The Food Medic - S1 E10 - Food Can Fix it

Episode Date: August 13, 2018

In the finale of season 1 of The Food Medic Podcast Hazel sits down with Dr Sandro Demaio, who is one of the leaders in the global health space, particularly when it comes to food. This episode is our longest and most robust covering topics from; non-communicable diseases, malnutrition paradox, nutrition at medical school, planetary health and sustainable diets, and childhood nutrition. You can find Sandro on Instagram and twitter as @sandrodemaio, and his book 'The Doctors Diet' is now available to purchase. Hosted on Acast. See acast.com/privacy for more information. Learn more about your ad choices. Visit podcastchoices.com/adchoices

Hello and welcome to the Food Medic podcast. I'm Dr. Hazel Wallace, founder of the Food Medic. I'm a qualified doctor, personal trainer, blogger, and bestselling author of the books of Food Medic and the Food Medic for Life. I'm passionate about maximizing our health through how we live our lives, including the food that we eat, physical activity, and stress management. We will hear from leading experts in their field who will be sharing evidence-based advice on how we can live healthier lives and we will cut through the confusing information that we find online. I like to think of myself as one of the final episode of this series of the Food Medic podcast.

I have been absolutely blown away by your support and love for this show, but I'm definitely keen to come back for another series and I hope that you guys feel the same. If you do, make sure to show this podcast some love on social and let me know what topics you would like to see covered in the next series. Now back to business. Today I'm joined by my first international guest, Dr. Sandro Di Maio. Sandro is a medically trained doctor from Australia with a Master's in Public Health and a PhD focusing on non-communicable diseases. Following his PhD, Sandro held a post-doctoral fellowship at Harvard Medical School from 2013 to 2015, and after that he was Medical Officer for non-communicable conditions at the WHO. Sandro has recently been appointed chief executive officer of EAT, the science-based global platform for food systems transformation.

He also does a lot of media work, including TV, and has just released his debut book, The Doctor's Diet. First of all, welcome to the podcast, Sandro. Thank you, Hazel. And secondly, I had a really hard time condensing your bio because you've achieved so much. So first of all, it'd be really great if you could just introduce yourself and let everyone know the many things that you do. Yeah, thanks very much for having me and also a huge fan of yours, Hazel. I grew up in Australia.

I came from a family with a dad who was a GP. Mum was involved, was an allied health professional, an OT. And so medicine was sort of in the veins growing up and always wanted to be a rural general practitioner and had some fantastic experiences in remote medicine early in my career. But it was working then as a junior doctor in some of the biggest hospitals in Australia and also in remote Indigenous communities

across Australia, that I realised that there was a public health disaster unfolding in Australia. And this was, of course, around poor diet and obesity. And then when I was lucky enough to spend some time in Sri Lanka and Cambodia and then eventually Mongolia during my PhD, I realized that in fact, these weren't just diseases of wealthy, developed nations, obesity, heart disease, cancer, a group of diseases we call NCDs are actually the leading cause of death worldwide. And although I loved clinical medicine, I made the decision that, you know, that classic sort of conundrum, do you continue to patch up those who fall off the cliff and are at the bottom with a broken leg? Or do you try and build a fence at the top so that no one falls off the cliff again?

And so I increasingly turned my focus to prevention and how do we get prevention on the agenda politically? How do we get people engaged in preventing disease? And just like you, I realised that the best way to do that was through food. And so since then, I've been lucky, launched a few social start-ups, made short films around the world, been able to have a regular column for a newspaper at times and now front a television show in Australia on ABC and soon worldwide on another digital platform. Is that Netflix? It might be, but I'm not allowed

to tell you yet. Yeah, and sort of moved off into public health and had fantastic experiences in Mongolia, you know, seeing a country transforming and seeing such an incredible culture and beautiful young country of incredibly passionate individuals trying to make sure that they don't go off on the same unhealthy path that the rest of the world has gone and being able to be a small part of helping them to do that. And then in the US, you know, postdoc continuing research, and then eventually with some fantastic allies at the World Health Organization in Geneva and now in Oslo based with the foundation focused on food systems. Yeah, it's so much, but such incredible work. And for everyone listening, myself and Sandra actually met at the EAT Forum in Stockholm not too long ago and instantly hit it off largely because we're both really passionate about increased awareness and action towards preventing global malnutrition and NCDs. And we keep mentioning NCDs. So I think

