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Jonathan Wolf
Welcome to Zoe Science and Nutrition, where world leading scientists explain how their research can improve your health. The case against the Western way of eating is stacking up heavy unsaturated fats and refined carbohydrates. It's been linked to heart disease, stroke and other chronic diseases. We hear a lot about potentially healthy alternatives like the Mediterranean or Japanese diets. But today we're talking about another diet that you probably haven't heard of, but seems to have some astonishing and fast acting health benefits. The traditional African diet. Rich in fibre, grains, fermented food and plants, this diet has never been properly studied or understood until now. Today we're joined by one of the scientists behind a groundbreaking study that has just been published in Nature just a few weeks ago, exploring the traditional African diet. Dr. Quirine Demast is an infectious disease specialist at Radboud University Medical center in the Netherlands. And by the end of today's episode, you'll have a better understanding of how the traditional African diet improves our immune system, our metabolism and our gut microbiome. And some simple tips on food swaps that you can make right now as a result. Quirain, thank you for joining me today.
Dr. Quirine Demast
Thank you. Lovely to be here.
Jonathan Wolf
And Tim, thank you for joining me as well.
Tim Spector
Likewise.
Jonathan Wolf
So, Quirain, we always start the show here with a rapid fire Q and A with questions that come from our listeners, but we have some very strict rules, very hard for scientists. You're allowed to say yes or no or a one sentence answer. If you absolutely have to, you're willing to give it a go.
Dr. Quirine Demast
I'm ready.
Jonathan Wolf
Can a traditional African diet really transform your health?
Dr. Quirine Demast
Yes.
Jonathan Wolf
Do you need to wait months before getting the benefits of an African diet?
Dr. Quirine Demast
No, certainly not.
Jonathan Wolf
Tim, is the Western diet harming people?
Tim Spector
Sadly, yes.
Jonathan Wolf
Is a traditional African diet healthier than the Mediterranean diet?
Tim Spector
Not necessarily.
Jonathan Wolf
All right. And Quirain, for a Western listener, what's the most exciting thing about an African diet?
Dr. Quirine Demast
I think what excited us the most as researchers was the clear effects, the immune effects of a traditional fermented beverage that we used in the study.
Jonathan Wolf
Everyone has their Achilles heel when it comes to sort of tempting treats. And Quirene was telling me that he was raiding the breakfast buffet of the hotel he was in last night. And it's funny, cause for me, it's like fresh bread, it's chocolate and actually it's that ultimate combination where they put the fresh bread and the chocolate together and they make a pan au chocolat or, you know, chocolate croissant, depending where you are. And all of Those are sort of key foods in the Western diet. And that diet in general features a lot of processed meat, high sugar drinks and refined grains. But I'm very excited to be talking about a completely different diet today and to be speaking with the scientists behind the very first significant clinical trial of the sub Saharan African diet, published in the world leading journal Nature just a few weeks ago. But just before we dive into it, actually, I thought maybe, Tim, you could just summarize, what's the problem with the Western diet?
Tim Spector
The Western diet, also known as the SAD diet or the standard American diet, is basically responsible for millions of deaths a year through the chronic diseases that it's causing. So obesity, diabetes, heart disease, cancers, autoimmune disease, mental health problems, you name it. This has been linked to our poor diets. So anything we can learn from other populations about how to manipulate or change our diets, looking at other examples is really important for our health. And it's becoming increasingly true that it's not just about the fats, it's not just about the calories, it's about something else in the food that is upsetting our immune systems and our bodies and our gut microbes in ways that in the past we haven't really thought about. So thinking about new mechanisms about how other diets might be beneficial is really absolutely vital for us moving forward to really redesign the way we eat and think about food.
Jonathan Wolf
I really asked about this Mediterranean diet versus African diet because I think we hear about the Mediterranean diet often as the answer, Tim, why is that?
