← Feel Better, Live More with Dr Rangan Chatterjee
Feel Better, Live More with Dr Rangan Chatterjee
The Simple Nutrient That Could Transform Your Gut Health, Brain Power & Longevity with Dr Emily Leeming #658
01:32:21
The chances are, you’re one of the 96 percent who aren’t getting enough fibre. And I’m not talking a little bit off the mark. For most of us, our intake is seriously lacking. Why does that matter? Because given everything we now know about what fibre does for our gut, our brain, our metabolism, our mood, our weight and our long-term disease risk, it’s an easy fix that we’re missing.
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- [00:01]
A
Fibre is pretty potent, it's pretty powerful. Even just a small amount on top of what you're already eating is related to significantly lower risk of type 2 diabetes, heart disease, colon cancer. It's not about having to have the most perfect diet, but making small practical changes for your health that make you feel better here and now, but also support your health in the long term.
- [00:24]
B
Hey, guys, how are you doing? Hope you're having a good week so far. My name is Dr. Rangan Chatterjee and this is my podcast, Feel Better Live. More research suggests that 96% of us are not getting enough fiber. But why does this actually matter? Well, that is the topic of this week's brand new episode with returning guest Dr. Emily Leeming. Emily is a dietitian and researcher at King's College London who spent years studying the relationship with between what we eat and the health of our gut microbiome. And her brand new book, Fiber Power, makes the compelling case that fiber may be the most underrated nutrient in our diets. National guidelines here in the UK are that adults need at least 30 grams a day, but most of us get 17 to 20 grams, tops. And when you hear everything that Emily has to say about what fibre is actually doing in the body, these statistics start to feel quite urgent and serious. In our conversation, we explore what fiber is, where it's found and why it's so much more than a digestive aid. Emily explains how it feeds the trillions of microbes living in your guts and why those microbes and the compounds they produce have a reach that extends to your immune system, your metabolism, your brain, your hormones and your risk of serious disease. We also look at the evidence linking higher fibre intake to lower rates of type 2 diabetes, heart disease, bowel cancer and depression. And Emily also shares findings from from the major bowel cancer study that is currently running at King's, investigating why rates in the under 50s are on the rise. Fibre is so much more than just a dull, functional food. It's one of the most researched nutrients in existence. So whether you've never thought much about it or you already know that it matters, but keep falling short, I think this conversation will educate, inspire and motivate you to take action. Emily, you highlight in your latest book that 96% of people are not getting enough fibre. Why is this such a serious issue for our health?
- [03:08]
A
I think there's so many ways to come across that. I mean, fibre really has been seen as being this kind of dull, bland, you know, boring stodge that's simply there to Help us do a nice poo. It's not really something that's been on people's radar as something interesting and worthwhile having. Yet so many of us are struggling to get the fibre we need. And what's this fibre actually even doing? There's so many things it's doing for our health. It's actually one of the most researched nutrients in terms of having an impact on our health. We're looking at things like your heart health, so it helps to lower kind of bad cholesterol levels, it helps to balance your blood sugar control, so things like type 2 diabetes risk in later life. But also this kind of new science around the gut microbiome and really fibre being that key fuel that feeds your gut microbiome for a thriving microbiome that's going to make molecules for your health.
- [03:57]
B
If I think back to when I was a kid, I can't say this with 100% certainty, but I kind of feel people were talking about fiber. What's different today? What do we know now? What does the latest science show us? Which makes it even more important perhaps today, that we actually think about this nutrient and how much of it we're eating.
- [04:21]
A
So the gut microbiome science, for example, we're talking about the last 20 years. Now, a lot of the research that we have around fiber is really actually centered around heart health and the risk of heart disease. So that's really where a lot of recommendations. So that recommendation for 30 grams of fibre a day is kind of based mostly on kind of heart health recommendations, some kind of bowel cancer recommendations, also kind of type 2 diabetes risk. But the recommendations that we have aren't actually centered around what does your gut microbiome need, because that has only been, you know, a lot more recent and a huge amount of science that's happened in that space since. But I think that's really brought fibre to the front of. Hold on a second. This is a whole nother aspect of fibre that we hadn't fully even appreciated. That is really essential for us to have this thriving gut microbiome, these trillions of tiny living organisms that are a cornerstone of our health. A forgotten organ, if you will, because we didn't even know it existed. And yet now we really recognize that, that it is kind of foundational, not just for your digestion. And I think this is where, again, fiber has really shifted from talking about, you know, talking about gut health, talking about the gut microbiome and talking about fibre collectively has moved from talking around, okay, it's simply good for digestion, simply good for doing a nice, you know, smooth poo. This is all a bit awkward, embarrassing to hold on. This is foundational for our entire body health and this is something we need to be talking about. And I think that's where really, fibre has now stepped into the spotlight more and is finally getting the recognition it deserves.
- [06:00]
B
In Fiber Power, you talk about at least 10 different benefits of fiber. When we're thinking about our health and wellbeing, you know, cancer risk, brain power and memory, healthy aging, et cetera, et cetera. I thought what might be quite fun is to go through each of the 10 and just get a little understanding of how fiber helps us with each one of those. Because, as you say, actually, if you want to live well for as long as you can, fibre's going to help you. So the first one I think you write about is it's fuel for your microbes. I guess you've kind of just touched on that. But what is it we need to understand about fiber in that context?
- [06:44]
A
I think what's key about fibre is the fact that it's almost this rebel nutrient. And what I mean when I say that is that when we think about your digestion, your digestion starts in your mouth and it goes down to your stomach, where you've got this kind of swirling sac of acid, and then it's your small intestine, it's almost like this kind of garden hose pipe that is part of the next stage in your digestion. Now, the small intestine is a bit of a misnomer. It's actually pretty long. And that's where 90% of the nutrients that you eat get absorbed. So things like protein, fats, simple carbohydrates, fats really getting absorbed into your body for your body to use for energy and nutrition. What's happening there that's different with fibre is that fibre is resisting being used by your body. We don't have the enzymes, our body doesn't have the enzymes to break down fibre. So actually what happens is that fibre then passes through to the lower intestine, which we previously only really thought of as this almost like sausage packing factory getting ready for poo to kind of be shipped, you know, a bit further down and out into the toilet. But actually, this is the home to your gut microbiome, these trillions of tiny living organisms. And so this fiber is landing on their kitchen table, meaning that they then can feed on this fiber that helps them to grow, to multiply. But actually, what we really get excited about with a Gut microbiome is the them making molecules for your health. And in particular a group of molecules called short chain fatty acids. And it's these short chain fatty acids which really help with the health of the cells that line your gut barrier lining. They kind of act like battery chargers, you know, providing energy, but they also can be absorbed into your body and travel around to different sites and really support your health in that way. One key example, just to show that how far reaching these short chain fatty acids are, they help to kind of support the blood brain barrier, which is this kind of protective membrane that kind of stops toxins getting into your brain, but also helps kind of nutrients pass through. So they've got many different actions that are happening around your body. So that fiber is so key and instrumental for that thriving gut microbiome to do the job it needs to do for our health.
- [08:59]
B
There's been this growing awareness over the past years of the importance of gut health. Right. And as you say, there are all kinds of benefits for the rest of the body. And I guess you've just shared one of the possible mechanisms there, which is the fiber that you eat interacts with the gut bugs and that makes short chain fatty acids. And we know those short chain fatty acids go all around the body. They can have positive effects on the immune system, be anti inflammatory, et cetera, et cetera, and as you say, can even impact the blood brain barrier. So really it goes way beyond just the digestive tract, doesn't it?
- [09:35]
A
Yeah, absolutely. And I think what I really like to think about, and I think you talk about this a lot in terms of health as well, is thinking about how do I feel in the here and now and how do I feel kind of later kind of in terms of disease risk. And I think, you know, the gut microbiome is absolutely one piece of the puzzle in terms of linking that with disease risk later in life, but also in kind of thinking about how is it influencing how we feel day to day. And I think we do talk a lot about fibre in the gut microbiome, but also fibre's doing so much without necessarily even feeding our gut microbes, because actually there's lots of different types of fiber and I'm sure we'll go into this. Some types of fiber feed your microbes, some types of fiber don't, but they're also helping how you feel in the here and now and also later on. So examples like that are balancing your blood sugars, so when you have a meal, you then have energy that lasts longer throughout the day. And you kind of feel like you've got focus and you can kind of get on with what you need to be doing because you're not kind of on this kind of rollercoaster ride. Same with helping you feel full and satisfied. That's then going to help to mean that you're not kind of feeling really hungry and kind of scratching around for snacks during the day.
- [10:52]
B
When many of us think about diet or food or how we might want to eat, a lot of us think about fat, protein and carbs. Okay, we think about those three things and often talk about what we're doing with our diet relative to those three macronutrients. Protein, of course, has been all the rage for a few years now. People talking about how much protein you need, scientists and researchers arguing about how much protein you need, should you measure it at each meal or all kinds of things. But do you think that we have over prioritised other nutrients at the expense of fibre?
