The Dr Louise Newson Podcast - 06 - Is food the best medicine? Dr Rupy breaks down the science of protein, fibre and more

Starting point is 00:00:02 So on the podcast today, I've got with me one of my really dear friends, Dr. Rupi, who's brought out this great new book, Healthy High Protein. We talk about protein, of course, but we also talk about fibre. And most excitingly, we talk about inflammation and the important role of reducing inflammation in our bodies for our health and our future health as well. It's a great, warm, friendly chat. So hope you enjoy it. So I'm super excited, Rufi, to have you back. you haven't been here before

Starting point is 00:00:33 and I'm quite excited because you have a bit of podcast studio envy because this space is great isn't it? Yeah, it's gorgeous. I feel like I'm in your living room which is exactly how a podcast should be. Yeah, so you're here. I am I'm also very delighted that you've chosen the colours to like my website's got this exact sort of green

Starting point is 00:00:54 has it really? It's got lime green so you could have maybe changed this to lime green okay well there's always room for the second and fourth room. it's like blending pretty well so you've made this book for me. It does suit the aesthetic very well. It does. I would like to say it was intentional but I had to pick those colours like over a year ago. Well, there you go.

Starting point is 00:01:12 We obviously think the same. But the other reason that you've, I think, written this for me is that I've sort of really, I'm a lot better with my diet than I used to be. I was cooped up in a boarding school for many years. And then my mum's a very meat and two veg type person. And then I sort of ate, like most students do as a medical student, I was taught as a medical student about protein, fat, carbohydrate, amino acids. That was probably all probably same as you.

Starting point is 00:01:41 That's what I got taught. You can wing anything when you're 18, 20s, that's fine. And then once I had children, I thought, oh my goodness, I need to be really responsible to what I eat. So I really changed how I ate. Then I got pancreatitis and I was really ill. And I thought, right, I need to eat even better and better. and that's helped me

Starting point is 00:01:59 like mentally, physically, like migraines, everything else. But then I thought, I don't really enjoy meat. I've been brought up with meat in too bad. So I thought, I don't miss it. I don't want it. My mum's not cooking from anymore. I don't have to have it.

Starting point is 00:02:11 So I've carried on eating fish, but my ferretin, my iron's always a bit low. I do a lot of yoga, but I've been doing some more weight, you know, weights and things. And then I keep thinking, oh, when you mentioned me a while ago, your book was coming out about protein, I was like, oh, I really need to read this.

Starting point is 00:02:27 because I see so many women who are vegan as well and this podcast is not about promoting any sort of diet by the way and they think they're doing really well but they're not having enough protein or there's other people that just are having so much protein they're forgetting all the other sort of basic food foods and like food is in my mind like the most important medicine

Starting point is 00:02:54 but I feel really cross that I wasn't taught enough about nutrition. Yeah, yeah. It completely resonates with me. And I think, you know, we've chatted loads of times about how the lack of nutritional medicine knowledge during our medical education has really put us on the back foot. Yeah. And it's only until you see thousands of patients that you realize, oh, the penny drops.

Starting point is 00:03:19 I was lucky in a way where the impact of nutrition has brought to my attention through personal patient experience. In a similar way to you, you know, with your pancreatitis episode, with me, it was atrial fibrillation when I became a junior doctor that forced me to reconcile the quality of my diet and also my lifestyle as well. And I feel like I'm having a moment again where I adopted a plant predominant diet similar to yourself, right? Focusing on beans and legumes, ensuring that I'm getting lots of diversity, looking after

Starting point is 00:03:54 my gut, probiotics, etc. And it was only during my nutritional medicine masters that the penny dropped for me again where I realized I was underconsuming protein. Kind of sounds embarrassing to think about it because protein is literally the primary macronutrient that we were probably taught about at medical school to emphasize. And it's so true. But even with all the knowledge and even by looking at all the studies, I didn't pick up on the fact that I was underconsuming this critical macronutrient myself.

Starting point is 00:04:25 And so my recovery after working out was less than it should have been, my energy levels, my focus, all that kind of stuff, could have been improved by just doing the simple act of increasing protein. And also this kind of forced me to realize that the guidelines that we have around protein today are far too low. and in a similar way to the, you know, the, the, the, the, the, the, the, the, the, the, the, the, the, the, the, the, the, the, the, the, the, the, the, the, the, the, you've been going on and, and, and, and, and, and, you know, very impressive in terms of the accuracy, but it's not reflective of the population, nor is it reflective of different life stages. And looking at the research, and I'll get off my soapbox in the second here, but looking at the research over the last five to ten years, it's abundantly clear that we should be reassessing those protein guidelines, particularly for women, particularly postmenopause, and particularly for the older adult population as well. The other thing is, though, like about protein, there's different types of protein. It's a bit like me talking about hormones. You know, there are natural hormones that we've produced ourselves. When we prescribe HRT hormone replacement therapy, we give exactly the same, like for like.