Tim Spector
That's probably because we've got most data worldwide comes from our study of the Mediterranean diets. Since the 1950s, we've been really looking at that as the model of why there was this big difference between north and South Europe in terms of heart disease. That's how it all started. And American researchers like Ancel Keys did these big epidemiology studies following populations that were e lots of dairy and fatty foods, but with large amounts of legumes and vegetables, fresh fish, et cetera, and plenty of olive oil, and found they had a third of the rate of heart disease of the average American. And so it was this idea that we should be somehow mimicking what they were eating in southern Europe, in Greece and Italy and southern Spain. And if we could recreate that in in northern Europe and North America, then we would actually dramatically help improve our health. So that idea has been with us for over 50 years now, although it's been very difficult to define the Mediterranean diet. And if you go to the Mediterranean. Now you'll see pizzas and pasta and that isn't what they originally thought of as the Mediterranean diet. So this is the problem. And that's been exported. There's pizza places everywhere in the world now. Doesn't mean that's now the healthy diet place like Italy are getting increasingly obese and having problems as well. So it's trying to define what are the key elements in these diets that are helpful rather than just saying, oh well, just eat like the Italians or the Spanish and you'll be fine.
Jonathan Wolf
So, quirain, it's really exciting to have you here because I think we've tended to speak a lot about the Mediterranean diet across many different scientists on this podcast. This is the first time actually that we're talking about a traditional African diet. Could you start by just telling us what is a traditional African diet?
Dr. Quirine Demast
It's not easy to define because there is not like a typical traditional African diet. I mean, Africa is a huge continent and there's so much diversity in dietary patterns across the different regions. That said, there are some, I would say some unifying themes if you talk about African diet. So many of the traditional African diets, they're mainly plant based. That's one. So people consume a lot of legumes, traditional grains like millet, sorghum, teff in Ethiopia. And these are very, I would say, interesting small grain cereals with many health benefits. But also they have a rich tradition in Africa in using fermented foods.
Tim Spector
They also have a lot of porridge, don't they? They sort of. The thing we don't do is that they put all different grains into some gruel and porridge. And that seems to be what I've noticed in Africa is the grain might be different, but they still have a similar. That's the base of many meals. Like we would have potatoes, they have a sort of grain porridge.
Dr. Quirine Demast
Yeah, that's correct. So in Tanzania, where we, we did our studies, people consume two, sometimes three times daily. Indeed, a porridge is made of, of maize or from millet. But you see in many areas that they have, their local porridge can be made from maize, can be made from sorghum, for example. So that's true. Yeah.
Jonathan Wolf
And you've mentioned quite a few grains that I'm not familiar with, like sorghum. I wouldn't know it if it dropped on my head. Could you describe for listeners who maybe are not familiar with like a millet or a sorghum, what are they similar to that we might be used to finding in A Western supermarket, to be.
Dr. Quirine Demast
Honest, I can't really say, like, compare it to what we're used to here in Europe or in the Western supermarket. But they are extremely interesting. These grain cereals, because they're so nutritious, contain lots of fiber, more than, for example, wheat. They're rich in polyphenols. They also have a low glycemic index. So you don't see this, like this spike in glucose or insulin when you eat them. Yeah, they're kind of neglected, I would say, but they have very interesting health benefits.
Jonathan Wolf
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Tim Spector
So there are many grains that our ancestors used to eat and we've all become very focused on these monocultures of just having maize and wheat as our principal ones and they're the ones we export. But if you go to other countries, you'll see all these varieties of these cereals and it turns out they're much healthier than the ones that we've evolved in that we're just more efficient for storing long term and big commerce, sort of global commerce. So this is why when you go to Africa, you'll see these regional grains that we don't see anymore in the rest of the world.
Jonathan Wolf
And so I should think about these as being like the seeds of these plants, a bit like I might have with wheat. And these are traditional plants that as human beings we've presumably cultivated for very long periods of time in Africa.
