Feel Better, Live More with Dr Rangan Chatterjee - The New Science of Eating Well with Professor Tim Spector #350

Episode Date: April 4, 2023

Professor Tim Spector rarely eats bananas these days. He treats a glass of fruit juice as he would a can of cola. And, despite having to watch his blood pressure, he no longer restricts the salt he adds to food. Controversial views? Perhaps, if heard out of context. But, as Tim explains in this episode of my Feel Better Live More podcast, these are just a few examples of new thinking he has adopted on certain foods, since discovering his own, personal metabolic response to them.   Tim was my first-ever guest, five and a half years ago, and I’m pleased he’s returning for his fourth conversation. And if you've heard the previous three conversations, there is plenty of new information in this conversation. And if this is your first time listening to me talking with Tim, I think you are in for a treat. Tim is an award-winning scientist, professor of genetics and author of four fantastic books, each of which challenge commonly accepted views about food, weight and health. He’s Head of the Department of Twin Research at King’s College London, and, as Director of the British Gut Project, a world-leader when it comes to gut microbiome studies. Tim’s latest book Food For Life: The New Science Of Eating Well is his most thorough yet In this conversation, we talk about a health technology called CGM (which stands for continuous glucose monitors) and touch on what Tim has learned from using them. We talk through the biology of blood sugar spikes and why it's not the odd spike here and there that's problematic but regular ones that can lead to health issues, such as chronic inflammation and insulin resistance. We also discuss Tim's views on calorie counting, the role that exercise plays in health and weight loss and Tim’s view on the concept that food is medicine. We both reflect on what a transformative difference it would make if more patients were offered nutrition advice as a first line of treatment. I think one of the things I respect the most about Tim is his willingness to change his mind and his views in public. I think it helps all of us be more open minded and less stuck in our ways. I always enjoy sitting down with Tim, this is an enlightening thought provoking, and I hope inspiring conversation. I hope you enjoy listening.  Support the podcast and enjoy Ad-Free episodes. Apple Podcasts https://apple.co/feelbetterlivemore or https://fblm.supercast.com. Thanks to our sponsors: https://www.calm.com/livemore https://www.athleticgreens.com/livemore https://www.vivobarefoot.com/livemore Show notes https://drchatterjee.com/350 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 with any questions you may have. Never disregard professional medical advice or delay in seeking it because of something you have heard on the podcast or on my website.

I've changed my mind on this. Food definitely is medicine. We're getting all this really good science now building up to show the key importance of what foods we eat, how that affects our gut microbes, this huge effect on our immune systems. Calculations have said that if we move the UK from its current diet to an optimum diet,

we would reduce chronic diseases by about 70%. There's not many medicines that would have that effect at this population level. Hey guys, how 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. This week's guest is back for his fourth appearance on my podcast. The previous conversations I've had with him have proved to be some of the most listened to episodes in this podcast's history. And if you've heard the previous three, there is plenty of new information in today's conversation. And if this is your first time listening to me talking with

this week's guest, I think you are in for a treat. Professor Tim Spector is an award-winning scientist. He is a professor of genetics. He's head of the Department of Twin Research at King's College London. And as director of the British Gut Project, he is a world leader when it comes to gut microbiome studies. He's also a best-selling author and his latest book, Food for Life, The New Science of Eating Well, is his most thorough to date. It's a bold and practical look at what we all need to know about food today. Now, these days, Tim rarely eats bananas. He treats a glass of fruit juice as he would a can of cola. And despite having to watch his blood pressure,

he no longer restricts the salt that he adds to his food. Controversial views, perhaps, if heard out of context. But as Tim explains in today's podcast, these are just a few examples of the new thinking he has adopted on certain foods since discovering his own personal metabolic response to them. Now, nutrition really does appear to be a very divisive topic these days, and I don't think it needs to be. So there are two things I want to highlight right at the top of this conversation. First of all, what nutrition advice we all need is going to depend on what your goals are and at what stage of life you are in. Now, I really think we have to keep this in mind when listening to any conversation about nutrition.

For example, if you struggle with or are recovering from an eating disorder, then it's likely that the advice you need regarding nutrition is different from the advice of someone who is trying to manage their blood sugar needs. The second point I wanted to raise is in relation to a health technology called CGMs, which stands for continuous glucose monitors. CGMs, which stands for continuous glucose monitors. Now, we do talk about these CGMs in today's podcast. And if you are a regular listener to this podcast, you will know that this is a topic that's coming up more and more. Now, I am aware that this technology is not widely available at the moment, although I do expect this to change over the coming months. I also appreciate that this

technology is not within everyone's price range, at least not at the moment. I think like all new technology, initially the costs tend to be quite high, and then very quickly those costs start to come down. I do expect that to happen with CGMs. And if you want to learn more about my thoughts on CGMs and how you can start using them, I will be sharing some of my thoughts on them in the coming weeks in my free weekly newsletter, which is called Friday Five. If you are already signed up and get those emails every Friday, you don't need to do a thing. If you are not signed up yet, you can do so for free at drchatterjee.com forward slash Friday Five. Now, in this week's conversation, Tim talks us through the biology of blood sugar spikes and

why it's not the odd spike here and there that's necessarily problematic, but regular ones that can lead to health issues such as chronic inflammation and insulin resistance. We also talk about Tim's views on calorie counting, the role that exercise plays in health and weight loss, his view on the concept that food is medicine, and we both reflect on what a transformative difference it would make if more patients were offered nutrition advice as a first line of treatment. I think one of the things I respect the most about Tim is his willingness to change his mind and his views

in public. I think it helps all of us be more open-minded and less stuck in our ways. I always enjoy sitting down with Tim. This is an enlightening, thought-provoking, and I hope inspiring conversation. I hope you enjoy listening. And now, my conversation with Professor Tim Spector. Tim, you've been researching, exploring, studying, writing about nutrition, to me at least, for a good decade now. And I thought what would be interesting is to start by talking about where you've changed your mind. Perhaps some foods that you previously thought were healthy and were going to help you with your short term and your long-term health but you've now realized that's not the case

well there's plenty of them um because yeah i i sort of came into this when i first started yeah over a decade ago with a fairly open mind well i, I'd say that in retrospect, it was the sort of traditional medical mind, which is what we've been spoon fed. But yeah, as I've dug deeper and deeper into this, obviously new things are coming up all the time and, you know, the evidence is changing. And I think that's what's really exciting about nutrition is that it's not standing still. It is changing. And we need to treat it much more like a science than a religion. Bananas, I believe, is something you've changed your mind on. Bananas. Yeah. You're hitting me with bananas straight off. But yes, they were my go-to fruit. So I don't know about you and probably many

people i think they're they're the the number one fruit people eat in probably the us and the and the uk uh stick you know it comes in its own packaging so uh you can stick it in your rucksack when you cycle to work and and have it as a snack snack. And it was pretty much my go-to fruit every day. And I thought it was always going to be healthy for me and really good. And by doing my research into bananas in great detail for the book, I've discovered that, hmm, maybe not so great to have it every day.

Still, all of these things you can have every now and again, no problem. But for me, it was because of personalization, actually, that I discovered that bananas for me were actually something I shouldn't be having every day because they gave me sugar spikes. actually something I shouldn't be having every day because they gave me sugar spikes. And when I did the Zoe test, when we started, even before it was commercially available, you know, we're doing, I was looking at my normal diets and seeing what spiked it. And it turns out that bananas came a sort of moderate sugar spike every time I had them. So as a snack, as a sort of quick on-the-go alternative to lunch if you're too busy, they're fine occasionally, but for me, they were not something I should be having. And since I've discovered what my scores are,

I know that, you know, they don't have as much fiber, they're not as good for your gut microbes, and they do have this ready available sugar in them. I'm much better off having other fruits instead. So I've thrown them out of my rucksack. And it's quite good because I don't have all these rotting bananas in my fruit bowl, which I used to put in the freezer and then try and make smoothies out of. I don't have that problem anymore. I just get apples and pears,

which for me on my personalized scoring, give me like double the score. So a banana, I think, I can't remember exactly. I think it gave me about a score of about 30, which means I can sort of have it occasionally. This is the Zoe scores out of 100. And apples and pears are more like 60 or 70 for me. So that was a clear indication that what I thought was a fruit

I would recommend to everybody doesn't turn out to always be that way. And, of course, also bananas, you know, we're only having one variety of banana now in the world because of the sort of monoculture. It's a great example also of how we used to have hundreds of varieties of bananas and now there's just one. And we all have exactly the same type of banana, which is sterile and could be wiped out at any minute.

So we shouldn't become over-dependent on the banana for that reason. But I do know that my wife tests herself and her scores for bananas are much higher than mine. So it does depend who you are. But bananas have gone out of my rucksack. There's so much there. I mean, the first thing that came up as you were talking about bananas is I distinctly remember in the 80s, I think it was the 80s, when Michael Chang was playing at Wimbledon. And tennis player, and often at his break, you know, after two games, when they'd be sitting there in their seats, he'd get a banana and peel it and eat it. And I can remember my dad

saying something like, hey, look, bananas, really, really good source of potassium. That's why he's having them. They're going to help him. So I was infused with this message at a young age. Like many of us are, that bananas are a perfect, if you will, a superfood. I'm not sure that term existed in the 80s, but they were very healthy foods. And I think what you have just demonstrated there, Tim, is this concept of personalization. I'm really fascinated by that, especially because you started off, I think, your career looking at epidemiology, which my understanding of that is we're looking at a lot of populations. So your book really covers this beautifully, but I think you explaining how you have big sugar

spikes or moderate sugar spikes to a banana mean that it shouldn't necessarily be daily in your cereal, if you still eat cereal, we'll come to that later. But for your wife, it seems to be okay. So maybe talk a little bit about your journey from being an epidemiologist, looking at populations, to how you got to this point where now you understand that each and every single one of us respond differently often to the same foods yeah well it's that's a big question because it's the you're absolutely right my my early career was all about finding risk factors so i i would look do a big study of several thousand people and say well for example does eating bananas make you more likely to get heart disease or diabetes or does

it prevent and generally most studies would show that bananas are people who eat bananas are protective for these because generally people who eat bananas probably have other healthy lifestyles, etc. But it's totally nothing about the banana and the individual. And the epidemiology I used to do, I think, is most of those studies have been done. There's very large-scale ones, observational ones, looking at association between eating certain foods and getting a disease. It was always aimed at these groups, and the power of it was in the group. So it wasn't until I got ill personally that I started actually worrying about the individual. It was very selfish, actually, to try and say, well, how do we sort this out?