- [11:31]
A
I think with protein in particular, I think we really went down kind of, you know, protein was prom king. He had the stage to himself. There was no one else kind of invited to the table. And yes, I think it's quite difficult. We've got to have a nuanced conversation around this. Protein, of course, is important and you know, quite often most of us do need to be getting a bit more protein. But I think with nutrition we become so hyper focused like a telescope lens on one single thing. That then means that there's just not room at the table to bring all these kind of other nutrients or other kind of dietary components to play with fiber. You know, I think there's some concern, hold on. Fiber's now the big, you know, the new kid on the block that we're all talking about. And it's like, oh, we're going to have the same problem again. And I actually think it's a very different case. And the reason I say that is that protein foods that, you know, most of us, you know, if we're eating animal based foods like chicken, fish, eggs, do not contain any fiber. But fiber containing foods do tend to contain some protein. So you kind of already getting like this mix a medley of. Yes, you're still supporting your protein levels in some way. So I think there's less of a concern that we're going to end up having a massive switch to another nutrient. But I do think it means that we do need to just be thinking collectively. Like in my book, for example, I very clearly have the recipes as both meeting protein needs and both meeting Fiber needs, because I think we just need to stop having this one or the other. Let's think of it all collectively and that's what's gonna make you feel great. But really recognizing that where's the spot that we're really, really struggling with? And actually, if you break down the kind of general nutrition guidelines, they often get kind of summarized into kind of nine key kind of recommendations for the UK dietary guidelines. So things like fruits and vegetables, are you having your five a day, are you having below a certain amount of kind of free sugars, things like saturated fat and kind of processed and red meat. Of all those nine, the one we're really doing the worst on, so worse than sugar, worse than how many people are having fruit and vegetables, is fiber. So that's, you know, 4% of people are meeting that recommendation, 25% of people, still very low amount people, are generally meeting their five fruit and veg a day. So we need to be doing a lot more work across the board. But that one key element where we can make a massive difference is the gap that we have that's the biggest and that's where fibre is.
- [14:11]
B
Only 4% of us are meeting that recommendation. I mean that's staggering. And then I think about the, the current state of population health, let's say here in the UK we know that many people, I think in the UK it's around 60% or at least 60%. But I know in America this is 90% of people have some degree of metabolic dysfunction. Okay. And regular listeners of this podcast will know. But if anyone's tuning in for the first time, you know, poor metabolic health is one of the root cause drivers of multiple chronic diseases, heart attacks, strokes, Alzheimer's, even maybe up to 40% of cancers we think are related to some form of metabolic dysregulation. Right. So I think if a large part of the population are metabolically dysregulated and only 4% of the population are meeting the fiber guidelines, is there a correlation there? Should we put those things together and go, actually you've already mentioned how fiber helps with blood sugar, but do you think, for example, that if we were as a population able to increase our fiber intake, then actually our metabolic health is also likely to improve?
- [15:31]
A
Oh, absolutely. I mean, we have really strong evidence, the concrete kind of long term studies, you know, meta analyses of observational studies that show that there is an associated risk, step wise, of how much you increase your fiber by to a lower risk of type 2 diabetes, heart disease, colon cancer. And even looking at things like for example your HBA1C which is your kind of report card of your blood sugar control over kind of a three month period. You know, lower levels of that with eating more fibre. And I think, you know, you don't have to go from zero to hero. I think you know, ideally we want to be working our way up to that 30 grams and if not perhaps a little bit beyond as well. That's still a kind of an area of unknown that we don't know much about. In terms of the true, you know, how much more sizable are benefits. Maybe 40 or 50 grams. We don't necessarily have the research there yet but even just a small amount of fibre, just 7 grams more on top of what you're already eating has, you know, significant is related to significantly lower risk. That's the same as having a half a can of beans. That's how much more you know, we're adding. That's not that much adding to your plate.
- [16:44]
B
Yeah, just reading your book over the last few days actually has reminded me about the importance of fiber. Again, it's not that I don't know that. Right. But we all get stuck in certain patterns of eating. Right. And just reading the book, reminding me scale. Oh wong. And you know what, you could just add some nuts and seeds to this. You know like I used to do that then maybe I was in a habit of not doing that. Like last night I had some coconut, yogurt, blueberries and I added some nuts and seeds and pecans because of reading fiber power. And again it would have been a great meal or a great snack without that. But it was quite easy to just up my fiber intake by those two small things.
- [17:26]
A
That's why I feel so strongly that there are small little changes that we can make. And I think, you know, again the difference between us understanding about protein, most people will be able to say, say hey can you just list some high protein foods? They will, you know, list off, you know, eggs, fish, maybe they'll say beans and lentils. You know, that's, that's very much kind of in our, in our psyche, in our, in our understanding of, of nutrition. But if I say the same about fiber, you know, the room goes quiet and I totally get that. We think, we think okay, well hold on, do I talk about all bran or kind of we talk about it's a kind of some high fibre cereal or something that we just associate as being quite brown and heavy. But actually, you know, fibre is found in an absolute wealth and range. I mean it's pretty much in every plant food. But the key ones that are really kind of high in fibre are things like beans, whole grains and nuts and seeds. So, yes, fruits and vegetables, fantastic sources of fibre as well, but just don't pack quite as much as those beans, whole grains and nuts and seeds. And I think I feel so strongly about how can we break this down? Like, what could that look like on your day to day? So I kind of talk about something called, which I call the kind of 4, 3, 2 method, which is when you're building your plate. Let's just think of this like the starting point to your meal doesn't have to be every meal. It's just like if you're thinking about how you're putting your meal together, if you can make a quart of your plate, whole grain, so that could be whole grain pasta, that could be Bulgar wheat, that could be kind of brown rice. What other kind of whole grain kind of grains that you have? And then, so that's, you know, four is a quarter, quarter of your plate. And then think about a can of beans. If you can do the three is a third. So things like chickpeas, butter beans, cannellini beans. There's so many beans out there and they're absolutely delicious. If you could have make sure that you're including in that meal somehow. You could be cooking into a sauce, you could be blending it up into a dip, but having that kind of quantity, a third of a can onto your plate and then having some nuts and seeds. So, you know, the two comes from it being half a handful or just two tablespoons of seeds. And just having that, you can mix that all into a delicious salad, add in your chicken, add in your eggs, you know, add in some avocado, some healthy fat. But just if you've got that kind of framework, you are automatically hitting 10 grams of fibre in that meal and you don't have to weigh anything.
- [19:52]
B
And your sort of, well, I guess aspirations for people is to go for 10 grams at each meal if you can. So on three meals a day, that's your 30 gram target. Is that right?
- [20:04]
A
Yes. And the reason I say let's go, let's split it across the three meals is that fiber is pretty potent, it's pretty powerful. If you eat too much too quickly and you're not used to it, your gut needs time to adapt. And actually it's kind of like your gut microbes have been in kind of famine mode and you're suddenly throwing them a massive feast and they get a little Bit kind of drunk on all the Kool Aid of what's available. And one of the things that we know our gut microbes do is, yes, they make these molecules for our health, but they also make gas as a side effect. So if you go straight from 0 to 100 and eat a ton of fibre in one sitting, you can potentially end up with having a lot of discomfort in terms of your gut. It's not harmful, but it's kind of like running a marathon. If you've never run a marathon before,
- [20:55]
B
does that mean that. Emily, some people will say beans gives them gas and wind, right? And that might be a reason for them to not continue eating it. Are you basically saying, look, give it time, build up slowly and after a month or so you won't feel that gassy and that windy? Is that what you're saying? Or will it always make gas to a certain degree?
- [21:22]
A
So we haven't got that many clear, clear cut studies on this, surprisingly. Maybe scientists don't want to research farts, but we do have some of the studies that I did find when I was looking into this. And actually, funnily enough, we're building this into the study that we're running now, which is called the Eat Fiber Study at King's, where we're wanting to understand how your symptoms change on a week by week basis from eating more fibre. But effectively, what we know at the moment tends to be more based around fibre supplement studies. And what we see in the first few weeks is an increase in farts when you're having those fiber supplements. But actually your gut microbes and your gut adapts. And actually for those participants, their amount of farts went down to what they were before. So I think, yes, you probably are gonna be a bit more gatty. But I also think everybody farts. If you can go for a walk after a meal, that's gonna be great for your energy levels. Let it rip. You're outside, you know, maybe you can play some music and do it very silently, depending if you've got people around you, or maybe you don't have people around you and you can just really, you know, be as musical and fruity as you need to be. But I think also the key thing is that they're not necessarily gonna be smellier. I think that's probably maybe something that people worry about because the smelly parts of farts, and it tends to be just a gas that makes up kind of 1% of the kind of gas volume of your farts of which most people are farting. 20 times a day and don't even realize it. That's just very normal. It's that 1% that has got that kind of rotten egg smell and that actually comes from kind of certain amino acids, that kind of sul sulphur based that tend to be more in meat. So if you're a big meat eater, that tends to be more a reason of why that might be. You've got more kind of stinky farts though. Those compounds are also present in things like broccoli and cauliflower. Obviously those are really good for your health. It's not that we shouldn't eat them, but little things like drinking enough water and fluid to get things moving through at a nice pace, making sure you're moving your body, all these things. And I think that's another reason why in the book I don't just do a four week plan of slowly increasing your fibre. There's also lifestyle changes that you make alongside that. So for example, week one is very focusing on drinking enough water because fibre acts a bit like a sponge and then it's kind of moving your body all these kind of different and thinking about how can we look after our kind of mental well being and that connection between our gut and our brain. So all these things can help.
