The Dr Louise Newson Podcast - 137 - The challenges and importance of eating healthily with Dr Rupy Aujla

Episode Date: February 1, 2022

Dr Rupy Aujla was in his mid-20s and beginning his career as a doctor when heart problems caused him to re-evaluate what he thought he knew about health, nutrition and medicine. Having previously rejected his parents’ influences of traditional Indian medicine, Dr Rupy began delving deeper into some of those concepts and the science of nutrition that he wasn’t taught at medical school. In this episode, he talks to Dr Louise Newson about the principles of healthy eating, how a busy lifestyle and your environment often make it challenging to find and choose healthy, affordable foods, and the experts share their concerns around childhood obesity, anxiety around food, and the particular metabolic changes faced by those going through peri/menopause due to a lack of estrogen. Dr Rupy’s 3 tips for improving your nutrition: Start with making a small change to your diet by adding just one more fruit, vegetable, nut or seed, at every meal if possible. Have a back-up healthy meal that’s easy to prepare, or stored in the freezer, for those times when you are tired and lacking motivation. Try to reflect what foods you really like but find a healthier version of it. For example, if you love pasta, add 3 different vegetables to any pasta recipe. For details about Dr Rupy’s app, his books and recipe ideas, visit thedoctorskitchen.com

Hello, I'm Dr Louise Newsome and welcome to my podcast. I'm a GP and menopause specialist and I run the Newsome Health Menopause and Well-Being Centre here in Stratford-Bron-Avon. I'm also the founder of the Menopause charity and the Menopause support app called Balance. On the podcast, I will be joined each week by an exciting guest to help provide evidence-based information and advice about both the perimenopause and the menopause. So today I'm very excited to have with me in the studio, Dr. Rupi, some of you might know him best for the doctor's kitchen. So welcome today, Rupi. I'm very excited to have you here today.

Thank you, Louise. I'm excited to be here. It's great to connect. So you probably don't know it, but I've been stalking you for a while, actually. And if I didn't do anything in the menopal space, I would do something in nutrition. most people who know me know I'm completely obsessed with what I eat in a healthy way, but I'm very careful about eating because actually when I eat well, I feel better and I get more out of my day. So when I bought your book, was it 2015 when it came out? 2017, actually, yeah, 2017. It was interesting because then I actually, when I was reading your beginning words, you're talking about evidence-based medicine and you're talking about

how improving your health, using food and preventative medicine. And when I read it, I actually read it twice. It's really sad, isn't it? I don't normally read whether I just go to recipes, normally in books. And I thought, actually, this guy is doing what I'm trying to do with the menopause, but he probably doesn't know anything about the menopause. No disrespect to you, Rupi. And I thought, how interesting, there's lots of analogies here.

So at a far I've been sort of stalking and watching and really actually amazed with your success, actually, and your perseverance and your drive actually to make a difference. So make cooking and nutrition accessible to everybody. So yeah, so this is a bit of a sort of stalkerish moment actually. So it's a great honour to be here, but I'd really like to just learn a bit more about how you got into food. Because if you're like me, obviously you are like me, we're both doctors. If your training is like my training, you'd just get nothing about diet, nutrition, how food works about a gut microbes.

I didn't know any of that. So is that the same for you? Or did you have a different experience to me? That was totally the same for me. First of all, that's very kind of you to read the book twice and say those nice things. That's really, really nice. Yeah, so I mean, like I grew up in a real foodie household.

My mom was like a typical sort of Indian matriarchal figure, but she also had like a whole bunch of other stringster as well. So investment banker, she studied law, she started her own graphic design company, she started her own magazine. This is a way before magazines went to digital and she's already about digital. So she's been like, not only like an incredible maternal figure, who's someone who told me how to cook before I went to med school, but also someone who showed me that it is possible to juggle all these things as well and still look after your diet.

