The Rich Roll Podcast - Gemma Newman, MD Is The Plant Power Doctor

Episode Date: June 20, 2019

Recorded live during our recent Plantpower Italia retreat in Tuscany, I'm delighted to share a fun and highly informative conversation and audience Q&A with the delightful, whip-smart “Plant Power Doctor” herself. Gemma Newman, MD has worked in medicine for 15 years, the last decade serving as Senior Partner at a family medical practice in the U.K.. She studied at the University of Wales College of Medicine and has worked in many specialities as a doctor including elderly care, endocrinology, pediatrics, obstetrics and gynecology, psychiatry, general surgery, urology, vascular surgery, rehabilitation medicine and General Practice. In recent years she has developed a specialist interest in plant-based nutrition and lifestyle medicine, serving as a Jikiden Reiki practitioner and advisory board member of Plant Based Health Professionals UK. On the daily, she provides evidence based nutrition, mental and physical health modalities, energetic healing and lifestyle advice to her patients, who have gained tremendous results using the power of their plate. As a broadcaster and writer she has been featured on numerous national press outlets including ITV, Channel 4, Channel 5 and Sky News Sunrise. She is a regular contributor Glamour, Zest and Health magazines and has appeared in the feature film Vegan 2018. Gemma's journey to plant-based advocacy isn't rooted in ideology or moral compunction, but rather on hard science matched with self-experimentation. As a young doctor in a high-pressure environment, like many newly minted physicians she began neglecting her own health. Struggling with her weight, and having bought into the background hum of ‘cut the carbs', she adopted a low carb diet. Calorie counting ensued, combined with a modest daily exercise routine. It worked. Sort of. Dropping from a size 18 to a size 8, she was feeling pretty good about herself. Then she checked her blood profile to discover an elevated lipid profile, markers suggesting a tendency to heart disease. She shrugged off to genetics. Both her father and grandfather died relatively young of atherosclerosis. It's just something I was born with. Something I just have to live with. Nonetheless, she couldn't shake the feeling that perhaps there was something she could do to alter this seemingly immutable fate. Meanwhile, Gemma's husband Richard picked up a little book called Finding Ultra while training for the London Marathon. He decided to give this plant-based diet thing a whirl. Being the skeptical doctor she is, Gemma was less than enthusiastic. Where would he get his protein? Won’t there be nutritional deficiencies? We will never be invited to friend’s houses for dinner ever again! How would I feed my family?  Undeterred, Richard completed that marathon, slicing an incredible one hour and ten minutes off his personal best. This got Gemma's attention. She had already been passionate about researching lifestyle medicine. How changes in stress, sleep, exercise and diet could improve health for a long time. But nothing was to prepare her for the powerful transformations that were possible when people embraced a whole-food plant-based diet. Hence ensued a deep dive into medical literature, scientific research, and self-experimentation. Today we explore the result of Gemma's journey. How it transformed her life and medical practice wholesale. Peace + Plants, Rich

My take on it is I like to put out positive energy and I like to be able to maintain a compassionate approach to this because people try these diets because they want results and they feel frustrated with what they've currently got. I remember myself, I did low carb for a while thinking it was best for me and I got results and I looked good and so I thought well of course this is the way forward. So I can completely understand where people are coming from with regard to this. And the same with keto. People go on keto diets to get results or to feel better. And I'm not going to be in a position where I deny people's personal experience,

but I am going to be in a position where I share information, both on long-term health and short-term health outcomes, so that they can then hopefully come to a decision based on rationality over what someone told them once on the internet. That's Dr. Gemma Newman, and this is The Rich Roll Podcast. The Rich Roll Podcast. Hey, everybody. How you guys doing? What's happening? My name is Rich Roll. I am your host. This is my podcast. Welcome or welcome back.

Today, we have a fun conversation, an informative, immersive conversation, a participatory conversation that we recorded during our recent retreat in Italy. It's with the lovely, the delightful, the whip-smart, UK-based, plant-powered doctor herself, Dr. Gemma Newman. What's interesting about Gemma is that she isn't an ideologue. She didn't arrive upon her conclusions around plant-based eating by way of some kind of moral or ethical compunction, but rather by hard science and self-experimentation. As a young doctor, a recent med school graduate, she, like many newly minted physicians, had been neglecting her own health for some time. She was struggling with her weight and thus went on this journey.

She tries a low-carb diet, having bought into the background hum of cut the carbs and all sugar is bad. She'd also read some research around intermittent fasting. She begins calorie counting and carb restriction. She does an hour of exercise every single day and it worked. I mean, sort of. She found herself going from a size 18 to a size 8, lost a bunch of weight and feeling, I guess, a little bit smug. She then goes and checks her blood profile and discovers that her lipid panel was significantly raised. And she knew, being a doctor, that having a raised cholesterol and LDL were both markers suggesting a tendency to heart disease. And this is something that runs in her family. Both her

father and her grandfather died relatively young of arthrosclerosis, but she just sort of chalked it up to being a genetic marker. In the wake of all of this, Gemma is offered a book deal to tell her story, to kind of share her weight loss secrets, but something just didn't feel right to her. She couldn't do it. She didn't feel like she was a nutrition expert. And even though she looked healthy on the outside, this lipid profile issue was really kind of nagging at her in the back of her mind. And she wanted to be able to share an opinion based on research as well as her personal experience. So she turns down the book deal. The story with Gemma continues. And I'm going to tell you a little bit more about her and all that in a minute.

But first. We're brought to you today by recovery.com. I've been in recovery for a long time. It's not hyperbolic to say that I owe everything good in my life to sobriety, and it all began with treatment and experience that I had that quite literally saved my life. And in the many years since, I've in turn helped many suffering addicts and their loved ones find treatment. And with that, I know all too well just how confusing and how overwhelming and how challenging it can be to find the right place and the right level of care, especially because unfortunately, not all treatment resources adhere to ethical practices. It's a real problem,

a problem I'm now happy and proud to share has been solved by the people at recovery.com who created an online support portal designed to guide, to support, and empower you to find the ideal level of care tailored to your personal needs. They've partnered with the best global behavioral health providers Thank you. Navigating their site is simple. Search by insurance coverage, location, treatment type, you name it. Plus, you can read reviews from former patients to help you decide. Whether you're a busy exec, a parent of a struggling teen, or battling addiction yourself,

I feel you. I empathize with you. I really do. And they have treatment options for you. Life in recovery is wonderful and recovery.com is your partner in starting that journey. When you or a loved one need help, go to recovery.com and take the first step towards recovery.

To find the best treatment option for you or a loved one, again, go to recovery.com. Okay, so here we have Gemma. She's struggling with this conundrum, slimming down, low-carb style, yet facing unfortunate lipid panels and kind of struggling, grappling with what to do. And around the same time, her husband, Richard, who's a great guy, by the way, picked up a little book called Finding Ultra while training for the London Marathon and decided that he was going to give this whole plant-based diet a try. And now Gemma, on the other hand, being the skeptical doctor that she is coming out of a very traditional educational background, was, let's just say, not exactly happy about this. She was a little irritated, maybe perhaps a little shocked. Where is he going to get his protein? Won't there be

nutritional deficiencies? Will never be invited to a friend's house for dinner ever again? How will I feed my family? These were her fears, not necessarily in that order. But her husband was undeterred. And this guy, Richard, ends up running his next marathon an incredible one hour and 10 minutes faster than his previous time. Now, this got Gemma's attention. She'd already been passionate about researching lifestyle medicine and how changes in things like stress and sleep, exercise, diet could improve health for a long time, but nothing really prepared her for the powerful transformations that were possible when people embraced the whole food plant-based diet. So she starts looking into it more deeply. She starts experimenting on herself

and the results of which we're going to explore today. Again, this is a live recording, and it also includes a really great Q&A with the amazing guests that joined us this year for our retreat in Italy. Really special bunch of people. I thoroughly enjoyed this conversation with Gemma, her second retreat with us, along with her husband, Richard. So let's talk to her. This is me and Dr. Gemma Newman, MD. So last year on this day, we had the happy pair guys here and it was similar. They did a demo and then they came in here to do a podcast and we were sitting on this couch and they were literally like sitting in each other's laps like I was like could you guys be more conjoined as a singular human um but it worked it always does with them so over the last couple days we have uh explored many themes and topics. We have probed our minds. We've done yoga. We've been trail running,

meditation. We traveled to portals unknown beyond Westeros through holotropic breathing and everything in between. And as you might gather, today is more of a food, diet, and nutrition themed sort of experience. We had our food demo with the lads and I thought this would make for an appropriate moment to have Gemma come on, not just the podcast, but to share with all of you guys here today a little bit about her experience with diet and nutrition from a medical point of view, from a medical perspective. So we're going to talk about all things plant-based. Are you up for it?

I am well and truly ready. Yeah, good. I cannot wait. Well, first of all, what is the kind of landscape or temperature currently in the UK in terms of the plant-based lifestyle and how people are perceiving it and practicing it? I think it's really mixed.

And there are some areas of medicine that are kind of really switched on. For example, we've got the Plant-Based Health Professionals UK. And I'm an advisory board member for them. And they're really helping to promote a plant-based lifestyle for health longevity and you know planetary health as well and then you've got the other sort of contingent where you've got the whole diet wars thing going on you know you've got the low carbers and you've got the paleos and you've got the ketos so my aim in cutting through

all that is to just think what do people actually really need to know? And what they really need to know at this point is that we're eating more than 50% ultra-processed foods. The National Diet and Nutrition Survey in the UK tells us that there's only 8% fruit and vegetable intake in the UK. That's what we are eating. And so when you look at those basic facts, you think, what's the point in arguing amongst ourselves? We need to get people to understand that whole foods, fruits, vegetables, whole grains, beans, lentils, chickpeas, oats, all those kinds of foods, herbs and spices,

that is the cornerstone of health. And nobody else can argue over the other bits and pieces, but it's a bit like David Katz at the True Health Initiative. He really tried to get all the nutrition experts, dieticians really focused on what do people actually need to know. And that's what I always try and focus on. And where is the consensus amongst professionals across a variety of disciplines and specialties? The consensus on the whole is fruit and veg are good. That's what we can all agree on. Unless you're coming from the carnivore perspective, I suppose. Yeah. Yeah. If you're a carnivore, then no, obviously. But that's a whole new level

of crazy. Yeah. Well, that 8% statistic, do you know if that's higher or lower in the United States? I don't know, but I would imagine it's similar. Probably slightly lower even, because it does seem to be that there's a bigger preponderance of ultra-processed foods here. And many people don't even know what ultra-processed means you know when i say the word ultra-processed then they'll think what does that mean it's basically yeah define it yeah so when you go into a store you have a look and see okay where are the packaged cakes where are the packaged breads um all the ready meals that aren't made with whole fresh ingredients that's essentially what an ultra-processed food is.

