The Dr Louise Newson Podcast - 147 - Changing minds about food and diets with Dr Robert Lustig

Episode Date: April 12, 2022

Dr Robert Lustig is Professor emeritus of Pediatrics at the University of California, San Francisco. He specialises in the field of neuroendocrinology and his research and clinical practice focuses on childhood obesity and diabetes. Dr Lustig has led a global discussion of metabolic health and nutrition, exposing some of the leading myths that underlie the current problem of diet-related disease. He is the author of several books including the books Fat Chance and Metabolical: The truth about processed food and how it poisons people and the planet. In this episode, Dr Lustig talks to Dr Louise Newson about the influence of sugar, fats, and processed foods on our brains and health, changing minds of the public and health professionals and challenging the food industry. And – just as with changing public perception of HRT – challenging misconceptions about sugar and processed food starts with education. Dr Lustig’s 3 tips to improve your diet: Yoghurt is good but make sure it doesn’t have any added sugar Juice is not healthy. Fruit is healthy and has fibre which is the good part. It’s food for your microbiome. Trans fats are not good for you at all, try and avoid them at all costs including watching what oils you cook with. Dr Lustig’s website is https://robertlustig.com/ and you can find out more about all his books here.

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 Wellbeing 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 interviewing someone from across the pond in America, someone who I've been following without him realizing for many years actually. And so I'm very excited to introduce to you Robert Lestig from America.

So thank you so much today for joining me. Well, thank you so much for having me, Louise. Well, I have them was. I've always been interested in nutrition. And it's something that as a medic, I got taught very little about actually, and I don't think things have really changed over the last 25 years or so. And I read your book in 2013 Fat Chance. It also says on the title, The Bitter Truth About Sugar. And I thought, sugar, what's sugar, fat? How is that connected? I didn't really know much then. I hate to tell that. And I read your book, I remember starting reading it in the bath, actually, and I had such a cold bath at the end because I couldn't put it down. And everything you said made so much sense. And then I got really crossed because I thought,

why hadn't anyone told me this before? And so you have been so instrumental in even the way that I eat, the way my children eat, the way I help patients, actually. And it's incredible. And then you've just brought out your most recent book, Metabolical, which is a just a play on words that we will talk about in a bit, a phenomenal book. So can we start with just a bit about your background and why you decided to write the first book and what you're doing now because it's really very interesting. Well, thanks. First of all, why were you reading it in the bath? Because then you might have to take a cold shower afterward. You know, I came at this totally, completely through the back door. This was not my mission.

This was not my jam, as it were. It is true that I did major in nutritional biochemistry in college. So I was set up for this. And I was always. interested in sort of the micronutrient story going way back to even, you know, high school days. Why is it that, you know, vitamins and minerals, you know, went to MIT, which had a wonderful nutrition department. And I had people like Nevin Scrimshaw and Vernon Young and Hamish Monroe, you know, giants in the field of the early days of nutrition and vitamins. And then I went to med school and they beat it out of me and said, oh, you know, we don't deal with any of that. It's just about calories. And I thought, well, you know, I'm paying

big money for this medical degree and I should listen to the gurus, you know, and I sort of forgot about it. And I practiced like I learned in med school, you know, calories in, calories out, energy balance, you know, you are what you eat. If you're fat, it's your fault, blah, blah, blah, And then in 1995, the endocrine community discovered the hormone leptin. And as a neuroendocrinologist, this sort of was the Holy Grail at the time. And I knew leptin was coming because I worked at Rockefeller University alongside Jeff Friedman and Rudy Libel and the whole group that actually cloned leptin from the OBOB mouse. So, you know, I was there when they were planning it, you know, and we all had to take calls. in the Rockefeller University Hospital together. So, you know, everybody knew what everybody else was doing.

So I was very prepared for this. And at the time, I had moved from the University of Wisconsin to St. Jude Children's Research Hospital in Memphis, Tennessee, where I inherited a cadre of children who had survived their brain tumors only to become enormously morbidly obese. And the parents were basically claiming, this is double jeopardy. My child survived the tumor only to succumb to a complication of the therapy, which is absolutely true. This form of obesity where you damage the hypothalamus, the energy balance area of the brain, which you know a lot about because as a menopause specialist, you know, it's sort of, you know, going great guns for you too. This form is called hypothalamic obesity. It's been known for 100 years, but we didn't know what caused it. And when leptin was first discovered, I said, you know, these kids clearly must have had leptin working before the tumor. But now that the, you know, hypothalamus has been damaged and, you know, that area of the brain is dead, now they can't see their leptin.