- [23:59]
B
That's one thing I really enjoyed about the four week plan in the book was that each week there was a food change and a non food change which I think is critically important because there are so many factors that impact our health. Our gut, microbiome, yes, food, but stress, movement, how much we slept, you know, all kinds of things also play a role. So I really appreciated the fact that it was quite a holistic approach to, you know, yes, increase your fiber, but also just generally improve your health and well being. I don't want us to go through these 10 benefits and I know we've covered a couple of them. We'll get back to that in just a minute. One thing I think is really worth bringing up here is this idea that everyone is going to hear this message but they could potentially be in a different state of health. Right. So I totally understand that if you are, you know, well, and you're, I don't know, teenager or in your 20s or 30s, you never had any problems, you're just trying to look after yourself. Yeah, these are great recommendations. You spoke about whole grain pasta, right. Let's say someone has got type 2 diabetes already. Okay. So the preventative element of eating fiber to prevent these problems in the future. I wouldn't say it's out of the window. But they're at a different point on their health journey. And let's say they have found huge amounts of benefits from adopting a low carb diet. Some people who do that may be thinking, yeah, but on that sort of diet, I don't eat whole grains and I don't have whole wheat breads. I do think it's worth making sure we're keeping those people in mind. Is every element of the recommendations for everyone or in those particular individuals, might it be that, hey, listen, there's many ways to get fiber, but yeah, maybe you're gonna benefit from not having these types of fiber and increasing other types?
- [25:59]
A
No, absolutely. I mean, I think, as you say, like broadly, generally if you're well and healthy, then you know, you can pretty much dive right in and kind of low and slow increase. But of course, if you've got type 2 diabetes or you're on a low carb diet, it doesn't necessarily mean that it's completely kind of contradictory to eating more fiber. I think what's so key is understanding that fiber is present in so many different foods. So if there are certain foods you might have a food allergy, you might not be able to eat nuts, for example. So there are so many different options. And I think again in the book I have tables of different foods in the back so that you can really kind of change and add in what you want. And so I really want that to be a kind of flexible approach of also your own preferences, like, this is how I eat, this is how I feel. Well, how can I then adapt? And I mean, I used to work as a chef for five years and I worked a lot with people who had health problems and dietary preferences. And for me it was always like, what are you eating now that works for you? What would you like to change and what do you enjoy? And how can I kind of move things that way? I'm not going to come in and completely say, you need to have this meal that you absolutely dislike and it's going to make you feel rubbish so very much what's going to work for you. And I think this low carb and high fiber is maybe they're going to be the kind of new talking point when we talk about carbohydrate diets. Because the same, very similar with ibs, for example, there's been some benefit for some people in a lower carbohydrate diet. There's some evidence there, there's different dietary strategies, but again, like kind of just bringing in the language There of low carb but high fibre, absolutely possible and not one or the other.
- [27:46]
B
Those examples are really interesting because there's what's the right diet for you right now with your current state of health? And then there's also, if we work on various aspects of your health, how might that change? And so, you know, you mentioned IBS there, right? So for some people with irritable bowel syndrome and you know, there's many different types and you know, each individual is unique and we'll need to find the right approach for them. But it could be that on a low carbohydrate or a low fodmap diet, let's say for a few weeks, they feel really good, they don't get the gas and the bloating and their symptoms are better. Right. So there's a temptation then to stay on that diet long term. And I get that because I feel good. So why would you want to change that? Right. But of course, over time we want to see if we can broaden things out for you. Another example, which I think we touched on the first time you came on my podcast, but I think again, it's worth talking about because there are a lot of people who are experiencing relief from their autoimmune symptoms when they go in what's called the carnivore diet, right. Or they go meat heavy and they're cutting out all plant food or virtually all plant foods and they're feeling better in themselves. Right. For someone like that, what would you say to them when it comes to thinking about their fiber intake?
- [29:23]
A
Foreign
- [29:27]
B
I am really excited to share that I am bringing my Thrive tour, Transform your health and Happiness to Canada and Europe this September and November. It's a live, interactive, uplifting show that over 20,000 people came to last year across the UK and Australia. I'll be sharing powerful stories, life changing insights and simple tools that will inspire you to feel better, think clearer and live with more intention and joy. To get your tickets right now and see all of the dates and venues, go to doctorchatterjee.com live. I really hope that you can join me. This episode is sponsored by Sleep Reset. Now, many people struggling with sleep feel stuck between two options. Take sleeping pills or keep suffering through bad nights. What most people don't realise is that there's actually a clinically proven treatment for insomnia that does not involve medication. Cbti, which stands for Cognitive Behavioral Therapy for Insomnia, which helps retrain your brain and body to sleep naturally. Sleep Reset is a virtual sleep clinic that Delivers a personalized program based on CBT I that helps you rebuild healthy sleep patterns step by step. Instead of just tracking your sleep, it gives you a personalized sleep schedule. Daily guidance and support from real sleep clinicians who specialize in insomnia. Think of it like having access to a sleep clinic without leaving your home. For my listeners, Sleep Reset is offering a free seven day trial. All you have to do is go to thesleepreset.com podcast, start your first week of real clinician designed insomnia treatment tonight.
- [31:33]
A
I think we need to recognize that if you, you know, quite often if you get to that stage, you know, you're in a condition that perhaps you've seen multiple, multiple doctors and you are just at your absolute wit's end to want to find a solution. So I totally kind of understand why somebody might want to try a carnival diet, for example, and think, oh my goodness, I've just had relief for, you know, this significant period of time. I think there's so many different, you know, individual factors that could be going there. But I probably would say is that we know that long term in terms of, you know, if that's having short term relief, but long term, that is not going to be ideal for your health and may end up just causing more problems later on. And actually if you can go to, for example, a dietitian or clinician, you know, have some personalized structured support into, you know, introducing things back in, because it might be that there's some key elements there that, you know, haven't been picked up on before, that you're suddenly like, oh, hold on. Actually it was this bit, but you've cut out an absolute swathe of everything else that are probably fine and very great for you and supportive of your health. And I think quite often what happens with these very restrictive diets is that they can feel better. And I think people say this, they bring stuff back in. Having not had it for a very long time, your body can suddenly go, oh, hold on, what's that? And so they're almost stuck in this trap of, oh no, I can't eat anything now. We're. Which is completely debilitating as well. And I think you've got to really recognise how that impacts your social life, that impacts, you know, what can you at the supermarket, your time and what you're cooking also kind of financially. So I think if we could have a lot more support of people being able to connect with getting that support from a dietitian, for example, because, and again, I say this in the book, I say if you have a gut health condition, you know, you are probably very much in need of specific advice that is unique to you because it is very different from people. It's all very much, you know, what's going to help you.
- [33:40]
B
Yeah, yeah, I really like that approach. So once you acknowledge that in the short term, certain diets, certain restricted diets may offer symptom relief to people, you're basically saying, look, the research on fiber is, is pretty damn solid and pretty overwhelming. Okay, if we can, let's see if we can help you over time by starting slowly and by recognizing that there are lots of different types of fiber, not just one thing. You try that. Yeah, I'm not good with fiber. It's like, hold on a minute, why don't we just try, we'll start small, we'll try some things you haven't tried yet and let's see if over a period of months we can, you know, increase the range of foods that you potentially have access to. I think that's exactly a really nice approach for people to take. Let's go back to these benefits. So we've done fuel for your microbes. I think you also touched on the second one, which was more fiber helps us to lower inflammation. Anything else you want to say on that? You mentioned short chain fatty acids. Anything else that's worth commenting on?
- [34:42]
A
Yeah, so I think, I mean, again, it's going back to that kind of whole body health. And we know that low grade inflammation, which is kind of like this kind of background wear and tear that may, we might not even pick up in terms of how we feel. But you might just be not feeling quite right or you might not kind of notice that's happening. I talk about it a little bit like you're a train going around a track and if it's going too much at high speed, that track might start kind of the wheels are going to start squeaking and maybe there's some sparks happening and your body's just getting a little bit too much stress and pressure. And so what we see is that people, in terms of patterns and populations, that people who eat the most fiber versus people who eat the least fiber tend to have lower levels of this kind of background inflammation. And this inflammation is often connected with different disease states. And so it's something that we kind of very much see as a potential kind of early warning fire for what could happen later down the line.
