Feel Better, Live More with Dr Rangan Chatterjee - #269 Dr Rupy Aujla on How To Eat Your Way To Better Health

Episode Date: May 10, 2022

Do you believe that food can be medicine? Most of us would agree that a healthy diet – whatever that means to the individual – is vital to our wellbeing. But can the right foods actually prevent and even cure illness? I know what I think, and my guest today not only agrees, he provides living proof! Dr Rupy Aujla was just 24 when he was diagnosed with atrial fibrillation, a heart condition rare in someone of that age. But it wasn’t Rupy’s years of medical training or even his consultant’s advice that turned his life around. It was only when he listened to his mother, looked to his diet, and transformed his eating that he was able to defy medical expectations and reverse his condition. This experience led Rupy to do a deep dive into how this ‘impossible’ feat was achieved and in this conversation, he shares some of the explanations he’s uncovered, including a reduction in inflammation and an improvement in the health of his gut.  Back in 2015, he founded The Doctor’s Kitchen, a movement to inspire and educate people about nutritional medicine and help them eat well every day. He not only shares recipes but also explains the clinical research behind them and how they can help you with your health. And he does this via his bestselling books, podcasts and social media posts. Recently, Rupy has taken the decision to pause his NHS career and focus on making healthy eating more accessible by launching the Doctor’s Kitchen app, which is set to become a must-have resource for finding research-backed recipes tailored to your personal likes and health goals. It is available now on the App store. Rupy is a great friend and our lives have followed a similar path in many ways. We talk in-depth about the concept of food as medicine, as well as the polarising nature of discussions around diet. We also consider identity when it comes to career choice, and what it really means to be a doctor in the modern world. If you can help hundreds of thousands of people live better through your public platforms, is that any less meaningful than helping patients in a surgery or hospital each day? There’s lots to think about in this conversation and I hope you enjoy listening as much as we enjoyed chatting. Thanks to our sponsors: https://www.athleticgreens.com/livemore https://www.leafyard.com/livemore https://www.vivobarefoot.com/livemore Order Dr Chatterjee's new book Happy Mind, Happy Life: UK version: https://amzn.to/304opgJ, US & Canada version: https://amzn.to/3DRxjgp Show notes available at https://drchatterjee.com/269 DISCLAIMER: The content in the podcast and on this webpage is not intended to constitute or be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your doctor or qualified health care provider with any questions you have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have heard on the podcast or on my website.

If you just look at the stats, one in five deaths globally diet related. The WHO, all these huge institutions are all recognising the impact that diet is having. It can have conversely the positive impact as well. I'm an example of how that can be in an extreme way. Hi, my name is Rangan Chatterji. Welcome to Feel Better, Live More. Do you believe that food can be medicine? I think most of us would agree that a healthy diet, whatever that means to each individual, is vital to our well-being. But can the right foods actually prevent and even cure illness? Well, I know what I think, and my guest today not only agrees, he provides living proof. Dr.

Ruby Ordula was just 24 when he was diagnosed with a heart condition called atrial fibrillation. Now, it wasn't Ruby's years of medical training or even his consultant's advice that turned his life around. It was only when he listened to his mother, looked to his lifestyle and transformed his diet that he was able to defy medical expectations and completely reverse his condition. This led Rupi to do a deep dive into how this impossible feat was achieved and in our conversation he shares some of the explanations he's uncovered, including a reduction in inflammation and an improvement in the health of his gut.

Following this experience, back in 2015, he founded The Doctor's Kitchen, a movement to inspire and educate people about nutritional medicine and help them eat well every day. He not only shares recipes, but also explains the clinical research behind them and how they can help you with your health. And he does this via his best-selling books, his podcast, his social media posts. And recently, Rupi has taken the decision to pause his NHS career and focus on making healthy eating more accessible to more people by launching the Doctor's Kitchen app, which is set to become a must-have resource for finding research-backed recipes tailored to your personal likes and health goals. Now, in our conversation, he tells me how

this app came about and how he hopes it can evolve to help people from all walks of life. You can think of it as the headspace for healthy eating. Now at the moment, his new app is only available on the app store. To check it out, just type in The Doctor's Kitchen. Or to find out more, you can go to his brilliant website, thedoctorskitchen.com. Now Rupi is a really good friend of mine and our lives have followed a similar path in so many ways. We talk in depth about the concepts of food as medicine as well as the polarizing nature of discussions around diet. We also consider identity when it comes to career choice and what it really means to be a doctor in the modern world. If you can help hundreds of thousands of

people live better through your public platforms, is that any less meaningful than helping patients in a surgery or hospital each day? There's a lot to think about in this conversation, and I hope you enjoy listening as much as we enjoy chatting. And now, my conversation with my good friend, Dr. Rupi Bordula. I was looking at the podcast app this morning, and I think you were last on the show four years ago, episode number four. Things have changed quite a lot since then, haven't they? They've changed hugely, mate. For this podcast, it's insane to see how it's changed that much.

It's massive, mate. Congrats. Yeah, I mean, I love doing it. But I guess both of us, we probably changed a lot in the last four years, right? Yeah. I don't think you're the same person I was chatting to then. Or are you? I don't think you're the same person I was chatting to then. Or are you? Well, I don't know. It's interesting.

I was thinking about that on the way up here. The last time I was here was about five years ago. I'm 37 now. I would have been 32 then. I wasn't in a long-term relationship. I've got those extra clinical years under my belt. We've had the privilege of speaking to millions of people via the podcast and interacting with them through the books, through the newsletter, all that kind of stuff.

So it's definitely grown my appreciation for what people struggle with and how we can help them as well. And, yeah, it's been quite a journey for both of us and it's it's nice to have someone to experience this yeah with you do you know what i mean like i know we haven't seen each other in person for about two years now because of obviously what's happened but just seeing you and and seeing what you're up to is this it just feels like you know you've got a brother in arms yeah i, I agree, mate. And, you know, we were meant to start recording about an hour ago, but we've just been chatting in my kitchen and catching up.

And it's like, well, let's catch up on the mic because there's so much to talk about. Where I thought we could start this conversation is talking about food. We're both really passionate about the healing power of food and what it can do for a whole variety of different conditions but i think what happened to you in your early 20s really shows just how powerful food can be so i wonder if you could take us through what happened how old were you you know what were the health problems that you were struggling with yeah and how did you sort of go ahead and deal with them yeah absolutely um i think it's funny isn't it that a lot of us who are in this sort of industry have had to experience some adversity whether it's personal whether it's right a family member

to get us to that point of appreciating the wider aspects of lifestyle medicine and its impact on on our health and our mental well-being and our happiness actually my story starts earlier i don't know if i've i've told you about this uh properly before but when i was 11 my mum used to suffer from anaphylaxis and it was idiopathic. So fancy word for saying we don't know why you have anaphylaxis. And just for the listeners, anaphylaxis is the worst form of allergy where you lose your blood pressure. You can go into shock. And my mum would have these attacks of anaphylaxis without any triggers. She saw some of the best immunologists. She saw some incredible people. And she was basically told to be on medications lifelong and to have an EpiPen, so adrenaline, any suggestion that she was going to go into one of these anaphylactic episodes.

And when I was 11, she took me into the lounge and she said, She took me into the lounge and she said, Rupi, mommy needs to have an injection. Here is the pen. She took it off for me and gave it to my hand. She needs to inject this into my thigh right now. And I remember as a kid, I was shaking. I was like, oh my God, what's happened to mom? And I remember pushing down it was through her clothing and i heard this click of an epi pen if anyone's used an epi pen before you'll know

exactly what i mean and i had this click and then she feigned rubbing her thigh you know oh you did really well did really well and then she turned to me and she said that was a test yeah this is a this is a dummy epi pen mommy needs sometimes, and sometimes mummy won't be able to tell you when I need said medication. And that was sort of some of my inspiration as to why I became a doctor in the first place. But the other element of that story is that she actually was able to reverse her own condition using Ayurvedic principles, traditional medicine principles. She essentially put herself in what we would call an elimination diet now. I remember she would just have brown rice and spinach whilst we were having all the other wonderful things that she would cook for us.

She was an amazing cook. She was running her own business at the time. She started doing a lot more yoga and meditation. She started engaging with holistic practitioners, Ayurvedic practitioners. started engaging with holistic practitioners, Ayurvedic practitioners. You know, that was another inspiration of mine behind going into medicine and actually finding a bit more about how the body works, how is this possible, as well as that deep appreciation for the medicine that brought her back to life. But I quickly forgot that when I went to med school and now you know like going to med school conventional practice you're taught some incredible stuff pathophysiology the anatomy of

the body how everything works and unfortunately because of the lack of appreciation of nutrition and lifestyle at med school i didn't really come to realize the power of food until I got ill myself. So this is where the story starts again in my twenties. So when I was, when I was 24, I started working at a busy district general hospital, amazing place. I loved working at Basildon hospital and I was three months into a busy junior doctor life this is back in like 2009 now you know night shifts ward rounds um eating sandwiches on the go uh eating in the middle of the night the stresses of learning all this stuff from you know critical medicine and all the rest of it and uh i started having palpitations. And I remember vividly the first time I had it,

I was sat at the nurse's station, casually writing in my notes. And I could feel nauseous and my heart beating through my shirt. I could almost see it jittering on my chest. And I turned to my registrar and I was like, look, I feel my heart's going a little bit faster. Would you mind feeling my pulse? And literally within five minutes, bleep taken off me, hooked up to a cardiac monitor and the ECG showed barn door atrial fibrillation. So I was in AF, which is an irregular heart rhythm where your heart beats are regularly. And in my case, very, very fast, like 200 beats per minute. And that was my first experience of being a patient myself. Up to that point, I think if I'm being honest with myself, I had that sort of a steer of authority, like I'm a junior doctor, I've got this stethoscope, I'm charging up and down the

ward, speaking to patients, really leaning into that idea of like a doctor, that sort of the identity that was, and that was quickly stripped away from me. In an instant, I was in a patient hospital gown. I was hooked up to a cardiac monitor. I was being, this is a memory that I have, being wheeled down the corridor, everyone else minding their own business. But for me, that was so embarrassing. That was so embarrassing. Seeing all those people walk past me and me being

in hospital gown when moments before I was in the corridor, probably attending to patients that I'd been seeing. Do you know what I mean? And- 24 at the time? Yeah, I was 24. 24. Unusual, very rare. And in good health until then, would you say? You would say that.

Generally good health. As in no kind of diagnosis or pre-existing condition that anyone knew about. Exactly, yeah. So nothing in my family to suggest that I would have any cardiac problems. I wasn't overweight. I didn't have any blood work issues. I'd never, you know, had any, I wasn have any cardiac problems. I wasn't overweight. I didn't have any blood work issues. I'd never had any, I wasn't even drinking caffeine at the time. There was nothing in my personal medical history that would have predisposed me to having this issue. And that

was the start of my journey as a patient. Luckily, I didn't need a cardioversion i i left uh the hospital the next day going back to work a few days later actually with some medications and antiarrhythmic pill in the pocket we call it flaconide and were you scared i was definitely scared the the moment uh my parents came to see me actually when i was in the cardiac assessment unit and they came through, they peeked through the curtains. And my mum was putting on a brave face. But when she saw the cardiac monitor and she saw the wires and all the rest of it, I could see that she was a bit freaked out. And that honestly made me a bit scared as well, even though I was a doctor, I knew what was going on. But that was scary.