And the other thing about this, my upbringing, is that it was really influenced by traditional Indian medicine. So all those sort of like old wives tale was about turmeric and milk and stuff and having the right collection of spices and looking at the root cause and focusing your gut. That was sort of always in my upbringing. But I never paid attention to any of it because, you know, it's coming to my parents and you always kind of disregard what your parents saying that none of them are medical. And, you know, so when I went to med school, I promptly forgot all that kind of stuff. And as you know, from your experience in medical school as well, it's, you know, we're not taught about holistic living.

We're not talking about nutrition. We're not talking about any of that kind of stuff. And so my sort of introduction into nutrition as a science really came a lot later. And that actually happened from personal experience. So I got ill straight off the medical school. I was three months into my clinical job. I started having palpitation episodes that I kind of brushed off. And then basically would occur two to three times a week,

anywhere up to, you know, 12 to 36 hours at a time. The first time I got diagnosed, I was actually working, as was the DGH, Basilden and Essex. And I was admitted whilst I was on call at 6pm on a Sunday. I remember my consultant came around. I was so embarrassed. I was in like this gown and I had the cardiac monitor. You feel so vulnerable as a patient.

So vulnerable. Honestly, so vulnerable. I was at 24, you know, and I was getting used to that medical lifestyle. And, you know, walking into the wall. with my stethoscope and then suddenly I'm a patient and, you know, it's embarrassing and you have no idea what's going on. And that was when I started paying a bit more attention to what my, my mum was telling me all those years ago and then started returning me as well about how I need to really look at my diet and lifestyle, optimize it alongside taking the medications that I was

prescribed at the time as well. It's so interesting, isn't it? Because I think, especially when you're young, you think you can get away with anything and often you can, of course. but it sometimes is an illness or a condition like I know you had atrial fibrillation didn't you that can really stop you in your tracks actually and I think it's good for medics to be ill that sounds really awful but I think you learn a lot and I had pancreatitis a few years ago and came out of the blue I had this awful pain when I was ironing and my husband said oh you've got pancreatitis and I looked at him and I said how I don't drink alcohol you know we're always taught at medical school people with gallstones are sort of slightly overweight, bare-haired, 40,

and I was 40 when that happened. But it was just the worst pain I've ever experienced in my life. I can't even begin to tell you how to awful it was. And my amylase was very high. And my husband actually came to hospital and said to me, oh, Louise, if you die, I don't quite know how I'm going to look after the children. I say, I don't need this. I just need looking after. And that first night, my blood pressure was going down. My pulse was going up. My oxygen. So, fluctuations is going down. We all know how serious pancreatitis is. And it was really, really scary.

And I learned a lot about how to talk to patients because there was that compassion that sadly wasn't there for some of the medical staff, partly because they were busy. But also it makes you realize how important life is and how health we cannot take for granted. And my lifestyle then was good. I already said I wasn't drinking, I wasn't smoking.

I ate well. You know, I've always eaten well. but afterwards I decided to eat really well because I was so scared and there was no obvious trigger for the pancreatitis. I've since had my gallbladder taken out which seems to have helped. But there was a time where I was still poorly and I thought, right, I've got to be in control of this because I've got to look after my children more than anything else, include quite like to have my job as well. So I really, really played with diet and bound that certain foods just made me feel better. I didn't help my pancreatitis symptoms. But I just

just felt mentally more alert. I just felt, you know, I used to have a bit of a sweet tooth and I'd eat it. It's awful, isn't it? Eat a donut or something. And I'd feel great for a few minutes and then I'd feel really tired. And I'd be, that afternoon, I'd be looking at my couch, my examination couch, I just want a bit of a nap there. And then I suddenly thought, not having these processed foods, not having sugars, I didn't have that dip. So you're nodding. So I presume you agree with that. Yeah. Yeah, totally. But it's interesting. But it's hard to to do, isn't it? I think it's really easy. And I don't want people to listen to this podcast. They are, look at them. They eat really healthy. How easy is that? They don't understand.

