Feel Better, Live More with Dr Rangan Chatterjee - How To Burn Fat, The 4 Food Rules That Will Transform Your Health & The Truth About Calories with Dr Rupy Aujla #520
Episode Date: February 5, 2025Why has nutrition - something that should be so simple - become so complicated? With 70% of our diet now consisting of ultra-processed foods and conflicting advice everywhere we look, is it any wonder... we're confused about what to eat? Today's returning guest is my good friend, Dr Rupy Aujla, who is on a mission to make healthy cooking accessible and enjoyable for all. He’s a medical doctor, nutritionist and founder of The Doctor's Kitchen and author of five best-selling books. If you haven't heard Rupy's story before, his life was changed after suffering a significant heart condition in 2009. After learning about nutritional medicine, he was able to reverse his condition using a food and lifestyle approach. Today, Rupy is constantly creating tasty recipes that help people optimise their health and he shares them - yes, in his cookbooks - but, also, in his wonderful Doctor’s Kitchen recipe app that helps over 10,000 people each week use evidence-based food and lifestyle medicine, to live healthier, happier lives.  In this fantastic conversation, you'll discover: The science of burning fat and why calorie counting often fails in the real world Four evidence-based principles for sustainable weight management that don't require strict tracking Why ultra-processed foods lead to overconsumption and how to naturally reduce them in your diet The power of single-ingredient foods and how they can transform your health - and why protein at breakfast is crucial for appetite regulation throughout the day Why eating dinner a little bit earlier, can significantly impact our metabolism and weight How the quality of our sleep directly affects our food choices and the connection between emotional eating and our relationship with food Why different diets work for different people, how to find your personal approach and practical tips for implementing healthy changes while maintaining a busy lifestyle This conversation strips away the complexity of nutrition, offering clear, actionable strategies that anyone can implement. So, if you're feeling overwhelmed by conflicting nutrition advice, this conversation offers a practical roadmap forward, showing you how simple - and enjoyable - healthy eating can be.  Support the podcast and enjoy Ad-Free episodes. This January, try FREE for 30 days on Apple Podcasts https://apple.co/feelbetterlivemore. For other podcast platforms go to https://fblm.supercast.com.  Thanks to our sponsors: https://thriva.co https://drinkag1.com/livemore  Show notes https://drchatterjee.com/520  DISCLAIMER: The content in the podcast and on this webpage is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your doctor or qualified healthcare provider. Never disregard professional medical advice or delay in seeking it because of something you have heard on the podcast or on my website.
Transcript
Discussion (0)
You have to be your own expert. You have to navigate what is a complicated world of nutrition.
There's so much in nutrition that cannot be explained. When you eat for nourishing your body, your body knows what to do.
Hey guys, how are you doing? Hope you're having a good week so far. My name is Dr. Rangan Chatterjee and this is my podcast, Feel Better, Live More.
Why is it that nutrition, something that should be so simple, has these days become so complicated?
Well, today's returning guest is my good friend, Dr. Rupi Aujla, who's on a mission to make healthy cooking accessible and enjoyable for
all. Rupi is a medical doctor, nutritionist, founder of The Doctor's Kitchen, and author
of five bestselling cookbooks. And if you haven't heard Rupi's story before, when
he first came on my podcast, his life was changed after suffering a significant heart condition back in 2009.
After learning about nutritional medicine, he was able to reverse his condition using
a food and lifestyle approach.
Today, Rupi is constantly creating tasty recipes that help people optimise their health and he shares them, yes, in his cookbooks, but
also in his quite wonderful Doctor's Kitchen recipe app that helps over 10,000 people each
week use evidence-based food and lifestyle medicine to live healthier, happier lives.
And as a special offer to my listeners, Rupee is offering 10% off an annual subscription
to his brilliant app by using the link in the episode notes of your podcast app.
In our conversation, we explore the science of burning fat and discuss why calorie counting
often fails in the real world.
We also talk about the crucial role of fibre,
why protein at breakfast is vital for appetite regulation,
and why eating dinner a little bit earlier
can significantly impact our metabolism and weight.
We also discuss emotional eating,
how the quality of our sleep directly affects our food choices,
and the four basic foundational
eating principles that benefit almost everyone.
In a world where something as simple as what to eat has seemingly become so complicated,
our hope is that this conversation offers you a practical roadmap, showing you just how simple and enjoyable
healthy eating really can be.
We all know that nutrition is important for our health.
You've been a medical doctor for 16 years.
You've got a a masters in nutrition. Why is it that
something that should be on the face of it so simple has become so complicated?
Yeah, it's a really, I think it's a really good place to start because I think a lot
of people, particularly online, I'm not having to go anyone online, but I think
particularly online, people like to be very binary about the explanation as to why things are going
so wrong within the nutrition sphere, why people are getting more obese, sicker, why there's a rise
in type 2 diabetes. You know, some people will lay the blame squarely
at the guidelines. The guidelines are wrong. There's too many refined carbohydrates in
it. It's not evidence-based. There's lack of science behind that. There is a, you know,
a conspiracy around food companies having undue influence on the guidelines. I understand
those arguments. Other people will put the blame on food companies. Food companies are
introducing seed oils into our food. Toxic chemicals, obesogens, artificial flavourings,
sweeteners that affect our microbiota, refinement, disruption to
the food matrix, completely understand those arguments as well.
Other people like to have a go at the food environment, right? When you go to work or
you have a vending machines, I know particularly in medicine, when you go to hospitals, the food choice is a diet.
I did some work with a large food corporation who do not only the patient's nutrition, but
they also do the staff canteens.
And there is a lot of discouragement and a lot of annoyance with the food options that
are available to people
within hospitals, particularly out of ours. I completely understand those arguments.
And then other people say, well, it's nothing to do with that. It's nothing to do with the
food guidelines. It's nothing to do with processed food. It's the cost of good, healthy food
options. It is the cost of living crisis. It is the fact that people have less money on their pockets to make the right decisions
for them and their families.
All of those options are correct.
And just like there is no one single diet for everyone, there is no simple answer to
the reasons as to why we are seeing rises in obesity, rises in metabolic disease and rises in illness in general.
And I could rattle on about any one of these issues, but I think the biggest issue personally
is people lack simple strategies to do the simplest things first. And I think if we simplify what people can do
within their locus of control,
we make it easier to make healthier choices.
Now there's a lot of psychology behind this.
You've talked about this so eloquently
in your latest book and previous books as well,
the reliance on information from so-called experts.
Some people are saying that a plant-based
or plant-focused diet, which helps your microbiota,
which increases plant diversity
and increases fiber is the best way to go.
Completely understand that other people say
carnivore, keto, high fat, low carb is the best way to go.
And really it depends on context.
It really depends on that individual
and what is right for them.
Aside from the complexities
of the different distributions of macronutrients,
what can people do today to help them navigate
what is a very complicated food landscape
that has cost as an impact,
that has food processing as an impact,
that has guidelines and uniformity at it.
And I think the four things that people should really anchor
any nutritional strategy around are unprocessing your diet.
And we can talk about these in a lot more detail,
adding more fiber to our diet,
eating protein, particularly at breakfast.
I think protein is a bit of a controversial area,
but it's definitely something that I've changed my mind on.
And eating an earlier dinner.
I think these are the four very, very simple strategies
that people could align their 24 hours of eating around
that can certainly help with improving their gut health, improving their metabolic health and staving off weight gain.
Yeah, that's a great answer, Rupee. I love those four... I'd call them principles.
I think one of the reasons, well, we get on very well off the mic as friends, but I think we share very similar philosophies
on health because we understand that different things work for different people.
Yes, on an individual level, but that bigger picture, why is it that we're so confused
about nutrition?
You very eloquently went through all of these so-called reasons that people are saying that we're struggling.
And the truth is, as you were going through them, I was kind of nodding my head out.
A lot of them going, I think there's a lot of validity to all of them.
Absolutely.
Right?
There's a lot of validity to the science on lots of different diets, but let's try and
bring it together.
Instead of making it complicated, let's try and simplify.
I think those four principles, unprocess your diet, increase your fiber intake,
protein at breakfast and having an early dinner
are really interesting.
I definitely wanna delve into them in a very practical way
so that people can actually take something
and start applying.
Before we do that though,
I thought it would be useful to look at these ideas through the
lens of weight loss.
So I think many people these days are trying to lose weight.
Sometimes it's because there's a lot of excess body weight.
Someone may have obesity or be overweight.
But even if you're not, a lot of people are often looking at themselves in the mirror
going, oh, I can lose a bit of this belly fat, let's say, for example.
So I think, although we often don't like to talk about it anymore, a lot of people actually
do want to lose weight.
They want to lose fat off their bodies.
So through that lens, how do you view the right approaches to take?
Yeah.
I think it's a really good point.
It's almost become unfashionable to talk about fat loss
and weight loss because the more noble activity
is to focus on wellbeing, focus on gut health.
I get that and I think you can have both.
So to answer your question more directly using the science-based tools
that we have available for us, the way to weight loss is a calorie deficit. That is
the way people lose fat, period. There is no controversy around this. The science is
very much aligned on this. If you reduce the number of calories
that you require per 24 hours, you will lose weight and you will preferentially lose weight
from visceral fat. So that's the fat if you have it around your organs and then your subcutaneous
fat. So that's the fat that we have in roles around our abdomen, for example.
If you wanted to be purely data driven about this, so put your emotions to one side about
whether you agree with calorie deficit diets at all. The way people go about this in a
very scientific regimented way is they get an idea of their caloric needs and their daily burn.
And there's two main ways of doing this. You can either do a resting metabolic rate test
that you do in a lab setting. It's actually quite cheap to do. You lie on the floor, you
put a mask on and it will give you an idea of what you are burning at rest. The other
way is to use a very simple calculator online, which gives you a ballpark
figure of your basal metabolic rate. I'm going to talk to you about what one would do from
a very science-based perspective. And then I'm also going to explain to you why I don't
recommend doing it. It sounds very counterintuitive, but I don't recommend calorie deficit diets.
So just have that in the back of your mind.
This is the really interesting part of this conversation. I think it's going to be around
this, whereas you are saying a calorie deficit is important, but you're then going on, I
think, to say that you don't necessarily need to focus on that.
Exactly.
Right. So let's, okay, let's break it down. So I think this will be really interesting for people.
And not to rail on anyone particularly online,
but you have a lot of people who have very staunch views
about how people lose weight.
And they will say the only way to do it
is via calorie deficit diet.
And that is truthful.
That is very valid and very accurate.
Generally, these folks who are promoting calorie deficit
diets are actually quite motivated individuals themselves. They tend to be from the bodybuilding
community. And if you think about the attributes of that individual, they generally are pretty
regimented in the diet. They're very highly motivated individuals
who can take that sort of black and white approach
to nutrition and sort of be unemotional about it.
That's not very relevant for, I think,
the majority of people,
particularly those who struggle with weight.
I think it's a really interesting point there, Rupi, for me,
which is all of us,
as much as we think we're not, we're all a little bit biased. So, I think a lot of the time,
the arguments online over the right diet or the right way to lose weight, the reason they become
so toxic is because people are very attached to what worked for them.
And I understand that to a certain degree.
If you have struggled your entire life with your health and your weight,
and you've tried to follow the guidelines as you perceive them to be,
and you've struggled, and then you find something that works for you,
and suddenly you're losing weight, you've got more energy,
you can see your abs for the first time in years
or whatever it might be.
I understand why you wanna shout from the rooftops
and you wanna tell people,
guys, this is the way to do it.
But the trap I think we fall into is thinking
that the way that worked for us is necessarily the way
that it's gonna work for everyone else.
I think there's
multiple approaches that can work like you. And certainly my view is that it's kind of
on us to try and find what is the right approach for us.
Yes. Yeah. And I think there's a lot of common ground within all of these different approaches,
regardless of whether you're in the calorie deficit camp or the different macronutrient
distribution camp. And when I say different macronutrient distribution camp.
And when I say different macronutrient distribution, that's just a sort of science speak for saying
some people low carb, some people low fat, some people high fat, low protein, for example.