And when I was working on genetics, there was this idea that because of our genes, we would all subdivide into these little groups of people that some people would have the gene for eating bananas properly and others wouldn't. And it turned out that's not the case. Genes weren't really good enough at doing that apart from just for milk and alcohol and maybe coffee. They can't separate us out into these other groups. So there was other things going on. And it was this individual journey of my poor health

and then testing myself that suddenly got this insight that everyone responds differently. And we come back to that sort of classic, the Zoe Predict study that showed, you know, given the same food, everyone responds 10 to 20 fold differently to an identical food in terms of sugar and fat peaks. So the realization that what could be a reasonable healthy food

for some people might not be as good for others has been a slowly evolving idea i think i i don't think there was a necessarily a eureka moment yeah in that and but the other point is that we shouldn't get too obsessed with one food yeah and i think i don't want anyone listening to get the idea that you know they have to ban bananas if they have a low sugar control like myself. We should be eating any proper food, but it means that we don't necessarily have it every day, or that we have it with other things that are much more important. So it's this holistic view of food we have to get away with, which in a way is... But you're talking about you and your dad and watching

Wimbledon were obsessed with this this banana because it had this magical potassium properties that got Michael Chang you know going in the fifth set and and hanging on to victory and he said oh every kid wants to have that banana so they could you know play soccer you know and not fall over and get cramp but it turns out that actually there's many more fruits and vegetables that have more potassium than banana anyway it was like this massive great pr campaign maybe maybe it was big banana hey michael chang it was probably the sugar in it anyway and but you know we all have these habits and so at the same time we we're all human,

and it's not possible to vary your fruit snack every single day and have this range of 20 different tropical fruits that you can take to work or to school or wherever it is. So we do have to pick some, but just a simple change from a banana to a pear can have a very big difference for some people. Have you noticed a difference since you didn't snack on bananas compared to when you did? And I'll tell you where I'm going with this, Tim. You have used the CGM, continuous glucose monitor, to help you understand what certain foods are doing for you. I, like you, think they can be very, very helpful tools if used responsibly. And if given with good education and a good, you know, help people understand what it actually means. I think they can be misused as well, of course. And it's interesting, not everyone yet has access

to this. There's a cost element to it. And I think a lot about health tech. I have real concerns over some health tech. I think sleep trackers can be incredibly problematic for a lot of people. Yes, they can be helpful for sure in the short term for some people, but I think for many people, they cause more anxiety in the long run. But what interests me is how we can use trackers like a CGM to help us be more in touch with our own bodies. For example, when I eat a food like this, let's say a banana, and I have a big sugar spike and then a sugar crash two to three hours later, I feel hungry again. I feel a bit jittery. I feel a bit a brain fog. Oh, when I stop doing that and I'm having an apple instead, let's say,

I don't have that drop two and a half hours later. Was there anything like that that you have started to notice since? And I know we're going into one food, the banana at the moment, but have you noticed that as you have understood which foods give you sugar spikes compared to others, that as you made those changes, you become more in tune with yourself? I'd love to say yes. The reality is I'm not particularly sensitive to these changes. And I'm usually surprised by my blood sugar result. And I know that's not the same for other people. I know some people are very sensitive. They can sort of predict when they're having that They can sort of predict when they're having that,

the sugar dip, three hours that we recently published on. Some people seem to be able to pick it up. Others can't. I guess I'm usually too busy doing something to be focusing on myself. It'd be an interesting experiment to actually say, or to sort of guess what's going on, i.e. blind yourself to your sugar which is sort of what uh you know a lot of people do when they are testing themselves you know with these cgms or with the zoe programs or whatever but i i think there are different categories of people

just like we found that people who have a sugar dip um baseline, which everyone has it occasionally, but some people have them regularly. But one in three women, one in four men have a three-hour dip below the baseline. But only those people will report feeling less energy and hungrier, et cetera. So not everyone has a sugar dip. And I think you notice the dips more than you do the peaks.

So I think there's a difference between people. So I'm not a big dipper, actually, it turns out, whereas other people might be. So I didn't tend to really – the only time I've noticed it was when I was eating these rather controversial Zoe muffins, which some people love and most people hate, every four hours for 24 hours. And my trace was like, you know, it was like a mountain range just going up and down. I felt terrible, but I felt terrible for a whole 24 hours um that's a

lot of people's norm yes that's the average uh uk and us diet on ultra processed foods and high sugar and but it's not my norm and so i really noticed that now that was yeah i'd say that's the worst diet related experience i've had i couldn't concentrate i couldn't work on my book i couldn't do anything and when i looked at my trace i sort of you know saw exactly why uh it was it was just going from one high level to a low level and it it really messed up my brain but i I don't think I'm, my makeup is such that I can detect these small changes of a banana. But I think it's still illustrative that you can do that. And so the difference between a banana and apple, personally, I don't think I noticed that. But I think other people might well do. But it's also, you've made other changes as well,

right? So, you know, there's a pattern of eating now you're probably doing in a way that you weren't. And therefore, certainly for me, and I think we touched on this last summer when, you know, when you were last on the show, that I had found one of the things that CGM taught me was how much quantity makes a big difference. Like, so for,'s say, white rice, for example. I don't want to talk about rice a bit later. I know you've written a whole chapter on rice in the new book. But I like white rice. And as an Indian guy, heritage-wise... You can't not like it. White rice, you know, we grow up eating white rice. But too much white rice doesn't do that

well for me. I think that's quite obvious, but when you see it on a CGM, you really see what's happening. And I've realized if I can reduce my quantity significantly, and I'm used to it now, I probably have a third of the amount that I used to. I still can enjoy it, enjoy the flavor, enjoy eating the foods that I'm used to with white rice, but not have these horrible sugar spikes that I know long-term are going to have a high potential to cause me problems. So I found it really, really useful on an individual level. And I have noticed as I made a lot of these changes that my energy is more stable, my cognition is more stable because I'm not getting the sugar ups and downs. Another thing just to finish off on bananas is

I had a patient about four years ago. And it's really relevant to this part of the conversation, Tim. It was a guy in his mid-40s who was complaining of blurred vision a lot. And in front of computer screens, also when walking, sometimes his vision would just go, you know, sort of hazy, just couldn't see anything. Not one-sided, you know, there was no evidence on examination of any stroke or anything like that, do you know what it ended up being? It was, he would have two bananas every morning with his breakfast because he thought it was healthy. He'd have a snack on a banana later. I think the diet was quite high in refined carbs and refined sugars. But this is the most starkest example I've seen. This was without any personalization, without any CGM data. It was as he cut out bananas for two weeks and reduced a couple of other things in his diet, it went away completely. I've never seen anything that dramatic. And I would love to

go back now and just see what was going on if he did have a CGM at that time, you know, what was happening to the sugar. But that's a pretty extreme case. And I just thought it's worth sharing that because I think it's quite relevant to what you just said. Yeah, but I think, yeah, so I did this extreme experiment just eating these high sugary muffins and felt absolutely awful. And I guess some people who are more sensitive than myself will have this with just by picking the wrong breakfast. And to me, you know, breakfast is the fairly critical point here. So when I changed my breakfast, I felt I didn't need a snack. And so the need to suddenly have that mid-morning banana just wasn't there.

And so you asked me, so it's very hard to take one food out of this context when people are sort of changing their habits, not only what they eat, but when they eat. And it's all part of this whole picture. And I've just found I don't snack nearly as much now as I used to, because I was being driven to that, as we now know from our research, that either having ultra-processed foods or high sugary foods, for some people, just makes them hungrier three hours later, and they will overeat, and they'll be seeking other similar foods to keep it going so once you break that cycle you definitely don't you're not as hungry and

your as you say your mental your mental state is much flatter and now you're remembering i'm out you know i remember at work um in the hospital um you know i used to go and have my lunch in the can you know i stopped going to the canteen after a while you know, I used to go and have my lunch in the can, you know, I stopped going to the canteen after a while, you know, you can't face shepherd's pie and chips, you know, for that long. But even though I went and got my sandwiches, which I thought were healthy, came back, you know, with my Tropicana or whatever, I did struggle the afternoon with concentration and tiredness. whatever, I really struggle with the afternoon with concentration and tiredness. And I don't get that anymore. That whole idea of, you know, I needed three coffees to get me through the afternoon is no longer the same just because of the changes I've made to my diet. And I think

that's really revealing. Yeah. I think a lot of people still don't realize that often, not always, often their hunger or certain behaviors they engage in, let's say, I need coffee or tea in the afternoon to get me through, is a response. It's a symptom. And we're not addressing the root cause. It's like, no, I'm just that person. I get a dip at 3 p.m. I need coffee at 3 p.m. Okay, maybe you do, maybe you don't. Maybe it's because of your breakfast choice or your lunch choice. And I think once people, if they choose to consume breakfast, let's put it this way, once people change the first meal of their day, it is pretty remarkable what can happen. If you have a meal with a stable blood sugar,

it is remarkable how many compensatory behaviors you no longer engage in because you don't want to. You mentioned a couple of things there. You mentioned the hospital sandwich and Tropicana. So in terms of things you change your mind on, we've covered bananas and tried to expand it out beyond bananas, of course. Fruit juice, Tropicana. I remember, Tim, as a junior doctor, I was working medical SHO, Western General in Edinburgh, had my, I was hiring a flat, renting a flat opposite it. I thought, yeah, I'm a young professional and I'd go to the Sainsbury's in Edinburgh and I'd buy a Tropicana because I was earning money. I could afford this freshly squeezed, this is what the packet said, orange juice. And I'd have that in my fridge and I'd have it with breakfast. I may have it after work because I thought it was

healthy. This is a long time ago now we all did yeah we all did so talk to me about fruit juice what have you changed your mind on that well they're not healthy there's virtually no fruit juice that is healthy we don't we're not deprived of vitamin C. So the original rationale to have this was sort of post-war with people with total lack of fruit, and they used to sort of preserve some of these juices in cans and things. I still remember as a kid having the first fruit juices, which used to come in cans or reconstituted sort of frozen things before fresh juice was ever available so

for many people you know my generation this was a totally exciting new thing uh that we could have and we've just been misled by all the marketing that uh this is the same as eating oranges. And there's no doubt oranges are healthy, but you wouldn't eat 10 oranges in one go and just use the liquid from it rather than all the fiber and the other good bits. So I think when you compare it and you do these studies with CGMs, you'll find that drinking a glass of orange juice is actually, for me, it's slightly worse than drinking a Coca-Cola or a Pepsi. In terms of what?