And what was scary was the lack of control because this wasn't a one-off episode as I came to find out. I thought it might be a one-off, you know, maybe I didn't have enough water that day. Maybe I was a bit stressed. Maybe I hadn't slept properly. There's a whole bunch of reasons as to why someone might flip into atrial fibrillation as a one-off but then it would happen again and again two to three times a week lasting anywhere between 12 and 36 hours 200 beats per minute you know it was a chronic issue that was seemingly getting worse and and the first time it happened it happens you're in the hospital did some of the time it happened when it happens you're in the hospital.

Did some of the time it happened when you're trying to relax at home or you're out with your friends? And what are you experiencing at that time? Yes, you can feel your heart beating, but is it hard to take a breath? I mean, just paint a picture of what that's like. Yeah, absolutely. I would love to have said that it was a triggering event, have said that it was a triggering event, whether it was stress at home or hospital. But honestly, I could be going to play tennis and just about getting my racket out of the bag, and then I'd flip into AF. That was incredibly frustrating. Sometimes I'd be having dinner and I would just flip into AF. There was no seeming pattern of why I was having these issues. And when I was having that, it was nausea. It was a bit of sweatiness. It was an uncomfortable feeling that I'm about to faint.

It almost felt like a bit of a panic attack. And there's probably some stresses involved in that as well that lead you to that sort of impending doom. But this was a a real physical symptom i caught multiple times on ecgs because there was a suggestion from a different number of different cardiologists i saw at the time i saw a whole bunch about whether what type of uh arrhythmia this was was it a re-entry pathway was it bond or atrial fibrillation was it flutter you know but we we found out after doing some electrophysiology studies which is where you put a guard right into the heart and you look at

the electrical impulses and seeing where they're coming from that this was definitely atrial fibrillation but it was it was almost the um it was not knowing when it was going to happen as well that was really frustrating and in a way it mimicked a lot of what my mum went through yeah when when i was younger because she had to live with going to a store and not knowing whether she would ultimately need to use her epi pen or call for help or call an ambulance that like a control i mean you know whether it's with your case or your mom's case or if i think about just any number of patients when when there is that lack of that that that there's no sense of control over when this may or may not happen it's very disempowering even the

idea and we'll get to this later, this idea, I've always felt strongly that I have to be able to empower a patient in front of me in some way that they feel they've got some degree of agency over what happens to them, because without that, it's really challenging. So you get this in your early twenties, you know, the, I guess, prime of your life, you're disqualified, you want to go out and actually learn the skills and, you know, make your way in the world. And something holds you you back you have atrial fibrillation you have this irregular heartbeat so you've seen the cardiologists what happens where you know you obviously had some pills that you could take if you ever go into atrial fibrillation you can take the pill to help you

but you know what happened because there's a very powerful story here in terms of how you empowered yourself made some changes I think advised by your mum tell us a little bit about what happened what the conventional medical profession advised that you do yeah what you ended up doing yeah and you know I think it tells a huge story as to where you are today absolutely yeah and I think it's important to say from the outset, either path would have been perfectly acceptable. I've had some close friends of mine actually, later on in their life, experience similar things to me. And they've gone down the conventional medical path, some with success, some not so. and some with success, some not so. But at the time I was offered something called an ablation,

which is where you burn an area, it sounds a bit awful, but you isolate an area around the pulmonary vein where you have these misfiring cells that cause atrial fibrillation, this irregular pattern of beating. And as a 24 year old with no preexisting issues, with no weight problems, nothing, I was a really good candidate for this. And this was being sold to me by a number of different senior colleagues, really esteemed people, some of the best cardiologists in the country, if not globally. I had my mum with no pre-existing medical qualifications, you know, very smart woman, analytical, runs her own business, you know, investment banker, has done a whole bunch of things. She was like, you really need to look at your diet and lifestyle before you allow someone to burn a hole in your heart, which is the exact way she described what the procedure is.

It's not as gory as it is, as she described it. And honestly, to appease her, I was like, okay, fine, I'll take six months. I'll delay this procedure for six months. I got the blessing of my cardiologist and said, look, you're going to need this procedure at some point. Take the medications in the meantime. If you want to do some weird, wonderful stuff with your diet fine but you're going to need to come back at some point and so i had nowhere to start really i mean my mum would suggest a few recipes and that kind of stuff and luckily i had instilled within me from an early medical student the the ability to cook my mum actually taught me how to cook before i went to med school. She taught me a couple of recipes. One of them was a Thai lemon grass curry. So I got this, a new identity when I was at university that, oh, this guy can cook. He can make this like wonderful curry. And

so to keep up this pretense, I would always learn new recipes and I'd be that experimental person, you know, in my house share. And I loved it. I absolutely loved getting into cooking and stuff. So I applied that knowledge of flavor building to healthier ingredients. And it was a very simple thing at the start. I would have cereal in the morning, I'd have a sandwich at lunch, and I would have pasta in the evenings. That was like my normal quote unquote diet. If you analyze that with a critical eye, it's a lot of refined sugars, there's lots of inflammatory fats in there. What I was having was most likely going to be on the go, so I probably was impacting my digestive system. You compound that with all the other insults that I was likely having on my

microbiota and my sleep and my stress levels, all these different things may have contributed to atrial fibrillation. It's still quite arguable. But to start off, I started really simply. Out went cereals in the morning, in came oats and nuts and seeds and leftovers from the night before. Very, very simple changes. And that catapulted into me bringing in Tupperware. And I got labelled Tupperware boy by my consultant. So you'd cook foods, whole food and bring it in.

Absolutely. Things like what, Do you remember? Yeah. Dark green leafy vegetables, bit of miso, some pumpkin seeds. It wasn't really recipes. It was like non-recipe recipes. It was just whatever I thought looked healthy. And whenever I did a little bit of research and I was like, oh yeah, this is meant to be better for me. You know, we didn't have any nutrition training back then.

So just from what you had picked up from society or your mum or, I don't know, magazines. Yeah, yeah, yeah. Essentially, yeah, yeah. Like, oh, I think this is healthy, healthier. Let me focus more on these sorts of foods. Absolutely, yeah. I didn't have a grounding in nutritional medicine at that point in time to really give me the blueprint or the guiding principles behind what I should be eating. It was sort of a bit of intuition. It was, how do I feel after I eat this? Do I feel sluggish

like I would having that pasta bake at the hospital? Or should I add a little bit of greenery in there? Would I look at some recipes and try and add a side to it, yeah, absolutely. I would do sides of whatever was seasonal, some root vegetables. Again, nuts and seeds, quality fats always kept on coming up for me because it added crunch and texture and taste. It's really interesting to me. Your mum says, before you burn a hole in your heart, why don't you think about changing your diet and lifestyle, which actually is a very reasonable thing to say. Actually, you can think about changing your diet and lifestyle which actually it's a very reasonable thing to say yeah and actually you can think about well as doctors as a profession why do we not say things like that more often about a whole variety of different things so we've got these medications

and treatments before we go down that route what would happen if you did six months off a change to your lifestyle? So you start changing your diet. And a couple of things that you said, one was, oh, how do I feel when I have this compared to the pasta bake from the hospital canteen? Right, so that's really interesting to me. Did you start to notice, because you were doing it for your heart, right? But what were those short-term things you started to feel immediately when you changed, you know, your food intake? And when did it dawn on you that actually this might be having an impact on this potentially more serious condition of this heart complaint, the atrial fibrillation?

Yeah, yeah, yeah. Definitely becoming more intuitive about how I felt afterwards was something that my mum taught me how to do. She was like, you know, just check in with yourself after you eat and just see, you know, if that, she was very, very vague about things. That was the thing I was, you know, coming from a medical background, I was quite analytical. I wanted to see results. I wanted to see the impact of it. And that answers your second question, because I was really fastidious at tracking when I had episodes, what I'd done before that, how long the episode was for, and how frequent said episodes were. So I had like a

whole notes file and all these different things. And after practicing some of these different dietary hacks, combined with some lifestyle ones as well actually because my mum actually taught me how to meditate when i was a teenager before my gcc exams so i had the knowledge of meditation that i started to practice at the same time as all these dietary impacts as well and all these dietary changes and so that combined with everything i think has definitely part of the story definitely you know paved the way as to how i feel today and how i feel about lifestyle medicine in general but what what i started to notice was that the time in between different episodes started increasing you know instead of it being two to

three times a week it would go once a week between these hot episodes between these episodes that would last you know 12 hours 36 hours or so and you could draw a correlation you could say wait a minute like this used to be three times a week now it's only once a week so it's not gone but it's getting better was that enough to keep you motivated that was a motor small motivating factor but then again i i spoke to one of the cardiologists that i was seeing at the time and i said look i've noticed this pattern and i didn't have the i didn't actually have the confidence to tell that person about what i was making what changes i was making myself actually yeah and i remember saying to us i'm noticing a pattern that it's it's not

as frequent and they kind of brushed it off you know they're like you know you can go through a period of quinescence i think they called it a time or uh because of course food and ice i'll have nothing to do with exactly yeah yeah and and to be fair to them i hadn't told them about the changes i was making but it was you know it wasn't like oh, interesting, let's monitor you for a little bit longer. Or maybe the medications are kicking in. Or maybe it's, you know, because of some of the other, you know. Were you taking medication during this time as well? Or was that, it was an as and when medication

that when you flip into atrial fibrillation, you take something, were you taking something to prevent it coming on? So initially for the first part of the treatment plan, I was on a beta blocker persistently i came off that very quickly it was within four weeks so i did not like the side effects a lot of people can experience depressive like symptoms uh they can have libido issues it can impact your sleep yeah there's a whole bunch of reasons as to why people come off beta blockers

even if it was a cardioselective beta blocker that I was on. And so I was left with flecainide. So like you said, an antiarrhythmic that is actually not very nice to take. You actually get a real sort of nauseous feeling for a number of hours after you take it. So it wasn't a perfect solution, but it was something that kept me from the impact of atrial fibrillation. I should probably point out the reason why atrial fibrillation is problematic is because when your blood is pumping in an irregular way, your blood becomes sticky. All those different particles are pushing and bumping into each other, which makes that blood sticky, which makes you more at risk of clots which is why atrial fibrillation

is associated with things like strokes and and even ischemic events in different parts of the body exactly yeah um and so that that was certainly something that crossed my mind at the time but i persisted with it and that little motivation around diet and lifestyle was like okay maybe I should just carry on and maybe I should compound this with yoga and flow and all these things that my mum was talking to me in the background you know what it's like with mums when they say you should do something you're like nah I don't know you kind of brush it off but she was very tactical about the way she would approach these things with me. She was like, oh, I heard this thing about yoga. It's really interesting, isn't it? Yeah.

Instead of, you should do this, you should try and practice this, you should, you know, instead of giving me rules around it, it was almost like a subtle suggestive hint about something that could improve how I was feeling. It's really interesting. I think the approach your mum has taken, I think we can all learn quite a lot from that. But what was that moment? So you've gone from three a week, you change your diet, you go off the beta blocker. So you're not actually taking anything unless you go into atrial fibrillation, but you're changing your diet, doing a bit of yoga, doing a bit of meditation.