So okay, let me, let me anchor ourselves in what the science says about weight loss. And
then I can talk to you a bit about the different sort of paths
to that. So if you want to be data driven about this, you'll find plenty of people selling
programs or promoting the information around getting an idea of your caloric burn. You
simply use an online calculator, you input your data, age, and as you age, your metabolism tends to slow down, which is why age is a
very important input to determine what your caloric needs are. You then add things like
sex, so male and female. Men tend to have more muscle on their body, which will require
more calories in terms of the daily burn. And then height and weight to use to calculate your body size and
composition. And then they use one of a number of different calculations equations. The common
calculation is something called the Mifflin-Sent-Dur equation and this uses your age inputs, your
activity inputs to create something called your basal metabolic rate. So this is the number of calories that you are burning at rest. And when this is all very rough as well. So there is there
are some caveats within that, but let's just assume that this is accurately measured what
your caloric burn is. When you have this information now, the next step is to simply track the calories that you consume from food
and drink for seven days. And then typically what they ask you to do is subtract the calories
per day that you consume by five or 10%. And I think a 10% deficit is probably the way
to go without shocking your body and makes it a lot more likely for people to adhere
to.
So that means, or let me try and explain it the way I've just heard that, right? Let's
say that you are a middle-aged woman and your BMR, your basal metabolic rate is 2000 calories.
That's it 2000.
Let's just make it simple. So your body needs 2000 calories a day, currently.
Are you saying that if we then reduce that by 10%?
So, again, I know you're not promoting this necessarily as a way to do it,
but you're illustrating the point.
If you only consumed 1800 calories a day consistently,
when what your body actually needs is 2000, you're going to start losing
weight.
Yes.
Yeah.
That's exactly what I'm saying.
Is there a consequence that if your body, I guess this is, I guess, what does the BMR
mean really?
Because if your body needs that, are you going to get tired and exhausted and have hormonal
dysfunction and all kinds of other things
if you're not giving it what it needs? Or is sometimes your basal metabolic rates
not your ideal one, but what you currently have? Does that make sense?
B. Yeah, it makes total sense. And we're going to talk about some of the caveats to prolonged
calorie deficit diets and how you want to reach a maintenance phase as well a little bit later on.
So just on the evidence for why calorie deficit diets work, there are so many different studies
that we can point to. The more recent meta-analysis that I found that was published in the BMJ provides
strong evidence that calorie deficit diets implemented through something like what
you've just described, 2000 calories a day, less 10%, 1800 calories a day, are effective
for fat loss, particularly visceral fat as well. There are 40 randomized controlled trials
in the one that I was looking at, with over 2000 participants focusing on the effects
of caloric restriction. And other studies also show that calorie deficit diets,
independent of whether you're doing this with a vegan diet, a low fat diet, a high protein diet,
as long as the calories are controlled for, it will all lead to fat and weight loss.
Neil Milliken Yeah. And also on that though, which I know you'll probably be coming to,
Yeah. And also on that though, which I know you'll probably be coming to, it is also theoretically possible to eat 1800 calories of so-called junk food and still lose weight, but potentially
not promote better health.
Absolutely.
Right. So, which is again, another important caveat.
Absolutely. Absolutely. And, you know And there was a study that was published
in the New England Journal of Medicine 2003
that compared low fat and low carbohydrate,
because I can hear them right now.
You've got some low carb is probably listening
to this podcast and think, well,
there are studies that show that your metabolic health
improves if you're low carb,
you're removing some of the refined,
independent of calories.
And that is absolutely correct.
And in this study, they looked at just 60 adults
with obesity and they found that after six months
comparing a low fat group with a low carb group,
the low carb group lost a bit more weight,
statistically significantly more weight
than the low fat group. So in
the short term for certain people, and I just want to underline that for certain people,
low carb fares better. However, if you look for longer, so after 12 months, 18 months,
24 months in this study, they looked at 12 months, the differences disappear. And whether
that's due to adherence, the fact
that it's harder to not have some extra carbohydrates in your diet, just because of our, you know,
going back to the initial points we were making around the food environment, it's not exactly
easy to remove carbohydrates from your kitchen, your environment. Maybe that's the reason,
but the statistically significant differences
between them at six months, vanished at 12 months.
So it stands to reason that this energy model
of if you just simply reduce energy,
independent of the types of macronutrients,
independent of the quality of food,
you will see weight loss.
And this is why you have a lot of people
who are adamant that calories are the only
thing that you need to worry about. So why then am I not a fan of it? And why are we
both not a fan of it? In short, I think that they tend not to be as subtle as a 10% reduction
in calories. Typically what you find, and you've probably
found this in practice as well, I've seen this many times, is a more aggressive calorie deficit.
So from 2000 to 1500 calories. So the energy content of ingredients
over other quality measures, things like fiber and processing and the nutrient value of food
beyond the energy intake.
Yeah. It's really interesting, isn't it? There's many ways to get to the goal that you want.
And as you say on the face of it, if your only goal is weight loss, and yes, you can
argue if you're carrying excess weight and visceral fat that reducing that is going to
be helpful.
But at the same time, if you do that through eating lots of junk food, and we can
elaborate what that potentially means, there's going to be other implications for your health.
If you're eating pro-inflammatory foods in order to lose weight, yes, you might lose weight,
but you may also increase inflammation. And then you have to sort of weigh out what you're looking for. So I agree, like I accept that that works.
I don't dispute that that works.
In my clinical experience, I've never personally found it a helpful method with my patients.
Now again, I said we all have a bias.
I have a bias.
My bias is the tens of thousands of patients I've seen over two decades.
That's my bias.
The bias is I saw these patients, they were struggling.
I saw different diets work for different people.
I saw there's different approaches that people can take to lose weight
and improve their health at the same time,
because that was always my goal as an adult,
is to help you improve your wider health.
So I would often actually not focus on the weight loss actually.
I would focus on how do we create health in your body through nutrition, movement, sleep,
and stress management, what I call the four pillars of health.
Let's really focus first on creating health.
And a lot of the time, not all the time, a lot of the time,
the weight loss comes
along as a pleasant side effect.
So you're not focusing on the weight loss, you're focusing on the creation of health
and that's giving you the weight loss as a side effect.
And the analogy I draw a few months ago, Rupi, I had this amazing movement expert on my show
called Lawrence van Lingen.
People actually love that conversation.
And in the running world, right? So for endurance runners, they will often talk about cadence.
So they'll say, good endurance runners have a running cadence of let's say 180 per minute.
Your feet are hitting the ground 180 times in a minute.
And most recreational runners or a lot of us have a much slower cadence. And so people often think the way they improve their running is by getting a metronome and
actually trying to increase their cadence.
And he's like saying, that's like looking at Bentley drivers and going, oh, the way
I become rich is to drive a Bentley.
He's like, no, no, no.
It's like, he says, the cadence is a natural consequence when you do the other things right
to improve your movement dynamics.
It may not be the perfect analogy, but I think it kind of works there, which is, do you know
what I mean?
I don't know what you would take on that.
I think that is a perfect analogy, which is going to go into something we're going to
talk about later because all the things that I've already mentioned, unprocessing your
diet, increasing fiber, increasing protein at breakfast, and ensuring an earlier dinner
time leads to a calorie deficit as a natural consequence of those actions.
A side effect, dare I say it.
It's a side effect.
It is not the thing that we are intentionally going after,
but it is a side effect.
And I think that is what makes it a lot easier
to ensure consistency, because consistency is king.
So I'm going to talk a little bit more
about this calorie deficit issues that we have.
We both have, because in clinic clinic everyone has had this experience, no matter whether you're into lifestyle medicine
or not. Someone comes in, they've gone on a calorie deficit diet, whether it's January
or the middle of the year, whatever. They've had some early wins. They've improved their
metrics on their scales, whatever it might be, and they hit the dreaded
plateau. They say they put it out on a graph and it goes like this, the L shape, and it
is devastating for your confidence because you're doing exactly the same thing. You're
maintaining your calorie deficit. You are ensuring that you are rigorous with what you
are consuming. Nothing has changed whatsoever. So why then do we
see this plateauing? Surely if the energy balance model is consistent, then you would
just see a linear outcome in terms of your weight loss, particularly if you're starting
off at quite a large amount to lose, right? Why would you see this plateau?
And there's a number of different things
that you've alluded to already.
There's hormonal changes and there's metabolic adaptations.
Your body is essentially, has essentially evolved
to ensure that you have calories on it.
Your body has evolved through thousands of years to endure famine.
We are hardwired to keep energy on us. And so when you go through an aggressive calorie
deficit, it's sort of mimicking what happens when you're going through a famine, when you're
lacking food in your environment. We haven't updated our hardware to be relevant
for our modern environment.
It doesn't recognize that we have food
in every single corner.
And so just this realization should enable people
to understand why we see this plateau.
And if you're thinking about it again,
from the scientific lens,
what happens to your basal metabolic rate,
which is the number of calories that you burn through every single day,
as you lose weight, your body requires fewer calories to maintain its new smaller size.
And this reduction in basal metabolic rate will slow down your weight loss. Essentially, it's sort of like, if you're a startup company and you're getting in
every single month, you're having a certain amount of revenue coming in into the month.
If that revenue starts to decline, what do you do as a responsible business owner? You start to spend
less. And that's essentially what your body is doing. Your body is very smart. It will start spending less calories every single day, such to maintain the balance
of the energy on your body in the same way business wants to maintain runway and maintain
its longevity in terms of cash flow. So this is just a very simple analogy to illustrate what's
going on at a biological level.
It's not an argument against the calorie deficit though. And what I mean by that is
if it was just about calories, then surely reducing calories means that you're going to lose weight. So
why would it then plateau? Yeah. Yeah. Yeah. And I guess it makes me think about this kind of,
you know, we're not robots and machines, right? That we're a complex milieu of hormones and
biochemical signals, which actually, when you really start to think about it, it's like,
you know, think about the basal metabolic rate. We're spending calories on all kinds of things,
aren't we? Breathing, digestion, and... But there's a bit of reserve there, you know,
and we have the capability to reduce how much we're spending on those things, perhaps, if
we need to. If we're facing a famine, for example, where these complex beings that are
constantly responding to signals, right? Which is, I I think what we sometimes forget. We're not robots.
Yeah. We forget how intelligent our body is and how much of that is outside of our control.
All this stuff is involuntary. Like, you know, we have something called adaptive thermogenesis,
for example, the body will decrease its energy expenditure to match the calories that you're
putting into it. It's a very, very smart system, you know?
So essentially it's responding appropriately to you putting less food into your body.
It is an appropriate response because it is geared towards survival as well.
And the other thing that happened, I mean, there's so many other things that happen,
but just to illustrate this point, you get a reduction in your anabolic hormones. And explain what that term means.
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Anabolic hormones are essentially hormones that promote muscle growth and promote metabolism. And this can also get people to understand why you feel tired.
It will give you an understanding as to why people feel that fatigue.
And also your satiety signals reduce.
You become more hungry.
It becomes essentially more difficult to have that willpower to maintain a calorie deficit
over time.
At the start, it might be easy. It might be very regimented.
But then your body actually starts fighting against your voluntary decisions
to reduce calories by amping up these biological signals
as a result of what's going into your stomach and your intestines,
your digestive tract. Everything is telling you to eat, eat, eat.
Which is why, another reason why I'm not a fan of this.
We have this biological set point, don't we?
Yes.
You know, the set point, a bit like a thermostat that your body, your brain kind of, there's
a weight that it kind of wants you to be at your set points. And, you know, if you aggressively are losing
weight for some people, that set point is still there and it's kind of, you know, driving
you to say, wait, there's a problem here. It's like your thermostat at home, the heating
kicks in. Yeah. Yeah. Because the temperature's dropped. Yeah. It's a kind of similar principle
that we need to think about. I think.
You know, there's so many, so many weird and wonderful things that happen.
Like, I don't know whether you're like this,
but I'm a bit of a fidgeter, right?
My wife always tells me this as well,
particularly when we're like watching TV on the sofa.
I'm constantly moving around and like, you know,
just like feeling my thighs here or like move my,
what this is referred to in the sciences,
non-exercise activity thermogenesis.
So every little movement, all this different fidgeting that I'm doing,
it's actually expending calories just naturally.
If I was to put myself on a calorie deficit diet, outside of my voluntary control,
the fidgeting will reduce.
I will actually reduce the amount that I move,
as just as a consequence of me just moving around.
But you're not trying to.
But I'm not trying to.
This is a thing.
And it's a real big contributor to the amount of calories that one person expends every single day.
Some people are naturally more fidgety than others.
It's just one of those weird quirks of human nature.
But this is something that you actually witness.
And this is something, again, that proves how smart your body is.