Dr. Quirine Demast
Yes, correct. Yeah.
Jonathan Wolf
But we haven't traditionally eaten them. If we are, you know, if you listen to this, in the States or Northern Europe or probably Australia or Canada or wherever, they somehow never really made the transfer with people as we came out of Africa.
Dr. Quirine Demast
No, not I'm aware of. So we don't have a tradition with eating millet or sorghum. Indeed.
Jonathan Wolf
And what made you want to study this African diet queering?
Dr. Quirine Demast
Well, it's one of the reasons it's my own observations. So I've been collaborating with a university hospital in northern Tanzania, KCMC. So it's the foot of Mount Kitimanjaro, and I've been collaborating with them for almost 20 years. So 20 years ago was my first visit for I was doing a PhD on malaria. And since then I've been a regular visitor. And I do see clear changes in disease patterns over these past 20 years. So 20 years ago, if you would look in the hospital, there were mainly people with infectious diseases. But nowadays you see this very rapid rise in people with non communicable diseases or lifestyle diseases. So there's a lot of obesity, lot of type 22 diabetes, people with cardiovascular disease, kidney failure. So we are interested in what does cause these changes in disease patterns. And my department, our research focuses on factors that regulate your immune system. We've been doing different studies in the Netherlands in cohorts of healthy people and people with underlying conditions. But we thought it would be of particular interest to Also perform these studies in Africa and Tanzania to look what are the factors that regulate your immune system. Because if you talk about cardiovascular disease, for example, we know that there is an essential role for inflammation. And so we conducted some years ago a larger study, over 300 people, healthy people, Some of them were living in a city, some of them were living in a rural area. And we looked at all these factors that might associate with the function of your immune system. And what stood out was what people eat. These studies where you look at, we call them cross sectional studies. So you look at one time point. So we had a clear hint that the change in diet between people living in the city and people in a rural area, that that was one of the main factors driving inflammation and the function of the immune system. But we wanted to confirm that it's indeed diet. So that's why we did this intervention study.
Jonathan Wolf
And Quirain, can you maybe draw a picture for the many listeners who have never been to Tanzania? What was it like when you first visited 20 years ago and what is it like now? Because you're painting a picture, I think of a lot of modernization and a rise in diseases I think will probably be surprising to most listeners.
Dr. Quirine Demast
Yeah, no, it's totally different. So Tanzania is a country in east Africa. It has a steady economic growth, so it's now a middle income country. More and more people living in cities. And in these cities, life is like what we know from the western world. People are surrounded with processed foods. There is fast food on each street corner. There is snacks everywhere.
Jonathan Wolf
So they're now eating hamburgers and french fries and lots of processed food in packets produced by big food companies.
Dr. Quirine Demast
Yes.
Tim Spector
Every street corner has brightly colored stalls with soft fizzy sodas of every single bright color of the rainbow. Really fluorescent colors. The thing you notice most when you go to these countries and yeah, these snacks that last for years that never go off. Big food companies have got their first. They've made sure that these foods are everywhere and they're cheap and available.
Dr. Quirine Demast
And another thing is that I notice is that so 20 years ago, people would walk a lot. But nowadays there are motorcycles everywhere. These motorcycles imported from China and tuk tuks, people have a much more sedentary lifestyle. So these are two major changes. And what's interesting, in the Kilimanjaro region where we did our study, so we have a town, it's called Moshi, but it. Moshi lies at the foothill of Mount Kilimanjaro, but very nearby on these foothills of Mount Kilimanjaro people still live kind of a traditional life where they still exercise a lot, they walk a lot, but also they preserve their traditional diet. So that makes this a very interesting area to look at the effects of lifestyle changes and dietary changes on health.
Jonathan Wolf
It's almost like a time machine where you can look back into a diet of people living in sort of pre modern Western lifestyle, and then literally next door you've got people who are now living the sort of diet that you would be living if eating, if you were in New York or London or Amsterdam.
