack, it's something you're snacking on in isolation or you can choose your snacks. A lot of the time your lunch meal or your evening meal is dictated by who else you're eating with or what you're doing at work.

And so actually, yes, 25% of our energy on average comes to snack. But it's the simple, single strategy that we can change. change and do something about. So what would you change it to? So we've actually done some quite a bit of research on snacking ourselves. And so we've done some within our Zoroa Predict study that shows that actually it's not so much the frequency of eating, i.e. the snacking in itself, that's the problem. It's about the timing. So avoid snacking after 9 o'clock.

Ideally after 8 o'clock. We see people snacking, even if it's on healthy snacks, if they're snacking after 9 o'clock, increase risk of cardiovascular disease. higher blood cholesterol, blood pressure, etc. Also changing the type of snack you're having. I mean, I know that's obvious. But we did a study recently. Well, it is sometimes it is just you want to be doing something. So actually it's...

Well, do you know what? They did a survey and 25% of people say they snack purely out of boredom. 25% of people out of habit. So 50% of people are snacking, not because they need it. But we did a clinical trial where we asked 50 people to eat. a 20% of their energy from typical UK snacks. And so basically we made these muffins that had the same profile as, let's say, a bit of Walker's Crisps, a bit of a McVitties digestive.

But we worked out what's the average kind of snack in the UK? And then we had another 50 people who for six weeks were eating almond nuts. But the exact same percent energy was coming. So this 20% energy was coming from either nuts or from snacks. We said, don't change anything else. Carry on a living as you normally would. eat everything else you normally would, but you must eat these snack foods that we provide. By the end of the six weeks, the improvement in health outcomes on those on the almonds was phenomenal.

When you actually calculated what the estimated improvement in cardiovascular risk was from some of the different factors that had changed like their cholesterol and their blood vessel function, it equated to a 30% reduction in cardiovascular risk. And that was from changing nothing else. And I think this is what's so exciting that actually, we can make small changes. So, you know, if you want that bit of salami, you know, with your dinner, but if you make an effort to change your snacks, I'm not saying everyone should just eat almonds all the day.

Well, I've tried to, even if I'm not fasting, I've tried to kind of not eat after, I've tried to do that, not eat after 8 o'clock. Yeah. Even if I do have breakfast at 6.30 or whatever because I'm going to work. But I try and not snack in the evening and just drink water. you know, not be drinking tea or anything because that messes with my sleep. And then try and do nuts and things.

I want to show you something. So I bought these and this. And what's interesting because you just mentioned. Oh, I love an almond nut. You just mentioned almonds. Yes. And what I think is interesting is that on the packet, it would give you, companies would give you the same nutritional value for both of these.

But that is not entirely correct. Am I right? and saying that. You are totally correct that that is not entirely correct. So can you explain why? So we've got ground almonds here and a whole almond here. Yep. So this is a great example of the importance of what we call the food matrix, so the structure of the food. And it's a great illustration of why processing food actually changes its health effects. And a great example of why we need to think about the food and not think about the backer pack nutrient. So if you were to pick up these in a supermarket, that would tell you that there is 170 calories per portion, which is probably

about that, maybe a few more. So it's about 28 grams. Wait a minute. Wait a minute. 170 calories per portion. But I think that some people would go, what, only that number of nuts for a hundred. It's probably a few more. A few more. A slightly bigger handful. Okay. I'm going to get some more from down here because I'd quite like to know roughly what that would look like. That's better. I haven't got my weighing scale. That's better. A few more. Oh, okay. Okay. So I would say... I don't even know if I could eat that many on this.

Okay, if anyone's looking at this and counting, they might say, they might say this is not totally accurate, but let's say roughly, roughly, yeah, I'd say that's 170 calories. Okay, so, but I'm just interested because people, but these are good calories. They are, because this is good fat. That is like a powerhouse of nutrition. So stop thinking about calories.

It's got fiber. It's got micro, it's got micro, So it's got phytochemicals. That is just, well, like I said, that's 30% reduction in cardiovascular disease if you're swapping your unhealthy snacks with that. And I'm chewing it whole and that is better than this. Okay, so this is why it gets interesting. So backer pack labelling shows that that's 170 calories.

Okay. Now, what actually happened, and the back of pack labeling for this, which is, I assume this is grand almonds. Yes, grand almonds. So the backer pack labeling for both. Would be exactly same. 170 calories, 28 grams, whatever, 28 grams, whatever, you know, amount of fat, protein, fiber carbohydrate, nutrients.

