Feel Better, Live More with Dr Rangan Chatterjee - Tim Spector: The Latest Science on Gut Health (and How To Find The Right Diet For You) #291

Episode Date: July 12, 2022

For the last in the current series of Feel Better Live More, I’m welcoming back someone I know you’ll love. Professor Tim Spector was my first-ever guest, and he returns for the third time today, with the very latest on gut health and personalised nutrition. Tim is a professor of genetic epidemiology and Head of the Department of Twin Research at King’s College London. He’s a world-leader when it comes to the gut microbiome – and Director of the British Gut Project – whose research has transformed what we know about food and health. Tim is author of two excellent books, The Diet Myth and Spoonfed: Why Everything You Know About Food Is Wrong. This conversation will bring you up to date with all Tim’s most recent findings and practical advice. But don’t worry if you’re new to the subject of gut health, as we also provide a need-to-know guide to get you up to speed. We start by discussing why gut health is such a hot topic. Tim explains that, unlike our genes, it’s something we can influence, thereby improving not just digestion but almost all aspects of our wellbeing. He reveals the gut-friendly properties of plant fibre, polyphenols and fermented foods. And because diversity is key, Tim shares some of his own food hacks for getting to 30 different plant foods a week. Tim believes the obesity crisis is more of a food crisis, fuelled by ultra-processed foods. We discuss a move towards counting quality instead of calories, and why the new mandatory calorie labels are unhelpful for most people. We also talk about personalised nutrition and the revolutionary PREDICT studies, carried out for Tim’s ZOE nutritional science company, which found people can have dramatically different biological responses to the same foods. The results have led him to develop a personalised nutrition testing kit and app that you can try too. Our conversation covers much more, including the benefits of time restricted eating for gut health, why skipping breakfast isn’t bad for you, and the pros and cons of health trackers. Tim also reveals the gut parasite that 1 in 4 of us have, which rather than making us ill, can actually have huge benefits for our health. This is a fascinating conversation; full of practical and actionable information. I hope you enjoy listening. Show notes https://drchatterjee.com/291 Order Dr Chatterjee's new book Happy Mind, Happy Life: UK version: https://amzn.to/304opgJ, US & Canada version: https://amzn.to/3DRxjgp 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 other qualified health care provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have heard on the podcast or on my website.

Even if you feel perfectly normal, you can have poor gut health, which is going to affect how long you live, how many chronic diseases you get, whether you get allergies, whether your immune system is going to fight off COVID, your mood, your sleep, all things we hadn't even thought were related. We have to think much more widely when we talk about gut health. Hi, my name is Rangan Chatterjee. Welcome to Feel Better, Live More. Hey guys, how you doing? This episode is officially the final episode of the current series of my podcast. Now, if you're a long time listener of my show, you will know that every summer we stop the podcast for about six weeks or so. Now, there are many reasons for this. But the main one is really because the

summer is a time of year where as a family, we try as much as possible to prioritize undistracted time together. And my wife is the producer of this podcast. And so clearly very involved, like me with the weekly production of each show. so clearly very involved, like me, with the weekly production of each show. And so for us as a family, it's really important to have some time each year when we stop. And for us, because we have two young children who are on long school holidays, the summer is the perfect time. Now, I'm well aware that many of you really look forward to each week's episode and that this podcast has earned a place in your weekly schedule. And I honestly am truly, truly grateful for that.

Please don't forget that there are close to 300 episodes in the back catalogue. Most of them are just as relevant today as they were when they were first released. So perhaps this summer, you can take this break as an excuse to delve into the back catalogue and listen to some episodes you may have missed, or perhaps revisit some of your favourites. And I think honestly, many of them are well worth a second listen. If I ever go back and listen to some of the older conversations, I will often hear different things, and I'll find that the ideas land in a different way because, of course, we hear ideas differently depending on what else is going on in our lives. Now, my plan is to relaunch the next season at the start of September.

As per usual, it will be the Wednesday long-form conversations and the shorter 10-minute bite-sized episodes every Friday. Now, before we get into today's show, I have a quick announcement. This podcast is looking to recruit over the summer. We need some help on the production side, so we are looking for a sound engineer and a sound editor. Someone, ideally, who likes the content of this show, who is on board with my mission, ideally who likes the content of this show, who is on board with my mission, but is also skilled in audio engineering and editing, and is committed to high quality sound and production. If that is you, please send an email to info at drchastity.com with sound engineer in the subject line.

Alternatively, if you know someone who may be interested, please do let them know. Now, I always try and end the season on a really good episode. And I think today's show is one that you are going to love. I'm welcoming back Professor Tim Spector, who is my first ever guest on this show. And today, he returns for his third appearance on the podcast for a conversation that is jam-packed with actionable information that you can be thinking about over the coming months. Now, Tim is a professor of genetic epidemiology. He's head of the Department of Twin Research at King's College London. He's a world leader when it comes to the gut microbiome. He's director of the British Gut Project. His research

has transformed much of what we know about food and health. And he's also the author of two excellent books, The Diet Myth and Spoonfed, Why Everything You Know About Food Is Wrong. If you're already familiar with Tim's work, this conversation will bring you bang up to date with all of his most recent findings and practical advice. But if you're new to the subjects of gut health, please don't worry as we provide you with all you need to know to get you up to speed. And we start off discussing why gut microbes are such a hot topic these days and where we are currently up to in our understanding of the science. Tim explains that unlike our genes, our gut microbiome is actually something that we can influence, which will improve not just our digestion, but many different aspects of our health,

including our moods. Now Tim reveals the gut-friendly properties of plant fiber, polyphenols, and fermented foods. And because diversity in our food intake is so important, Tim shares some of his own food hacks for taking in 30 different plant foods a week, a number that Tim genuinely believes is achievable for all of us. Now, I'm well aware that when we talk about gut health and increasing our intake of certain plant foods like vegetables, it's important to recognize that some people actually struggle to tolerate this for a variety of different reasons. In our conversation, we both put forward our views as to why this may be the case. We also talk about the obesity crisis, ultra-processed foods, how we should

be focusing on food quality rather than calories, and why the new mandatory calorie labels are likely to be unhelpful for most people. We also talk about personalized nutrition and discuss the revolutionary PREDICT studies carried out for his Zoe Nutritional Science Company, which has found that people can have dramatically different biological responses to the same foods. And these results have led him to develop a personalized nutrition testing kit and app that you can now try as well. We also talk about the benefits of time-restricted eating for gut health. Tim dispels the myth that breakfast is the most important meal of the day for everyone.

We talk about the pros and cons of health trackers. And Tim reveals the gut parasite that one in four of us have, which rather than making us ill, can actually have huge benefits for our health. This really is a fascinating conversation full of practical and actionable information. I thoroughly enjoyed chatting with Tim. I hope you enjoyed listening. And now, my conversation with Professor Tim Spector. I think a lot of people hear information about food and gut health and inflammation and the immune system, and often they get confused. So you are renowned as a global expert on these topics. And so I thought maybe we could start with the question, why is gut health so important?

Because it's a crucial organ in our bodies. And it is one of the few things that we can really control. So there's a huge range of gut health across the population. We know that we've lost half of our gut microbes compared to perhaps even 50 or 100 years ago. And that's affecting us in many ways. And yet it's not like genetics that you can't change. It's something that all of us can improve. And all of us needs to understand more about gut health so that we can improve many things in our life very simply just by altering our food choices.

So it's becoming apparent that it's something that the public can change. You don't need doctors. You don't need specialists to do it. It's all within our power to really nurture and improve our gut microbes, which in turn are key for our gut health. So it influences everything to do with our body, our mood, our brain, and our metabolism, our weight, et cetera. Yeah, a lot of people think about gut health

and digestion and they think yeah the guts if i can get my gut functioning better my gut's going to feel better but as you say that it's not just about your gut is it it's about many different things in the body yeah it's not i mean as you said i think in the past people have said gut health oh that just means you know to avoid heartburn or bloating or constipation or whatever it is. And now we know it's nothing like that. Even if you feel perfectly normal, you can have poor gut health, which is going to affect how long you live, how many chronic disease you get, whether you get allergies, whether your immune system is going to fight off COVID,

all kinds of things, your mood the next day your sleep all things we hadn't even thought were related so we have to think much more widely when we talk about gut health i think it's nearly a sort of uh it's like talking about holistic holistic view of your body uh that comes back to the you know the ancient indian teachings that says it all comes from there, which if you said it that way, sounds a bit pseudoscience. But if you just, instead of that, you call it the gut microbiome, then it's starting to make sense again. Yeah. You mentioned that what's really great about the science of gut health is this idea

that we don't need to go and see a doctor or a specialist. We can manipulate it. We can change it for ourselves. Now, as a fellow medical doctor, that's something I'm incredibly passionate about. How can we disseminate information to people that means they can be, I guess, the architects of their own health rather than need to rely on other people? What have you found since you started spreading that through your books, through your podcast, through all these mediums that you use, what sort of feedback have you had?