Starting point is 00:05:54 Like, if I don't know about protein at all, I could go and buy a protein bar or protein shake, or I could go to the butcher's and buy some meat. Like, surely they have different effects in the body? Yeah. So let's actually dive into what we mean by proteins. And I think most people have this idea of protein just being about meat. and muscle. Yeah.

Starting point is 00:06:16 And proteins a lot more than just those two things. So I always use the analogy of Lego. So if you remember when we used to play with Lego, the beauty of Lego was that you could build anything from a little toy car to a massive skyscraper or cathedral using the simple, like 15 to 20 different Lego blocks. As long as you had enough of those blocks, anything was in the realm of possibility. So Lego are the building blocks in the world of toys in the same way proteins, almost specifically amino acids, are the building blocks in the world of amino, the building blocks in the world of biological materials. So simple proteins like linear structures where you just put amino acids in a long chain are simple amine hormones as an example.

Starting point is 00:07:09 make that a little bit more complicated and you build a 3D structure with some amino acids. You've got enzyme receptors, enzymes themselves. You've got bigger hormones. Make even bigger structures with the same amino acids. Then you've got things like muscle, yes, but also bone, nail, all these different organs. So the magnitude of protein and its use in our body is much more than muscles. And in fact, when you consume protein, only 25% of that protein goes towards muscles. The vast majority of it is going for all those other biological materials and processes in our body

Starting point is 00:07:48 that we don't really make the connect with protein. But it also helps with energy, doesn't it? It helps the mitochondria to work. Absolutely. It helps our immune system. It's a really important. I think people think you eat it and you build muscle. Exactly.

Starting point is 00:08:00 And you only need it if you're exercising. Exactly. Yeah. And the reality is we all need protein for all these other support. systems. I'm not saying that you're like going to magically build a brand new spanking immune system or new hormones. If you eat enough protein, it's part of the puzzle. It's part of all the other lifestyle factors that you talk about as well. But it is critical to at least appreciate that protein is much more than just muscle building and for bodybuilders. And the fact is when you look at population

Starting point is 00:08:32 data, there is this sort of myth out there that we eat enough protein at a population. level, if you're looking at the lower amount of 0.8 grams per kilogram of body weight, then yes, we definitely meet that threshold, the majority of us do. When you look at the threshold that I believe should be the minimum of 1.2 grams, the vast majority of people underconsume protein. And protein, you can get from multiple different sources as well. So I've addressed the muscle myth. The meat myth is another thing that I think we need to address as well.

Starting point is 00:09:04 Because whilst it is true, chicken, fish, lean red meat are great sources of protein. They've got all these nine essential amino acids in good amounts that people always look at when we try and assess the quality of protein products. We also have those same amino acids in things like nuts, seeds, even things like raw cacao. You've got them in beans, you've got them in lentils, you have them in whole grains. do have them in all plants as well, but in much lower amounts. So what I want to teach people about is, yes, we need enough protein, but what I would encourage people to think about is let's get our protein from a multitude of sources

Starting point is 00:09:49 and let's eat more overall. That's really important, isn't it? You know, I've always cooked meat for my children and I'm now eating meat. But I would much prefer to have really good quality meat where I know it's where it's fun. but then pad it out with beans and vegetables and everything else as well. And even now, my older children, I will still sometimes use my blender because there's some vegetables they don't like, but it doesn't matter having that smooth pasta sauce. How old are you?

Starting point is 00:10:15 I don't even know. We've got a joke. They're 22, 20 and 13, but they make this like tomato pasta sauce. Yeah. And I've made it for them for years and I just always batch cook and put it all in the free. Yeah. So they come in. We can add lots of stuff to it.

