ZOE Science & Nutrition - ZOE’s best health tips of 2025 - Part 2

Starting point is 00:00:00 Welcome to Zoe Science and Nutrition, where world-leading scientists explain how their research can improve your health. Welcome back to part two of our 2025 highlights, the moments that changed how we think about our health and give us practical tools to feel better every day. Today, you'll hear what happened when I put my own breakfast under the microscope, how arthritis symptoms were reversed. in a groundbreaking trial, and we finally get a scientific answer to the question, does cheese really cause nightmares? But first, a person who has arguably pushed the boundaries more than anyone, Brian Johnson. Brian has dedicated his life and his body to testing cutting-edge health interventions to slow down aging. His meticulous approach to sleep, diet and exercise has sparked global debate

Starting point is 00:00:57 and raises a question that matters for all of us. How much should we experiment with our own health? I began by asking him how he developed his unique way of living. We wanted to approach this question scientifically, and so I hired 30 medical professionals, and we went through this process where we evaluated all the scientific literature on health span, my span. We tried to grade the evidence that we could identify,

Starting point is 00:01:24 that, you know, do we think, for example, a given therapy, let's say it slows down the speed of aging or reverses aging damage to a certain degree, do we bleed the evidence? And then we stacked ranked all the evidence and said, okay, we have our list and let's just start with number one. And let's do that therapy or that measurement. And so we had a firm principle that we would do everything based upon measurement and scientific evidence. And so I became the most measured person in human history. There's more data on my body than anyone before me. It's amazing. And we've just gone to this process of measurement, application of the science, and again and again. And I think it's possible that I have the best comprehensive health markers of anybody in the world. You know, take 50 different markers from my sleep quality to my inflammation levels to uric acid, to muscle, to fat, to take any marker. We're going to share this actually the next coming days, but it's really a contemplation of like what, does health look like and comprehensively, from how you sleep, to what your microbiome looks like, to your biological age, your methylation patterns. So we really have tried to just do

Starting point is 00:02:32 this by the data and numbers and with as little storytelling as possible. And Brian, when you say the best possible markers, do you mean the best possible markers for someone of your age? Or are you saying that, like, they're better than, you know, my 16-year-old son? And so in every biological age marker, there's typically a ideal age. So, for example, like in grip strength, as you grow older, you increase in grip strength capacity, that you hit a certain age, you decline in grip age capacity. And that is true for a lot of things. That's your cardiovascular fitness. It peaks at age 18 and then declines from there. And so we've tried to identify the peak health level of every category of every marker, and we try to peg that. So we say, what is peak cardiovascular

Starting point is 00:03:21 fitness for an 18-year-old, and then how do I achieve that? So, for example, my cardiovascular fitness is equal to top 1.5% of 18-year-olds as measured by BL2 max. We completed a test today looking at oxygenation of muscles, and so that's also a marker of age. So my oxygenation of my muscle is in the top 5% of 18-year-olds, elite swimmers. So we try to find peak levels and then peg my markers to that as best we can. If I understand, Roder, you are saying that, yes, you are better than my 16-year-old son, basically, on all of these markers? Yes. I mean, if you basically said, because a conventional wisdom would say, a 47-year-old could never be as healthy as 16-year-old. Now, in certain regards, that's probably

Starting point is 00:04:06 true, right? They have the anatomy of a 17-year-old. I have anatomy of a 47-year-old, and there's just some things our technologies can't do today. However, if you compare the 16-year-old and me on these markers, inflammation, sleep quality, cardiovascularability, momental density down the line, it's possible my health markers are, in fact, better than these 16-year-olds. That's amazing. Listening to Brian, I was struck by the contrast between his extreme routine and the much smaller health experiments most of us might want to try.

Starting point is 00:04:36 My Zoe co-founder, Professor Tim Specter, Brian and I shared a really honest, useful exchange about what's safe, what isn't, and where to start. One question I think a lot of listeners will have listening to this is, is it safe to experiment on my health. So how should people, you know, if you were going to advise anyone listening to this, thinking about experimenting with their health but wanting to do it safely, what would you be saying, Tim? I think it's reasonable to explore, particularly, you know, with, say, sleep exercise and food, if you do it for short periods of time and you're not going to overdo it, it's probably reasonably safe if you don't have any other medical conditions

Starting point is 00:05:15 and you're fairly young and healthy. Everything I believe in, is about self-experimentation because everyone is different and learning what sleep is good for you, how much exercise is good for you, what the right diets, you know, what are personalized to you or you should be on a high fat or a high-carb diet. These all require some self-experimentation if you don't have access to things like Zoe program. But I think I would do it for short periods of time. You know, the danger is if you overdo it and in areas we don't fully understand And I think the gut microbiome was one, certainly when did this 10 years ago,