You know, you get these little cupcakes and cookies and crisps and chips and those kinds of foods, that's all ultra-processed. And some people, that's all they live on. In the United States, a big kind of driving contributor to that is socioeconomic. There's a lot of people who are living in food deserts. They're on food stamps, their access to fresh produce is limited, and there's a cost barrier in many cases. And this is kind of further driving that divide and making the people who are most in need of health the

least healthy. Is it similar in the UK? Yes, it's similar, but it's not quite so bad in that respect. We have a benefit system and we have various supermarkets that are within reach for all people. Having said that, there are still financial constraints for a lot of people. And I spoke with a dietician recently. She was heading up the Blue Dot campaign, which is in the UK. And it's basically helping people to understand about planetary health and making sure that they're making choices for their physical health and the health of future generations. And people who are on the breadline, they don't necessarily want to hear about that. But actually, this dietician I spoke with who's working with people who've just got out of prison, working with people who are very low socioeconomic status, helping them to understand that actually a diet centered around

fruits, vegetables, whole grains and beans can be incredibly, incredibly cheap if you know where to look and if you know how to cook. And that's the other barrier is actually knowing how to cook in the first place. So that's what she's working on and she's doing some really good work there. So your practice is, you're a general practitioner, essentially, correct? But you have all these like subspecial sub specialties i mean you've had experience in a wide variety of disciplines in your medical career yeah i have um and i chose to specialize in generalism because i realized that that was probably the most effective way of getting people from cradle to grave gradually slowly getting to know them making those bit by bit changes because the system in the uk is quite different although they're still the same pressures we've only got 10 minute appointment slots so you have to be fairly fairly disciplined in how you spend that time they come in they've got

their own expectations of what they're going to get from you you've got your expectations of what you think they need and then you've got to marry that with what they think they need and what they actually need, in your opinion, and then you try and bring it all together in 10 minutes and come up with something that will be useful to them. But I like to think of it as a little bit like saving lives in slow motion, because you have the time over several consultations, when you know families and you know lots of different people in that family and friend group, to gradually chip away and to give them a few ideas here and there. And it's a really rewarding job. I wouldn't have chosen any other specialty because it's the only one that I've found where, you know, you can really get to know people. And where did the

diet and lifestyle component of your practice begin to you know enter into the equation for you well you know like most enthusiastic young medics i wanted to help people you know that's why most go into medicine and so lifestyle was always pretty important to me but as a young as a young graduate i didn't look after myself So I just ate what I was used to eating and I didn't really think much about it because I wasn't ill myself. So I mean, you weren't like exercising and eating super healthy while you were, you know, handling some crazy medical school curriculum, working till like four in the morning and on these 72 hour shifts where they don't let you sleep.

No, yeah, you're right. I wasn't doing that. So I ended up getting obese. I had a high blood pressure. I had high cholesterol. And I felt a bit hypocritical because I knew that I was going to be in a position where I'd have to help people make some drastic life changes. And I wasn't doing that myself. So my first foray into the world of lifestyle medicine was thinking, okay, well, I need need to lose weight I need to get fit I need to get healthy so I just turned to popular culture as most doctors do unfortunately in terms of nutrition at least and I went on a low-carb diet and I started calorie counting and I started exercising for an hour a day and I got fairly rigorous with it and I gone I went from a size 18 to a size 8 which I think in the US is 14 to a 4, something like that. Anyway, I worked very hard.

I was really kind of smug then. I thought, oh, you know, this is easy. But then, you know, I decided in my smugness to check my blood profiles and I had a raised cholesterol and lipid profile still. And I kind of had to eat a bit of humble pie because I thought, okay, maybe this is just my genetic heritage. Maybe this is never going to change for me because my grandfather had already died of heart disease. And I didn't know it back then, but my father was also going to die suddenly of heart disease in his late 50s, not overweight.

So anyway, I kind of forgot about it and just thought, oh, well, just going to have to live and do what i do until my husband ran the london marathon and for him um he wanted to do something good he wanted a good time but he was getting injuries all the time he kept on getting inflamed feet and ankles and hips and had to stop training and he was quite disappointed with himself he thought okay next year i'm going to do better and so he started looking for inspiration and he was quite disappointed with himself. He thought, okay, next year I'm going to do better. And so he started looking for inspiration, and he looked at your book, Finding Ultra. Sorry about that. And he also read Brendan Brazier's work, you know, the guy that made Wolverine,

like really, really buff. And I think Scott Jurek. Anyway, he said to me, Gemma, I'm going to go plant-based. I was like, what's that? What do you mean? And you're the doctor, right? Like, let's just take a step back for a moment. So I gather that there was no nutritional instruction of any substance in your medical

school experience. Is that true? We had physiology and then we had pathophysiology of disease mostly and communication skills and consultation skills and various specialties and anatomy and pharmacology so we had a good foundation but in terms of wellness in terms of prevention no not a great deal at that point so yeah i thought what does that mean to be plant-based so you know i'm gonna i'm gonna go healthy vegan i was like oh my god we're never going to be invited to someone's house for dinner again, ever. And I was kind of quite negative about the whole thing.

And how long ago was this? Probably about three years or so ago, maybe. Maybe a bit more. Anyway, so he did what he was going to do. And he ran the next marathon. And he didn't have to stop training. And he was just going from strength to strength, as you can probably imagine. And he ran the marathon an hour and 10 minutes faster than the previous attempt that he had done.

An hour and 10 minutes. It was a fluke. Oh, my God. Complete fluke. It made no difference whatsoever. So, you know, he piqued my interest and i began to read and then i read more and then i read more and then i realized that when i read more there was even more to read and i kept on researching i read first of all starting off with books but then research papers more research papers and then i began to feel a little bit silly

to be honest with you i just thought, my first thought was, why had nobody told me that all this evidence existed? Yeah, it's interesting that in your own kind of exploration of diet through popular culture in order to get yourself sorted out so that you could be the person you wanted to present to your patients, that you didn't come across this or that this came as some sort of shock. It was a huge shock to me. This is strange, isn't it?

So I felt stupid a little bit. But then I felt like I had a mission. I thought this must spread. Because if someone like myself who's had years of training didn't know this, then how is anyone else expected to know this? So it became a passion from that point. But I sneakily decided to start eating plant-based without telling anybody because I didn't want to lose face, you know, think if I could fail, not do it right. And, um, after four weeks,

I know, so naughty. And after four weeks of my secret plant-based diet, I tested my blood and, um, you know, over 10 years later, two kids later, exercising less than half the amount, I managed to completely normal lipid profiles. And I thought, oh, okay, there's something in this. Um, I already knew that there was, cause I'd done a lot of research on it, but it took that final personal experience to kind of kick me into action. And then can I, sorry, can I interrupt you to ask one question? Just from you being a scientist, you have your husband's anecdotal experience and you have these, you know, and he's reading these books by these other athletes, but you're coming from this from a different perspective. So I would imagine you're thinking to yourself, like, that's all fine, but like, show me the truth here. So when you did go about looking into the research or trying to find other resources

that would kind of meet your litmus test of proof, like what was it that you looked to or what was it that kind of tipped you over to the other side? It was a combination of mechanistic data and epidemiology, really. I wanted to be able to see, does this play out on a population level? And is there a plausible mechanism by which this could be useful? And once I've been able to tally those two together, then it kind of helped me to figure out, okay, there is something in this. Because, you know, any personal experience is going to be useful, but we will have our own cognitive bias.

And that's the same for research too. That's something that we have to be mindful of. But at least if you're trying to employ the scientific method, you have a possible plausible mechanism and then you see does this play out on a population level? Could this play out? And then when it does, again, it kind of really corroborates that point of view.

I interrupted you though. Where were you? Yeah, where was my flow? I don't know. What was I saying? No, you were talking about just making your blood lip i saying no you were talking about oh that's right yeah making these your your blood lipids normalize yes that's right so i was i was jolly very happy at that point and then i had the confidence then to sort of mention it to my family and we had diverticulosis clearing up arthritis

clearing up recurrent dental abscesses you know sorting themselves out i thought okay this is this is actually pretty powerful and then of course when I spoke to my patients that's when the magic really happened and I began to understand that the power of it really um and what's interesting is I've been talking to them about lifestyle for a long time and I knew instinctively from my own practice that there was much more to health and wellness than what you put in your mouth. But never had I seen such an easy sort of inroad so that people could actually make those changes gradually in their own health. And it was incredible to me to see the difference in people. Do you remember like the first patient that you, because I'm thinking like, okay, like this is working, but like now I'm going to

see if you know I can prescribe this but thinking well I don't know should I do this should I not do like what was that distinctly distinctly remember the first patient I tried this on so the patient walked into my room and uh he's a South African man and uh was an alpha male type, you know. Maybe not my first experiment, you know, ideally, but it was quite funny because he walked in and he sat down and he looked completely distraught. And he never looks like that normally. And so he turned to me and he said, I've been sent home from work and I've been told not to come back. And I thought, what if I let myself in for here today? Because, you know, in UK medicine, you really have no idea what you're going to be getting.

When the patient comes in, it's literally, it could be anything. And people kind of open up to you about crazy stuff, you know. Anyway, I didn't know what he was going to say. I said, why? What's happened? What's happened? He said, well, I failed my work medical. I had a spot test medical and they did my blood pressure

and it was 180 over 100 millimeters of mercury, which is very high. Normal optimal would be about 120 over 80 millimeters of mercury. And they took my license away. They informed the DVLA, which is the regulatory body in the UK. And they said, no, you can't come back to work unless you get this sorted out. So here I am. And he just looked at me. I was like, what are we going to do? And how old was he? Um, 50, 56, I think he was.

And, uh, I said, well, normally someone with the blood pressure that high, we're going to need to try at least three different agents to kind of get it under control not one not two probably three and he said there's no way i'm doing that i said what do you mean he said well i've never i've never taken tablets i don't like tablets i said well we've got to do something if you want to go back to work he says i'll do anything and i said anything he said yeah anything i said okay right okay well how about we do a really strict whole food plant-based diet and you stop eating your meat your eggs your cheese and you start eating fruits vegetables whole grains beans lentils chickpeas and oats and herbs and spices and he looked at me his jaw dropped and he's like hmm well maybe i should take that pill i said well it's up to you i said everything but i didn't mean everything

no but he was he was actually really curious because he'd not heard about it either. And he was also desperate because he really loved his job. So he said, okay, doc, I'm going to give this plant thing a try. I was like, okay, fabulous, great. And I gave him some resources and off he went. And I was really wondering what happened to him. So 10 days later, he came back.

And he had this big grin on his face. He sat down. I said, all right, so what's happened? He said, I bought a blood pressure machine. I've been checking it at home. I thought you might like to see my readings. I would love to see your readings. And he got them out.

And after the first few days, they were all completely normal. 120 over 80 millimeters of mercury. And I checked it again. It was normal. I brought him back the next week, checked it another time. It was normal. Brought him back the following week i checked it again it was normal i brought him back the next week checked it another time it was normal brought him back the following week checked it a third time and did his medical and then he went back to work and that was actually the first time that i'd

had the the confidence to think could this be an answer because i'd done the research around heart disease and you know all the benefits for reversing coronary atherosclerosis i knew about the lifestyle heart trial from the 90s i knew knew about Dr. Colwell Esselstyn's work and his incredible results with people with end-stage heart disease. The Mount Abu heart trial from 2011, I'd done, you know, I'd seen that it could work, but to actually see it in practice in real life was just another level. And it was really fulfilling. It was, that was my first, my first foray. how's that dude doing now he's doing fantastically and he's still at work and he still loves his job and he's

yeah he's managed to stick with it and this is the interesting thing what i've noticed in my practice is that when people get results they become the best advocates for that way of eating and they want to share it with their family and friends and they can't stop talking about it. And that was the case for him. He was really enthusiastic after that. Well, there's nothing like desperation to fuel willingness. Exactly. That's why it creates the foundation for like real change. Yeah.

But I would imagine that that level of panic and desperation isn't the norm and the patience that you seek. So what do you do when someone comes to you and they're kind of mildly in trouble, but they don't have that like I'll do anything look on their face? Yeah, that's more of a slow burn. So I'll plant a seed and I'll see if it grows. So what's good about general practice is that you have the opportunity to see them again and I had this experience of one of my other patients actually um she was in her 40s and she was she was actually quite desperate in the end but the first time I saw her she was kind of saying

oh I'm having issues with my periods and it's not really getting better so we talked about some of the normal things that we would try and do for that um but then when she came back to me after another couple of consults she said i am desperate so i'd already mentioned the idea of a plant-based diet and how it might be able to help her with her hormonal regulation yeah and um i'd already told her about the benefits of turmeric and how two studies i'd read showed that it could be as effective as an anti-inflammatory painkiller for period pains. I'd already mentioned about how a portion of soy a day

could dramatically improve flushes, hormonal flushes. I'd already told her about how estrogen could be avoided, estrogen recirculation could be avoided if you have a high-fiber diet. Estrogen. Estrogen. Estrogen. And I'd already... So I'd already given her a lot of information about, and also mood, how I could boost her mood.