Now, when you eat these, actually, you excrete about 30% of the calories. So you only actually absorb about 60 to 70% of those calories. So actually, on average, and I always like to say that on average, you'll actually get about 130 calories from those. Right. From this, you will get the full 170. calories. The reason it's different is because of the food structure, the matrix. So plant-based foods are made up at thousands and thousands of cells, just like we are. Yes. And these cells have cell walls. And the nutrients are encapsulated within the cell walls. So the fat is encapsulated within those

almond cell walls. Now, the cell walls of almonds and lots of plant-based foods are tiny. We're talking about like 20 micrometers, which I mean is smaller than the grain of sand. Now, when you chew, you don't chew down to that tiny amount. We actually do what I call mastication studies. So these are chew and spit studies. They're discussed in. And so we get people to chew the almonds. Then at the point at which they swallow, they spit them out.

And on average, the particle size at which you swallow is about one to two millimeters. So that means you've got this little particle that's, going down into your stomach and inside it is hundreds and hundreds of cells that haven't been broken. So apart from the ones on the surface, so you've got all of these almond cells with the cell walls intact, with the fat inside it, going in your stomach, going to your small intestine, and it's quite resistant to digestion. Now, it will be digested a little bit, but what happens is because it's quite resistant to digestion, actually a lot of these intact cells, then come out in your poo.

So this is great because, firstly, you've got loads of this wonderful food reaching your large intestine, your colon, which is wonderful food for your microbiomes. These trillions of bacteria, they're going to be having a party. Can I say something quite funny about Mike? Since I've met you guys and other brilliant gut health doctors

that I've talked to, I've literally, I don't know whether you remember the numb skulls. You're probably too young. But when I was a little girl, there was a TV show called The Numskals and they were people in your brain and it was a kids TV program and the one person would go

okay open the mouth food coming I imagine that my whole gut is like just people oh yeah you know inside out with like all the people in the head oh they're having a party when you eat your almonds yeah I'm imagining that they're all going they've literally turned into humans because you keep going your gut microbiome so happy

that they've actually turned into like little people anyways that was a side note so yeah so they are they're happy because you've had these almonds and all of these like bits of left over that's not absorbed you're excreting 30% of the energy for which for many people might be beneficial I'm not saying you know everyone there's obviously people we want to make sure they're getting adequate intake um of energy and yet if you have the ground almonds all of the cell walls are broken so because they're ground yeah so all of that fat is released

you've got to think of it's like it's all bursted out yeah and so what happened is you're able to absorb it all so it's not reaching your large intestine. So your microbiome is still having a bit of a party because some of the fibres there, but not as big a party. It's not like the crazy all-nighter. It's a bit more sedate sort of party. And so that's a really good example of how the backpack labelling is really misleading. And what we also know, as well as it infecting your energy levels, it infects your hunger levels. So we have a lot of it. We have a lot of it. It's a loads of receptors in our gut that tell us how hungry we are or how full we are. They're actually more dense lower down in our gut.

Those whole almonds get all the way down there. Get down there. And we'll be saying, hey, Davina, you're actually quite full now. Actually, you don't need any more. And so there's so much more that goes on. But I think the most interesting thing about that almond data is that whilst I said, and I know I emphasized it, on average, you'll get about 130 rather than 170 calories. When we look in studies where we feed people the whole almonds

and you look at how much energy they're actually getting, there's huge variability. Some people are absorbing about only 68 calories from that 170 calories. Other people are absorbing the full 170 calories. Right. So whilst I told you on average, there's huge variability. Disgrances, yeah. Huge variability.

And this is that where we are so fascinated now, where I'll predict programme research comes in. Do I want to give the same advice to that person who's getting the 170 calories? That's the one who's getting 60, if we were thinking in terms of calories. Would that mean that some people absorb more calories than others? That's what the evidence shows. It does go a little way to explain why some people really struggle with their weight maybe. Would that be right?

I think that for some foods, yes. I think that for the majority of the food that we eat, if we're talking about a typical UK diet that's heavily processed. Oh, right. It is that kind of alma flower where actually it's not going to make much of a difference. Okay. When we're talking about plant-based foods in its kind of original structure, that's where we see more of the variability.

I think that that's one of many, many, many factors to do with different levels of obesity, different weights amongst different people. Okay. So generally speaking, if we're talking about plant-based food, eating whole. Yep. You know, don't mess about there. Yeah, eating whole plant-based foods is always better. There's some really old studies that actually we still talk about.