Starting point is 00:05:53 we didn't understand quite how harmful some of these practices could be. But I think we should really, yeah, everyone should be encouraged to some extent to do self-experimentation. Do you agree with that? Yeah, I mean, life is an experiment. So whether someone is actively opting into experiment,

Starting point is 00:06:13 they are experimenting every second of every day. So when you decide to go to bed, you're doing an experiment. When you choose something from the menu, you're experimenting. Like, every decision you make is an experiment. So the question is whether you have data just to inform you of the results of your experiment. But what I think is really cool is that we've learned that, you know,

Starting point is 00:06:33 just with food, if you just record how you feel a few hours after eating it in a notebook or something, you can get a pretty good idea of, well, that food does agree with you or not. And these are things we never thought of before, because we always assumed we're all the same, we will respond to exercise, food and sleep the same way. But, you know, there's some experiments Brian's doing, you know, very methodical, very technical. But I think everyone can just make a mental note to think about how they fear.

Starting point is 00:07:01 How does it make them feel? That idea of simply paying attention, noticing how you feel after you eat, move or change your routine has really stayed with me. It's such a low effort habit, and yet it can tell us more about our health than we realize. And it doesn't just apply to food. Brian told us that sleep was one of the biggest levers he's found for improving his overall well-being. So with that in mind, I turned to someone who knows it's better than almost anyone, world-leading sleep scientist, Sophie Bostock. In this next clip, she explains why good sleep doesn't just help.

Starting point is 00:07:33 It sets the foundation for everything else. We tend to increase our perception of threat when we're sleep deprived, and I think this is an incredibly important theme that will probably sort of run through this conversation, because that sense of thread, that is not just psychological, that is very much physiological. So if your brain and your body are feeling on edge, then what happens, you amp up that sensitivity of the stress response, this physiological cascade which has evolved to help us to fight or flee or freeze in the face of danger. And for most of us, that means increasing adrenaline, increasing cortisol, increasing blood pressure, increasing the blood flow to the

Starting point is 00:08:16 muscles, perhaps making us sweat a little bit more, mobilising blood sugar, blood glucose, so that we're fired up for action. So that is an evolutionary response to being in an environment where we couldn't sleep well. So if you think about our hunter-gatherer ancestors, you know, if they were camped out next to a den of saber-tooth tigers, there was an evolutionary advantage in being in this increased state of fight or flight. They were much less likely to get eaten. And over hundreds of thousands of years, our brains have learned to associate sleep loss with potential danger. And so we are more on edge. So that helps to explain those emotional responses. Also the physiological responses that over time our immune system becomes

Starting point is 00:09:06 dysregulated, more like to be exhausted almost because we're constantly ramping up our immune response ready to fight infection. We also see that we're at increased risk of hypertension, of inflammation, these diseases which help to increase risks of heart disease, of diabetes, disrupted blood sugar. I could go on. But I think the other aspect is cognitive function. So we know that the brain does a huge amount of mental processing overnight. We are consolidating memories. We are pruning back information so that we can focus on what is most important. So sleep is really helping us to learn and innovate. So when we're sleep deprived, that sort of brain fog, that slowness to respond, slower reaction time,

Starting point is 00:09:56 that can also have, you know, knock on effects and increase risk of accidents and things like that. So we've got very acute effects and also more chronic long-term effects on health. If we want to make real progress with our health in 2026, we can't ignore sleep. It isn't just a nice to have. It shapes our stress levels, our immune system, our blood sugar, even our ability to think clearly. The good news is you don't need to start a complicated routine. In this next part of our conversation, Sophie shares some simple science backsteps you can try to build a more solid sleep foundation.

Starting point is 00:10:33 I love this time of year. Yes, it's busy. but it also means a moment to reconnect with the people you love. And what brings us together more than anything? Food. It's the season for family feasts, long dinners with friends, and hearty home-cooked meals. The good news is, social eating isn't just enjoyable.

Starting point is 00:10:55 Connecting over food can also support our mental and physical well-being. And that's why we've created the Zoe Holiday Hosting Guide. It's free and full of simple hosting ideas, plant-rich dishes, and shareable gut-friendly meals that will nourish you and your guests from the inside out. So if you want good food for when you're in good company, this guide is for you. To download your free guide, simply click the link in the show notes or go to zoe.com slash holiday guide. That's zoe.com slash holiday guide. Let's keep it simple. Start first thing in the morning.