the first stop would be great to just explain what they are and why they're important, particularly now. NCDs stand for non-communicable diseases. And so what does that mean? It means diseases that you can't catch from someone else. So I can't sit near you and catch diabetes when you sneeze on me, for example. And why on earth would we call a group of diseases that are so important, that are in fact now the leading causes of death by far and away around the world, and in almost every country on the planet, apart from the absolute poorest, every other country is now struggling with an overwhelming epidemic of these diseases. Why would we call them what they're not? It doesn't seem like a very logical way of framing the biggest health challenge facing

the planet, arguably. And that's because 100 years ago, these weren't a problem. 100 years ago, the big challenges for public health for countries around the world, including here and in Australia where I'm from, were water and sanitation issues. They were not having enough food. They were infectious diseases. They were surviving to the age of five. You know, they were the big challenges, but we made such incredible gains in so many parts of public health last century and were able to extend those life expectancies from 50 to up to 80s and 90s now in many countries. So much so that in fact, coupled then with processes like globalization and the kind of westernization of our food systems and our food supply, increasingly eating poor quality diets that have kind of westernization of our food systems and our food supply, increasingly eating

poor quality diets that have kind of originated in the US rather than the traditional diets that we've been eating for hundreds or thousands of years. Coupled with all of those changes, the increasing wealth in the world in general, and the fact that we're able to make huge progress on those infectious and kind of, you know, starvation type diseases, we're now in a situation where the kind of the non-problem, the non-communicable diseases are the biggest challenge facing us all and in fact cause about 70% of deaths worldwide and increasingly affect individuals younger and younger and poorer and poorer. And that's not just here in the UK, but also all around the world. So it's diabetes, heart disease, cancers, chronic lung conditions,

and mental illness. They're the kind of big five, what we call NCDs. And then why do we put all these together? Why would you put cancer, which is a group of diseases in itself, some of which you actually do catch from an infectious cause with heart disease or chronic lung disease? Well, because they actually are caused by common shared and changeable risk factors, what we call modifiable risk factors. So this is the harmful use of alcohol, it's tobacco use, it's physical inactivity, but in particular, it's poor diet, which is the leading risk factor for disease worldwide. So what we realize is that in fact, the power of grouping this sort of diverse group of diseases together is that we find really powerful and effective ways of challenging three or four of the biggest killers on the planet all at once.

And one area where we can make huge advancements on all of those and mental health and social inequity and even climate change, of course, is through our food. Through food, yeah. Something you know very well, Hazel. Something I'm very passionate about. So like you've just quite rightly said, worldwide we are experiencing this malnutrition paradox where we're seeing this dual burden of undernutrition and hunger, but also a pandemic of overweight and obesity. And this isn't just at a population level or even at a community level,

but we're seeing it within the same household. An area of huge complexity. Where do we start? Yeah. Well, first we need to understand when we're talking about malnutrition, we're talking about actually a few different things because we instantly think of hunger. We think of very thin children, but actually malnutrition is the full spectrum. So it's deficiencies in vitamins and minerals because of a diet that is full of calories, but very poor in actual nutrients or quality food. It might be people who are too thin for their age or their height. And it's also those that are overweight, obese, as well as suffering from diet-related chronic diseases

like diabetes and heart disease. So all of that together is actually what we call malnutrition. And what we're seeing globally is this rise of what we call the double burden of malnutrition. And it's frightening because what we're seeing now is, you know, countries, developing countries, low and middle income countries that are still struggling with high rates of children who are so undernourished, that have such a long period of starvation early in life, or even when they're developing in the uterus during pregnancy, that they're actually permanently short for their age, for the rest of their life. And with that, their kidneys, their heart, even their brains are underdeveloped and they will have a setback for

the rest of their life because of a period of a lack of nutrition, a lack of good food early in life. But what we're seeing in those same countries where you might have 20 or 30% of kids affected by chronic long-term hunger is in fact 20 or 30% of the same population is overweight or obese at the same time because those kids are then entering into an environment. I was there in Mongolia when the first KFC opened. I saw the 400-meter line down the street to taste this kind of Western food culture, which is going to bring