- [35:48]
B
Wow. When we think about the topic of gut health, yes, fiber comes up, but so do things like fermented foods, for example. And how would you say the benefits of fermented foods, for example, compare with the benefits of fiber?
- [36:07]
A
There was an interesting study done by Stanford University that effectively compared the two. They did a high fiber arm and they did a high fermented food arm. People who were eating the fermented foods were eating about 7 servings of fermented foods a day. So that's quite a lot. And they kind of, you know, looked and tracked them and looked at what happened towards the end. And actually, funnily enough in that study, they didn't necessarily see that there was inflammation kind of impact in terms of the fiber, but they did see that with the fermented foods. Now a lot of that might be like, oh, hold on, that's completely opposite of what you've just said. But I think we've got to really program into is it that fibre just needs that bit much more time. This is, you know, so that when I talked about that pattern in the population, that's people who are already eating that diet, they'd probably be eating that way for years and years because we tend to eat very similar consistently in terms of the macronutrients that we eat. And this was, you know, a short term intervention. So I think, and I think that just plays back to hold on. We know if we make changes for our health, we're not just doing it for a couple of weeks. We want to make changes that are simple and practical and that we're going to keep up in the long term. And I think particularly understanding that fiber feeds the gut microbiome and the microbiome is closely related to your immune system. 70% of your immune system lives in and around your gut and they are constantly interacting with each other. Your gut microbiome from birth is helping to train and shape your immune system. It's a very strong hypothesis and connection in between that being a likely influence.
- [37:52]
B
Yeah, I remember that study. I think it was Sonnenberg and Chris Garner, wasn't it, who did that? And from recollection it was only about 30 people in that study. And I do remember, as you say, that the fermented food group had lower inflammatory markers. And I think it was like 19 inflammatory markers they measured. It was lower. But I think we have to bear in mind that a lot of studies are short term and of course there's many things that can show a short term benefit. But what we're really looking for is long term changes, sustainable things that we can change that give us those long term benefits with our Health. So on that topic, are you a fan of fermented foods?
- [38:33]
A
I absolutely am a fan of fermented foods and I think, again, like a lot of fermented foods do naturally, inherently contain fiber in them anyway. They contain so many different, you know, phytonutrients for our health. If you think about kimchi, sauerkraut, all these fantastic fermented vegetables, they aren't just containing those kind of live microbes, they've got this kind of plethora of other benefits that, that are within them. And I think, again, this is why science is so kind of fun for us scientists and clinicians. It's that we'll look at different studies and it's just pulling that overall body of evidence together and also taking, okay, well, can I just think about this through a nuanced understanding that background, how can I then interpret the findings from that? And maybe I have to come back in a year when we've got the results from our Eat Fiber study, which is running all this year, and that is effectively comparing people who are eating 30 grams of fiber to eating 40 grams of fiber and looking at the gut microbiome, looking at inflammation, looking at lots of different other risk factors. So, yeah, very excited to hopefully see what the results of that are.
- [39:39]
B
Is that Eat Fibre study also to try and assess bowel cancer risk in under 50s?
- [39:45]
A
Yes, this is a kind of huge project and initiative which is a 20 million pound funding, which is fronted by Harvard, and it's a Cancer Grand Challenge Challenges initiative. And we are looking at why is bowel cancer rising in people under 50?
- [40:01]
B
How long has it been rising for?
- [40:03]
A
It's been rising consistently. You know, we've got each kind of batch of kind of what we call birth cohorts are consistently kind of getting rest, is increasing. So, for example, in the UK in 2017, 5% of the cases of bowel cancer were people who were under 50. Now that's 10%. So that proportion has increased and there seems to be this increasing amount of people under 50 where those rates are increasing. But people. This is traditionally a disease that is of people in their 70s. It's been very much a cancer of old people and yet levels seem to be stabilizing in older adults. And yet we've got these kind of rising risks. So we're thinking that perhaps there's something that's happening consistently maybe at an earlier point in life. So maybe kind of adult, you know, young being a young adult, maybe earlier than that being a child, or maybe it's, you know, Antibiotics when you're. When we're in babies and children. So there's lots of different potential things. Is it microplastic? Is there dietary influence? Because we know with, you know, bowel cancer, that diet is, you know, probably one of the most central players in terms of the different cancers, because your gut is directly interacting with the food.
- [41:25]
B
You just mentioned an increase in rates from 2017, but were rates going up before that?
- [41:30]
A
Yes, it's quite scary in a way of how the rates are increasing. So if you born in 1990 or afterwards, then your risk of getting rectal cancer is potentially quadrupled and your risk of getting colon cancer has doubled versus if you were born in 1950.
- [41:49]
B
So this has been happening for quite some time. And so this Eat Fibre study, you're basically trying to see if you can figure out what some of the causes of that might be.
- [41:59]
A
We're looking at, generally we're looking at healthy participants, so they haven't got bowel cancer. But what we're really wanting to understand is that preventative element. So are there certain risk factors, certain signals that we start seeing in people's biology? So that might be changes in their microbiome, in their blood, in their urine. There's lots of things that we're collecting and seeing, whether by changing their diet, by eating more fibre, but also looking at a variety of fiber. So we're particularly giving lots of recommendations around. Can you eat more whole grains, can you eat more beans, can you eat more nuts and seeds that aren't currently in the UK dietary guidelines to have specific quantities for those and seeing whether that is going to make a significant difference in terms of those risk factors. And I think really what's been so instrumental is that we've so wanted to design this study to have very simple, actionable advice that can come from it. So it's not something that you're like, okay, well, this is interesting science, but what can I do about it? The whole principle of the study is can we really depending obviously, if we get positive findings, can we give people simple, actionable advice based on this? And we're comparing it to the current gold standard practice advice, which is the UK dietary guidelines. And so we really can see is this necessarily better? And therefore, you know, that give people that really kind of confidence that the change they make are, you know, really kind of true to the science that we're seeing.
- [43:28]
B
In the meantime, whilst that study is taking place, from your research, can we convincingly say that people generally who have higher fiber diets tend to have a Lower risk of certain types of cancer.
- [43:42]
A
Yeah, absolutely. So for every 10 grams of fiber that you eat, that's related to a 10% lower risk of bowel cancer. But this tends to be that. This is looking at all types of bowel cancer here. And one of the reasons for that is that we have all these different types of fibers. There are certain types of fibers called insoluble fibers, and these are kind of the ones that bulk out your poo and also get things moving through your gut at a timely pace. You don't want things to stick around for too long. So it's a little bit like a kind of sweeping broom. It's kind of moving things along, getting things to move on. And that is very important. If we have potentially problematic kind of compounds that might just. That's naturally just what happens. Maybe things that could end up being carcinogenic, if they're hanging around, those compounds are hanging around in our gut and having too much contact with our gut for too long because you've got a very slow transit time, you know, things aren't moving. Then that is potentially, you know, one of the factors that we think is kind of what could be kind of triggering cancer in some people with this. So that's one of the key reasons that fiber can be really helpful in that sense, in terms of preventing.
- [44:58]
B
Okay, so we've got. So far, fibre's helping us because it's fuel for our microbes, our gut microbes, I should say. It helps to decrease inflammation in the body, which can have all kinds of other benefits. You mentioned how it can help balance blood sugar and reduce our risk of type 2 diabetes. You just mentioned cancer. Okay, so I've ticked off four out of 10 curbs, hunger and craving. I think you sort of touched on this before, but anything else we need to know about how and why it curbs hunger and food cravings.
- [45:33]
A
Yeah, so there's lots of different things happening, but mainly really is that fiber does tend to add bulk to the foods that you eat. So it just makes you feel kind of. And that's why you feel kind of fuller, is because that bulk is effectively stretching out your stomach and stretching your gut, and that is then sending signals to your brain to say, oh, great, hold on, I think you've eaten enough because I can sense it. So that's one of the reasons why we have that. But also it's the gut microbes that are also involved in this as well. And they're, you know, really a player in every single aspect of the things that we're talking about. So they're helping to influence the release of those kind of satiety hormones in your gut. Again sending messages to your brain saying, hello, you know, this is time, I feel good now, the meal's over, I've got what I need. So the gut microbes are also playing a role in that as well.
- [46:23]
B
Even if we think about curbing hunger and cravings through the lens of what you just said, right, you're providing bulk and stretching out the stomach. So it's sending messages to your brain that hey, I'm full now. The amount of people who struggle with their calorie intake, right. I'm not saying necessarily to focus on calories, I'm just simply saying that, you know, yes, as a population we're putting on weight and of course a lot of people are trying to reduce their visceral fat levels and all kinds of other things related to weight. It could be if you're trying to moderate how much you eat, maybe increasing your fibre intake is a very quick and easy win there.