So when I teach about this to our students, I refer back to a study back from 1977, which is the year that I was born. Don't show off. And this was a study where they fed people whole apples. Yeah. they fed people curate apples. So again, back of pack labelling was the same. And then they fed the apple juice.

So they took away the fibre a bit. And they looked at what people's post-pranagal glucose responses were, which is basically the post-meal increase in blood sugar. So about 15 to 30 minutes after you have any carbohydrates, you have this big increase in circulating blood sugar. And they found that firstly, people who were eating the apples, at those apples, at least 100 times. or 100% more slowly than if they were having the juice or the puree.

So that impacted the blood sugar responses. But even if they controlled for the speed of eating, there were still really big differences in terms of people's fullness and hunger. So even though they were having exactly the same calories from the apples or the puree, which again, remember, Becker-Pax are saying, the puree didn't keep them full for me long. The apples kept them full for long, as well as the fact that, you know,

you're getting different kind of other sort of benefits with your glucose, etc. You've touched on glucose there and the spike after having calves. And we've all become quite savvy now that the order of eating food has some relevance. You know, I've started kind of actively trying, all of my family have, in fact,

trying to maybe after a lunch, take a 10-minute walk to kind of help even out the spike. And it's all about inflammation. But I do think it's interesting, especially for someone my age to think about why is inflammation something we want to avoid. What is it?

So inflammation is a normal physiological response to an injury. So cut your finger. The reason that you heal is because you have an inflammatory response. we have inflammatory responses going on all the time inside our body. It's a normal physiological response. The problem is if it's in the wrong place at the wrong time and too much of it, we know that it can increase our risk of disease. And so what we now are starting to understand is that many chronic diseases,

cardiovascular disease, type 2 diabetes and some cancers are underpinned by inflammation. And inflammation that's going on inside your body, inflammation, for example, it's going on at the level of your arteries. So we know one of the core underlying kind of physiology that happens in terms of development of cardiovascular disease at the level of the blood vessel, inflammation plays a really key role in that. So, I mean, would it be fair to say that just sugary sweets and stuff, you know, look, we need carbs, we need fat, we need protein, you know, we need all of those things. But actually in terms of just eating sweets, in terms of inflammation, it's like. like really just in moderation. Just really try and chill out with the sugar.

Extra sugar. It's in moderation. Look, having some sweets here and there, having some of these foods. I can't do it in moderation. And again, this is where I think everyone's just got to listen to themselves. I can go and eat a few sweets. I'm fine.

Give me a bar of chocolate. I need the whole hundred. Yes, yes, that's me. And so it's about kind of, yeah, different people, different. I mean, I try and just stay away from chocolate. I think it's also very hard at our age. We've got kids in the house. And just because I'm really trying hard not to do something,

if they can moderately eat something, it seems unfair to not have it in the house if they don't have a problem with it. But then it only lasts for 20 minutes because I've eaten it all. And they literally have to hide their chocolate. It's in... I think if it's not every day or all day long, I think everyone, I think, you know,

we have such a disparage. in people's view on diet, I think, in the UK. You have the people that just don't recognise the importance of it or can't do something about it or aren't motivated to do something about it and have terrible diets. We have quite a lot of people in the middle and then we have a lot of people that, you know,

are doing so well and having incredible diets. And I think, you know what, for these people and these people, just don't worry about it. Having a chocolate bar, having that pack of Chris, having it's okay. We need to solve the bigger problem. But, yeah, I've gone off on a tangent now from inflammation. Yeah, sorry about that.

Right, I'm going to talk to you about my show sponsor, Zoe. Do you listen to your gut? No, I'm not talking about your female intuition. You know, not talking about that bit, no. I'm talking about your gut gut, the home of all your digestion and the gateway to great health. So much amazing research has been done around it. And for such a long time, I ignored mine.

And actually, what I should have done, was listened to my gut. And now because of Zoe, I actually can because their team, including Professor Sarah Berry, has taught me so much about how my body works, its relationship with food. It's backed by science and a great team of world-leading scientists

and one of the most advanced at-home gut health tests on the planet. As a Zoe member, you'll get an at-home test kit and a personalized nutrition program, which is so good with lots of recipes and stuff that are good for you to make, specifically for you, so you can make smarter food choices that support your gut. Go to zoe.com. The code is, Davina in caps, 10. I've got a little challenge for you. Think of one creative project you've always wanted to start. Okay, now let me tell you how you can bring that idea to life with our sponsor Adobe Express. So it's a really quick and easy, create-anything app by Adobe. So this tool's designed to give you the confidence to turn those dreams, your dreams, into reality. I've even tried it myself. We've used it to brand this show.