You're noticing the frequency come down to one a week. Then what happens? Does it at some point, I don't know, does it at some point stop? Yeah, yeah. So I've still got the notes, actually, with all my ECGs and all the sort of clinic notes and stuff. And there's a moment where I have this realization. And I look and I'm like, it's been two months. And then it goes to three months.

With nothing. With nothing. And then it just carries on. I remember having that conversation again. And this time I spoke about diet and lifestyle. And again, I don't want to make it seem as if every cardiologist is dismissive of diet and lifestyle. And again, I don't want to make it seem as if every cardiologist is dismissive of diet and lifestyle. There are plenty out there, especially now,

that are coming around to this idea of just how powerful it can be. But at the time, it was just seen as, again, a period of time where it goes away, it will likely come back. It will likely stick around and we should still really push ahead with some of the more the interventions that are a little bit more aggressive and so that realization was was huge for me because at this point i'd done a bit more

research into i was looking at things like the microbiota inflammation pathways specific types of ingredients you know looking at it with like a more of an analytical mind and it actually changed my practice as well it changed what i wanted to do i was sort of hell-bent on being a surgeon when i started and then i moved into the idea of maybe i should do something like general practice where i can have conversations with people about other aspects of of yeah their diet and well-being as my experience of gp was when i was in f2 20 odd years ago so you have your first episodes at 24 do you remember when you had your last episode of atrial fibrillation where your heart was beating this fast? No.

I don't. That's so weird. I don't have a vivid memory of the last time. Because I guess it's like a lot of things. It's like when you've had bat cake for years and then you don't kind of remember. It's almost like, oh, I don't have it anymore. Yeah, yeah. All my life isn't being held back anymore by that thing.

Yeah. And so do you think that was within a year of it starting? Yeah, it was just over a year. Just over a year. So about a year or so since quite a scary thing happening at 24. And a condition, atrial fibrillation which people wouldn't naturally draw a link between diet and lifestyle i think what's so powerful about that for me is that when we talk about foods and its impact on our health i think for many years the

prevailing narrative in society and within our profession is, yeah, we can see a role with obesity and type 2 diabetes. There's kind of an obvious link there. But I don't think that link has been made for many years with other things, whether it's how fast we age, depression, gut problems, libido, electrical heart issues, psychiatric fibrillation. Do you know what I mean? I think that really speaks to this healing power of food and that you change your diet and your lifestyle and you no longer have atrial fibrillation. Yeah, absolutely. And I think it's that mismatch between how powerful diet can be for a collection of different issues that has plagued our thinking around diet and lifestyle in general. Like you eloquently demonstrated on your show,

the impact of diet and lifestyle beyond the traditional ways in which we view it, which is cardiovascular disease, reducing cholesterol and obesity. No one's really going to argue much with that. But when you're applying those same principles, which are very simple to mood, to chronic pain, to cognitive disorders, brain fog, all these issues, brain fog all these issues you you then see the links that it's it's all foundational so what i was doing in retrospect was building the resilience for my body to look after itself and that is something that i want to try andinterpreted as food as the pharmaceutical. One of the things I wrote about in my first book, actually, food is not a pill. It's not a symptom killer.

It's a way in which you can build a more resilient body and mind such that it can take care of itself and it sounds a bit out there but that's genuinely what i believe and what i can see from that research with all the training in nutritional medicine you've done since then all the studying you've done the three best-selling books the podcast you know the new app which we're going to talk about you've gone deep into the weeds of the science of nutrition and how it can help if you reflect back now what do you think was going on right what was going on that you were having heart problems scary heart problems right at such a young age what do you think changing your diet and lifestyle actually did? Have you thought about that? Have you got some ideas?

I've thought about it a lot. And it's really hard to pinpoint just one thing. And I don't think it is one thing. And we don't need to. Exactly. That's the model we get. What thing was it? Well, maybe it's a combination of everything. say, well, maybe it's a combination of everything. Yeah. And this is the thing that dogs, nutritional medicine in general, because we can't envisage a world where we can test multiple factors simultaneously. We can only really think about that randomized control trial model where you add an intervention, whether it be a supplement or a pharmaceutical to someone's regime, and then we observe an impact and we control using placebo and we take time to make sure we've got the right cohort, et cetera, et cetera. In my end of one case, it's likely going

to be a bunch of different things. So we can look at the microbiota, for example, the population of microbes that live in and around us all over our body, largely concentrated in the large intestine, foundational to our health, inseparable from wellbeing. We know now about what it can do to improve the lining of the gut, improving the functioning of our natural immune system, how it impacts with our mood, how it impacts on inflammation pathways, how it balances sugar. What I was doing by changing my diet very broadly without going to specifics from a pretty processed diet, if I look back on it and actually look at it with more of a critical eye, to something that was more whole food. And it doesn't need to be like raw food.

It wasn't anywhere near as well as I eat today, actually. It was just better than the norm. It was just better than the norm, exactly. That would have had a dramatic impact, as we can see now from research, on improving the functioning of those microbes. That include bacteria, fungi, viruses, nematodes, a whole selection of different microbes that we're learning a lot more about even today. And that shift can happen very quickly. I know in my case, it took quite a while before I

observed quite an impressive reversal of my condition. But even in some studies, as short as a few days, you can drastically change the population of your microbes. So me consistently eating well and changing it from processed to unprocessed would have definitely had an impact on multiple levels. So the gut microbiome is one thing that now with all the knowledge you've got reflects him back. It's like, well, I had more whole foods, less refined processed foods. So my gut health improves. And as my gut health improves, that can help a whole variety of different things in my body. Any other theories? Absolutely. Just taking a quick break to give a shout out to AG1, one of the sponsors of today's show. Now, if you're looking for something at this time of year to kickstart your health,

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and five free travel packs with their first order. But until the end of January, they are doubling the five free travel packs to 10. And these packs are perfect for keeping in your backpack, office or car. If you want to take advantage of this limited time offer, all you have to do is go to drinkag1.com forward slash live more. That's drinkag1.com forward slash live more. forward slash live more. By having a lot more greens in my diet, just general greens,

I mean, I was having whatever I could at that point in time. We know, looking at inflammation pathways, the impact that greens can have at a cellular level. So they have what we call a hormetic effect. So people see foods that we intake as having a direct anti-inflammatory effect, i.e. when I have turmeric, for example, that's going to reduce my inflammation levels. Actually, what's happening is that it is activating our endogenous anti-inflammatory pathways. So having a mild aggressor like turmeric actually does, it actually aggravates some of our cells.

We have a net benefit overall. I use the analogy of exercise. So when you exercise, you're actually shearing your muscles. You're creating quite a stressful event in your muscles and your physiology. It puts your blood pressure up, increased cortisol levels, increased sugar. If you looked at a snapshot, it doesn't look like a very healthy thing to be doing, but the net effect on that, on dementia, on mood, on cardiovascular disease, massive improvements. So at a similar level, that's kind of what we're doing with food as well.

So me having a collection of all these phytonutrient rich foods, so these plant chemical rich foods, was having that net benefit at an inflammation level in my cells as well. So that's definitely another element of it. So you've got the microbiota, you've got inflammation. about it, you've got inflammation. Something else that I think is harder to prove in my case was perhaps having a selection of different foods that were nutrient dense, that had more things like magnesium in, or selenium, or vitamin B12. What does nutrientense mean to you? So nutrient-dense to me means less processed, such that it contains a lot more of those bioavailable micronutrients. So things like vitamins and minerals, but also there's plant chemicals of which we know there are thousands.

Polyphenols come up quite a bit in things like berries and coffee and other anti-inflammatory chemicals that you find in greens like sulforaphane, indole-3-carbinol, all the indoles, all the glucosinolates. That for me is nutrient dense. And when you look at that processing pathway, the spectrum of processed versus unprocessed, the more refined your food, the less nutrient-dense it is because we're stripping away bit by bit all those different nutrients. It's incredible. You were describing there all kinds of benefits that you get from, let's say, greens. The way you were talking, it made me think that within these foods is a whole pharmacy of

medicinal compounds that are doing different things you know the way you know we let's talk about food as medicine yeah because well before we do what would your mum say if someone said to your mum is food medicine what do you think her answer would be she would be she would be the absolute champion of that statement. Yeah. Absolutely. Without a shadow of a doubt. And it's because, not because it's something that she has developed a belief for, it's because it's a reflection of her cultural heritage. This is something that we have known for millennia and we've chosen to ignore,

have known for millennia and we've chosen to ignore maybe not in in a negative light but certainly something that we've we've forgotten about yeah absolutely so your mum would day would so your mum would 100 say food is medicine i've got a view on this which i'm about to share um but this term food is medicine has become in some circles a bit divisive. And I don't really know about this divisive movement, or that I didn't really know much about that people were questioning that. But many of my followers have brought certain things to my attention say, hey, look, what do you think about this term you know a lot of people saying we shouldn't be using it you've been in the public eye for a number of years now promoting you know with your own story but also with your cookbooks and all your amazing content on social media you're helping people understand just how powerful other food can be do you consider it to be medicine i definitely do and the reason why

is because when i think about all the different things i do as a clinician and what constitutes medicine it would be naive of me to belittle medicine as the prescription of pills and the practice of interventions like surgery or minor ops or even the application of psychotherapies as that's medicine. By us having a conversation or by you having a conversation with someone or someone listening to this, it is medicinal in lots of ways. Absolutely. By me showing empathy to someone, by me describing how they can improve their sleep, this is medicine in its absolute form, in its purest form. But to drill down on why I think people have an issue with the term. I can understand that. I definitely recognize the controversy around the term food is, food as, food and medicine. I get that.

Can you explain it? Because to me, it's very clear that food is medicine. It doesn't mean other things are not medicine. It's like there's lots of things, as you say, exercise, sleep is medicine. Love is medicine. Listening carefully and attent, exercise, sleep is medicine. Love is medicine. Listening carefully and attentively to your patients is medicine. That's how I view it. So what do you think? Yeah, so explain where you think that there aspects of what we just described as medicine. I think that's where it becomes problematic, where it becomes food is an exclusive medicine.

This is what we should be focusing on and nothing else. That's just... I've not really seen that much though. Does anyone promote that? I mean, I personally haven't seen that, but I've certainly heard of that. And there was a really impactful case that I came across as a junior doctor. I was working in renal medicine. I know you specialize in renal. She was on dialysis and she had a form of cancer. I forget the exact type now. This is going back about eight years or so. And she'd completely taken herself off all medications at the advice of a healer who had suggested that all she needed to do was have the selection of foods.

And so I think those isolated, and I have to stress it, it's an isolated case where people take the food is medicine to the extreme. Yeah. That's where it becomes problematic. But what I think we're getting here is there is sometimes on social media a willing for misinterpretation to try and taint someone on social media. Yeah. Right? And I think we've both been on the receiving end of comments and that kind of stuff. So I think that's where it becomes an issue.