But it is really difficult to change eating habits, isn't it? Yeah, absolutely. I mean, just to go back to what you said about why it's important for medics to maybe not personally experience ill health, but have that real close experience, I completely agree with that because at med school, we're all taught communication schools, we're taught how to empathize. And I think most people who are going to medicine are empathetic people. However, when you have that personal experience, when you're literally wearing that gown, where you're literally in the hospital for days at time, where you're looking at the risks of having an intervention like an ablation or removing your gallbladder, you're reading that consent form and it's you on the other side of that form. It's completely different, a completely

different experience. And so that's why I think a lot more medics are getting involved and learning about lifestyle because if it's not them, it's their loved ones who are having these problems, whether it be type 2 diabetes, cardiovascular disease, strokes, all these things that we know are preventable through long-term changes to one's lifestyle. So I think that's really important. The principles of healthy eating that you'll know that I talk about in all of my books and they haven't changed despite what you might have seen through the headlines in the nutrition world, you know, suddenly cheese is back and butter and all the rest of it. You know, healthy, amount of vegetables, plant forward, lots of different types of fiber, quality fats, making

sure you're hydrated and eating whole foods as much as possible. So that spectrum of process versus unprocessed, we want to be more towards the unprocessed. That's sort of very simplistic for me to just try and advise as many people. Putting that into action consistently every single day, that's where the magic happens. It's not through the inclusion of a particular superfood or a particular spice, it's consistently eating that way. That's why it's so hard because our environment is conspiring against us at every level. So you were just talking about a donut, for example, when I was working as a junior doctor, I didn't drink coffee, I was in a smoker, definitely didn't take drugs or anything like that, had a drink at the weekends, but it wasn't like binging or

drinking throughout the week or anything like that. But my environment was in a hostel canteen and I was having serials in the morning, whatever they would slop up for lunch or lunch or dinner on the go, which would be a meal deal, white bread sandwiches, crisps, coke, you know, things that we normalise and we still normalised today. I was recent on a train and I didn't bring my Tupperware with me. It's kind of like geeky to talk about, but I bring a Tupperware with my food at all times now because you have to because my experience in the train was biscuits, chocolates, chocolates, crisps. There was nothing else. The only thing I could really have was just water. So no wonder it's hard when you're hungry and you're tired and you're working to eat well everywhere you go because our environment is really, really against us. And then there's the education, the access. If you live in a deprived area, what options do you have? None. Because the cheapest food is marketed to the most vulnerable people. And as GPs, both of us, you know, we've had that experience of telling people about eating well and then having a conversation with words. expensive, isn't it? And I don't have the time and I've got three kids and I work two jobs.

And, you know, it's super, super hard. So that's why my sort of approach is personalising it the person in their convenience in the environment, personalising it to their cultural background. I'm not recommending kale salads to my Sherylankan patients. And also starting really, really slow, such that they can compound those behaviours over time. And that might be as simple as just adding one portion of fruit and vegetable or nut or seed at one day. meal time in the day and then just doing it from there like you know that james clear sort of methodology of just making the habit change as small as possible and just making sure you don't post any zero days and i think that's really important and i like the idea of adding something

rather than taking something away because i think that is really important and i'm sort of fortunate not fortunate i get migraines quite badly and certain foods trigger migraines so if i was on that train with you and had any of those foods i would be guaranteed to have a migraine later. So actually, I can't have those because I can't afford the time off to have a migraine. And so my diet now is controlled by my migraines, actually. But actually it's really good because I can't then have a piece of chocolate or I can't just have a little sandwich because I forgot to bring my lunch into work. And so that way, I have to be more organized. I'm like, you, I have a Tupperware or I have an empty yogurt pot if I'm travelling because I can just put it in the recycling

when I finished it. So I carry food with me and it's a bit of a joke. And I'm always worried about who else is eating, what they're doing. Because if I don't have lunch, I would be guaranteed to have a migraine. My husband can operate all day and it doesn't matter. But actually, I think I'm, when I say I'm lucky, it means I have to eat well. But for a lot of people who don't have migraines or have another condition, they can get away with it, can't they? And then you put on a bit of weight, you feel a bit sluggish, and then you're less likely to make those changes. I had a patient once who was, she was so lovely.