So I can actually genuinely say that it makes creating gorgeous graphics and social posts and professional presentations just so straightforward. With smart templates, I can get things done in a few clicks, and there's an AI feature which is like having a little creative genie with you. So whatever you're dreaming about, honestly, it's never too late to begin. So I dare you. Sign up for Adobe Express for free and take that first step. The most transformative chapter of your life is waiting for you.

Another thing you mentioned earlier, which I do want to touch on, which is something again. I think from a childhood, my granny was always... like, eat up. And I eat really quickly. And I think it is also something I may have passed on to my children. I thought it was a good thing. So why isn't it? So it's not a good thing. And sadly, I think we're all brought up to eat more quickly, whether it's survival of the fittest, whether you come from a big family like my own. Everybody's eating your food before you can finish it. Or, you know, whether it's at school. I mean, it's shocking how they're giving. in such short periods of time in the canteen before the next class.

It's a real problem at school. Eat up, eat up, quick, quick. Evidence shows that if you eat your food fast, and we call this having a high eating rate, that you have higher levels of obesity, you have higher risk of cardiovascular disease, higher blood pressure, higher insulin resistance, so kind of impacts your glucose metabolism.

Now, there's a number of reasons for this. We know that the kinds of food that, encourage you to eat fast typically aren't the best foods of you. But what we also know is if you actually look at some of the trials out there and there's some trials that have been conducted where they'll get people to eat more slowly. And they will have then another group that are eating exactly the same food. So we're talking the same food, but eat at a faster rate. You see differences in energy intake. So if you increase the time in which you're eating your food by just 20%, so you go from like a 10 minute breakfast to a 12 minute breakfast, you without

subconsciously, so without even thinking about it, will reduce the amount of calories you're consuming by about 15%. Now, for people who are wanting to reduce their energy intake in this kind of abysogenic environment we live in, I think that that's quite a valuable added tool in our toolbox. I think one of the great things again about Mediterranean's, and we were talking about the fact that it's not just about the fact that they eat lots of salami and ham, It's like what else do they eat as well.

And at school, they have frisais lettuce, they have iceberg lettuce, they have rocket, they have, they are given a different type of cheese every day. The mayor of the village will oversee the school's weekly recipes that are making sure that they're getting a full varied. I mean, it is unbelievable what French school kids are exposed. to in terms of variety of food, all home cooked, all incredibly healthy. But it's this idea that you have cheese every day and it's a different type of sometimes uber smelly, sometimes really kind of quite simple or a goat's cheese or something like that. I mean, amazing. So I agree with you what you're saying about that, but also the thing that I love about the French, being half French, spending kind of half my life there, is that meal times are a time of family.

and it goes on for hours. And I mean, here, I know that everybody's running everywhere all the time. We've forgotten. I mean, I'm saying this really kind of about myself that hearing you talking about eating slower, I think, gosh, we must kind of try and remember to properly sit down. All phones under table, you know, let's talk and take our time over this.

I think the way that we used to eat has been lost for many, many people. And so that whole kind of social connection that we used to have over food has been lost. And, you know, people eating while looking at their phone, people eating while on Zoom calls, people eating while they're working.

I do that nearly every lunchtime. I know I shouldn't do it. Unfortunately, I do. We know that if you're eating food while on your phone or whilst watching TIEM to you, that you tend to eat more of that food and you tend to eat it more quickly because you're distracted, you're not listening to your fullness, hunger signals. You're not kind of, you know,

you're kind of warfing it in maybe. And I think it's one of the many, many examples of how we could go back a little bit to how we used to eat as well as how we used to live. But the reality is now, in their last 20 years, 30% more women are in the workplace. So 30% more women who were the ones traditionally doing the home-cooked meals, sitting with their children, having the longer meals maybe when the husband was still at work. It's all changed. And we have to find a way to move with the times. I mean, I think this is, this is a brilliant thing and a problem. Yes. You know, it's great that 30% more of us are in the workplace. I love working. I really enjoy it. But often the last thing I want to do when I come in is cook. But,

what I have found, and I mean, I guess I'm saying this in case anybody listening, you know, this might be an idea for them, is that actually if we say we're going to cook together, it then becomes quite a fun thing, what shall we make? And, you know, I do one bit, Michael do another, and it's a thing that we can do together as part of our debrief for the day. And that's quite nice, you know, make together, clean up together. kind of it becomes sort of a pleasure rather than a chore, one person doing it for someone else.