Starting point is 00:11:32 wake up at the same time as often as you can. So set your alarm for the same time each day. When you start to do that for a week or two, you'll find that you don't need the alarm anymore. But try and aim for consistent wake up time. Aim to get some natural light, ideally within the first hour after waking. That's going to kickstart your circadian rhythm for the day, tell the clock that it's wake up time. And the advantage of doing that is that if you get this bright light in the morning. It's going to banish the melatonin, so you're going to feel more alert. But automatically, 15 or 16 hours later, you're going to start to feel sleepy. Move your body during the day, whichever way makes you feel happy, but get physical, be active. There was some recent

Starting point is 00:12:17 research actually suggested that yoga was one of the best forms of exercise for sleep. So it doesn't need to be super intensive. It just needs to feel good for you. Take some time out to relax during the day, particularly if you're a busy person that goes from A to B at 300 miles an hour, just take 15 minutes for yourself, a moment to be and not do. And then as we come towards bedtime, try and have a consistent wind down time. I'm not bothered about whether you get into bed at exactly the right time, but try and have a consistent time where you start to switch off. So in that hour of wind down, you know, get done what needs to be done for tomorrow, some form of relaxation, something to look forward to, whether it's a warm bath or reading a book or

Starting point is 00:13:03 doing some breathwork, listening to music, some intimacy with your partner, with your family. Social connection is often unneglected in terms of its role in improving sleep. And then during sleep, you want darkness. Use an eye mask or blackout blinds, try and sort of banish light from your sleep environment. And just let it come. Don't try too hard to sleep. That sounds brilliant. The one thing I haven't heard you mention I'm curious about is use of that smartphone.

Starting point is 00:13:35 Because you said right at the beginning that's the number one thing that's really changed everything and made this worse. In my book, that wind down time, that's when I'd be switching off the phone. Ideally, the phone does not come with you into the bedroom. Buy a cheap alarm clock that has no smart functions. And this is something that actually can be really good for families. So parents will often say, you know, how do I separate my teenager from their phone? Well, if it's something that everybody does, it's just a norm. The phones don't go into the bedroom.

Starting point is 00:14:04 That's not where they live. That just is a rule that you can make for yourselves. If I do all of these things, if I'm not in the insomnia, but I'm in that 50 to 60% of people are not getting their best sleep, can it really transform my sleeping? All of those things might help a bit. I don't want to overdo the sleep hygiene piece because I also know there are some great sleepers out there who have pretty poor sort of sleep habits. They're all part of this picture of positive sleep health. I think if there was anything to add to that, it's just that I would love people to believe that sleep is important, but also to believe that they are good

Starting point is 00:14:46 sleepers. A lot of what I do is help people build confidence. So if you do those habits, it's what happens is that you build confidence that you are going to sleep well. So that helps to ease the anxiety. If you're someone who has been anxious about sleep in the past, the danger of this advice is that it's too rigid and that if you haven't had 15 minutes of daylight within an hour of waking up, you start to get anxious. If your phone's accidentally gone into the bedroom,

Starting point is 00:15:15 then you might have a terrible night's sleep. So these are guidelines. They are recommendations. They are not strict rules. There's one sleep rule many of us grew up with, never eat cheese before bed. Supposedly, it guarantees bad dreams. I asked Sophie whether there's any real science behind this idea,

Starting point is 00:15:35 or if it's just another sleep myth, we can finally let go of. As you'll hear, the evidence is, well, pretty thin and mainly linked to people whose bodies don't tolerate dairy well. So for most of us, there's no strong reason to fear a bit of evening cheese. it's nice to be able to finally put that particular sleep story to rest. So there was a paper that was published, I think just a month or two ago on this. And it was actually a survey. So this was a Canadian study and over 1,000 students who got credit for taking part in the survey.

Starting point is 00:16:07 And they asked them about the foods they ate and whether the people thought they influenced their sleep and their dreams. And out of 1,000 people, I think only 1% suggested that dairy influenced their. dreams. The study suggested that that population were more likely to be lactose intolerant, so of course, if you're eating something that really doesn't agree with you, it may well disrupt your sleep. So now you've had a good night's sleep, you wake up feeling more rested, and then comes a very familiar question, what should I have for breakfast? For many of you, that answer is a bowl of oats. But in 2025, oats became surprisingly controversial. Some people praise them as heart-healthy hero, others worried they might say,

Starting point is 00:16:51 and blood sugar through the roof. Dr. Sarah Berry and I unpacked the evidence. First, we looked at the big picture. What do the long-term studies actually show about oats and heart health? There's some fantastic data that's come from what we call the epidemiological studies, which are studies in large populations where they've followed people for a long period of time and looked at depending on whether people are oat eaters or not oat eaters, whether that affects their risk of disease.