The blood sugar peak. And should we just pause here for a second to kind of explain why is it, in your view, important to consider these blood sugar peaks? You know, there's a lot of controversy around CGMs and I think a lot of the controversy is quite limited in terms of the way they're being viewed. I think it's a pretty sensible, logical conclusion given how many people are suffering with their metabolic health, given how prevalent type 2 diabetes, heart disease, strokes, etc. are, and how much we know metabolic dysfunction can contribute to them, I don't think it requires a huge leap of faith to sort of get to the conclusion that, well, how we manage our blood

sugar day-to-day is going to play a factor. But for people who are coming to this for the first time, Tim, what would you say? Why is what's happening to our blood sugar day-to-day important? Everyone has blood sugar peaks. This is part of our natural physiology, and we've evolved to have them. Sugar goes up, it goes into the bloodstream, and gets absorbed if we need it and then insulin is released to bring it those levels back down because too much sugar is if it hangs around too long it's not good for our body and what we see in some people are susceptible is very high sugar peaks which if you have them regularly will predispose you firstly to type 2 diabetes. There's increasing evidence that is the case.

That's not really new. What is new is the fact that these sugar spikes, if they are prolonged, then you get inflammation related to it. So it means that the body is under stress and that all the cells in the body are sort of pressurized. They're not happy. And just because that environment for them is causing them distress. And so if you've got distressed cells in your body long term, because you are every two hours getting a sugar spike, then over years, that's going to cause considerable harm to you and that's that's a really important long-term point that you know drinking one glass of orange juice is not going

to be bad for you it's it's having these things as a regular consumption uh but also with the fact that it's promoted as a health drink. Yeah. And promoted to kids as a health drink. And it really should come with a health warning, not on the health shelf. So it's the idea of these regular sugar spikes causing stress to the body, inflammation, type 2 diabetes, and all the epidemiology studies show that it is related to heart disease and there's even some suggesting that it might increase your risk of cancers. So I think that's one reason that we shouldn't be having orange juice

because we've been sold it as a health food that gives us vitamin C and it gives us all these marvelous nutrients you have in an orange because it's very different. And I explain in the book how most of the orange juice we're drinking is at least two years old, even though it's sort of portrayed as fresh because it's been sitting in some vat in Florida or Brazil in taste of nothing. And when they're ready to ship it over, they add in these taste packets that are these chemicals that give it back the orange taste that they took away so it doesn't go off. So it's a highly industrialized process. You know, it's not some guy in Brazil and Florida just, you know, squeezing an orange and putting it into that pot. It's ultra-processed food. And what I object to is the fact that it's

sold as health food and, you know and generally regarded that way. That's much worse. And much rather people actually drank Coca-Cola because it's pretty obvious that's not good for you. That is a treat, but nothing says it's great for you and your teeth. Whereas orange juice is, in my view, just as bad. I mean, it's interesting that two years old, a lot of the orange juice people drink. I mean, it's not that pleasant a thought when you think about that, you know, fresh, that packet, that carton with the beautiful image of

the tropical climate and, you know, someone squeezing it in for you. And I think we all kind of know if you've ever had just taking a quick break to give a shout out to Athletic Greens, one of the sponsors of today's show. Now, of course, in this episode, you're hearing from Tim and I just how important nutrition is. Like, I don't have fruit juice. We don't have it in the house.

It's not something I consume very much at juice. We don't have it in the house. Yes, it's important for physical health, but it's also important for our mental well-being. Now, I always want to make it really clear. In an ideal cafe when they were doing it, everybody would get all of their nutrition from real cold food. But I really enjoyed it as a treat, and it was absolutely delicious. So I think what you're really talking about,

and this is, I think, one of the key themes in Food for Life, is you want transparency. You're not saying people should or shouldn't eat anything. It's more like, if you're going to have fruit juice, just be aware that it may not be a health food. And have it as a rare treat. Yeah, exactly. And enjoy it and get the very best one, know rather than paying every day to to have it or you know going to hotels in the u.s where they they it's compulsory they sort of virtually serve it at your table with you know the iced water and the orange juice it's part of your the package and just you know we got to say no to that and as you said have it as this very special um event where you can actually see

it coming from the the fruit or eat oranges instead you know or do it yourself you know squeeze it yourself then you know exactly what's in it and you don't and it's impossible to drink as much of it anyway you're not going to be squeezing 10 oranges every morning before you go to school or work. If someone says to you, okay, I understand what you're saying about fruit juice, it's going to spike my sugar, which if I do this day in, day out,

it's going to cause me problems in the long term or has the potential to. And they then say, but what about freshly squeezed? That's better, isn't it? Because it's not been sat in a factory for two years. It's fresh. I've seen what's happened. Can you talk to us about the differences? Is that a better option or is it still going to do the same thing to our blood sugar or a similar thing? It's going to be pretty similar. I think it was going to have less of some of the chemicals and other ingredients that are in those the mass processed ones and less of the added flavors and things like this but um it's still going to lack the essential ingredients of an orange, which is the fiber content,

which is the thing that mops up the sugars, which doesn't give you those big sugar spikes. So, yeah, I'm not saying people shouldn't have freshly squeezed orange juice, but realize when you do it yourself at home, you squeeze orange juice, very quickly it sediments out, right? If you don't stir it, you get the light bit at the top and the dark bits at the bottom. And often even on these freshly squeezed ones you buy in shops,

you don't have that. They've added something to it, other chemicals, to keep it looking nice. So there are always these subtle differences that we have. But, you know, I like, like you, I like the occasional orange juice. keep it looking nice. So there are always these subtle differences that we have. But look, you know, I like, like you, I like the occasional orange juice. Let's just have it occasionally. Let's realize it's a bit of a naughty treat. And if you want the goodness of orange juice, you know, have an orange. And I think people very obviously get it when you explain, look,

in a glass of orange juice, there may well be eight oranges in there. Try and eat eight oranges. You can't do it. With all the fiber in it, the satiety, maybe two. You're going to struggle to go much beyond that. Certainly, that's what I say to my kids when trying to explain this to them. They kind of intuitively understand it when you put it like that. So bananas and fruit juice in many ways both relate to blood sugar and the sugar spikes that are affecting us in the short term and in the long term. I think you've also changed your view on salt, haven't you? Just taking a quick break to give a shout out to AG1, one of the sponsors of today's show. Now, if you're looking for something at this time of year to kickstart your health, I'd highly recommend that you consider AG1. AG1 has been in my own life for over five years now. It's a science-driven daily health drink

with over 70 essential nutrients to support your overall health. It contains vitamin C and zinc, which helps support a healthy immune system, something that is really important, especially at this time of year. It also contains prebiotics and digestive enzymes that help support your gut health. All of this goodness comes in one convenient daily serving that makes it really easy to fit

into your life, no matter how busy you feel. It's also really, really tasty. The scientific team behind AG1 includes experts from a broad range of fields, including longevity, preventive medicine, genetics, and biochemistry. I talk to them regularly and I'm really impressed with their commitment to making a top quality product. Until the end of January, AG1 are giving a limited time offer. Usually, they offer my listeners a one-year supply of vitamin D and K2 and five free travel packs with their first order. But until the end of January, they are doubling the five free travel packs to 10. And these packs are perfect for keeping in your backpack, office, or car.

If you want to take advantage of this limited time offer, all you have to do is go to drinkag1.com forward slash live more. That's drinkag1.com forward slash live more. That's drinkag1.com forward slash live more. I have, and this is a very controversial topic, so I'm sure some people listening won't like my views on salt. But I originally, when I wrote the first book on this diet myth, I looked at the salt thing. I said, you know what, there's no real controversy there. Everyone, every doctor knows that salt is bad for you.

We just need to reduce it, right? All the data's there. Then about six years ago, I started looking at this in more detail. And there'd been some other recent studies on this. in more detail. And there'd been some other recent studies on this. And it was clear that there was a lack of, you know, there's no doubts people on high salt diets can increase their blood pressure. And what wasn't clear was if you put people on low salt diets, how much their blood pressure decreases and do they get significantly less heart disease and problems. So the sort of causality link wasn't quite there, nearly as much as people expect. They think this is a done deal. So everyone's been focusing on

salt, particularly in ultra-processed food, as, oh, well, all you need to do to make ultra-processed food safe is to reduce the salt, reduce the fat, reduce the sugar. Bingo, you've got the perfect healthy food. And that's the thing that really annoyed me. So I started looking in great detail at salt and saw that there's a huge range in actually how we respond to salt. There's this personalization that no one's really tapped, but if you look in the clinical studies that have been done, you can see big differences between people who are ill with cardiovascular disease or very high blood pressure or who have African origins. They are really quite salt responsive and makes a big difference whether they have salt.

But if you take someone with normal blood pressure, European or Asian backgrounds, they are much less responsive. And the difference on changing from a high-salt diet to a low-salt diet is trivial. And I did this myself. When I first got diagnosed with high blood pressure, I went for six weeks on a low-salt diet. It was revolting. That six weeks you'll never get back, Tim.