She was in her late 70s and she was larger than life. And her husband had sadly died from cancer a few years before. And she was just gradually put on weight, but she would always be very overweight. And when I had pancreatitis and was off, I came back to work and she said, Louie, said, Dr. Newsom, she said, this is all those seeds that you eat. I knew there would be a, and she said, I knew there's no point eating healthily. So I said, oh, you're probably right, but actually I feel better. And then over the next year, she lost five stone in weight.

and it was transformational. And I said, how have you done this? She said, I suddenly thought, I'm joking at you, but you're always looking slim. So I decided to cut out my tape, to change what I was doing, and the weight's just fallen off me. I said, my goodness me, this is somebody who's elderly has made that change and admitted to me, as well as to others, that her diet could improve. But I've never known anyone, you know, lose that weight so easily and quickly. once you got their mindset. And to be, it's harder, isn't it, when you're older to make those changes?

Definitely. So there's hope for everyone. Yeah, yeah, absolutely. And I think, you know, your experience and my experience is almost like forced us, has put the rails on such that we have to keep to a lifestyle in order to protect our health. A lot of people don't have those carrot and stick habit change methods. So we don't have that instant fever that, you know what you need to keep on this because otherwise you're going to experience poor health again.

that you've already had that experience. A lot of people are habituated to eating a certain way until it gets to that age where they're 40, 50, 60 and they have raised cholesterol or they have a heart attack or they have anything, you know, even more sinister than that. So that's why what I'm asking people to do is inherently very difficult. I'm saying invest now for your health later in the same way, you know, people don't invest in pensions as much as they should do because they can't really see the benefit until later. So we tend to put things off. It's just within our human nature to do so. So, yeah, hearing stories about how people can change their habits at such a late ages, it gives me a lot of hope for everyone.

But then talking about prevention, I'm really worried about children, actually, because certainly at medical school, there was hardly any childhood obesity in the 90s when I was a student. Whereas now it's very, very different, not just in the UK, but worldwide as well. And I was listening to a great podcast by the fantastic. twins who are medics, Chris and Zand, I'm sure you know them from Operation Out, because my 10-year-old absolutely adores them. But they were talking with great podcasts about ultra-processed foods, and they were looking, I'm sure, you know, Chris and Zand now weigh different amounts.

Their eating's very different. And this ultra-prosive food was very interesting because my daughter was listening to it. And she eats well, but like a lot of children, she has a sweet tooth, and she'll love a packet of cris. We don't have christs at home, but if we're out, she'll, and she's really listened and said gosh mommy i had no idea and she's listening to it from the most amazing people that she just adores so it's very different from me and i thought actually this is incredible and chris has been very very open and zand was as well and i think when you have a bit of a personal story but then you've also your medic so people are listening to you and your educating children i mean goodness me they did such a good job but i do think it's

It's, as a mother, I have a real responsibility for what my children eat. And that's actually worse than the responsibility of feeding myself, because this investment for their future health is so key, isn't it? Yeah, absolutely. And I think childhood obesity is a really complicated topic. Because on the one hand, we know that we need to be investing in their health today to prevent that huge tide away of a disease that we're already experiencing today. You know, the analogy is almost like environmental change in clients.

climate change. We also need to be aware of the potential detrimental impact of making them too anxious about healthy eating from a young age as well because we know that has a whole suite of issues. It's the minority, but it's certainly growing. And I'm seeing that in my short time on social media, I've really seen the rise of young people, not necessarily like 10, 11 years, but certainly in like the late teens and 20s, being really, really anxious about what they're eating, which is why actually every now and then I try and tell people to unfollow me because I'm the kind of person that will always talk about healthy eating and that might be detrimental to certain people

who actually have an unhealthy obsession with healthy eating. So I think being responsible influences, particularly from the medical profession, we need to be cognizant of that. But it's a real issue because not only is the environment, again, conspiring against kids, but it's also something that, again, we're not taught about as medics to open up that conversation. You know, how do you approach a mother and talking to them about their child for which they have a responsibility without offending the mother and actually leading them with some advice

that's actually going to make a change over the long time that they can sustain as well, given all the pressures that we have as individuals today. And I'm not a parent yet either. I've got a partner and I'm lucky to, I'm engaged at the moment, getting married next year. So I've still got that sort of element to understand. and to truly empathise with parents. But it's certainly something that I'm cognizant of with my colleagues who have got kids as well because they tell me about their struggles.