Starting point is 00:17:18 And in one such study where they followed more than 500,000 individuals over many years, they found that people who were oat eaters versus those who didn't eat any oats actually had lower rates of type 2 diabetes by about 15% and lower all-cause mortality, which basically means risk of dying. And that was by about 20%. Now, obviously, there's lots of other things that might... explain some of this, you know, people who eat oats tend to smoke less, etc. But you can actually adjust for that in the analysis. You can never fully disentangle it. So it's not kind of the strongest

Starting point is 00:17:58 evidence to pull on. But that gives us an idea that there's something going on there, that there's something about eating oats that might be beneficial for our health. And so the next thing we need to look at is clinical trials and also is there a mechanism? Is there some kind of rationale that why we might be seeing this? And what we know is that oats contain of a special fibre called beta-glucan. And this fibre is well known to reduce circulating cholesterol levels. So to reduce total cholesterol, but also reduce LDL, which is our bad cholesterol that we know is linked to heart disease.

Starting point is 00:18:35 And there's been lots of clinical trials that have been published showing that if you add oats to a meal or the beta-glucan to a meal, that you can significantly reduce people's cholesterol levels. It needs to be about a certain dose. So we know that you need to be having about three grams of the beta-glucam a day in order to lower your cholesterol. And so the FDA in the US and the EFSA, the European Food Standards Agency in the UK,

Starting point is 00:19:04 actually have an approved health claim that beta-glucam, this fibre that's in oats, at three grams a day, can reduce your cholesterol. and hence is associated with improved heart health. And I think the evidence is quite consistent for that. So, oats came out looking pretty good from a heart health perspective, especially because of that special fibre, beta-glucon, which can help lower cholesterol when you eat enough of it regularly.

Starting point is 00:19:32 But what about the other concern? Blood sugar spikes. To test this properly, Sarah and I turned ourselves into guinea pigs. We both ate a ball of instant oats, the kind you might pop in the microwave in the morning. And we tracked what happened to our blood sugar in real time. I'm going to scan mine and show you what I've got, Sarah. Here we go. Wow.

Starting point is 00:19:53 Can you see that? So Jonathan's has just gone up to 10.7. I can't believe that. Well, I can believe that, but I'm quite surprised. And mine's gone up to 8.4. So, Sarah, I just had 10.7. And my number, you know, when we scanned it 20 minutes ago, was around 6.000. six, what does any of that mean? What's going on?

Starting point is 00:20:15 So what's happening is the carbohydrate from the oats is being processed and broken down into glucose molecules. And the glucose molecules are now passing through your bloodstream and this is what we're detecting from the glucose monitor that you're wearing on your arm. So you're seeing this increase in circulating glucose from the carbohydrates that are in those oats. And this increases within 5 to 10 minutes after eating any carbohydrate rich meals. Typically, it peaks around 30 minutes. So it'll be interesting to see what it looks like in about 10 or 15 minutes. And it seems to me that that number has shot through the roof in the last 20 minutes when I ate this instant oats. In fact, I have worn these before. I don't think I've managed

Starting point is 00:21:02 to get above 10 with anything I eat in the last three or four years. I definitely did use to go above 10 before I started at Zoe. So that's a pretty impressive spike I've achieved, isn't it? Yeah, that's quite a big increase in blood sugar levels. Now, an increase in blood sugar after carbohydrate rich meal is a normal physiological response. But once it starts to get really high, quite often it can impact how you're feeling in the moment. So it might be that you have a like headache or you might feel that your heart is racing a little bit. Also, about two to four hours after having quite a big peak like that, you might get a dip in blood glucose. And we found from our own Zoe research that that dip can drive increased hunger, increase food intake,

Starting point is 00:21:48 it can give you poor energy, poor alertness. What we also know is if you are eating every day all of your meals to cause that kind of peak, the over sustained period of time, we know that that's linked to some unfavourable long-term health effects, like an increased risk of obesity, type 2 diabetes and cardiovascular disease. So I would not recommend, based on that, you having instant porridge on its own with water for every meal of the day, absolutely. Or even every breakfast, right? No, because you're likely as well to just not feel great for the rest of the day, because it sets you up on that kind of roller coaster where you're having the big peak,

Starting point is 00:22:23 you're having this dip, it's driving you then to go and have a quick fix to get your blood sugar, back up, you're then eating more at your next meal, and you'll probably feel less energetic, less alert. So, yeah, I wouldn't advise that. Now, Sarah, you didn't eat exactly the same thing as me, did you? You added all those other ingredients onto these instant oats. Why is your number not the same as my number, Sarah? So I added nuts, seeds, dried berries and some nut butter, and they contain extra fibre, extra protein, and extra fat. And we know that fiber, fat, and protein impact the rate at which our stomach empties. They impact also the rate at which blood glucose is then absorbed from the bloodstream