Dr. Quirine Demast
Exactly, yeah.
Jonathan Wolf
I had no idea how fast that change was happening. And I think I'm also rather shocked to hear how much these sort of Western disease. We tend to think about them as Western diseases. Right. The diabetes and the obesity. And you're saying that now in Tanzania, which is only 20 years ago, you're saying that almost nobody was eating these foods and you really see the impact already today on things like obesity?
Dr. Quirine Demast
Oh, absolutely. So in an urban population, so people living in cities, 30 to 50% of the adults are overweight or frank obese.
Jonathan Wolf
30 to 50%.
Dr. Quirine Demast
30 to 50%.
Jonathan Wolf
So that's immense.
Dr. Quirine Demast
It is immense. So it's a huge challenge for healthcare nowadays.
Tim Spector
And generally, when I've been to Kenya and Tanzania, they believe that Western food is more likely to be healthy for them because it's seen to be associated with being rich and wealthy and therefore more advanced. Even if it comes in a bright green packet, it's seen generally as something that you should aspire to. So there's a big gap in education about what is good and bad.
Jonathan Wolf
Well, I think you've painted a really powerful picture for why you'd be really interested to understand whether the diet change is what's sort of behind this change in health that you're describing. And I think we've got a bit of a picture also of what this African diet is, and it's clearly very, very different from the Western diet. Your team was the first ever, as far as I know, team, to sort of comprehensively try and examine the effect of, of a traditional African diet with a very strong sort of study structure where you could really, actually do an intervention and see what happened. Could you describe in sort of in simple terms what the study was and then we'll go on and talk about what you found out.
Dr. Quirine Demast
Yeah. So we selected a group of healthy young men. Half of the men were living in the city and they were consuming a Western type diet, while the other half of the young men, they were living in a rural area. So up Mount Kilimanjaro somewhere, almost 2,000 meters. So what we did, we set up a study site up on Mount Kilimanjaro. So kind of a pop up restaurant at almost 2000 meter altitude.
Jonathan Wolf
Pop up restaurant, I love it.
Dr. Quirine Demast
With a cook. The rural living men, we would switch their diet to western type diet. So they would come three times daily to our study site, to our pop up restaurant. They get breakfast, they get lunch, they get dinner. And then we measured the function of their immune system. We did that with blood tests and we sampled their microbiome and we did that at the end of the two week intervention. And then they would switch back to their habitual diet. But we resampled them four weeks later because we were also interested in the longer term effects of this such a short intervention. And in cities we did the opposite. So the man, they had a western type diet. And so we switched them to this traditional Kilimanjaro style diet. So we gave them lots of beans, traditional grains, the millet, sorghum porridge, for example. Again with the same resampling four weeks after the end of the intervention, we did exactly the opposite. So we switched basically their diet. So western to traditional and traditional to western.
Tim Spector
Do you remember roughly the difference in fiber consumed per day?
Dr. Quirine Demast
Yeah. So in the heritage diet, people would consume, yeah, roughly 90 grams of fiber a day, while in the western diet was roughly 30 grams a day.
Tim Spector
Wow, that's a big difference. And just so people know, the average American in the west has about 15 grams of fiber per day. So 30 is actually a recommended level. So it's not bad. But you've got three times that in the African diet. That's amazing. Yep.
Jonathan Wolf
So I'm just doing my little mental maths. You're saying that traditional African diet goes from like 15 grams, you see in America, on average, all the way up to 90. So it's like six times more fiber they're eating every day. So, you know, we talk a lot about deficiency, but that relative level is extraordinary, isn't it?
Dr. Quirine Demast
Absolutely, yes. We also had a third group in our study. And there we made use of a traditional fermented beverage that's commonly consumed in this Kilimanjaro region. And this drink is called Mbege. That's the local language, also commonly referred to as banana beer. And it's a beverage made of bananas. So they kind of mash bananas, so make banana juice, and then they add some millet. And then this is fermented by some, you have some local producers. And then People typically drink for sometimes half a liter or a liter a day. So in our third group, we had men with a Western type diet and we gave them this fermented banana beverage for one week.