But she only tried it when she got desperate. And she said, look, two weeks out of every four is hell for me. So I'm willing to try it. So you allowed her that space without judgment. There's a very similar thing in recovery community, circles around that kind of thing. It's like someone who clearly needs help and you know exactly how to help that person,

but they don't have that willingness. And you're like, okay, well, maybe you need to go out and do a little more research. But here I am, you can call me when you're ready. It might be six months. It might be a week. It might be a year. But that phone generally rings at some point

because they have to discover it for themselves because willingness is a self-generated thing, right? You can't compel somebody to have that desire to make that change. Completely. And it has to come from within. And that's the case with everybody that I see, you know, they're all on their own journey and they're all deciding what part of that journey they're on. And so it could just be a quick conversation. It could be, so what did you have for breakfast this

morning? Or it could be, okay, so, you know, have you taken up that hobby you mentioned to me last time? Just little pushes here and there that will help someone towards their intention, towards making a difference that will then make more differences and then create that snowball effect to health. So it's a slow process sometimes. Other times it's like that. If they're ready for a change at the first consult, I have one chap who was completely ready the first time I met him,

and that's probably one of the most profound transformations I've seen actually so so you have you have these uh experiences you know personally and Richard your husband and that and then you're starting to see this with your patients um so obviously you're becoming more invested in this as a viable solution long term how is this being received by your peers like you're part of a practice group right like you work with other doctors or you're part of this you know larger community medical community is there was there like a what was the response when you started telling people like hey I'm getting great results doing this I'm tremendously fortunate in that I chose a small, friendly practice, and I'm a senior partner there.

So when I chose a partner to join me, I chose somebody who was going to be open and friendly and willing to sort of listen to some of the research that I shared with her. And I've had an overwhelmingly positive response on a personal practice level. In the wider community, there's obviously going to be mixed responses, but being a member of the British Society of Lifestyle Medicine,

they are affiliated with the American College of Lifestyle Medicine. And if you look at the diploma, it's all very much around the idea of a general plant-based nutrition approach so it's not actually something that's necessarily controversial it's just not widely known or accepted so what is i mean you said you mentioned earlier that you never know what you're going to get like when somebody comes in the door you see because you're a general practitioner you're going to see all different kinds of things but i would imagine there's a general kind of theme in the you know the types of

problems let's you know restricting this to kind of chronic lifestyle type ailments that you're having to contend with yeah what does that look like i would say that the root cause of a lot of the chronic disease i see is some sort of stress response um be that physical or mental or spiritual and that can then manifest itself most commonly with things like heart disease and cancer and diabetes um hormonal imbalances and in, you've got the kind of chronic respiratory infections, allergies, constipation. And then in the elderly, we've got rising levels of dementia. But yeah, I'd say probably heart disease number one.

But in terms of why that happens, there's a number of things, but the stress response, I think is something that's, that's very much underrepresented. And, um, when people lack, um, good food, but also lack sometimes a purpose or sense of community or sense of belonging, um, those can really contribute to long-term disease as well. That's what I've noticed in my practice. I mean, I've been in the same place for 11 years and I see it time and again. Yeah. Yeah. Just earlier today, the happy pair guys were saying, look, we have our five pillars

of health and diet and nutrition are just one of those pillars, right? Sleep and community, et cetera. All part of like this holistic equation to be truly well. And we have an epidemic of not just heart disease and diabetes, but mental health disorders that are being driven by workaholism and anxiety and stress and all of that. So when you have that person come in who's dealing with some combination of the aforementioned, in addition to like, Hey, maybe look at these, you know, dietary protocols. What are some of the other guidelines that you kind of set for someone like that? So I, I have a little acronym I like to use and, um, it's gloves, which is, um, you know, so we can either take our gloves, gloves, you know, like gloves on your hands. So you can either take your gloves off and get your hands dirty

or put your gloves on and get to work. But basically, it's a good word to use to help people remember the different things. So G is, I'll go through what they mean, and then I'll tell you in detail so it makes sense. So gloves. You've got G is gratitude. L is love. O is organic produce. V is veggies, vegetables,

E is exercise, and S is sleep. And I will aim to try to approach one of those things as part of one of my consultations, depending on how much time I've got with them. So I mean, in terms of G, the gratitude, someone's walking in and they're clearly not going to feel much gratitude because they're like there's something wrong with me you need to fix me but i try to explain to them look if you're having a sense of gratitude in your life or you're trying to find things to be grateful for it changes your physiology and then that also changes your disease risk and then there was an interesting study done at a conference in Washington last year where they measure people's blood levels of cortisol and IgA. So cortisol is the stress response hormone,

and IgA is one of the immunoglobulins that we need to create an immune response, a beneficial immune response to protect us against infection. And they measured them before the conference, and then during the conference, they got them to do five minutes of gratitude exercises about three times a day, just for two days. Then they measured their blood afterwards, and they saw a significant drop in the cortisol, and they saw a significant rise in the IgA. I tried to explain to them, in terms of physicality, what an attitude of gratitude could do for them in terms of their current disease state. do for them in terms of their current disease state. And L is love. And again, that might sound a little bit cheesy, but it kind of helps me to incorporate self-love, love for others, love for community. Like what drives you? What is your motivation for change? What gives you meaning, purpose and intention in your life? And if they can find that, then that's a really good step

towards creating a life of wellbeing-being and that can be loads of things basically what they're trying to do there is activate their autonomic nervous system and there's loads of ways of doing that you know you could get into journaling you could get into meditation you could get into a hobby you could get into a community outreach project you could just spend five minutes dancing around your kitchen but whatever it is to you find that time find that thing find that thing that one thing that you change that week which would then give you more of a purpose towards moving forwards to well-being so that's the l and then you've got the o organic organic so to me that's

really important and i understand that there are some financial constrictions for a lot of people in that regard and so i start out by telling people why don't you try and get the um the clean 15 organics you know the environmental working groups clean 15 fruits and vegetables at least that's a start and the dirty dozen organic i mean so you've got the the 12 that absorb the most pesticides those would be the organic ones at least for people that are listening just go to ewg.org and you can easily find those yeah and they do a new list each year don't they so um but also it's a good way of making sure that you know you're reducing your pesticide and your antibiotic exposure which is so crucial for gut health which many people are now talking about the benefits of gut health and how important that is for pretty much every chronic disease that

we're suffering right now so for me that's foundational um and uh the v is veggies and that includes fruit as well fruits and vegetables um because again that's a huge cornerstone for health and there's a lot of confusion around fruit and whether we should be eating fruit and the whole kind of low-carb approach to that which i can come on to later but it's a nice reminder for people get as many as you can in there was a study done that showed that, because in the UK, I don't know what it's like in the US, but the guidelines say about five portions a day of fruits and vegetables, which is not nearly enough.

And there was a study done recently which showed that seven or more servings could reduce mortality by around 42%. And then there was a lecturer at Imperial that got together 95 studies, epidemiological studies, and they realized that they didn't seem to be able to find an upper limit of benefit for vegetable and fruit consumption. So nearing 10 portions a day is actually potentially more optimal. So is that the big speech that you, like if somebody comes in and says, look, you know, I'm trying to lose weight or trying to tackle this, whatever,

you know, medical condition that I have. But, you know, I just, I can't eat fruit. Like fruit is like drinking, you know, Coca-Cola or whatever. That's what I've been told. So tell me how to do this without doing that. I mean, is that a common refrain and how do you? Yeah. Well, commonly people say, oh, I can't eat carbs because i'm trying to lose weight and potatoes and fruit are not good for you so that can be a whole new conversation around the causes of insulin resistance and um and you know why that happens so essentially what i try to explain to them is that high blood sugar is the symptom but not the cause of insulin resistance and insulin resistance basically means that the insulin your body's producing is not

being recognized by the cells that need to recognize it so it's kind of floating around the bloodstream and you've got these glucose molecules from the food that you're eating floating around the bloodstream and those glucose molecules need to get inside the cell in order for you to use them for energy but they're stuck because they need that invitation from the insulin receptor to get inside the cell. So if you're suffering from insulin resistance, it doesn't matter how many new insulin keys your pancreas makes for you, the door's not going to unlock because the lock is jammed. And so when you remove the source of the jammy lock,

the lock is jammed. And so when you remove the source of the jammy lock, so if you remove predominantly saturated fat from the diet, from junk food and animal products primarily, then you're going to be reducing that jamming of the lock. And then the sugar can go directly into the cell where it's needed for energy and your insulin sensitivity shoots through the roof. And there's so much research around this now. Researchers are actually able to infuse free fatty acids into people's bloodstream and watch their insulin resistance rising and then remove it from the bloodstream and watch their insulin sensitivity rising. So yeah. Yeah, yeah, yeah, yeah. But Dr. Newman, carbs are bad. Fruit is bad. Yeah. And I read a book that said I shouldn't eat beans anymore. Oh yeah, the beans book. Let's not talk about the beans book.

It's interesting because I think there's only one study where they said that someone had a bad reaction to beans. It's because they were drastically undercooked in a hospital environment. Everyone else can have beans. It's okay. But, yeah, it's a struggle sometimes. But you know what? That's the beauty of the family physician paradigm is you

can just kind of keep plugging away and you can show them research and you can say, okay, how about you read up on this and check out this website and come back to me, let me know what you think. Well, we're in a very interesting and confusing time. I mean, for generation after generation, when you had something that ailed you, you went to the expert, to the doctor, and the doctor told you what to do. And that was like, God, to the doctor, and the doctor told you what to do. And that was like, God, that was not to be questioned, and you were to take that advice. Then something called the internet happened, and suddenly information became readily available, whether it was good information or bad information seemed to be less important.

And now everybody's an expert, and everybody has an opinion. And now everybody's an expert and everybody has an opinion. And this is something that has fueled, you know, in the positive side, the empowerment of people to be more invested in their well-being and to be in a mode of discovery all the time and to sort of, you know, question paradigms, all of which I think are healthy, but at the same time, it's led to these silos and the kind of consolidation of confirmation bias and, you know, kind of tribal signaling and all of this that has led to some toxicity and confusion. And when you're dealing with medicine, lives hang in the balance. So how do you think about and participate in kind of the discussions, either online or in person, that have to do with this kind of diet divide? You know, we call them the diet wars right now that are rampant. Yeah. So my take on it is I like to put out positive energy.

And I like to be able to maintain a compassionate approach to this because people try these diets because they want results and they feel frustrated with what they've currently got. And oftentimes when, you know, I remember myself, I did low carb for a while thinking it was best for me and I got results and I looked good. And so I thought, well, of course, this is the way forward. So I can completely understand where people are coming from with regard to this. And the same with keto. People go on keto diets to get results or to feel better. And I'm not going to be in a position where I deny people's personal experience, but I am going to be in a position where I share information,

both on long-term health and short-term health outcomes so that they can then hopefully come to a decision based on rationality over um over what someone told them once on the internet so the internet i think is fantastic i do honestly when when patients come up to me and said oh i googled this i'm really sorry i know you won't like it or i know i shouldn't i think actually no i'm really glad that you did because it shows me you have an inquisitive mind, you want to learn and we can discuss this and you can hopefully find some answers that are going to suit your long-term health and wellbeing. So I don't get involved with the diet wars, but I do like to disseminate positive information. And I think when people are ready and willing to receive that information, then they'll come and they'll read it and hopefully they will accept it.