I know. I know. It's terrible. And, you know, I took my blood pressure every day. It didn't change. And I went to look at the results and it shows that someone like me similar demographic to myself would only change about two millimeters their blood pressure right which you can't really tell taking your home measurements it's not enough big enough change on average and so i think it's been oversold to us, the impact of salt. The studies show that people who are on salt-restricted diets often end up with more problems with diabetes and renal failure

than people that don't. So the American Heart Association has got these very strict guidelines, which is basically less than half a teaspoon of salt a day, are very hard to adhere to makes you makes your food disgusting and it turns out that the body doesn't like being at those low levels for many people and so it may be that 10 percent of people do respond to that load load out and benefit but most people don't and some people are actually worse off. So that's the data that I've seen. And what's really interesting is that some new studies showing that it's the sodium-potassium ratio that's important. So salt is sodium chloride,

and in our body, there's a constant balance in all our cells between the sodium and the potassium. And they have a sort of inverse relationship. So if you increase the potassium, so you're eating your 20 bananas, you actually have a three times bigger effect on your blood pressure than you do from reducing your salt which and they've done these there's a meta-analysis of at least i know at least 10 studies showing that if you use these salt substitutes which are made of where you have about a third of the salt changed to potassium chloride um you get um a three times bigger effect on the blood pressure so i think we've

been obsessed with reducing salt whereas everything points to being that's only a minority of people that are sensitive and that we should really be focusing on increasing vegetables which are the main source of potassium and if you do that then you'll have a much bigger effect as an individual or population level on reducing blood pressure which you know is huge so again this is part of this reductionist idea that i'm always going on about in nutrition that we focus on one thing we say okay let's do that get the manufacturers to reduce that then we're all happy whereas what we should have been saying is actually you know let's get that balance of sodium to potassium better how do you do that eat more vegetables and fruits and if we do that it's going to be a much

bigger impact and it doesn't allow manufacturers to say that some terrible product they've got is now healthier because they've slightly tweaked the salt, which isn't going to make any difference at all to anyone's health. Yeah. What was interesting as you were telling your story to him for me was he said for six weeks, you were actively consuming a low salt diet, but your blood pressure wasn't budging. I think it's a really key point here. When we give generalized, un-nuanced nutritional advice, I think we can make people feel really, really bad. So I'm trying to do what I'm reading in the newspapers or the health influencers are telling me, yet I'm still struggling with my health. Were you frustrated at all during those six weeks?

Are you thinking, well, I'm doing this, but it's not making much of a difference to my blood pressure? Yeah, hugely. And if I hadn't, you know, been a doctor and a scientist and, you know, you know being a doctor and a scientist and and you know subsequently looked up some of this data realized that i wasn't abnormal i'd have felt a failure and i think that's and there you know and that's a lot of you know people listening might say well you know i did i followed this advice of my doctor nothing happened therefore i'm not i'm going to give up all the advice and this is the huge risk we we have when we generalize all this advice and we don't personalize it and we don't say, listen, the data actually shows that, yes, on average, you know,

you might get a 2% improvement in your blood pressure. It might be hard to measure it. But if you're lucky, you might get a 10% one. And if you're unlucky, you know, nothing will happen. Don't worry about it. Just tell us what you've got. And I think this is this new age we're in now of personalization, of gadgets. You know, I'm wearing a blood pressure little wristwatch now that gives me every half hour my blood pressure. And you don't have to go to a doctor to do all this stuff. You can really, you know,

this technology can help us out of this as we realize that we are all individuals and we're going to react not only to foods differently, but interventions and exercise and all the other things that, you know, doctors have been telling us is, that's going to be good for you. This is going to be good for you. Well, it may be, but it may not be to you've got to find out what works for you

and for me um you know i still love salt and um i've also changed my mind and you know i was very against these salt substitutes um but i think for people who do find it difficult to have lots of but I think for people who do find it difficult to have lots of plants or vegetables, it's quite an easy swap and there's no evidence they are harmful, although they are rather chemical and ultra-processed. But the data is pretty clear that when you do swap, you can reduce your blood pressure by five or six millimeters, which is quite a lot. It's interesting. You said there can be a 2% reduction if you go on a low-salt diet. If the consequence of that,

for example, means that you are 50% less likely to stick to your new diet because it tastes so awful, to stick to your new diet because it tastes so awful, that part of the equation doesn't get factored in. It's very, very reductionist. I think not beyond food, I think a lot of what I've realized now in over two decades of practice, Tim, is that there is no one right approach for everyone. Like 10 people can come in with headaches, let's say migraines. And there may well, apart from pharmaceutical medication to help potentially reduce the severity of the headaches, you could have 10 different approaches with their life and their lifestyle to address that very similar symptom, because we're all different. We've all got unique pressures. And I think that nuance is very

important. We like salt in our food, many of us. And so you can do something for six weeks, maybe, with a view to improving your health. But if it's not sustainable, that whole concept we can expand out to weight loss or whatever sort of things people are trying to improve, you've got a real problem, haven't you? Well, and yeah, just take that example of if you tell people to have no salt, half a teaspoon of salt a day, right? All your vegetables taste rubbish, right?

You know, it's one of the most sought-after spices that we have. You know, meat is virtually inedible, completely without salt. And you want people to, you know, if the holistic advice is to eat more diverse plants and foods and you're taking away a way of seasoning it properly it's far worse so probably you know this could explain why these people on low salt diets ended up doing worse yeah it's probably because what they didn't check is all the other things they were eating and the quality of their foods etc in these in trials. So there are always consequences of these dogmatic

reductionist views that don't take the holistic picture. So I think we're in agreement there. People in the low-carb community, I would say for many years, a lot of people in that community have said that, look, the problem is the processed foods, the ultra-processed foods. They're the ones that have got these large volumes of salt in them. So potentially the research is relevant if you're consuming a lot of ultra-processed foods. If on the other hand, you are predominantly having a whole food-based diet, whatever your brand of that diet is, but it's predominantly whole foods close to their natural form if you're able to. If that's what you're eating, a lot of them have said for many years,

actually adding salt to your food is not a problem in that context. And again, this just speaks to what we're talking about. Context really matters, doesn't it? talking about, context really matters, doesn't it? Yeah, exactly. 100% agree. Ultra-processed food is the problem, not salt. Salt is just one bit of the problem of ultra-processed food. But I'm sure if someone did studies and that, you know, long-term use of ultra-processed foods end up having more strokes and heart disease, and it's all related to that so it's picking these things apart that that is important and yeah realizing that you know as you said adding salt to a bit of broccoli that you've steam cooked yourself is very different to having a frozen lasagna with masses of salt or you know a breakfast cereal that's got lots of

added salt to it. To finish this part of the salt conversation responsibly as medical doctors, what do you then say to the people who are listening or watching, Tim, who say, well, my doctor said I've got high blood pressure and they've asked me to reduce my salt intake. How would you help them to move forward? Well, I think if you've got high blood pressure, you know, you are at high risk of heart disease, strokes, et cetera, and you should do every experiment you can to see what works for you. So I would get hold of a blood pressure monitor yourself and measure yourself two or three times a day, keep a log of it as you change,

and do it for a couple of weeks and see what results you get. If it comes down by 5% or so, you say, okay, there might be something in this. Or you simply say, say well i'm already on again it's all context dependent yeah cutting out the ultra-precious food is the number one thing everyone who's told they have you know a potential blood pressure problem a soul problem um but assuming it's someone like you and i who suddenly gets diagnosed though with high blood pressure you can do a little experiment for a couple of weeks see what effect it has are you a very sensitive

person or not that's something everyone can do right you probably put up with it for the two weeks it actually makes you appreciate um seasoning in food as well for the rest of your life um then if you can't tolerate it then of course you might switch your salt for this potassium these potassium chloride substitutes which in the trials show three times bigger effect and then do that for a couple of weeks and then see how you're getting on there so i think it um realize that you are different realize yourize your doctor may not know all the data. And this is a traditional view that's been around for the last 30 years or so. So it's instilled in every doctor. And just take that individualistic approach.

Okay, well, that's advice which on average might help me a little bit. Is it feasible? But I think it comes to the other point is every time you get some advice about an intervention you've got to say to yourself can i sustain this for the rest of my life yeah and if you really can't or you you try it for a few days and realize i can't do it there's no point yeah and you've got to find another way to get there i think increasingly there's no point in just doing something, being a goody-goody for six weeks to impress the doctor

if you know that you cannot do that. Well, that's a problem with a lot of trials, right? They run for six weeks or they run for 12 weeks, which is wonderful, but our life doesn't stop 12 weeks after we make a particular change. It goes on. All the diets work for six weeks, brilliantly. And yes, you can advertise any diet in the world.

The strawberry diet, you can probably have the Tropicana diet. There is a potato diet which works. Potato diet. Remember the special K diet. They all work, but that's not for life. And we've got to start looking at a much longer timescale of all these things. And in a way, that's what we're doing with the Zoe Health Studies, trying to instill habits and see how pragmatic it is for people to pursue that. You know, how easy is it to, you know,

switch your banana for a pear or an apple and avoid this or not have orange juice or reduce your salt long-term? You know, you've got to start planning. There's absolutely no point in doing it other than as an experiment. I think it's an interesting thought experiment, and you and I would do that sort of stuff

because we're, you know, into hacking hacking and stuff there might be some other people listening to it but the majority of people they just want to know what to do uh to get them healthier what what lifestyle change and i'll just say to them if if you know it's just unrealistic um go for something else yeah my passion tim as, Tim, as you know, is beyond food. It's lifestyle as a whole, right? You've written three wonderful books on nutrition. It's interesting for me that I've never written a book about nutrition. Nutrition has featured in many of my books, but it's never been the sole topic. And if we talk about blood pressure, for example, people really need to understand, in my view, that it ain't just your

food intake either. If you are chronically stressed, what is the stress response? The stress response is preparing you for danger. Your blood sugar goes up, your blood pressure goes up in the acute stress setting, right? So if you're undergoing chronic stress, which is many of us these days, that could be why your blood pressure is going up. If you're sleep deprived, your blood pressure can be up the following day. So if you're chronically sleep deprived, that may be something you want to address. Movement, exercise, physical activity can help lower our blood pressure. And so why I think that's relevant is, let's say for argument's sake, you are someone who is salt sensitive, right? Sure, try that for six weeks and see. And if you get a two millimeter

reduction in your blood pressure, so let's say your blood pressure, you know, we really want it around 120 over 80, let's say. I mean, you know, this is not a blood pressure topic today, but... Below 130 anyway. Yeah. Okay. Yeah. So let's say that's what we're aiming for optimally. And let's say yours is currently 150 over 92. And you think a low salt diet, which you don't enjoy, brings it down to 148 over 90. Okay, it's better. But then you could also do a try and go, what if I eat, I go back to what I was eating, or I go to more whole foods and I don't necessarily watch my salt intake, or I go to more whole foods and I don't necessarily watch my salt intake, but what if I bring in a 30 minute walk every day, which actually I enjoy, gives me some physical activity, helps me with my cognitions, helping me sleep better. Or what if I do, if you're that way inclined, five to 10 minutes of meditation each day. You can start to self-experiment and go, actually, I have all these tools available to me.