So they must have what we would call leptin resistance. They can't see their leptin. and because they can't see their leptin, their brains think they're starving. And when you're starving, two things happen. And I knew all of this already. One is you eat like crazy. And the other is you burn like crap. Basically, you stop burning.

Reduce your energy expenditure. You actually ratchet down your mitochondria, an attempt to try to conserve. So you need to eat and you need to conserve because your brain thinks you're starved. And I said, well, I got 40 of these kids. What the hell am I going to do? Well, I, you know, I've researched the literature. I knew a little bit about this anyway. And I knew that these kids put out an enormous amount of the hormone insulin. Now, insulin for your audience is, you know, the diabetes hormone, certainly. But actually, that's really a bad moniker for it. What it is is it's the energy storage hormone. Insulin takes whatever energy, energies in your bloodstream that you're not burning right now and it puts it into fat for storage. More insulin, more fat. And we knew that these kids had very high insulin levels. So I then assumed, well, something about their leptin resistance meant that since their brain thought they were starving, they were putting out more insulin in an attempt to make more fat to try to raise the

leptin level, but they never can see it because, you know, that part of the brain's back. So what am I going to do? Well, let's try to get. get the insulin down. And I had a drug at my disposal called uctreotide, which you make you familiar with. And what it does is it suppresses growth hormone for acromegalics. And I knew that as an endocrinologist, but it also suppresses insulin. And I said, all right, let's try this drug. We did it in, you know, IRB approved protocol and all that pilot study. And lo and behold, the patients started losing weight. but something even more remarkable happened. They started exercising spontaneously.

Out of the blue. One kid started lifting weights at home. One kid became a manager of his high school basketball team. One became a competitive swimmer. These were kids who sat on the couch, ate Doritos, and slept. So very transformational. Right, absolutely. And it happened within a week.

And the parents would say, I've got my kid back. And the kids would say, this is the first time my head hasn't been in the clouds. since the tumor. You know, this was really remarkable, that their behavior changed because we got their insulin down. So then, of course, we did a double-blind placebo control trial

and showed the exact same thing, that if we got the insulin down, these patients not only lost weight, but they felt better and started moving more. And so what that showed me was that the behaviors associated with obesity, the gluttoning and the sloth, was actually secondary to the biochemistry.

Okay? And the biochemistry comes first. And we know that this is true for all sorts of things, including, for instance, menopause, okay? We know, for instance, the irritability that comes along with menopause is due to the hormonal fluctuations. We don't argue that. We don't say, oh, those women are crazy

and that's why their estrogen goes down. No, we say the women estrogen go down, and that's why they go crazy. Okay? We know what the cause and effect is. Well, this was no difference. So I changed my belief system on a dime because I saw the research, because I lived the research. Now, I have been for the last 20 years trying to get the medical profession to wake up and change their belief system.

Is that easy? You can imagine that that is quite a heavy, heavy lift. It is tough. It's so interesting, isn't it? Because like we said at the beginning, you know, medical schools. undergraduate, even postgraduate training really doesn't include much about nutrition. And it makes it very simplified. You know, you talk about calorie, we talk about fats, we talk about sugars. We talk about insulin in a very good way because we need insulin. You know, if you don't have

insulin, you've got diabetes, right? So, but what we don't see is how different levels of insulin and the spikes of insulin can really be very pro-inflammatory. And we also don't see how this sugar conversion to fats is something that I didn't even really think about until I'd read your book because you think, oh, fat's all bad, but actually, of course we know there's some really good healthy fats that we should all be having. Hey, 60% of your brain is fat. I mean, if you don't eat fat, guess what? You know, your brain rots. And the fact of the matter is, it's like putting blinders on, you know, if you don't know what's out there, you know, you don't know to look. Yeah. And I think it's

really important. And I think the other thing is that we all do learn at medical school is we have to listen to our patients. Our patients know the right things. Often in medicine, we're trying to compartmentalize things. We're trying to find a diagnosis. And I have sat there in consultations for many years, listening to middle-aged women telling me that they put on weight. And they're saying that their lifestyle hasn't changed, the exercise hasn't changed. And you sit there and the first time it happened, And you think, yeah, really, I bet they're having a sneaky McDonald's or they're having a packet of crisps or they're having some biscuits with their cup of tea in the afternoon. But you hear it time and time again. And like you with these children, you think, well, maybe there is something.