What are some of the other experiences that you've had with patients working in this regard? One major patient that sticks in my mind always, he had a serious problem. So he came into me and he was the one that I was talking to you about just now who I'd only seen him that one time. And I know that he'd been in and out to see doctors many times before, but he'd never met me before. And he had prostate cancer. So he'd been seen by the urologist and they'd said to him, look, it's not an aggressive type. It's a slow growing type. So we can offer you surgery or we can kind of watch and wait. We'll see how things go if you want to. And he decided to get his PSA,

his prostate specific antigen checked every so often to make sure it wasn't going sky high because he was worried about the risk of surgery and impotence. Okay. But he also had other problems. He was severely depressed. He'd been depressed for many years. He had chronic shoulder pain and tendonitis. He had low back pain and arthritis. He had high cholesterol. He had high blood pressure. He was on eight different medications, strong opiate painkillers, you name it, he had it. And he was only in his 50s and he was a slim man. Generally, you know, I felt that having seen him for the first time, he'd already been given everything in the traditional medical model paradigm that he could have been given. And, you know, he was in tears

that day. He said, look, I, I just want something to make me feel better. The main problem for him at that point was the pain, his arthritic pain. And I thought to myself, could, could a plant-based approach be the thing that at least helps lead him to changes in his life? Could it work? And I started to explain to him about some of the studies around prostate cancer and some of the studies around arthritis. And he said, what do you mean? Do you think my pain could be improved through diet? And I said, well, yes, I think it's really worth a good go. So he went away. He was like, I'm not sure. I don't think I can do it. What am I going to make? What am I going to cook? So I did spend quite a long time with him that day. Normal 10

minute consults. I spent about 25 minutes, which again, if I had, if I had limitless time, then I would have probably spent a good two, three hours with him talking it all through. But he was at that point of desperation that we were talking about earlier. He really wanted to change. And he knew that he tried for years on traditional lines and hadn't got anywhere so I gave him a lot of detailed written handwritten information and I couldn't help but feel for him because he had so many problems and he came back to me several months later and I'd wondered in the interim what happened to him but you know you've got so many patients, you're seeing 30, 40 people a day. You can't be ringing around people saying,

yeah, I haven't seen you for a while, what's going on? So I hadn't contacted him, but he came back into me and I barely recognized him. He had a huge smile on his face. He said, I feel fantastic. I was like, oh, wow, that's great. But what about the shoulder pain? That was really bad. He said, oh, it's gone. I was like oh wow that's great but what about the shoulder pain you know that was really bad

he said oh it's gone I said oh okay how long how much time had elapsed seven months seven months had passed and I said

okay tell me about the tell me about the back pain he said oh that's gone as well I said alright okay he said I've stopped my medications I said alright that's great that's fantastic I said what about your blood pressure

no I've stopped no no no doctor you don't understand I've stopped all my medications I was like, all right, that's great. That's fantastic. I said, what about your blood pressure? No, no, no, no, doctor, you don't understand. I've stopped all my medications. I was like, all eight medications? He said, yes. I said, oh, right, okay. And then I'm panicking, thinking, well, you know, what's his blood results going to be? Is his blood pressure out of control? But I checked his blood pressure, which was completely normal. And he'd come in for his blood test results that day. And I was able to confirm that his lipid profiles were fine, he didn't need his statins and the most powerful effect for me actually was being able to look at his PSA result, his prostate specific antigen because what I realised when I saw the result was that he'd

actually managed to reverse his prostate cancer as well using these lifestyle changes and when I told him the result he was in floods of tears and he immediately called his daughter to tell her the good news and it's things like that that really create a huge powerful effect in me in terms of my medical practice because it gives me a sense of meaning and purpose to continue but also you know it's life-changing this is this is life or death and you know I don't think family physicians, I don't think that they realize how much difference they can make if they've got the right tools.

And we all go into medicine to help. We all go in because we care about people. And often maybe we get a little bit jaded thinking there's nothing more I can do. I've used up everything in my toolbox. But if you keep filling up your toolbox, then you find something like plant-based nutrition, which can be hugely powerful. Yeah. I mean, that's amazing. You know, I think that, that,

that what happens, and I say this as a total outsider, you know, observationalist is that you're correct that people go into medicine, well-intentioned, they go in because they want to help people, right. They're well-intentioned andentioned, and it's a very laudable thing to do, but there's a system in place that wears people down and creates that cynicism. And you kind of referenced one aspect of it, which is that 10-minute window that you get with a patient. Like, what can you do with that other than try to quickly diagnose and prescribe? And I don't know what the differences are in the UK versus the United States,

but in the United States right now, we're seeing the rise of these functional medicine clinics who are trying to create a new paradigm outside of that 10, 15, 20-minute window, whatever it is, to try to treat patients in a more holistic, 360-degree way. But it sounds like you're trying to do that while still within the structure that that limited structure right which has to be challenging i would imagine that's what i'm trying to do yeah um and i understand a functional medicine paradigm has been quite useful for if nothing else for really helping somebody be clearly heard and understood and looking at many different aspects not just medications and prescribing, but actually how much are they sleeping? How much are they moving?

What toxins may they have been in contact with? But for me at the moment, and for as long as I've been practicing, my passion has been to help people who may not otherwise see the data, may not otherwise look online. So it's kind of a surprise to them when they come in to the clinic and they see me because they're not they're not expecting that sort of lifestyle

approach they're just expecting me to you know give them another um pill but that's for me that's where the magic happens is because these people they wouldn't be able to afford to see a functional medicine practitioner it would cost a lot of money and they'll be giving out a variety of supplements which they wouldn't be able to afford or maintain and so for me i want to make this accessible for everybody i want every single person at every kind of financial situation to be able to understand simple things that they can do to improve their health and improve their well- And that can include food. It can include intention. It can include purpose, meaning, exercise, sleep, all that stuff. And that stuff's, you know, a lot of that stuff is free or very cheap. Right. Right. Well, the, and the information also is not, you know, often it's already,

you know, it's not just readily available, it's understood. Like, some of these things are common sense, right? So there's this gap between information and understanding and actually practicing it. And it seems that, you know, going back to this discussion around the systemic limitations, you know, a big part of trying to promote adaptability long-term is accountability right like having having programs in place with your practice like health coaches or whatever who are checking in on these people how are you doing do you have questions like is somebody gonna just you're gonna send them off and say okay you need to meditate and you need to do this and you need to do that and they're like

they've just been going to you know whatever the uk's version of burger king is or whatever you know for as long as they live like the chances chances, the chances that they're just going to be able to like, you know, adapt and do it in, in, in the manner in which you're prescribing is pretty limited. Right. Like, so that goes like functional medicine clinics can have those kinds of personnel. And, you know, I know. Yeah. They've got Brendan here. Yeah. So Brendan works with Dr. Osfeld, Robert Osfeld, who does have people that kind of check in, right, and kind of keep you on track and accountable. That's wonderful.

And that's a wonderful resource to have. And it's also, yeah, I know Dr. Osfeld. He's lovely. He's such a nice guy. And yeah, I think that's wonderful. It's a lovely future for the healthcare model, and I'd love to see that available for everybody. That would be my ideal, is that everybody could access that.

And we don't have the same insurance systems as you do in the US. It's a nationalized service. And that's the other big thing, like getting insurance to cover all of this. Exactly. That's what changes it all. Yeah, yeah. Right. So that's what changes the paradigm in the US,

is being able to kind of get that in your medicare um but in the uk it's it's we have this basic system where um things are protocol driven and financially driven which in a sense is a good thing because for example the pharmaceutical companies can't um advertise direct to consumer in the uk and they also have to there's a there's an element of competition between the different pharmaceutical companies and what drugs that they're able to prescribe, or at least they're able to promote for doctors to prescribe in the UK.

They have to be efficient in terms of the finances. So that's a good thing, I think, in terms of keeping the costs down. But we don't have a medical system, I think, that's going to be able to cope with the rate of chronic diseases that we're now experiencing no western medical system that i've seen is going to be able to cope with the current rates of chronic disease that we now have and that's where i think a massive shift needs to take place um which is why i want to try and make this information

ready for everybody to use um eating organic, eating fruits, eating vegetables, you know, no-till agriculture, restorative agriculture. These are the things that are actually going to change the world and hopefully, you know, change people's lives. But yeah, trying to make that. Well, the happy pear guys met with Prince Charles yesterday. Or the day before, who I guess is super into like regenerative. Yeah. I think he must be. He loves his plants.

Let's hope those guys will save it. Well, now you're, you're, you know, you're like the plant-based doctor. I am plant power doctor. Yeah. And I'm wondering whether there are like, people are like, don't go to Dr. Newman. She's going to tell you to go vegan. It's funny. I know. I don't expect all my patients to go vegan because there's that big emotional barrier for a lot of people.

But I do promote plants, yes. I think, and I say most nutrition experts and dieticians and physicians around the world hopefully would also do the same. So for me, it's just about making sure that they get the education, they understand where their food is coming from, eat as low on the food chain as possible, eliminate sources of antibiotics, pesticides, and toxins, and just eat with joy. Yeah. And not everybody's going to go vegan, but my hope is that more people will eat a whole food plant-based diet and feel good. And as a result, spread that message.

Well, I feel like there's a really vibrant, growing community in at least the London area who's super into this. There's so many events and so many young people are into it and so many restaurants. And I attended that thing that you put on last year for you're doing panels with all these medical professionals in this area, and they're well attended. They are. Plant-based news is in London. There's a lot happening in the UK in this movement. There is.

And there is momentum being gained, and there is a lot of excitement. And there has to be. This is an exciting time. We're changing the paradigm a little bit on what people think we have to be. And the time is now. We are in the middle of the sixth great extinction. We have to do something now. So young people are hugely receptive to that message because they understand it's their future and the future of their children that's at stake here.

So pun not intended. Do the ethical and environmental considerations play into how you think about all of this or do you just try to keep it on the health tip? With my patients, I try to keep it on the health because I think that that's my most important message to them. But when people are taking this way of eating on board for their own reasons, so say for example, somebody is hugely passionate about animal advocacy and they want to live a healthy life and be a good advocate so that's where I help them say okay well this is how you do it really healthily you know you have a whole few plant-based diet you don't go along

and have all those chips and oreos you know because you're not going to be doing yourself all the animals any favors if you do that and you know likewise I've got patients who are millennials and they've done their research around climate change and they've been reading up on the Planetary Health Report and all the journals that come out from Oxford University about climate change. And they're really clued up. And so for people like that, their passion is clear. And I just want to make sure that they do this as healthily as possible so that they can keep going with that passion. as possible so that they can keep going with that passion. I want to open this up to everybody so that everybody has a chance to ask their kind of questions around Gemma's expertise and make this more inclusive. But before we do that,

I think I want to kick it off with one question that I have, which is, and I get this a lot, like, Rich, you know, I love what you're doing and your lifestyle seems amazing, but I go online and there's so many health, you know, quote unquote professionals or experts who are saying all different manner of things. And it all seems to contradict each other. Like you referenced, you know, low carb keto, you know, fruitarian, raw vegan, carnivore. It's like really hard for even the most well-intentioned, you know, intelligent consumer to make sense of because everybody seems well-intentioned and they all seem very passionate

about what they're saying and you know how many people are going to go on pub med you know a and then read past the you know the the little summary or whatever to really it's like no one's going to do that right so we're relying on all of you to try to provide us with guidance and the facts but it's becoming increasingly more and more difficult to really figure out what's real and what isn't. I know. I feel for you, Rich. I feel for you. I just refer people to people like you. And I'll be honest. I think most doctors don't go on PubMed and read past the abstracts. This is

partly why we have a big problem is that people who have medical credentials don't necessarily read the whole paper, or they may misrepresent the paper. So all I can say is, based on the evidence that I have read from mechanistic data, from cellular longevity, from epidemiology, making plants the basis of your diet is key for microbial health and beyond. So I think it's interesting because when people do well, for example, on the ketogenic diet, I don't want to discount their experience. I think to myself, well, why is it that they are doing well at this point? And what's interesting to me is that a lot of it does seem to stem from gut health. So if somebody has something like small intestinal bacterial overgrowth or a leaky gut, then it's going to be very difficult for them to tolerate these healthy, vibrant foods that are so common in a plant-based diet. And so maybe they do feel a little bit better to start

with. But of course, if they then try to eat these healthy foods in the future, then they've made their underlying issue worse. And so my aim in speaking with patients is always to come at it with empathy and compassion like what has made you do this way of eating and how do you feel now and then take it from there and gut healing i think is one of the major um things that that people need to do when they when they are starting on this journey if they've got gastrointestinal issues and things like quercetin and glutamate and restore gut health by the fabulous Dr. Zach Bush as well as you know gradually reintroducing FODMAP foods, fermentable foods that are tremendously healthy but may cause initial bloating or discomfort so it really

depends on where they're coming from and where they're at. Bottom line is a plant-based diet is the only one that's been proven to reverse heart disease and it's been proven to be very beneficial for people suffering from a variety of different cancers and we have great mechanistic data to show why that might be possible. So I have every confidence in recommending a predominantly plant-based diet and then what they do with that is up up to them but um yeah um in terms of things like keto part of the reason that they might be feeling good on it initially is because it's quite an effective way of um regenerating mitochondria they're a little bit tired and worn out by the

pgc1 alpha pathway so you think to yourself well how else how else can you regenerate your mitochondria and there's plenty of ways of doing that that don't involve high meat consumption. In fact, if you are eating a lot of meat on a keto diet, you're probably doing it wrong because you're getting too much protein when you should be having more in the way of fats, actually. So what are the other ways of doing that? Well, you can do high-intensity interval training, for example.