On balance, this is the tool that I can use, I can implement in my life, I enjoy it, and it's going to be sustainable for me. So yes, we need to be holistic within food, but we also need to be, in my view, holistic beyond food and go, there's many things that cause our blood pressure to go up. It's not just our foods. But it's also a time to make change to your lifestyle. As you said, do more exercise. But even if we're taking salt as this reductionist example, it's a great time to say, the evidence shows that the more plants you eat, the lower your blood pressure. So go for the rest of your life to try and maximize your

diversity of plants because now do you think that's because of potassium yes that's that's that's awesome isn't it so instead of reducing salt you just increase we've got some data from the zoe uh studies that says that you know not only the number of plants but if you divide them by the potassium ratios in each of those plants, it comes up very strongly. So that just by eating, you know, my mantra of the 30 different types of plant a week, you will be getting a proportion of high potassium plants, mainly vegetables, that will lower your blood pressure. And so, again, it's this holistic approach rather than this obsession with one thing,

whether it's vitamin C or it's salt or it's, you know, it's all good. And I think this is where the science is accelerating so much that we are suddenly seeing it all come into focus and these things being linked up. Ultra-processed foods has come up um a number of times in this conversation and i think i've heard you say tim previously i think i think i've read it in your book actually that it seems to be the countries without strong food cultures that have been susceptible to being overrun

with ultra-processed foods? Can you speak a little bit to that? Because I found that really, really interesting. Yeah, there have been a number of surveys in the last 10 years that look at different countries and the proportion in each country of total energy that is given by ultra-processed foods. And the world leader is, of course, the United States. I think latest data, it's getting close to 70% of total food energy is in ultra-precious food. The UK has gone up from 50% to 57% and is the highest and worst in Europe. And you look at other countries, say in Europe, you see the southern European countries, it's much lower,

so very low levels in Portugalugal italy spain for example where there's a very strong food culture and it just hasn't made those inroads into the day-to-day eating so kids you know they won't be having ultra processed food in this in you know given to them in in in their box food boxes and uh the school dinners are you know properly prepared or they go home for it and people just wouldn't think of snacking in the same way that we do um in in the uk and the us you know the idea of you know eating in your car or at your desk just doesn't sort of happen. Yeah.

So there's a clear correlation between these food cultures and the progress of ultra-processed food, although depressingly, even in those countries, it's slowly creeping up. Yeah. Okay, and people used to say, oh, well, it's just because, you know, it's related to poverty or other aspects of finance. But it turns out that some of the poorest countries, you know,

Portugal compared to ourselves, you know, they've got a fifth of the rates of ultra processed foods. So I think there's a, that was why it got a hold and why, in a way, there's no pushback against it. And in a way, I think ultra-processed food got its handle because those countries also spend relatively less on food than the ones with the food culture. So that's the other element to this is the financial one.

The percentage of GDP spent on food has been decreasing much faster in the US and the UK than in, say, these high food culture countries. You tweeted that, I think, last week from the Times, that's not a graph, almost like a chart, showing what percentage of our income in different countries do we spend on food. And was it just Europe? I can't remember now. Maybe US was in it as well. There was a number of countries around the world.

And yeah, it's really fascinating. It's huge differences. And we complain that we're going through a cost of living crisis in the UK here. And there was something about the news about how inflation has like, the cost of food has like doubled very recently in the last year. But we're still, on average, paying considerably less attention to our food bill compared to 10, 20 years ago,

where traditionally a large proportion of the family budget would go on food and food quality, which it still does in food culture countries. So we don't regard food as something to spend lots of money on. It's like it's just a consumable energy source. And that's why, you know, governments have been protecting it being cheap at all costs. It doesn't matter how unhealthy it is. It's got to be cheap.

Otherwise, they fear there'll be a revolution in the streets, you know, attacking the nanny state. And that just doesn't happen in these, these, uh, culture strong countries. I guess to, to the, to the British, um, the obvious, I won't even call it a cliche. The obvious, uh, country that would come to mind is France with its very strong food culture and eating at a table culture. And I've written about this in one of my books, but I always remember this so well that when my first book came out in France and I did an interview with a French journalist, remote interview, this is maybe in 2019, 2018, 2019, something like that. I remember asking her, because she was in Paris. I said, look, my understanding is that everything I've seen, whenever I've been to France and my friends who

are French and et cetera, et cetera, you stop for lunch. You don't work at the computer. You don't answer emails whilst you're eating. You sit down somewhere. There's a certain tradition around eating a meal. Is that still going on? And she said, yeah, this is still absolutely part of French culture. The only places where this is starting to get eroded are in the international companies in the centre of Paris. And it's amazing how we're kind of exporting, well, America has exported its ultra-processed diet to the entire world, and it's making inroads everywhere. I'm not sure it's something that America should be proud of necessarily, but it's definitely one of the gifts it's given to the world well i think originally it was positive you know there was a an idea what the world would starve if we didn't change our system

but we've now gone past that stage and uh we can't stop the beast if you like it yeah that's a great point it's a great point sim and you know it's interesting to reflect back on that, how it did all start. So, Tim, I have, like you, been trying to communicate health messaging to the public for a number of years now. Maybe, I don't know, maybe 10 years for me, but I don't know when you started communicating with the public on a big scale. Well, I tried, but yeah, I guess about 13 years, but I wasn't very successful the first few years. Well, you've definitely had a few clips from conversations you've had early on this year

blow up in quite viral fashion and put a lot of attention on what you do. Let's talk about it. There was a clip cut from a podcast you run on Stephen's show. And wow, did it generate interest. And not only did that clip generate interest, there were videos being made about that clip. I mean, truly went viral. Can you explain a little bit about that and how that all was for you? Well, it was a bit of a shock. I had no idea. So during the sort of two-hour discussion, we discussed these points.

discussion we discussed these these points um steam bartler steamer you know incredibly professional about um trying to get previews of the longer longer conversation and we had we discussed a lot of these these topics from a position that i don't think he'd discussed before about and he didn't really, you know, it was I think the first time really there'd been any real discussion on health and diet on his podcast. So he was asking from his point of view, you know, oh, I do low-calorie diets, you know, should I go on a low-calorie diet, should I do this, you know. And he was very surprised that I was prepared to be fairly dogmatic on on this

and they used a very short clip um to highlight this you know hour and 45 minute discussion in a sort of hollywood hollywood style clip where i was just giving one word answers to these, to these things. But, uh, and it was used as clickbait, but, um, you know,

and it was obviously cut and edited, but it came across as very exciting. And I said, I think two things, you know, calorie counting doesn't work and, uh, exercise doesn't make you lose weight i think they were the two

key ones that sort of to an audience that hadn't heard that before from from anybody i think it it caused a real stir and led to you know these six or seven million downloads and lots of copycats and and shock and i i louis capaldi made a video didn't he i think was it your kids who showed you that that's right so read you know i had all these uh uh you know the sort of under 30s who aren't exposed to these you know the sort of chats that you and i are having suddenly coming out oh i had no idea you were doing any of this you know and i was suddenly um i'd made it because lewis capaldi was talking about me and did a video on me so it's proud of you that's the first time they've ever been proud of me that's right so uh but but i

think you know and and people said oh do i regret it you know wasn't it too sensational? No, I don't think it was. If it got millions of people to look at that discussion, to talk about nutrition and food and health in a way completely different to what they'd been brought up on in the marketing and the other things that have been pointed out, particularly younger people, great. and the other things that have been pointed out, particularly younger people, great. I think anyone who thinks that, you know, you can get nuance from a 30-second clip on Instagram or TikTok is very misguided, and you have to look at the bigger context. But, you know, I think it's great that we can have these discussions and that, you know, in a way, food and nutrition can be an exciting topic that involves young people. And it's a bit of a wake advertise a Hollywood film with a trailer.

Yeah. It doesn't mean that you can watch that and get a sense of everything that's in it. But it's drawing people to this. And I think the more people that do understand these key things about calories and exercise and ultra-processed food, the better. And that's the way we can change the world. And that's, you know, what I want to do. Yeah, it was interesting watching all that. Because I think if people actually heard the conversation, there was so much more context there than, which is kind of, I guess, to me, I would say obvious, but, you know, whether something's obvious or not is in the eye of the beholder. Well, it is the danger of Instagram and the fact

that if you can't say it in your, you know, 90 seconds, no one's going to bother to look at it. And it used to be 60 seconds. It's gone up. And, you know, Tim, the truth is, you know, I've been running this podcast now for maybe close to five and a half years. And it's probably only been video the last three and a half years, something like that, or maybe four years, I don't know. And this is a challenge we always have, which is I want context and nuance. Hence, we do these long form conversations. The fourth time you've been on the show, you know what the show's about and how we do things. But then if you want to raise awareness and get people to listen to the conversation, but one way of doing that is to use

platforms like Instagram, for some people TikTok, and these sort of social media platforms. And you could take the conservative approach and go, we're not going to play any of those games at all. And then you could argue that that information that you have in your books, in that conversation that is so valuable, that is going to help so many people improve their lives, it's not going to get anywhere, or it's going to be limited. I'm not saying these things are easy. This is something that me and my team think about a lot. How do you communicate these ideas? But I think we're coming from a place, particularly in medicine, where we were told,

really, don't do anything on the media. Don't put your name out there. You're sullying the reputation. You mustn't do anything. And so it takes a long time to overcome that. And, you know, if you have a, yeah, a 30 second clip on TikTok or Instagram that brings people to say this podcast, and then this, we're talking in broad strokes here, but if they really want to go, you know, they can go to the book and look up. And then if they want to go into those chapters, they can look at the references. That's. And then if they want to go into those chapters, they can look at the references. That's what we want.