Let's just, and I always think in medicine, if I'm not sure about something, let's go back to some basic pathophysiology. Let's just work out first principles. What are these women? What's the common denominator? Well, they haven't got enough estrogen and probably haven't got enough testosterone as well. We know that the body needs estrogen. of course it does. And we know that adipocytes, fat cells produce estrogen, not a very nice estrogen, but they still produce it. And so these poor women are having these

metabolic changes going on out of their control. So there's us as physicians not believing them and there's them having these processes that they don't know what's going on. And as you know, well obviously that's why you've called your book Metabolica, the whole metabolic syndrome is really scary actually and it's far more scary than diabetes once you've got diabetes you've got a diagnosis but actually before that we want to stop type 2 diabetes or any of the other inflammatory conditions and there are so many aren't there but we don't as doctors we wait for the disease but we should be looking more about how to prevent these diseases and they're all connected aren't they well they are you know the fact is that at menopause women start making

lots of triglycerides. Now, we still don't know exactly why premenopausal women don't. Everyone's looking, but we don't know. But what happens is that women catch up. There's probably some role of estrogen in changing liver metabolism so that glyceride levels stay down. But as soon as menopause hits and the estrogen levels fall, those triglyceride levels go up. And triglyceride can either be a substrate for heart disease, or it can be a substrate for obesity, or it can be a substrate that never leaves the liver and it causes fatty liver disease, which then causes insulin resistance, which then causes type of diabetes, Alzheimer's, and everything else. So postmenopausal increases in triglyceride are at the heart of the metabolic syndrome in postmenopausal women. And so

the fact that they say that they are feeling different, the fact that they are metabolized differently is very well borne out by the data. What causes that is anybody's guess. But there's no doubt that using transdermal estrogen to raise estrogen levels back up can mitigate some of that. Yeah, absolutely. We certainly see it a lot, and even myself when I was perimenopausal and didn't even realize I just thought I was working too hard. I was moody, irritable, tired, back-to-back migraines, all the rest. And I suddenly looked down and think, gosh, I've got this extra bit of fat that I've never carried at all on my waist. And it was really quite disconcerting. And we see a lot of women in the clinic who have raised cholesterol, raised triglycerides. And we know that,

or we see a lot when they have estrogen back, let you say, transdermal. So it's eustradial. Their markers reduce. Their cholesterol goes down. And we know that. The cholesterol goes down. and their body shape changes as well. And testosterone seems to have an effect as well because I think it can help shift some fat to muscle too. So there's these very interesting metabolic processes that are going on. And we don't know enough about it because no one's interested in men orples or women. There's not enough research, you know?

Well, plenty of people are interested, including me. It's just a question of, you know, being able to actually demonstrate mechanism. We have the empiric data. We understand the phenomenology. But until we understand mechanism, we won't really understand whether there's a drug target or not. And, you know, basically, if there's no drug target, then doctors don't talk about it. That's wrong. But that's the way we're, you know, bred in medical school is, you know, there's a drug for everything.

You know, it's a pill for them. Well, you know, unfortunately, there's no pill for this. No, but there's hormones. So, you know, having the hormones back makes a huge difference. And as you know, the minority of women are taking hormone replacement because they've been scared away for the wrong reasons. Ultimately, and I don't want to get into a tip for tat on this, the fact of the matter is that certain estrogen preparations,

especially those with progesterone, have been associated with increased risks of cancer, especially breast cancer. However, lack of those hormones is associated with an enormous increase in cardiovascular disease. Everyone has to die. Yeah, totally. It's just a question of how and when.

So the idea that doctors would withhold hormone replacement therapy, specifically because of this cancer issue, I think, is shall we say, misplaced. Yes. So there's a lot that needs to be done for education. And that gets back to obviously the work that you're doing is educating healthcare professionals, but also you're doing a huge amount educating the consumers, the people that buy the food, the people that eat the food. But also more importantly, I think you're doing a lot of awareness for the people that make the food. Because the other thing that I learned very early on when reading your work and reading other works as well is about the processing of food. You know, the calorie is not a calorie. And in fact, just after I read your book, I was at a meeting with someone from Public Health, England. And it was... I'll bet I know who.