You could have an intermittent fasting, time-restricted feeding. I mentioned quercetin, which is a plant-based nutrient that you can get from a number of plant foods and also in supplement form. Even jumping in the ocean, having a cold plunge is another way of doing it. Having a massage. There's so many ways of activating the mitochondria that you don't have to do a ketogenic diet to do that. So it's just about kind of helping people understand why they got a benefit and how else could they do so without

risking their long-term health. I like that answer. Good. I'm glad you like that. Let's open it up. I want to hear from all of you guys and what you want to hear from Gemma. Hi, Gemma. Thank you very much for what you do, by the way. We need more doctors like that. My question is around the controversy right now with soy and its connection to estrogen production. And we seem to get a lot of women that are backing away from soy products because of that. What's your take on that? So I think that soy is sorely misrepresented.

Soy has been shown in studies to improve menopausal flushing and in a number of different mechanisms. So you've got the, you've got, it does contain phytoestrogens, but you've got the alpha and the beta estrogen receptors in the body. And the alpha estrogen receptors tend to be on the breast and in the uterus, and the beta ones tend to be on the bone. And the beauty of soy products is that they bind preferentially to the beta oestrogen receptors, the ones on the bone, so that they're proven to be quite good for bone health. And whereas when you've got mammalian equivalent oestrogens, so for example from cow's milk, they're going to bind preferentially to the alpha oestrogen receptors to the breast and the uterus, which would then therefore increase risk potentially of abnormal growth in those areas. So I think if you're worried about phytoestrogens, you probably need to drink less

beer because the most potent phytoestrogen is in hops. So if a man's worried about getting man boobs, he should stick away from the beer and carry on having as much soy as he wants. Although I would say organic soy is always best. You're welcome. All right, thanks, Jo. It's a super specific question. So I recently had, I mean, I guess just to me, I went plant-based about 15, 16 months ago,

and I didn't have a recent blood test before that to compare. But when I had this one, my white blood cell counts were really low. So like it was a three, and I don't remember what the scale was. I think it's in the thousands, but mine was like 3000 or something. So I'm just curious if you've seen other plant-based patients who have like a low white blood cell count or anything I could do to kind of counteract that in diet or supplement. What's interesting is that if you're feeling generally well, you may not need to counteract that because it may just be that your body is not producing that many white cells because it doesn't have much inflammation or infection to be dealing with

at the moment. So I can't go into specifics for your medical history, but what I would say is get it checked again so that you can monitor it over time. And if you're feeling generally well and it's just slightly at the lower end of normal or slightly under the lower end of what most of the people in the population have, it's not actually necessarily a problem because you're not going to be making so many white cells or neutrophils if you don't have so much inflammation and oxidative stress in your body. Yeah. Hi, Gemma. Hello. I have quite a few friends

who are dealing with ulcerative colitis and Crohn's. And one in particular who's tried every diet, is on steroids all the time. All of the stuff they normally, you know, tell people ulcerative colitis to do. And she feels best when she's eating a high, very high protein diet with very little good carbohydrates and all of that, you know, normal kind of autoimmune protocol diet type thing. My question for you is, she did try an

Ayurvedic diet for about a five-day period and said that she felt worse on it than on her high protein autoimmune protocol diet. What are your thoughts on someone with ulcerative colitis and what they should do and if if there's a way to do it more plant-based um yeah that's my question thank you really round about sorry that's okay thank you i do really feel for your friend because she's obviously suffering hugely and ulcerative colitis and crohn's disease are hugely on the rise over the last 50 years much more so even in the last 10, 20 years. And a lot of that is around our gut health and leaky tight junctions of the gut and issues around pesticide use and

ultra-processed foods. And also actually saturated fats sometimes can also contribute to a disruption of those tight junctions, antibiotics, pesticides. These are all things that have contributed potentially to her issues so it's going to be a long road probably of healing and i can't give specific advice for her about which diet she tried and which ones are useful but what i would say is that giving the gut a rest is is always a number one strategy and you're immediately trying to heal it trying to seal up those tight junctions is number two and there's multiple ways that i've already mentioned that we can attempt to do that and for long-term health and people with ulcerative colitis and crohn's disease a whole food plant-based diet is tremendously effective um and she might be interested to read the work

of dr alan desmond he's a good friend of mine. He's a gastroenterologist. And he's talked a lot about the benefits of whole food plant-based diets. And he is a specialist in inflammatory bowel disorders like Crohn's disease and ulcerative colitis. He's on Instagram as Devon Gut Doctor. And you've got Dr. B as well, Will. He's an American gastroenterologist. And he, again, talks in great detail about some of the benefits of plant-based nutrition for these inflammatory bowel diseases but it's it's a it's a it's a slow road and she has to heal the gut first and foremost so yeah so those are some good resources for her to have a look at i would also suggest checking out dr robin shut can who i did a podcast with several years ago

and has written a couple of books on this. But she's amazing as well. Fantastic. Yeah, thank you. I just wonder what your opinion is on B12. So B12 is an essential vitamin. We use it for, among many things, breaking down homocysteine, which is an

inflammatory protein. We also use B6 and folate for that. B12 comes from microbes in the soil. And so if you have a whole food plant-based diet with unwashed vegetables and untreated water in the middle of nowhere, then you're going to probably get plenty of B12. You could also make it if you have optimal microbes within your gut, they will make B12 for you, which is quite wonderful. However, if you have poor gut health, or you're living in a sterile environment, or you're washing your fruits and veggies, or you're drinking treated water, you may find over time that you'll become B12 deplete, in which case a simple supplement is all that you need. And what's interesting is if you're eating a lot of fatally farmed animals,

they will also be receiving B12 supplementation in their corn, which you then just eat through their muscles because they've been supplemented. So in a sense, you're cutting out the middle cow by doing that. So those are my thoughts on B12. Also, one other point to make, many meat eaters are B12 deficient, especially if you're over the age of 50. If you're taking a proton pump inhibitor, which is a really common kind of antacid medication. If you're on metformin, which is the commonest diabetes medication. If you have an autoimmune disease, again, you're going to be far less

likely to be absorbing the B12 from your animal products. So anyone over the age of 50, whatever their diet, may need to just get their B12 checked to make sure that it's optimal. Yeah, two little follow-up questions on that. One of the things that I have to field or that I hear all the time is, well, a plant-based diet can't be a great diet if it's lacking in this one thing that you have to supplement with it. So it just gets discounted, right? Yeah. And it's unfortunate because when you look at the nutrient density of different diet types, what you find is that nutritarian approaches, whole food plant-based approaches, and simple plant-based diets are number one, two, and three in terms of nutrient

density. And then you have things like paleo, maybe a little bit lower down the list and you've got keto a little bit lower down than that because you're going to get folate deficiency and other sort of mineral deficiencies using that kind of diet so it's the most nutrient dense way of eating but yes b12 is one of the few caveats but as say, many animals in the wild don't get B12 deficiency because they're living in accordance with nature. And I think that's what we need to do far more of now and in the future. They eat dirt, basically. They eat dirt.

Let's get back to eating some dirt. And the second little cleanup follow-up thing on that is there's two kinds of commercially available B12 supplements, right? There's methocobalamin and cobalamin. Is one better than the other and why? Yes, I would say methacobalamin is much better because it's more bioavailable. You haven't got to do the methylation within your body.

And some people have a methylation deficit genetically, which means that they're less able to make that conversion. So in the UK, there's a methadcobalamin spray that's available, which I love because it's absorbing sublingually, you know, through the tongue, which is my favorite, which is what I like to tell people to use. But you'll have to have a look online

and see what's available to you. But methadcobalamin is my preferred version. And what about B12 shots? Well, it could be. it depends on your levels, really. I mean, if you, if you're feeling well and you've got massively high B12 levels, could you store it for up to five years? So if you're getting a B12 shot every month, then you're probably going to be drastically overdosing on B12. So I don't, I don't think it's necessary unless you have obvious gut issues or malabsorption issues or methylation issues that you've already had to look into with your physician or nutritionist yeah who's next i

have i have the mic hello jill hi um you and your husband obviously are both um eating a plant-based diet and i was curious how you decided to approach it with your children and having those kinds of conversations, both in regards to health, but also like getting them to eat it. Yeah, I know. So we are really lucky because, so our two children at the moment are seven and four and our youngest, you know, he just enjoys what we make at home he hasn't really put much thought into it he just loves the food that we give him so that's you know that's quite easy um i imagine that that might get more challenging as he gets older our youngest um he's he's an interesting soul because um he was more into the compassionate side of things from a young age. So he was the person that encouraged me to stop eating chickens a long time ago.

He said to me, we went to the farm and he was picking out eggs. And he said to me, Mummy, what do we eat when we eat a chicken? I said, well, you know, we eat their muscles. I kind of tried to flex my mini bicep and show him what a muscle looked like. He said, that's what we eat. And he said, oh, well, how do we get it I thought oh no you're only little do I have to tell you how we get it so I had to be honest with him I said well we you know the animal is killed he said how how how do we kill it I thought oh no I don't actually know um I said oh maybe we shoot it or stun it or maybe a knife i was not obviously prepared for

this conversation and um the look on his face i just thought okay you know what we don't have to eat this so um he he had autonomy in that decision actually which really helped him because then um he became quite passionate about not eating animals from that point onwards, and perhaps more so than myself. I'm very much into it. And this is pre-Richard running marathons? Yeah, yeah. So you buried the lead here, because it's all about your child. It was my son all along.