We want people in that funnel, don't we? So I think people just got to realize that there are different levels of information and it's all useful. And we just want people to get engaged at the level they're prepared to go to. And we shouldn't be frightened of starting at a way that attracts people

into this discussion and funnel, even if it means some punchy, you know, controversial terms. Obviously, there's some dangers if you tell people, you know, give up, if I said, well, you know, give up all your drugs, you know, that would be wrong. But I don't think anything we're talking about is in that league. You mentioned the two things which really got people's attention, exercise and weight loss and calories. Would you like a bit of time just to clarify your views on both of those things? Before we get back to this week's episode i just wanted to let you know that i am doing my very first national uk theater tour i am planning a really special evening where i share how you can break free from the habits that are holding you back and make meaningful changes in your life

that truly last. It is called the Thrive Tour. Be the architect of your health and happiness. So many people tell me that health feels really complicated, but it really doesn't need to be. In my live event, I'm going to simplify health and together we're going to learn the skill of happiness, the secrets to optimal health, how to break free from the habits that are holding you back in your life, and I'm going to teach you how to make changes that actually last. Sound good? All you have to do is go to drchatterjee.com forward slash tour, and I can't wait to see you there. This episode is also brought to you by the Three Question Journal, the journal that I designed and created in partnership with Intelligent Change. Now, journaling is something that I've

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

but the practice of answering them regularly will be transformative. than five minutes, but the practice of answering them regularly will be transformative. Since the journal was published in January, I have received hundreds of messages from people telling me how much it has helped them and how much more in control of their lives they now feel. Now, if you already have a journal or you don't actually want to buy a journal, that is completely fine. I go through in detail all of the questions within the three-question journal completely free on episode 413 of this podcast. But if you are keen to check it out, all you have to do is go to drchatterjee.com forward slash journal or click on the link in your podcast app. Calories exist.

I'm not a denier of a sort of physical fact that if you burn food in a jar, you can get heat off that is, you know, has a, you can measure food in that way. But, you know, so many people have gone through Weight Watchers or they've been given these strict calorie controlled diets that make calorie the center of the universe. You know, it's the only thing that matters. How many calories did I eat that day? And, you know, it's massive business. You know every every time you go to the supermarket all you see is reduced calories only 400 calories only this and so for most people in this country where we lack

a food culture that's the number one thing that most people have been bombarded with oh I can't have that, you know, I should have this, eat this. And it's a total distraction from the quality of the food. And we now know that you give people two meals of identical calories, but completely different quality and makeup and macronutrients, it'll have a completely different effect on your body. So it's, you know, for so many reasons, obsessing about the calorie is wrong. The quality of the food is far more important. If you eat good quality food, it doesn't make you as hungry.

If you, you know, it changes when you next eat your meal um and it's impossible to actually count calories really accurately anyway so and even if you do you calorie restricted diets give you the six week improvement as we all see but virtually all bounce back to baseline uh however however hard you try if you're only focusing on the calorie which is what most uh the clinical trials and everything have done so i think it's it's trying to move people away from this camouflage of calories being the most important thing about selecting your meal and i particularly get upset in restaurants you know this idea that we could solve all these problems by people in a you know in fast food restaurants selecting something that had slightly less calories in it because all the evidence shows is people then just get an extra dessert or they um they get two of the the low calorie ones or

they're not looking at the ingredients or we're not no one has said let's have a quality score and that's something i'd love to do um in the in in the future with zoe is actually you know i've got in in food for life lots of these tables where i've got you know my scores but if you could start to give people gut friendly, or things that are more holistic that take into account the number of different plants, the lack of chemicals, all these other things that are bad. So calories, you know, I'm not saying they don't exist, but quality of food is so much more important. And also how you eat and all these other things. And so, you know, getting people from the onset to start thinking about what they're eating, not how many calories they're eating, is so much more

important. That was really my point in that big discussion. I think that's a very important point, Tim, and you said a couple of things there virtually. So virtually everyone who does this in the trials that you're talking about have reverted back. And I know the third time we came on the show about, I don't know, nine months ago, we had a wonderful conversation. And I know we touched on calories in the middle there. And I remember saying to you, and I remember your answer as well, which was, look, if someone is calorie counting and they find it useful and they're getting the health outcomes they want with that, because some people will say that they find that really helpful. I personally... They've written to me and said, Tim, you're completely wrong. I've been

calorie counting for 10 years and I enjoy it and it's great. So I'm not saying those people don't exist. I'm just saying they're not the norm. Yeah. And I would agree with that. And again, we all have our biases. My bias is my clinical experience, what I have seen. I've never found it particularly helpful with people. But I know some personal trainers will say they found it incredibly helpful with their clients or for themselves, let's say, for example. But I think the wider point which your work, for me, always seems to make is that let's say your goal is weight loss, right? And let's say you find counting calories helpful to help you meet that goal in the short term and hopefully in the long term. Okay. But if we look at food in a

much more holistic way, if we think about food's impact on inflammation, food's impact on immune system balance and immune system regulation, if you look at food a lot more holistically, you go, well, calories doesn't take any of that into consideration. Technically, you could lose weight restricting calories or counting calories, but you could also be doing that with really poor quality food. So yes, on one hand, you could be getting weight loss, but on the other hand, you could be choosing foods that are increasing levels of inflammation and are causing or contributing to immune system dysfunction. So again, I'm not trying to confuse people. I'm trying to just, like you, Tim, just bring this more rounded approach to when we think about foods,

which I just still think is missing massively. Yeah, no, absolutely. And I do recognize that it does work for some people. And for example, there are some type two diabetics who are very obese that do find, you know, a kickstart if they're highly, you know, if they're followed up and they've got a lot of supervision, you know, it can be helpful for some of them. But, you know know we're talking probably at most about you know one in four one in five people uh who are highly motivated can get some benefit from this but for the sort of 80 percent of the rest of the population all the data suggests that um it is not

the likely way forward so it doesn't doesn't mean you should never try it i'm not saying you know but i just think even though the act of trying it means that you're ignoring all the scientific evidence about food quality and your long-term health. And I'd much rather people sort of heal themselves from the inside out rather than, you know, just reducing the fat on the outside

and doing it that way. And I think if we start thinking in that holistic way and treating these things as long-term problems, not a sort of three-month problem. And generally, that really echoes my own clinical experience, which has been not always, but generally speaking, when you focus on improving health by a variety of things that we've already measured, when you focus on improving health by a variety of things that we've already measured, when you focus on improving

health by improving the quality of the food you're eating, how much you're moving, how much you're sleeping, how much stress you are being constantly exposed to, it is amazing how often weight loss, when it is needed for health, comes along as a side effect. So rather than the weight loss being the focus, often when you do the other things right, which has always been my approach, the weight loss comes along as a beautiful side effect for certain people. Well, that's exactly what we're finding with the ZOE program, where we're not promoting it as a weight loss product. We're just saying we're going to change as a weight loss product. We're just saying we're going to change the way you eat to get less of this inflammation and less of the sugar spikes.

And as you said, as a side effect, many people are losing small amounts of weight, but in a sustainable, long-term way, rather than this sort of crash diet and rebound. So I think people do realize it, that particularly if you look after your gut microbiome, all those immune benefits start to build up and have this great impact and reduce problems of aging and help protect you against cancer, help you deal with adverse problems in life. And i think we've just got to get this across

that um yes there are some people that need a kickstart you know which could be you know in a very few people uh you know they might benefit from crash diets but now we've got we've got to deal with the zempic and other weight loss drugs that, again, if that's not done carefully, then those people will be thinner, but if they're not improving their diet, their health isn't necessarily going to improve. Or you've got bariatric surgery, which is the other way to permanently sort of reduce weight. And I think we've got to, in all these discussions,

start educating people about food quality because of these longer other effects. Exercise and weight loss. What is your nuanced view on this? If you want to lose weight, exercise is one of the least useful things you can do. And all the trials show that it has either no or very, very modest effects in randomized controlled trials.

So this is where people overweight are allocated to, say, physios or exercise or just videos and focusing on the food. So there's no doubt that that's what the studies show, the randomized studies, which is the only way you can really test this. There is some evidence that once you have lost weight, so you've improved your diet, that if you are exercising, it reduces the rate of rebound. So as we explained, everyone can lose um in the first three months of any

sort of diet and people who do no exercise at all do tend to go back even faster or above where they started from if they're not exercising so there seems to be something there it's not a huge effect but it's it's something so no the the summary of the clinical trial it's not my work it's other people's shows no benefits of exercise on a bit on weight loss but if you have managed to lose weight there is some evidence that it might help about 10% to keep it off. So this is very different to what most people are told when they sign up for their gym membership in January and they're told all this nonsense about burning fat

and all these different zones in the body and how you've got to do all this as if it's some well-worked out science that you just, by, you know, by being on treadmills, you just burn off the fat on your body. Because all that does really is makes you hungrier and alters your metabolism. So that instead of having, you know, a fairly active metabolism to burn up the energy, your body slows it all down. So it's a sort of reflex. So exercise is fantastic for your health. It's great for your mental health.

It's great to avoid cancers, heart disease, virtually every disease we know about apart from maybe arthritis um but it is not uh a useful tool for most people most and because i'm talking about trials where they look at the averages and in in every single trial, if it shows no benefit of exercise or weight loss, that means that as many people benefited as failed. And some people, when they exercise, will put on weight, and other people will lose weight. And what the trials show is that the average is in the middle.

So by all means, give it a go because you might be you you might be in that lucky group that does respond but don't expect that that you can alter things without changing your diet because on on average most people will not purely get that that benefit and some might be worse off. And I think that's the important thing. The understanding of all these clinical trials is that they're summing all these individuals and drawing a line between them in the same way we've always done with nutrition, which is where we've gone wrong.

But you can expect, like tossing a coin, to get better or worse if you exercise. Many people just feel much hungrier and suddenly they're going home, they're raiding the fridge and their metabolism slows down. They sit down in front of the end of the sofa and, you know, it's having a negative effect on them. Others might be lucky and get a beneficial effect. Well, I think that's a key message from this conversation, Tim, is that none of us are average. None of us are necessarily that average conclusion in that study. And for people who

find benefits that when they exercise, it helps them to lose weight. Fantastic, I'm sure you would say. But I think why this information is really important to share is because there's a lot of people who are slogging themselves on treadmills in gyms, getting frustrated, feeling like failures because they can't understand why they're not losing weight despite putting in five, six hours at the gym each week. I think for that individual, that's very, very helpful to go, oh, wait a minute, maybe I'm one of these non-responders. Maybe this isn't the right approach to me. So I think that's worth saying. I'm one of these non-responders. Maybe this isn't the right approach to me. So I think that's worth saying. For me also, when I think about exercise and weight loss or exercise and general health, but let's talk about in the context of weight loss. I think Herman Ponce's research from two

or three years ago was really quite profound at showing that just adding in exercise, you know, doesn't mean that that's going to be additive to your calorie burn that day. You know, yes, sure, you've done some exercise, but your body can compensate and down-regulate other parts of calorie expenditure. I think that was a brilliant study. Yeah, we're not machines. We're not this in and out machine. This is this, going back to the calories thing, that people say, oh, well, my watch has just told me I've done another 200 calories exercise. You know, I can eat a donut or whatever it is. And it's just, it doesn't work that way.