Starting point is 00:10:30 But I just put any vegetables under the sauce. sun in it with tomato and basil and parmesan so it's quite sweet blend it all up yeah i have no idea it's just brilliant it's just a great hack but also like if i'm doing mincemeat i will put in lentils i will put in like dice i don't know whatever's in the carrot sweet potato it doesn't really matter it's just all goes in there yeah so it means that i because meat's really expensive i can i'm spending less on my meat because it's going a really long way because actually it's a bit like you know he's saying protein is not the same. Chicken breast is not the same

Starting point is 00:11:04 depending on where you buy it from. And there is a problem, isn't there? With the farming, where the meat's coming from, people think vegetables are better, but then it depends what, pesticide, where they grow. And it's really hard, actually, isn't it? When you try and really work out,

Starting point is 00:11:20 I want to have as natural as possible. Yeah, we'll go into the amounts that people should be consuming in a little bit. But to address that point, I have a very simple formula that I like to tell people about so they can increase their protein without necessarily increasing their meat consumption. So I would start off with, it's like a three-step plan with any meal. You want to start off with a core protein sauce.

Starting point is 00:11:44 You can choose whatever that core protein source is. If you eat fish, it could be, you know, cod or hake, it could be chicken, it could be lean beef mints. If you're vegan or vegetarian, it could be eggs, it could be, um, Tempe or tofu, think of a core protein source that is typically quite high in protein. All of those ones that I've just mentioned are around 20 grams of protein per 100 grams of product. That's your core protein. Then you want to have a plant-based partner.

Starting point is 00:12:14 A plant-based partner can be things like legumes and beans. It could be like tahini, peanut butter. These are all great things that you can just put into stews and castles to bolst up the protein content ever so slightly whilst adding some texture as well. And then you want a protein topper. Your protein topper could be pumpkin seeds. It could be peanuts. It could be shelled hemp seeds, for example.

Starting point is 00:12:37 These are all quite high protein as well. I mean, you look at some really interesting dishes from around the world, particularly from Southeast Asia, India, where a lot of my cooking inspiration comes from. They have this kind of formula. They have a core protein. They have plant-based products. So you're blending different proteins together. And they always have a topper.

Starting point is 00:12:57 and it's, you know, like peanuts in the top of Pad Thai, for example. You see this like pattern every now and then. And it's just a very easy thing for people to get their head round when it comes to increasing protein without having to rely on just increasing the chicken or increasing the fish. So that meat and two veg is really just gone. And it is great because even when I have a salad and I'm quick and I just get some rocket or something, I always put pumpkin seeds.

Starting point is 00:13:19 It tastes nicer for a start. You know, it just lifts it, doesn't it? Yeah, totally. And actually, like, seeds and nuts are expensive, but often I'll like chop the nuts myself so it makes a bit cheaper but they do go quite a long way because you can't eat that many of them without filling full. Yeah totally and like you know there are cheaper ones like sunflower seeds

Starting point is 00:13:37 there are some seeds that you can buy in bulk as well organic you can assure that they're from a pesticide free sauce one other tip that I always say is if you are using bulk buying of seeds and nuts you might want to just gently roast them to get rid of any mold that could be lingering around. The other thing, and I talk about this in the book, actually, to make the most out of your nuts, seeds and grains in general, soak them.

Starting point is 00:14:04 So soaking, which is an ancient technique that all cultures have, my mum always bangs on about soaking to me and soaking lentils and all that kind of stuff, you're essentially starting that germination process, and it releases some of those amino acids, so makes them a lot more bioavailable. It's an extra step. So if you get if you've got some raw almonds, for example, soak that in fresh water, take it out over, leave it overnight. The next day, leave it to dry in like either a low oven or on the counter when it's summer.

Starting point is 00:14:34 And then you've got slightly more protein per almond just by that one little thing. Yeah. Yeah, no, that's really good, isn't it? And you've got your protein calculator. Yes. Yeah. Get it from the book, but it's also online as well. Yeah, it's free.

Starting point is 00:14:47 Yeah, it's free. Yeah. I really want people to know their number. Yeah. And I want to be careful about, you know, healthy eating and an obsession with healthy eating, also known as orthorexia. I want people to be good guesstimators of how much protein there is on a plate. So I can look at a plate and I can make a judgment as to whether, you know, this has got 20 grams or 30 grams. I want people to sort of hone that skill. But I think it is really important to know what your number is. So for me, as someone who is, someone who is, you know, who works out when I can with a newborn, but works out most days. I'm otherwise fit and healthy.

Starting point is 00:15:29 I don't have any particular aspirations of being a bodybuilder. 1.6 grams of protein per kilogram of body weight for me per day, split over two to three meals. That works for me. That works out about 120 grams of protein in 24 hours, which is about 40 grams per meal. For women as well, postmenopauseally, I would also say the 1.4 to 1.6 grams is also a good starting point as well. The reason why is because protein is critical, not just for muscles that we've just established, but for bone health and also for metabolism as well.