His three-year-old inquisitive mind at the time. But it can be a challenge especially if they're used to things but then in a sense that's true of any kind of healthful diet change because kids love sugar and you know if they're eating a lot of stuff that's kind of junk food then that's always going to be a challenge whatever you're trying to give them um so get them involved in the kitchen get them involved involved in making recipes and make it fun. I'd also say simple things like sitting down together as a family to make it a special occasion, especially as they get a little bit older, they might like to have maybe a little candle with dinner

if they're not going to reach forward and grab the flame. So yours, I think youngest is two, isn't she? Yeah. So let them get messy, let them get involved and, you know, make it fun and not too much pressure. If they don't want to eat it that day, then they don't have to. And then maybe they get a little bit hungry and that's a shame. But then the next day they're going to really love the dinner. But I have made a Vimeo series with Plant Based News on raising children with a plant based diet. And I've also

done some podcasts on that. So if you go on my website, jemmanuman.com, you'll be able to see quite a lot of resources around children and cookbook recommendations and ideas and a variety of resources around pregnancy and raising children with a plant-based diet. And just to flesh that out a little bit further, what is your response when someone comes to you and says, listen, I'm really attracted to this plant-based lifestyle, but I'm terrified of raising young children on it. I'm afraid they're going to be deficient in something. Yeah. And that's super common because people only want the best for their kids and they hear these scare stories. And I try to reassure them that actually evidence shows that plant-based kids are generally much, much healthier than their best for their kids and they hear these scare stories and I try to reassure them that actually

evidence shows that plant-based kids are generally much much healthier than their omnivorous counterparts there's less in terms of chronic respiratory infections allergies asthma eczema and so you know they'd be reducing their short-term risk of allergies and recurrent infections and they'd be reducing their long-term risk of heart disease and cancer. So overall, it has to be a good thing. There's not many scientific studies on raising children plant-based, although I did read one in the American Journal of Clinical Nutrition that was done on British children back in the 70s and 80s, which is really interesting because there weren't that many vegan children back then. And they certainly didn't have... kinds of terrible satan you know yeah who knows what they were eating my goodness

must have been fruits and vegetables and grains you know pretty good stuff overall um so what they discovered was that this group i think they managed to they managed to gather around 60 plant-based kids and they they followed them for 13 years some of them pre-pregnancy some of them up to teenage years and what they discovered was that they were actually doing tremendously well this was before they didn't necessarily use any supplementation they didn't have any of the fortified milks or any of that stuff um and what they found was that they actually comparing them to their omnivorous counterparts they had a far superior nutritional profile and there were two there was they were slightly lower in their calcium scores but

that wasn't significant in terms of their health and they were lower in terms of their saturated fat exposure but every other nutrient and mineral they exceeded and were doing exceptionally well so the researchers actually it was quite funny reading the study because the researchers were actually saying, you know, these parents receive a lot of discrimination in the communities, but actually looking at the data, the kids are doing brilliantly. And is there anything in particular that pregnancy demands or requires in terms of supplementation or something to be aware of if a pregnant expecting mother is on a plant-based diet? What's interesting about plant-based diets in pregnancy

is that they're already excluding a lot of the things that pregnant women are told to minimize. So, for example, pregnant women are told in the guidelines to minimize their exposure to fish because of the heavy metals, dioxins, PCBs, all of the pollution from ocean fish. So they're going to be excluding those. They're going to be excluding eggs and salmonella risk. They're going to be excluding dairy cheeses and listeria risk. So they're actually doing pretty well in terms of benefiting the baby. In terms of things that they might want to look at, I would always suggest a general supplement for every pregnant woman just to be on the safe side. I would recommend iodine

because many, many areas of the UK and in the US are going to be, the soil is going to be iodine deficient and it's quite hard to get your quota of iodine, which it should hopefully be in the multivitamin, but that's one of the main things um and um epa dha supplements i like to recommend there's no study data to suggest it's worth doing but we can see that it's beneficial for brain health and heart health and so when you're making a new human why not get an optimal amount so yeah i'd say algae oil supplementation and your multivitamin which must include things like iron and iodine what about iodine or iodine so it's interesting actually vitamins the vitamins yes sorry sorry um yes what's interesting is in the uk there's this condition called lancashire neck

um where people used to get these massive thyroid goiters because they had iodine deficiency from a lack of the mineral in the soil nowadays there's some supplement there's some supplementation and also in dairy they use iodine to sterilize the milk vats so that's why a lot of people can get iodine through dairy if you don't want to get your iodine that way then you can take a supplement or you can have um organic nutrient rich fruits and vegetables or um you can nibble on nori sheets actually i mean my kids love those as a snack i don't know if you've tried to buy those because you know you can make sushi out of those nice nori sheets they're very iodine rich yeah doesn't milk do a body good i mean there's a lot of like listen to to be know, very compassionate about this argument,

like, no parent wants to, you know, do the wrong thing by their child. And there's this idea that you need dairy for strong bones. And, you know, who wants to raise a child with brittle bones? You'd feel terrible, right? So that, whether it's myth or fact, i'm interested in how you you know your your thoughts on this it is pervasive and it's very very strong and so overcoming that you know presumption of truth is very difficult yes it is um and i think in western european societies people relied on dairy for a long time because when you're going through a stage where in human evolution

where you've got nutritional scarcity you're going to want to be able to make sure you can get nutrition from any source possible which would include the milk of a cow you know in your town or village you had a cow you'd milk it you'd get some nutrients that's fine. I think nowadays we've become acutely aware that milk isn't what it used to be. The cows are kept in very cramped and difficult conditions which means that they usually receive antibiotics, which will often then be in the milk. They're raised to be pregnant whilst also lactating, which would increase their hormone profile, which is not great in terms of long-term health. You'd be producing IGF-1 insulin like growth factor 1 when you drink the milk,

which has been strongly associated with increased cancer risk. And what's interesting is people are always talking about bone health and how important it is. I haven't read a single study to show increased bone mineral density with increased milk consumption. And I've read maybe two or three studies to say that actually the opposite is probably true. There was one from Sweden, 100,000 people followed over 20 years. They looked at their milk consumption and they realized that over time there was actually increased fracture risk in women and increased mortality risk for men and women the more milk they consumed. And so trying to understand the mechanism behind that, you can't necessarily get the mechanism through the epidemiological data,

but you can have a guess that it could be related to the galactose content because it didn't see the same association with yogurt because the galactose was partially fermented and what's interesting about galactose again is that researchers often use de-galactose to induce cellular aging in the animals that they test and so you think well if you're giving giving something specific from dairy that will then age the lab animal prematurely, do you really want to be drinking that every day in your coffee? Not really. And also, actually, on the topic of coffee, when you have dairy, when you have cow's milk with the coffee, it can cancel out some of the phytonutrients in it. So it's probably best to be avoided in your coffee as well. But yeah, I's loads of there's loads of controversy around it but i think just trying to get back to basics look at the data look at the mechanisms by which um potential harm could be caused and

hopefully you'll get to the truth of the matter i mean it's interesting because i think you had volta longo on as a guest a while back and he's a longevity researcher and what he discovered through the m2 pathway was that there's three main mechanisms of cellular aging you've got excess leucine excess refined sugar and excess calories in general so if you're going to be having a lot of extra calories then that's not great for cellular aging if you're going to be having refined sugar from processed foods and junk foods that's not great but also excess leucine, which is primarily from animal products, will also age you prematurely. So there's a number of reasons why dairy might not

be a good idea. And also the case in proteins, they've been linked to oxidative stress and inflammation as well. There's links to prostate cancer specifically. There's links to other hormone-dependent cancers, breast cancer, ovarian cancer. So yeah, I'm hoping that, not to be all doom and gloom, but I'm hoping that at least it will be a reassurance for any parent out there that may be deciding not to give their child dairy, that it can actually be a really good decision. I agree with you, the dairy is not good, but how do I increase my calcium without taking a supplement because supplements can be bad for you too I think probably the main things for you to focus on would be your green leafy vegetables your sources of seeds and nuts and things like tahini actually is a really good

calcium source I'm sorry say that one again tahini it's um it's like a spread that you make from sesame seeds um dried fruits are really good for that as well but more than anything else weight-bearing exercise would be really beneficial i work out every day oh yeah some weight-bearing exercise is a really good one so well done you're doing you're doing a lot of the right stuff but mainly as i say um seeds dried fruits and leafy greens they the calcium and leafy greens is more bioavailable on the whole so i think 56 bioavailability compared to 32 or something around those lines um between things like broccoli and um and dairy so you're going to be able to absorb more of it as long as you keep eating lots of those delicious whole plant foods and how about vitamin d so vitamin d is crucial for bone health and um we make most of it through sunlight exposure

on us and it's actually a hormone many people are vitamin vitamin d deficient i want you to keep saying it your way vitamin d so many people have a deficiency in vitamin D, and it's hard because we're not living the same lives that we used to. We're not out in the sunshine very much. So I would recommend a supplement from that point of view, yes, just to make sure that you're optimized. And some people are not very good at making their vitamin D from sunlight exposure. So again, checking your levels, making sure they're optimized,

and then taking that as a supplement if necessary would be my best advice for that. And vitamin D is not a vegan omnivore thing. I mean, the levels of vitamin D deficiency across population in general is quite high. Exactly. And as I say, 90% is through the skin. So even if you're having loads of things

like mushrooms that have been fortified through sunlight if you're having loads of things like mushrooms that have been fortified through sunlight and fortified nut milks and things like that, it's only 10% of your requirement, 90% through the skin. So try and get outside in nature. Of course, that's the most important thing. But other than that, then yeah, lots of getting the test done

and making sure that you've got a supplement if you need to. I just realized something. I didn't go through the rest of my special gloves acronym about all the things that we need to do. Well, why don't you seize this moment to do that? Because I had a little... You didn't go through that? Yeah, we should because I had a reminder with regard to that. So O for organic, V for veggies.

So for the exercise component, then I would say it's so important to just get outside. But whatever you can manage. We've got Dr. Zach Bush tomorrow and he's going to talk about all sorts of things, I'm sure. But on my website, I've got a link to his four-minute nitric oxide workout, which I think is absolutely fantastic. Because what it does is it just gives you a four-minute of intense, but also very achievable exercise

that will kind of you know activate your body and get you moving but getting outside in nature as part of that exercise is really really beneficial you're going to be breathing in all sorts of beneficial microbes forest bathing the japanese do that and there's a study i read recently which shows that that that is really beneficial for improving our immune system boosting again iga levels so getting outside breathing in that fresh air um and staying active is crucial and sleep i know that might be a little bit of an issue for you rich but we've got to try and get a good night's sleep and for for overall health and um seven to eight hours if possible trying to keep a regular sleep pattern is really

good you can't really catch up on lost sleep, unfortunately. A lot of the study data shows that people who stay up too late during the week and think, oh, I'll just lie in in the weekend, it doesn't work. It doesn't do the same job metabolically. So trying to stay regular with the sleep patterns, reducing blue light in the evenings so that you can get your serotonin turning into melatonin which will then improve your sleep patterns um is also crucial um so yeah that was my that was my little acronym gloves yeah uh i just want to thank uh rich and jemma for what you're doing it's fantastic last february um i hadn't listened to rich's podcast at this stage, but I give pet public lecture talks on how to rewire your brain, et cetera. And people had asked me about nutrition.

And I honestly believed at that point before I started this podcast that if you did everything in moderation, you're going to be okay. And that's what I was doing. And then my lab discovered sugar is as addictive as alcohol and nicotine. So my question is really about sugar and what you tell people. But I basically got diagnosed in February of last year with kind of a mild form of Hashimoto's hypothyroidism, which I didn't expect to ever have because I was exercising, you know, blah, blah, blah. And then for some unknown reason,

I got to Richard's podcast and I went plant-based. And then I did blood tests in February, August and December of last year. I did it the same lab, the same time fasting, you know, to make sure I kept all the variables as tight as I could. And all my numbers went down, not just my TSH and my T3 T4 and my antibodies for the diagnosis but also my triglycerides my LDL and my HDL reversed in exactly a better direction even though I was kind of in range sort of for all those anyway and I won't go into the rest of how it made me feel but anyway so on the sugar side that was really my question to you because I wanted to just thank you for that, saving me for getting drugs. My doctor was like, how did you do that?

But on the sugar side, so what we've shown is that sugar changes the brain, the prefrontal cortex, and activates the amygdala, the emotional part of the brain, in exactly the same way that alcohol does. And most of the world, the Western world, is consuming three times the recommended world health organization levels of sugar and they don't even know they are and what as you know

you've seen probably all of that research around fructose activating the visceral fat cells that's where the energy stored and then it doesn't activate ghrelin and leptin and that's what make people over consume other food because it doesn't make yourelin and leptin. And that's what makes people over-consume other food because it doesn't make you feel hungry, right? I mean, you never feel satisfied when you eat too much sugar. So I'm just interested in your take on what you'll tell your patients. I know you'll be really well-read on that. Yeah.