Outside of your voluntary control, you will do things naturally, whether it's thermogenesis,
whether it's because of our set point, whether it's because of non-exercise activity, thermogenesis,
all these things coalesce to protect yourself from the insult of lack of
energy going into your system.
It's pretty amazing.
It is phenomenal.
There's just a couple of things I want to address there.
First of all, as we keep saying that term, calorie deficit diet, it's such a dry term,
isn't it?
Do you know what I mean?
It's like such a dry scientific term.
And I get why we're using it,
because you're trying to illustrate a point here,
a very important point.
But in terms of making food and engaging with your health,
fun and exciting, it's kind of, it's very cold.
Do you know what I mean?
It's a term like, that was the first thing.
The second thing I wanted to just say is that
some people may start to get a little bit disheartened from what they've heard already. They may go, oh,
so you're basically saying it's impossible for me to lose weight. You're basically saying
that I've got this set point and I'm going to lose it. My body's going to respond and
it's going to just make me hungry and drive me back. So Rupee, is that what you're saying? Rupee
No, that's not what I'm saying. I'm saying that I'm trying to give people an explanation
as to what is the lived experience for many of us who have struggled with our weight. There's so
many drivers that we can go into as to why people have more weight on their bodies. You know, we talked about guidelines,
we talked about the food landscape.
Our genes can also dictate the ability of us
to put on and lose weight.
The environmental pollutants, for example,
and our sensitivity to those.
What does that mean, environmental pollutants?
So environmental pollutants is a loose term that I'm using
to describe chemicals and toxins in
our environment that are obesogenic.
So they will induce a milieu of different hormonal changes like insulin resistance or
resistance to the hormone insulin that is released by the pancreas that is anabolic
in its nature that will promote growth.
Yeah.
BPA in plastics.
There's, I mean, have you dived into this research?
I mean, it's pretty scary.
Some of the research I've seen in terms of what BPA in plastics can do to our hormones.
Yes.
Yeah.
And in some ways you don't want to go there because if you go there, you're like, well,
we're living in a pretty toxic world these days where there are these kinds of obesogens,
these chemicals everywhere that are also playing havoc.
I think one of the nice things about how you start this conversation is that it's not really
meant to be disempowering.
It's actually meant to be very empowering and meant to help people realize that, hey,
listen, you might lose a bit of weight at first.
If things start to plateau, don't worry.
It doesn't mean you're doing something wrong.
It's just part of the natural process that some people have to go through, right?
Absolutely.
And also, just to harbour on that point, I like to keep things really simple.
There's so many different rabbit holes that we can go into with regards to inputs into
why people struggle with weight.
So in terms of the big picture,
what are the big reasons as to why people struggle
with the weight?
I think Obesity Genes are probably less of the issue.
There's still an issue, still very much something
that I pay attention to and I advise people
to pay attention to from a general disease prevention
standpoint. But in terms of weight, I think there are probably other things that we can
focus on before we start going into redesigning our kitchens and redesigning our lives to
remove abstrions and remove environmental pollutants.
Yeah, it's also how much can you focus on at one go?
Like if you try and focus on all 20 factors that you may have heard about that are driving your weight,
it may start to get overwhelming and you can just go back.
Look, and for some people that is going to probably be a big issue, right?
I guess it probably, I think what we're going to learn over the years is that some of us genetically are better able
at dealing with the toxins in the modern environment and some of us just aren't as
genetically predisposed to deal with them well.
Totally.
And in terms of, you know, this podcast is each week I try and have empowering conversations where
people feel at the end of it, yeah, there's something I can do here. There's really something I could do. Yes,
I know the world's hard and life is tough and whatever it might be, but actually there
are a few simple things I can do. And I think that's where we share very similar approaches.
So we definitely want to get to these four food principles at some points. I think, I
think they're just really helpful. Yeah, yeah, yeah. And just to re-emphasize that sort of lived experience that a lot of people have with
constantly going on diets and you know, you have a lot of motor, it's not lack of willpower,
it's not lack of motivation that people have.
Because the fact that people have experimented with a lot of calorie deficit diets, dressed up
as lots of different diets, whether it's, I don't want to name names, but there's plenty
of calorie deficit diets out there that are promoted by big companies.
The very fact that people even are able to go on one of those shows an incredible amount
of willpower, an incredible amount of motivation, because everything in your body is driving that individual to eat.
But what tends to happen is a yo-yo diet doesn't,
a yo-yo dieter doesn't lose weight, maintain that,
and then go back to the original weight.
You see an increase in their weight over time.
Why does that happen?
Well, for the same reasons that I just mentioned, why
a calorie deficit diet does not work over three, six and 12 months in terms of their
basal metabolic rate. What happens is you change your basal metabolic rate after doing
a calorie deficit diet. When you start eating the same number of calories prior to that
diet, what happens? You're in a calorie surplus.
And that's why you see a trend upwards of people who are chronic dieters rather than a plateau,
rather than a steady weight.
Does that make sense?
Yeah.
So let's go back to that example then.
Let's say that you are a woman who roughly, let's say 2000 calories is necessary for you to function.
Your breathing, your digestion, whatever it might be, you know, all the things in your
body. And so you're saying that if they then eat 1800 calories, so that's a 10% deficit
for a period of time, they're going to start losing weight. Let's just say a month or two, right?
You're going to consistently lose weight.
But then for some people, it's just going to start to plateau.
But some people may be thinking, Rupee,
that if I started at 2000, was what my need was,
and I'm eating 1800 calories, and I'm starting to lose weight,
then surely my basal metabolic rate also
will naturally go down because I have less mass on my body. So if I have less mass on my body,
presumably the energy necessary to feed that mass to do all its functions is going to be less.
Do you understand what I'm saying? Exactly. Yeah.
So surely then I'm just trying to think where the listener might be at in this. Surely then
what they need to do is then consequently, you know, if their new metabolic rate becomes
1900 calories, then they now need to, you know, reduce, you know, reduce even more. Yeah, exactly. And that's exactly what happens. But in a real world environment, we don't
maintain that same strict regimen of a reduction in calories. We go back to what we were eating
before and we're not very good at estimating the number of calories that we consume. It
goes up and down every single week, just like the ebb and flow of life.
And so what we tend to do is overconsume compared to our needs.
And that's what leads to excess weight, even more so than prior to when you started on the
calorie deficit diet. It's a very, very common experience that lots of people have.
And that's why you see when you examine yo-yo dieters
or people who have tried different calorie deficit diets
and all the different flavors that they come in,
you see a general increase over time
rather than a steady weight.
Does that make sense?
So if someone's listening, Rupi,
and they're like, okay, well, what on earth should I do then?
Yeah.
Right?
You've shared some of the science, Rupee, with me
in terms of what it says about how one technically loses
weight, but you mentioned that term real world.
That's the key thing, isn't it?
There's what the science shows.
There's what we can control in people
in a laboratory setting, in a research setting,
but what actually happens in real life?
Yeah.
Busy people with busy lives faced with constant temptation
when they go out in the world,
they're stopping to fill petrol in their car
and they're in the queue and they suddenly see,
they're a bit stressed and worked, they're a bit tired.
Oh, those chocolate bars look good.
Do you know what I mean?
All those kinds of things.
What do you suggest they do?
So I think there are strategies that as a side effect, like you suggested earlier, will
put you into a mild calorie deficit, but importantly, ensuring that you don't have to think about
it. And you're also creating something that is sustainable, that you can maintain consistency around that actually changes your biology
that makes it easier to maintain a calorie deficit rather than forcing yourself into
a calorie deficit. That sounds a little bit jumbled up, but I will explain when I go through
these different practices, what happens to your biology that makes it easier for you
to do so. So instead of you like pushing yourself
to maintain calorie deficits,
which I think are just inherently very, very hard,
these practices I think will make it super simple
such that you don't really have to think about,
okay, I don't need to restrict myself by not eating that.
And possibly more enjoyable.
100%.
I mean, I am a massive foodie, right? I mean, I live and breathe food every single
day.
How many cookbooks have you written now?
The fifth one is coming out in March.
And they're all brilliant guys.
Thank you. I appreciate that.
If you look for ways to actually improve your health and cook tasty food, they're brilliant.
And I think in terms of the number of recipes that we've created is well over 2,000 now
because we have over a thousand on the Dr. Skish and App.
I've done some for other people, some on the website.
They're just, I live and breathe creating recipes
with this health slant with injecting flavor
and yes, fiber and yes, all the functional ingredients,
but flavor is really, really at the forefront
of what I'm passionate about.
And I think it's really important to maintain
sort of this perspective on like food being,
food is life.
Everything is geared around like in the enjoyment of food.
It's like, you know, we've had so many dinners together
and amazing experiences over breaking bread
or breaking vegetables,
let's say, or like, you know, just it's the real sort of bond that people share. It's
how we celebrate other people's cultures. It is so much to me. And I think it's so much
true.
And I think that's one of the things people really love about your approach, Rupi, is
that you're trying to bring back the fun and the joy about
food rather than food being this thing that I have to control and count this and count
that and restrict. And of course, everyone responds to different approaches. But one
thing I really like about your approach is that you are trying to bring that joy and
say, hey, this can be fun. Before we get to those food practices that you recommend, I
just want to really emphasize this point that we're talking about, which is what can be really helpful for many people is this idea that
we focus on wellbeing in a variety of different ways. And the side effect is that we consume
less calories. And you're going to talk us through it from a food perspective. Let me
just bring something in to really help people
think about that point from another perspective, sleep. We know from certain studies that if
you sleep five hours a night compared to eight hours, you eat on average 22% more calories
the following day.
Totally.
Right? So let's just really think about that for a moment about this concept that we're
talking about. You're saying that technically you need to eat less calories
per day than your body is burning if you want to lose weight.
But what we're trying to say is that there are many ways
to get to that end point without actually trying.
So I have had patients in the past group
where I've helped them lose weight,
actually not by focusing on food,
by getting them sleeping eight hours a night.
Because when you sleep for eight hours a night, or let's say you can't manage that, you improve
your sleep, right? You're less hungry the next day. You feel fuller earlier and your
ability to resist temptation is much higher when you've slept well. Right? So it's something
that I don't think people think about enough. Like just because the food is important,
there are other upstream levers that you can turn,
which means that naturally you will make better food choices.
Like when you're less stressed,
you make better food choices and all those sort of things.
And so, yeah, I just wanted to sort of double click
on that point,
because I think it's really important
for people to understand.
I completely agree.
And I think there's a point I make in the next book
and on the podcast, I do this all the time.
We need more longer term strategies for weight
rather than quick fixes, which are being offered to us
in the form of medications and diets and all the rest of it.
But as part of that long-term strategy
are non-nutritional strategies.
It's not just about the food.
I know we've just talked about calories and in and out,
and this is the scientific way to lose weight.
And yes, that's absolutely true.
But what you're a big fan of and so am I,
are the other upstream effects that actually lead
to behavior change in the real world.
And I think, you know, it's very easy for, you know, I'm trained as nutritionists now
and as a medical doctor, it's very easy to lean on papers and the evidence that we have
presented to us and established journals. Great. We need that, but that informs our
opinion. It doesn't dictate the opinion.
And I think that's really, really important
for people to realize that,
yes, I'm gonna present the evidence to everyone today.
Yes, I'm gonna be pretty factual about it,
but it doesn't mean that this is the be or not.
I'm going back to what we were talking about at the start.
I think it's really important to maintain perspective on
this really has to be contextualized for the individual. And that's what I genuinely think.
And, you know, whatever modality you work in, they're studying the science
and then they're seeing real world impact.
And they're not always the same thing.
And I think the very best researchers, like I remember the first time Satchin Panda came on my show
and he's been on yours, I think, several times as well as mine.
Like he said something like, you know, we're going to really appreciate what you're showing
with your work, that actually what I'm seeing in the lab actually works in real life.
I think the very best researchers get that.
They get that look, we're studying this in a very particular setting.
We want clinicians to tell us actually, does this actually translate to real life?
And I think that's a point that sometimes we miss. It's a, what does a science show?
What does a science show? What does a paper show? Yeah. It's helpful, but it's not everything.
Absolutely. So let's get into food, right? Unless there's more on the science you want
to share. Should we get into these four strategies? Or is there something you want us to cover
first?
I think we're going to get into it as we go through it because I think there's so many
different ways in which we can again contextualize what I'm going to talk to you about with regards
to unprocessing your diet. That's the first thing. I think if there's one thing that you
can do, it is to unprocess your diet. What does that mean? Okay. I think the way you've described it in one of your books on weight loss really packs
so much information into a very simple strategy, which is focus your diet on one ingredient foods.