I'm not going to mention any names. But it was about obesity, actually. and it was about awareness. And this lady stood up and she was talking about, we need to reduce calories, we used to have low-fat milk, we need to have low-fat spreads rather than butter. So I put my hand up and said,

well, surely if I had 100 calories of Mars bars or chocolate or 100 calories of almonds, surely metabolically that would be quite different in my body. And she said, no, a calorie is a calorie. And I said, but hang on, I drive to work and I see all these children eating crisps for their breakfast. When I grew up in the 70s, we would have full fat milk, we'd all fight over this cream at the top on our cereal. And we'd have butter. We'd have cream.

But we would never have any processed food because it wasn't there. We couldn't go and buy a ready-made lasagna or a, you know, and there's no way we would be allowed a bag of crisps in the morning. So surely this has an effect. They wouldn't listen, and there were a few other doctors there who thought I was mad. But it makes sense, isn't it? I will tell you on your show that two years ago, before the pandemic, I had an audience, along with my good friend and colleague, Dr. Assim al-Hotra, with Sadiq Khan, your mayor, to talk about just this issue.

But in the room were two members of Public Health England. And I will tell you that they, number one, were immovable on this subject. And number two, ignored all the evidence because for them, a calorie is a calorie. The question is why do they think this? This is their belief system. Or are they being paid off? And now we have some data to suggest that it might be the latter. Bottom line, I know who you're talking about.

I know the person in question, I will not embarrass them on this podcast. But I am going to tell your audience that just because a governmental agency says something doesn't make it so. That is what I will say. I mean, there's a big corruption out there, isn't there, with the fast, not just fast food, but the process. You know, there's a small number of companies that really feed the majority of people. And it's the same in the UK, but it's worse in the USA, isn't it? And it's very frightening when you see what people put in their mouths. But actually, I feel really sad for a lot of people because they don't know what they're doing

because the labeling of these foods looks like they're healthy, doesn't it? Well, I feel bad for them too, which is why I write books. On the other hand, you know, you can write books and you can provide people with the information. And then, you know, it's what they do with it. And, you know, unfortunately, what many people do with it is, you know, basically put it in the circular file. You know, the question is why does that happen? And this sort of dovetails with the question you asked me at the very beginning. People ask me, you know, who are your detractors, Dr. Lustig? And I can basically put them into four bins. And I call them the four Ds. The dinosaurs,

the people who calcified that they can't learn something new. The deniers, okay, the, like the anti-vaxxers, who have sort of a religious penchant, you know, in one direction or another. The dilettance, you know, the people who are actually taking money, as it were. And unfortunately, there are a lot of people in medicine and science who take money. We can have a whole talk about, you know, that. And they are in the UK in full force. One of them being diabetes UK. I suggest everyone look at diabetes.co.com.

Not diabetes, UK. Different organization, completely different message. And then finally, the last one of the four, the four Ds is the drug addicts, who basically say, don't take away my sugar because I'm addicted. The fact of the matter is every one of those is their own belief system. So we're battling multiple belief systems at once. and it's highly problematic to get information out to the public in a meaningful way. So people say, well, how do you change minds?

How do you change minds? And here's how I do it. Imagine you and I are on opposite sides of a brick wall, and my job is to get to you. There are three ways to try to get to you with this brick wall in the middle. One is to blow a hole on the wall. Now, if I do that, you're going to run a wall. away. And so that's not going to work very well. Number two, I can try to walk around the wall. And sometimes that works. But what if the wall is circular? What if you just keep walking around

and around and the other person's on the inside? And that's that, you know, religious belief system. How far you walk around. There's no getting there. So that's a problem. And then the third way, which is the most effective way, is dismantling the wall. brick by brick. Now, dismantling the wall is not the same as blowing a hole in the wall, because you can actually reassemble the wall with you on the other side. And if you do it slowly and you do it methodically, you can actually keep people in the conversation until you finally reach the point where they can't deny what's been said. Now, that takes a long time. It takes It takes some perseverance to say the least. And that's what I try to do. Now, I will tell you that for

30 out of my 40 years in medicine, I blew holes in walls. And it wasn't all that effective. And I sort of into that realization, oh, about a decade ago. And so now I do my best to dismantle the wall. And that's one of the reasons why I write books. I love it. I absolutely love it because I feel like I've blown so many holes in walls over the last five or six years. And often I've crumbled at the bottom, to be honest. And it's very hard to sometimes get up and think, actually, why am I doing this? What am I doing this for? And then I go to my clinic and I hear another story of another woman who's given up her job or her partner's left her or I speak to suicidal women because they haven't got their hormones and no one will listen to them or people that can't sit down because

they've got such bad vaginal dryness and no one will give them vaginal estrogen. And so you think, all right, I've got a choice. I can wallow in self-pity or I can just carry on and just be a bit more careful with this warm. And I think someone said to me a while ago, just be persistent and consistent with your messaging and make sure that whatever you say is evidence-based. And I think that's so important. That's exactly right.