so many problems to not only Mongolia, but the entire, has done to the entire world. And it's this double burden of having hunger early in life, but then entering an environment that's very similar to the one we have in the UK. Junk food everywhere, poor quality food that is low in nutrients, but high in calories everywhere. And so by adulthood, as soon as you stop rapidly growing, you suddenly start putting on weight. And so what we're seeing around the world is you might have in one household in countries like Malaysia or Indonesia or many African countries, you might have a child that is chronically hungry. You might have a mother

that is anemic because they're not getting enough quality protein and meat in their diet, coupled with a lack of access to sort of the same reproductive health opportunities that women would have in other parts of the world, as well as overweight or obese in maybe the grandparents. And in countries like the UK, we see overweight and obesity coupled with a deficiency in key vitamins and minerals. That's a very common type of the double burden. So what we're seeing is not only a shift of an increase in overweight and obesity, we're seeing for the first time in the last three or four decades, hunger is once again on the rise, very frightening in the context of continuing rise

in overweight and obesity. Now, basically, we know that roughly one in two humans on the earth are malnourished in some way. So the scale of this problem is huge. And the last really challenge for public health and for the global community is that we are seeing a strong association with malnutrition and poverty. Whether it's here in the UK, you can draw a very close line between poverty, increasing poverty or decreasing wealth and increasing obesity, increasing malnutrition in general, and increasing all of the diseases associated with those. And worldwide as well, in fact, some of the highest rates of particularly the double burden are in the countries that are

least able to cope with it financially and from health systems and a governance perspective. What we're also seeing is that the cost, if you think about the level of wealth that you need to have as a country to kind of be able to, in inverted commas, afford malnutrition is getting lower and lower. So what does this mean? It means malnutrition is becoming more common across the world. It's becoming a double burden, a kind of double whammy of overweight, obesity and types of hunger. And it's getting cheaper and cheaper for countries to, you know, populations that are poorer and poorer are starting to develop it earlier and earlier on. And that's a very frightening situation that we need as a global community to start acting on. Yeah. I think it's really interesting how KFC and other high street takeaway chains

and other processed foods, the availability and ability to buy them is almost a sign of affluence in these developing countries where it's the opposite here in the UK. And yet it's still a problem in both. And huge. And as those companies are expanding their global reach, I mean, they are shifting their focus to low- and middle-income countries. As soon as populations are able to afford to pull themselves out of poverty worldwide, those companies are there with the shops opening up that are the last thing that

these populations need. And they're being framed, as you say, as a sign of affluence, as something that is aspirational, when in actual fact, it's one of the drivers of a huge health problem facing the planet. Yeah. It just really, really kind of hits home to everyone listening. It's not just an issue within the UK, it just really, really kind of hits home to everyone listening. Like it's not just an issue within the UK, it's really, really across the world. And especially after being to the Eat Forum and hearing from people from all over the world and the problems they're facing, it was very, very apparent to me that nutrition should be at the top of every country's agenda now. And we have to think for a second. I mean, we live in a world now where 800 million people

are still hungry. In 2018, how is it that we haven't got ourselves organized enough as a global community to make sure that those 800 million people aren't waking up hungry every morning? And in fact, that number is rising again, as I said, for the first time in decades, it's going the wrong direction. At the same time, 2 billion people, that's a B, go to bed overweight or obese every night. And 2 billion people are deficient in key vitamins or minerals. So all in all, our food system currently fails half the planet. How on earth have we got ourselves into that situation? And why are more of us not acting in a way that will create a better future for the entire planet and create a food system that is able to deliver a diet

that truly leaves no one behind? Yeah, absolutely. And I think that's really important, that last line, leaving no one behind. Now, not only is the type and quantity of food affecting our health, it's also having a huge impact on the planet. What can be done on an individual level to ensure we are following a sustainable diet that reduces the demand on the planet whilst also supporting human health? Is the answer to go completely plant-based? Well, I have to declare I recently turned 33. And on my 33rd birthday, I was challenged by my team to be vegan for a month, my first time being vegan. And it was a really fascinating experience. It finished on the Norwegian National Day. I live in Norway now. And to answer your question, no, the answer is not