And where do you find these one ingredient foods? Well, you find it on the outside of the aisles.
You find it in the supermarkets with ingredients that you recognize without the need for labels. It's a very easy thing for people to remember. It's a heuristic,
a rule of thumb. I know there's going to be some nutrition scientists shouting that down at the
podcast. I understand there is an over-classification. I understand that it's not as simple as saying,
if you don't recognize the ingredients
on the back of a packet, then just put it back on the shelf.
I think this is actually a good strategy for most people
because it's understandable.
Yeah, it's like, what is the goal?
If the goal is to help people,
we need to communicate these ideas in a way
that actually resonates with them that they can apply.
Although I understand it doesn't fit in every situation,
I still believe that actually that concept of
if it's got more than five ingredients on it,
just think twice before you put it in your mouth.
I still stand by that.
Yeah.
Right?
Because I kind of say it works 100% of the time.
No, I can't say that. But is it a useful
framework to think about as you're going through life? I found it very helpful. I know many of my
patients in the past have found it helpful as well. So I'm still going to go, I think it's
helpful for most people. I agree. And I think if you look at the stats around the number of processed
foods that we have in our grocery stores, it's around 70%. I
mean, 70% of the UK and US's diet is processed, ultra processed foods. So these are foods
that are really far removed from the original intended ingredient. They've had added salts,
added emulsifiers, other additives to ensure its sweetness.
What's an emulsifiers, other additives to ensure its sweetness. What's an emulsifier?
An emulsifier is something that changes the texture of food to make it a lot more palatable.
There are other additives that are used to ensure that the shelf life is preserved.
And there are other things that we also do to food to preserve shelf life like dehydration.
So all these things collectively have been shown
in a number of different studies to be linked with poor health, independent of the calories
that they consume.
And independent of weight loss.
Exactly. Independent of weight loss as well.
Which is why, going back to what we said before, even if you could technically lose weight
by eating junk food, because I guess you could say I could literally have soft drinks and french fries, but as
long as it's in a calorie deficit, I will still technically lose weight.
You may not be improving your health at the same time.
Or you may, you know, on one hand be helping a little bit, but on the other hand be causing
a whole host of other issues for you.
Yeah.
And there are stories that have done that. I mean, they're pretty impressive. And you look at
it and you're like, okay, yeah. I mean, the energy balance theory does work. Absolutely. But, you know,
what are the long-term ramifications? You can't do a study for more than a couple of years at most.
Like what are the implications of this kind of habitual eating over decades? And the only
evidence that we have around that are observational. Essentially, no one's going to put someone on a randomized control trial between ultra
processed and less processed foods.
We look at natural experiments and so this is the strongest evidence that we have.
Let's connect this, this first principle, unprocess your diets.
Let's connect that to this concept of calorie deficits, right?
So again, the principle being that we're trying to engage in practices that are fun, that
are enjoyable, that naturally lead to us consuming less calories without focusing on the calories,
right?
So, you know, how does unprocessing your diet fit in with us consuming less calories?
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The mechanisms that exist that explain why ultra processed foods are damaging for our health, are multifactorial. One of the key
things I think, and probably the simplistic explanation, the Occam's razor approach if
you like, is that it actually leads to over consumption of these foods. Because they're
so hyper palatable, because they light up the reward systems within our brain, we generally over consume calories.
And this is a bit of a conundrum for folks like us, right?
Because on the one hand, we understand the reasons
and the biological reasons as to why this leads
to ill effects like weight gain.
But on the other hand,
it kind of gives food companies a bit of a way out.
It gives food companies a bit of a way out.
It gives food companies a narrative that says, well, as long as you don't consume these foods, as long as you maintain willpower not to consume as much of these chips and cookies and whatever,
then these are perfectly safe for you. They are safe within the context of someone's motivation.
And I think that's incorrect because what's happening is a hijacking of
our senses that leads to the over consumption in the first place. And so you could also
argue that ultra processed foods displace healthy foods from our diet. The matrix degradation
of the food leads to a lack of ingredients for our microbiome.
And we know, and you've spoken during your podcast many times, that anything that supports
our microbes health is super important from the perspective of inflammation, sugar balance,
but also weight maintenance as well.
And unfortunately, the marketing of these foods tend to be those of the most vulnerable in society.
And this sort of availability and convenience of ultra processed foods leads to what we see in the studies being the reason as to why it makes up so much of a population's diet,
particularly in the West, in the US and UK. And it's growing in other countries as well. I know you've spoken to Chris Valentine on the podcast about the subject.
Everything he says is true. And I think it's on us as health communicators to not only
give people the information around ultra-processed foods and the mechanisms and all that kind
of stuff, but give people simple strategies and simple ways in which they can deep process
your diet. I think one of the most like, I mean, there's so many things about doctor kind of stuff, but give people simple strategies and simple ways in which they can deep pressure you.
I think one of the most like, I mean, there's so many things about doctor in the house that
are like buried into my brain, but one of the best things, and I think it's controversial
to a lot of people today, but when you went into a family's house and you opened up the
cupboards and you're like, take all of this out and it was cereals, it was marinades,
it was sauces, all these this out. And it was cereals, it was marinades, it was sauces, all these different elements.
That's going back some time now, almost 10 years.
I remember doing that.
Yeah.
I mean, you say it's controversial, right?
And I agree it is.
One of the most useful strategies I found with patients over the years and frankly myself is this idea to not use up
willpower in your house. Now, I post about this relatively regularly and I think the
last time, one of the last times I posted about this idea on Instagram, there was a
small section who, like this is ridiculous. We should be able to have unhealthy, let's say, ultra-processed
foods in our house and we should be in tune enough with our bodies to not consume it.
Now I don't disagree that that would be a great aspirational state to be in. I just
don't think many of us are in that state and I feel that a lot of the time we're making our life really
difficult if we're using it willpower in the house. So I genuinely do not bring food into
my house that I don't want to be consuming. I don't tend to keep sweets, chocolates, cakes.
I don't keep them at home because there will be an evening when I'm feeling tired and a
bit stressed and I will start opening the cupboards and look for something a little bit sweet. And all I can see at the
moment are whole nuts and olives. And sometimes I'm like, ah, I'm not sure I feel like that
at the moment. It's not really what I wanted. I thought don't eat. Because it wasn't what
I wanted. I wanted that little hit from something sweet. So again, in terms of what is practical for many people, and my bias is
the patients I've seen over the years, I think not using your willpower in your house is a great tool.
And also thinking back now to that family who I helped to doctor in the house, I think a lot of
these principles depend, they depend where you're at on your journey. If you're used to having loads of ultra processed foods and that's, you know, making up 70% if
you're diet, as it is for many people, actually to reset, maybe for a few months, you don't
want that stuff anywhere near you.
So it can help you reset your taste buds.
And I know you know all the studies on, and maybe we can talk about them, about how we tend to over consume ultra processed foods. Most people
listening will know the advert, you know, Pringles, once you pop, you can't stop. Well,
I think most of us know that feeling. Once that packet opens, it doesn't take long before
it's empty.
Yeah. And I think to your point about the folks who are saying,
you know, it's lunacy to take all the ultra-presses foods
out of your kitchen and that we should have willpower
and the self-control, I think that's honestly
antithetical to the science.
And just one study, I mean, there's
so many different studies, but there was one study that
was performed in a metabolic ward. So that's where you have a very accurate idea of
calories in calories out. It was done in 2019. They looked at just 20 adults and
they consumed ab-libidum. So whatever they wanted, they were able to consume of
two weeks of a minimally processed diet.
And then it was crossed over with another two weeks, again, ab libitum, so whatever
they want, of an ultra processed diet.
And the participants who were on the ultra processed diet arm, when they were on the
ultra processed arm, they consumed on average 500 calories a day more
than on the minimally processed diet.
So let's put that into context.
Going back to the lady at the start,
the sort of example of 2000 calories,
you're gonna be consuming another 500 calories,
an extra 25% more energy.
What do you think that's gonna do to fat, visceral fat? And that's
just after two weeks. What's that going to do over time? So this idea that we can be,
that we can exercise self-control in an environment where we have food that clearly shows us that
we overconsume. That clearly is something that we overconsume when given
in a free living environment. It's something that I think needs to be addressed by having
some guides, some sort of rails around so we don't use up the willpower when we're in
our kitchen, when we're at our home, because outside we don't have a control of that. In
our houses we do. Let's just think about that again.
Let's just think about it through this wider point,
which is to improve our health,
to reduce the harmful levels of fats
that are on many of our bodies, right?
Even if we're just a little bit overweight,
but have that dangerous visceral fat,
the fat around our organs, the pro-inflammatory fat that's increasing our risk of chronic disease.
The point we're trying to land in this conversation, I think, is this idea that we want to help
people generally eat less, but we want to help them do that by not necessarily focusing on eating
less. We recognize that some people actually probably do okay by focusing on eating less.
And you mentioned some people in certain industries, very motivated, they like to track calories,
they like to measure how much they're having. Okay, great. I don't think either one of us
are saying for that individual to stop. We're saying, if that's working for you, brilliant.
We want the same outcome.
We want people's health to improve, right?
If that's your way of doing it, wonderful.
But so far, there's two specific things
I think people can grab their heads around, right?
What you just said about ultra processed foods.
If you are eating ultra processed foods regularly,
you're probably gonna be consuming more naturally.
So if you can, and we recognize it can be tricky, and there are cost implications, but
if you can go to more whole unprocessed foods, these one ingredient foods, as much as you
can, it's likely that you're naturally going to consume less.
Right?
So you're not trying to consume less, you're just choosing different foods and you're naturally going to consume less. Right, so you're not trying to consume less,
you're just choosing different foods
and you're naturally consuming less.
And we also mentioned with sleep,
if you can improve your sleep a little bit,
let's say you're sleeping six hours a night,
you can even get that to six and a half hours a night
to make it, instead of black or white, perfect or nothing,
it's like, no, no, even 30 minutes extra,
it's gonna have an impact on your hunger, it's like, no, no, even 30 minutes extra, it's going to have an impact
on your hunger, your satiety. You're going to naturally be consuming less the next day.
And you're going to naturally be able to resist temptation a little bit more. These are two
kind of relatively simple levers to turn, simpler for some than others, of course, that
will naturally lead to you
consuming less calories.
Yes, exactly that. Exactly that. And I think it's a nice framework that you've, you've
done like throughout this part of getting people to understand that you're going to
naturally consume less energy. We can explain it through the energy balance model. Absolutely.
But I think it's important for people to actually think about the tangible activities that they can do every single day.
And it can be explained by the science, but just get people to do these practices of, you know, swapping your crisps for nuts
or swapping the marinade for something that you make yourself at home.
These little things, even reducing the amount of ultra processed foods in your diet is still better than completely eradicating it as well. What do you say Rupee to someone who goes, okay, listen, I hear all this stuff about
ultra processed foods, right? But what are they? What is an ultra processed food? What
do you say to them?
So there's a scientific explanation as to what ultra processed foods are.
Has it got cool terms in like calorie deficit, metabolic, Metabolic Ward, Adelabitum.
People love these terms.
I know, I know.
So it was created by a Brazilian scientist who, you know, is credited with the NOVA classification
scheme.
But even within that, like scientists still argue over the classification of certain foods,
whether that means class two or three, or whether it's even helpful to have these different
classifications. So NOVA one, it's pretty much your one ingredient foods. It's
your culinary ingredients, your fruits, vegetables, poultry items.
When you say culinary ingredients, do you mean like herbs, like spices?
Spices, that sort of stuff.
So then these are acceptable. These are things that you're encouraging.
Yeah. These are things that we encourage essentially one ingredient foods. And then you have the next step down, which is processed culinary ingredients,
yogurts, cheese.
These are things that have undergone some processing,
but essentially they still have health benefits
or they're at least health neutral.
Homeless?
Homeless is essentially one of those.
Yeah, cause I think sometimes again,
everything gets quite extreme and black and white.
People go, yeah, well, what about these things? They're processed, but we're not, we're not saying
no processing. Yes.
We're saying minimal processing as close to its natural form as possible.
Exactly. Yeah. Yeah. And so within that you have so much gray area. You have a marinade
that's made with wholesome ingredients, olive oil, garlic, tomatoes,
that are perhaps being cooked themselves.
That would still be classed as a processed food.