Well, amazing feedback really of people writing me letters, sending me presents, all kinds of messages saying that just reading my book, The Dartmouth or Spoonfed, and saying it changed the way they thought about food. And actually, they taught the rest of their family, and suddenly, they're feeling healthier, they're feeling better. And there's nothing quite like that as a doctor, to feel that you've made not just a change to someone for a few weeks, but actually changed something probably for the rest of their life. And that's incredibly empowering for me to know that, you know, just by writing some books and talking on podcasts, you can actually change people's attitudes long term. And so that really is a major motivating factor for me, rather than the hundreds of papers I've written

that only a few academics read. I think getting these messages out and doing doctors out of a job is really what spurs me on and probably you too. Yeah, for sure. And Tim, I've been really thinking long and hard over the past few years, what does it mean to be a medical doctor? For me, at least in 2022. Because when I was at medical school, I always imagined it would be, you know, I would make impacts by seeing

people and helping them change their lives. And, you know-on-one, do some tests, make some changes. And of course, that has incredible value. But I've realised more and more, if we do our jobs right through spreading this information, through the media, through podcasts and books, I kind of feel we're still doing our job as a dot, sir, just in a very different way. Well, reaching many more people and being much more efficient about it and not trying to just sort out the short-term problems, which I think is what modern medicine's still unfortunately dealing with and predominantly dealing with pharmaceutical solutions to those problems. And that's just the way it's set up at the moment so i but i think we are seeing more and more well i am things optimistic is is uh you know doctors like you

and many others who are suddenly uh having a voice and speaking well because it was very hard to find any any doctors 10 years ago that would be you know prepared to do this without feeling they were going to be ridiculed or told off by their peers or would simply not have the right language to appeal to the general public. So I think we're certainly, I mean, it was a bit more advanced in the US, I think.

But certainly in the UK, we've been very behind with doctors really scared to talk out and say what they think yeah in terms of practical things we mentioned that improving our gut health can improve all kinds of things in the body and you mentioned food as a powerful driver um it's a powerful tool to use for our gut health what are some of the things that people should think about bringing into their diets to improve their gut health well the first thing i think is to to realize that we're not really in an obesity crisis we're in a food crisis and that's because we've lost an idea of what good food is and the

first thing to do is to realize you know the difference between good and bad food and forget a lot of what we've been told about calories and fats and sugars and the fact that you can really tell a product by its calorie count or its percentage fat on a stick on a label and most people don't really realize the difference between ultra processed foods and whole foods, because they're the same category, you know, a bread is a bread for most people. And so I think the first thing is to just realize that actually, virtually all the population don't fully understand what food is. So I think educating more about what food is, is really important more about what food is is really important realizing that quality

is something we should be talking about and we should absolutely stop talking about calories so in a way that's the first mindset shift um i would like people to to do and everything we're doing now and doing with the company zo is to completely ignore the C word. Well, I want to get to Zoe and personalized nutrition shortly, because I think that is really revolutionizing the way we are all going to think about our diets in the future. You mentioned you want people to forget thinking about calories. Now, to a lot of people, you want people to forget thinking about calories. Now, to a lot of people, that's a very controversial statement. I happen to agree with you on that. But could you elaborate why is the idea of focusing on calories or even calorie counting, in your view, potentially problematic?

Well, there's several reasons. The first is that if you judge a food or choose a food based on its calories, you're ignoring the quality. And manufacturers of foods use calories to disguise the poor quality of the ingredients. All the other chemicals there affect the highly processed that's going to have lots of other negative effects on your body. Second is it's the estimates of how many calories are in it are wrong. Even in manufactured processes, they're sort of plus or minus 10%. And in restaurants, they're plus or minus about 200%. So you can't judge what's going in. You can't work out what how many calories you actually burn in a

day either huge differences the idea that you know all men have two and a half thousand calories is at all ages is complete nonsense and you know different times of year and all kinds of factors mean it impossible that you can work out what the right amount of calories is. So even if you could accurately measure the amount of calories going into your body, it wouldn't be personalized for you, it wouldn't be worthwhile. And even if you do go on calorie restriction diets, over time your body adapts and so it changes its metabolic rate, therefore equalizing. So that's why calorie-restricted diets simply don't work.

And also, in this country, in the U.S., people are, the more they go down those routes, the more they tend to go down low-fat, low-cal processed foods. And so they're often swapping calories for quality. And we know that these other products of food, understanding what's in ultra-processed foods, will drive your hunger, drive your cravings, make you more tired, all kinds of things that they're not supposed to do because we're just supposed to think about calories and fat content and so it's driving people down the wrong direction and that's why we've got it so wrong over the last 50 years that's why obesity rates are going up diabetes rates are going up and ultra processed food

rates are still going up in the US and the UK, which are the two top countries in the world. So that's the first thing. So it's about firstly understanding the differences between foods. There's a huge difference between a cooking oil that's made in a highly processed way or olive oil. There's a huge difference between a bread that's bought in a supermarket that's been hanging around for a year, frozen and reheated in front of you

and a sort of artisanally made rye sourdough. Massive difference. And yet they're all called the same and in most guidelines, oh well, you know, they'd be equivalent. So it's understanding those differences between ready meals and something you do yourself. It's all those nuances that we need to start thinking about

much more than this ridiculous concept of calorie counting. Yeah, I mean, I always say that, look, if someone's listening or watching this and they have found calorie counting helpful for them, I'm like, hey, go for your life. Certainly, I'm not trying to change what anyone does if they're finding it useful i've just never ever found it useful with any of my patients at all well one percent might like might like it so let's yeah that's yeah so yeah if it's working great a couple of things to respond there um a few days ago because when did it come in in the UK? Mandatory calorie labeling came in,

what, a few months ago? And I was in a cafe down the road from here a few days ago. And I can't remember what I chose, but it had some avocados and had some nuts in it. And I think maybe some salmon. I can't remember what it was. When I looked at the ingredients or something, I was looking at the menu, then the calorie thing popped up. And I wasn't used to it because I'm not used to seeing calories on the food that I look at. And the calorie count was pretty high, actually. So now I happen to, I think, know a reasonable amount about nutrition and what foods are nourishing me. And I thought, wow, if you don't know, you may look at that calorie count and go, no, no, I'm not going to eat this because there's a lot of calories. I'm going to get something else

instead, which may have lower calories, but may be ultra processed and have detrimental effects on multiple aspects of our body. That's one thing I wanted to mention. The second thing is this reductionist way in which we often look at food now and constituent parts of that food has become so reductionist that particularly the focus on calories that I think we're missing that big picture on what food is and what quality food is. It's information, isn't it? It sends the body signals that can influence our inflammation, our gut health, our moods, hormones, genetic expression, all kinds of things are influenced by food. And I think we forget that. And it goes back of mind when we simply look at just the calorie number

yeah absolutely so we're agreed we should ban it and uh get it get it uh or in a font so small you can't see it on the on the label which is what they do to the other interesting stuff that you do want to know about but uh the restaurant stuff is interesting because new york um introduced this over 10 years ago and i've been doing stuff there's been lots of publications on it and show that it works for a few weeks and then ultimately fails and then ultimately has a sort of reverse effect that people um will choose the lower calorie options and eat much more of it than they would have done otherwise so it's uh and if you talk to the also the people preparing the meals they just guessing what's in those in those meals they've got no real idea and it's

totally depend on portion size and so which can change so easily so it's not only misleading but it's also likely to be unhealthy for us. And it's just a tick box for governments to say, oh, I've done something that, you know, the food industry won't worry about, and they'll be quite happy to go along with it. And, you know, it ticks a box with doing something for people's health, but it is absolutely of no use. And totally agree, it's obscuring all the other good things that are in that food that people should be picking it on. So that's, yeah, we're agreeing. When you go to a restaurant, you know, look at the ingredients, not the calories. In terms of the good things people should be focusing on then, so we know the importance of gut health. In terms of those foods or the types of foods

that you would love people to be focusing on more what are they well gut friendly foods so you know i'm hoping one day we'll have a a nice label on the food that gives it a like a calorie score a gut friendly score and you are seeing some of the some of the companies starting to you know have these labels on it but they're it's the wild west West. Anyone can put anything on at the moment. You don't trust it. So what you've got to think of is what do your microbes want to eat when you're picking them out? And generally, if you pick foods that your microbes are going to be happy eating, they're going to be good for you and they're also going to be good

for the planet. So as a very general rule, that's a pretty good one. And what microbes like to eat is they like to eat predominantly plants. They like to eat high-fiber plants that are complex and they like a variety. So there's no point only eating one type of salad every day, even if you love it. Do mix it up because we've done studies showing that the sort of sweet spot for the number of plants you should eat in a week is around 30. And that's not a precise number, but you should be aiming for at least 30 plants,

different plants a week. So bear in mind that's so you're generating as many species of microbes that can feed off all the chemicals in each of those plants. So it's like the perfect nourishment for them is to get that variety across the week. So if someone, let's say, loves broccoli and thinks, you know, I've got to eat more vegetables because I know it's good for me. I love broccoli. Okay, I'm gonna have broccoli five, six, seven times a week. Compared to not having that, I guess that would have an improvement. But are you saying that for that person, because I think there'll be people listening to this right now who like broccoli or whatever, green beans or kale, got their favorite one, and they have that

all the time. Can you just sort of expand on that for that person that actually that's great but you might want to think about expanding it more yes i mean so you've got to think of it as yes you love broccoli and broccoli has lots of fabulous nutrients in it but it's going to generate certain microbes that like eating the broccoli and the broccoli side products. But if you just changed it slightly to, okay, I'm going to have a bit of cauliflower, which is the same family, but it's got different chemicals, different nutrients, you'll introduce different microbes to your gut. And eating both together would actually create different chemicals that would be made by your microbes and have even better results. But if you are a big fan of broccoli, you, you know, occasionally go for purple broccoli, which also has slightly different nutrients in it to straightforward ones.