To further clarify what I think about in terms of food as medicine is we should look at it like a spectrum, right? The majority of what I think I can do by helping people eat well consistently every day is preventative medicine. And this is the biggest bucket of food as medicine for me is preventative medicine. We have a bunch of studies to show that if you improve one's diet, increasing whole grains, increasing plants, et cetera, et cetera, we can prevent a whole suite of different disease. There is another minority bucket where it's food as a supportive medicine, where it's alongside all the other things. And that can be alongside cancer therapies. It could be alongside psychotherapy, psychiatric therapies. It can be as part of recovery after having an elective procedure. Great, wonderful, supportive medicine, something that we don't utilize a lot in medicine today. And then in the minority of cases, food is literally the sole medicine that we utilize. And there are some cases, even like treatment refractory

childhood epilepsy, where we prescribe ketogenic diets that have some fantastic results in the isolated group of of pediatric patients where food has been remarkable yeah absolutely remarkable and so i think when we think when we try to get to the nuance of what we mean by food as medicine we and we we display it like that that spectrum like I've described. It's quite hard to argue against that. It is. It is nuanced. For me, you know, I spent a lot of time thinking about food medicine. Is food medicine? So to me it is.

And I've got to say to having used that term with many of my patients for years, I found it to be helpful. And I feel I've never had any feedback from my patients saying, actually, that term is quite confusing for me. I don't like it. So I'm biased by my own experience with tens of thousands of patients. But for me, there's like literal, cultural and philosophical reasons why I think food is medicine. Philosophically, I think we're living in an era now where about 80% to 90% of what we see as doctors is in some way related to our collective modern lifestyles. So therefore, if we don't give lifestyle and nutrition the same weight as pharmaceutical interventions,

I say the same weights, if we don't talk about them in that way, it's always going to be deemed as inferior. You know, the classic case, someone comes in to see their doctor with a new diagnosis of type 2 diabetes. Doctor spends the first nine minutes out of the 10 minutes talking about the blood results and metformin

and the fact that you're going to need more medications and you'll end up on insulin. And then as you're walking out the door, oh, and if you can just, you know, maybe go to the gym and change your diet a little bit, that may help. Well, what message does that patient get? It's like, yeah, there's diet and lifestyle there,

but it's really about me taking this medication. So I think philosophically, given what we're now afflicted with, what's bankrupting healthcare systems all over the world, I think it's time to elevate the status of foods and lifestyle in terms of what we view as medicine. But also I think there's a cultural element to this, which you touched on with your mum. And I think to some cultures, certainly, you know, we've got Indian backgrounds, this idea that food is not medicine

is just an alien concept. I don't think my family would understand that. I don't think my grandparents would even understand the question. What do you mean? You know, we were brought up in such a way that, you know, I've got a slight cold at the moment. So what was I, literally before you arrived, I'm doing what my mum taught me to do when I was little, when I had a sore throat, which is, you know, hot water, finely cut ginger, pepper, turmeric, and manuka honey. That's literally what I was drinking all morning so that I can have this conversation with you. Do you know what I mean? Yeah, absolutely. So I don't know if any of that fits with you or not, but that's kind of my take on it and why I passionately believe it is. But I'll also, before you respond, I also

want to say, look, if that term doesn't work for people as well, I'm okay with that. If that doesn't fit your belief system, totally cool. But I think it's hard to make the case that food isn't super, super powerful. Absolutely. Yeah. And I think I completely agree with that analogy of looking at food in those different elements, cultural philosophy. It's very, very ingrained in us and it's very easy for us to understand. But certainly for someone who doesn't come from that background, who hasn't been brought up with that, I can understand why it can be a little bit off-putting for whatever reason. I get that. But for the reasons that we need to take nutritional medicine a lot more importantly, I think it's important, just as you said, to elevate the conversation around food in all environments, clinical, academic, culturally, day to day, the food environment. environment and if you just look at the stats i mean like one in five deaths globally diet related

increasing the likelihood of uh mental health disorders by 43 if you're on a westernized diet if you look at the number of cancers that are related to diet and lifestyle it's around anywhere between 25 and 30 depending on where you look at all these different sources from. The WHO, all these huge institutions are all recognizing the impact that diet is having. It can have conversely the positive impact as well. I'm an example of how that can be in an extreme way, but also just generally looking at, like you said, the issues that are afflicting healthcare systems globally and causing the most amount of cost and damage to people's livelihoods and their ability to live disability-free lives. It's having a huge, huge impact. And that's why we need to talk about it a lot more. I wanted to talk a little bit more about my issues at the start as to the reasons as to why I might have improved my own condition.

I realized we left the listener thinking about inflammation, the microbiota and the micronutrients that I may have been replacing. And I think looking at blood work, just to tie a knot on this, thinking about the blood work that i was offered at the time it was pretty standard but not really robust in terms of looking at all the different micronutrients that could have been off whack and actually contributing to the irregular heart rhythm and there's no real way of showing that now but i know from my own research E, certain types of B vitamins, magnesium, even omega-3 at low levels can predispose or at least have an association with heart irregularities. So had I just through chance improved those through diet, it's hard to say. I did try some supplements at the same time as well, but I think that's an important part of the story you know mate what's interesting is you said that i was just

drawn back to my days on cardiology wards or in hospital medicine or even as a medical student and you know we know that potassium and magnesium impact the heart and sometimes we're giving iv infusions you know with magnesium right and it's like, well, of course you can take magnesium through your vein or as a medication, but you can also get it from food, right? So it's just fascinating to me that even now, I would say in 2022 with, you know, loads of people around the world are trying to elevate the conversation about food as medicine you're one of those prominent voices i'd say in the uk who's doing this which is fantastic um and globally having said that you know i think your message is is is going everywhere but even now it's still very much okay as i said type 2 diabetes and obesity

you know we've been talking about things like the SMILES trial and depression and mood for years. There's this emerging field in nutritional psychiatry. We're understanding that there are more conditions, but I still don't think a heartbeat irregularity, I don't think that is common knowledge that actually, well, what if? And so for me, the wider question is, what's it going to take for a 24-year-old who's now gets atrial fibrillation for the first time, is scared, is worried, goes to see their doctor? Of course, some things are going to need treatment quickly, depending on the condition. I totally understand that we both respect the field of cardiology. But in cases that are non-urgent, that potentially can wait, how far do you think we've got in terms of people

saying, hey, listen, before we, to borrow from your mum, before we burn a hole in your heart. I love the way she put that i know just blunts and she was really trying to get me to change why do i laugh so clearly so she's taken a few softly softly approaches hey have you you know i heard this about yoga but when it came to someone's you know burning something in her in her baby boy's uh heart yeah she she took a rather more more approach so hey come on yeah but But I guess you see the point where I'm going with this. It's like, are we moving on, do you think? Are people having these conversations more? As a cardiologist listening to this now and go, wait a minute, I didn't know that. Reapy's

story is really powerful. Maybe that patient who I've got on my cardioversion list for next week, maybe I should just go, hey, listen, should we just pause two or three months? Let me ask you the question about your diet and lifestyle. You know, are we making progress? Yeah. I would like to say that we are, but it's really hard to state that with any degree of certainty because I think we all live in our little bubbles, right? And so some people in my close personal network, they get it. They see what I've done. They have seen some impacts on their patients. I've inspired them to do a bit more reading. Perhaps they've read some of the references in the the books that i've written they've done some of their own primary digging and they've found you know what having these conversations with their patients has been

really pivotal yeah my skeptical side is saying i don't think we're at a point now where we can reasonably expect people who have been in the established medical system for over two, sometimes three, four decades, to suddenly have a realization after listening to this conversation or maybe multiple conversations about this topic before they enact change in themselves. bit before they enact change in themselves. Because coming from it, very honestly, I was battling for the establishment against my mum in a lot of ways as well. I was like, mum, you have no idea what you're talking about. The conversations I had with her, which I'm really embarrassed to talk about now, but I've spoken to this senior doctor, I've spoken to this colleague of mine, this guy's a registrar, he's seen so many people. You have no idea what you're talking about. You have no evidence. You have none of these different studies to back you up. What you're saying, I need to have this. This is my life in the balance right now. And I think the reasonable suggestion of someone who is having a non-urgent

intervention, who has the time to explore other areas, that's definitely something I'd want to see in the future. But are we there now? I don't think so. Will we get there in the future with the stuff that you're doing with prescribing lifestyle medicine, with what culinary medicine is doing in the US and hopefully what we're doing in the UK as well, with all the prescribing uh practices including social including exercise including sleep elevating the conversation amongst people that we haven't even had any interaction with let's say i think yeah we'll get there at some point in the future but today i i think unfortunately ronan we're still a bit fringe. I don't know if you agree with that. What do you think?

I'm an optimist, right? I mean, are we there yet? No, definitely not. Is it better than it was when you were 24? I think so. Is it better than it was five years ago? Yeah. I think it's getting better.

Is it too slow for some people? And there'll be many patients listening to this or watching this on YouTube right now, who will be, you know, stamping their feet on the ground. It's not going fast enough. You know, I went to see my doctor last week and they said food has got nothing to do with my condition and there's no point changing my diet because it's not, you know, you always always hear this i'm sure you get the same dms or similar ones that i get right but i do think it's changing and my evidence i guess for that is the course that a mutual friend of ours a and panja and myself co-created with my cash this course prescribing lifestyle medicine i think we've trained over

maybe 3,000 healthcare professionals around the world now. And the feedback very much like in your course has been phenomenal. People are saying, I think the last study, the last survey we did, I think 95% of people who have done it say it's significantly changed the way they practice. And it's not just GPs who've done this course, there's consultant cardiologists, psychiatrists, gastroenterologists, we've broadened it out now, so nurses, pharmacists, physios, you know. And that's accredited by the Royal College of GPs, right? So the fact that it's got the stamp of official approval from the establishment, that wasn't happening 10 years ago. Do you know what I mean? You bringing over culinary medicine to the UK, that didn't happen 10 years ago.

It's hard to change. So if you know how to do your job and manage your workload, doing it a certain way, I don't know, it takes something like a personal issue. You had a personal issue, which changed what you thought, and now hugely influences what you do. And you help so many people around the world now with what you do. I've had personal issues, namely with my son when he was six months old. So I think without that, it's really hard because you're fighting against the system and it's easier to practice. Here's the truth, mate. It's easier to practice in the current system and not talk about nutrition and lifestyle. It's easier to make the diagnosis, give the drug, you run on time time do you know what i mean

that's that's the uncomfortable truth i think you've really hit the nail on the head there and it is really uncomfortable because i don't want to i don't want people listening to this to think that we're suggesting that anyone is lazy or they don't want to help but when your back is up against the wall and you're battling through tens of patients in your morning session and then you've got to do your phone calls and your prescriptions it's easier to have the cks guidelines clinical knowledge summaries on your computer the algorithms that all the ccgs will have your list of medications and just look at the symptoms, look at the blood results, bang, bang, bang, you're done, eight minutes, next patient, please. We've all been there. We've all had to

work in that environment. And unfortunately, that is going to be the biggest barrier before we actually engage in conversations where we can truly look at the root cause of why people are ill. And let me just be clear. I still don't know what the root cause of my illness would be. I believe that it was food. I believe it was stress. Was it other things? Was it movement?

Was it sleep? Was it all the other things going on? I don't really know. But I know that the solution will always be doing what I did naturally. And that's what we need to scale up to as many people as possible. There's also this prevailing belief. This is something that I've discussed a lot with other doctors. And I love your opinions on this.

Is that we work in a system here in the UK and in the US as well, for people listening to this around the world, where we constantly need more staff. We need more doctors. We need more nurses. We need more boots on the ground to tackle the issues that we're seeing. My belief and my understanding is that it's not a staffing issue. It is the way we practice that needs to change. And also the way in which we engage with these lifestyle-related illnesses

are pervasive. And actually it's about empowering people directly. So it's almost like, you know, using the analogy of going upstream. It's going upstream to the patient, actually going straight to them and getting them to instill those practices. Not assigning them with any blame, not doing it in a really empathic way. But that's how we actually prevent a lot of disease rather than going for the age old, get more doctors in. We need to train up more nurses.