It's very different to an ultra processed food.
An ultra processed food would be something like a crisp.
It's been dehydrated.
There has been an additive added to it.
There's perhaps even a flavoring.
There's so much that has happened from creating
from the original ingredient that could be corn
or rice or potato to the product that you have in your hand.
This is so interesting, we've just had a thought, right?
So we talk a lot about ingredient labels
and actually I think one of the things I've found is very
helpful for patients over the years is trying to teach them to start looking at ingredient
labels, right? Because many people just never look. And I probably didn't 10, 12 years ago.
I imagine there was a time where it was now I look at everything before, but I'm like
turn it around again. Wow. I didn't realize it had all this stuff in.
Why is this product, why has this got sugar in it,
for example, I didn't, you may not tell
until you flip it over,
but this ultra processed foods kind of templates,
it kind of takes it one step further, right?
Because you could potentially look at a crisp, right?
And there are healthier version of crisps
or what they call potato chips in America, okay?
And if you look, you will see that some of these have,
some of them actually are trying to market themselves
as healthy and it will be potatoes, olive oil and sea salt.
That there are some out there that exist like that, right?
So on the face of it, it looks healthier, let's say.
At the point I'm trying to get at, it's not only the ingredients, is it?
It's what's happened to those ingredients because they're still dehydrated and they're
still probably going to make you over-consume even though their ingredients are technically
a little bit better. And even though they've got less than five ingredients on the packet.
Do you know what I mean? That's, I go back to the original question. Well, this is why
people are so flipping confused about food. Do you know what I mean?
Well, there's so many different inputs because what you're referring to there is the disruption to the food matrix. So the food matrix is essentially the
3D structure in which we find natural food. So I can still have something like a potato.
And like you said, on the crisp packet, it can still have just olive oil and salt. And you might
think that's great. You know, that's, that's all that's been done to it. But actually we've disrupted that food matrix.
We've boiled it down to the constituent ingredients of starch, carbon molecules,
and then reformed it in the form of a Crespo or whatever it might be.
And that in itself is an ultra-processing method
that can lead to overconsumption because of the palatability of it.
Yeah, it's such a good point because also,
let's think of it through the lens of one ingredient foods that so-called healthy crisp packet has got three one ingredient foods in, right?
Potatoes, olive oil and sea salt. So the complexity is yeah, but what's been done to those potatoes?
Yeah, yeah, but what's been done to those potatoes. Yeah, yeah. Because you, it's hard, you know, people may push back on this, but potatoes are quite
a, they've got pretty good levels of satiety.
You know, you're probably not going to over consume boiled potatoes.
Oh, a hundred percent.
Yeah.
You're going to feel full very quickly, but you can over consume potatoes in crisp form.
And even let's take it one step further, right?
And I'm just thinking this through in real time, Rupee.
Just I really, you know, I really want to land these points to people so they really
get it.
So let's talk about that healthy crisp packet.
Potatoes, olive oil and salt.
You could steam some potatoes at home, right? Your organic potatoes, you can
wash them, you can steam them, put them on your plates if you want, put on olive oil,
and put on some sea salt. Sounds delicious, right? But you're going to consume less of that. Even
though the salt makes it more palatable and you're going to consume a bit more, like you're still going to consume less of that than the same
three ingredients put in a crisp packet.
Yeah, exactly. And I mean, the same thing can be said of one ingredient foods. I mean,
think of orange juice, orange juice can have one ingredient. That's it. It's just oranges.
That's, you know, one of your five a day, full of vitamin C.
These are the health labels that you find on products.
But unfortunately, because of that food processing method,
because of the disruption to the natural structure
of the orange, because of the removal of fiber
and the concentration of the natural sugars,
there's nothing wrong with the sugars in fruit.
But when it's refined to that point,
it can still be a one ingredient food,
but it can still be detrimental to your health.
So this is where people get really confused.
And you can understand, well, I've, you know,
one ingredients, you know, this is what I've been having.
It comes down to, you know,
what our ancestors would have eaten,
what our grandmothers would have told us, you know,
this is why I'm a big fan of simple messaging of like one ingredient foods as much as possible,
shopping the outer outskirts of your supermarkets and be realistic about what's up, whether
something is processed or not. If it comes from a packet, just think twice. Like you
said, read the back of the ingredient label.
And also be realistic. You know, there's, there's ideal and optimal, and then there's
realistic, right? You may not be able to get to a hundred percent of minimally processed
foods. I mean, sure, that would be amazing, but I think for many people, they feel that's
a little unrealistic, but they perhaps don't need to. You can still get, even if you reduce
it and change the balance by 10 or 20%, you're still
going to get those benefits.
Or you're going to start to get those benefits.
Yeah.
I don't think, I'm glad you're making this point because it's very easy to be puritanical
about this stuff.
And I'm certainly not a fan of being puritanical of this to the point where I make a point
on social media and on the doctors Kish and Ab
of highlighting processed foods that I love, you know, chili oil, love it. Gotu Chang, love it.
There's a Korean fermented paste that gives beautiful depth of flavor and color and heat
to whatever it might be. It could be something that I add to beans. It might be something that I add to
cauliflower to make a one ingredient food that much more delicious and palatable.
And I think there are ways in which we can use some processed ingredients into our diet and still have very
holistically a healthful diet that will ultimately lead to better weight maintenance and even weight loss.
You mentioned the Doctor Doctors Kitchen app.
Last time you came on my podcast,
you shared a little bit about that app
and when you were up to,
how have things changed over the last couple of years?
I mean, how's the app doing?
You know, what are people reporting?
Yeah, it's been phenomenal.
One of the reasons why I started The Doctor's Kitchen in the first place is to amplify what I was able to do
in clinic on a one-on-one basis with people watching
on social media.
And I think what the app has allowed me to do
is be in people's pockets whilst they're cooking
in their kitchens at home.
They don't have to listen to me on a podcast.
They don't have to read an article.
They can follow a recipe.
They can learn about the ingredients of that recipe.
They can share it with their family members
and they can enjoy it with their loved ones.
And what we're doing is teaching thousands of people
every single week to eat well every day
through recipes,
through information about the benefits
of certain ingredients.
And we have over a thousand recipes
on the Doctors Kitchen app now
and more every single week with a simple meal planner.
And, you know, cause it is quite hard
when it comes to planning what to eat every week.
And, you know, you've got so many different issues.
You've got the indecision
of what to make. You've got different taste preferences of your kids. For example, I'm
going to learn about that when my son's a little bit older. I'm sure you've got the
cost implications of food. You've got seasonality. There's so many different things to keep an
eye on and then allergens and dietary preferences and all that kind of stuff. And so if I can take away some of that complexity through a very simple elegantly designed app
that helps you make food decisions that introduce variety and balance and don't make you feel guilty
and it's just easier to cook from scratch, then that's a win for me.
Because it's amazing.
And who, you know, for people who didn't hear us talk about it last time,
who is it for? I know it's not a weight loss app, but does, will it help someone who hears this conversation goes actually, yeah, I want to try these practices and I do want to lose a bit of
excess fat from my body. Do you think your app will help them?
Naturally, it will absolutely help people because we're not a weight loss app. We don't promote
calorie counting. In fact, you
can remove a lot of the nutritional information if you wish from the app. But there are so many
people who have just simply done essentially what I'm talking about, unprocessing their diet
by cooking from scratch more, increasing the amount of fiber and protein that they consume
and eating earlier dinner if they can, and they lose weight naturally.
that they consume and eating earlier dinner if they can, and they lose weight naturally.
What we've done with our app is we've structured it
around eating well, which is like kid-friendly
and generally family-friendly,
but also around certain health goals.
If you're looking to lower your cholesterol,
if you're looking to improve menopausal symptoms,
if you're looking to improve brain fog,
we've looked at the dietary patterns and ingredients
that align with those health goals to make it easier
for you to choose recipes that aligns with that health goal
rather than just giving you the information,
don't eat this, eat this instead,
which you're just making a lot more practical.
And I think that's where a lot of this confusion lies
because people are looking for information without actually getting the practical solutions to it.
You're putting it all together. So it's essentially for anyone who wants to eat better.
Yes, it will help you with the weight, with hormonal balance, with energy, vitality,
whatever it is. And so, yeah, and I know how hard you work on it to help people
get that information in a very easy and accessible way. You've
got these four food principles, right? Number one, unprocessed your diets. I think we've
covered a lot about that. I think we could keep going for another hour on that, but let's
move on to the second one, which in some ways is not unrelated to the first one. But I think
worth pausing on fiber.
What's your take on fiber?
So there are some stats around the consumption of fiber in the US.
90% of the US population do not eat enough fruits and vegetables.
This is where we tend to get fiber from.
In the UK, I know everyone's heard of the five a day slogan.
Our average is around three.
That ranges between zero and around
five or so. The optimal, if you're looking at the stats, is close to 10 portions of fruit
and vegetables per day. This is looking at some research that was done by Imperial researchers
back in 2019. Now that doesn't necessarily mean that everyone needs to eat 100% 10 fruits
and vegetables a day.
I think there's a lot of nuance in this conversation.
The more fruits and vegetables that you can naturally introduce into your diet without
having to force it is great.
And that was why I had this principle of just eat one more.
I did a Ted talk on it a number of years ago.
Now, every time you sit down to eat, can you add just one more fruit, vegetable, nut or
seed?
Just one more. It could be a topper,
it could be a side, it could be a steamed greens on the side. Just think to yourself,
can I add just one more? Do I need just one more?
Okay. Just on that, I just want to not play devil's advocate, but we're sort of saying
at the start that many of us are kind of over consuming for a variety of different reasons.
are kind of over consuming for a variety of different reasons. So how does eating one more help in that environment? Could someone say, well, Rupi, you're saying to us, we need
to eat less. Now you're saying I should eat more. I know you're not saying that, but for
the purpose of this conversation, how does that fit into what we've just said?
When you eat more fruits, vegetables, nuts and seeds, what you're inadvertently doing is eating more fibre.
And what happens when you eat fibre is that it increases your feelings of fullness and satiety.
So how satisfied you are. Satiety is just a fancy word for satisfaction.
It leads to reduced overall calorie intake as a side effect.
And this is particularly pronounced with soluble fibre that we find in fruits, vegetables,
nuts and seeds.
It also creates this sort of gel-like substance in your gut.
This is from soluble fibre that slows down absorption and this improvement in your blood sugar levels as well that we
know is critical in protecting us against things like type 2 diabetes.
So you're basically saying eat one more of the right stuff.
Yes.
And you'll eat a lot less of the wrong stuff.
Of the wrong stuff.
Exactly that.
Exactly that.
You can have that.
I'll make that the subtitle of my next book.
And what also happens is you're inadvertently increasing
the food that your microbes have to munch on.
So I like to describe our microbial community
in a largely populated, largely in our large intestine.
We have microbes all over our skin and in our mouths,
but the biggest population of microbes
that include bacteria as well as viruses and nematodes
live in the large intestine.
And when you're introducing and presenting to them
lots of different types of fiber, they love it.
They ferment it into these short chain fatty acids,
acetate, propionate, butyrate,
all these wonderful funky words.
All they do is, well, not all they do,
but what they do is they nourish your colon cells.
They keep this thick mucin layer
between the interior of your digestive tract
and the thin gut lining.
So there's a bit of a barrier there.
It's a nice sort of spongy layer.
So your barrier isn't being disrupted
or there's no excess leakiness that can lead to symptoms
and a heightened immune system.
It also regulates appetite or helps regulate your appetite
by affecting hormones and signaling pathways via the gut brain axis.
So we have this highway indirect and direct
via the vagus nerve, this long winding nerve
that goes all the way from your digestive tract
all the way to your brain.
And it signals satiety, it signals that you're satisfied.
So you don't have the over consumption behavior
that is otherwise lacking if you have a diet
that is largely ultra processed as well.
So it all sort of ties into each other.
And that's why I'm a fan of just one more.
It sounds sort of counterintuitive,
but when you eat just one more fruits, vegetables, nuts,
and seeds and more fiber generally,
you tend to eat less overall.
The science on the benefits of fiber is, you know, pretty convincing. There's a lot of
it out there. How do you, with your experience, how do you view the many people around the
world who are improving their health on low fiber diets? So the, I guess one of the extreme
aversions of that might be the so-called carnivore diets,
where people are consuming a lot of animal products and minimal, depending on how people
are applying that.
Some people are only having meats, for example.
Some people are having meat and fruit.