So it's about thinking about how you can just subtly change. You know, you can still eat your broccoli, but mix it in with other things that are similar and try other ones. There's so many crucifers that are fantastic to eat. So I think that's the idea. It's about mixing it up. It's about trying new stuff. And it's about enjoyment in food as well.

So we all get into ruts. However interested you are in nutrition, even myself, I get into food ruts. And I sometimes have to go to a restaurant and say, I'm going to pick something new I've never heard of. Oh, I don't know what that is. I'll have that one.

Or you go to a foreign country and there's some vegetable you don't know what it is, pick it. And I think that's what we've got to change our attitude that we have our comfort zone of particularly vegetables. That I think, you know, whether it's avoiding the ones from school or it's actually wanting the ones from school. But realize that even within certain varieties like lettuces or cabbages, there are a huge range. You can now buy carrots with three different colors.

Yeah. And they're all nutritionally different. So the way they're bred and the chemicals in them are different. So for your microbes, they're seeing them as different. You might call them all carrots, but they'll be different. Similarly, different range of sweet potatoes and baked potatoes, and there can be purples and all these other things so it's that variety that's important but don't get obsessed that we're only talking about different varieties of kale here because the 30 includes um nuts and seeds and uh herbs we don't know exactly how much, but increasing studies are showing that

just adding spices, spice mixes to your diet every, at least, you know, a couple of times a week can enhance your gut microbes. So increasingly the evidence is building. It's this, So increasingly the evidence is building. It's this, the people who have the more diverse diets do better. So snap yourself out of your routines, whether it's for your salad or your breakfast, and try and work this in. So you mentioned out of those 30 that you recommend as a ballpark figure,

fruits, vegetables, nuts, seeds, herbs, herbs spices lentils and things like beans as well black beans chickpeas all those sort of things yes i mean because suddenly the 30 when you include all that it doesn't sound quite as daunting as when it just what 30 vegetables no exactly you think of a plate and i've got to get 30 different vegetables on my plate every day no um i mean i you know i cheat and for my you know my breakfast uh which i start now with a you know a full fat yogurt with kefir you know i will have a mixed uh a bowl full of mixed nuts and seeds and it gives me eight straight away he's not on the day with eight yeah i'm you know and then i'll if I've got something in the fruit bowl, I chop up whatever's in the fruit bowl, a pear or an apple. And so I might start with 10.

So if that's Monday morning, I've only got to find another 20. And that's just one meal. So as long as you start thinking how you can introduce things, what meals are good to sprinkle stuff on and you keep an open mind and you know i i think it's not only it's it's a practical tip but it's actually it's a way for people to really enjoy food and get excited about food again and and and not have this uh this problem that you know in the US and the UK, food is a sort of punishment because of, you know, it's a fuel and it's a problem because, you know, we eat too much of it.

We've got to start going back to enjoying it and enjoying seeking out those foods and not just eating for the sake of it, you know, on the run. So, you know, that's the other side of it. But, you know, so I think there's 30 rules. Some people say immediately, oh, on the run. So, you know, that's the other side of it. But, you know, so I think there's 30 rules. Some people say immediately, oh, that's terrible. It feels like a burden. But it can be so easy. And, you know, just by preparing big jars of stuff and buying berries when you see them and freezing them or, you know, a new seed or not, and you just add it to your mix,

it's incredibly easy. For someone who may be on zero or five at the moment and they hit 30, what does the research show in terms of, yeah, look, from wherever you are, even if you go from five to 10 a week, you're going to get an improvement, aren't you? You're going to improve the quality and the diversity of your microbiome. 30 may be the ultimate target, but for some people who can't achieve that, I guess we don't want them feeling bad about that. It's a case of, look, start where you're at and just see what you can do. Absolutely, yes. The 30 was just where we saw on the curve in the population that people sort of reached the maximum diversity. So going to 40 didn't really give them much more diversity.

On average, no. On average. I mean, of course, you know, as we've talked about before, it's all individual. So there's lots of individuality here. So, you know, some people might be fine on 20, others might need 40. We don't know yet. So we're setting a rough bar.

So don't knock yourself out if you're only on 28 one week and you feel like you're a total failure. It's fine. I think it's an aspirational goal. The more important is to just keep it in mind, your mentality, you're looking for that. Everyone has weeks where it's hard, they're working, they're having to travel, you're not prepared, or you're at someone's house and they're serving, you know, they're having to travel, they're not prepared, or you're at someone's house and they're serving you boring food, you can't say, oh, is this all you've got? You know, this is terrible.

You know, we live in a practical world. Yeah. And yeah, just on average, have that as an aspiration and see how you get on. But as you said, for your breakfast, which I find fascinating, you'll get eight to 10, which almost insulates you from some of the issues that may arise with working late or traveling.

And you know, if you've got eight to 10 on a Monday morning, you're in pretty good shape going into that week. So just talk me through that breakfast again, because what I know is that people really enjoy the conversations I have with you. They feel really inspired to change. And I think hearing that you get eight to 10 plants in a breakfast, I think, may be super helpful for people. So would you mind just sharing that again, exactly what do you do for breakfast when you have it? Just taking a quick break to give a shout out to AG1, one of the sponsors of today's show. Now, if you're looking for something at this time of year to kickstart your health,

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it's now become a full-fat yogurt, a 50-50 with kefir, which is fermented milk, kefir, as it's pronounced in the US, and which has even more, so there's two probiotics in that. Wow. With perhaps, we think about 15 microbial, 15 to 20 microbial species between them, if you're lucky. So that's also, I've got a probiotic start as well. And then I will go to my jar where I keep generally dried nuts and seeds, which I sort of collect as I go around supermarkets and other places

or markets and see, trying to find new ones. Wow. And it's almost like a hobby, a pursuit for you to see these things and pop them in this jar. It is, yes. And it varies. Sometimes it gets a bit low and down the bottom of scraping the barrel and it's a bit grainy and things.

And other times it's over bulging. But I am aiming to get, you know, because it's quite easy to get the common ones. But the idea is, you know, you can buy easily, you know, chia seeds and these ones, but you wouldn't want to eat just those. So the idea is to mix them up with common ones. And there's nothing, it's not particularly the ones that are expensive or not. It's just this variety expensive or not it's just this variety uh you you can put in there and i add also to that you know i got for example at the moment some pomegranate seeds yeah um and i just stick those in um and um whatever's around i i will use and whatever's in the fruit bowl i generally chop up um i've was in the fruit bowl, I generally chop up. I used to eat a lot of bananas, but since I did my test and realized that they are really bad for my blood sugar, I've swapped them around and I use

chopped up pears. Pears and apples are particularly fine for me and they will often go in, but anything I've got lying around will go in that mix. And I have that with a double espresso, which is also, people should know, a very good source of polyphenols and fiber and is very good for your gut. And coffee drinkers are healthier and live longer and have less heart disease. So it's completely the opposite.

That's a great study to refer to if we like coffee, isn't it? Yes. If you don't like coffee, it's a bit tough for you. Are you a coffee drinker? I am, very much so. But most people don't realize that there's more fiber in the average cup of coffee than in a glass of orange juice. And we all know what orange juice does to your blood sugar.

So I think it's changing our idea of what's healthy yeah and what's unhealthy because just for context 10 years ago i was eating a you know a bowl of muesli with some low-fat milk a cup of tea and often a bit of a tropicana orange juice and that's terrible for me because this gives me a very large sugar peak, which is my blood sugar goes up from its normal level overnight to over two or three times

what it is into a pre-diabetic range. So I stress my insulin levels and as it comes down, I get a sugar dip. And that makes me more tired and more hungry several hours later. And increasingly, if I do that every single day, as I did do, it causes stress on the body, increased inflammation, and alters my metabolism. So I will put on weight very gradually and not feel as good as I would if I wasn't having those peaks. And this is only new science and new technologies teaching us that

because based on those macronutrients I was having with my muesli and my tea and my low-fat milk, it was a very low-fat breakfast, which ticked all the boxes in USDA guidelines or whatever they are. And most GPs would say, that's a pretty good breakfast. You're healthy. You're not having eggs and bacon or whatever. And it turns out for me, it was processed muesli. And could buy expensive ones but they're still pretty much ultra processed there might be one or if you're lucky one or two nuts in there but far outweighed by the negative effects of the sugar yeah so i think that's the that's the big

shift i've made so i think breakfast is probably the most crucial meal of the day for a number of reasons you know we can discuss some of the other ones but for people who do like breakfast do like eating it's the one if we could all change ourselves generally in our home we're in control of the situation and we've got into a rut because most of us have a very similar breakfast every day and it's the one that's easiest to change and change all our habits and if you change, I think it sort of sets you up, your mentality for the rest of the day, the rest of the month, the rest of the year.

You've just got that in your mind. The first thing you wake up, I'm going to get my microbes off to a good start one way or another. And for me, it works. And I know the difference when I'm staying at someone else's house and I'm offered toast and marmalade. And I was in France, in Paris recently, and I couldn't resist a croissant.