We need to get more people in hospitals. Well, I agree, mate. First of all, we're never going to find enough doctors and nurses to deal with all the patients who are sick and struggling. It's just not going to happen. It's just simple maths in my view. And let's just say your case, because this really speaks to one of the things I want to talk to you about today, which is something that's been on my mind a lot over the last few years, really, is what does it mean to be a doctor in 2022 for you and for me right but for anyone really but let's say for you and for me so going back to

your case you didn't have any studies to back up what you were doing you didn't really see a nutritionist and i'm all i'm a huge fan of people who've got an expertise in nutrition i think we should absolutely be utilizing them as and when we need to and when people need that expert help right but let's think about what you did there were simple changes right the changes you made anyone can do if they pick up one of your first three books, right? I've got your second book here, Eat to Beat Illness, which I really, really like. It's probably my favorite, if I can say that. I like it. I don't know if it's the pink lettering on the front or not, but I just love, there's something about it I really like. Like, you don't need to see a doctor to do that, right?

Like, you don't need to see a doctor to do that, right? One of the reasons that I write books and I do this podcast is because, you know, for your own podcast, I probably get, I don't know, hundreds of messages a week of people saying, oh, that podcast helped me with my depression. I don't have anxiety anymore. Oh, your first book helped my mum reverse her time to diabetes. You think, well, hold on a minute. Do we need more doctors and nurses? Possibly for some things, no question. But a lot of the stuff that you and I are talking about and have been talking about in public, despite certain criticisms for many years, because we've got the passion and the desire to help people. So my question for you, especially given what you're currently doing, perhaps you could tell that story, but also start off by saying, well, what does it mean to you to be a medical doctor in 2022?

Before we get back to this week's episode, I just wanted to let you know that I am doing my very first national UK theatre tour. I am planning a really special evening where I share how you can break free from the habits that are holding you back and make meaningful changes in your life that truly last. It is called the Thrive Tour. Be the architect of your health and happiness. It is called The Thrive Tour. Be the architect of your health and happiness. So many people tell me that health feels really complicated, but it really doesn't need to be.

In my live event, I'm going to simplify health. And together, we're going to learn the skill of happiness, the secrets to optimal health, how to break free from the habits that are holding you back in your life. And I'm going to teach you how to make changes that actually last. Sound good? All you have to do is go to drchatterjee.com forward slash tour, and I can't wait to see you there. This episode is also brought to you by the Three Question Journal, the journal that I designed and created in partnership with Intelligent Change. Now journaling is something that I've been recommending to my patients for years. It can help improve sleep, lead to better

decision making and reduce symptoms of anxiety and depression. It's also been shown to decrease emotional stress, make it easier to turn new behaviours into long-term habits and improve our relationships. There are, of course, many different ways to journal. And as with most things, it's important that you find the method that works best for you. One method that you may want to consider is the one that I outline in the three-question journal. In it, you will find a really simple and structured way of answering the three most impactful questions I believe that we can all ask ourselves every morning and every evening. Answering these questions will take you less than five minutes, but the practice of answering them regularly will be transformative.

Since the journal was published in January, I have received hundreds of messages from people Telling me how much it has helped them And how much more in control of their lives they now feel Now if you already have a journal Or you don't actually want to buy a journal That is completely fine I go through in detail all of the questions Within the three question journal

Completely free on episode 413 of this podcast. But if you are keen to check it out, all you have to do is go to drchatterjee.com forward slash journal or click on the link in your podcast app. That's a really powerful question and something that I've been thinking about quite a bit, actually. I must admit that is my favorite book as well. The reason why is because what I invited the reader to do, and no one needs to buy the book. I mean, I put all the information out on free podcasts and all the rest of it, but the chapters are such that I zoom into different topics, right? I zoom into skin, brain, eye health, even cancer, the uncomfortable topic of mental wellbeing. And I zoom into how

nutritional medicine intersects with that particular specialty. And I drill down on some of the studies that we have available to us now, looking at what was studied, what diets, what dietary patterns, what ingredients. And then I come up with a list of suggestions at the end of each chapter that people should think about through the lens of whatever that particular health goal is around. So brain health or eye health or whatever. In the final chapter, I basically invite the reader to zoom out. And when I invite the reader to zoom out, and I say, look, these are all the foods that I suggested. And these are all the lifestyle

practices I suggested. It's all the same. Because what I'm doing is basically allowing you to see and read how all nutritional medicine is about is optimizing your physiology such that your body knows how to look after itself. So going, looping back to what I was talking about with me earlier, this is what we do with nutritional medicine. There's no, it's not like a food for every symptom. It's not a specific thing that you need to change

in your diet to have this desired outcome. It is really about leveling up and improving your physiology such that you can engage in those innate mechanisms that know how to prevent disease in the first place. To answer your question about what a doctor is in 2022, we've chatted about this I think about a year ago because I was really struggling and I think it comes down to identity and what other people perceive me to be if I call myself a doctor. So in my mind, a year ago,

a doctor was someone who goes to clinic, goes to A&E, engages with patients, writes prescriptions, have those meaningful conversations, instills lifestyle changes, instills lifestyle changes, instills nutritional changes, all the things that I love doing day in, day out. But that's changed a lot for me as I've seen the potential for what I can do through other means, whether it be books, whether it be podcasts, whether it be the new app that's going out.

How can I actually help people better themselves and it goes back to what we were talking about i don't think we actually need more doctors and more staff i think we need more empowerment of patients and is me going to clinic every single day and seeing 40 sometimes 50 patients in a 24-hour period. Going to move the needle as much as I can if I engage more in all these other activities that I've been blessed to sort of have in all these different pathways I've got now. And I did a bit of reading and looking into the data around the number of staff that we have in the NHS and comparing it to other healthcare systems. So right now we have around 2.8 doctors per capita,

per thousand in the UK. That's not bad in terms of an average. If you look at Europe, it's around three. And the best country, I think, in the world is Qatar, it's around seven, seven per thousand. So it's a big difference there. The difference in health outcomes actually is not that big. In fact, the UK is number 10 in the world if you look at a

certain rating system. You also look at spend as well per capita. We're again, pretty high up. And if you track population growth over the last 60 years with the number of doctors and the number of nurses going into profession, we're outpacing population growth. So we're actually getting more and more doctors per capita, as should be the case as we invest in healthcare systems. But fundamentally, what we're missing is that we're treating a different collection of diseases than we were 60 years ago. And I know you know a lot about this. It's less of the infective conditions and it's more of those other conditions that come out of, quite frankly, the environment in which we've created for comfort. We're inside all the time. We don't

go out as much. We don't exercise much. We're exposed to a lot of things in our environment, in terms of toxins, in terms of the foods, etc everyone knows this kind of stuff and so really to tackle that we need to really change the way we we practice medicine and so me being a doctor in 2022 doesn't necessarily mean i should be on the front line battling day in, day out. Because I think that, and I have the utmost respect for anyone doing this day in, day out. It's a tough, tough job. But I've actually taken the decision to take a prolonged sabbatical over the next 12 months where I explore this very question and figure out how I can actually have the biggest impact, the most meaningful impact on the most amount of people. And I'm coming around to this idea that it's a collection of education, teaching, inspiration, and also digital, where I can actually scale some of the teachings

that I put into books and actually try and spread that far and wide such that we can actually create a population of proactive empowered people where we don't need to treat them in emergency rooms. I mean I love it it's it's clear that you've spent a lot of time thinking about it and and the thing for me if i'd circle this a bit before you came up today i want to talk to you about identity because you know a couple of things in your story that i've heard about before apparently you weren't very confident at school which i think people see you today giving keynotes and you know making your videos on instagram for many years and sharing stuff it'd be like hold on a minute guy didn't, or maybe doesn't identify as confident. I think that was interesting.

You mentioned in your story in your twenties, how you had this identity of a doctor, you know, with the, I don't know, the shirt on and the stethoscope. And then before you know it, your heart's going at 200s and suddenly you're in a patient gown and a wheelchair feeling embarrassed right which i found you know super interesting when you said that but even this whole idea this i guess this what it means to be a doctor in 2022 is something i've sat with a lot as well because you know something pippa grange said to me when she came on the show a couple of years ago, she said, I'm going to think about psychology and medicine. They're

very conformist professions. I've never forgotten that because we want to be accepted by our peers and we think a doctor means doing a certain thing. But if we just sort of, again, zoom out, I think the original meaning of doctor is educator. So I would argue like you, given what we are seeing, which is symptoms and diseases as a consequence of the way we're collectively living, that's not putting blame on people. I totally get life is tough and the way we're collectively living. That's not putting blame on people. I totally get life is tough. And the way society is set up makes it very hard for any one of us to make those decisions that we want to make. But the reality is that's what's making us sick. And so therefore, well, education and inspiration, and that's the way you make change. And again, I've been questioning stopping practicing, at least temporarily. As we record this repeat, I've nearly been in practice for 21 years. That is tens of thousands of patients. Now, over the last year or two, most of my focus has been

on patients who've been chronically sick for years. They've been on the specials, been on GPs and they're still struggling. I see them for an hour, hour and a half and I try and put all the pieces together for them. I love that, right? I absolutely love doing that. But honestly, what I do with them is literally what I put in all my posts. Literally what I talk about in the podcast each week. There's nothing different. By and large, 95% of it is the same thing. Absolutely. And as much as I love that, I also love being a husband. I love being around for my kids

and seeing them. And I've realized you can't do everything. You've got to make choices. The podcast that went out recently was with this amazing guy called Oliver Berkman, who wrote a Guardian column for years on time management and productivity. And it's such a powerful episode. And the big thing I got from talking to him in his book was this idea that everyone says you've got to say no to stuff that you don't want to do. He's like, yeah, sure. You've got to say no to stuff you don't want to do. You've also got to say no to stuff that you do want to do. And that was game changing for me. It's like, oh, I've got to say no to something that I do want to do because time is limited. And I'm now getting to the point where

I'm like, well, I think I'd rather focus on teaching doctors and making that course as good as it can be, writing a book every year or every other year with the best thoughts that I can come up with in an easy to read fashion and educate people through this podcast and social media content regularly. And again, it's letting go of this identity that you don't quite know where you've absorbed it from, this kind of society is given to you. This is why I wrote this section on identity in my new book, this idea that actually these are fictional, a lot of these things, they're constructed for us. We don't have to buy into them. So I think, I would almost argue, given how many people you touch with your books,

with your podcasts, hopefully with the app as well, which I'm wondering whether you really understand the app shortly. Well, you can almost make an ethical case, Rupi, that if you don't do that, and okay, let's say some days 50, but let's say on average, I don't know, 30 patients, let's say, let's say in a day you could help 30 people, right? Well, how much can you really help them given the current system? You can try, you can run late, you can give them your recipes and stuff. But if you can, so what's that? On a five-day week, right? Which is pretty brutal these days for a doctor. So we're seeing patients like that five days. Call it four days, right? On four days, that's 120 patients, right? In a week.