that everyone on the planet has to be vegan. But I have to say, I found that a really interesting and educational experience to actually give up meat and plant-based foods for a month. And I think it comes back to a philosophy that I have growing up in an Italian family. My grandparents were very poor, illiterate, came from the very southern part of Italy and could not afford the amount of meat and milk that we eat today. So I grew up in a family that ate a lot less meat probably than most Australian families. And I think the philosophy that we need to try and adopt and that really this month reinforced in me is when it comes to protecting our health

and also protecting the health of the planet, reducing and really thinking about our meat and animal product consumption is a big part of that. It's not the whole piece, but it's a big part. It's not about everyone becoming vegan, but if you can, it's about really taking a moment to respect and understand and appreciate the meat that we eat. Meat consumption is not a right, it's a privilege. And understanding that it is a privilege and therefore eating less, it's about eating the best quality that you can afford. You might not be on the same income as the person next to you, but eating the best quality you can afford and making sure that we waste none. That's the worst thing that we can do.

We know that one third of food is wasted in the world. And we know that at the same time, about 30% of global greenhouse gases come from, in fact, it's the largest contributing sector from food and food systems towards greenhouse gases. And about half of that comes from meat production. So if we want to make an impact on our health and on the health of the planet, and in the process, give animals a much

better life, I can tell you that if you start buying meat that is sustainably sourced, that is not using antibiotics, and that is free range as much as possible, they sound like really kind of romantic ideas, but actually it's as much about respecting your own body and your health, the health of the planet, but also the health of the animals that are produced in that process. Because to be able to produce an animal without antibiotics, you can't pack them in as closely. You need to give them a life that is fair and respectful. And so you can kind of hit all three by appreciating the meat that you eat. Maybe what I like to do is try to be a weekday vegetarian and eat meat on weekends when I

can really take the time to cook it slowly, enjoy it with friends, cook the foods that I really love. And also then I think of it as something that it's something that I associate with weekends. It's something that I associate with, it's a special occasion. Yeah. So eating less, eating the best quality you can afford and wasting none. That's the recipe I believe when it comes to meat. That's something that a lot of people can achieve as a first step anyway, you know, just reducing, it's just eating less, you don't have to absolutely cut it out. And if you do decide to do that, you know, do that and do it in a stepwise fashion and always make sure that you are supplementing if you need to. But we didn't talk about fish and fish comes

into that also because we're massively overfishing. And I know you speak about this in your book. So can you expand on that a little bit? Yeah, fish is so important. So we know that currently, while our oceans contain 50% of global biodiversity, only 1% of our total global calories for humans come from the oceans. If we're going to feed 10 billion people by mid-century, we're going to need to get more food from our oceans, but we're going to need to do it in a way that is sustainable. Because at the same point, I know there's a lot of statistics being flown around here, but 80% of global fish stocks, so 80% of global fish stocks are either at or overfished. So at capacity or overfished already now. And we're still going to have to increase how much we produce. So we're going to need to find more sustainable

ways to produce fish. But also there are lots of things that we can do every day to increase the sustainability of the fish that we're eating. Including the fish that we choose, right? Exactly. So first of all, it's about, again, the same principles, eating the best quality that we can afford and making sure that we don't waste any. Throwing food away is a huge, you know, it's not good for anyone and definitely not for the planet or the fish. But then simple things like eating lower in the food chain. So the further up in the food chain, things like unfortunately tuna and salmon, those are inherently less sustainable options because they take more fish to produce

per kilo of protein. They're also, in general, more overfished than the smaller fish lower in the food chain. So, lower in the food chain, smaller fish, they're two good starting points. Third is to get to know the fish. Just like we have seasons for our fruit and vegetables, a lot of the fish that we produce also have seasons for our fruit and vegetables, a lot of the fish that we produce also have seasons. So understanding when certain fish are available locally, that's number four, within our own immediate environment. So here in the UK, great fisheries, some very sustainable options. If you stick to sort of lowering the food chain when they're in season and therefore they're fresh,

also then better in terms of nutritional value often. And the last is there are some great certifications. So if all else fails and you're at the supermarket and you've forgotten the incredible, you know, you've listened to Hazel's podcast on repeat for a week, but you've forgotten this part, then look for the little labels and And they're things like MSC, ASC. There are quite a bunch. But understanding, do a bit of a Google. Understand what these different labels mean and which ones actually mean something. And then make sure you always kind of vote with your note at the checkout and buy the

ones that are actually shown to be sustainable. If you can do those things and then just not waste any fish, that's already a really great start for the oceans. Absolutely. So it's just about being more of a conscious consumer overall. Yeah. So providing evidence and guidelines that support change and advice for living healthier, more sustainable futures, it's obviously super important. But chatting about it amongst ourselves, academics and doctors and other healthcare professionals, isn't going to have much of an impact at a grassroots level.