And if you didn't like croissants, well, you got pan au chocolat or a baguette. That was the choice. So you realize it can be hard, but it's changing what you think is normal. And I think that's really important. What happens in Paris? Because you're very in tune now with your body. You measure blood sugar regularly. You measure your microbiome regularly. You're in tune with how you feel after certain

foods. So I get it. You're in Paris. You get tempted by the smell. You look at it. Yeah, you know what? I'm going to have gonna have that so number one were you measuring your blood sugar at the time when you had that croissant and number two what did you feel like could you tell madam like were you hungrier was your mood off were you you know what were some of those things that now that you are in touch with this that you were quite aware of in a way that you may not have been in the past so yes i i was tempted and who who can go to paris and resist a croissant you know i get it and uh i think we've all got to realize that you know there's nothing wrong with that either there's absolutely no problem with it and as long

as you enjoy it and it's a good one and but if you you know if it do feels it's stodgy and you feel it's just been reheated don't eat it but if it's a good one absolutely eat it do feel it's stodgy and you feel it's just been reheated, don't eat it. But if it's a good one, absolutely eat it and enjoy it. You may want to try and have a yogurt afterwards, but I couldn't get one. Yes, so I had the croissant and my sugar went up to 10.5. 10.5? Yeah. Can we just give some guidelines to people who are not familiar with those terms? I know what 10. a half. 10 and a half. Yeah. Can we just give some guidelines to people who are not familiar

with those terms? I know what 10 and a half is. What should it be for people? Or what should they be looking for, the range? Well, so my resting one is about five and a half when I wake up in the morning,

five or millimoles. And you'll have to do the calculation in the US. Yeah. Milligrams. We can stick to that, five. Yeah. Which, yeah. and so it normally, well, I say normally,

we know from the ZOE predict studies, there's about a tenfold difference in how people respond to the same croissant. So there's no, but the average of if you took 100 people, they would go from maybe four and a half to about uh six and a half okay so you get a small increase in your blood sugar when you have something uh like a croissant or a baguette or a bit of white bread and so that that's a normal response we all go up a little bit but there are some people that go up less and there's some people go up more there's about a tenfold variation that we saw in tenfold from what the

the lowest rise to the top rise yes wow yeah so and you went up to ten and a half yes you know i've been higher than that you know if i had my orange juice it would have you know taken over 11 the same as with i have a bagel which i used to think was fairly healthy but for context of people i know it's possibly not quite the same thing as it's you know blood it's a continuous monitor as opposed to uh you know let's say an hba1c a three-month average but you know on that 6.5 or above is type 2 diabetic, if that's your average, right? 6 to 6.5 in the UK. Well, 6 to 6.4, I guess, is pre-diabetic in the UK. I think it's 5.7 to 6.4 in America.

So 10.5 is clearly very, very high. You certainly wouldn't want that to be happening day in, day out. No, exactly. And after it, know i i do feel more tired and i sort of regret my croissant after that there's a feeling sort of full of guilt you know especially when you see the result in your blood you get this instant sort of um oh dear why did i do that um it wasn't that good you know but um i'll try and find a better one next time. But, yeah, and I find that three hours later,

I am feeling hungrier than I would have done if I had my high-fat breakfast, which suits me. But I do realise I'm different, and my wife is quite happy to have lots of croissants and doesn't have any. It doesn't go up the sugar in the same way. No, not at all. Wow. And so there's a few terms that have come up so far, Tim, like fermented foods, polyphenols, ultra processed foods, breakfast potentially being the most important meal.

And I don't want to come to those four points specifically because I think there's a lot to say on each one. But we are talking a lot about this personalized nutrition your company Zoe these continuous blood sugar monitors let's take an overview we're understanding more and more now with science with research that we all respond differently to food the truth is I've just seen people thrive on a whole variety of different diets. We know humans have always been opportunistic omnivores, right? Our diets can wildly vary depending on where we live on the planet, geography, climate, all these kinds of things. So personalized nutrition potentially is going to help us explain this. Why are some people crushing it on a low-carb diet?

Why are some people crushing it on a whole food plant-based diet? Do you think personalized nutrition potentially is the missing piece here? I think personalization is a key missing piece of the puzzle that we really haven't paid attention to and could help a lot of people in deciding which food to eat. And to do that, we've got to do away with the fact that one size fits all advice works and that it's all about the simple reductionist ideas. We are all omnivores, but we're all different.

We're all unique. We've all got totally unique gut microbes. And I think we need to both think of foods that are going to help our gut microbes and i think we need to um both think of foods that are going to help our gut microbes which are all going to be individual but also to get to the other that other half of perfecting our nutrition it absolutely has to be personalized yeah you mentioned about improving our gut microbes. Have you got evidence at the moment that let's say someone has currently got quite a barren gut microbiome? They've not been nourishing it, let's say their diet hasn't been good and there's all kinds of other lifestyle factors like stress

and sleep deprivation that can impact the gut of course which we can maybe touch on later. deprivation that can impact the gut of course which we can maybe touch on later their gut microbiome is not in a good place so certain foods at the moment may have a certain response certain foods may spike their blood sugar do we know yet if they then spend a few months working on their gut microbiome aiming to increase the amount of plant foods the amount of diversity and they improve the health of it it's more robust robust, it's more diverse. Do we think then at that point, the same food might generate a different response because their microbiome is different? We believe that's potentially likely, but we haven't been able to prove it. There aren't enough longitudinal studies. So the evidence base is that that makes sense,

that that's what we see cross-sectionally. So if you just take people at one point in time and you compare them to lots of other people at another point in time, we see that there's a correlation, but we don't know its causation. And it's slightly difficult because we know that there's a two-way process. If you're sort of unhealthy and you're giving off inflammation from having too much sugar peaks, it's going to affect your gut microbes in that direction, so make them worse and attract sort of unhealthy microbes. And at the same time, we know that if you

can dampen down those unhealthy microbes, you can actually improve things. So certainly in rodents, it works like that. What we don't know is yet in humans, but we're going to have the answers pretty soon as people, for example, doing the ZOE test get retested, and we can see the people that have really changed their gut microbes, can they change their responses? My guess is that it's not going to be quite as easy as that, and it's not going to happen overnight.

I think it's a very slow process that could take months and years as you change your physiology. But we do know cross-sectionally that people who've got robust gut microbes do react less to, say, ultra-processed foods. And we've got some data now, again, from about 20,000 of the ZOE participants that snacking is also – you can tolerate snacking better if you've got a good set of gut microbes. You can tolerate snacking better if you've got a good set of gut microbes. So there's a sort of interaction going on cross-sectionally that we're seeing that I'm hopeful we'll see in real life. So I think that's the aspiration.

That's what I tell people is that the idea is to build up this really robust community of microbes, which are, I think, best thought of as like your own personal pharmacy. So you want to have a pharmacy that's well-stocked. You don't just want to only have paracetamol and Calpot, you know, and Band-Aid. You want to have everything at your disposal. And to do that, you've got to give everything to your pharmacy, have it supplied with everything it needs.

So microbes are pumping out these healthy chemicals. And if they do that, your body's in better better balance it can then deal with these stresses yeah and it's not just stress of food it's stress of everything it's the stresses of life it's you know dealing with poor sleep it's dealing with um everyday problems as well yeah what i found in practice, this is without any of this kind of high-tech testing, I remember certain patients who were quite reactive. They felt they were reacting to quite a few different foods in sort of an intolerance. And as I helped them improve various aspects of their health, you know, reduce stress, physical activity, better sleep, yes, and gradual changes to their diets, which no doubt would have improved the health of

their gut microbiome over a period of time. Sometimes, maybe two years later, they would report back, and I've experienced this myself, actually, that certain foods that I used to find problematic, I no longer find problematic or those patients no longer would find them problematic. They would no longer in many ways feel that they were intolerant to those foods. Now, I find that fascinating because I don't have any data to prove this, what was going on there. But I suspect that working on these four pillars, food, movement, sleep, and relaxation with them, helping them improve the health of their guts, it made them more resilient. It gave them more

of a buffer so that a couple of years later, they just have got more, as you say, more resilience, I guess like a garden, isn't it? Where if the garden is well-stocked, it's got diverse plants, it's less likely that one species or one foreign species or a weed is going to be able to overtake it all and overgrow it because you've got that resilience. Is that a fair analogy? It is. And I think the thing we've forgotten is that a lot of the way the microbiome works, the chemicals that they produce, is through the immune system. And so most of the things we're talking about is having also a really well-balanced immune system that isn't overacting.