And we definitely need to approach that. And there are multiple ways in which we can do. But we have to understand the environment in which we operate in and it's very complicated when it comes to childhood obesity. Of course it is. Absolutely. And talking about things that went taught at medical school, how much do you know about the manipulative groupie? Well, we were chatting about that on my point.

earlier, weren't we, about menopause and how much attention that was given. I mean, I remember vividly the first time a woman came into clear, I think I was an F2 and I was doing like a GP placement and she told me about a moon cup. I literally looked her like, but I have no idea what you're talking about. I was very open about no idea what a menstrual cup is. I've never heard about this before and she was educating me on it. It's kind of embarrassing to be honest because we really should be taught a lot more stuff about practical obsession of gynecology, not just the stuff that you see in hospitals, which was my experience. It's just like the day to day. So yeah, no, I had to teach myself a lot, but even post-genre practice training. Absolutely. So, and I think when we think about menopause,

as you know now, thank you for reading my book about it being a hormone deficiency. How much did you think about menopause and weight changes around this time? Did you know, or did it, was it ever on your radar much about the sort of metabolic effects of low estrogen and how women can put on weight just because of their menopause rather than any lifestyle changes? So that was new to me. So when you were talking about your book on my podcast, I talked to you about how the lack of estrogen causing an increase in particular types of tissue, edipose tissue creating a form of estrogen and the reason why that can explain unexplained weight gain in middle-aged women that process that mechanism was nutrient so i'm definitely going to be looking

at that in a bit more detail the more obvious effects the more metabolic issues that we see around that time period it's sort of like it's very obvious now looking back at it that there is clearly going to be a fly-will effect of all these issues that are related to estrogen deficiency. So looking after someone's osteoporosis, looking after someone's deficiencies in vitamins and minerals as a result of that period is, you know, that's something that I'm taking a lot more interested in. Good. Very pleased to hear that. And it's interesting because you've done a master's haven't you in nutrition. Did you have any modules on female hormones at all? Oh, no. No, no. That's a really good point. So we've had modules on obesity, dementia, brain health, what are the other

ones. We did one on statistics. I'm currently doing the dissertation for the master, so it's not completed yet, but my dissertation, there weren't any titles on that. So I think there were some on children's nutrition, pregnancy, nutrition, postpartum nutrition. But specifically looking at the menopause, no, there wasn't. And certainly something I'm going to be writing to University of actually, because it's super, super important, obviously. Like we said on the pod, it affects 100% of 50% of the population at a certain point. So, you know, it needs to be looked at. We've looked at isolated issues that affect people going through the menopause.

So cardiovascular disease, we've looked at osteoporosis, we've looked at psychopenia when it comes to nutrition. So those things are all relevant. But as an individual module, looking at all those different things that we can optimize nutrition around, no, that wasn't included. And it's very important. And then even, you know, when we were just talking about children, if you're menopausal and you're caring for a child,

it's really hard to look after yourself, let alone your children. And if you're feeling under part, it's so easy to give your children rubbish to eat. Because obviously that's what they want to eat. They want to eat rubbish. These foods are highly addictive, as you know, and there's all sorts of reward things that get lit up in the brain when people eat these foods. If you've come in from work and a job that you're barely putting together,

you get home and you're exhausted, the last thing you're going to do is think about food or think about what's in the freezer or have I cooked before. And so, you know, children are indirectly affected by the metaphors so often. They're not careful in the same way. I really worry about even abuse at home because women who are struggling, it's really difficult for them. But the children, I really worry. And I do think it's another reason that their diets maybe not be as good. Obviously, there's no research done in this.

This is just hearsay. But I know personally, And I had some symptoms. I batch cook. I've got no food in the freezer. I've got an Argon. I'm very lucky so I can constantly give my children fresh food, even though I'm not at home cooking all the time.