Mate, you do one Instagram post with some information and there's, do you know what I mean? It's kind of like, well... Absolutely, yeah. And so, yeah, I mean, I could talk about this for two hours, so I'll wind it up here. But essentially, I've been thinking a lot about this and I totally understand. It's like, given the health landscape of the world at the moment, well, maybe this is also a part of medicine. I'm so glad we're having this conversation

because I couldn't agree more. I think also, it's important for me to recognize that I'm in a very lucky and privileged position where we have the opportunity to step aside from the grueling day to day and actually exercise our ability to influence and to empower and to teach people of all walks of life simultaneously and really scale up the information, which is really going to have true impact. And as you just said, you know, hundreds of people every single week message you. Think about the people that don't message you, right? You know, do you know what I mean? There's going to be thousands of people that haven't taken the time because they're just getting on with it, which is great. It could just take that moment, that one thing that you say to, even in a clinical environment, that one little thing that you say to a patient that enacts that change, that gets them to quit smoking, that gets them to think about something in a slightly different way that makes them happier. These are things that we can scale up using our current activities.

One thing that really put things in perspective for me was when the first wave started, I went back to work full time and I was in A&E. Thankfully, it wasn't as busy as I expected it to be, but it was still busy. And I got involved with ICU because I'd done some ICU when I was in Australia and I was helping out with the family relationship liaison team. So that's intensive care. Intensive care. Speaking to patients' families every single day, explaining what was going on with the ventilation settings because as a lot of people are aware, people weren't allowed to come into the intensive care unit and see their loved ones, which was horrific for everyone involved and there was a senior team of doctors of cardiologists and ethetists who were tasked with relaying this

information from the frontline ITU staff to patients and loved ones on a daily basis and the reason why it was seniors because we had to have those almost breaking bad conversations every single, breaking bad news conversations every single day. And that reignited something for me where I was like, I want to retraining emergency medicine. I remember having a chat to our mutual friend, Ayan, about this on the phone. I was like, I'm going to do my MCAMs. I'm chatting to my senior about this. I'd like, I've just reignited this passion. And then when things opened up again, and I was still working full time, I went to A&E, doing all the other stuff, I realized actually what we're going to be witnessing is an acceleration of what I already knew pre-pandemic

in terms of what was the real issue which is the things that we talk about here the ways in which we can prevent things from occurring in the first place but it's going to be heightened because now we have the extra strain on a resource constrained system that can't managerially find its way out i mean the bureaucracy in our healthcare systems as it is in a lot of places is like treacle it's like wading through archaic systems and we don't have processes and there are lots of barriers whereas now we have these platforms like you can get that information instantaneously to people it's incredible and so instead of doubling down on what i was going to do about a year and a half ago which is retraining

now i'm like actually actually, I see clearly. And if I'm honest, I think there was a bit of an identity that I got caught up in. I'm a real doctor. I'm going in, I'm fighting the pandemic. I'm one of those people that people are clapping for every Thursday. If I'm being very, very honest and vulnerable with myself, part of me was that was a bit of an ego trip for me. That was something that I wanted to consistently identify with. But when reality set in and I actually asked myself the question, what actually makes me happy? And what do I feel like I'm good at? And what am I actually passionate about talking about and passionate about doing on a day-to-day basis it's it's what we're doing right now it's identity mate it's noise it is most identities i think are

ego boosting in some ways and that's why i'm at a stage in life now where i don't really like for me it's about values not not identity, because values are universal, and you can apply them to anything you do in life. Whereas identities are, you know, if my identity is a doctor, and that's a big thing for me, well, what happens if I get sick, and I can't work? What happens if I get fired, right? And I'm no longer a doctor. You know, this is what happens when people retire. You know, the whole identity is that person, and then they're no longer working, and everything goes downhill. Physical health, mental health, emotional health, because we've become really attached to a certain, I say fictional identity,

they're not really fictional, but I don't think there's anything wrong with having that identity. It's just not becoming too fixed and too attached to it. You know, wear it loosely. So I find that interesting. And again, I think I would have, I think I've been wanting to make this decision. Even now, I still even can't say to you I've made

the decision you know what I mean there's still some yeah obstacle but I'm pretty sure again pretty sure within the next few months I think I'm gonna stop practicing and just see how that sits with me yeah for six months 12 months 18 months. You know, if you think about it another way, people take... Just to stop you there, just the vernacular around stopping practicing, I think it tells a different story in your mind because you're not stopping practicing at all. You're engaging in it even more so.

You're almost evolving. Absolutely. It's an evolution. Absolutely. Again, it's a fear. You know, a few years ago, no way the fear, you know, will people think I'm a real doctor? As I've got to the place in my life where I don't really need external validation like I used to, because I did for most of my life. That's what I feel is allowing me to now go, yeah,

it doesn't matter. If people don't like it, they're entitled not to like it. Their thoughts have nothing to do with me. But can I look at myself in the mirror each day and know I'm doing the best that I can for my job. I'm doing the best I can for my children, my wife, for what I want out of life. That's a kind of different conversation. Absolutely. You're probably further along on your journey. You've clearly thought about this quite a bit and i think it sits with you a lot better i'm probably better than i was but i'm still on that journey myself because i had these sweet conversations with my dad all the time and you know bless him he doesn't fully understand the impact of what a popular podcast can deliver. And the questions I get are like, so were you in the hospital this week? It's a lot of that. And for as much as I feel that we're having impact, sometimes it's those little things that kind of dig at that. I'm like, am I doing the right thing?

And I think, again, over over time I'll firm up that decision in myself but it's a process for a lot of people myself included when your dad says that to you um how do you honestly feel uh annoyed I do get a little bit in my in my head I'm like it just doesn't get it like it doesn't understand and it's like it's pushing a stone up up a hill sometimes it's I'm trying to get him to understand so it will help me along my own journey if I'm being honest yeah yeah it's can I offer a phrase which for me has literally transformed the quality of my day-to-day life. Something I've read about in many ways in many books over years. It was really brought home

to me in a conversation I had with Peter Crone on this podcast, I don't know, a couple of years ago. And the phrase is, if I was the other person, I'd be acting in exactly the same way as them. And essentially that phrase is, if I was, the meaning really is, if I was that person with their upbringing, with their view of the world, with their bullying experiences as a child, with their parents, with the toxic first job they had, right? If I was them and I'd had their worldview and life experiences, I would think and say the same thing as them. And that honestly is something, whenever I struggle with the actions of someone else or thinking, oh, if they did something different, I'd feel different, which is very disempowering because ultimately, effectively what we are saying then is, oh, if my dad could only change,

you would be happier and calmer, which means you're putting your inner contentment and happiness in the hands of someone else who you can't control. Yeah. So I would contend that maybe your dad loves you. And in his eyes, maybe, I don't know, medicine is a secure job. You know, Rupees works hard. You know, medicine is a secure job, you know, Rupee's worked hard, you know, what's he doing all this social media podcasts? I'm like, you know, get a respectful job, you know, get married, you know, like, could you, do you, would you, I mean, if you're happy

together, would you say that this is probably coming from a place of love? Absolutely. Absolutely. And the way you've articulated that, and I've heard you say that before, actually, and I'm glad you reiterated it when I was telling that story, because it's made me think about it in a much clearer way. If I was to unpack it a bit more, my dad grew up in Punjab, grew up on a farm. He went to a really good university because his dad made lots of sacrifices such that he could go to that university. And the ultimate sacrifice being he allowed his son to go and travel abroad to the UK where he started his own thing. He worked in bakeries and bed factories and any job he can get his hands on until him and my mom mustered enough capital together to start a business. And again, all the risks, all the seven day weeks, all that insecurity to build up to a point where he can afford to send his son to some of the best medical schools, the best schools, and then one of the best medical schools in the the best schools and then the one of the best medical schools and then for

me to veer off and be like i'm gonna take a risk here of course yeah of course he's gonna be like what are you doing could i could just just take the safe i've done all that absolutely so in my mind now just from you saying that it's made it a lot a lot easier for me to contend with. Because what I love about it is it takes the sting out of a situation. So it doesn't necessarily change the reality. Well, it does actually. It changes, you know, what is reality? It's our perception. So if it's on the, like I use that most days.

Honestly, that phrase, whenever, you know, something's happening, it's like, oh, if I was that person. Like if someone's, it's very rare these days, someone's trolling me, right? You know what, if I was that person with that person's view of the world, you know what, I'd probably do the same thing. And it then means compassion becomes the first sentiment you feel. It doesn't mean you have to accept stuff. It just means that instead of being emotionally triggered and reacting from that place, it's just a lot calmer. You can make rational decisions. Like you might, for example, say, hey, dad, listen, you know, can I have a chat with you? You know, when you say that to me, it's interesting because I suspect you're, you

know, you're wanting the best for me. But what I hear is this, and you know, I've done that with mum. I've had conversations with my mum, not quite the same thing, but stuff where instead of feeling emotionally triggered, I come from a place of compassion and actually you make progress. Do you know what I mean? Yeah, absolutely. Absolutely. Now I see that. I'm going to try that. Well, do you, before we get to the app because i really want to understand the app because i think it's incredible what you're trying to do with it are you up for trying a quick exercise yeah let's do it let's do it man yeah so it's it's it's a two-part exercise okay and i think it relates to what we've just been talking about about you know life what what we want from our life,

not necessarily what other people want. So if I was to ask you, what are three things you could do this week and you think you could do them regularly each week that would make you happy, what are they? So definitely investing time and spending with my parents for sure. Absolutely. With family. I really value time with my friends as well,

whether that's over a dinner I've cooked them or even a walk in the park. I love like those are pivotal moments in my week that I really want to try and get in every single week and work to serve as many people as i can through really deep good work whether that be through podcasts copywriting newsletter app creation uh the recipes and all that kind of content that i do for the digital platform that i honestly gives me so much so much joy and the three things that are quite clear demarcations you know friends and family being really you know nurturing relationships important one i should probably say my fiance as well i was intended but that comes under nurturing relationships, right?