You know, you're alone in the kitchen, they're watching telly, it's not as much fun. I know that's not possible for everybody because not everybody has a set up like that. But I think finding ways that work with your setup, your family is important. So I would like to move on to this amazing bit of research that you've done recently because obviously in the menopause, we have this massive range of symptoms and we have been told so much recently that the gut brain access is so important

and what we eat has such a massive effect. But you've actually found some solid, really good research evidence, evidential research? What would you say? Evidence. Research evidence. Research evidence. You found some great research evidence. We got some good evidence.

We've got some good ones around. Around symptoms and the menopause. Can you just talk us through that? Yep. So we've done a big program of research where we've looked at the number of symptoms that women have who are peri or postmenopausal. I mean, there are a lot.

It's huge. Up to 60, I think, now we've got two. So, yeah, we're monitoring 20 symptoms. But yeah, there's like 50, 60 symptoms that people are reporting. but we've been monitoring the core 20 symptoms. And so we've been looking at how many symptoms they have and the severity of the symptoms. And I mean, it's the prevalence is huge.

So we see and the prevalence for symptoms that people don't typically think of as being traditional menopause symptoms. So tell us a few of those. So we see that about 80% of women have sleep disturbances. I think that's reasonably well known. Similar percentage. So 80% of people are,

people have brain fog, have anxiety, have memory loss, have all of these other kind of neurological, you know, the irritability, etc., that goes with it. We have loss of libido. I know that's talked about a lot in, I think it's about 70%. The traditional symptoms like the night sweats or the hot flashes, we see in about 50%. So it's really interesting. It's these kind of non-traditional ones. But they're the ones that are really impactful.

10% of women actually leave their jobs because of the symptoms. And what I was really shocked by, and I did have to double check the analysis, I'm such a skeptic, I'm always like, right, we need to check that. I don't believe it. We found that 99% of people had at least one symptom. This is an alperian postmenopausal group. That's interesting because we're sort of led to believe that 25% of women sail through it. But actually what they might not realize is that they're sailing through it,

but they have got a few symptoms. You know, that it's not enough to bother them, but they are symptomatic. And I think it's a case of recognising nearly everyone will have some kind of symptom. Some people, the 10% that's so severe they leave their job, 50% of people will say it's actually really bothersome. And 25% of people say it's severe enough to actually impact their quality of life. And so as well as looking at how many symptoms people had in the severity of the symptoms and how it impacted their quality of life, we also looked at, okay,

how does it differ depending on? whether you're on HRT, how does it differ depending on what kind of diet you have? And I think that, you know, we're all, as you know, better than everyone, very focused on the benefits of HRT. And we know, I think there's, you know, incredible evidence to show the benefits of HRT in reducing your symptoms, as well as reducing some of the health effects. And I think it's important we recognize that with menopause and our research has shown this as well, it's not just the symptoms of the problem, it's the health effects,

the increase in blood pressure you get, the increase in bad cholesterol, the increase in inflammation and so forth. So yes, we see a significant reduction in symptoms. We still see lots of people are still having symptoms despite the HRT. Now, that could be a whole other topic of conversation about how well controlled they are on whatever regime they're on. But what's most surprising from this body of research that we did is the power of diet. Now, this is where I was a real skeptic. So having been in nutrition research for 25 years, obviously, I think diet's quite important. But I was like, look, as long as you take HR to eat, then that's it.

But actually what we found was people following the ZOVI program, which is basically healthy eating dietary advice. We found that if you looked at them at the beginning and then at the end and then looked at how large their change was in diet, there was a relationship between their change in diet and reduction symptoms that they're reporting. So that on average, as people improve their diet, they reduce their symptoms by about 35%.

Every time you say it. I've heard you say this before now. And I can't, 35% is enormous. But do you know what to be in there as well? Which I think is fabulous is when we looked at those taking HRT or not taking HRT, we saw a similar percent reduction. Although those taking HRT are coming from a lower threshold, we still saw about, yeah, it was around 35, I think it was 34 or something, but similar.

So I think the message from this is everyone will benefit. Everyone will benefit from following an overall healthy diet. Now, obviously being the boring scientists, I do have to caveat this, there's no silver bullet. No. Can you give me the kind of headline changes that me as a menopausal woman could make to help me? Yeah. So I can give you the headline and then I can give you a few kind of extra pointers.