But when the freezer was going lower, that's a warning sign that I'm not in control of my life. And my freezer was quite low until I found or realized what was going on. And, you know, when children are young, they've got no idea, have they? So it is really important, this education. And I think they need to watch you cook and realize that it's, quite easy to do as well, isn't it? Yeah, absolutely.

I mean, that is such an important perspective that I'm embarrassed to admit I haven't actually thought about at all. You know, yes, I understand the impact of financial insecurity, being overworked, multiple responsibilities, multiple kids, you know, all their different worries and how diet can fall by the wayside. But if you compound that issue with hormone deficiency, where you're, you know, you're not sleeping properly, you're fatigued for that and for the genuine hormone deficiency itself. You've got brittle bones, you're suffering from skin changes, that has a huge psychological impact.

Your sexual wellness is being impaired as well. All these elements are going to, again, compound the problem of just putting diet to the wayside and just feeding whatever. And to your point about food addiction, we had this, again, it was another debate similar to, you know, is the whole obesity issue, a disease or a symptom. I agree. I think food, we have to get really used to talking about food and it's addictive qualities because we know processing certain elements like sugars, the way it's presented to us, the visual appeal of it, all these different things do light up reward centres that we have to be cognizant of because we're more attracted to that. And the companies have spent so much money in R&D to achieve what's literally called the bliss point. There's a bunch of studies I think that came out of, I I think it was Harvard or somewhere, but they gave certain elements of food, let's call it like a potato chip. And they would give it to a bunch of testers and then would reformulate based on their feedback again and again again until they reached that bliss point. So this is like perfectly crafted food that has millions of pounds or dollars in research and development.

Of course it's going to be like super attractive to us. It's just lighting up everything. So again, that's going to become the thing that we fall on. if we're tired, fatigue and we don't have all those things that let us think straight. Yeah, I mean, even the crinkle of those crisp packets, you know, it's all lighting up your reward centres. And I had a patient a while ago who came in with really high blood pressure, overweight, middle-aged man, raised cholesterol. And we started talking a bit about diet. And he said, oh, my wife cooks me really well.

So what else do you have? What else? Wow. Every night, I can't believe it. Every night when I come home from work, I go through the drive-thru, Kentucky Fried Chicken. and he said, but you can't tell my wife. And his wife was a patient of mine as well. And I said, but that's terrible.

He said, yeah, I know, but it's so nice. I can't tell you how lovely it is. And he said, I'm really worried because actually now I drive five miles out my way to Kentucky's Thai chicken, but they're opening one just down the road. And I'm really, really worried. So I said, right, you've got a choice here. You can look at your weight, your blood pressure, your cholesterol, you know, your father had a heart attack.

You're going to get that weight. Or you can think, right, this is a real opportunity. I'm really going to stop. And luckily he did the latter. And then just before I left general practice, he came in with his wife. And I knew both of them very well over the last 15 years of been with them.

And they just came to say goodbye. And he said, I've just got something to tell you to his wife in front of me and I knew what was happening. And he said, you know that Kentucky Friday? You know that. And she was absolutely mortified because she could not understand

why he was putting on so much weight. And they've had this big lie. But then when he talked about how addictive it was And there was a bit of a formula going on It wasn't just the food It was the process of afterwork He'd drive through He'd have a bit of time

He'd be in his man cave Before he went home He'd sit in his car He would stuff his face With this disgusting food And it was this sort of self-rewarding behaviour That he had developed over the years actually But it all caught up with him

But it's hard And I think when you explain to people How hard it is to come off these foods it's actually quite a relief for them, isn't it? Because they don't realise quite the power and the chemicals that are released in the body, especially the brain, due to these foods. Yeah, absolutely. And it gives them a reason.