And then obviously something about work. How good are you at doing that? Nurturing those relationships each week? I think I'm good. I've definitely got a lot better. And the reason why I've got a lot better is actually because of my fiance. I'm not just saying that. I think I've got a strand of uh overworking from my from my dad i think you know

immigrant parents where we've all got that strand in us exactly you know i've seen i've seen how hard he worked when i was a kid both my parents um and that element of me has led to some sacrifices over the last five, six years where, you know, I'm not essentially practicing what I'm essentially preaching. And Rochelle has really kept me on the straight and narrow in that respect, actually. She's, you know, made sure we made time for sitting down at the table with no phones, checking with each other, making time to go and visit my parents more regularly i do that actually more with rochelle wow um and and even just spending time where it's just like me and her you know that that kind of stuff that i mean i was the kind

of person particularly i was writing those the first book i wouldn't go out with the weekend i'll just be stuck there writing because i was working five days a week as a gp and then two days and all the evenings writing and creating content so i mean we've sort of gone into the second part a little bit the first part is you know the three things that you could do on a weekly basis that i i call happiness habits second part of the exercise is fast forward to the end of your life you know rupi orjala doctor's kitchen is on his deathbeds right looking back on your life what are three things you will want to have done um it's a really really good question man it's i think it aligns fairly similarly to the families and friends i i would have wanted to have really rich experiences with my my family

my friends i did this thing sorry to go of course i i uh i went on my first camper vanning trip last year with two of my best friends and i can't tell you how much i laughed for about seven days straight you know i mean we had disagreements we had had jokes, we had just being in the outdoors. I was the cook, I was the driver. It was just constant hilarity. And like those experiences, I want to have those over and over again. And I think if I'm sat on my deathbed, I want to be able to reflect on a bunch more of those. I think certainly bringing the power of food to billions of people worldwide,

that's exactly what sort of the mission of The Doctor's Kitchen is all about. And having that rich family experience where I've brought kids into this world, where I've put good people on the planet who are grounded and have just amazing rich experiences and are allowed essentially to grow into whoever they want to become like that's i mean i'm not at the point right now where i've got kids or we're thinking about kids but certainly there's definitely something i want to want to do i mean it's it's it's I always love hearing people's responses to those questions because I think it's an exercise we should all do with regularity um it's it's one of the exercises in

chapter one of my book and I've started doing it on the podcast asking people yeah and it's it's really great because it's not about beating yourself up it's just about bringing intention to our life like often it's on our deathbed we kind of know we want to have spent time with our friends and family you know you've got this other mission to help you know billions of people understand the power of food right and that i guess pivots nicely into into your rap and that's kind of what you were saying about these weekly happiness habits, you know, you want to nurture time with your friends and family. And the whole point of it is, is if we do these three, I mean, three is an arbitrary number, right? But it's, I think it's a

nice number. Three weekly happiness habits. If we do them, irrespective of anything else, we're going to get the happy ending that we've just defined, right? So for me, it helps, again, cut down on that external noise. Should I do this? Should I do that? What are other people saying? It's like, well, hold on a minute. For me, it is friends and family. So if I spend quality time with my wife and my kids each week, well, if I do that consistently week after week, well, I'm going to tick off one of the three things I want on my deathbed to have spent quality time with them. Right. On my deathbed, I want to have helped improve the lives of millions of people around the world, very much like you. If I record a podcast each week and put it out there, I'm doing that.

Yeah. And it also helps people realize when their life is unaligned. helps people realize when their life is unaligned. Okay, wait a minute. I say, and I know from a few years ago, you probably like me, probably didn't neglect our friends. Absolutely. You know, very typical for men. I'm not saying women never do this, but you know, as a generalization, a lot of guys do this. You know, I've got some of the best mates anyone could wish for, but for years I was too busy to see them. Do you know what I mean? So I best mates anyone could wish for but for years i was too busy to see them do you know what i mean so i think we learned from that and changed that so absolutely you know i think it's just a very simple way to um cut out on the noise it's a

great exercise yeah it's important it's funny because i read that and obviously i'm going to jump on my podcast in a bit but i read that I didn't do the exercise. I'm just getting through it. Oh yeah, yeah. It's a nice exercise. But that is really profound. It's just, and we know what people are going to say on their deathbed. Why? Because palliative care nurses tell us. Absolutely. They all say the same thing. I wish I spent more time with my friends and family. I wish I'd worked less right but also this one gets me every single time which is i wish i'd lived my life and not the life that other people expected of me wow i think that kind of sums up a lot of what we've been talking about you know it's something i sit with a lot of people if i know that's what people say at the end of their life if i know that's what i'm going

to say why do i need to wait for my deathbed? Why can't I start to make that decision now? So we go a lot deeper there, but I do want to talk about your app. You said on your deathbed, you want to have impacted the lives of billions of people about the power of food. Where does this new app fit in to that grand vision?

In many ways. I just want to say that that exercise really did click well for me. I'm still sort of like reeling from how much more clarity I have, actually, particularly the last thing you said about how people wished that they didn't live the life that other people wanted them to live or live through the lens of other people's opinions and i think part of that is why i even started the app i mean who am i i'm not a tech entrepreneur i've got no reason to be in this sort of game and starting the i mean the audacity of starting a tech company from scratch is pretty incredible. But yeah, I did it because, and I'm doing it because it really aligns with what I want to do. It really aligns with where I feel that I can take The Doctor's Kitchen to the next level. So to answer your question,

the app is a very simple digital platform where I create recipes. We have a health goal filter where myself and the nutrition team have gone through all the nutrition papers and pulled out the dietary patterns and ingredients that align with specific health goals. We've got five health goals at the moment. We're going to build more. They are brain health, mental wellbeing, inflammation, cardiovascular health, general well-being. And it allows people to choose recipes based on those health goals and their other dietary filters. So it makes it a lot easier to know what you should be eating and also to eat well consistently everywhere. Because everyone wants to think that it's about these

specific nutrients and you need to get these specific amounts. I get that. Supplementation and targeted personalized nutrition is definitely the way forward. But in a lot of cases, the simple thing is consistently eating well. So the app is designed to make eating well every day as simple as possible. What we have right now is our MVP. We're essentially just- What does that mean? A minimal viable product

a very very simple product which is a library of recipes that you can filter according to those means so hold on you could you can go on and let's say right let's say i struggle with eating well and i'm like you know i want some help you know rupee's said he can make it easier for me okay great so i go on to go yeah like i want to focus on brain health please and i don't like these two foods and i have an allergy to this one food what i can put all that in you can put all that in and then what does the app spit out for me so you get a personalized for me section where you can choose from a selection all those recipes that fit that criteria so so recipes so i then get recipes but i guess in a book for example

you've got loads of great recipes right but i have to choose i have to go through it go well what's this one for oh does it have any ingredients and oh i didn't it has something that i don't like yeah i'm allergic to that ingredient oh i need to send rupee a dm to go what else can i put in yeah it's the app basically just taking all that out and go you just put it straight in then it will spit out the right recipes for you absolutely yeah so that's that's certainly the aim of what we want to do and at the moment you can you can use alternatives we put alternatives for the different ingredients and we also allow you to filter according to intolerances and allergies that you might have as well as the health goal filter that you choose. And you can choose up to two. But the beauty of the app and

the simplicity of it is we did a ton of research with people. We brought people into the studio pre-pandemic. We asked them a whole bunch of questions about what the barriers to healthy eating are, what makes it so hard for you. And a lot of the themes came out were culinary creativity the time and the complexity of recipes so the majority of the recipes are actually one pan recipes all the recipe instructions have got step-by-step uh images so you can see at what step of the way everyone should be we're also going to add new features so we're still very very much minimal viable product but new features where you can're still very, very much minimal viable product, but new features where you can build a shopping list that integrates with supermarkets. So you can say with your family, say, which recipes would you like kids? And which recipes would you like to all your other

family members? Choose those, builds your shopping list and that integrates with any online supermarket they want, or take that shopping list to the market if you like doing that as well. The other thing that we want to add is an integration of the ability to see a vetted nutrition professional as well so it's kind of like the healthy eating version of headspace or calm if michael acton smith is listening uh the uh the the integration and the communication of babylon or push doctor or one of those telemedicine platforms with also the sort of evidence based in the culinary creativity of all the recipes that we create as well so it's like a beautiful integration of all those different things on this one platform what what i see this solving the problem of is the consistently eating well issue some of the latter things that i want

to build on top of are features that include wearables the investigation data what does that mean investigation data that would be like microbiota testing genomic testing metabolomic testing oh wow also things like oring integration or whoop integration or whatever wearable you prefer using like apple health and that way we can actually say you know what you you jog very often or you you are expending this amount of energy or these are your needs because of these activities that you've identified in the app these are the kind of recipes that you should be really eating and this is how you can make it super easy for you and then another stage and I'm just sort of like future scoping here. We want to have

the ability where you can have a selection of recipes that are available in your area that are freshly prepared according to our standards, using the right oils, the right cooking techniques, and then delivered to you, to your door and your family at the cost price. So this is where I see it being a viable option for insurers, as well as healthcare practitioners, as well as the individual consumer as well. I mean, it sounds incredible and this vision you have. A couple of things came to mind as you were describing it there. One of them is circling back to a theme throughout this conversation is this idea of helping know helping more people helping people eat better

if you succeed in that through the app you're already succeeding in it in in you know through your instagram through your through your books through your podcast that's being a doctor right that that's that if if if the advice you're trying to give in a 10 minute GP consultation to someone is, hey, listen, I think food plays a role here. Let me help you. Here's, hey, why don't you try these two recipes or whatever, however long you might need to do that. Ultimately, the goal is what? The goal is for that patient to eat better, right? Because you think it's going to have a myriad of different benefits on their health. Well, if you're doing that via an app,

because you've nailed it there. Everyone's got a good week where they're well-rested and they buy the fresh foods. We all have those days. But we also have those days where, you know what, life's tough and we're looking after an elderly parent or we're struggling with loads of deadlines at work.

We don't have time to cook. And actually, we start to make decisions that we wouldn't ideally choose, right? But again, when we go and see our doctor, we give them our best day. What do you eat? Oh, you know, I eat this for breakfast, I eat that for lunch. It's like, well, it's consistency. It's like anything in life, isn't it? It's like exercise or any new lunch. It's like, well, it's consistency. It's like anything in life, isn't it? It's right. Exercise or any new behavior. It's consistency. So if you can do that,

make it easier for people, you know, that's the way to have impact. And you mentioned like Headspace and Calm. And it made me think, well, those are great apps, right? They help make meditation accessible. So many people who utilize those apps now are having health improvements. So they're probably going to see their doctors less. There's less pressure on the healthcare system, right? And you could argue, actually, Rupi, well, maybe you're even better placed than a tech founder because of your, you know, years of experience seeing tens of thousands of patients. Actually, maybe that's a unique skill set. And maybe this is the best use of your time, actually bring that knowledge to technology to help people. To help, exactly. yeah. And I think that just verbalizing this now,

actually, with you is helping me really solidify this in my head because there's been a lot of indecision along the way. I mean, like building a, even building what we've built right now with a library of 300 recipes and the photography and the, you know,

the system that allows you to choose according to your allergies and all that kind of stuff. It's been a real, real journey. And I've had a lot of imposter syndrome along the way as well. Like, who am I even thinking that I could even achieve this? That idea of me being a tech founder better being better placed because of my clinical experience because of the communication i've had directly with people i mean i was doing customer service essentially for like the last six years because of like instagram podcasts and newsletters feedback and all that kind of stuff so you know all that has really gone into this and what i feel that this could serve very similar to the likes of Calm and other wellness apps there that have been super successful, is scaling that information to as many people as possible.

And that's why I've been obsessed with this idea of creating a tech platform for a long time now. And hopefully seeing it to fruition. I mean, we've got a long way to go with all those different features. seeing it to fruition, I mean, we've got a long way to go with all those different features. Hopefully being able to see that fruition is going to be a real, not just a career defining goal, but a clinical career defining goal for the reasons that you just suggested, because that is hopefully going to have a tangible effect on people's lives. I know that if I can increase someone's portions of fruit and vegetable consumption, as simplistic as it sounds, I know that's having a demonstrable impact on their propensity for illness. I know that I'm

practicing preventative medicine in its purest form. So yeah, that's the goal anyway. It's pretty exciting hearing this. I'm not that techie in terms of my natural interest, so it's very inspiring for me to hear that. Who said about an aura ring? So I see you've got one on. I mean, what are your views on trackers, incidentally? So I think it really depends on the person, right? Me too, mate. So I'm the kind of person that can look at my aura ring data in the morning, and I can make a reasonable judgment about how I should exercise, what things I need to be looking out for in terms of my cravings, in terms of what kind of food would make me sleep better the next day and make a reasonable, solid decision about my day. And

I'll forget about it until I check it the next morning. Another person would become super anxious about the fact that their aura ring scoring or whatever tracking device you use is less than 80%. And that's going to derail them psychologically for the rest of the day and actually create health anxiety around it. It's kind of one of the reasons why I've taken to on social media asking people to really establish whether they should even be following me.