Some people are having, you know, meats and vegetables or whatever.
You know, it's very hard to say what is the carnivore diet.
Different people have a different interpretation of it, but there's no question that some people
are experiencing some quite profound health changes, a reduction in autoimmune systems
and joint pain and sometimes skin problems by what may seem on the outside as a low fiber diets.
Yeah.
Right. I'm sure you're aware of this.
What is your take on that?
I think that people are absolutely thriving
on some of these, I don't want to call them extreme diets.
I guess they're extreme in the context of how much they
differ from the standard dietary advice that most governments give.
What does an extreme diet even mean?
Yeah, exactly.
So I think in terms of how I would appropriately describe
them, I say that they're quite an outlier
from what we would typically recommend
to the average individual,
not that an average individual exists.
I think absolutely for certain people,
they are thriving on these diets.
And you can explain it through a number of different reasons.
Some people have had their guts ravaged
by an excessive use of antibiotics over years.
Could be stress.
It could be their genetics,
that they're just more inclined or more attuned to a diet
that is higher in certain types of fats,
whether it's coming from polyunsaturated or monosaturated fatty acids or saturated
fatty acids that are coming from mainly meat products. There are certainly people
that are absolutely thriving. I would say that those individuals are most likely
going to be in the outliers. And the reason why I say that with some degree of confidence is because in terms of the long-term implications
of a carnivore style diet,
and I should probably define what those sort of mean
that they're essentially very high in animal-based products.
In the case of carnivore diet, it's quite relatively low
in fat, a ketogenic diet is a lot higher in certain types of fats
and low in protein, low in carbohydrates.
So there's different variations of what we're talking about.
But essentially, the outlier diets,
there is certainly a lack of evidence
in looking at long-term data for these individuals.
Short-term improvements in inflammation,
improvement in symptoms, improvement in symptoms,
improvement in subjective measures of health.
Brilliant, wonderful.
In terms of what I care about,
in terms of the implications on cardiovascular health,
on dementia, on metabolic health over time,
there isn't as much evidence that I would like to see
for me to confidently recommend
that this is a strategy that people could start with.
And I'm saying start with really intentionally here.
So I think most people, as I mentioned earlier,
are on ultra-processed diet.
The safest gateway onto a dietary strategy that works for an individual,
I think, is to go on something that resembles
a Mediterranean way of eating,
which is relatively high in plant material,
good sources of fats, so animal fats,
as well as extra virgin olive oil, for example,
and monosaturated and polyunsaturated fats,
and a decent amount of protein
that largely comes from plant-based sources.
The reason why I'm confident
that's a great gateway to start off with
is because we have long-term evidence on that
in terms of cardiometabolic benefits
and all the disease prevention studies
that I have read myself.
In and around that, let's say you start that.
Let's say you do start increasing your fiber.
Let's say you start having 30 plants a week,
based on some of the studies that we've seen
at the American Gut Project, and you don't thrive on that.
And actually your symptoms get worse,
or you have digestive complaints,
or you start having symptoms suggestive
of an autoimmune condition. don't force yourself to go
on that just because I said that and don't force yourself because that's what the science says.
You have to be your own expert. You have to navigate what is a complicated world of nutrition
and I always advise someone to do that if they can with the guidance of a nutrition specialist or a dietitian
who can essentially enable you to decipher what might be going wrong.
And for certain people, a low carbohydrate diet, a high fat diet,
a carnival diet might be the right option.
It might be the right option, but it's certainly the outlier in my opinion.
Yeah, I really appreciate you going through that because I think what I think happens
sometimes is when we just give generic nutritional advice and we say that the science supports
this, it can make some people who are thriving on different diets feel really bad and sometimes
angry and sometimes then have a distrust of
the information they're getting.
And look, the truth is I have seen so many patients over the years with autoimmune symptoms
who actually seem to dramatically improve them at least temporarily when they go on
what might be considered a quite extreme diet.
And I have seen some patients with going on carnivore,
thrive and I get why they want to do it.
I'm like, if you've had joint pain for 10 years
or skin problems and then you change your way of eating
and then you suddenly feel fantastic,
man, I get it, if I were you, I understand.
And what I always come back to is I always think,
what do we not know yet?
Right, for all that we do think we know,
what do we not know?
Because I think we're always learning new things.
Like 30 years ago, we barely knew
what the gut microbiome was.
Right?
Because now we're all experts on the gut microbiome, right?
And it's like, well, hold on a minute,
what else do we not know that we may learn about?
So I've always been more interested in patient outcomes
than scientific studies.
I'm like, if that patient's feeling better
and I can do their blood tests
and their markers are all looking good as well,
I'm like, I can see why they're doing it.
And I can't really make a strong case.
Now, it's not that I disagree with
increasing fiber. I actually think for most people it's a really good recommendation,
but I also just want to recognize that some of us need these more extreme diets to feel good.
I think it's a really important point that people should ponder on because, you know,
it really depends on what you're trying to optimize, right? And I think from the perspective of what we were talking about
right at the start, you know,
people who can maintain a calorie deficit diet
or train, you know, for bodybuilding competitions and stuff,
those are really highly motivated people.
I also think people who thrive on some of these
outlier diets also have to be very, very motivated
individuals as well and all power to them. Can I just say, I think they're really motivated thrive on some of these outlier diets also have to be very, very motivated individuals
as well and all power to them.
Can I just say, I think they're really motivated because sometimes they've had horrible health
outcomes in the past.
Yes, exactly.
And they're like, I'm not going back there.
100%.
And you know, someone who has experienced that sort of the stick of like trying to change
their lifestyle because they're, you know, trying to change their lifestyle because they're trying to improve their health
and optimize their health.
I completely understand that.
And that's why you have this motivation
as a product of that individual situation.
And so where I think it falls down
is where someone might see a carnival advocate
talking about this online and be like,
great, I'm gonna do that, I'm gonna lose weight.
It's very, very hard to maintain that lifestyle
because of our food environment.
And it's very easy to unfortunately have a hybrid
of like part carnivore, part just eating what I want,
bit of wine at the weekend, bit of ice cream in the evening.
And then all of a sudden the weekend, bit of ice cream in the evening.
And then all of a sudden, gosh, you analyze their diet.
It's essentially a standard American diet.
Yeah, that's interesting.
It's high fat, it's high protein,
it's high refined carbohydrate.
And it's that toxic milieu that leads to a lot of these metabolic complications.
And so I'm all for an individual who has had success on some of these outlier diets
to go for it if they can maintain the
Restriction that it requires considering our food environment and our and the landscape. Okay
Let's go on sir three and four right protein at breakfast. Yeah. Yeah, okay
Why is that important? Gosh, I think this is probably one of the areas
of nutrition that I've changed my mind on quite a bit.
So protein, if you look at the required
or the recommended amounts every single day,
is set at 0.8 grams per kilogram of body weight.
I used to think that was enough.
I've actually changed my opinion on that. More
recent protein researchers have suggested that the ideal amount of protein that one
should require every single day is 1.2 grams per day, which is 50% more than what the recommendations
are.
2 grams per kilo per kilogram per day. And it's more if you are over the age of 55,
because we tend to assimilate less protein from our diet
as a result of our digestive tract.
It is more, again, a little bit more
if you are postmenopausal,
and more if you're breastfeeding as well.
The stats demonstrate, or the recommendation
is close to 1.6 grams per kilogram of body
weight per day, which is a lot higher, double the amount that's recommended.
And I think, and this is a hunch, I haven't looked at any statistics on this, but I think
people who transition to more plant-centric diets with good intentions of increasing fiber and following the science, etc.
may inadvertently be under consuming protein. And that could lead to feelings of fatigue,
lack of energy, thinning of hair, which is why I think a lot of vegans and vegetarians who have
gone that way from an omnivore lifestyle, revert back to an omnivore
lifestyle because they haven't really put the importance on protein that they should
have when they transition to a different lifestyle. And I think this is probably one of the missing
pieces of the nutrition puzzle for a number of other reasons around proteins. I mean,
protein is so important, you know, like it's the molecule of life. It's, you know, the
building blocks of not just our muscles. A lot of people think of protein as, you know, like it's the molecule of life, it's, you know, the building blocks of,
not just our muscles,
a lot of people think of protein as, you know,
I eat protein that goes to my muscles.
25% of the protein that you consume goes to your muscles.
The rest of it goes to bones, enzymes, hormones.
It is the structure of so many important
biological living things in our body.
It's beyond muscle health,
even though it's very important for muscle health.
And so again, why am I a fan of eating protein at breakfast?
It can help regulate your appetite levels during the day.
It's satiating, it has a higher thermogenic effect.
So a high protein diet promotes
an increased body temperature and energy expenditure
because your body has to break down protein, which is actually quite a lot harder So a high protein diet promotes an increased body temperature and energy expenditure because
your body has to break down protein, which is actually quite a lot harder than breaking
down carbohydrates and fat and also re-assimilate it in the process of muscle building.
That affects what you said at the start, calorie deficit.
Exactly.
Exactly.
Yeah.
You could see all these things like, so I'm glad we started off with the calorie deficit framing
because I think everyone can see these recommendations
that are being given to by a lot of people
without the sort of explanation
of inadvertently causing a calorie deficit.
There's a really interesting study that I think
it illustrates this point quite well. It's a relatively small study
looking at adolescent Chinese individuals. There are 150 obese individuals and they were
randomly assigned to one of two iso-energetic breakfasts. So that's calorie controlled breakfast.
So that nothing to do with calorie deficit here, nothing to do with difference in calories.
One of them were given,
one of the cohorts were given an egg for breakfast
or an egg-based breakfast.
And the other one was steamed bread.
So you've got something that is high protein and high fats.
There's a limitation on the study there.
And then something else that is high in carbohydrates.
And what they did is they measured
their subsequent lunchtime food intake.
So again, real world kind of study,
and they recorded appetite
according to their subjective levels,
but then they also looked at their hormone levels as well.
They looked at their satiating levels.
And what they found is that folks who had the protein
at breakfast
ate less for lunch. They had lower levels of the hormones
that drive hunger at lunchtime.
So there was a biological observation that they've seen
and they also saw it within the real world behavior
of those individuals as well.
That's just one of the studies
and just looking at the
bigger picture of protein. When you look at the mechanisms and when you think about, okay, what is
Rupi suggesting here in terms of how do I improve my weight control, have protein at breakfast,
it's really important. And if you look at most people's breakfast, what is it?
Carbs.
Carbs and carbs.
Sugary cereals.
No judgment.
I used to be like that all the time.
Cereals, croissants, what's offered to us in food chains?
It's all refined carbohydrates.
It's a lot of cereals and there's nothing wrong with having those, but it is at the
expense of the protein that we consume.
Yeah.
I love that.
I mean, look, there's no part of this conversation that's about judgment, right?
You're just saying, or one of the ways we can interpret
what you just said is that it's not about good or bad.
It's just that there's a consequence, right?
If you have a low protein breakfast,
it may well be that one of the reasons
you're over consuming later throughout the day
and therefore not in a calorie deficit
and over consuming calories overall is because of that low protein breakfast. So it could
be one of those big upstream levers that you turn that naturally mean you're fuller for
longer, you eat less, your hormones are different. Do you know what I mean? And so, you know,
you said at the start 0.8 grams per kilo, 1.2 grams per kilo. Again, a lot of people find those things very dry. It's
like, well, what do I do with that? Like, am I going to weigh myself and weigh proteins?
So can you sort of bring that to life with people? What does that actually look like
for someone?
Yeah. There is a protein calculation in the Dr's Kitchen app. I just want to add a little
plug there. So if people
are confused about this, I understand. I'm confused about it. Well, I was confused about
it myself. And I think we try to make it very easy for people to visualize exactly what
that protein requirement is. So if you think about it from the perspective of, for argument's sake,
a 50 kilo individual, prior to the changes in my recommendations
on protein content,
people would be advised to consume,
let's say 40 grams of protein for that person's weight.
So broken into three meals,
that's around 15 grams of protein.
That's a couple of eggs at each meal.
I'm not saying have a couple of eggs at every single meal.
Lots of different plants have proteins in
as do animal products.
Now the recommendation would be, okay, having 60 grams.
That's 20 grams of protein at every single meal.
And I think it's very important to have protein
at every meal because of the impact on your appetite.
It means that you're less likely to snack
in between meals as well.
And it also is again important from the perspective
of maintaining your protein intake
because we can't store protein.