Great. So headline is back to veils. basics, there's no silver bullet. I'm afraid it's the simple, boring message of less of their heavily processed foods, more of the plant, whole foods, so the whole almonds, for example, more of a diversity of foods. So making sure, like you were talking about in the French schools, they have a real mix, getting a real diversity of foods so that you're getting a diversity of different kinds of micronutrients and phytochemicals, making sure you're getting plenty of fibre, making sure you're minimizing that.

kind of processed or meat, the refined carbohydrates in particular as well, adding some fermented food to your diet. So, for example, cheese, yogurt, doesn't have to be anything kind of posh. Fants, yeah. I mean, because people, I know, people go, kimchi, oh, God. You know, kefir, like all of that kind of stuff. I like that. Yeah.

Well, Tim made me. Tim Specter. He's not converted me, yeah. Tim Specter made me change to kefir. Oh, no, I don't mind caffeine. I quite like it. No, I don't mind caffeine. quite like that. A tiny bit of honey or mix it with your piece yogurt. Yes, I had it this morning.

On my, on my, on my, um, the sourcrow. I'm not there yet. I'm not there with sourcrow. I don't know if I ever will be. Yeah. I'm not sure if I ever will be. But a really mega, mega change that I've made. And I'm, and I, I would like to implore all places where you can buy soft drinks, any venues where you can buy soft drinks. Please, will you give me as a non-alcoholic drinker. You know, I'm a teetotaler, and I have no choice but to go with either a diet soda or a soda of any of the famous brands. They never put anything else on unless it is a non-alcoholic cocktail, and we know that that is made with syrups after syrup. I don't want to have, that's the point. And kombucha can't be that hard to have on a, on a menu now. And I love kombuchas.

There's more places serving it, but I think it's, but not, once you go outside London, I think it's less. Well, I think outside of London, almost nowhere. Yeah. So that's a plea that I'm making. But anyway, so yes. So it's going back to those basic healthy eating principles. So plenty of fibre, plenty of palm-based foods, a variety of different foods,

minimising odd processed, high sugar, refined carbohydrates. I mean, refined carbohydrates is a big one as well. Because I think that that is just something where you've just got to get used to it. and can I ask you, whole wheat toast, is that better than sourdough? sourdough is such a bath bread at the moment. And I just want to know, is it as good as we think it is? So I think it depends what you're having it for. Yeah.

So I always go back to what you enjoy the most. Sourdough. Okay. So then have sourdough. I think when you're talking about two kinds of food that there's probably only marginal differences in their health outcomes. That's where you've got to just choose what you prefer the most. There has been no studies comparing that I'm aware of whole wheat and sourdough.

Okay. We do know that sourdough because it has, you know, is a kind of probiotic. So we know that, okay, it might be better for your gut microbiome. But in terms of other health outcomes, I don't know. Okay. Good. Yay. And what are the other, you said, okay, that's the broad brush stroke,

but what are the other kind of little tips that you can get? So there's other tips that relate a little bit to how we eat because, like I said earlier, you know, I think we've got to stop just thinking about what we need to think about how we eat. So we've got some amazing research that's just coming out, actually, where we looked at the time of day effect in pre versus postmenopause or women. So by this, I mean that we know that if you eat your carbohydrates in the morning, on average, you have a lower blood sugar response than if you eat them in the afternoon on average. My God, that's really interesting.

But then what we did is we did some analysis of ours, Zoe Predictator, and we looked at people who were premenopausal and postmenopausal. And what we found was if you were a postmenopausal or perimenopausal woman, the time of day effect was more pronounced. So what that meant was is that you had an even bigger impact from eating your carbohydrates later in the day than in the morning. So the take-home message from that could be, if you want to have your cake, fine.

If you want a cup of tea and cake. 11 o'clock. Have it 11. That's amazing. That is amazing. It's little things like that. It's not saying don't have your cake. That's so interesting.

The other piece of research, again, this is related to blood glucose responses is when you have a carbohydrate rich meal, what we know is lots of people have a dip in their blood glucose. So about two to four hours after you have, if it's a very refined carbohydrate, we know about 30% of people have quite a big dip in their blood glucose. So you might find that some people talk about being hungry or getting a bit of brain fog. I get that sometimes. Yeah, about, and for many people, for me, it's when I'm walking home from school with the kids. And so it'll be about two or three hours after I've had my lunch. Right. Oh, I'm very hungry.