- [47:03]
A
I think also the biggest shift that I see and I think, you know, I hope my mom doesn't mind me talking about here in the sense that she's wanting to lose weight, she's postmenopausal, she has kind of gained a bit of weight in later life and she's of the generation where, you know, if you wanting to lose weight, you make, you know, whatever's on your plate, a tiny, tiny little kind of bird sized amount of food and then she's absolutely ravenous, she's so hungry and then she's kind of stressing of okay, well I just ended up having loads of biscuits cause I was so hungry. And I think this is such a different way of eating where if you're putting loads of fibre on your plate, you are eating in abundance. You are eating, you know, what feels like a very like almost indulgent amount of food. It feels like so refreshing versus particularly for women where we're kind of, kind of almost institutionalized to, oh God, we've only got to have a small amount. This is, you know, eat to your fullness, eat, you know, and enjoy it. And it's different, lots of different colours and lots of different flavors. It's a very joyful way of eating that these foods that are high in fiber are naturally lower in calories. They contain a lot of different micronutrients for your health. Meaning that yes, you're eating more fibre but reaching many of your other micronutrient needs as well without necessarily Needing to think about it, you feel full, you feel energized, and I think, you know, going through the day where you feel like you're able to focus, you're able to do the things you want to do and you're taking care of both your body and your gut microbiome and it doesn't feel restrictive.
- [48:38]
B
Yeah. You mentioned before how you used to be a chef. I remember from our first conversation. I didn't get around to asking you because I think was it used to be a chef on yachts from recollection?
- [48:49]
A
Yes.
- [48:51]
B
What do you think that those years of being a chef for people on yachts, what do you think that taught you about nutrition?
- [49:00]
A
Oh, I think it taught me so much and I think I was quite shocked when I went and did so. I did my undergraduate in nutrition, worked as a chef for five years, and then when I did my master's in dietetics, I remembered it was me and one other person could chop an onion. And I thought, how are you interested in nutrition but don't know how to cook? Because it was so foundational to me that of course, if you're interested in food and the impact that food has on your health, then you need to have a deep rooted understanding of what flavors go together. How can you make food joyful and also cooking for other people? I think it constantly makes me think about that person likes to eat in this certain way or has these certain requirements. And you can, I think on super yachts, there's no such word as no. If somebody says they want to eat bread, but they don't eat grains. I think I had one. I mean, it was. And it was disgusting, so please no one try this. But, you know, I made bread out of broccoli. I was like, but, you know, we made it happen.
- [50:02]
B
And so bread without the grains.
- [50:05]
A
And it was so you kind of, you know, where there's a will, there's a way. And I think I so saw it play out time, time again where, you know, quite often people would want to come in and have, you know, just a massive health kick. And they wouldn't want to have anything that was sweet and delicious. And yet they would then completely kind of fall into a pit and, you know, go and have, you know, a very indulgent meal or just like, you know, be rifling through the snack cupboard. And so it was just something where I just saw this pattern of, yes, we need to think about things. Most days. I think that's something that's been really instrumental with how I Think about nutrition. It's. Can we make changes for our health? Most days that work for you, that you enjoy food, that you enjoy and you'll eat, but of course, still have those delicious little things here and there, because that's also part of a balanced lifestyle.
- [50:57]
B
What did they think of your broccoli bread?
- [51:00]
A
I think more the deck hands were irate. Cause it crumbled all over the deck and I think they had to wash it all away.
- [51:07]
B
What do you even put on broccoli bread? Like, how do you jam on it? Or marmalades?
- [51:12]
A
We were racing for a regatta and, yeah, I think it was, you know, had all the kind of fillings, but it just disintegrating as the poor man was trying to. Trying to eat it.
- [51:21]
B
I'm sure a valuable life experience, right? You know, being in what many might regard as a privileged environment, but having to work and actually, you know, cook food and cater to people's tastes. Do you think your experience on those yachts has helped you design recipes in this book?
- [51:38]
A
Oh, absolutely. Absolutely. I was like, I know what I mean. I really set myself. I was like, I want all the nutrition targets that I want to meet, but mostly I want it to be affordable, simple, practical. You know, I was making, you know, doing the. We were doing the job element, only using one or two pans. I was like, no, this is, you know, it's gonna be simple, but at the heart of it, it's always been, this has to be joyful, this has to be delicious. And yes, simple, easy, yes, hitting all the nutrients. But this needs to just make you feel great. Just when you're from that first mouthful or even just even before the first mouthful, you see it. I mean, the book is packed with colour. I felt so, so strongly about that. I was like, fibre. No, more of this brown, dull stodge, you know. Now, this is, you know, fibre as it should be. It's colorful, vibrant, and it's gonna make you feel energized and fantastic.
- [52:31]
B
What's your favorite recipe in the book?
- [52:33]
A
Ooh. There's some that have, like, an emotional connection. For example, there's the carrot cake, which my mother always used to make and I've made for my brother's wedding and I've made for a friend's wedding.
- [52:45]
B
Oh, wow.
- [52:45]
A
So that slightly had a few kind of tweaks to amp up the fiber. So that's quite close to my heart. But I love all the kind of salads. There's a salmon salad which has got lots of kind of very spring, like, Kind of fresh green, kind of peas and mint, which is all kind of very delicious and very, I guess, of the spring that we're in now. But lots of. Yeah, lots of favorites in there. They really are a, I guess, a love letter to fiber.
- [53:16]
B
It does very much feel to me that you're trying to make the case for fiber in quite an inspiring and aspirational way. I think you've done a really good job with that, actually. As I say, it's helped me immediately just add a few tweaks. And again, it's not that I don't know that more fibre's good for you, but we all need a reminder from time to time that, oh, yeah, it's not that hard. Right. So I think we've done five benefits so far out of year 10, and I think there's more than 10, but I wrote down 10 as I was going through the book. I thought this would be quite good. You say that more fiber helps us with healthy aging. How does it help us do that?
- [53:56]
A
So in terms of healthy aging, I think quite clearly we talked about reducing risk later in life, but there was really an interesting study, a large study done in Australia where they tracked older adults for over a decade. And what they found was the people who were having the higher fiber diets were 80% more likely to kind of just be living well in terms of having better kind of cognitive, reserved, kind of moving ability than people who were eating the least. And I think that really tracks quite nicely on top, because quite often we see fibre as almost a signal of a general healthy dietary pattern. So it's one of the kind of key ways, as nutrition researchers, that we tend to see if people eating more fiber, they tend to be eating more fruits and vegetables, they tend to be eating more whole grains, more beans, nuts and seeds, obviously within what you choose, within that. So it's a kind of clear signal that fiber impactful, but also that kind of healthy diet throughout life as well.
- [54:55]
B
Yeah, it's an interesting study, I guess. Is there a downside to that sort of take in the sense that someone who's eating more fiber is likely to have other helpful components in their diet? They're also, I guess, likely to have more helpful components outside their diets, like they're probably not drinking alcohol to excess, maybe they're not smoking as much. And is that not what the Eat Fiber study is trying to address? In some ways it's like a direct intervention on increasing fiber to see prospectively what happens.
- [55:26]
A
Yeah, exactly. I mean, it's something so My background is this what we call epidemiology, which is kind of, as you say, looking at patterns in populations. And as much as you try and effectively adjust your analysis to account for these other factors, because as you say, people who tend to eat healthier, tend to perhaps be of a slightly higher income and tend to spend more time exercising, tend to sleep better. So it's like, how can we account for these other factors? So we do in our analyses, tend to adjust as much as we can. But within that there's still an absolute recognition that that could be a signal of, you know, other things within that. Which is why I'm always quite keen to say, you know, fiber is such a great one for saying we need to get more of. And naturally then around that you'll get all the other wonderful things that come with fiber from this whole foods. But it's also, they're all playing, you know, it's not just one instrument. We're talking about the orchestra, really.
- [56:21]
B
Yeah, that's a beautiful way of looking at it. And I think if we have populations who've been eating high fiber and have been healthy and living with great health spans for multiple decades, you know, it gives us a great degree of confidence, doesn't it, to go. This is likely to be a helpful recommendation.
- [56:40]
A
Yeah. And they all layer on top of each other. And I think again the fact that all these studies again have been pulled together and then people have done what we call almost like an umbrella. You pull everyone under an umbrella and then you look at what's the general overview. And I think this is what's so fantastic about talking about fiber, is that it's not just a handful of a study here and there for most things. It's really that there is just this overwhelming amount of evidence and yet it just hasn't really played out in terms of what the public are hearing.
- [57:11]
B
Yeah, you mentioned heart health before. So I'm going to give that a take. Mood and mental well being. How does fiber help us here?