Tim Spector
Did you try it yourself?
Dr. Quirine Demast
I tried.
Tim Spector
It's quite sour, isn't it?
Dr. Quirine Demast
It's very sour, yeah. Yeah. So you really have to get used to the taste.
Jonathan Wolf
And is it as. Is it as an alcoholic, as a beer?
Dr. Quirine Demast
Yes, it is. It has low alcohol content, so it depends on the time of the day that you drink it because it gets stronger during the day because the fermentation is ongoing.
Jonathan Wolf
So like how alcoholic in the morning and how.
Dr. Quirine Demast
So it varies, but usually in the morning it's about 1%, but it can increase to up to 3% in the morning.
Jonathan Wolf
That doesn't sound very alcoholic. You're not likely, I guess, to have a lot of hair at 3% and you drink a liter, you're going to.
Tim Spector
Feel might make you sleepy in the afternoon and evening.
Jonathan Wolf
And it sounds like you're not really selling it, that it's going to take over my local wine bar from the taste is that people say, well, it.
Dr. Quirine Demast
Depends on the local producer. Some are well known to make it also more sweet. So it depends on your producer. But yeah, for me, when I have tasted several times, yeah, for me it's pretty sour.
Jonathan Wolf
Well, I want to find out what it does for me and then we'll be figuring out how to source a tasty version. So Qui Rain, I think you set up, sort of describe this study with these three arms. The people like halfway up Kilimanjaro switching to a Western diet. The people in the city who've been eating a Western diet for a long time now switching back to that traditional diet. And then a third version where you're saying they're on a Western diet, but you sort of reintroduce this fermented beverage and I guess you're sort of giving them away free, basically giving away free beer each day.
Dr. Quirine Demast
Is that correct? Yes.
Jonathan Wolf
What did you discover?
Dr. Quirine Demast
So in the people with a traditional diet who we switched to a Western type diet, we basically saw that they developed more inflammation. That's the main finding.
Jonathan Wolf
Within two weeks?
Dr. Quirine Demast
Within two weeks. So we looked at several aspects of the immune system. So if we looked at the circulating immune cells in the blood, we saw that they became more activated also they started to produce more inflammatory proteins in the blood. And third, we isolated the immune cells from the blood and we stimulated these immune cells. So in the lab with microbes and what we noticed is that these immune cells performed less well. So on the one hand they developed inflammation, but on the other hand if you stimulate the immune cells with microbes, you see a poor response.
Jonathan Wolf
And quiraine, these are like bad microbes you're talking about sort of bad microorganisms causing salmonella.
Dr. Quirine Demast
Yeah, indeed. With salmonella for example, and the tuberculosis.
Jonathan Wolf
Bacteria, two weeks on the western diet you gave them tuberculosis and they like didn't deal with it as well.
Dr. Quirine Demast
Yeah. And this, this shows that there is kind of an immune disbalance and the one hand the immune system produces too much inflammation.
Tim Spector
So it's like ramped up really. So it's ramped up. Yeah. So it's getting excited in a general way.
Dr. Quirine Demast
Yeah.
Tim Spector
But it's not very effective when you actually give it a real villain to attack.
Dr. Quirine Demast
Exactly, precisely. So the switch to a western diet had quite some negative effects on the, on the immune system basically. While in the people that we switched from a western diet to a traditional diet, we saw the opposite. So we saw a clear reduction in inflammation, which is good. And in the third group, the people with a fermented banana beverage, it also had mainly an anti inflammatory, so an inflammation inhibiting effect. And we saw that the immune system was much more imbalanced. So these were the main findings.