You know, and a lot of people's, currently these modern food allergies, et cetera, are caused by an immune system that's just out of kilter. It's either overreacting or underreacting. And I think that's also the key to this, that the chemicals your microbes produce are going to keep all the the lining of your the gut where most of your immune system is all those cells in the perfect condition the right tune so that they're not going to overdo it and if you get

that system right then you're in this better balanced state you know it's like you're generally fitter it's like an athlete yeah who can do all kinds of things but i think it does take time it's a thing yeah and i think what your point is is that you know in the modern world we're looking for a quick fix yeah and everyone says oh i've got you know my tummy hurts when i eat this you know i've got i think i'm getting sensitive to this i want a quick fix so i've got to cut it all out and people just we need to really educate people that it's a journey it's not like there's a three-week course and you cut this out you're done you're done it's you know you need to we've got such a long way to go back to the guts of our ancestors that didn't have these problems that you can't do that in six weeks you know this is

months this is years and but it's worth doing and it's not a hard thing to do and it can be a pleasurable thing to do and i think that's what it's changing that mindset that everything's got to be fixed quickly a quick diet a quick uh healthy snack bar or whatever you know some pills to saying okay this is a journey i'm going to change my idea about food and once i do that i'm going to build up this slowly build up this resistance like you you know if you were an athlete training and you wouldn't expect to be super fit and run a marathon in in in four weeks so that's the real difference and i think i think we're in agreement here. And they all connect with each other. Yeah, they all do.

And the microbes, you know, we didn't know when we started these studies how important things like sleep would be on your blood sugar responses. Can you speak to that a little bit? Yeah, so this crucial study, the Zoe Predict study, was 1,000 people all eating foods at the same time in precisely the same manner. We've replicated this now thousands of times. And it turns out that if you got poor sleep the night before,

you had like a 30% greater sugar spike eating an identical meal. That's incredible. The same food, but the way your body handles it, the potential damage or the inflammatory consequences of that food are completely different depending on your sleep. That's huge, isn't it? So, yeah, and also, you know, the way you reacted,

you know, there was obviously a link also. People did a lot of exercise, had lower peaks than those who didn't. So that another factor when do you last do your exercise and you know whether you what sort of meal you had the night before also influenced the next day so and how much gap you had in that that time so things that you wouldn't even have thought about um are all coming together and they all interact a lot through the the gut microbes as well so it's not like they're all in independent they're sort of working together with each other so we know that shift workers for example who get poor sleep have poorer gut microbes and higher sugar responses so

we also we've just done a study on um what we call social jet lag of people who's have big party people at weekends there might be some people listening who who can uh say that you know very good during the week and then they get um go to bed at completely different times and they change their clocks at weekends and they have uh you know on the monday morning bigger uh sugar spikes and their microbes are also um uh suffering as a consequence so everything's about getting this balance right between all parts of the body and because of the technology we've got now in measuring microbes and measuring these sugar responses you you know, as you said, we can suddenly start to see it and not just guess it. How tricky does this get as a scientist? Because it's not just looking at that food, is it? And saying, how does that food affect me with my

current gut microbiome? You know, should I eat more of them? Should I eat less of them, depending on my sugar response? Because as you've just just mentioned there's other inputs going in how stressed you are how sleep deprived you are what time you had your previous meal the night before so how easy is it or how difficult is it to actually make a to draw a conclusion what this food does for me or you or for anyone else because of all the other inputs that are there as well when we do the zoe scores for example once you've done the test it is a holistic test so so we are accounting for your sleep your exercise and your meals and your age or weight all these things together so and and we've talked about sugar peaks but we haven't talked about the fat peaks which is the other part of the the test is that we're looking at how fast the fat is dispersed from your body which we know in some people is very slow so if you've still got lots of

fat molecules hanging around in your blood at six hours after a fatty meal that irritates the blood vessels causes inflammation, and is going to cause the same sort of metabolic problems. So it's combining all those things together gives you a holistic score about which foods are better or which are worse for you. And so you can make those choices. And at the same time, you know, we do give people lifestyle advice, advice, you know, if do give people lifestyle advice. You know, if you're sleeping terribly, you're doing shift work, and you're only getting four hours sleep a night, it's going to be really hard to whatever you're eating to be healthy. So I think increasingly the advice on exercise and food and sleep and stress are all related.

Yeah. So absolutely. And I know that's your core teaching. Well, I've always found, for me personally, Tim, I've always found that I can't limit it to one thing. It's everything. It's like I've always been drawn to looking at the whole picture and an individual. And I've always been drawn to looking at the whole picture and an individual and, you know, I've always been like this, but even doing, you know,

the Doctor in the House series on BBC One in 2015 and 2017, where I'd spend four to six weeks with different families with a whole variety of different health outcomes. I got so much time with them, I got to see everything how, you know, the way a husband and wife would talk to each other in the evening before, you know, how that would impact their health. And, you know, like I would see how they were eating. Are people eating together in a relaxed way or people, you know, eating in separate parts of the house whilst also scrolling Instagram and Facebook? You know, I guess one of the reasons that show was such a good fit for me is because I literally would see, oh man, I'm missing a big picture here in just 10 minutes or even 20 minutes with a patient.

It's all of these factors play a role. And I think the science now on lifestyle, but even on the gut microbiome is showing that actually, yeah, all these factors actually play into the health of our guts. Yeah, no. And it's realizing that all these things have a role and that many of them or most of them you can change. We all go periods of time when it's tough, you've got young kids or you've got some work things, some things you can't work on

at that particular time, but you can generally work on some of them all the time, and I think that's also the approach to food. And we talked about people who can't get their 30 plants every single week. Don't worry about it. There's other things you can do. And it's changing the idea. So if I can't do that, I'll do something else. It's not all lost if you didn't do it that week. And I think that's the big problem. You mentioned Zoe a few times, right? So this personalized test, let's go through what is it.

And I know, Tim, there'll be many people listening thinking, can I do it? Can I have access to it? So if you could just walk us all through what you're measuring and then also who is it available to and how can anyone listening to this show or watching it on YouTube, how are they going to be able to access this or when might they be able to in the future?

So Zoe is the Greek word for life and it's a company that myself and two entrepreneurs founded five years ago really to develop personal personalized nutrition and based on science so we did the science projects first which are these predict studies which we published in in nature medicine and in many other journals so we decided to do this actually do the science first before launching the product rather than the other way around, which is often the case. And it's a kit that you basically reproduce what we did in the science projects at home. So you sign up, you go online on joinzoe.com in the US or the UK, and you get sent a kit which contains three main elements to it.

It contains a continuous glucose monitor. It contains a skin prick test for your blood fat, which you do six hours after a fatty meal. And it contains a gut microbiome test where we use high-density sequencing, metagenome sequencing, not the single-gene one, to measure your gut microbes. And at the same time in that pack, you've got some standardized meals in the form of muffins, which everyone has taken the same muffins at the same day, so you've now got, I think it's 25,000 people's results to compare with

uh you get uh you download the app which allows you to log food you log your energy levels you log your hunger levels for those two weeks and you can do a number of little experiments yourself in a standardized way logging your results as you go so that first two weeks is just to get your baseline results compared to everyone else and then a couple of weeks after that you get your results which are a as we discussed a holistic score but mainly focusing on the three components your blood sugar response your fat response and your microbiome. And so all the foods that you can think of or scan in a supermarket or restaurant or at home are given a score from 0 to 100. And you're then given the chance to sign up for a program for between 1

and 12 months that gives you access to an online nutritionist who goes through your scores and then works out meal plans for you to maximize all those three components and that's the basic idea with it's combining foods you know and you can still have a food you don't like if you combine it with something that isn't good for you with something that is good for you. So your score can match up. So the idea is to very much personalize your meals, at the same time, making it fun, make it interesting, and never once talking about calories, and trying to change the way people think about eating as well and trying to reduce maybe unnecessary snacking trying to make your your meals fun and substantive and as you said giving yourself time to eat and prepare and actually enjoying the food and trying new ones that's

the whole idea so you know you get this app and this amazing list of different foods and things you can eat. Some of you never thought of trying, but, you know, that's the whole idea is we make it fun, exciting, and you've got an online nutritionist which is proving extremely popular. And we're doing a randomized controlled trial to see exactly how it works in a scientific way. randomized control trial to see exactly how it works in a scientific way but of the few hundred people that we've looked at um in a sub-study you know most are losing um uh eight to nine pounds in

weight uh and over 85 percent report less uh less hunger and importantly more energy we didn't expect that but energy is a we didn't we hardly we was an afterthought we thought we'd record it in the app yeah um and it turns out it's highly correlated to uh keeping your sugar peaks down and your fat peaks down i think energy is a big one it's in some ways the currency of life, isn't it? It's we all know what it feels like when we've got low energy. We don't want to do anything. Our food choices are affected. We don't want to cook something fresh. We take the quick and easy option. You know, energy is everything, I think. And I would argue that if there's one thing we want to improve, certainly in my experience, more than anything else, it's

energy because all our decision making, all our behaviors, I find so much better when we've got energy. But as you know, so many people are struggling with that. Given that it's personalized, and I know you've sent me a Zobie kit, and I still haven't done it. Week on Monday, I will be doing it. So when you come on the podcast next time, when your next book is out, which I'm really excited about, we'll definitely talk about how I found it and what results I got. Given that it's personalized, are there some general trends that are applicable to people who haven't done it yet, who are like, okay, I get it's personalized, but is there anything I can learn from what you have learnt so far? Before we get back to this week's episode, I just wanted to let you know that I am doing my

very first national UK theatre tour. I am planning a really special evening where I share how you can break free from the habits that are holding you back and make meaningful changes in your life that truly last. It is called the Thrive Tour. Be the architect of your health and happiness. 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. I can't wait to see you there. This episode is also brought to you by the Three Question Journal, the journal that I designed and created in partnership with Intelligent Change. Now, journaling is something that I've been recommending to my patients for years. It can help improve sleep, lead to better decision making and reduce symptoms of anxiety and depression It's also been shown to decrease emotional stress, make it easier to turn new behaviours into long-term habits and improve our relationships There are of course many different ways to journal and as with most things, it's important that you find the method that works best for you.