- [57:18]
A
So this is one where there is, this is like newer research into how we're looking at it. What we see in terms of mood and kind of memory is again stepping back to that, what is a general dietary pattern that is healthy and that does tend to be higher in fiber. But of course recognizing that there are other components that are important for brain health in that. So we know, for example, in the Smiles trial, which was a Mediterranean dietary pattern, high fiber, full of beans, lentils, nuts and seeds, whole grains, what they saw was that after that intervention in people with depression that 30% of people at the end of it still doing their therapy, still taking their medication, but were not seen as falling into that bracket of what is clinically defined as depression in comparison to the group who were effectively doing what was called a befriending protocol, which is like social interactions,
- [58:15]
B
just so people are not thinking. That was a vegan diet. There was fatty fish and lean meats in it, I'm pretty sure in the Smiles trial. So it was absolutely as well as those things. There was these rich, diverse arrays of fibre, weren't there?
- [58:28]
A
Yeah, yeah. And I think that that's, you know, all these foods, lots of different colours, lots of different textures. You're getting an absolute variety of different types of fibres in that that are supporting how. So we think. And again, if we think about brain health being effectively very similar in terms of how we look after our heart health, we need to be thinking about supplying nutrients through our blood flow to our brain and the same is for our heart. We want to make sure that we're not clogging arteries. So things like blood pressure, blood sugar management, looking after your cholesterol levels, those are things that fiber are really helpful for, but are also really important for your brain health. Also looking at some kind of early supplement studies that have looked at prebiotic fibers. Now, these are particular types of fibres that feed a select group of microbes in your gut to then have a health effect. What colleagues at King's College London found with certain prebiotics is that these were kind of, you know, generally, well, slightly kind of, I may think, average kind of 60 years old kind of females, after, I think a couple of months of taking these prebiotics versus the placebo, they were performing better on cognitive tests that are often used as like early kind of check ins for signs of Alzheimer's and dementia. So some kind of kind of cognition benefit there. And we do see in terms of like emotional frameworks, again, studies from Oxford University, not necessarily seeing people report better mood because that's kind of quite subjective, it's quite hard to see. But actually seeing that perhaps there's some kind of underlying kind of automatic response that's happening that's making them more drawn towards positive items versus and spending less time and less attention on things that are kind of negative.
- [60:30]
B
Wow. You mentioned the term prebiotic there. For people who don't know what that means. Can you explain what it is and give some examples? Today's episode is sponsored by Do Health, a personalized health companion that I have helped Create Now. I built Do Health to transform the way we think about health. You see, for many years whilst working in the nhs, I saw the same thing over and over again. Modern medicine is really good at treating illness, but it was never designed to prevent you from getting sick in the first place, nor to optimise your health. Do Health is here to change that. It takes everything that I know about health and wellbeing, including my four pillars of health, and makes it personal to you. You get an initial blood test which measures and screens you for over 50 biomarkers. But then all the focus turns to the 11 core biomarkers that are scientifically proven to improve your metabolic health, including many markers which are not easy to get from your NHS gp, like fasting insulin, APOB and homocysteine. Once we have your blood tests each week, together with you we create a personal achievable plan and several times a year we recheck your bloods to make sure that things are moving in the right direction. This is the future of preventative health. A few small changes that will have a huge impact on your life. For listeners of my show, Do Health are offering you fixed early access pricing less than 21 pounds per month to all those that sign up to the waitlist today. This is incredible value. Don't forget that this price includes three yearly blood tests as well as 52 custom weekly plans and unlimited daily interactions with Coach Joy. All you have to do is go to DoHealth Co LiveMore and use the code LIVEMORE to gain access to the wait list. Right now. Today's episode is sponsored by Exhale Coffee who are literally offering you a free bag of coffee. Now, if you know me, you'll know that I absolutely love my morning coffee. For me, it's about ritual enjoyment and starting off each day with intention. A few years back, I switched to Exhale coffee. You see, most of the coffees on the market are over roasted and have lost up to 90% of their healthiest compounds. And worse still, many have been contaminated with mold, mycotoxins or pesticides. Exhale independently test their beans to produce a coffee that's higher in the good stuff and has none of the bad. In fact, an independent test found that a single cup of exhale coffee has the same antioxidants within it as consuming 55 oranges. Now, if you're hesitating to try Exhale because you're worried that being healthy, it won't taste as good, Exhale removes the risk. They are so confident that you'll love the taste as much as how it makes you feel that they'll send you a bag to try for free. They'll even cover the cost of shipping, so you won't pay a single penny. Head to www.exhalecoffee.com livemore and tell them where to send your free bag of coffee.
- [64:38]
A
So, prebiotics, so you have types of. I'm going to talk about it in the terms of fiber, because a prebiotic can also not be fibre. If I talk about it, you have fermentable fibres, which are really the group of fibres that feed your gut microbes. These aren't necessarily what we call prebiotic fibres, they're actually slightly different. That's because those fermentable fibres as a whole are just generally supporting your gut microbiome. They're generally feeding them. The slight unique difference there is that prebiotic fibres are feeding a specific group or specific number of bacteria in your gut and then having a health benefit that we kind of know about. So these tend to be things like inulin, galactooligosaccharides and they, you know. Yes, we talk about supplements and I think there's so many, you know, on the shelves these days, but really they're found in everyday foods. So things like garlic, onions, leeks, asparagus, lots of different probiotics just naturally embedded in the foods that we eat. And these are all helping to support your gut health.
- [65:46]
B
Yeah. What I think is really great about the prebiotic research and how we apply it in our own lives is that, you know, food has got more and more expensive. Right. But onions, garlics, leeks are cheaper foods, aren't they?
- [66:04]
A
Yeah. And I think that's what I think we are so bombarded with. Take this expensive supplement, buy this amazing product and it's essential for your gut health and it's gonna make all these huge differences. I really, really think the benefit you're gonna get for most of these, unless it's something that's clinically, you had a clin recommend it for a certain problem, you know, so small, and yet you're spending a lot of money on it. Yet those going back to that foundation, you know, building a kind of healthy balance, plate making fiber kind of central for your gut microbes. That is affordable, it is delicious. It doesn't have to be some, you know, very fancy, you know, special super yacht type dish. Yes, super grain, you know, it is just, you know, those everyday delicious things that we enjoy and just recognizing. I think, you know, maybe onions need to Be the superfood of the year. They don't ever seem to register on anyone's, you know, health list, but they're very good for you.
- [67:07]
B
I love cooking with red onions. Like, I absolutely love it.
- [67:11]
A
And they make any dish better. I'm always like the base of any dish. Onions, garlic, you know, you're already on a flying start.
- [67:17]
B
So someone's heard up to this point, Emily, and they're like, right, that's me. I'm going to get on my fiber game now. And they come and see you. What do you say to them?
- [67:27]
A
I think there's key things. It's like, how can we recognize which foods are the highest in fiber so that we can make it easy when you go shopping. So I know, I think I talked about this last time around the podcast.
- [67:38]
B
Let's do it again.
- [67:39]
A
Going to do it again. But I talk about the BGBGs B
- [67:43]
B
G B G S. So these stand
- [67:48]
A
for so B Berries. Now when I'm highlighting berries in particular is because any fruit that has some seeds in it are going to be naturally higher in fibre than other types of fruits. So this is obviously a kind of bit of a rough and ready approach, but we're thinking about things like raspberries, blackberries, but also some things that maybe won't fall necessarily into the berry category, but things like passion fruit, for example, if you think about those seeds. So that's just a really kind of useful way of. Okay, if I'm thinking about fruit, the ones that are high in fibre are going to be the berries. Then we're talking about greens. This is basically thinking about green vegetables. Again, just a kind of rough and ready, kind of, kind of easy way to think about which vegetables are higher in fibre. So thinking about things like garden peas, thinking about green beans, thinking about broccoli, you've got kale, a lot of different kind of green vegetables. I might also. I know that technically avocado is a fruit, but I always seem to. I'm just going to put it in the vegetable category. Avocado, surprisingly high in fibre. And I think again, this is where we've got to shift away from thinking that anything that is crunchy is high in fiber because that's not really the case.
- [69:02]
B
That's one thing I remember from our first conversation very well is that avocado has got quite a high amount of fibre in it, which I don't think I knew up until that point. I think like many people associate it with, you know, so called healthy fats, but it's also Rich in fibre, it's
- [69:18]
A
one of the highest. I mean, again, if we put it in the vegetable category, it's one of the highest ones in fibre.
- [69:22]
B
In terms of vegetables, for this acronym, you've gone for berries and green veg. If we broaden out beyond berries, other types of fruit, of course, have fibre in them as well. Is the reason you've gone for berries is to highlight that actually if you're looking across the category of fruit, berries tend to be higher in fibre.
- [69:44]
A
Yeah, these are really like your high fibre heroes that I just kind of, you know, want to make them regular features on your plate. When you go to the shop, you know, going to the supermarket, you can think, okay, well, I'm going to make sure I have some of these around because it's going to make me hitting my fiber requirements that much easier. But of course, all vegetables, all fruit, fantastic source of fiber. This is more just a kind of quick hit list.