Starting point is 00:16:09 It's super, super important. You won't magically lose weight without doing the basics, like moving and exercising and resistance training. but that protein is a critical component of ensuring that we are protecting our health as we age as well. Yeah, absolutely. And the other thing with your book is not just about protein. You know, most of us don't eat enough fiber. Yeah. And fiber sounds like bran flakes from the 70s.

Starting point is 00:16:36 Do you know what I mean? Yeah, yeah. People get really confused with fiber, don't they? But fiber is so important, isn't it? Yeah. Can you just explain, like, what fiber is? Yeah. Yeah, yeah. So fiber is polysaccharise. They're carbohydrates, essentially. They are complex units of carbs that your body actually can't break down. So you rely on this magical population of microbes that we have harnessed since birth and we have grown and evolved with over millennia.

Starting point is 00:17:12 and these microbes which include bacteria but also viruses actually there are more viruses than bacteria if we look at the genetics but also nematodes and fungi they will digest that fiber and create byproducts short chain fatty acids other elements in your gut that nourish your intestines and they also reduce inflammation they also improve your mood they can change your skin very important for hormonal health as well. And so part of this concept of healthy high protein is yes, trying to get people to eat enough protein, whilst also not forgetting about fibre and the gut and also lowering inflammation. So the three questions I want people to ask themselves at every meal time is, am I getting enough protein? Do I have gut supporting ingredients, i.e. fiber and probiotics in my

Starting point is 00:18:05 meal? And is this overall plate going to be pro or anti-inflammatory? If you can answer positive, to those three things. Can you eat the plate? You're looking at a very healthy plate, a really, really healthy plate. So fiber is super important for those reasons. The general guidelines are to try and get 30 grams of fiber in every day. I think, to your point, a lot of people might think,

Starting point is 00:18:24 okay, I just need to get like, you know, a good dose of brown flakes in my morning, you know, routine or whatever. Actually, you get fiber from a plethora of plants, beans and lentils are fantastic sources, nuts and seeds, also have the extra bang for the buck because not only they're high in protein, but they also have fibal, which is why they're so satiating as well.

Starting point is 00:18:44 And also you get it from green vegetables, woody vegetables, starchy vegetables. These are all things that we should be encouraging in the diet. So you mentioned inflammation. Yes. Now, I think you know this. I've got a first class honors degree in pathology,

Starting point is 00:18:59 and I spent a whole year, I did it in a year, and I spent a whole year learning about macrophage and monocytes and the immune system. and I really enjoyed it because it was the first time really you're such a geek girlie, I am really I'm so sad

Starting point is 00:19:15 it's a first time probably in my whole career that I could just dedicate myself like really thinking and like you could intercalate after the first two years and you could do basic sounds like you know biochemistry physiology and I thought no I want to do a bit more

Starting point is 00:19:29 so I did a third year and then I intercalated and it was pathology is obviously the study of disease but you have to know about how the body works and then what goes wrong And so that's the whole thing about inflammation. And I recently, it sounds really sad, I was looking at my notes, and this is like 1992 I did the degree. I'm very old.

Starting point is 00:19:48 I wrote a three-hour essay on, explain why atheroma is a precancerous condition. So atheroma is bearing of the arteries with atherosclerosis, cardiovascular disease. Cancers, obviously we know about cancers, but they are associated with inflammation. So my whole three-hour essay was all about the macrophages, inflammation, what goes wrong and how they're associated. And there was an article in the paper the other day and it was saying, we don't know how osteoporosis and dementia are linked.

Starting point is 00:20:23 It's like, well, think about inflammation. It's not rocket science. And it's like we're so inflammatory the way we live. That doesn't mean we're angry with each other. But like you say, our diets are more inflammatory than ever before. really our lifestyle, what we're putting in our mouth, you know, hormones, they all affect our immune system. And without our immune system, it's not just their ability to fight infections, it's to fight diseases as well. Yeah. So how would

Starting point is 00:20:51 you describe inflammation? Yeah. So without diving into the macrophages and the histopathology and all that kind of stuff, the way I describe inflammation is like it is the language of your immune system. And the, the analogy of, I use in the book, it's kind of like your internal campfire. It's not a perfect analogy, but I think it proves or explains the point around inflammation that want people to understand. So when you go on a holiday and you're in the British countryside and you set up for camp, what you really want to do, if you're allowed, is create a lovely campfire to warm yourselves

Starting point is 00:21:31 up as it gets colder, to cook your food on, to provide you with a bit of light. to ward off predators, a campfire is a beautiful thing. If your campfire was to get unruly, you could burn yourself, you could overcook your food, you could get it to the point where it could set fire to the entire campsite, or maybe even set fire to the entire woodland area that you're in. Your immune system and inflammation is very similar. You need enough inflammation because inflammation signals to immune cells it fights off pathogens.