We have stores for glucose, we have stores for fat.
We don't store protein.
You remove it via urine every single day.
So you need to maintain your protein consumption
every single day.
If you don't, the inefficient way in which
to maintain your protein requirements that your body has
is to draw it from muscle.
And you don't want that.
Your muscle is essentially like
your pension savings account.
You don't wanna be drawing from that
to do the weekly shop in the same way.
You don't wanna be doing that from that to do the weekly shop in the same way. You don't want to be doing that for a long term financial strategy. So protein intake every
single day is super, super important. Yeah. So you're saying for a 50 kilo individual
and you're using that for the ease of maths, right? So if you weighed 50 kilos,
you're saying the previous recommendation was 0.8 grams
of protein per day per kilo of body weight.
So that effectively 0.8, 50 is 40.
So 40 grams of protein and roughly that's 15 grams of protein at every meal.
And you're saying the new science, the new recommendations are saying that's a little
bit low.
Let's go to 1.2.
So again, for that 50 kilo individual,
that 1.2 now becomes 60 grams of protein throughout the day, which instead of 15 grams at each
meal, there's 20 grams of each meal. And I guess people like Gabrielle Lyon, I think
Gabrielle's great. And I think her research and what she shows in her book and on her
podcasts about, you know, she's, she's, she kind of says she goes a
bit higher than that, I think, and she would recommend that everyone starts their day with
at least 30 grams of protein for a variety of different benefits. And of course, what
you need depends on your size as well, because, you know, you know, I'm six foot seven pretty
much, right? So it stands to reason that I'm going to need more protein than someone who's five foot five.
Yeah.
Right. Which again, we really need to think about.
What are your favorite sources of protein?
Because protein again, it's like, okay, people might initially go to things like,
well, I know meat is protein, I know fish is protein, and of course they are.
But what's your list of healthy protein sources for people?
Just in that point, I agree with Gabrielle. I think the amount of protein that people
require if they train, so if they exercise, if they do cardiovascular training, for example,
is high. It's at like 1.6 grams per kilo of body weight. So if you are that 50 kilo individual,
you are getting close to that 30 grams.
What she refers to in some of those studies
from protein researchers is the effect on something
called muscle protein synthesis,
which is essentially muscle building and muscular health,
not necessarily hypertrophy.
So not necessarily growth,
but certainly the health of muscle.
And I think that it stands to reason.
The 1.2 grams is the minimum amount of protein
someone requires to ensure non-protein adequacy.
And there is controversy around that as well.
You'll find some other researchers saying,
no, it's 0.8 grams per kilo. That's what it should be.
So I agree.
I think the amount that she recommends is more in line.
They tend to go a little bit higher.
And I think the reason why I tend not to personally
is because in a real world scenario,
if we encourage people to eat that higher level of protein,
what comes along with it,
what comes along with it.
And it tends to be a little bit more of the fats,
a little bit more in terms of the energy density.
And then it becomes into that odd world of over consuming in general.
And unless you're regimented, it can be quite difficult.
Yeah. For someone like me, right,
these recommendations have been interesting
because I've been observing them.
I've had Gabrielle on my show twice. I'm six or seven,
right? I'm pretty lean, but because of my height, I'm still almost a hundred kilos,
right? So if you then apply these new protein guidelines through the lens of someone who's a
hundred kilos, and of course a hundred makes the maths really easy. Right? Well, 1.2 grams per kilo per day is a hundred and twenty grams
of protein. Right? Which means I would have to have 30 grams four times. That's one way
of doing it or 40 grams of protein at each meal, which is quite a lot. Right? You know,
it's not that easy.
You would have to probably eat meat and fish regularly
to actually try and do that in an easy way.
And then if you go to 1.6 grams per kilo per day,
which I know some people are recommending,
and I understand why they're doing that
based on that research, I really do.
I'm like, wow, that's 160 grams of protein.
That is a huge amount of protein for, yes, I'm like, wow, that's 160 grams of protein. That is a huge amount of protein for, you know,
yes, I'm tall, but I've still got a kind of
similar size mouth to like, I don't know,
I haven't done a test, but do you know what I mean?
It's a lot for me to actually consume.
And you know, I'm studying this research.
I keep looking at it.
I keep tracking things in my own body
because of course I want to maintain my muscle mass
as I get older, but it's interesting, isn't it?
It is. Yeah. And I think your example really does illustrate the issue and the shortfalls
that I think people might find themselves in. Cause if you start following blindly the
recommendations of 1.6 or even two grams, particularly if you're training, you can over
consume it's very, very easy.
And just generally, it's very, very hard to do that.
Cause what you're describing there,
I mean, people always use chicken breasts as the example.
So I'll use that, but there is protein, obviously,
and lots of other products,
but a hundred grams of chicken breast
contains anywhere between 25 and 30 grams of protein.
So you would have to essentially consume
one and a half chicken breasts every meal
if you're eating three meals every single day.
The equivalent of chicken breast in the plant kingdom
would be something like tempeh or tofu.
Tempeh has around 25 grams of protein per a hundred grams
but obviously there are differences.
Tempeh is probably one of the best sources
of plant-based protein.
It's a natural fermented product.
The fermentation essentially allows a lot more
of the proteins to be absorbable.
Has all nine essential amino acids,
although it has the less leucine,
which is the muscle building amino acid.
So you have to be really conscious,
particularly if you're a hundred percent plant-based
to ensure that you're getting lots of different types
of proteins into your diet from nuts and seeds.
I know lentils and pulses in general tend to get grouped
into the high protein category.
When you look at the nutritional value of chickpeas
and beans, it's actually quite low.
It's around eight to nine grams of protein per 100 grams.
So if you're getting all of your protein largely
from whole grains and pulses,
for you, you'd have to be consuming a couple of cans
of beans every single time you eat.
And that's a lot.
It's a lot of fiber.
It's a lot of strain on your digestive system. And this is where
I think people will have to move into more of the supplemental realm. So supplements
of soy based protein or pea protein, which have all sorts of issues around those as well
in terms of ultra processing and the additive ingredients.
I know it depends on the quality of the supplement you're consuming.
And I know your approach is a food first approach,
but do you think that is a valuable role
for protein powders for some people?
Absolutely, yeah, I think so.
From my new perspective on protein,
just because of the issues surrounding
getting your requirements from whole foods alone,
I think supplemental protein from a good clean source is something that people should be
leaning more into.
Because I guess going back to our ultimate strategy here, we're looking for a goal which
is long-term health.
And part of that is quite unnatural. We're not naturally
born to live this long into our 80s and 90s. If you look at the Hadza, the Masai, their
average age is very, very low. Evolution has guided us to procreate and thereafter procreation
it doesn't really care about us. It is ruthless in its design, essentially. So from that, can we take then your perspective is the reason we're having to perhaps do some
things that might feel artificial through an evolutionary lens, like take a protein
powder and, you know, we could do a whole two hour podcast just on this topic alone,
right?
But just very simplistically
is because actually we're living in a new world now, we might have different goals and
actually evolution has designed us for a different purpose. So if we want to live to a hundred
in good health, we might need to do some things that people didn't need to do before.
Totally. That is a really good point. And I think people need to lean into some of the perhaps
of the unnatural elements of nutrition
and also lifestyle as well.
Trying to purposely put ourselves into discomfort,
for example, trying to purposely move our bodies
in ways that perhaps are not natural
to the way we've been designed in terms of
we're bipedal organisms,
we walk over long periods, but we need to do muscle bearing exercises. We need to train
certain areas of our anatomy if we are in the camp of wanting to thrive in our later
years. So there are certain things that we will do naturally. And part of that is the
nutritional strategy that amps up protein, particularly in your later years.
Yeah. Well, we'll maybe touch base. We'll probably go deeper on that in the next podcast
we do together.
For sure.
So this one, okay. So you have these four food principles. We've done unprocessed your
diets. We've done fiber. We've done protein at breakfast. Before we move on to an early dinner, can you just briefly explain why specifically at breakfast?
At breakfast, I think there's a number of reasons
why I say specifically at breakfast.
One, we tend to rely on ultra processed
or refined carbohydrates.
And it's an opportunity that we miss
at the start of the day to get our total protein requirements for our 24 hours.
That's probably number one.
The second thing is the impact on appetite regulation.
So if you have a cereal,
the likelihood is that you're gonna feel hungry
because you haven't satisfied your body's requirements
for protein mid-morning.
If you have protein in the morning,
like was eloquently described in that study
that I described from the Chinese adolescents,
you're gonna be less hungry.
And in a food environment where food is abundant,
particularly hyper-palatable food,
you're gonna have a lot more self-control
to not over-consume said calories.
So that's why I think protein at breakfast
is a great strategy to ensure that you're not over consuming
and improve weight maintenance.
Yeah, and one of the things I've often said to patients
to help them with this is eat dinner for breakfast.
Yeah, I do that all the time.
Yeah, I mean, it's a very simple way
because we've got this idea of what a breakfast food is.
Yeah.
Actually, it wasn't always. No. It's kind very simple way because we've got this idea of what a breakfast food is. Yeah. Actually, it wasn't always.
No.
It's kind of come relatively recently what a breakfast food is from cereal companies.
Right.
And when you really dive into where this all came from and the marketing of all,
it's actually, you know what?
Who says that these are breakfast foods?
Yeah.
Yeah.
And so I think eating dinner for breakfast in this modern context can be a very useful
concept for people to apply.
There's that beautiful photography set of photos from, I think it's the New York Times,
where they looked at what kids eat for breakfast around the world.
It was done about 10 years ago.
I come back to that all the time.
You know, what you see in the UK and the US are just these refined sugary cereals.
And you definitely see that in certain other countries like Latin America, in particular Brazil.
But then you look at like Asia and it's just like a tali, you know, like Sri Lanka was like a tali with some,
I mean, that's the kind of stuff that I would eat for dinner.
We used to go to India for six weeks every other summer.
I can still remember my cousins before they
went to school, they'd have these big plates. There was like vegetable curries, there was
dahl, there was sometimes meat, there was like rice. It was like a proper meal. And
then I noticed after about 10 years, you're going back and like there's all these adverts
from the cereal companies,
like people are starting to change their diets
to the quick and easy Western breakfast.
And I'm like, actually this is happening everywhere
or it has the potential to happen everywhere,
but naturally people were eating different things.
Let's get to number four, before we run out of time.
Yeah.
Hey, I could talk to you for hours,
but let's get to this early dinner.
Yeah. So I think eating an early dinner is a really simple strategy for ensuring that
you are not going to overconsume. And I know I've just seen this through the lens of calories
in, but bear with me for this. So one of the reasons that people cite for why an early dinner works in terms of better regulation
of weight is because your body is better equipped to deal with nutrients from food during daylight
hours and eating an earlier dinner essentially aligns with your circadian rhythm, which is
the rough 24 hour cycle by which all biological organisms operate
on. And so it's promoting efficient use of those, the energy and the nutrients. Late
night eating leads to this inefficiency of metabolism and a higher likelihood of storing
excess energy as fat. And there are some beautiful studies actually looking at this. So there was a randomized crossover trial and from 2020 of a late dinner versus a routine dinner. And their
routine dinner was at 6 PM. I don't know how many routine dinners are at 6 PM. I'd love to have an
early dinner at 6 PM, but I definitely don't right now. And their late dinner was at 10 PM.
So kind of like mimicking a lot of what people might eat
at 10 PM, particularly if you come back from work
or whatever.
And then they had a fixed sleeping period
between 11 and seven.
This was done in a laboratory setting.
So there are some limitations there.
They had 20 healthy volunteers.
And like I said, they were crossed over.
So this is something that they observed in both arms. So when they were given the late dinner at 10 PM, what
they observed was that they tended to have higher blood sugar levels, so high glucose
levels. They had higher fats in the blood as well, something called triglycerides, and
they had lower free fatty acids and dietary fatty acid oxidation. What that
means is that they were using less of their fat for burning, so they burnt less
fat and what they recommended or what they suggested was that over time if
you are consistently eating in a late dietary pattern that is inconsistent
with our circadian rhythms,
it could put you at higher risk for type 2 diabetes.
So that's just one way in which just simply changing
when you eat can have a drastic impact
on where you store fat and also the risks
for type 2 diabetes as well.
Yeah, it's, you know, once you start looking at nutrition
through the lens of our circadian biology,
then you have another factor to consider, right? And I'm pretty sure there were these
Spanish studies from a few years ago where they showed that people who had the same amount
of calories, right? And this really speaks to where we started this conversation. But
if the majority of those calories were eaten in the first half of the day compared
to the second half of the day, people lost more weight.