- [70:08]
B
Okay.
- [70:08]
A
Like for example, with, you know, fruit pears, really fantastic source of fiber. This is why at the back of my book, I have a whole section of the list of the different fruits, I have a list of the different vegetables. So you can see yourself. Okay, well, that's. That, that's got that.
- [70:24]
B
Do you know if hard pears are different in fibre content in any way than when it's sort of super ripe?
- [70:32]
A
There is this change and I think particularly most of the research has been around bananas, actually. And if we think about a banana, obviously has a bit of a life course, doesn't it? Starts, you know, we buy it and maybe it's still got that little bit of tinge of green on it and we might start eating it when that skin turns yellow and then it might hang around in our fruit bowl and get kind of brown and spotty and, you know, slightly change shape a little bit. So they've looked at actually the resistant starch content of that banana at different kind of phase of the banana's life. And resistant starch is kind of newly added into the fiber family. And you can tell from its name, resistant being kind of rebelling against being digested by your body and therefore kind of passing through to your gut microbes. And what those kind of just ripe bananas, you can tell when you taste them, they're less sweet and they actually have kind of higher amounts of resistant starch. But that then kind of transforms into kind of simpler, kind of more sweet, sugary flavours as that banana ripens. So that kind of level of overall fibre is getting a little bit less, which of course, in terms of your health isn't really. It doesn't make that huge difference. It's just an occasional banana here and there. But I did kind of cheekily use that as an excuse in my book for the banana recipe. I always want to make banana bread when I don't happen to have lovely, you know, very brown ripe bananas which you're meant to use. You know, the very spotty kind. And so I purposely made the banana bread recipe with the, you know, more high resistant starch bananas. Of course you can use what you want. But I think I'm always like, I want to make banana bread so I'll buy the bananas and then they're never quite at that stage, so.
- [72:12]
B
But potentially has a little bit more fibre.
- [72:14]
A
Yeah, exactly. So win, win.
- [72:16]
B
So it's win, win. So it totally fits the book, right? I. Okay, we've got B for berries, G for green veg, then there's another B. What's that?
- [72:25]
A
And then so now we're in like the big fiber hitters. Okay.
- [72:28]
B
So wow. So we've just had like a warm up. We've had this been the one like the opening act.
- [72:31]
A
Yeah, the opening act. Because as wonderful as fruits and vegetables are, we need to be eating more of them. They often don't tend to contain as much fibre as beans. And also the next one is grains and whole grains and then S is seeds as in nuts and seeds. So these are the three that you know, really if you're getting those regularly in on a day to day basis, it's going to make it that much easier to reach your 30 grams of fibre. Of course, these are all things that listen to what works for you, your, your tastes. You know, if you don't like, you know, nuts and seeds, you can shift to something else. But I, but I really like it. It's just easy tools to be like, okay, well actually I'm going to have some more beans. And beans can be, you know, it doesn't have to be adding physical beans into things all the time. It could be that you're blending it into pasta sauces. I think this is like an absolute kind of trick that we could all be doing. For example, like a tomato sauce, if you blend in some white beans like butter beans or cannellini beans, it's going to make it that lovely, creamy, almost like mascarpone like sauce and you're automatically boosting that fibre content. Really great for kids who maybe might feel a bit kind of unsure about trying kind of whole beans. And I also have a Recipe where I make a kind of Mac and cheese. And it's actually a lot quicker and easier to thicken the sauce with blended beans. You can't taste it at all. It's still deliciously rich and cheesy, but it just kind of adds a bit of extra oomph without you realizing it.
- [74:06]
B
The thing I get from your book, mostly in terms of practical take home, is it's really not that hard if you are aware of the foods that are rich in fiber, and if you start looking at your diet through the lens of fiber, whatever your dietary choice is, right? Vegan, omnivore, Mediterranean, actually, it sort of doesn't matter unless you're kind of super strict carnivore and not having any plants at all. And we covered that earlier on in the podcast, I think pretty much. For anyone else, it's not that hard once you know where these foods live.
- [74:44]
A
Absolutely. And I really felt so strongly in that. I was like, I wanted this to be a practical guide. I mean, the whole beginning of the book, that first page says, this is for you. Because I wanted to just give everybody the simple, simple, enjoyable tools that you could then make work for your life. I mean, even. Yes, it's got kind of over 60 recipes, but it's also got what I call the food combos. You know, each week there's a whole list of ideas of how you could throw ingredients together that aren't necessarily recipes, they're just five things that will help you meet your fibre and your protein. So that could just be making a bagel that's a blt, you know, what do you need to add and what do you need to think about for that? Or it could be that it's a breakfast or a dinner, or like, sometimes I just like to have a sweet potato with some chicken and some broccoli and what do I need to maybe just have a little bit with that? So just really simple, practical, because we are so time poor. And as you say, quite often you just happen to have these things in the fridge and not a full recipe
- [75:48]
B
itself for people who perhaps are trying to keep on top of their blood sugar. So I, for example, will wear a CGM every so often. I have found it to be one of the most powerful behavioral change tools I've ever seen. I'm not saying it's everything, but I think understanding what foods spike your blood sugar give you sort of rapid drops in blood sugar, which foods keep them relatively more stable, I think can be very helpful, certainly for me and many patients in the past, what would you say to someone who's also trying to look at their blood sugar and think, yeah, but some of these foods, Emily, may really send my blood sugar soaring high.
- [76:31]
A
I think this is really like, we just need to bring fibre into the conversation when we're talking about carbohydrates. Because really carbohydrates are things that sugar and really that particularly the type of fiber that's called soluble fiber. And effectively it dissolves into, you know, you might not even see it sometimes it's kind of fiber that dissolves into water and liquid. But some of these types of soluble fibres also make a gel and so they can act a bit like slowing down that sugar release into your bloodstream because they're acting a little bit like a kind of fishing net, they're slowing things down. And so all these foods, if we're talking about things like berries, which naturally contain more kind of sugar in them, but it's a natural sugar that's encased within a structure, so it's going to naturally slow that down. All these things have fibre in them. So I think, like, it's not to say that, you know, any of these things are gonna necessarily be problematic for your blood sugar control if we're bringing fibre into the conversation with it.
- [77:31]
B
I think, Emily, you've really made the case well for fiber both in your book and on the podcast today. Just for that person who's thinking about, you know, getting involved now and increasing amount of fibre in their diet, what are the key things that we need to remember?
- [77:49]
A
I would say let's, yes, fibre is powerful, but let's just really remember that we need to start low and go slow. And I think that also could be very individual to that person, somebody who's maybe got more of a sensitive gut. It may mean that you need to go a little bit more slowly in terms of how quickly you're introducing more fibre into your diet than someone else.
- [78:09]
B
If you are currently on a low fibre diet, is going to 30 grams a day too much, would you say go slower than that? Basically.
- [78:19]
A
So the whole four week plan is about taking four weeks to get to 30 grams.
- [78:23]
B
Got it.
- [78:24]
A
The first week is just making changes to your breakfast. Second week, you then start making changes to your lunch and you keep up those breakfast changes and then we start moving to dinner and then we start moving to snacks. So it's a small stepwise changes that's giving your gut time to adapt and that's gonna make you feel much better in terms of your microbes adapting to the new amount of fibre. But also you're going to notice all these fantastic changes on the way to your digestion energy levels.
- [78:53]
B
The other thing I really liked in your plan was that each week you're helping people build awareness through tracking, which I think is so, so important. It's not just blindly following a plan, it's also like paying attention to how was this impacting me. Can you tell us a little bit about that?
- [79:10]
A
Yeah, I kind of wanted to bring people on the journey of being a scientist with me. So I kind of say this is your kind of own individual science project where you're the participant in your own little study. And so I kind of have trackers of how fun ways to kind of fill out and keep an eye on how did you feel on all these different metrics when you started it? How's your poos as well? How often are you going, are they kind of healthy? Size and shape are your energy, your mood, your stress, your sleep, all these things that maybe you don't necessarily think are all related, but very much are. And then each week you kind of check in and keep track of how you've been feeling and then you can see has there been shifts and what those shifts are across that four weeks. And I think particularly for moments where we all have them and maybe you're like, oh, just feeling a bit kind of of rubbish today or something. You can think, well, actually, overall, wow, I really have made this amazing change and I can keep it up as well.
- [80:09]
B
Yeah, I think building that self awareness is one of the most important components of change. I just think if you don't do that, you're constantly following other people's plans and recommendations. At some point it has to change from being someone else's plan to being something that, you know, helps you and supports your wellbeing and that comes through this kind of tracking of, oh, wow, my gut is better, I've got more energy, I'm sleeping better. Wow. And that really locks it in. So you're more likely then to continue. Whereas if you're blind to that, it's like, oh, I tried that. I don't know, I'll just go back to the way I was eating before. So I think that's really, really important. Emily, gut health is always a popular topic with my audience and we let people know that you were coming back on the show and there's quite a few questions that have come in. So is it okay if I put a few of these questions to you and get your sort of take on Them. Okay. Sarah has asked Emily, what is the impact of menopause on our gut biome and what can women do to optimize this?