Tim Spector
And could you separate out whether this is an effect of the bad effect of the western diet or the lack of good effect of the African diet? How do you separate those in your mind?
Dr. Quirine Demast
It's hard to separate, but I think it's certainly both. Yeah.
Tim Spector
Right. So that if, if people had carried on eating their African diet, they might have been able to tolerate a little bit of western diet and sort of vice versa.
Dr. Quirine Demast
Yes.
Jonathan Wolf
And with the banana beverage alone, is that enough to solve everything or was that not as good as the people who moved on to sort of the full African diet?
Dr. Quirine Demast
Well, you do see some different effects. The banana beverage could correct some, but I think there were additional effects of the switch to the traditional diet so the combination would be perfect.
Tim Spector
And in fact, it's interesting, our colleague Christopher Gardner did a study at Stanford where they compared in Americans high fiber diets against high fermented food diets and they found different immune profiles of the two. So it's. There are different processes involved, both are beneficial, but certainly the fermented food has a big impact of its own and that's certainly something we've done some studies in Zoe as well with our citizen science. People having extra fermented foods do get benefits that look as if they're different to the ones just by increasing your fibre intake or your plants. So lots of different mechanisms being brought into play.
Jonathan Wolf
What are your thoughts on this study and the rather amazing results after just two weeks?
Tim Spector
I don't like to ever read too much into one study, but it is actually backing up a few older studies that weren't as sophisticated that did something similar. So where they've swapped some Africans for some American diets and just looked very crudely at their microbiome and that improved when they went onto the African diet and got worse on the American diet. And of course this Stanford study where they compared fermented foods and fiber. So it is very consistent and I think it is really exciting that we're seeing that we're now getting a new idea of the mechanisms of why foods are good for you is that it's not about the calories, it's not about the fats, it's not about the vitamins, it's about their interaction with the gut microbes and our immune system and how that is so crucial for to nearly everything in our health. If we can get that balance right, then we can actually start to control these diseases that we've let go rampant. And I think this is the really important message from these kinds of studies about learning these new mechanisms. And as you said, it's not just about ramping the immune system up, it's getting the right balance. So that on the standard American diet, our immune systems are just going crazy, attacking everything, but they're not very effective. So we're getting more infections and the body's being confused by all these immune signals and not repairing damage, leading to all kinds of metabolic problems. So yeah, we need to learn from these studies and learn what the best foods are to eat so we can help ourselves.
Jonathan Wolf
Can the two of you help me to understand the link between this immune system response that you were measuring and then the impact on people's long term health? And you were talking about obesity and diabetes and heart disease and all these things that we know we are likely to die of in the west. We're not very likely to die of an infectious disease anymore. How is that linked to this immune system that you were measuring? Because that's not immediately clear to me.
Dr. Quirine Demast
No. So we know that inflammation is key to many diseases indeed, like cardiovascular disease, cancer, dementia, name it. On the other hand, what we're more and more starting to understand is that if you have a chronic inflammation.
Jonathan Wolf
And Quirenheim, when you say chronic inflammation, what does that mean?
Dr. Quirine Demast
Chronic inflammation is that Your immune system is chronically activated. So, yeah, that's basically long term.
Tim Spector
It's quite normal to have an immune system that every now and again pops up because it sees a threat, but it goes back to its normal levels. What we're seeing now in Western populations on these bad diets are levels where it's continually being triggered. It's like, you know, your fire alarm's going off all the time, not just the weekly test, it's like on all the time. So the body can't focus, it can't concentrate because it's just got all these alarm signals. It doesn't know where to go and repair things. It doesn't. It doesn't know how to efficiently attack some microbe. And we think this then disrupts metabolism, our mitochondria, and affects all kinds of diseases because the body's just running really inefficiently. I think that's the way to think about it. It's like you're just putting the wrong petrol in your car and so it can never really function properly when the whole system is just ramped up. It's just like you're revving the car too much.