So the same amount of calories, but the body processes things differently at different
parts of the day.
It was, it was quite eye-opening that for me to go, wow, there are all of these kinds
of complexities. And I think one of the problems with this research on early dinners,
because I totally agree with you. I think it is much better if you can.
Now, I want to say a couple of things. One is I recognize that some people who do,
let's say, time-restricted eating and they go, right, well, I'm going to eat all of my food
within an eight-hour window and for those 16 hours in in a 24 hour period, I'm not going to eat.
And yes, there were some good studies which show for some people that can be really, really
helpful in the modern world because of work patterns and because of the fact that sometimes
the way we connect with our family is at 8, 8.30 PM or whatever.
And afterward you get back, you down tools, you sit down and have that meal. So I think some people
will actually find this early dinner recommendation quite difficult to apply. And I think we both
recognize that. I think it's also important to say that actually you can tweak other levers.
You don't have to do everything.
You probably can't do everything.
And some people, for example, will say that when I eat lunch or when I eat breakfast,
breaking the fast, or let's put it another way, when I ate my first meal at 12 PM and
my last meal at 8 PM, I thrive.
And so you go, yeah, actually maybe they found what's going to work for them in the context
of their life.
But I do believe that most of the research supports this early dinner, if you can.
And I think just again, trying to connect nutrition with other aspects of our health.
We kind of know for so many people that if you eat within two to three hours of your
bedtime, if you measure and you track your sleep, you will see often
a difference in sleep quality.
I've seen this with my sleep trackers over the years.
Like if I eat near bedtime, I could still be in bed for the same amount of time, but
the quality of my sleep isn't as good.
My heart rate is different.
My heart rate variability in the morning, you know, that marker of how well my body is dealing with stress is different. My, my heart rate variability in the morning, you know, that, that marker of
how well my body's dealing with stress is different. So I know for me, and it doesn't
mean I can always stick to it. I know for me an earlier dinner is worth its weight in
gold for multiple, for multiple different reasons. And Rupi, I've also discovered for
me, and I'm not saying this works for everyone,
but if you're traveling for work, let's say, and you're out of your rhythm, what I used
to do is if I got back late, now that I'm home, it's what a nice meal now. I've actually
learned for me, sometimes I'm better off skipping my evening meal, if it's going to be late
and going to bed a bit hungry. Again, I'm not saying everyone has to do this. I'm just saying on a personal level,
I found sometimes for me, I do better, my sleep's better.
I wake up with a beautiful hunger, like a real hunger
and my heart rate's down, all things.
I'm like, yeah, I think sometimes I just need to resist
that late meal.
And I think it all works through the lens
of my circadian biology, basically.
Totally, yeah.
And I think it all works through the lens of my circadian biology, basically. Totally, yeah. And I think to that point, you know,
we need to reframe this cultural phenomenon
of it not being acceptable to be hungry anymore.
We have evolved to deal with hunger
and to be hungry as well.
There are lots of things that occur when we are hungry.
And I get it, there are lots of people
for whom this is inappropriate
and we have to be respectful of that.
But for lots of us who have access to food 24 seven,
these are things that we actually do need to lean into.
And there are so many mechanisms that we could describe.
It is in line with our circadian biology.
Essentially, when you have an extended fasting period,
you have greater what's called lipolysis,
which is essentially fat burning.
You have better insulin responses.
Overall, I think again,
like just using a very, very simplistic perspective on this,
tend to eat less.
You just, you know, if you're a bit more regimented
and you're like, I'm not going to eat after 7 p.m.
That means that you're less likely to slack out of boredom
or in front of the telly or grab that cookie.
If you put some guide rails around your dietary strategies
every 24 hours, then you naturally lean into what is,
you know, deemed fasting.
Yeah, and I think it's really worth, I think it's really worth emphasizing that point in
the modern food environment. If you do not have some form of guardrail, you may end up
struggling. Right. And so one of the reasons, not the only reason, but as you say, one of
the reasons like, you know, having a rule that, you know, I only eat within 10 hours, right?
I stop eating at 8 p.m.
Whatever it might be, I only have,
I have a low carb diet or I have a low fat,
whatever it might be, some of the time,
the reason it works is because you found a guardrail
that works for you in the concepts
of this modern food environment.
And so I actually think, yeah, we may not have needed that 200 years ago. Maybe your
grandparents didn't need a guardrail, right? But you're living in a different world now.
Our food environment is naturally leading us to, unfortunately, a poor state of health.
So we need to find some principles that apply for us. I think the other point around that is that
one of the things we haven't really addressed
is that we don't only eat an excess of calories
for physical hunger.
We also eat for emotional hunger.
You know, if you've had a big meal at 7 p.m.
and you're still craving ice cream
in front of the sofa at 9 p.m.,
you may not be physically hungry.
You may be lonely, you may be stressed. You may
have some emotional discomfort that you're trying to appease with food. And that's a
topic for another conversation. That's a topic that I talk about a lot on this show because
I'm so passionate about it. But Rippey, I love what you do, man. Honestly, I think you,
you're clearly very passionate about helping people, about making food enjoyable
and fun. I think those four principles are going to be really helpful. Again, just emphasize
what you mean. People don't have to do all four, do they?
No, no. And I think I want to emphasize what you were just talking about in terms of non-nutritional
strategies. I've been pretty hardline and data-driven and clinical on this podcast around, you know, everything can be seen through the lens
of calorie deficit.
And yes, absolutely you can.
But you can also choose to look at it through the changes
that are enacted by your biology, by your hormones.
There's so much in nutrition that cannot be explained.
And I think that we need to just be mindful of that.
I've tried to give the sort of like the real hardline
scientific perspective on it,
but I think your emotional state,
the speed at which you eat,
the sleep that you've had,
the distractions that you endure,
like all of these different, and the exposures that we talked
about earlier in terms of Obstetrics, I think these are all coalescing to that results in people
having issues with weight control. So I've tried to just give some very, very simple tips for folks.
And if you could just do one or two or if you can do all four, great.
And not only that, do them and then experiment.
Exactly.
And pay attention. Is this working for you? Which aspects of it is working? Which aspect
isn't?
Absolutely.
And then you can start to tweak it. All right, Rupi, a few final questions which have just
come to my mind. Are you ready? I've got a slight cheeky look in my face.
So, okay.
So you've got several books out at the moment.
I know the new one's coming in March.
So we'll definitely get you back on to talk about that.
Thanks man.
But out of your current books that exist,
okay, they're all great.
If you were going to point people to one of them
to start their doctor's kitchen journey,
which one would it be?
Oh gosh, that's a great question. I would say probably the one of the most impactful
ones is eat to be illness. Cause I go into sort of the different areas of health goals
and explain the nuance and the science. And actually the final chapter just brings it
all together. And like when you eat for nourishing your body, your body knows what to do. So
regardless of the symptoms, regardless
of the affliction you might have, that book really just puts the priority on providing
your body with the right tools and nutrients that you require to thrive. And I think yeah,
E2B Illness and obviously the Dr. Kitchen app will help people with that.
Yeah. Okay. Great. We'll put links to all those things, including the app and the show notes.
Next question.
My daughter who beat you at netball
last time you came to our house,
said, when are you coming back for a rematch?
We'll do it on the next podcast.
Okay, all right, I'll let her know, okay.
Third question, what has becoming a new father done to your eating habits?
Well, how old is your eight weeks? Okay. So congratulations. Thank you. Fantastic.
I know you're going to be a wonderful dad. I think it has really stressed my eating habits.
But after reading your book, you know, I and doing some work that I've done this year, It has really stressed my eating habits.
But after reading your book, you know,
and doing some work that I've done this year,
I'm really reframing the story that I tell myself
about the stresses on my eating habits.
And actually I'm rising to this new challenge
that gives me a real insight
into what parents around the world have to deal with.
I've sort of looked at nutrition
through a very sort of simplistic way of like,
oh, just bang everything in the oven and it's fine. I'll do your cooking for you. Just add
the beans to this and all that kind of stuff. And actually I've got to learn how to cook one-handed.
I've got to learn how to ensure that, you know, I'm doing things rapidly if I want to maintain a good
eating habit. So I'm really rising to this challenge of parenthood and maintain
my nutrition.
Love it. Welcome to the new world, man.
Thanks, man.
Okay. You've given super practical advice in this conversation as always, Rupi. To finish
off then, so let's put it like this. If someone is listening to this conversation and they
are saying, okay, Rupi, okay, you've inspired me. I want to start improving my life. What are some of your three or four top tips that you would leave them with to
get started? They can be nutrition based if you want, they can be non nutrition based,
but what comes to mind? Three or four tips that people can start applying straight away.
Well, with my nutrition hat on, I would say try and master one recipe. So choose a recipe
that you absolutely love that is nutritionally balanced, has got enough protein in. I think
that's a really important strategy for folks. Because when you master a recipe, when I say
master, you want to master a recipe that you can make from store-cubbed ingredients, frozen
ingredients, things that you can do with your eyes closed because it becomes so habitual. And that is antithetical to, you know, getting
variety in your diet every single week. But I think we need to rise the level of our challenges.
And that as a strategy for me has been really, really useful. So master recipe, I would get
an idea of your, I know this again, I'm harboring on about nutrition, but get an idea of your
protein requirement.
Like I said, there's plenty of protein calculators
out there online.
We've got one on the doctor's kitchen app.
When you start understanding your protein requirements,
things kind of fall into place and not just your appetite,
but also, you know,
why you might be feeling a bit more fatigued
or you don't have energy or why you find like you're
snacking between meals and stuff
from a nutritional perspective. I get that. There are loads of other reasons
as to why that might be happening. And I've say, look, the third thing, and it speaks
to your first book is really have an understanding of your emotional requirements, your emotional needs, your exercise needs, your relationships.
These are all just as important to the health and wellbeing conversation that I know you're
putting a spotlight on, but I don't think we put enough emphasis on in medicine in general.
And I think that for me has been really groundbreaking
because I think I've always tried to explain
my personal experience with reversing
my cardiovascular condition that I spoke to you about
on the last podcast that we had
through the lens of nutrition and, you know,
what did I do to my microbiota?
What nutrients was I lacking? You know, how did I change my dietary patterns to my microbiota? What nutrients was I lacking?
How did I change my dietary patterns
to remove refined carbs?
That's all I'm sure that had a huge impact,
but also the stresses of me being a junior doctor,
the threshold that I could withstand
before succumbing to a condition,
the relationships that I had at the time, all the existing relationships that I had at the time,
all the existing relationships that I had with my family,
these are all things that would have absolutely
had an impact on me recovering.
So I think that's really, really important.
So really lean into what your emotional needs are,
your relationship needs are, and your stresses.
Do we get a fourth tip?
Can't think of one right now, mate.
I'm on like four hours sleep.
You're killing me here.
Well, that's a good enough reason, right?
So I hope you start sleeping soon.
Well done on becoming a father.
Good luck with everything, mate.
And thanks for coming back on the show.
I appreciate you, bro.
I appreciate you.
Really hope you enjoyed that conversation.
Do think about one thing that you can take away and apply into your own life. And also have a think
about one thing from this conversation that you can teach to somebody else.
Remember when you teach someone, it not only helps them, it also helps you learn
and retain the information. Now before you go, just wanted to let you know about Friday 5. It's my free weekly email containing five simple ideas to improve your health
and happiness. In that email I share exclusive insights that I do not share
anywhere else including health advice, how to manage your time better,
interesting articles or videos that I've been consuming and quotes that have caused
me to stop and reflect. And I have to say in a world of endless emails it really is
delightful that many of you tell me it is one of the only weekly emails that you actively
look forward to receiving. So if that sounds like something you would like to receive each
and every Friday, you can sign up for free at drchatterjee.com forward slash Friday five.
If you are new to my podcast, you may be interested to know that I have written
five books that have been bestsellers all over the world, covering all kinds of different topics,
happiness, food, stress, sleep, behavior change and movement, weight loss and so much more.
So please do take a moment to check them out.
They are all available as paperbacks, ebooks and as audiobooks, which I am narrating.
If you enjoyed today's episode, it is always appreciated if you can take a moment to share
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Thank you so much for listening.
Have a wonderful week.
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And always remember, you are the architect of your own health.
Making lifestyle changes always worth it. Because when you feel better, you live more.