Starting point is 00:23:08 and also some hormones like insulin, which obviously also impact how we metabolize the blood sugar. So by adding and layering on this extra fat, protein and fiber, it modulates how quickly we absorb the glucose. So it modulates this rise in blood sugar. And Sarah, I know what we. have with our meal is one part, but also it's true that we don't all respond the same, right, as we eat these meals. And you already showed that, like, my baseline blood sugar was higher than yours. So even with your pairing, Sarah, and the fact that your blood sugar control is better than mine, isn't it? I think when we've done these very tests, it turns out that my blood sugar

Starting point is 00:23:48 control is really quite poor. My memory is that yours is fairly good. Yeah, mine is a little bit better than yours, yes. And it's surprising, actually, even though I paired it with the fiber, the fat, and the protein that it's still gone up that high. And I remember the first time that I ever did this test with Zoe, with my blood sugar sense. So this was the thing that blew my mind because I sort of thought like these oats, right? They're really healthy for you. And yet I was having this response, which was sort of as fast as when I just drank a sugary, drink, and it seems to me that what you're seeing there, Sarah, is even when you've mixed in those other things, that this instant oats is, it feels like it's almost like you're

Starting point is 00:24:34 having sugar with your yogurt. What's going on there? Yeah, and it's all to do with the magic of the food matrix that we often talk about here at Zoe, which basically is the structure of the food. So, for example, there was a clinical trial where they asked people to eat one day these steel cut oats, another day the rolled oats, another day, instant oats and another day really heavily processed oats that are used often in breakfast cereals like Cheerios. And what they found similar to what we've observed today is that they're less processed, the lower the blood sugar response. So the steel cut oats caused the lowest increase in blood sugar after eating.

Starting point is 00:25:15 the rolled oats that we had yesterday called only a moderate increase, but as it became more processed up to the level of the oats that we had today, you got a bigger increase. And it's because of changing the structure, changing the rate at which the stomach empties it, the rate at which they're absorbed, that you see these differences. One of my biggest lessons from that experiment is that not all oats are created equal.

Starting point is 00:25:38 The more processed they are, the bigger the blood sugar spikes we tend to see. A simple habit I'm taking into 2026 is to choose less processed oats, like steel cut or plain rolled oats with no added ingredients, and to dress them up with plants, fiber, healthy fats and protein to help smooth out those spikes. Repeated blood sugar spice can contribute to chronic low-grade inflammation in the body. And inflammation is at the heart of many conditions, including arthritis. So next, I turn to Dr. Tomiko Katsumoto, clinical associate professor at Stanford University, to help us understand the different types of arthritis and why joint pain is becoming so common. So osteoarthritis is, unfortunately, one of the most common types of arthritis.

Starting point is 00:26:22 And, you know, we used to call it kind of a wear and tear degenerative arthritis, less inflammatory. These are the types of arthritis that can occur in joints that have previously had, for example, an injury, a lot of athletes that have messed up their knees or their hips, whatever, that can happen. However, I think we're learning osteoarthritis actually might have a more inflammatory component than we previously realized. It's more common in people that are overweight. It's possibly related in some ways to the fact that they're burying more weight on those joints. So there may be a mechanical component, but there are other components for osteoarthritis we don't fully understand. For example, the hands can be affected in osteoarthritis. And so clearly we're not

Starting point is 00:27:04 bearing weight in our hands. Osteoarthritis is sort of one of the classic most common types, which is less, it's not considered to be truly inflammatory. Rheumatoid arthritis is the most common inflammatory arthritis. And again, I think that we are starting to understand that there are genetic contributions, but more and more, as we move forward, we're learning the environmental components are substantial. What do you experience as a patient living with osteoarthritis or rheumatoid arthritis? O.A., osteoarthritis, I'll call it OA, osteoarthritis, tends to be less inflammatory, people tend to get more and more pain with motion, with using their joints. In contrast, rheumatoid arthritis is considered inflammatory, meaning that people tend to

Starting point is 00:27:47 wake up, feeling incredibly stiff, takes a while for them to get up and going. They often feel like they need to get their joints moving. A hot shower might really help get them moving. They experience what's called jelling, where you sit down for a prolonged period of time, and your joints kind of gel, and then as you start to move them, that starts to get them feeling better. But rheumatoid arthritis can be profoundly disabling, the amount of pain, the amount of dysfunction. A lot of patients aren't, for example, if it's affecting your hands, you're not able to open jars or grasp things or, you know, using your joints the way you normally would like to. It can be very painful in terms of it if it affects your foot joints. You know, it feels like you're walking on marbles or glass in some cases.