Your science is your sword and your shield. Yeah, absolutely. And I also, you know, I don't do any work with any pharmaceutical companies. I don't endorse any products. So I think as a physician is such a powerful position, but it's so easy to get wrong if you get greedy or if you get lured into something. And I need to sleep at night. And so I want to make sure that everything I do is as good as it can be.

And I think that's the only thing that making some people listen. And I've got some great supporters over here. But it takes a while, doesn't it, for people to? And I think it's changing something that people have never thought about before. You know, we've got data from the WHOI showing that estrogen-only HRT is associated with a lower risk of breast cancer. Well, that's very hard for people to understand when they've been told for so long. And it's the same with you and food. You know, we've been told for so long that fat's bad and that sugar's probably okay.

That's right. And then suddenly you're telling us other things. And how do we believe that? Well, here's the way I explain this to people. In the last 30 years, there have been four, count them, four cultural tectonic shifts in America and both in the UK, no different. Okay, and here they are, four. Number one, bicycle helmets and seatbelts. Number two, smoking in public places. Number three, drunk driving. Number four, condoms and bathrooms. 30 years ago, if someone stood up in a House or in Congress or in Parliament and proposed legislation for any one of these four.

They've gotten the last right out of time. Nanny State, liberty interest, get out of my kitchen, get out of my bathroom, get out of my car. All right. They're all facts of life. No one's belly aching about any of those. Oh, we have new things to bellyache about like vaccine mandates and all. But no one's belly aching about those four. And if you pull out of your driveway today and you haven't clicked your seatbelt, your kids will scream at you.

Okay. Now, how did that happen? And why did it take 30 years? Answer, we taught the children. The children grew up and they voted. And the naysayers are dead. This is a generational shift. But it started with education.

education softens the playing field education allows for an idea to ultimately take root and take hold and it has to germinate and it takes a while all right and you have to basically till the soil and you have to allow for this to occur it doesn't just happen the point is there's a beginning and there's an end And then there's everything in the middle. The issue with respect to diet, we're about, I would say, nine years into a 30-year cycle. And we're not even close to being done. But there are people who now actually recognize what the problem is. And we have empiric data to show that people's minds are being changed.

Iphick, which is the International Food Information Council, is the public relations arm of the food industry. in 2011 asked the question, what single food component causes weight gain? And back then, only 11% said refined carbohydrate or sugar. 42% said a calorie is a calorie or they didn't know. They asked the same question in 2018, exactly the same way. And now 33% of the population said refined carbohydrate and sugar. and the ones who changed their minds all came from a calories, a calorie, or I don't know. Amazing.

So they've done the work for me. All right? They've actually demonstrated that the messaging is getting out and that you actually can change people's minds. Okay. But it takes a long time and you have to be persistent and you have to be patient. And that's my counsel to you, Louise, is that you will have to be patient. is a possibility that this problem will outlive you and you have to be okay with that. Yes, I know.

People who are trying to influence public health have to be copacetic with the idea that this problem may, you know, survive them and they have to be okay with that. Yeah, no, it's really, really good advice and really interesting. And I think it is, you know, I'm spending a lot of time and energy this year, helping disseminate knowledge as much as possible. We've got our app balance, which is available free to people. and it's just tipped over half a million downloads and we've in over 150 countries.

And, you know, people are now helping themselves because they've got knowledge. And knowledge is power, isn't it? And I think that's the same, you know, with what you're doing is that we're allowing people to have choices over their diets and knowing what they're doing is really important and knowing how to make choices,

not just for them but for their families too. Well, I would challenge that. The question is, if 74% of the item in the grocery store are spiked with added sugar. How many choices do you actually have to avoid? Well, totally. But it's changing, isn't it? I think it's making sure that people try and eat the way that they can,

but also with the economics as well, because it can be more expensive. And so certainly, I mean, I've always cooked for our deep freezer because I'm so busy and I've got three children that I don't want them growing up on rubbish. So I cook a lot, but I'm very organized. So it's the organization that can be difficult. But it's also hiding vegetables in food. If I gave my children leeks and courgettes and lentils, they would just no way eat them. But I chopped them up small and put them in mincemeat.