How important do you think millennials are, including the use of social media, in disseminating the information and engaging with people? Well, I'm not just saying this because I'm with you, Hazel. No, look, it's super important. It's super important. I've worked at the UN. I've worked closely with government. Part of the change will come from policy. It needs to be decisions made by responsible governments. But a big part of it is going to come from us. It's going to come from not only community-based

bottom-up, us deciding that we're going to, you know, there is something that we all do three times a day, if we're lucky, every day, that is probably the most powerful gesture we can make towards global change, towards the future we all want, towards the future that us as millennials will inherit. And second to the vote that we take every three or four years in our democratic system, the most powerful gesture we can make is looking down on the plate in front of us when we're eating our food and reflecting what we believe as individuals in what we actually put on our plate in front of us. And when we are more hyper-connected than ever before, when we understand that what is happening

on the other side of the world affects us, when we've grown up as digital natives where, you know, you and I, like we connected through social media. Yeah, and I have so many friends in Australia who love what you do. And it doesn't matter that it's the other side of the world. We're all interconnected. And we understand that just like we're interconnected

as a generation, just like we're interconnected through the digital space, we actually live on one planet. Like what I do to the ocean in Australia, that's one body of water that is connected everywhere. If I am eating in a way that is unsustainable, or if I can make small changes and we can all do that, and then we can share that and create a movement around that through social media. And what is the most photographed thing on social media most days of the week? I don't know if it's an avocado, but it's probably food. You know, people love food. People love talking about food. People love being connected

through food. We're a hyper-connected generation. We're aware of the future we want to inherit. When you piece all of those things together, it becomes super important that millennials become, if we're not already, the kind of white knights of making sure that that future we want, that we're currently, let's be honest, not on track to achieve, is the future that we live in when we are all 50. Yeah, absolutely. It's really powerful. Childhood obesity is a global problem, and we've already spoken about this, but there are 20 million young people predicted to be obese by 2025. That's 70 million. Now obesity is defined by BMI which has a number of drawbacks as a measurement of health but we do know that a

higher BMI is correlated to negative health outcomes. This area is very difficult because we have so many different drivers aside from nutrition and that's including inequality and environmental factors. How do you think we can play a more effective role in enabling children to have healthier diets? Well, I think the first step is actually talking about the issue and accepting that we do have a huge problem globally. There is no country in the world that has managed to turn the tide on child obesity.

It is rising in every country across the planet. That is very frightening. And the first step is to realise, because there will be people who want us to believe that it's not a problem, and there'll be people then who also want us to believe that it's not our responsibility to try and improve the lives of those kids and make it easier for them and their families and their parents

to live a healthier life and to achieve a healthier weight. Childhood obesity is, for me, kind of the litmus test of whether we are on track to achieve the kind of society that we want to have in the future. Not only does it reflect everything we've talked about so far, not only does it reflect rising social inequality, the concentration of wealth, the marginalization of so many individuals within our population and the division and kind of politicization of a lot of these health issues, but it's also about kids. I mean, these are people who are still developing emotionally, intellectually, physically. As a society, we take responsibility for kids in so many other ways. We don't let them vote. We don't let them

go to war. We don't put them in jail. So why would we not step up and say, you know what, advertising food that we know and everyone knows causes disease that is associated with obesity and chronic disease, advertising those sorts of foods to kids, advertising alcohol in spaces where kids are around, advertising junk food directly to kids with cartoons is not appropriate. And we shouldn't allow it. And we should just like some countries in the world have said, we're going to, as a society, take responsibility and say, we will not advertise junk food to children. We will not advertise alcohol in a space where kids are around because those are young, impressionable minds still developing their perception of society. So for me, the fact that, you know, we still have this rising obesity epidemic in children in

particular is a really sad indictment on on the fact that we haven't been able to step up so far and and really take meaningful action but there is a lot that we can all do so the first is about realizing you know accepting that we do have a big challenge the second is agreeing we need to do something about it and then the third is actually doing something. And I think that there are things that we can do on all different levels. There are definitely things that individuals can do and kids can do with their parents at home. You've talked a lot about this, but I think the places we can start are thinking about making sure every kid has a nutritious, healthy breakfast, making sure that the snacks that they're eating across the day