Starting point is 00:28:32 Sadly, arthritis is affecting more and more people worldwide. And for many, the pain and stiffness can completely change daily life. But there was some genuine hope from Dr. Katzumoto. She walked us through a major trial that tested whether a comprehensive lifestyle program, including diet, movement, sleep and stress management, could meaningfully improve symptoms for people living with arthritis. This was a very exciting trial. I'm a huge fan of randomized controlled trials.

Starting point is 00:29:00 I think this is our highest level of evidence. This is a group, our Dutch colleagues, they ended up randomizing a group of patients with, but they actually did two studies in parallel. They did one in rheumatoid arthritis, and they did one in osteoarthritis. To clarify, it was a metabolic associated osteoarthritis. So patients that tended to have metabolic syndrome were maybe overweight, so those patients with OA. And so randomized control trials are basically the gold standard of scientific testing? Yes. They are helpful in that they may. minimize any confounding bias in terms of the fact that people are put into two different groups,

Starting point is 00:29:39 there's an equal chance of whatever intervention working or not, and comparing to a placebo provides a robust comparator. And basically, what they did was they put them through a lifestyle intervention. And this is absolutely thrilling to me because I'm a huge fan of the American College of Lifestyle Medicine, just to quickly provide their six pillars of lifestyle medicine. diet is number one, in addition, exercise, stress reduction, social connections, sleep, and then finally avoidance of risky substances. So those are the six pillars of lifestyle medicine. And essentially what this randomized control trial did was put these patients through either the active arm, they called it the plants for joints arm that underwent these

Starting point is 00:30:26 six lifestyle interventions versus the placebo, which was essentially standard of care. They ran them through this program for 16 weeks, and what they found at the end of the study, and even at eight weeks at the midpoint, they saw dramatic improvements in the patient's joint disease. So for the rheumatoid arthritis patient, the endpoint they looked at is called DAS 28. This is disease activity score based on 28 different joints. So you measure swollen and tender joints. You measure the CRP inflammatory marker. You measure how the patient's feeling. And based on that endpoint, which is a very robust end point, there was a very statistically highly significant difference in terms of the RA patients that underwent this lifestyle program. They looked more

Starting point is 00:31:12 deeply to see what was the most likely thing driving this difference, and it was most likely diet. Of course, you can't separate out. It was a full holistic intervention of multiple different domains. But anyway, bottom line, I think diet played a huge role. And what they did was they educated these patients on whole food plant-based diet. So minimizing processed foods, minimizing, you know, really or mostly eliminating animal products, increasing fiber intake, and really trying to encompass a very healthy whole food diet. Same thing was done for osteoarthritis. And the reason I got so excited to see the results for osteoarthritis is we don't have great treatments for OA. It's one of the most common conditions, debilitating,

Starting point is 00:31:58 a lot of us get it, and yet we often don't have good answers. And so the fact that this intervention, this lifestyle intervention showed such a promising result, I think is really exciting for the field. There was a big impact for both these groups with these different types of arthritis. Yes. Because I know sometimes scientists can get really excited about something that's like, it's statistically significant, but it's like a 2% change. And so the scientists get really excited about it, but as like a normal person or patient, you're like, well, that doesn't really going to change my life. Like, does this actually make any difference to the symptoms and how they were going to feel after

Starting point is 00:32:35 this? Yes, this was definitely beyond the minimally important clinical difference. So there was clearly impact on patients' lives, quality of lives. What was the most exciting? They did a one-year follow-up of these cohorts, and they showed that a lot of these patients were able to get off of their medications. They were able to actually give up their medications, because you were talking about how serious this is. So that seems rather amazing. Which is incredible. I think the, you know,

Starting point is 00:33:03 a lot of them ended up gradually, you know, deprescribing a lot of their meds. Many of them, you know, a lot of them lost weight, a lot of them improved in terms of their blood pressure, in terms of a lot of, you know, other cardiovascular, you know, lipid profiles, these types of things. But I was most struck by the fact that some of them were able to wean off these medications, which was striking. The results of that study were remarkable. Many participants didn't just feel a bit better. Some improved enough to reduce or even stop certain medications under medical supervision. So what does an arthritis-friendly way of eating actually look like in practice?

Starting point is 00:33:39 I asked Tamiko to break it down into something simple you could picture on your plate at home. And she used a straightforward approach called the plate method. This is sort of the approach where you take a plate and you divide it up and really half of it is fruits, vegetables, you know, good stuff, the whole concept of eating the rainbow, I think really is apropos because these are foods that are high in phytochemicals, a lot of the antioxidants that are super important for calming down our immune system. Cruciferous vegetables. These are things like broccoli and kale and cauliflower and these really kind of the deep leafy greens that I've come to love and embrace.