One method that you may want to consider is the one that I outline in the three-question journal. In it, you will find a really simple and structured way of answering the three most impactful questions I believe that we can all ask ourselves every morning and every evening. Answering these questions will take you less than five minutes, but the practice of answering them regularly will be transformative. Since the journal was published in January, I have received hundreds of messages from people telling me how much it has helped them and how much more in control of their lives they now feel. Now, if you already have a journal or you don't actually want to buy

a journal, that is completely fine. I go through in detail all of the questions within the three question journal completely free on episode 413 of this podcast. But if you are keen to check it out, all you have to do is go to drchatterjee.com forward slash journal or click on the link in your podcast app if i tried to say well what have i learned without knowing what my results were just look at other people's results is that many you know there's a proportion of people that are really sensitive to carbohydrates and there's a proportion that aren't and it's hard to tell obviously if you've got a lot of perhaps diabetes in the family you might suspect that's that's that's true is that refined

carbohydrates and whole food carbohydrates yes yeah it Yeah, it is. I mean, the more refined, the worse, but it's a spectrum. There isn't an absolute cutoff. No. As you expand there, just to share my own experience, because I have used the CGM, continuous glucose monitor, a couple of times. I don't use one regularly, but I did early one in the year and I've got one on at the moment. And last week over dinner, it was a pretty healthy meal. And I think the carb with it was sweet potato mash that my wife had made. Oh man, I can't remember what it went up to, but it was a big rise with my blood sugar about an hour, maybe an hour, hour and a half after the meal, which really surprised me. And I found with other things, like if it's a few

boiled potatoes or a small amount of white rice, actually it doesn't anywhere near to the same degree. Now there's a few other things I need to tweak and I need to replicate with different foods just to see which one it was. But sweet potatoes are considered, you know, a healthy carb, a whole food carb. Sure, it was mashed. So that was, you know, that's changed it somewhat. But that was really interesting for me, because I may have continued eating that. But that will definitely make me think again about how much do I want to have this if it's going to push my sugar that high. So that, I guess, speaks to what you're saying and what you're finding with people. Some people are exquisitely sensitive to carbs, whole food ones and yeah and there's and

different carbs so you know there will be some things that you know there's a difference between pasta and rice and and bread for some people and and and understand there's a huge difference you know within those ranges and i mean uh people will say okay okay, well, porridge is healthy, isn't it? Most people tell me oats, that's healthy. But, you know, for me, they're not. But, you know, I tried three or four different types of oat porridge. And what that tells you is the more refined, the more ground up, the more it's been factory made and the quicker it is to make, the higher my sugar peaks go yeah so as a general rule if you pick things that are less refined less processed and take longer to cook

it's because you know their outer coating is you know that that those that energy is stored much much uh and it's harder to get out so so steel-cut oats, things you have to cook overnight, don't have half the sugar peak of the identical Quaker oats instant meal, which for me is just like pure sugar. So I think it's telling you that... So hearing porridge is healthy doesn't mean anything. No. For who?

And it's the structure of food. Because you've broken down that oat, it can mean its whole form. You can have it cut. You can have it rolled. Or you can have it so finely powdered and air dried that that sugar just rushes out and you haven't got any fiber so understanding the differences between foods i think is is a really important lesson so that we mustn't over categorize again reduce everything to saying this is good this is bad within each category there are good and bad foods that we all need to learn about it's like hummus and chickpeas or you know almonds and

ground almonds you know that they have totally different amounts of things in them when the structure changes. Given how much data we can learn about ourselves through continuous sugar monitors, are we not getting to the point where it's almost in every single person's best interest to at least do a two-week trial with one of them to at least say oh man i'm having that every day maybe i shouldn't be having that obviously you've got to be careful with people's relationships with food and food is so much more than just the blood sugar response isn't it but i don't know have you got any comments on those things i think um people can get obsessed with blood sugar monitors and there are people who get obsessed

about all kinds of things about food and reducing it to purely a sugar peak is not the right answer because you can go down completely the wrong direction and just by adding double cream to everything, you can dampen down the sugar response. It doesn't mean that eating a bucket full of double cream every day is good for you.

So I think you've got to see it in that holistic light of all the things we talked about and your fat response. Some people can cope with a lot of fat, other people can't. And there are good fats and bad fats as well. So it's just part of the equation, but I think it does give people like an insight into you know the fact that something we shouldn't necessarily need the orange juice actually is not a health food and it's uh you know it should be in the alcohol category or

something like that that you take um it's not good for anybody really um which if everyone did have a glucose monitor on every time they they had a glass of orange juice they would see it's uh you know the same as a coca-cola and it would just be put them in the same sort of category and so you say well okay um that should go in the same so it would it would change people's ideas of things and i think you know I think there will be a watch soon, I think probably within five years, that does the same as a glucose monitor. And once that happens, everyone, like counting steps and things,

they'll probably want it. But I think we have to be very careful. We don't then make the same mistakes of reductionism that we've made up to now because humans love to make it simple and nutritional food is anything but yeah i mean i was playing devil's advocate a bit asking should everyone have one because my concern with trackers in general which is why i've used this twice. So I had two weeks at the start of the year, I'm in a two week cycle now. I've said this before on the show, but I always notice this with blood pressure monitors

with patients. People say, should I get one? Should I get a home blood pressure monitor? And it would depend on some patients would. And then it was pretty much a 50-50 split. For some people, it was awesome. They check it once a week or twice a week. They wouldn't stress about it. They'd use it as a way of keeping them on track with their lifestyle changes. The other 50% would check three, four times a day. Anytime it was slightly

up, they'd recheck it. They'd get anxious. They'd come back in. That would drive their blood pressure up even more. And I thought, wow, the same tool can be helpful or problematic depending in some ways on the personality type, depending on who that person was. And I suspect, you know, because there's tracking everything now, there's sleep trackers, there's step trackers, there's blood sugar trackers. And I think we've just got to be careful as you say I think a blood sugar tracker for two weeks for anyone is you bring stuff that you don't know about that's hidden inside you you bring it into the light like if you suddenly see your glass of orange juice that you think because of all the packaging it's got vitamin c and all the things the packet says is helpful for you. And you see yourself going to 10 or 11 on, you know,

way over the diabetic range, you might think twice about having that, you know, several times a week. And if all that does for you is help you realize, or maybe somebody who has porridge every day and they realize, wait a minute, porridge is spiking my blood sugar massively. It's going to, you know, do this for five years. I'm going to end up type two diabetic. Then that has value because they can then use that and they don't have to check it all year. They can move on. And maybe they do it, I don't know, maybe it's the sort of thing in the future they'll do once a year or once every six months. They go, oh, this is what's happening in the moment. Okay. I'm going to make some changes. I'm not going to look. I'm going to work on my gut microbiome.

And then six months later, I'm going to put it back on again just to see. I think that's how I'm going to be using this. Just because I think I could also potentially, because of my personality type, I think I could run the risk of getting obsessed, which is why I'm very cautious about trackers. Yeah, no, I totally agree and i i

i don't see this as a permanent feature on the human body no i think it'd be a real mistake we'd be creating super neuroses and you can artificially you know you can cheat it can't you can cheat the system yeah and and again forget the point of it, which is getting quality food into your gut microbes. So I think doing it once in a programmed way, it's not actually that easy to do it yourself. Oh, that's interesting. I mean, we've found, you know, several times I've told people, for radio programs, you know, do it and we'll discuss it.

Unless you've got clear guidance on what to do, what to look at, what the peaks are, when to measure it, you get the wrong impression about things. Which can be even more problematic. Yeah, you measure the wrong time after eating your bread, you miss the peak, you don't know what's going on, you can't compare it to anyone else,

you get the wrong impression. So I think in a standardised way, doing it, but I wouldn't do it more than once a year, I don't think. And I've found that even though I've used maybe 20 times or so, I'm not obsessional about these things and I do often forget I've got it on. I sort of know how I'm going to respond to things now. And so you have that early lesson, which is really good,

gives you a real sort of jolt about, gosh, I was wrong about food. I was wrong about my breakfast. I'm going to educate myself more. That's what I think we should be aiming for, which comes back to this, you know, the idea, what is good food? How do we tell? And for people without a glucose monitor, good food how do how do we tell and for people without a glucose monitor you know one in four people do feel uh energy levels and i think uh what they feel them going down down yes uh but

some people don't you know and you mean when their blood sugar spikes and crashes some people get a low energy but other others don't at that time. Well, or they're not particularly observant enough to notice it unless they're being prompted. And so I think, but I think this is perhaps one thing we should be promoting is that, you know, if you're doing self-experiments and you, you know, you haven't got the money to pay for these things, which are still not in everyone's reach,

how to listen to your body more to say well am i hungry what's my energy level like and just sort of make a note or you know keep a diary of things is the other way to do this and there are a certain portion of people who can judge pretty well what foods are but the nice thing about our study was people were blind to it yeah they didn't know their results and so when we saw these peaks and troughs which one in four people had really big ones you know we'd and they were on they didn't know why they were feeling tired they just reported they were tired on the app and i think that's really interesting yeah you mentioned breakfast a few times um you often appear in the media uh with some i'm mr