And then the mince is cheaper. It's easier. And then they're getting vegetables. So it's like win-win. But it's knowing these tricks rather than just going and buying something. I actually published a no added sugar cookbook. I don't know if it's available in the UK called Fat Chance Cookbook, specifically because real food, actually tastes good. And kids will eat it. So there are ways to do this. It's not a done deal and it's

not a foregone conclusion. The other thing is that some, I won't say all, certainly not all, but some of the consumer packaged goods industry, the CPG industry, they're onto this. They know there's a problem. And they are doing something about it. As an example, Denon and Unilever have both reduced the sugar footprint in their portfolio by 14%. Now, 14% is poultry, but it demonstrates that they understand there's a problem. I am actually working with an international food conglomerate in the Middle East to reduce their added sugar footprint by 78%. Wow.

So people understand that there's a problem. The food industry understands there's a problem. They're looking for the right answer that won't affect their bottom line. line. You know, that's the challenge. But the problem is well stated and people are starting to understand that there is a problem. It's amazing. I think the progress that you've made and the momentum has certainly started and it's not going to shift back. So I'm very grateful for your time today. And I could talk for hours, but we haven't got hours. But at the end of every podcast, I always ask for three take-home tips. So I'm very keen actually to ask you, Robert, if you could just say three

things that most people could change to their diet. It's going to reduce this inflammation and reduce their risk of metabolic syndrome, actually. Number one, yogurt. Okay, now yogurt's supposed to be good for you. And it is. It's a fermented food if it's yogurt without added sugar. So if you eat plain yogurt and add whole fruit to it, like yogurt was originally designed me, then you're good. But if you're good. But if you're just, If you're eating the strawberry yogurt in the refrigerator section of the supermarket, then it's a disaster. So that's one example. The second, of course, is juice.

Everyone says that juice is healthy. Juice is not healthy. Fruit is healthy because fruit has fiber and juice doesn't. And the fiber is actually the good part of the fruit. But we throw it in the garbage. The fiber is food for your bacteria, for your. for your microbiome. And if you don't feed your microbiome, your microbiome will feed on you.

It will actually strip the mucin layer right off your intestinal epithelial cells. And that will actually lead you to leaky gut, irritable bowel syndrome, inflammatory bowel disease, systemic inflammation, insulin resistance, and metabolic syndrome. So that's, shall we say, a no-no also. And then, of course, the third one, which sort of everybody knows now, is trans fats. Trans fats are the devil incarnate. There is no trans fat that is good for you. And the reason is that they were put in the food in the first place is because bacteria can't digest the trans fats because they don't have the desaturates to break the trans double bond. Well, our mitochondria

are refurbished bacteria. We can't break that bond either. And that means that when you consume a trans fat, it never leaves. Okay. What it does is it goes to your liver and causes insulin resistance or goes to your arteries and lines your arteries and causes cardiovascular disease. Consumable poison, verifiably consumable poison. Now we know that and they're coming out of our food. So you'd say, ah, trans fat problem solved, right? Not exactly. A lot of the polyunsaturated oils that we cook in, when you heat them very high, the heat will flip the double bond.

And so a cis fat will become a trans fat. So you can actually make trans fats at home, all right, from pernola oil, you know, which is, quote, healthy, unquote, not necessarily. All right. Olive oil, you know, the best oil to cook with, guess what? It's not the best oil to fry with. Okay, olive oil was meant to be consumed at room temperature, not to be used for, you know, frying up a chicken coat. So bottom line is watch your fats, not because fats are bad, but because the way you're, you're you cook them could make them there. Very good advice. And, you know, very easy to change, actually.

So lots to think about. And certainly we'll put a link to your new book in the notes so that people can have a look. And it's filled with evidence as well. So it's great to read and digest, literally. It's not about digesting it. It's about metabolizing. Excellent. So thank you so much for your time today.

I really, really appreciate it. Good luck with everything that you're doing. It's been my pleasure, Louise. Thank you for having me. For more information about the perimenopause and menopause, please visit my website, balance-manapause.com, or you can download the free balance app, which is available to download from the App Store or from Google Play.