are as healthy as possible, swapping out drinks that are loaded with sugar that deliver no other nutritional value or no nutritional value to their diets for water, making sure that safe drinking water is available in environments where kids are around. Then I think the second layer is what do we do in schools and as local communities? One of the projects that we're working on in Australia is around providing every child should have a nutritious breakfast and every child should have a nutritious lunch, regardless of how wealthy they are or how wealthy their parents are. That's what I believe. And if we need to create a program that will deliver a really healthy, nutritious lunch to our kids, there are so many reasons why that makes sense

as a society, not only because it's good for the kids, not only because we know that by influencing and changing their behaviors will probably improve the health of their parents and their families because they, you know, have a big influence on their parents. I know as someone who has two young nieces who nag me about all sorts of things, but also because it's a great investment for society. You know, not only because if we can't give kids a healthy start to life, they will probably never achieve full health across their life course. But also because it's a great economic investment. We're all struggling to balance budgets in countries around the world. A great way of improving productivity, a great way

of saving money from the health budget is to give our kids the best food we possibly can, and it's not that costly. So for a whole bunch of reasons, it makes sense to be using our schools, empowering, working with our teachers to deliver fresh, healthy, nutritious food, particularly breakfasts and lunches, not having junk food in those environments, not having sugary drinks in those environments. And then the last layer is as a government. And classically here in the UK, the work of Jamie Oliver is really a great example for the world, making progress on banning advertising of unhealthy foods to kids. It's saying, you know what, we've had enough of companies putting profit before people, before kids' interests, and that's not something that we're okay with advertising food, alcohol

in environments where kids are around or even using cartoons directly to target kids with sugary cereals that are 50% sugar. That just doesn't make sense. Pricing that's fair, making sure that we use policies around pricing, how can we make healthier food more affordable and unhealthy food maybe slightly you know less affordable yeah um parents in fact most people in society are really confused about like what is healthy and what isn't healthy i don't believe for a second that the obesity epidemic is you know the result of poor choices i think it's a result of a lack of choice and i think it's the result of a system that is fundamentally broken, one where disease has become much easier than health to achieve. And part of the answer is actually making it much clearer for people

on what is and is not healthy. And that comes back to labelling laws and making sure that, you know, that comes back to having great advice from people we can trust, you know, from professionals who actually know what they're talking about, but also having clear markers on the front of packaging so that when that parent is there trying to make a choice in 30 seconds of what they're going to feed their kid that night, having just left the office on the way home, 15 things to do, and they stop by the supermarket, they can make a really clear, obvious and informed choice based on evidence of what they should or shouldn't be eating by a simple label on the front that gives them the confidence to be able

and the knowledge to be able to eat well. So it it's complex but it's about all of these things yeah i think it is super complex but one of the words i hate using is complex because i think that's always used as a cop-out it's an excuse not to do anything yeah um and i think it's difficult to bring about change at a high up level but everyone can do something absolutely um i'm a big believer in you know we can't do everything individually but we can all do something. I'm a big believer in, you know, we can't do everything individually, but we can all do something. And then collectively that will make a change. And just talking about it, like you said, and getting people thinking about it a bit more.

But I do believe that labeling is a tricky area because we do have the traffic like labeling here, but we also, in tandem to that, we have like labels like healthy and whole grain even on breakfast cereals that are very high in sugar hugely misleading confusion yeah yeah so i think there needs to be a lot of regulation brought in there and i do think education is important what i'd love to see is that there's more done within schools not just providing food that is yeah absolutely key absolutely but helping children understand education again you

know without forcing anything it's just bringing people back you know you see gardens popping up in schools now and i think that's such a nice movement and where there's a hospital in london that does it as well um and gp practices where they invite their patients along to help grow things within the garden and you, you know, that's benefiting people on a social level, but also putting them back in touch with food and helping them. Reconnecting with food, the food supply, where it comes from, seasons, you know, they sound again like romantic ideas, but actually they're really sort of the basic necessities in life, the basic skills that we need to be investing in our kids. And I completely agree.