Yeah, it doesn't work that way. For me, one of the main reasons to move your body whilst trying to, let's say, lose weight, if that's your goal, is because I think people feel good when they're moving. There's something really, you know, I think in terms of self-esteem and how you feel about yourself and your mood, I think that often gets improved, particularly if you're sedentary and you start to move. And that in turn makes it more likely you're going to be able to stick with, let's say,

your dietary changes or engage in other lifestyle behaviors, like maybe going to bed half an hour early or whatever it might be. So I think all this stuff is quite nuanced. I think you wanted to respond there. Well, I don't think it's true for everybody. So you take the Lewis Capaldi's of the world, right? Some people absolutely hate the idea of going to a gym and doing exercise or, you know, running or jogging or doing this stuff, you know, and the sort of endorphin rush that many people get is like a negative, you know, running or jogging or doing this stuff, you know, and the sort of endorphin rush that many people get is like a negative, you know, this sort of feeling of, and I've had patients like this, you know, with ankylosing spondylitis, you say, well, if you don't exercise or stretch, you're going to get worse. And they say, you know, I'd rather be

worse. I can't, you know, and it does happen, right? So there are these people, but I think what is interesting is these micro changes, sitting at your desk and fidgeting your feet can reduce sugar spikes. Getting up every 20 minutes and going up and down the stairs to get a cup of coffee, if done over many hours, is another way of exercising. So I think it's also, there's so many different ways people can do things and sort of hacks to their body that we need to realize.

And, you know, just, we mustn't assume that, you know, the same exercise works for everybody because we're talking about personalization. Of course. And I think we've got to be, you know, more open and realize that you can give people the tools, but they say, listen, there's a big menu out there, just like all these foods and these other options. I think exercise has to be seen in a much wider buffet of ways to do it for people who don't like this stuff.

Yeah. And I completely agree with that. I guess what I was getting at is more, not necessarily slogging yourself at the gym, but like I've got some patients in mind where I would tell them to keep, I said, okay, you don't want to go to the gym. You don't want to work out. No problem. Okay. Can we keep a dumbbell or kettlebell in your kitchen? Something, you know, I talk about a lot. I think small little exercise snacks can be very useful. And for people who don't like exercise, I have tried, and this really does work with a lot of people, say, okay, every time you put your kettle on, just pick up that weight and do five bicep

curls in each arm. That's it. And put it down. If you have three cups of tea a day, that's you lifting that weight 30 times a day, 210 times a week, almost a thousand times a month. And I have found for people who don't like to, in adverse commas, work out in the way in which they think they need to work out, that can be incredibly powerful from a psychological perspective. Like, wow, I kind of feel good that I'm lifting a heavy-ish weight. It makes me feel good, which I think psychology also plays a massive role in how we engage with nutrition changes, lifestyle changes. And so, yeah, it's super rounded. Personalization is the key.

In terms of your 20 tips, Tim, in Chats of 33. We've done one of them. We've done one of them. Well you've got the other one too. We've done one of them. Well, people can get the book, right? It's a very thorough and well-researched book. I really like this one. In fact, I've got it underlined. 16.

I'm not just trying to cover controversial topics, but this is something I feel very passionate about. Tip number 16. but this is something I feel very passionate about. Tip number 16, understand that food is medicine and the right diets can be as effective as many drugs. Yes, and I've changed my mind on this. Certainly, since I was a practicing doctor where we dismissed nutrition as being pretty trivial compared to our powerful drugs that we're all love to prescribe and i think my i think the field of cancer has really opened my eyes to this about the power of nutrition um but just epidemiologically calculations have said that if uh we move the

uk from its current diet to an optimum diet we would reduce uh chronic illness chronic diseases by about 70 percent 70 percent so this is extrapolating from, you know, you take the health, the sort of healthiest quartile of the population, the worst quartile, and you move the average down to the best one. That's, there's not many medicines that would have that effect at this population level. Of course, these are models and you can criticize those. But the other thing that makes me really believe this is our work in cancer.

And I was running a consortium between a Dutch group and our group in the UK on melanoma, people who had metastatic melanoma who in the past you know had very poor prognosis and outcome but now they these new immunotherapy drugs that um you know work can suddenly save lives so they're suddenly getting a third of a third or more of people surviving forever. It's very dramatic. And rates are getting higher all the time. Now, we looked at effective diet on the baseline and the microbiome,

and it nearly doubled the success rate of the drug just by being on the right diet and having the right gut microbes at the beginning of that study. So you suddenly start thinking, wow, in a way, it's acting just like a drug, this food. And if we just knew and if it had the same backing as pharmaceutical products, we could do so much with it. And there's lots of data also about using things like mushrooms as adjuvants for chemotherapy where they increase survival rates by 20%.

So that's why suddenly I've got this, I've changed my mind because I thought it was, you know, it is controversial. You know, basically most of our traditional medical colleagues would say, you know, we're nutters if we said that. But we're getting all this really good science now building up to show the key importance of what foods we eat, how that affects our gut microbes, this huge effect on our immune systems. And that's why, you know, when we take these artificial sweeteners,

there's a new study out last week saying erythritol, which is one of these sugar alcohols has really big effects on immune cells and could be used as a either as for good or bad um either you know in terms of autoimmune disease it could save people or it has other effects so i think once you devolve food to its chemical form and we take it more seriously, rather than as calories and macronutrients, it becomes just like pharmaceutical products and very little difference. You know, artificial sweeteners, what are they? They're chemicals made from the petrochemical industry.

So they can be, you know, good or bad. So the same, we can visualize that. Yeah. We don't see food in the same way but once you start to do that it makes sense that food definitely is medicine i completely agree that food is medicine i know that um as you say there is a selection of medical doctors who push back at that and i've i've spent a lot of time thinking about this over the past few years. Because first of all, each to their own, right? If I use that

term with my patients and have done for many years, and when I explain what I mean by that, I think patients find it incredibly useful. That's what they fed back to me. But if you don't like that term, okay, great, don't use it. But you know, one of the definitions of medicine, I think is a drug or preparation that we can use to prevent or treat disease. Now, I think on that definition, food absolutely fits. I mean, you can take a whole selection of different diseases, type 2 diabetes being a very obvious one, where you can use food as medicine. You can use food to put your type 2 diabetes into remission. I struggle to see how it's controversial to call food medicine in that context, for example. I think there's a wider issue. There is a weighting issue to consider as well. If we say, no, medicine is medicine, but food's important, but it's not medicine, I think we're undervaluing how important food is. And I think what we're doing is we're reinforcing

the message that it's about the drugs. That's what's really going to sort things out for you. Yeah, change your diet on the side a little bit if you want, but it's really the drugs. And in this prescribing lifestyle medicine course that me and Dr. Panja teach, Royal College of GP accredited course, we often do this role play at the end of the whole day's teaching, where we go through, I'm the sample, he's the patient, I'm the doctor. We go through two sample consultations, where someone's been given a diagnosis of type 2 diabetes. And essentially, it's a bit of fun at the end of the day, but it really helps highlight this point for me whereby if you spend the first nine minutes of the 10-minute consultation talking about drugs and how important they are, and then as the patient is walking to the door, you say,

if you could just improve your diet and lose a bit of weight, it's also going to help. What message does the patient get when they leave? The message is, yeah, I know he told me to change my diet and lose a bit of weight without any advice on how I may go about doing that. But yeah, he did say that, but essentially he spent 90% of the time talking about these drugs that I need to take. They're going to go out with a certain message, whereas in the second consultation that we do on stage, we spend the first 90% of the time explaining to the patient, yes, there are some drugs we can use, but there are also things in your lifestyle that may have caused this to come in the first place. There's things that we can still manipulate and change. You know,

are you interested in me helping you understand what those things are? Same consultation time, two very different messages in that patient's mind. So that's the second reason why I believe food is medicine. But the third piece, Tim, and I think this really speaks to what we were talking about before about food cultures and how you were saying that the countries, the cultures with strong food cultures have generally, I'm sure not in every case, but generally have been a little bit more resistant to the kind of infiltration of the food industry

and ultra processed foods. There's a lot of cultures around the world, including the culture I'm from, an Indian culture, where saying like, is food medicine, is one of the most ridiculous questions you could ask. Of course food is medicine. It's not even something that's worthy of debate. So I think this denigration of food as medicine concept, which is you're also denigrating a lot of cultures and their beliefs. It's not just Indian cultures, there's a lot of South American cultures. And I think that's relevant because we're living in a global world. Immigration, you know, in every

country, you've got people with different cultures living there now, certainly here in the UK. So I think it's a little bit problematic when we say food is not medicine so that's that's my three-point case for saying why i think it is so i'd love you to respond well i mean i've been to some conferences that are you know called you know food as medicine or i've sometimes given a talk with that title and yet yet, some people say, well, you can't say that. You know, you're going to some wacko conference, right? This is just fringe medicine. And I think this is the reason that there's so much pushback from some of our colleagues on this is they're super worried that people are going to not take their prescribed drugs. They're going to

not take their prescribed drugs they're going to uh take turmeric or um you know lion's mane mushrooms instead and you know and and and it's been an us or them scenario so you know you go black or white thinking which is dangerous you know you go with terminal cancer someone says oh you know chances aren't very good but i will give give you this drug. And some people will go and see a functional medicine doctor and get, you know, chances are very similar because, you know, the prognosis is very bad. And they're worried about, in the past, and this is what I'm talking about, you know, but this is traditionally where I think people are. That's why many doctors are worried about food as medicine. Also, they don't know enough about it so suddenly let me tell food as medicine but i gosh i don't know anything about food or nutrition we didn't have any training

i've had no updates in the last 20 years you know it's not surprising and but i i do think you know there are some areas i mean if you turned it around and you said okay you're going you've got been diagnosed with cancer unfortunately you're going to see your oncologist and you say you know i like to you know would you like to know one thing that is going to double your rate of survival um or do you want to discuss you discuss all the different chemotherapy regimes? They don't do that. And I think it's becoming increasingly desperate that this is a vital part of what the patient wants to do something and they're not given those options.