Because I realized that we have like a microphone and we can't filter who listens via that microphone on the other end. People really need to take that decision themselves and be intentional about where they get information and whether that information is serving them. So going back to our conversation about food as medicine, for some people, that's like kind of triggering. And they have their reasons. I get that. I disagree, but they have those reasons.

For the same reasons, me always talking about healthy eating, increasing vegetable consumption, looking out for fiber looking after your microbes for some people that's not that's a net negative yeah and therein lies the decision for that person to either unfollow me disengage with my information or perhaps choose someone else that better serves their needs mate i think there's such an important point and it is, you know, I think personal responsibility as an idea gets hijacked a lot. You know, I think when it comes to food, of course, I'm for empowering people like you, but I think we both, I think we touched on it the first time you came on, we both recognise poverty plays a huge role in what people have access to um we we understand that

actually some people want to make good decisions but where they live the food landscape around them is very very challenging i know we definitely spoke about that even though it was over four and a half years ago when you were on the show the first time i remember you telling me the story about how when you were walking around your general practice yeah when i was in oldham yeah i forgot my lunch i couldn't buy something healthy like literally i'd have to walk at least a mile it was just kebab shots fried chicken shots i think this is where some people someone lives they are fighting against the prevailing uh direction of travel to make those good decisions so i get that but i think there's another part to personal empowerment and personal responsibility, which is, yeah, take responsibility of who you follow.

You know, and I've, you know, it's funny, over the last few months, I've spoken to a couple of people on the podcast, David Sinclair. And David was mentioning his view on, you know periodically fasting and skipping meals and one of the reasons i do long form podcasting is because i think we're missing nuance and perspective and therefore i think if you have a one and a half hour to our conversation with someone you can see all sides of it you can i think honestly i think long form podcasting is the way to change the world. I genuinely believe that. And I'm very passionate about doing that. But, you know, I promote the podcast on Instagram. And Instagram Reels is you have a one-minute maximum. So as a team, we try and be respectful and create something that is empowering for people on that platform,

but also encourages them to go and listen to the conversation. The problem is, is trying to cut down a two hour conversation into a one minute reel is challenging. And whenever, and actually this is something we haven't discussed yet, but food appears to be one of the most triggering topics in all of health and wellbeing, maybe close to politics. I don't know anything that's more triggering for people than foods. And so I remember when we put out a clip on the David Sinclair episode, which is one of the most downloaded episodes we've had, it was really, really powerful, interesting. But I understand that many people are struggling with eating disorders. Many parents are really, really struggling with their children at the moment who have got a disordered relationship with eating.

And actually, some of them were quite angry, they were quite disappointed in me that I put out that. You know, very much a lot of comments like, you know, I love everything you do, but really disappointed that you're promoting this. At the same time, that episode and the one with Dr. Jamnadas on how he uses fasting as a cardiologist has literally transformed the lives of people. And I've realized that one message can never appeal to everyone. And so I really reflect on this and sit with this and go, okay,

well, what do you do with this as a content creator like you? I want to inspire loads of people. And just realize it's impossible because someone who really needs to hear the message of fasting is not someone who's struggling with an eating disorder. So I caveat it in the audio. I do intros. I say, please notes, this advice is not going to be for everyone. I remember being in the studio, doing the intro to the Dr. Jamil and I's episode, really trying to get it right, saying, guys, look, please understand the context in which Dr. Jamil and I's is giving this information. He sees people who have got heart problems, who are really struggling, who've possibly over-consumed in their life. And he's now not having to put needles into people's hearts because of fasting. I want to share that

information. I also understand that if you're a parent and your 13 year old daughter is struggling with eating disorders and you're worried and you don't know what to do and then you see someone who you respect giving information that may not be relevant i understand that it's hard and i really have compassion for that and i as a team we think about this and i think about how can i make this better because what you don't want to do is not put out the information on fasting that's going to help people absolutely but how do you do it I don't have the answer I don't know if you have any any thoughts on that I've yeah I think the way you've described that is exactly how I think about it as well and I think you know

during my training when I was working at brighton i worked at the pediatric hospital and unfortunately we had a number of very young children come in with i mean it's really hard to to talk about it but there was there was a really young girl who just refused to eat and her dad was away and her mother brought her in and it was it was a you know a really traumatic time for for her and the team as well who we weren't specialized in eating disorders actually and again working on the wards would have a lot of young patients going into the bathrooms and exercising and and and doing all these these these activities that i'm sure we're all aware as a result of a psychological disorder.

So I have the utmost compassion for people who are triggered by these things. But to your point, it really does come down to your curation of your own digital environment. It's super, super important. And I think, again, looking at this through the lens of what environments we have at the moment, we have a physical environment, we have a digital environment, and we have something called meta, which people see as something in the future. Actually, I think it's right now. If you look at the amount of time that we spend on our digital devices via Zoom, via social media, via ingestion of news, I would argue for lots of people, it's more than 50%. So if meta is actually, instead of us living in like a 3D world using VR, instead, if it's a point in time when we are interacting with our devices more than in real life i would argue that we're already there and

so therein lies the importance of being really really intentional about how you create that environment so if that means not following people who talk about healthy eating or talk about fasting because that's going to have a negative impact on you then then that's your responsibility. It's hard to say that a lot without, because we are people- We are. We want to like have everything. We're compassionate doctors, we don't want to, but it's just hard. It's just difficult. We can try our best to put things out as compassionately

as possible, but ultimately we've also got to understand, but let's take this away from eating disorders. I know it's a triggering area and people are really struggling. But if we feel, let's say me, take it out of anyone else. If I feel it's my right to go on social media, you basically go on the internet, which is literally the entire world, and think that I can walk around on this street online and nothing's going to bother me. Like we know in the real world, that's impossible. You're not going to go into the city center and think every experience is going to be delightful. No one's going to stand in front of me or get in front of me in the queue or whatever. We understand, but somehow we think online,

it should all be beautiful and sugary. And again, I think it just speaks to this wider point that we've lost the ability to realise that we don't have to agree with everything that everyone else has. We probably don't agree on everything. Do you know what I mean? But we can respectfully disagree and go, oh, you know what? That information is probably not for me. Absolutely. And I think, just to finish there, I think half the problem also is when you've got kids on social media, when, I mean, it's hard enough being an adult, you know, do you know what

I mean? Yeah, yeah. If, you know, as kids are developing their sense of who they are and they're then going on, then, you know, I get why people are set, I understand why it's really, really challenging. Absolutely. And I've definitely got thoughts on this, because coming back to the idea of nuance, it's very hard to have nuance when you're using character-limited social media platforms. It's also becoming increasingly difficult to have, to hold,

even at a personal level two conflicting views in today's world you know covid great example you know i can be someone who is pro public health policy but i still want to have questions about lockdowns i still want to have a conversation about what is the best pathway for all of us what are we sacrificing on one side what is the best pathway for all of us? What are we sacrificing on one side? What is the opportunity cost of shutting down all healthcare systems for the prevention of an infectious disease? Just for the record, I think the first wave, I think we all had this worry and the lack of knowledge around what COVID was at the time to justify some of the actions that we did. Later on, I think it becomes more of a nuanced issue. And I think we've looked at it through the perspective of one opinion and anything outside of that opinion, you're a COVID-idiot.

That language and the demeanor that people used on online i think is just abhorrent and we really need to work on that and i think to the other point you were talking about with regards to food and why it's so polarizing i think it almost comes down to like the importance of food to people at an evolutionary level so if if you human me for a moment, it's a bit of an esoteric opinion that I have on the evolution of food and how we've evolved. But when we're hunter-gatherers, we would have been in an environment where we lived in a nomadic community, let's say. We would have woken up at the crack of dawn, circadian rhythm. We have uh gone out and either if we were typically the females we'd go out and and and gather berries and and forage probably with a baby struck to us so we've got load bearing so

we're working our muscles as the male probably would have gone out hunting we've walked over like long planes that would have been our exercise would have been our meditation would have been our sort of stillness to make sure that we are aware of any predation. And then coming back, we would have shared that with the community and we would have had that food and we would have gone to sleep at a reasonable time. There you have all the elements of lifestyle medicine, all centered around this idea of food. And if you look at our biology, we are so hardwired for procreation and food. These are really, really humanizing traits. And so it's no wonder that when you see on social media, when people are arguing about different diets, they're not really talking about the specific macronutrient composition that they believe is the right thing

for everyone. They're not really talking about why veganism should be the most important diet for everyone. They're talking about something that is deeply human to themselves. And I think that's what fuels a lot of anger online. Yeah, I think you've nailed it. I love that. I love that. It's a great perspective. I feel we're warming up, but we've been going a long time. So let's put a pin in this conversation uh one thing we've not spoken about is berries and coffee and all that and all the benefits of these things which i thought we might see they're all in your books yeah right so and in the app so people can if you're going to point someone you've got three books out there yeah um if someone's inspired it goes hey you know rupee look i i kind of struggle i know food's important but i don't know how to cook

like i'm a bit scared of it i didn't get taught by my parents i wasn't taught at school um which of your three books would you direct people to i think the last one three two one definitely it's my most practical book it's's three portions of vegetables, two servings, one pan, double the ingredients if you want to serve four. It's a really easy methodology and process of cooking that I employ myself whenever I'm time poor, which a lot of us are these days. It minimizes washing up and it increases the one thing that i think that one could work on which is the amount of fruit and vegetables that we consume on a daily basis and looking at all the research that's the one thing that i think that we should be looking at through the lens of nutritional medicine obviously there are all the other facets of of lifestyle that we also need to concentrate on but i think three to one is probably my most practical book but you know share recipes every week on the newsletter there's plenty on the website how do they get your newsletter on thedoctorskitchen.com yeah newsletter okay yeah cool yeah because you do

you share recipes every single week we share recipes and we also share something to listen read or watch that will inspire them every week. And the feedback for that has been wonderful. And it's genuinely me sharing what I've done that week to hopefully inspire people to live well. And, you know, it can be a TED Talk. It can be a piece of research. It can be a practice. You know, there's a whole bunch of different things

that people can employ every week. And, you know, like you've written about in your book on maintaining small habits, just stacking those on top of each other bit by bit and creating that sort of, I mean, that's why we haven't talked about morning routines. We'll talk about that on my episode with you. But that's how I've instilled things that have ultimately led me to heal yeah it's through practicing small things employing them and making sure that there's a system behind those and I think if we can all do that one thing that would be pivotal. Rupi you're doing great things in the world it's been so so fun chatting to you thanks for coming up to the studio good luck and uh let's do it again soon. My pleasure man my pleasure. It's been so, so fun chatting to you. Thanks for coming up to the studio.

Good luck and let's do it again soon. My pleasure, man. My pleasure. Really hope you enjoyed that conversation. As always, do have a think about one thing that you can take away and start applying into your own life. Thank you so much for listening. Have a wonderful week. Remember, you are the architects of your own life. Thank you so much for listening. Have a wonderful week.

Remember, you are the architects of your own health. Making lifestyle changes always worth it because when you feel better, you live more.