It's not just because they're being naughty on the way home. No. Because, and I know now having worn a glucose monitors because I am a dipper, as we call them. And what we know is if you're a dipper, not only do you feel a bit rubbish, like hungry, but also people who are different. have as well as less energy, less alertness. They have a bigger drive for hunger, join that time because of different hormone responses. And they will go on to eat about 100 calories more at their next meal

and about 300 calories more over the day. Now, when menopause comes into this, as we know from our own analysis, is that postmenopausal and perimenopausal women have a slightly bigger dip than premenopausal women. So therefore, they might be a bit more susceptible. So it's, again, another kind of reminder of try and reduce, I'm not saying eliminate, try and reduce that refined carbohydrate,

or try and make sure you're adding healthy protein and healthy fat into your carbohydrate meal so that you're minimizing the chances of having those dips. How big a difference is it between a refined carbohydrate and an unrefined carbohydrate? Because we're talking about white pasta, white bread, white. When I go out to a restaurant, I don't think I've ever been to a restaurant that serves whole wheat pasta ever. So I think that it does make some difference, not a huge difference. I think where you get the biggest difference is what else you're adding into the meal. And this is why I love taking the approach and we do this at Zoe is about, okay, what can you add in to make it healthier rather than, oh my God, I can't eat this and I can't eat that.

So if you were to have, let's say, some white rice, what can you add in to make it healthy? You can add in healthy oils, healthy proteins, more fibre. And then that will have a big impact. Something that I do want to say, though, Davino, is if ever I talk about blood sugar responses, it's so important. important to say their normal physiological response. Yes, it's normal. I don't want people to get over-focused with this obsession. It's a normal physiological response.

It's just if it's excessive and repeated, you can feel a bit rubbish, you might eat more, and there is some evidence that it's, if it's, you know, very excessive, repeated over long periods of time linked to later cardiovascular disease. One final thing I'd really like to talk to you about, because I love it when you say the word nutri-bolics, so I'm going to get you to say that today, but is, about something that we in the kind of menopause world have started calling mena washing, which actually makes me so angry.

So can we just discuss what is mena washing? So meno washing, from my interpretation, is putting the word meno in front of something and then charging double the price. Yeah, I mean, I'm surprised we haven't got meno t-shirts, Meno watches. Well, there's Meno face cream. There's Meno face cream.

There's menno hair. That makes no difference. We know menopause impacts our skin. We know menopause impacts our hair. But unless I... No, Michael says there is absolutely nothing that you can do to your hair that will change it. You could put a bit of conditioner on it,

but it's not a special ingredient. I do not understand the link between... And like this whole idea of a meno cream, face cream. Yes, your skin's going to change. So have, if it's drier, then have a... more richer moisturiser, but do you need meno in front of it and paying three times? Same with supplements. The supplement industry is like menno washing or neutrobolics.

Neutral bollocks. Everywhere. It's like crazy. You go into health stores and it's just like meadow this, meno that. And I mean, I often, the thing I think that's upsetting is that it's often more expensive. Oh, it's always more expensive. And look sure you might, what I don't like is when someone sort of tries to set up a problem for a menopausal woman and then solve it with some meno thing.

That upsets me because we're vulnerable and we're often a bit lost and we feel invisible and then sometimes we feel that these companies are talking to us and looking after us and loving us in some way. I would quite like to run three things past you that I do take. Yep. Vitamin D in the winter, good or bad? Good. Okay. And that's quite good for bones.

and I'm not quite sure, but I've read up on it, and I can't remember because I'm menopausal, but D3. Yes, so we know that in the summer, you don't really need it. You get enough from the sunlight. This summer. Yeah, it'll still get enough. But in the UK, in the winter, your stores,

so it's a fat, solid vitamins, it's stored in your liver, but by a certain period of time, by October November, I think it's beneficial to have. a supplement. Magnesium? I personally wouldn't take a separate magnesium supplement. Personally, if I was going to take a supplement. Do I get it from food? Well, obviously, we should always try and get it from food. Gosh, all of these micronutrients are in so many foods. So, I mean, walnuts is a great source, for example. I love walnuts. Different nuts. All plant-based foods are rich in this. And, you know, things like eggs as well. I never talk about eggs actually. When I do potts. Eggs are super food.

They eggs, not superfood. Yeah. I mean, obviously, you don't want to be having 10 eggs a day because it will reach a point in which it affects your cholesterol. But this myth that eggs affect your cholesterol because it's cholesterol rich is, again, another neutral bloc's as long as you're having, you know, eggs not to excess. But magnesium is found in so many different foods. Same with zinc, same with like so many of these other micronutrons. I think taking box standard supermarket, multivitamin and minimal is all most people need to do. I think that going for these...