Starting point is 00:34:22 And they're so important. I really think food is medicine. And these are incredibly important in terms of helping our liver detoxify. You know, we're living in a very polluted world. And I think that these are super helpful foods that can help us clear our body of a lot of these toxins, these endocrine disruptors, which we haven't talked about. But there's a lot of these things that we need to be thinking about that are super helpful for my patients. So half of the plate, I think, focusing on high quality vegetables, some fruits, and then a quarter of the plate being proteins, preferably plant proteins or lean proteins,

Starting point is 00:35:01 but things like beans and lentils, I'm a big fan of tofu, you know, a lot of, and then whole grains. I think the thing to keep in mind is that, as we know, with our ultra-processed foods, we tend to eat a lot of these very refined grains, you know, the white rice, white pasta, white bread, these things that have had a lot of the nutrients stripped out of them and a lot of the fiber stripped out. So refined grains is where we want to go. And so really whole wheat and whole, you know, things like kinoa, I love. And some of these ancient grains are also really good, like faro and bulgar and millet. If you kind of imagine, I guess it's really the plate method, the pyramid method is a little more, you know, more complicated to think through. But those are the key

Starting point is 00:35:49 staples that I try to encourage my patients to aim for. Again, animal products in moderation, really limiting them. If you look at the blue zones, they say that the majority of blue zones ended up eating meat less than five times a month. So really that comes down to maybe once a week. Meat should be considered a treat. The other thing I'll mention that I love about the blue zones is that one thing that was commonly shared across all the five blue zones is they all a half to one cup of beans a day. Beans are lentils, so these legumes that are so good for us, packed with protein, packed with fiber. Another food type that I love a lot are things like chia seeds and flax seeds. These are, I think chia seeds are the perfect food. They're high in fiber,

Starting point is 00:36:36 high in omega-3, high in protein. You know, they've just got so many great components that I add them to my smoothies. I just try to incorporate them wherever I can. I get a big, you know, bottle of them and add them wherever I can. Finding better ways to look after our joints is hugely important. Pain doesn't just hurt in the moment. It can stop us from moving, from doing the exercise and strength work that keeps us healthier for longer.

Starting point is 00:37:00 This year, I also learned that building muscle isn't only about getting stronger or changing how we look. Muscle plays a crucial role in how our bodies handle blood sugar and inflammation. My conversation with best-selling author and double-board certified orthopedic surgeon, Dr. Vonda Wright,

Starting point is 00:37:15 open my eyes to how vital muscle tissue is. for long-term health and independence, especially as we age. Muscle is a critical vehicle for pulling glucose out of the blood, turning it into the energy our body needs, often to contract the very muscle where it's made. So you can think of it as a glucose sink, as an energy sink for our body, which is critical, right? The more muscle you have, the more efficient you are at doing that.

Starting point is 00:37:42 And why is that important, Vonda? Why does it matter that I've got these muscles to pull in this? blood sugar out of my out of my blood. Well, I'm sure you've spoken many times about the roles of high blood sugar in the body. And at a very, very simple level, it's like we're barbecuing our body from the inside out where high blood sugar causes this chronic inflammation in our body, which is the cause of many chronic diseases, which is high inflammation. Sugar causes an internal process that produces is the substance it's called AGE's, which literally I think of it as an internal barbecue. It's crystallizing inside of our body.

Starting point is 00:38:22 Doesn't sound good. It doesn't sound good. It doesn't feel good. High inflammation is one of the reasons people get joint pain, frozen shoulder. One of the reasons we have the highly inflamed process of unchecked diabetes. I mean, all these things work together. And muscle is critical for helping control that glucose balance, because when there's too much circulating, it is stored in fat.

Starting point is 00:38:47 There's only so much our liver can store, about 2,000 calories worth. And then the rest of it has to be stored somewhere. And I'm going to tell you for sure that I find in joints where we shouldn't have this, because I'm an arthroscopist, fatty stores. It's like putting fat into the closets because there's nowhere else to put it. We have so much excess energy. Our body has to store it somewhere. stores it in fat, and then it shoves the fat a lot of places. You should not have big layers of

Starting point is 00:39:17 fat in our shoulder joint, in the hip joint, for instance. But yet I find it there pretty frequently. And so having more muscle helps to pull this glucose, his blood sugar, out of your bloodstream and helps to fight what you're describing? That's right, in a more efficient way, instead of just storing it in any convenient but unhealthy fat globule. So having more muscle doesn't just help you lift things. It helps your body clear excess blood sugar, more efficiently and may reduce some of the knock-on problems linked to chronic inflammation. That's why Vonda encourages people not to obsess over the number on the scale, but to think about body composition.