breakfast yeah some pretty crazy headlines now i've i've been around in media enough to know not to trust the headline um but skipping breakfast potentially being good for us is something that's often attributed to you now can you expand what is your view on breakfast um and i guess the the the kind of context here is that for many years, people have said breakfast is the most important meal of the day. They have. And that's really where I came into it and really writing the diet myth. My idea was to look at the data and challenge some of these myths, which I thought it was a longstanding one. And strangely,'s still there if you go to the nhs eight to eight healthy eating tips it's still there um despite all the evidence saying that

there is no evidence that skipping breakfast is bad for you so that's the first well the countless studies now show it is not bad for you. It doesn't cause metabolic problems. It doesn't cause diabetes or you to gain weight, or even it doesn't cause kids to perform badly at school, which was the other worry that was planted by the food companies in people's minds. Some studies have shown that it actually can induce some weight loss. Now, that's not totally consistent consistent but it is certainly going in that direction the matter when you combine all the studies together that's what you show but increasingly um the idea that this might be true is supported by science showing that it may not be

the the breakfast itself but just the gap you're leaving overnight. And this whole question of not just what we eat, but how we eat is becoming more and more important. And everyone's heard about intermittent fasting, but the new thing that all the nutritional scientists talk about is restricted time eating, which I'm sure you've talked about many times. But the finding about skipping breakfast was, in a way,

a pointer to that actually we've been missing this whole idea that the idea of we should be eating little and often throughout the day has actually been the wrong advice and that we should be compressing our mealtimes. Perhaps it doesn't matter whether it's two or three meals but they should be in a shorter time frame and so the sweet point seems to be somewhere between you know in about 10 hours of eating and and 14 hours of not eating and that's that might be the reason that skipping breakfast for most people, not everybody.

And again, I think there's quite a bit of individuality here. There are some people who generally feel hungry when they wake up and feel tired if they don't have some breakfast. But I would say the majority of people don't. And it's just a cultural or a sort of lifestyle reason to get some food in you when you're in your home, comfy environment. But increasingly, I've started myself to either skip breakfast or have it at 11 o'clock. And particularly post-COVID, people are working at home now. They are in much more control of their mealtimes.

And it's a great time to start. So that's a bit of practical advice that everyone can do. Either try skipping it and see how you feel and if that doesn't feel right or you still enjoy breakfast with its ability to have your yogurt and all your nuts and seeds which would be you know if i missed out on that would be problematic um have it later and uh have it as or either as a brunch or just a couple of hours before you you have your other meal yeah i think it's super helpful and as you say the problem with these cultural uh fixed ideas are that often people are not paying attention. They're not feeling hungry, but they think I should have breakfast because I keep hearing that. And the scientists say it's important

to have it. And the problem is it's very hard to say breakfast good or bad because it depends. Number one, what do you mean by breakfast, right? What time is it? Is it at 6am? Is it at 11am? You know, it also depends on the rest of your life. Do you enjoy a big meal with your family at 9pm? Right? Maybe people are working late. And actually, that's the way that they connect at that point or whatever. In which case, you know, at 7am, you may not be hungry. Whereas if you eat, like I try and eat with my kids at, you know, when I can around work about five, half five. Like I genuinely feel at my best when I'm doing something like, I'd say an 8am till 6pm or a 9am till 6pm eating window. Even sometimes a 10 till 6pm, it's like an eight hour eating window. I feel great.

I don't feel hungry before, I don't feel hungry afterwards, I sleep like a baby. so it's like an eight hour eating window i feel great i don't feel hungry before i don't feel hungry afterwards i sleep like a baby and it works for me my job and my lifestyle at this point in time at this point in time exactly so therefore these studies and and i i say with all this public health advice i'd encourage people to you know think a little bit you know become take a bit of agency over themselves, use what you're saying or what I'm saying or what they hear, but also try and filter and apply it in the context of your own life. I think that's important, isn't it? Yeah. And it's very different if you've got young kids, you're going to have a different time

scale than if you're, you know, grandparents and you've got, you know, the time is in your retired and you've got, you know, you is in you're retired and you've got you know you can plan everything yourself so because there's the social aspects of food of course yeah and we mustn't forget that really important that people don't obsess about yeah i i do worry that um and certainly uh looking at some of the zoe customers in the u.s it's about 30 percent are already on restricted time eating when they're coming into the program. So it's huge in the US compared to the UK. But some people might get so obsessed about their eating times

that they forget the healthy aspect of the food they have to eat and the enjoyment and the social aspect. And I think, again, for people who are a bit, you know, obsessional on it, have to make it not so extreme and i think that's the danger of people trying to outdo each other and say oh i can i can only need to eat in four hour window and you know i'm fine and it's just not you wouldn't get people in in italy or

spain or france uh who enjoy the long meals and the you know and the socializing doing that and they're the ones who live longest and are healthier. So we have to remember that. Some of those countries, of course, are having later breakfasts, aren't they? They're sort of technically skipping the breakfast that we might have in the UK, certainly at that time. Yeah, well, I work in Spain a lot and usually don't finish eating till 10pm, sometimes 11pm.

But you rarely see anybody having breakfast before 11 if they do or they don't bother this it's just a it's just a coffee yeah so i think there's different cultural ways to it we've just assumed that everyone has you know the same habits in different countries but you know there's a north-south divide in times of people eating in Europe. But in the south, it's not like they're at 7 a.m. eating breakfast. Yeah. And I think the ones who tend to eat earlier tend to have more earlier breakfast. But I think it's very personal.

It is. But most people I speak to, when you say, well, the first thing you wake up, you know, and you've had a cup of tea or coffee, most people don't feel really hungry. You know, it's not like that's the first thing on your mind if you had a choice of things to do, you know? Yeah. Just to finish off this conversation, Tim, we've mentioned polyphenols and fermented foods. We didn't go into that much detail on either one. Could we just briefly go through what are polyphenols? Why should people think about getting more of them in? How can they do that? And then potentially the same for fermented foods as well. So polyphenols used to be called antioxidants, and they are a group of well over a thousand

different chemicals that are in plants, in all plants to different levels. And they're defense chemicals that plants use to defend themselves against sun or predators. And they are often, when you eat them, have a slightly bitter taste, can cause a stringency, just like if you have a really old red wine, it gives that taste on the tongue. That's because the skin of the grape has a lot of these polyphenols in it. And they are in brightly colored foods. They're in slightly bitter foods and they're in complex foods. And so they're in things like coffee, dark chocolate, red wine, extra virgin olive oil, nuts, seeds, berries particularly.

So these are all health foods. And these polyphenols we now know are useful for us because they feed our microbes. And those microbes then convert them into other healthy chemicals. We can't really use them ourselves. So it's quite interesting. They really are like specific fish food that we're eating that provides us then these chemicals then get back into our bloodstream and dampen down inflammation and keep us healthy. So that's really important.

And there's big differences between foods, like the choice of a cooking oil between, you know, a highly refined vegetable oil and extra virgin olive oil is massive. Can you see that in Zoe as well? Well, it's reflected in the scores. Yeah. So we would give a different score to vegetable oil than we would for extra virgin olive oil, both depending on the quality of the fats, but also its effect on your gut microbes. So all of the scores do reflect polyphenols and the fermentation, which is the next thing we're talking about, which also affects the gut.

So polyphenols are really important. But you've got to understand a bit more about the food. So chocolate, for example, all chocolate has some polyphenols in it, but it's only in the cocoa part of it, not the artificial bits and not the sugar and not the milk. Which is why the dark chocolate is the preferred option. Dark chocolate is packed with it.

Milk chocolate has very little and is overridden by the sugar. So again, it's all about the quality and looking at the labels and seeing what's on the food. And the difference between picking a really brightly coloured lettuce or an iceberg lettuce is massive in terms of the difference of the polyphenol. So the color of the leaves and the way the lettuce is gives you a different indication of how many polyphenols. So what are we looking for when we're picking our lettuce? You're looking for one with loose leaves that is brightly colored,

loose leaves that is brightly colored, often different colors, reds, and that's true for a lot of foods. So generally it's a bit like the berry, the brightly colored berries have more of these things than the other ones do. So we're just understanding this sort of science. So some of the things we thought were good for us aren't, and this is another thing to look out for. So polyphenols are really good. Fermented foods are anything that has live microbes in it.

So it's like probiotics naturally occurring in food. So by the time you're eating it, it's actually got live microbes that can still replicate and produce chemicals. And so everyone knows yogurt has that, but kefir has several times more microbes than yogurt, and it's a thinner version of it. And then you've got kombucha, which is fermented tea, which is becoming more popular,

which has even more than kefir in it and has different fungi and yeasts so often up to 30 different microbes you can find in a in a proper kombucha and you've got then uh sauerkraut used you know in central and eastern europe which is fermented cabbage and of course going one level above that you've got kimchi one level above that in terms of the number of microbes? Number of microbes and diversity, because you've also got, as well as cabbage, you've got garlic, you've got chilies, you've got onions and other peppers and things. The more complex it is, often the greater the richness of the microbes.

That's super helpful because sauerkraut is known to be a, for people who read about gut health, they know that sauerkraut is one of those fermented foods that's really helpful. But this idea that you can upgrade to kimchi because it's not just cabbage, it's like going back to the very start of this conversation, the diversity, it's got more plant foods in it.