So I tell my patients that sugar is not the enemy as long as they're getting it from a whole source. I think we're wired to respond to sugar and the sugar from fruits in its whole natural form, which also contains the phytonutrients, the antioxidants, the soluble and insoluble fibers. These are all crucial for being able to absorb the sugar in the way that it's intended. And you're right, you know, the brain responds to sugar in the same way that it responds to other things that you can find addictive, but it's different with whole fruit. And I think if we go back to nature, we go back to basics, people understand that, you know, okay, if I'm going to

make fruit the cornerstone of my sugar intake, then that's only going to be a good thing. And it does, it certainly reduces the problems like fatty liver that fructose has been associated with. So I would strongly recommend fruit in its whole natural form as a general advice for anyone that's going on a whole food plant-based diet. What about smoothies and juicing? Smoothies and juicing will depend on your pre-existing medical conditions. So for example, say you're a type 2 diabetic and you've only just discovered the plant-based lifestyle, I don't think it's a good idea to have a fruit heavy smoothie because you're going to still be quite insulin resistant um if you're generally healthy and fit and well then I don't see there

being too much of an issue but it's just it's again it's that fast sugar rush isn't it so you're taking out extra fiber especially if you're juicing um so yeah I'd say whole foods in its natural form if you're suffering from any So yeah, I'd say whole foods in its natural form if you're suffering from any kind of condition related to insulin resistance, like polycystic ovarian syndrome or gestational diabetes or type 2 diabetes. And yeah, sticking with the vegetable based smoothies would probably be a better choice for those people. Yeah, right here. Yeah, hi. I just wondering uh in your patients or studies if you've seen any difference in testosterone levels and especially men like over 40 seeing how we're supposed to be

decreasing like a difference between plant-based or non-plant-based diets yeah testosterone levels seem to be better in vegans actually um which is rather nice um And we're still waiting for the game changers to come out, but it's not out yet, is it? No, it's still not out yet. But they did a fantastic study on young males who didn't have a reptile dysfunction, and they were just young, healthy guys, and they wanted to measure the strength and integrity of their erections overnight. And so what they did was... Isn't it turgidity? Turgidity, yes.

Isn't that the word? And what they discovered in these young men who didn't have any kind of erectile dysfunction was that when they gave them a burrito based on beans versus a burrito based on meat, they had significantly firmer and more frequent erections than the men who'd had their meat burritos. So I'd say not only is it likely that your testosterone levels will go up if you have a whole food plant-based diet, but your virility will also rise.

In fairness, that's more of a blood flow thing, though, isn't it? Yeah, that's more of a blood flow. Than a testosterone-driven thing. Yeah, yeah. That's not really where I was going with that, but that's cool. No, but like. You don't need to worry. For real, yeah, for real.

Like as men age up, we start to get concerned. Like our testosterone levels are, I mean, part of that is like, okay, they're going to dip. And I personally know a lot of men who are taking testosterone replacement therapy. Yeah. And it comes up in conversation with guy friends like, hey, are you doing that? Like, how is that working? Should I do that? Should I not do that? What are the dangers? What are the risks? What is the implications of diet on those levels? So, I mean, in terms of diet, we use cholesterol as a backbone for most of the

hormones, all of the hormones we make in our body so cholesterol is the backbone for testosterone and estrogen and cortisol and pretty much every hormone but we make plenty of that we make we're very good cholesterol conservators and we're very good cholesterol makers so we don't need any extra dietary cholesterol to be able to make those hormone backbones but when you're on a whole food plant-based diet it means that you're not overusing the hormones that are already in your system so having extra dietary fiber means that you're not overusing the hormones that are already in your system. So having extra dietary fiber means that you're not kind of reabsorbing unnecessary extra hormones, which is quite good for things like estrogen excess or testosterone excess. But in terms of deficiency, I've never seen anybody on a healthy plant-based diet have a testosterone deficiency. And in fact, what's interesting is I, not to get into the diet wars, of course, but

having watched one of the carnivore proponents talk about his own blood profile, he actually had a low testosterone on his carnivore diet. So I think the opposite is true. I think you don't, really don't need to worry about your testosterone levels. Yeah. Have you seen the effects of a plant-based diet on dementia? Yes. And I'd recommend that you look into the work of Dr. Shirazi and Shirazi on that because they are real trailblazers with regard to long-term health and dementia rates and plant-based diets. So yeah, it does seem to help a lot. And there may be multiple mechanisms for that. Again, getting back to gut health and why and where the

beta amyloid plaques build up, it's possible that the saturated fats in the diet can disrupt the tight junctions of the gut, which allow the lipopolysaccharides or LPS from the gut bacterial cell membranes to go inside the bloodstream, which then increases inflammation, oxidative stress, and then potential beta amyloid plaque formation. So basically, yes, there's quite a few mechanisms where it could be helpful. It's not the only thing that's helpful. So making sure that you're getting a good amount of sleep, for example, is crucial in reducing dementia risk. Yeah, generally things like wellbeing and staying active. So there's a number of things, but a plant-based diet can definitely be helpful and I'll check out their work if you're interested to know more.

Just to echo Gemma on that, conventional wisdom is essentially that when it comes to Alzheimer's and dementia, there's just not that much that can be done, right? But the Scherzes, Dean and Aisha, they're a married couple who have a lab at Loma Linda University. They're having some pretty remarkable success treating a population of patients with diet and lifestyle protocols, and a plant-based diet is part of that. So I would definitely look into their work. I did a podcast with them. You can find it in the archive, and they have a book called The Alzheimer's Solution that I would suggest you check out. Yeah. I have a question back on the vitamin d um do you still get vitamin d if you wear sunblock um my the foundation of the question is i always um am concerned about using sunblock um but then i also want to get the the vitamin d D. So I generally will go out in the sun and not have sunblock,

and then everyone's freaking out, like, oh, you're going to get skin cancer. And I'm like, well, I feel like sunblock is cancer, like a chemical that may cause cancer down the line. Or I can get it from the sun, so I'm choosing that one, I guess. Yeah, sunblock. get it from the sun so I'm choosing that one I guess yeah sunblock um so you're not going to be able to get vitamin d if you wear sunblock and um I would suggest sensible sunlight exposure as being the best solution for this so making sure that you go out in the sun at a time at which um your shadow is shorter than your body then you'll be able to more efficiently make vitamin D

through sunlight exposure. But also become aware of when your skin is starting to, you know, feel sensitive to that sun exposure and then you get into your long cottons and cover up. But that would be my basic advice. I don't think it's healthy to be wearing sunblock all the time. So yeah, that would be my best solution is to just exercise judicious sunlight exposure.

Has there been any formal studies on the plant-based diet and how it affects mental health and mood disorder? Yes, there have. So interestingly, the SMILES trial came out in 2017, which showed that a modified Mediterranean diet was being used as a therapy for depression. And what they found was, this was a diet that was very heavy in vegetables and grains and fruit. They still had a little bit of fish and dairy in that diet, but it was far more plant-based than not. And what they discovered was that in the intervention group with the diet alone, they had a third remission rate in people with mild to moderate depression.

And in the group that just had social support, there was, I think it was an 8% remission rate. So there was a very dramatic difference between the two. And there was a study done in the US on 300 people looking at their well-being and anxiety scores. So what they did was, it was a basic workplace intervention. All they did was they told people, look, you can have a plant-based meal if you like. There's the work canteen. You can choose the plant-based option. And here's a little bit of education around plant-based eating and why it might be good for you. So the people that were educated in plant-based diets decided to, on the whole, probably eat the plant-based option,

although they didn't monitor that. But what they did monitor was their cholesterol levels, their weight, and their well-being scores, productivity scores, depression scores. And what was fascinating was that with no other intervention, they were able to reduce their weight reduce their lipid profiles improve their diabetes if they had it but also crucially improve their mental health well-being and productivity at work which is i think is really interesting because a plant-based diet seems to be quite beneficial on a number of levels you know you've got the extra fiber so fiber is not just useful for bulking up your diet and making sure that you don't get diverticular disease or varicose veins or appendicitis it's actually useful on a microbiome level because what you're doing is you're providing fantastic short-chain fatty acids for your microbes

to digest and then your microbes do all the work for you they make serotonin for you they modulate dopamine levels and that's crucial for mental health you know if you're giving an antidepressant all you're really doing is stopping the serotonin from being you know taken up again by the body and you're stopping yourself from absorbing too much of it but the beauty of a plant-based diet is that your your gut microbes are able to make so much more serotonin about 70 80 percent so the serotonin production happens in the gut lining itself so it's really important for mental health to have a fruit and veg high diet and obviously i would promote organic fruit and vegetables um over non-organic because again you've got the um the beneficial effect of not having those tight junctions of the gut being disturbed and that can also increase risk of

depression there's a couple of studies on aspartame and artificial sweeteners as well on people who already have mental health problems. And there seems to be quite a strong association with worsening of those mental health problems with aspartame and other artificial sweeteners, which is something to consider. Because if you're having a fizzy drink with an artificial sweetener, you might be aware to stop it,

but they're actually contained in a lot of different foods that you might not expect, including things like chewing gum. So that's something else to be aware of as well. But there's loads of mental health resources. And if you want to look on my website, I've actually got a list of many studies to show the improvements in mental health with a plant based diet. So check that out as well. And can I just add, Gemma, the research showing about intermittent fasting promoting brain plasticity. So there's extensive research come out in the last year or two that's showing that the intermittent,

the 16-8 or whatever it is, I think you had this on your podcast too, but basically the scientists have shown that you get an increase in brain plasticity and as you strengthen the front part of your brain which is where impulse control and executive function sit that gives you top-down control over the emotional part of the brain which is where anxiety fear and all these other things sit so I think intermittent fasting also has a lot of value to in terms of brain

plasticity in terms of dementia and mental health problems. Because as you strengthen your brain, you're going to be getting more layers in the onion, so to speak, so you have less to come off as you get older. That's so interesting because when I clamp down on impulse control, then I start having all kinds of emotional problems.

That's because you're not getting enough sleep, your amygdala is on fire yeah I don't know what it is like right okay last thing also the brain needs an incredible large amount of blood flow and as you're correcting with plant-based and improving people's blood pressure cholesterol plaques and tangles and all the other stuff that's happening because everything's going to an end in the sense that and you're increasing telomeres as well and telomerase activity then you're getting more ATP more mitochondria active inside the brain cells which require almost all of your energy too and that's going to help with dementia depression all sorts of things too thank you it's wonderful hey jemma thank you hello it's been great um just wondering what your thoughts on probiotics are that i mean for a while it was all about

probiotics and now it seems yeah sort of be leveling out? So microbial research is, I think, still in its relative infancy. And so we jump on the bandwagon of taking lots of probiotics because we think, well, we've got to get the good stuff in and get rid of the bad stuff. But to my mind, the most important thing is to have a varied, healthy, organic plant-based diet in terms of being able to feed beneficial gut microbes. Fermented foods are really useful. They're kind of like the cavalry that comes in, but then, you know, they also leave again with your stools most commonly. So in order to get those beneficial microbes to stay within the gut where they're needed, to stay within the large intestine, you're going to be having to feed them

dietary fiber in the form of fruits, vegetables, whole grains, and beans. That is the cornerstone of health. When you've had a course of antibiotics, you're going to have to think a bit more carefully around making sure that you aim to regenerate those lost bugs because that's a little bit like a nuclear bomb to your beneficial microbes. And so it may be beneficial then to have a short course of probiotics, but it's more important to restore gut health through fruits and vegetables, organic. And yeah, I think also restore gut health is a really good supplement for that, which is made by Dr. Zach Bush. I also think, yes, we're kind of at the emergent stage of better understanding this field, but there's also a lot of misinformation out there. And I

think there's this idea that, hey, I just take my probiotic and so I'm good. And the truth is, is that the vast majority of the probiotic products that are out there are, you know, for the most part, like garbage and they're very limited in their strains. And I think because of antibiotic use and the way that antibiotics are used in our food system, uh, matched with the decline in biodiversity of, you know, our overall ecosystem and the way our foods are farmed, that it is a real issue. And I think we need to learn a little bit more about how to best deal with this because I think there are deficiencies that need to be addressed. I'm putting a podcast up soon with it. I did an interview with the founders of this new company called Seed. They're kind of on the cutting edge of this and there's a lot of great information in that conversation that might be helpful to you.