Starting point is 00:39:53 How much of your weight is muscle versus fat? And how does that balance support your health over time? Well, we know that when we just calorie restrict, we lose, depending on who you read, 20, 40, 50% of the total weight on the scale in muscle. We will lose fat. but a large portion of what we lose will be muscle because our body has a hierarchy of needs. Our body perceives certain tissues like bone and muscle as not only functional but storehouses. You're saying it sort of as though it's obvious, but that's pretty shocking.

Starting point is 00:40:31 I generally would think about it as like, well, you lose fat because after all, you're still walking around. We'll lose fat, yes. But I think many people like me will be surprised that you would lose fat. any muscle at all? Well, listen, when people are sick in the hospital for a week, it's estimated you can lose 9% of your muscle mass from laying still. 9% in a week. Yeah. Cachexia and being ill and drawing from your muscle as a source of energy can lead to profound changes. If I put a cast on your leg for one week and you're not contracting that muscle, your body will view it as non-vital and will start using it and you will have atrophy. It's interesting what the body does

Starting point is 00:41:10 Because back to the hierarchy of needs, in a situation where we're calorie restricted, our brain still is a very hungry organ and needs energy and your body's going to take it from somewhere. So if we're not in taking enough food, our body is going to start using the store houses to convert to energy for the brain to keep it alive, for the heart, to keep it alive, right? the vital functions. If we want to minimize muscle loss during the period when we're calorie restricting, then we need to feed ourselves enough protein so that we have the protein building blocks to maintain our muscle mass. We should also be lifting to try to build muscle that we feed with the protein as we calorie restrict. Because for instance, you can eat a lot of protein on a 1,500 calorie meal plan, right? So if your maintenance is 1,800 calories and you're trying to restrict by 300, you can still eat a lot of protein within that number of calories. You know,

Starting point is 00:42:20 you have to choose. You have to eat lean meats and lean sources, but is completely possible. The difficult truth is that if we only focus on cutting calories, you might be losing something far more valuable than just fat. The good news is that we can protect much more of that muscle by resistance training and eating enough protein while we're trying to lose weight. I asked Fonda what a realistic muscle-protecting workout routine might look like for someone who wants to improve their body composition,

Starting point is 00:42:49 not just shrink their weight. Your cardio needs to be 80-20, 80% base training, 20% high-intensity sprinting, that's about two days a week, and you need to lift weights. goal is strength and power. Strength, meaning what I can lift in a single lift, power in what I can lift over time. So to lift for strength and power, you have to lift heavier. And the ranges on those lifts are three to six reps for four sets. To build muscle for strength and power, four reps times four sets.

Starting point is 00:43:30 Because if I get to near failure in four reps, meaning with good form in the power lifts that I do, I can do, let's do bench press. I can do four reps of bench press. And I'm almost a failure. I can eke out five. It's going like this. One side's going down. But I'm not doing six. So to get to this place where I'm capable of lifting heavy, if you're starting from zero, it takes time. When I decided to recompose my body after perimenopause, I had lifted most of my life. I knew how to do it. I just went to trying to lift heavy. But if you're stepping away from the couch for the first time, you need to work through lifting light first, learning how your body works, learning the proper lifting technique before you attempt these.

Starting point is 00:44:19 And then this is a great time to hire a trainer to show you because there is technique is critically important when you lift heavy. What sort of exercises do I need to do within this hefty lifting to achieve what we're talking about? I think there's a lot of ways. And so I base my lifting and the lifting that I prescribe for people on power lifting. The upper body push pull, so some kind of bench, some kind of weighted pull, lower body pushbowl, which means squats and dead lifts. I prefer myself and for people to do them with bars and iron. You can do them with free weights.

Starting point is 00:44:57 So those are the four core lifts that we do the heaviest, four reps, four sets, because they're compound. They take multiple joints, multiple body balance. They take multiple muscle groups. To support that, the way we prescribe, is the supplemental lifts, and I'll describe that. We can do eight or ten of those, not to failure. So for the bench press, for instance, if I'm going to do fifth bench press day, and I'm going to start with that as my heavy sets, to round out the day in upper body, I might do three or four sets of eight to ten, biceps, triceps, lats, dealt rows, right, to augment this, to support the heavy lift I do. And that brings us to the end of our 2025 highlights. A huge thank you to every guest who share their expertise and to you, our listeners, for your questions, your curiosity, and your time.

Starting point is 00:45:56 I hope these conversations are given you a few ideas that you can take into 2026, sleeping a little better, experimenting more thoughtfully, moving your body in ways that build strength, and making food choices that support your long-term health. From all of us at Zoe, thank you for listening, and here's to a healthier, happier, 26. Thank you. Thank you.

ZOE Science & Nutrition - ZOE’s best health tips of 2025 - Part 2

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