I mean, we teach our kids maths, we teach our kids English, we probably teach them even a second language. Why don't we teach them about food? You know, they're going to have to do that unless kids leave school, knowing what food is, where it comes from and how to cook it. That's just as important in my view as arithmetic and grammar. I mean, they're all super important skills to be able to set young kids up for a healthy, prosperous and meaningful life. And not just within childhood education, but now nutrition at medical school is very, very topical here in the UK. And I don't know about you, but I didn't get very much education in nutrition when I was studying. How important do you think that it is that our future doctors

are trained in nutrition? And are you seeing any progress in Australia? Yeah, I think this is super important. And this is an area that I'm very passionate about. I also didn't get a lot of teaching on nutrition. And I think, you know, to many of us in medicine, to many doctors, the answer is to outsource the biggest risk factor for disease in our population, poor diet. That doesn't kind of make sense to me. And that's not to say that we want to replace dieticians and nutritionists. They are hugely important allies and we need to work much more closely and understand how we can work more closely between doctors and our patients, but also because it's such a fundamental part to so many health challenges that our patients are facing and because our patients are demanding it. So whether it's because we see the need or whether it's because our patients are very

soon going to be saying, hang on a second, what do you know about fiber? Or tell me about the different types of protein or how much iron should I be eating or what kind of meat should I be eating? These kinds of questions make a lot of doctors uncomfortable and we very quickly turn to someone else. But in doing that, we kind of, as I say, we outsource the biggest risk factor for disease in our populations to someone else. And if we're lucky, that person is a highly qualified professional nutritionist or dietician. But if we're unlucky, it ends up being someone who actually has no idea what they're talking about. Yeah, doctor internet. Yeah. And they've sort of taken a 15-minute course in something. That is also something that really frightens me because, you know, if not us, who? And if not now, when? That's the question I ask when, you know, people

say that doctors don't need to be upskilling in nutrition because if it's not doctors, who will patients turn to? And if it's not now when patients want it, then when are we going to do it? So, we're working very closely with a number of organizations in Australia, actually, through the work that I do with the ABC, which is, for those who don't know, the BBC of Australia, like the little brother of the BBC in Australia, the ABC. So, through the work that I do with ABC and also my book, I donate all of those funds to a small foundation in Australia focused on improving nutrition of particularly kids. And one of the projects that we're working on, and we've just finished a report for one of the health agencies in Australia recommending and offering to work with them on

improving the nutrition education of doctors. And so we're working with the Council of Medical Schools and some of the largest medical journals in Australia to really push this agenda forward. And I spoke on this just a few weeks ago in Australia, in Brisbane, to a group of junior doctors, and I can say the tide is turning. They're excited. They're excited. Yeah. They want to know about food and nutrition. They understand. They're totally on board. And I think it will be our generation that kind of brings that change that patients need and that patients deserve. You know, I'm all about the best medicine we can possibly provide

and keeping people healthy, not treating them once they become sick. And so if that's what we're all about, then upskilling in nutrition and learning about what makes up a healthy diet is surely the first step. Yeah, I completely agree. But I do see things changing. I know a lot of people listening are medical students and they are so keen to learn more and get involved. And I think even already qualified doctors who I work with on a daily basis are frustrated because they can't fully help their patients or they don't feel like they can and they don't feel like it's their place

and which is really understandable because if you don't have the right advice to provide then what do you do and we don't always have access to a dietitian or a nutritionist in an ideal world we all would every doctor would so i think it's fundamental that every medical student and doctor coming through now has at least a basic understanding of nutrition so that they can advise when it comes to just offering advice and again when it comes to even specific diets like veganism which is definitely on the rise and i know gps who are struggling to manage their patients from a dietary point of view because they don't know what to advise.