And you do think that might be a good idea? So I think that in an ideal world... Sorry, I don't mean to put you on a... No, it's fine. In an ideal world, we want everyone to get everything from their diet and everyone should be able to get everything from their diet. I think that I would not say to everyone, yes, you must go out and buy multivitamins.

I think as an insurance policy, there is potentially a benefit and there's certainly no harm if it's one of these bog standards. Where I worry is people doing these megatimates, mega doses. I know. Which is like a thousand times you're recommended daily intake

or spending lots of money. We shop at standard retailers, you know, high street retailers. I have in my cupboard standard multibitamin and mineral. When I remember I take it, when I remember I might give the kids one here and there.

It's my little insurance policy because I live a busy life. I know I don't have the diet that I should have. There's actually very little nutrient deficiency in the UK. Right. And so I think for most people, they don't need to worry about it. When it comes to, you need to tell me your third one, actually.

You told me two. Magnesium. Is that something that goes with, they said it goes with magnesium? I don't know. Okay. I've never heard of that. I'm going to, I mean, this is something, this is a problem, right? We get served this stuff.

Yeah. Like it is a problem and we're deficient in it. And then we end up looking at it and we think, oh, it does really good things for me. but I'm probably getting enough of it already. I think most people are. I think that's why if you want to take one, just take the standard supermarket ones that have your just have a low level amount. Because if you're getting too much of it.

Yeah. And if you're getting enough of it from your diet, then you don't want to megadose. And sometimes it's bad for you to megadose. It actually can be dangerous for your health. Yeah. So, you know, if you take one of these megadose vitamin C ones, I don't know if they've noticed in your wee.

It probably looks bright, yellow or orange. Have you ever seen that after? I don't really take vitamin C because I feel like I get a lot of fruit. I feel like I get loads. But sometimes if I haven't drunk enough the day before, when I wake up in the morning, I think, oh my God, I definitely need to get some water. But if you take, vitamin C is a great example. You actually will see, if you hours later, you'll whir it out.

Now to weed it out, your kidneys have had to process that. So you're just putting extra burden on the body. I think when it comes to the whole mena-washing of nutritional supplements, I think this is where we have a big problem that there isn't enough evidence yet. There are actually lots and lots of small trials that show that, oh, there might be a benefit here, or there might be a benefit there. But actually, as many trials show that there is a benefit for a particular supplement, the same number show that there isn't a benefit.

And there's only one supplement that I would suggest that people might want to try that there is reasonable evidence for. And this is soy isoflavones. So isoflavones are what we call a phytochemical. So they're not strictly speaking a nutrient. So they're a chemical found in lots of plant-based foods, but in very high concentration in soy products. And they can also be bought as a supplement.

And isoflavones are a chemical that has the same structure as esterative. And so they actually bind to your estrogen receptors in your body. And your body thinks, well, that's some estrogen bind into my receptors, stimulates a receptor and it does whatever the normal job that that cell was meant to do. Even there was estrogen there. And so what we know is if you supplement women with estrogen, that there is evidence to show there's deduction in some of the symptoms. Now, sorry, supplement, did I say estrogen?

Okay. So what we know is if you supplement women with is. of flavones. Oh, right. Yeah. There is a reduction in some symptoms. We know, though, that the bulk of the evidence shows there's a particularly active part of the isoflavone.

And so if people are wanting to go and get isoflavone supplements, what they should be trying to do is look at the back of pack labelling and looking to check it's got a chemical called genestine and that it's got about 15 milligrams per day in the capsule. I think I know we've discussed this before. But I think it's really important because there's lots of eyes of flavour and supplements that are below that threshold. And I don't think the evidence doesn't support them having enough. But if it's got more than 50 milligrams of genusine, then I think there's good evidence to show for the majority of people that will have an impact. It will be different between people.

And this again is where it's that whole fascinating area of variability. So some people have particular microbes in their gut that digest or proverbs. process the isoflavones so that they become like super active. And some people don't have these or have very low levels of these so they don't become very active. And so if we know that if you supplement people who've got these bugs, they have a 75% greater reduction symptoms and supplementing people who don't have these bugs. So it's an example of go try it, make sure it's got 50 milligrams, but be mindful that

depending on your gut microbiome, you know, your friend might buy it and say, wow, this is great, you might only see a small effect. We're all different. Exactly. I mean, we could make everybody literally stay here all night and carry on. I think I've waffled long enough. I've learned so much.

I can't believe every time I see you, I learn something. You might love it. Thank you. But it's been lovely getting to know you a bit better. Thank you very much, Sarah. I appreciate it. Love having such a nice chat about all my favorite things. Thank you. Pleasure.