All the data is pointing more and more towards, they help each other. It's not one or the other. They are both important chemicals that can save your life. Yeah. I mean, all information, if taken to an extreme, can be problematic. And I feel as a profession, we do need a bit more humility to sort of say, look, there's plenty we don't know. There's plenty we weren't taught at medical school. It doesn't mean it's not valid. And once you have learned how to use food as medicine, this is my bias, because I wasn't taught how to do this. I had to go and learn how to do this and use it to, let's say, help someone put type 2 diabetes into remission or help them with their depression. As Felice Jacker showed in her 2017 SMILES trial, I think it's pretty hard to

see that trial and go how, yes, they were already on some sort of therapy and 12 weeks on a modified Mediterranean diet versus the control group who just, I think, were given social support, statistically significant improvement in depression, it's pretty hard to say, well, but food is not medicine. You know, food... Yeah. And so every psychiatrist, you know, or GP who's facing someone with depression, it should be the first thing they do is say, let's talk about your psychiatrist, you know, or GP who's facing someone with depression, it should be the first thing they do is say, let's talk about your diet. You know, what do you eat? They might have a good diet in the first place, in which case you say,

okay, well, we're not going to optimize that. Let's do it. But if you don't ask and you don't have it as part of your armory, then, you know, in the same way, whether it's cancer or depression or diabetes, you know, I think we're, whether it's cancer or depression or diabetes, you know, I think we're absolutely missing a huge trick in this country that we're being overwhelmed with bad diets and food. It has ought to be the number one question. All doctors ask their patients as soon as they come in.

And we're just not equipped for it. We don't have the resources for it. There aren't enough people trained in it, you know, and we have to work out how do people get that information. And that's really, you know, what I'm about. And, you know, if a few GPs read this book or, you know, patients, you know, this is the starting point, you know. Yeah. But this is not very, it's not that hard.

It's not, that's it. It really isn't. Like, we can make this really complicated, but as I've said many times on the show, what I will do with pretty much all my chronic disease patients, if time and setting allows for this, is encourage them to completely switch

to a whole food unprocessed diet for two to three weeks. And that intervention has changed the way I practice medicine. I've been doing that for about 10 years. It has completely transformed the way I practice medicine because it doesn't mean every problem goes away, but it's amazing how many things start to get significantly better. So you then see, what am I left with now? What am I left with once that's gone out of the equation? And it does a very powerful thing of teaching that individual to go, oh, wow, I had no idea how much my food choices

was affecting my day-to-day health. People don't. People got no clue. And it's also empowering to say to someone, rather than just, well, what's the next tablet you're going to give me, doc? You know, to say, well, actually, I'm not going to give you anything, but this is a paragraph of what you need to do. Do this for two weeks and come back. But it seems so obvious, and you just wonder, well, we have, I don't know, how many 20 million sick people in this country. All of them should be given that advice today, and they're not. Yeah, completely agree.

I mean, Tim, we've not even scratched the surface. I mean, I was hoping to go through more things that you've changed your mind on, like bread, meat, fish. We touched a little bit on mushrooms. Of course, it's all there in the book for people. It's a very, very thorough book right it's very very comprehensive if i had to ask you to choose your favorite chapter what would you say i my favorite chapter i got a bit depressed writing it because it took so long. Took six years.

But I think my favorite chapter is actually the future of food. It's the one where I can see light at the end of the tunnel. It's not all about the harmful effects of ultra-processed food. It's not about obesity. I can see new technologies, particularly fermented foods and what's called precision fermentation um and uses of microbes to actually grow proteins that i see that as hugely exciting and you know i'm i get interactions with a lot of these startup companies who are making these stem cell meats and stem cell fish. You can now get prawns out of a test tube that will have such a huge impact on climate change and the world

if we can embrace it. And some of these are much closer than people think. We're probably within three years of getting meat substitutes that taste the same and are cheaper than the traditional American burger patty. How does that fit with ultra-processed foods? Because one of the critiques at some of these meat substitutes is that they're highly, highly processed, potentially not as good for the environment as is being marketed so how do you put all that together well that's definitely true for

the the current versions so yes you know they're better for the environment they're probably not much different for your health you know they're compared to a cheap burger you know the the artificial burger has lots of things you don't really want in there. But the next version, I've seen prototypes that are a really clean label. They've got no artificial ingredients at all. They're using bacterial fermentation to break down my friend's mushrooms and tomatoes and other things into something that really tastes, if you cook it right, just like meat. And it's got lots of fiber and plants in it. So I see there's this huge potential for this revolution as we get rid of cheap meat and dairy

and we replace it with either a combination of these sort of stem cell foods that we then ferment to give them extra texture and flavor and possibly as probiotics that we actually use them, you know, in a nutritious way, plus actually creating protein, getting bacteria and yeast to actually make proteins that we can put into foods. But knowing all the problems that went into ultra-processed before,

we can do this properly. So that was the bit that really filled me with some optimism because a lot of this is, you know, to read about our current food, there are lots of depressing bits in it. And people say, well, there's no future. But a lot of this book is about the environment. We haven't really discussed that. So it's taking each of the foods from an ethical standpoint,

a health standpoint, but also what effect you have on the environment. And we've talked about food choices being, you know, the food choices we make are the most important thing we make for our health you might argue differently but i certainly think food choices is number one um but it's also the most important thing we can do as individuals for the planet and climate change and this whole future of food has got to bring in the planet as well as our gut microbes, as well as our health. So there's the sort of, the three things there. So I think there's lots of fantastic tech in there that I think because

they're starting from scratch, they can actually do this properly. And I was very excited by that. So that's the bit that cheered me up and that's why I call it my favorite chapter. I was very excited by that. So that's the bit that cheered me up. That's why I call it my favorite chapter. Well, you've certainly set the scene now for our follow-up conversation,

our fifth conversation on my podcast, Tim, because, yeah, we've not really touched on the environment, which, of course, is something that's front and center in many people's minds. I know there's a lot of controversies there, which is really worthy of a full-on conversation to go through. Again, I don't think we've even scratched the surface about what's in this book. There's chapters on fruits, on vegetables, on legumes, on rice, pasta, breads.

What's your favorite rice? White rice. Do you know Uncle Ben's rice comes out as one of the healthiest ones? Does it? Yeah. In terms of blood sugar? In terms of nutrients. Really?

Yes. Just because it's parboiled. So anything that's parboiled means you seal in a lot of the nutrients. So there are some surprising things in the book here. There's loads of surprising stuff, you know. There really is. And brown rice is not that much better than white rice that's the other depressing thing well i found that really

interesting and we didn't really get into glyphosate and bpas and teflon and arsenic and the things i wanted to cover so maybe we'll save that for the next one but i find even in terms of rice like you know my parents are from kolkata and ind, right? Bengali. And the way Bengalis do rice is you will get, you know, you'll put the rice in a, I don't know, in some sort of pan and you'll rinse it three times. And I remember as a kid, you know, mom say, yeah, because you take off the excess starch, right? Whereas the way some other cultures, or my wife, who's also Indian, but from a Gujarati background,

she'll do it slightly differently. Or I know some cultures, some countries in the Far East will, you know, they'll make sticky rice in a way that all that water is part of it. So even the lowly white rice can be made in a whole selection of different ways that is likely to have a different blood sugar profile and all kinds of things. So I find it

really, really interesting. Yeah, I know. As you get into it, you just get more and more, you know, getting down in these little rabbit holes. It was really fun. it was really fun. Tim, just to finish off, yesterday was quite a significant day for me. I didn't realize it until I was thinking about it over dinner. It was 10 years yesterday since my dad died. And dad's ill health and that journey of caring for dad and now for my mum has played a huge part in my adult life it's uh informed a lot of what i do now how i interact with people how i think about health and i recently heard you talk about your dad who i believe died quite suddenly when he was when when you were 21 years old. I often wonder what my dad would think of my career today.

He's a conventional medical doctor, you know. I wonder what he would think of all the things that his son now talks about in books and podcasts all over the world now. What do you think your dad would think about what you're doing um i don't know i think i mean he wrote some books and as he died he was he was writing a book called social pathology which was trying to link psychology and social science with pathology so i think he'd have actually embraced a lot of the the in a way um vulgarization of of the science to the to the public i think um uh yeah i think he would have appreciated it and um and yeah he was a a questioning he was a research doctor as well

a pathologist and had a questioning mind so i i think he would have been fascinated but by uh what i'm doing now. Probably a bit surprised that I'd ended up in this particular area from where I was at the age of 21, where I wasn't looking like I had much potential at all, I would say. Do you think the fact that he was an author has influenced you in terms of you now writing books is any part of that related to your dad you think uh i think possibly i i i did uh update his he wrote a pathology book which was quite a dull topic if you remember in medical school i do but he he did all have a few jokes in it and so um uh i did enjoy that though

those bits that um uh you know it's like we have the same had the same sense of humor the sarcasm and uh sort of rather black humor uh so i did edit his book um uh another edition um you know as as the number of cytokines increased you had to there were only two interleukins when he wrote it and i sort of i think there's now over 35 but the um so yeah that gave me a little taste of it um so that probably made it easier for me to um go and write books which is for most people quite a big step as you know because it's a huge commitment and that stops most people doing it but you know but you know the sad bit is I didn't know him that well and that was my my big sort of regret is at 21 just starting to have a sort of adult relationship with your parents.

And then, yeah, it got cut short and I was, you know, very busy as a medical student. So he didn't get much time. So, but yeah, I'd like to think he was, he's up there somewhere smiling at all this attention about me talking about exercise and calories. I'm sure he is, Tim. I'm sure he would be incredibly proud of you. I think you've done a fabulous job over the last years at putting

real foods on the map, helping people understand that they can make choices in their own life that will improve their health, their family's health, the planet's health. Thanks for coming on the podcast. Been a pleasure. Really hope you enjoyed that conversation. As always, do think about one thing that you can take away and start applying into your own life. Now, before you go, just wanted to let you know about Friday Five. 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 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. Now, 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, 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 audio books, which I am narrating. If you enjoyed today's episode, it is always appreciated if you can take a moment to share the podcast with your friends and family or leave a review on Apple Podcasts. Thank you so much for listening. Have a wonderful week. 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.