- [81:19]
A
So we see that the gut microbiome can change and shift. You know, if we think about this as a kind of living ecosystem in our gut, what we tend to see in that between the difference between boys and girls when they hit puberty, women's microbiome or girls kind of newly pubescent microbiome will kind of shift and change. And we think this is all relation between estrogen, that sex hormone, and also the microbes having this kind of interaction back and forth. When we go through menopause, of course, we then start having these kind of fluctuating levels and fluctuating decline of estrogen. And we think then that this is one of the reasons why we see a shift, shift in the gut microbiome and it starts to become a little bit more similar to a man's microbiome in terms of, like, what microbes are around. So how that might play in terms of how you feel day to day, we're still not really sure. I think one of the most frustrating things about kind of women's research is particularly the kind of lack of funding and lack of evidence that we have in menopausal research, and particularly with kind of actionable strategies that we can take to manage symptoms. What might happen is that because there is this shift in the microbes, it could be a kind of key opportunity to think, okay, well, how can I just be more in tune with my gut? I think a lot of people say that they notice they have changes to their digestion. They might think their kind of bowel movements shift. There's kind of things happening where they feel that the body is different from what it was before. So can we then use that as a way to be like, okay, well, can I then pay more attention to my gut health? Maybe, you know, stop putting some of these kind of dietary strategies in place. Because we do see that from some evidence, again, these are patterns in studies, so we don't know that they're a kind of causal or not. But people who tend to have a kind of higher fiber, more plant rich, kind of healthy dietary pattern tend to experience less menopausal symptoms. But again, that is something that we just still need to tease out and understand a lot more. And I really hope that we get some more research in this space because it's, you know, shocking the lack of funding that it gets.
- [83:31]
B
Gemma has asked Emily, how can I test my Gut health, especially if I don't have the funds for very expensive tests.
- [83:41]
A
So I always say, can we just look in the toilet? Every day, whenever you go, this is really giving you a clear sign of the health of your gut. And when I talk about the health of your gut, it's not just about your gut microbiome. I'm talking about the entire kind of system going from your mouth all the way down to your bum. So what are you really looking for? You're keeping out for the fact that it's a smooth sausage or a sausage with cracks in it, it's a brown colour, you're going to the loo very easily, everything's coming out. And also that you're going within between a frequency of three times a day to three times a week. I know that gut microbiome testing is all the rage at the moment, but we actually had a consensus review by 69 experts in the microbiome space and they effectively put together a number of statements that they kind of agreed on. And what they said was that the microbiome testing is really not there yet in terms of the science to give any specific actionable advice when it's from a company directly to the customer. So where does that kind of land? If you are wanting and you've got the money too, and you just want to know who's there, then great. But don't feel like it's something that you have to do that you think it's an essential thing to understand about your gut health to do a gut health test. If you're having issues with your gut health, it's much cheaper to just go and see a clinician who's gonna help to help you directly with your diet if you are experiencing problems.
- [85:15]
B
Yeah. Charlotte has asked what causes people to become intolerant to garlic, gluten or onions when they've previously eaten all their lives and not had any issues.
- [85:28]
A
That tends to be something that we see with irritable bowel syndrome in terms of those key foods containing something called fodmaps. And these are kind of fermentable, kind of carbohydrates and sugars that some of them of which are types of fiber, that for some people can cause them some issues. And that might, as this person said, happen when they haven't had any issues before. For example, that could be that someone's picked up a bug on holiday, had a dodgy stomach. You can then suddenly get ibs. Why does that happen? We don't actually really know why exactly. We're happening. We think the microbiome is one key component in, for example, ibs. And why, if you've then had food poisoning, dodgy stomach abroad, that's then disrupted your gut microbiome, it hasn't been able to kind of make it back. And then it's just meant that you are more sensitive. So it's not necessarily those foods are harming you, but it could be then that you've got more kind of sensitive signals from nerve endings, kind of sending pain signals back and forth, that you're getting more bloating because you're getting more gas produced from certain types of microbes. There's still a lot of kind of. And again, this gut brain connection as well.
- [86:50]
B
Paola has asked you to comment on the sauerkrauts and kimchis that are sold in supermarkets. He or she is saying, it would appear that most brands pasteurise their products and as such, aren't the beneficial probiotics eradicated by pasteurising.
- [87:08]
A
A lot of these products are pasteurised because it makes them more shelf stable, they're less likely to explode, they're easier to transport from location to location. So we do see from some of the studies that particularly looking at things like kefir, for example, that making kefir at home, you're gonna have a whole kind of wider range of microbes than perhaps, you know, a handful of number of strains that are kind of put in a bottle. There's no official kind of requirements and, you know, then put the label on. But I would say that I, having previously, you know, spent a lot of my life making fermented foods. I tend to buy them because I just think you've gotta really recognize how much time and effort you've got at hand and you're still getting some microbes. And I think also we have microbes all around us. It's not just in these fermented foods. They're on every surface that we, you know, we talked about this, I think, last time, you know, we're interacting with microbes. We have a microbial cloud all around us. So we are getting microbes from many different sources as well.
- [88:11]
B
Emily, you're such a wealth of information on all things gut, health and nutrition. We've, of course, spent a lot of time today covering fiber and its impact on various aspects of our health. But of course, you write a substack where you cover all kinds of things relating to all kinds of things. Right? You. God, was it, was it last week you were talking about the impact that nurseries have on our gut health. You're talking about the impact that certain medications have on our microbiome and how that impact can last for several years. For people who want to go deeper with you, what kind of things are they going to get if they go to your substack?
- [88:50]
A
Oh, absolutely. So I write every week and I'm very big on breaking down not only the latest science. So if I get very excited that there's a study that just came out last week or a few days ago, then I'll break down what that evidence says. Especially with the microbiome. It's so fast paced. So, yeah, keeping on top of the latest microbiome scientists. But I also do my background as a dietitian and also kind of researching nutrition. I very much tackle those key nutrition topics as well. So I think a recent one was is the advice and sort out data and actually understanding that kind of key advice behind that and lots of other kind of different kind of nutrition and things for your health that's hopefully very, excuse the pun, easily digestible. But yes, every week. And it's something I really enjoy sharing with people.
- [89:40]
B
Yeah, brilliant. Of course, the new book is called Transform youm Energy and Feel Amazing. It's out now. So for people who are interested, check it out. All those delicious recipes he's talking about are in there to finish off. Emily, for that person who's listening, who has really not taken care of their health for a variety of different reasons and they've recognized today through this conversation that actually, you know what, it's time to change things. It's time to put themselves first. And they decided to make increasing fiber the first step on their health journey. What are your final words to them?
- [90:19]
A
I would say, welcome. You're in the fibre family now and you know, this is something that I want you to have fun with and to enjoy and find delicious and understand that it's not about having to have the most perfect quote unquote diet, but making small practical changes for your health that make you feel better here and now, but also support your health in the long run. And that's really the key things that matter.
- [90:47]
B
Yeah. Emily, fantastically empowering message. Thank you so much for coming back on the show.
- [90:52]
A
Thank you so much for having me.
- [90:58]
B
Really hope you enjoyed that conversation. Do think about one thing that you can take away and apply in your own life and also have a think about one thing from this conversation that you can teach to somebody else. Remember, when you teach someone, it not only helps them, it also helps you learn and retain the information. Now before you go, just wanted to let you know about Friday 5. It's my free weekly email containing five simple ideas to improve your health and happiness. In that email, I should share exclusive insights that I do not share anywhere else, including health advice, how to manage your time better, interesting articles or videos that I've been consuming, and quotes that have caused me to stop and reflect. And I have to say, in a world of endless emails, it really is delightful that many of you tell me it is one of the only weekly emails that you actively look forward to receiving. So if that sounds like something you would like to receive each and every Friday, you can sign up for free@drchatterjee.com Friday 5 Now if you are new to my podcast, you may be interested to know that I have written five books that have been bestsellers all over the world covering all kinds of different topics. Happiness, food, stress, sleep, behavior change and movement, weight loss and so much more. So please do take a moment to check them out. They are all all available as paperbacks, ebooks and as audiobooks which I am narrating. If you enjoyed today's episode, it is always appreciated if you can take a moment to share the podcast with your friends and family or leave a review on Apple Podcasts. Thank you so much for listening. Have a wonderful week. And please note that if you want to listen to this show without any adverts at all, that option is now available for a small monthly fee on Apple and on Android. All you have to do is click the link in the episode notes in your podcast app and always remember, you are the architect of your own health. Making lifestyle change is always worth it because when you feel better, you live more.
- [93:15]
A
Sa.