Therefore, it's going to feed more and more therefore um it's gonna you know feed more and more microbes that's super helpful i think yeah and there's and then you move on to the if you like japanese food of course anything with miso in it is uh is is really important because miso is fermented soy and so there's plenty of um fermented soy dishes that you can get as well, but tempeh and other ones like this. So fermented food is really big. Be careful you don't buy ones with vinegar in it that are killed. And try and smell that when you open it, check it hasn't got vinegar in it,

and you can usually tell by the smell if it's live or not. And having a small amount every day is what I try and do. There's no point in having a feast once a week. We know that these things die out. So for practical reasons, try and have a small shot of one or two of these every day. And that's why if you have it at home in your fridge you're near the for breakfast or your first meal you've got it uh or you have it you know at night when you come back i love that that reminds me of what i talk about a lot which is like i you

know a lot of people who listen to show know that i do a five minute strength workout every morning whilst my coffee's brewing it's a habit that i've stacked onto that so I never miss it because I never miss my coffee. So I never miss that little five minute workout every morning. And I always say that I found that little regularly actually has a very powerful effect on the body, no matter what habit it is, no matter what behavior you were trying to bring in. I guess bringing that into gut health as well, a little bit every day with a fermented food is better than binging on the whole jar maybe on a Sunday when you have more time, something like that. Yeah, and I've changed. Cheese is the other thing, of course, which we forget is fermented if it's real cheese. But, you know, we're not talking about craft slices.

We're not talking about craft slices. We're talking that cheese that doesn't have to be unpasteurized, although that helps because you do get extra microbes if it's raw milk cheese. But most cheeses are good. The ones with blue lines and fungus on them have even more microbes. And just having a small amount of that every day is absolutely healthy. There's a myth that cheese is bad for your heart and things absolutely no evidence that's true um a small regular amount of that had you know and instead of a pickle that might be high in sugars and salt a traditional english pickle you know

try sauerkraut or kimchi with it and i think increasingly you can just build this into your your daily diet so you are having these things regularly and you just have something in the fridge you just pop on your plate as an extra you know and i think that that's what i found is having the ingredients ready around you so you can just add them whether it's you know the original seed mix or it's the the kimchi part you just grab it and you stick it in and you know like like your or just after your coffee you have a you know if you're in a hurry you just have a quick a shot glass of your your kefir or your kombucha and uh you're sorted so that's fermented foods and i think everyone you know needs to learn about them yeah uh other countries have been doing it for centuries

and we we've just lost out just before we finish off tim i think it's an important point to make that something i'm observing a lot is that a lot of people or certainly you know that there's a significant amount of people who struggle to increase the amount of plants in their diet they get symptoms they get bloating they don feel good. And you will have seen this online, as I have, that there is a growing movement towards more and more severe diets, more and more restricted diets. Now, a lot of people follow these days, what has been called a carnivore diet, which is, you know, all meat or predominantly meat with very few other things in it. And I know people, I know patients actually, and I know people who are thriving on these diets

compared to how they felt before. A lot of people say, my joint pain's gone. I've got more energy, my skin's better. So therefore you can see from their perspective that they're feeling better compared to where they were before, yet they're now hearing someone as respected as yourself talk about all the benefits of plant foods for the gut microbiome. And I think a lot of these people feel stuck between a rock and a hard place. They want to apply what they're learning, but they also know that they feel better on quite a wildly different diet. but they also know that they feel better on quite a wildly different diet. Have you come across this and do you have any kind of thoughts on that? Yeah, well, I've had people write to me saying,

I've been on a carnivore diet for two years and I feel great. You know, I don't understand what you're on about, you know. And I say, well, everyone is different. You could have a unique set of gut microbes that seem to cope with this. But my worry is that although initially changing from, say, a high-carb diet or an ultra-processed food diet, a carnivore diet, you will feel better in a number of ways. Long-term, I worry that we are omnivores, and our gut microbe diversity does depend on giving enough to feed.

If you're only eating meat, you're going to have a very limited range of gut microbes to produce all these chemicals and vitamins for you. So I would just urge those people, you know, not to give up meat, but to start introducing small amounts of regular different plants. It doesn't have to be huge quantities, but, you know, it doesn't have to be starchy ones either. It could just be, you know, the leafy green ones, which there is a wide variety. You know, certainly nuts and seeds and mushrooms, you know, also good.

You know, we haven't talked about mushrooms, but I've, the last few years, I've become a real a real big fan you know of this is an amazing source of protein and uh nutrition that um i think is you know probably going to say end up saving the planet as uh as we move forward but you know there are lots of um nuances but there isn't one size fits all. And there may be people out there who don't need 30 plants a week. I'm not saying it is absolute rule. I'd love to do some studies on these people. So it'd be fantastic if some carnivore dieters did the Zoe study and we could look at their gut microbes.

Well, I have someone who I'm gonna, someone just for you actually, someone who is literally thriving and has tried vegan diets before, has tried low carbs and literally finds that going full carnivore. And I know this lady super well and she is thriving, high energy, high cognition,

can work all day, can run marathons. I'm like, there's something going on here where she is thriving on this diet. And so I'm gonna, I'd love to know. So I'm actually gonna talk to something going on here where she is thriving on this diet. And so I'd love to know. So I'm actually going to talk to her and put her in touch. Because that would be interesting, wouldn't it? What's actually going on in the microbiome? Well, I mean, hopefully in five years, we'll be looking back at this and say,

well, we didn't know much, did we? Because science is exciting and it's always changing. And our views, we found a year ago this this micro blastocystis which is in one in four british people have this parasite it's not a micro it's a parasite that a few years ago you'd have had to go to the tropical medicine place and they'd have given you powerful antibiotics to get rid of it because they said oh you that will give you traveler's diarrhea now we know that it's to say it's with good health and lower fat levels isn't it associated with lower autoimmune risk as well potentially yes it dampens down inflammation visceral fat uh and one in four britains have it

we've discovered only one in far one in 20 americans have it wow but it's in a hundred percent of all hunter gatherers hundred percent of all uh indians that have been studied of all developing countries this is our normal state to have this parasite so we still know so little yeah about what's going on that who knows there could be hidden fungi or uh other other parasites inside our body that love meat and can produce sorts of chemicals. I'm not ruling it out. I'm just saying, on average, do be careful because you might get great short-term benefits,

but don't wipe out your microbes because it's really hard to get them back. So that's super fascinating that it's in 100% of hunter-gatherers. That is so, so interesting. It looks like it's tracking with the amount of ultra-processed food we eat. As in the more we eat, the less we get? Yes, yes. Wow.

But it could also be antibiotic use as well, you know? Yeah, who knows? Tim, it's always a delight to chat to you. You're a wealth of information, a wealth of knowledge. You're doing incredible work at helping improve the health of the UK and many people, many hundreds of thousands around the world. Thank you for that. Just to finish off, podcast is called Feel Better Live More. When we feel better in ourselves, we get more out of our lives. You've covered a lot today,

but if we were just going to simplify right down at the end of this conversation, what are some things that people can think about bringing into their lives to improve the way that they feel hopefully they will think about food in a completely different way think about food as the quality of the food both for taste enjoyment and for your gut microbes they'll go for a diversity of foods they can eat plants particularly getting those 30 plants a week getting picking ones high in polyphenols getting a regular shot of some fermented food in your diet and reducing as much as possible ultra processed foods and thinking about experimenting with the way they eat the timings their meals skipping breakfast maybe tying trying some mild restricted time eating, just to see how you cope with it. And getting some personalized nutrition testing done, which you can get done

in the US or the UK to really find out much more about yourself and about how you can start this journey to find the best foods that suit your own body. Tim, thank you very much. I look forward to part four in a few months when the new book's out. But thanks for joining us today. I really appreciate it. Pleasure. Really hope you enjoyed that conversation. As always, do have a think about one thing that you can take away and start applying in your own life. Now, as I mentioned in the intro, this is the final episode in the current season of the podcast.

I plan to be back right at the start of September, and I can share with you that I have some absolutely brilliant guests lined up already. I just want to say thank you to all of you who take the time to listen and share these episodes each week with your friends and family I do not take that for granted I know that your time is precious now each week my hope is that the conversations I put out help you reflect and inspire you to make changes in your own life and if you do enjoy the podcast, I have a favour to ask of you over the summer. My goal is to empower and inspire as many people as I can with positive, uplifting, and hopefully life-changing content.

And I would love to get these conversations out to more and more people, but to do that, I really need your help. My ask of you is that this summer, would you be willing to share an episode of this podcast with five different people? I think this can help in so many different ways. Of course, it's going to help the person receiving it, especially if you've chosen an episode that's relevant to that particular person. For you, this serves as an act of kindness from you to one of your friends or family members. And for me, it helps me to get the word

out, increase the reach of the podcast, which in turn helps me convince and persuade hard to get guests to come on the show. No pressure, of course, if you don't feel comfortable doing that, that's completely fine. But if you do have a moment, I would really, really appreciate it. Thank you so much for listening. I hope you have a wonderful summer. And always remember, you are the architect of your own health. Making lifestyle change is always worth it. Because when you feel better, you live more. Thank you.