Yeah. And also when you're taking a lot of probiotics for a long time, you're actually reducing your diversity of microbes, which is not good for long-term health. So yeah, if you're going to try and do it, then maybe pick one that has the largest diversity for the shortest time. But fruits and vegetables and organic is probably the best way forward. Getting your fiber in.

Excellent job. You would say that. For people that are listening at home that's Richard that's Gemma's husband thank you my darling thank you for the support so I just wondered

if there's anybody that listens to this podcast that is thinking okay this sounds great but how do I start what do you say to your patients when they say great doctor

what do I do for breakfast lunch dinner tomorrow how do I start yeah so good question yeah that's a good question thank you great doctor what do I do for breakfast lunch dinner tomorrow how do I start yeah so I give them a question yeah it's a good question thank you so I find their motivation I find their why and if they've got a good motivation then I I start simple I say okay so what do you normally eat for breakfast what do you normally eat for lunch what do you normally eat for dinner and

then I help them go through some simple swaps things that wouldn't necessarily taste identical but things that they could make just as easily. So for example, porridge is always a great choice for breakfast. You can mix in some fabulous flax seeds or chia seeds. We know that flax seeds in studies have been shown to dramatically reduce blood pressure in some people. So one or two tablespoons mixed in is really great. Can I, sorry, is it important that those flax seeds are ground

ground digest them if they're not ground yeah so they're better ground but then the issue with ground is you've got to make sure that you eat them quickly because then they are less able to stay kind of nutritionally adequate so buy them ground and use them quick or buy them whole and grind them yourself and know that the nutrients will stay anyway so not to over complicate things porridge seeds berries you can have wholemeal bread with your nut butters you could have a healthy muesli or granola with your nut milks give them some basic ideas for breakfast then again depending on what they like to eat for lunch perhaps a simple plant-based burrito the muesli or granola with your nut milks. Give them some basic ideas for breakfast. Then again, depending on what they like to eat for lunch, perhaps a simple plant-based burrito, or maybe

they, you know, they might like a tofu scramble instead of an egg mayo. It really depends on what they normally eat, but then dinner, say for example, they like a chicken curry, then maybe make a chickpea curry instead. Or if they're a spaghetti bolognese fan, maybe go for a lentil bolognese. A simple one pot lentil bolognese is so easy. It takes 15 minutes and you can, you know, batch cook. So essentially find out what they like and give them options that they can make that are just as good, but healthy too. And yeah, that would be my top tip. If people want more information about recipes and advice, then they can go to my website or my instagram plant power doctor to find out more with the little at symbol with a little at symbol

yeah at the front basically there's so much about there's so much more to health than what we put on our plate but what we do put on our plate if we can make it healthy and predominantly plant-based you're really onto a winner and then that's where you can look at other aspects of health with far more clarity yeah let me just go on can i ask one more question because here i can't believe that we've been going for two hours and the word protein has not been uttered yet nobody so i guess that's a testament to how well versed all of you are in this. But of course the question, where do you get your protein does come up. And one of the responses that I'm starting to hear or, or, or kind of statements that gets

bandied about is that animal protein is yes, you can, you can eat a plant-based diet and you can meet your protein needs, but plant protein is inferior to animal protein. So how do you field that question? So I like to tell people that I used to worry about protein too before I researched it, because I think that's the first question that most people ask. But then I reassure them that plants have protein because that's where the animals get their protein from so it's a fairly straightforward thing that if you're the animal that you eat has eaten plants then they got their protein from those plants um and in fact people

tend to eat twice as much protein as they need and half as much fiber as they need so the average plant-based eater will actually get twice as much protein in their diet than they actually physically need. So it's generally not a concern, but also you've got to look at your protein package. So what else are you taking in with your protein? And when you're having a meat-heavy diet, then you're going to be getting some protein, obviously. You're going to be getting some omega-6s, predominantly if you've got a factory farmed animal, over omega-3s. But you're also going to be getting various carcinogens at the same time so when you cook it what happens when you cook the meat then you release heterocyclic amines which are carcinogenic compounds and when you when you grill it you still get the same

heterocyclic amines and it's worse when you barbecue it but you can't really escape it any kind of animal protein when cooked will do this if it's a processed meat then you're going to get um and nitroso compounds which are also carcinogenic um then you've got to look at what your body does with it you've got heme iron which people say great you know you're going to have more bioavailable iron well that's true But heme iron also oxidizes more readily in the body, which is associated with inflammation and obviously not good for long-term health. And then what happens when your gut microbes come into contact with that meat? Well, they're going to want to digest the carnitine. And in so doing, you've got gut microbes that

produce something called TMA, which then goes to the liver and makes TMAO, trimethylamine oxide, which is a toxin. It increases risk of heart disease, it worsens kidney failure, it worsens heart failure. It's not a good thing to have in the system. So you've got a number of mechanisms by which your animal protein package might be doing more harm than good and I haven't even mentioned the IGF-1 factor which I talked about earlier. So you're going to be making more IGF-1, which is associated with increased cancer risk. What do you get in your plant protein package? Well, you get the phytonutrients, the antioxidants, the insoluble and soluble fiber. You get all this good stuff alongside it. So yeah, look at the package as a whole and then decide which one you're going to

have more of on your plate. And if someone's looking to make a change, but they're scared of the, you know, all in like, okay, you know in, like, okay, I'm just going to change everything overnight. Most people don't. Let's be honest. That's not how change really is made for people. So if someone's listening to this and they're intrigued and they're feeling motivated to make a change, but they're trying to figure out, well, what's the first thing that I should do? What's the most important? It's too overwhelming for me, right? Everything that you said, I need time. But like, tell me one thing I can do tomorrow. Like, what would be the first, most impactful

change that that person can make? The most impactful thing would be to think, I'm going to change, I'm going to learn one new recipe this week. One new thing that I can learn how to cook that I like, that I can incorporate into my life. And then if you do that every week for five weeks, you've pretty much got an entire repertoire because people kind of stick with the same foods in and out day after day. So if you can make a promise to yourself that you're going to get yourself a plant-based cookbook,

or even better, simply just go onto Google and go whole food plant-based recipes and then type in your favorite meal and see what comes up and promise yourself that you're going to make that meal just that one time see how it goes see if you like it and then perhaps the next week you might try an easy breakfast breakfast is kind of easy because you don't have to think too much about that as long as you've got simple things like oats you can make plant-powered pancakes you can make your porridge you can make your granola and that's really straightforward so that could be your first plant-based meal and then you just have to learn maybe a new recipe every week or two and gradually sort of ease yourself into it I mean there's no

pressure it's a it's a diet of abundance it's a lifestyle of abundance and that's the thing that we need to remember I think so many people are caught up on thinking oh i've got to stop eating this or that no you're going to be incorporating an abundance of beautiful fresh healthy foods into your life and hopefully as you eat those foods you're going to be able to really get an experience of how delicious it is and how much it's nourishing your body nourishing your mind nourishing your soul and then you're going to want to learn a new meal the next week you're going to want to learn a new recipe the week after that just take it rather than then then then looking at it from a perspective of lack and all the things that you're going to be removing from your plate focus on the awesome

adventure of building in all these new exactly foods that you're not used to eating. And then second to that, I think there's a lot of wisdom in mastering one thing at a time. You know, for a lot of people, it's like, I just can't imagine, you know, not putting milk in my coffee or, you know, something simple like that, that you can change like, okay, well, I'm going to just master almond milk in my coffee instead of that. And like, do that for a couple of weeks until you feel good about that and you can make the next change exactly in fact that's why i would encourage people to do anyone that's listening right now if you've been thinking about a plant-based diet if you've been wondering about a plant-based diet and you're not sure what the first step to take is we've obviously covered a

lot of ground today but this could be your chance to make one change just one thing that you can do tomorrow that could change your daily habit. And if you can keep doing that for a few days and then maybe make one more change, that's the beginning of a new reality for you. So maybe have a think, is there one thing that you could do today or tomorrow that would make a difference to your daily routine that you could commit to doing, that you could maybe tell your spouse about, or maybe a friend, so that they can keep you accountable and start you off on your fantastic,

abundant health journey. That's so inspiring. You're very optimistic. You've got to stay optimistic. Are you truly? When I kind of take a look from 10,000 feet down on planet earth, it's easy to, to despair of how we're treating the planet and to see the declining health of our population. There are tools like we've just been talking about today that can transform all of that, that are accessible and very doable.

And yet sometimes I feel like, I don't know, are we going to win this war? How do you look at that? I like to think of it as a journey of enlightenment for humanity rather than a war. Because otherwise it does get kind of depressing. But if we think of it as a journey of enlightenment, we know instinctively that staying close to nature

is super important for our health and for the health of our children. And we know, seeing that one species is dying every 20 minutes, we know we're in the middle of something serious and that something has to be done. But overwhelm is not the emotion with which to face this. Hope and gratitude and love

are the emotions with which to face this. Hope and gratitude and love are the emotions with which to face this. So stay positive, make a change for yourself, tell others about your change, feel good, and hopefully the message will spread. Mic drop. Let's hear it for Gemma Newman. Thank you. Beautiful.

You're welcome. Yes, what a delight. You can learn more about Gemma Newman. Thank you. Beautiful. You're welcome. Yes. What a delight. You can learn more about Gemma at gemmanewman.com and at Plant Powered Doctor. Anything, anywhere else you want to direct people? Yeah. So the Plant Based Health Professionals UK are a great organization headed up by Dr. Shireen Kassam.

And that also has a great website and we do lots of events. We've got a great event coming up with Dr. Kim Williams, former head of the American College of Cardiology. He's going to be talking in London next month and we've got the Happy Pear guys going to be there as well and also Bosch.

They've done a great plant-based cookbook. So please do come and join us at that event. That's where we'll be. We've got VegMed coming up in October, which is a fantastic international plant-based conference.'ve got dr clapper speaking there i should be speaking there as well if anybody wants to check that out there's still tickets available for the public to come along on the public day so please come and check that out and um yeah those are the two things really so yeah, yeah. All right. Peace. Plants.

There you go. Awesome. That was great, right? I thought she was awesome. The power of plants. What else can I tell you? I've been banging this drum for so long. Anyway, let Gemma know what you thought of today's conversation. You can hit her up on Twitter at drgemgem, D-R-G-E-M-G-E-M, and on Instagram

at plantpowerdoctor. You can learn more by reading her blog at gemmanewman.com. And as always, please check out the show notes at richroll.com on the episode page to take your edification of today's episode beyond the earbuds. Tons of resources and links and stuff like that to learn more about Gemma and plant-based nutrition. Another reminder to go to meals.richroll.com to check out our amazing meal planner that we talked about in the intro. Great reviews. Try it out for yourself. If you would like to support the work we do here on the podcast, a couple simple ways to do that.

Tell your friends about it. Tell them about your favorite episode. Talk to them about it at the bar, at the restaurant, over family dinner. Share the show on social media. Take a screen grab. Put it up on Instagram, Twitter, wherever, Facebook. Tag me. Sometimes I like to reshare that stuff.

Most importantly, hit subscribe on Apple Podcasts, on YouTube, on Spotify, on Google Podcasts, wherever you listen to this. Leave a review on Apple Podcasts. Leave a comment underneath the videos on YouTube, and you can support us on Patreon by going to richroll.com forward slash donate. I want to thank everybody who helped put on the show today, Jason Camiolo for audio engineering, production, show notes, interstitial music, Blake Curtis and Margo Lubin for videoing and editing the podcast. Right now, I'm with Blake. He's in the sound booth, so he's taking on some audio engineering tasks today as well.

Jessica Miranda for graphics. Allie Rogers for her beautiful photographs. DK for advertiser relationships and theme music, as always, by Annalema. Appreciate the love, you guys. Thank you for listening. I do not take your attention or your time for granted and I will see you back here in a couple days with a very hotly

anticipated fantastic conversation with the amazing the inspirational Rebecca Rush yes the girl power continues with Rebecca she's amazing she's an adventure racer an extraordinary mountain bike champion endurance athlete power powerhouse.

Until then, eat more plants, people, more fruit, more veg. Peace out. Namaste. Thank you.