It gives them sort of a greater understanding that it's not just because they lack poor willpower. It's because these foods are designed to counter their willpower. It's designed to be as rewarding as possible. And so when you explain that to people, it's like, ah, I understand it's not a fault of mine. In the same way, you know, drawing an analogy with women with the menopause, it's, you know, it's not their fault. It's not because they can't cope or it's not because, again, a lack of mental strength. It's because they have a genuine Eastern deficiency that needs to be replaced and needs to be catered for with all the other lifestyle suite of tools that we have as well to support that change. So when you understand a bit more about the mechanism and a bit more about how they can take control of that, then I think it's liberating for a lot of people.

You know, I had a patient who was a South Indian gentleman with UC and he had a number of different flares. And I hadn't seen him before, but we went through his diet and this is the first time I believe that one of the GPs that actually asked him about diet and littered things. and littered throughout this whole history were junk food just punctuating his week. And the reason why is because I think he was a driver from memory and, you know, he was working a lot on the roads and stuff and would have nowhere else to eat at these service stations. So he'd go for the McDonald's or whatever. And we know looking at peer-reviewed research, a lot of the additives that are added to these processed products are irritant to the gut.

And they can exacerbate not only your risk, but also flare-ups of inflammatory. through bowel disease as well. And no one had told him that. And so when we were seeing him and he'd come with a flare and stuff, and, you know, again, we were going through the whole rigmaral of steroids and determining whether he used to go to secondary care or not, him understanding what was in, within his locus of control was super empowering. And so when I saw him later, you know, he'd cut a lot of it out of his, he was feeling better himself. We didn't know whether that was going to have a long-term reduction in his flares, because his flares weren't as often as every month or so. It was like every six months. But that alone was super super empowering. So again, I think it comes down to education.

It comes down to giving people that locus of control. And just the knowledge itself can be liberating. Yeah. And it's so true. And it's such a great place to end on, actually, is about knowledge and making choices. And I think that's really important when it comes clearly to our hormones, but more importantly, to our nutrition and what we're eating. So I'm really grateful for your time, Rufie. But before we finish, I always end. three take-home tips actually. So I'd really be grateful for you to say three things that people can do easily and cheaply to improve their nutrition if that's okay. Yeah, yeah, definitely. So I'm a big fan of just one more. So making the smallest change that you can to your diet, even if it is just adding

one more fruit, vegetable, not or seed to your diet, as you have allergies. At every meal time, if possible, that would be great because I'm a firm. believe that we need to be eating more. That was actually the title chapter of one of my, the chapters in my last book. Again, going against the whole, the narrative of like restriction, actually we need to be thinking about eating more of these things in our diets. The other thing is having a backup meal. So you were just talking about the freezer. I think it's a really, really good addition to people's sort of routines to have a backup meal that you can make or you can pick up and just leaving your freezer at all time. So when you do come back and it's like a late

shift and it's 8pm or whatever you have a back of me you're not going to go for a takeaway and you've made something from scratch and the other thing is try to really reflect what you want and find a healthy version of that so my sort of i wouldn't call it a guilty pleasure it's something i super enjoy is pasta i love pasta my partner's italian she cooks like incredible pasta but i make that pasta with like three portions of vegetables per person in a batch cook sort of meal So I know that it's actually contributing to my plant diversity in my plant point. Every time I eat that, and I really, really truly enjoy that. So if you can healthify one of your favorite meals, it could be.

My recipe could be another recipe, it doesn't matter. Just add more fruit and vegetable to that and have that as something that you truly look forward to. Excellent. Yeah, really good, simple, easy advice. And certainly if any of you haven't seen or read your books, maybe they don't have to read them twice. but certainly have a look. We'll put links to them in the notes. So thank you ever so much because I know you're very busy

and it's been great listening to you and listen to your enthusiasm for good food as well. So thanks very much today. Oh, I appreciate it, Louise. Thank you. And good luck with everything as well. It's amazing to see how far you've grown and I can't wait to see what's next for your app

and everything you're up to. Oh, thanks ever so much. Well, hopefully we'll get you back one day so we can talk a bit more. It's great. Yeah, yeah, for sure. Thanks. For more information about the perimenopause and menopause, please visit my website, balance hyphen menopause.com, or you can download the free balance app, which is available to download from the App Store or from Google Play.