Yeah. And then they're going on, you know, the internet and having to, like, do further research. But if we could just give everyone the same level, we would be on a much better playing field and we'll be better able to tackle all of these conditions, I think. Yeah, completely agree. So, wow, we've covered so much. I wish that we could sit and chat all the time. But

before you do go, I like to ask every podcast guest, there are three top healthy hacks. So I'd love to hear yours. Yeah. First of all, understand what food systems are and what food environments are. We've talked a lot about this today, but get smart on food systems and environments. So understanding where our food comes from and the impact that the way that we grow, harvest, process, you know, transport, cook, consume and waste food has on our own health and the health of the planet. And then the influence that the environment around us, the food environment, the advertising, the access, the affordability, the acceptability of different foods has on our health and the health of our planet is really important as well. And if you just jump on Wiki or I know

you've just said, don't Google everything, but I think understanding, having a look at a few articles on food systems and food environments is a great way of understanding the richness and kind of everything that actually goes into or that influences what we do and don't eat. It's fascinating. The second is then very tangible, the last two are very tangible things, and this relates to the way I cook and eat. The first is to just, what I say, start with veg. So we often talk about, you know, should I be vegetarian? Should I be eating meat? Should I eat processed foods?

Everything else. I think the most important thing in Australia, 95% of Australians don't eat enough vegetables. The most important thing most of us can do, whether's for our gut whether it's for our waistline whether it's for the multivitamins we wonder if we should be taking the most important thing we can do is increase the amount of fruit and vegetables particularly vegetables on our plate and let those change with the season find the ones you love don't necessarily have to love them all but try and at least fill half your plate with vegetables. And what this will do is it will naturally put the range of micronutrients you need. It will naturally put the fiber and the

plant-based proteins that you need. And it will naturally displace, because if half the plate is full of vegetables, it means that half is not full of processed foods or meat or other things that we probably need to be eating less of. So rather than trying to remember 10 rules, just try and pack in as much veg that you actually like and is seasonal as possible. When it comes to seasonal, I like to also say, don't try and remember what's in season every month. Just go to the supermarket, whatever's fresh, whatever looks fresh, whatever is cheap and whatever is abundant, that's likely what's in season. And then the last is to cook and eat with others. And again, I come from an Italian

family, so it's easy to think, oh, you know, romantic Italian, Australian. With your pasta. Yeah, with my pasta and the long table and the passata in the summer. And that's true. We did all of that. But actually, again, cooking and eating with others, if you think about all of these rules that we try and remember, if you can cook and eat with others, not only will it be a lot more fun and a lot more enjoyable, but there's interesting research that shows that if you put down your phone and you actually focus on your food and engage with those around you, you're more likely to eat more slowly, you're more likely to eat less, and you're more likely to

waste less. And for most of us, some of the big challenges we have with food is actually portion size and also knowing when we're full and wasting a lot of food. So again, when it comes to generally understand a little bit more about the food system and the food environments, when it comes to our plate, try and start with vegetables and build out from there and cook and eat with others. If you can stick to those latter two, you'll kind of hit most of the goals when it comes to diet and food naturally without even thinking about it. And it will be a lot of fun along the way. I think they're both, like you

said, really tangible. And I think on that final one, if you don't live with anyone, challenge yourself for even a week to eat your meal without any distractions. That's phone, that's TV, that's laptop, that's anything. Because it's a lot more difficult than you think because we're not used to doing it anymore. But you will have a greater experience and you will probably feel more satisfied as a result. So that's my challenge moving forward. So finally, thank you so much for joining me today.

You're so welcome. It's been a pleasure. Can you please let everyone know where to find you? And can we get your book? Yes. We can? You can. pleasure can you please let everyone know where to find you and can we get your book yes in the uk we can you can uh so i'm at sandro de mayo on twitter and instagram feel free to get in touch the doctor's diet is doctorsdiet.com.au but there is a link so you can buy it anywhere in the around the world and and hopefully someday it will be available uh here in the uk as well yeah it's

really great i had a good look through it when you gave it to me. Okay, guys, so that wraps up this episode and the end of this series. I feel a little sad to say goodbye, but I don't think it will be for very long. In the meantime, make sure you do keep up to date over on The Food Medic on my social media and website. And I hope to see you very soon. Thank you so much for tuning in to the Food Medic podcast. Please do subscribe so that you are the first to hear about any new episodes. And if you are enjoying them, please leave us a five-star rating and a review

so that we can reach as many people as possible. Check out my website, thefoodmedic.co.uk, where you can find tons of recipes and articles. Follow me on social media, Instagram, Twitter, and Facebook at The Food Medic. And my new book, The Food Medic for Life, is out now, which is packed full of loads of recipes, nutritional advice, myth-busting, and feature pages on topics such as sleep and mindfulness. You can grab both my books on Amazon or in any good bookstore. Thanks for listening and I'll see you next time. Thank you.