Starting point is 00:22:09 It is a beautiful system that we have evolved to have because it protects us from things like environmental pollutants as well. Too much inflammation can do the opposite. And this is where there is a connection between mental health issues, dementia, type 2 diabetes, osteoporosis. These are all inflammatory conditions as well, where our immune system has gone out of whack. And when you look at the way,

Starting point is 00:22:36 way we live our lives, ultra-processed foods, screen time, lack of sleep, stress, these are all things that tip the balance into a pro-inflammatory state. And diet is one of the ways, not the only way, but I think a core tenant of one of the ways in which we can re-address that balance by being anti-inflammatory. And the way in which we do that is, yes, supporting our gut, using fiber and probiotics and all the rest of it. But having an antioxidant rich diet that is varied as well. Berries, greens,

Starting point is 00:23:13 nuts and seeds, oily fish, these all contain things like fats and resolvins and there are just wonderful ingredients that will put that balance back into our favor. And I think it's never been more important to really think about inflammation in this way because the links between all these different conditions

Starting point is 00:23:32 like you alluded to have never been more apparent and I think the power that we have to influence inflammation with our diet is there and I want people to understand that whilst this is a book primarily about protein I'm not forgetting about our guts

Starting point is 00:23:48 and I'm not forgetting about inflammation as well I love the campfire because also if it goes out you are cold you can't sit you can't do anything you can't function and gosh I should have put that in there yeah come on next to next book

Starting point is 00:24:01 you can put that in But I think it's really interesting because, you know, our immune cells are so important. And one of the things I learned a lot in this year was about how they can become pro-inflammatory. So it's not just you switch them on or off. They can work against you, like that campfire going out of control. And, you know, obviously, Easterdial progesterone, testosterone, receptors on those macrophages are really important. Because if we don't have those hormones, same for men not having testosterone. the macrophages become pro-inflammatory.

Starting point is 00:24:34 Increase information campfire goes out of control. You know more than anyone being a fairly new father, you don't have much time to cook. But actually, these recipes are so quick and easy. Like you say how long it takes. Yeah. Like your recipe list is not very long, is it? But everything's really colourful and really varied.

Starting point is 00:24:54 Honestly, I really tried to keep that ingredients list alone. I hope you had that in mind thinking about us as parents. Yeah. That's a big difference. Huge. Huge, huge. And that's probably one of the biggest pushbacks that I've had across my journey on social media is around the ingredients list and ensuring that that's as low as possible. Because even if they are everyday ingredients like, you know, paprika or like red chili flakes or cumin, most people are having their kitchen. If they see that long list, it's intimidating.

Starting point is 00:25:20 Because you always want to cook at 8 o'clock on a Sunday night and the supermarket's closed and you're just like, oh, so no, I really commend you. It's brilliant. I really, and I'm very touched by your message at the front. as well so thanks very much Rufi. So before I end, you're not going to get away without having three take-home tips. Okay. So I'm going to have to ask you three reasons why we need to have healthy high protein. Okay. So the key reason, I would say breakfast protein is super important because you need to be able to tackle that 24-hour target for protein.

Starting point is 00:25:56 And if you don't have enough protein at breakfast, you're less likely to hit that target. So you don't skimper that opportunity to get protein in a breakfast. The other thing is, after you fasted overnight, essentially, when you're breaking your fast, you need to replenish those amino acids that you've utilised. The other thing is protein is great at staving off cravings, improving your satiety, which is something that we know we all struggle with, particularly in older age as well. I mean, I could go on. But the other thing I would say is when you have enough protein and fiber in your diet,

Starting point is 00:26:34 which you'll get from all these recipes, your energy level is steady. You don't have these big, like, spikes and troughs of glucose. It will keep you nice and focus. And that's exactly what I need as a parent or newborn. Yeah, we all need, don't we? And also our pancreas needs it. We do not want type two diabetes. We can avoid it.

Starting point is 00:26:54 We want to look after our pancreas that produces insulin. So great. This has been a really great thought. I've really enjoyed it. Thank you, Louise. Thank you. That's been great. Subscribe to my newsletter for exclusive insights and updates on new episodes.

The Dr Louise Newson Podcast - 06 - Is food the best medicine? Dr Rupy breaks down the science of protein, fibre and more

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