Jonathan Wolf
I love that analogy of, like, the wrong petrol in the car. I suddenly think I, I'm, I'm getting it. So on the one hand, that sounds very depressing if you've been on the Western diet your entire life, like, like me. On the other hand, I think you're saying that in just two weeks, switching to this African diet, you could really see a measurable improvement. Like, was that meaningful?
Dr. Quirine Demast
I think it's meaningful. So it shows that even after a few days that you can already see changes in your immune system. And that's what we also know from, from earlier studies, to be honest. So we know that it doesn't take very long to see effects if you change your diet.
Jonathan Wolf
I think it's amazing, before we switch on to sort of, like, what can this mean for listeners? Are you able to understand what the components of the diet are that are affecting the body? So you switch this, you know, this whole diet for one group, another group just given them this banana beer. Do we understand at all, you know, what's going on? What parts of the. What are the characteristics, I guess, of this African diet that are being so much healthier?
Dr. Quirine Demast
Yeah, I think it's the combination. So it's not just one type of food, like, which did the magic trick, so it must be the combination. So I think the foods that were important in the traditional diet, so it's the traditional grains which contain lots of fibers, but also the legumes which are fiber rich and traditional vegetables. They were eating lots of fruits. They contain anti inflammatory products called polyphenols, also the fermented products they used. So they contain some live microbes who could have beneficial effect on the gut microbiome. So I think it's the combination.
Tim Spector
I remember when I was spent some time with the Hadza tribe, which is just about six hours from where your experiment was, they had a lot of these berries and that was a big part of their diet, was these tiny little berries which are the precursors of many of our cultivated berries. And they had something like a thousand times the levels of polyphenols that our almonds do. And the other thing they were eating at the Hadza was digging up tubers, things which we now know as things like yams, bit like these root vegetables that become potatoes, but actually they're much more nutritious than potatoes. Was that part of their diet in this group of Tanzanians?
Dr. Quirine Demast
Yeah, so we didn't give them berries, but what we did we gave them indeed, like roots and tubers, cassava, taro. So absolutely there are some variants which is an important part of the regular traditional diet.
Tim Spector
And baobab was that?
Dr. Quirine Demast
No, in this region there are not too many baobab. So baobab fruits were not part of this.
Tim Spector
They've cut down the trees, unfortunately, so they don't have them. But yeah, that was their porridge that Hadza had as their daily porridge was the baobab, which is interesting. But yeah, this porridge seems to be the binding thing across Africa, that it's a very really easy way to get the fiber into your body quickly.
Jonathan Wolf
You know, I think of a porridge or something or an oatmeal as something that I get in a packet that I rip the top open, I pour into a bowl, I put in some milk and I put in the microwave for a minute and a half. I have a feeling you're describing a slightly different porridge or oatmeal. How do you make this porridge?
Dr. Quirine Demast
So the porridge is a most commonly consumed ugali. It's traditionally it's made from unrefined maize and they add some water and they boil it and then you get this kind of stiff porridge. But you do have variants. So in our study, also at breakfast, we served participants a porridge made of millet, for example. So you just use millet, you add water and you boil it and you make it into a Porridge.
Jonathan Wolf
So it's almost like making, like, rice or a sort of sticky rice, and you're just keeping the liquid in it. I'm imagining as soon as you say porridge or oatmeal that I'm adding sort of dairy milk. But actually it's just really sort of boil to break it.
Dr. Quirine Demast
Yes. Down.
Tim Spector
It's. Yeah, it's the grain plus water and a bit of heat or a lot of stirring. The hadza didn't really use. They didn't have a lot of boiled water. So, you know, they would just add normal water to crushed bits of the baobab into these little cubes. And basically with 10 minutes of just beating it up, it would. It would just become this creamy, thick liquid. And I think this is the general way that for millennia we've been consuming these foods which we've sort of forgotten. Your type of porridge, Jonathan, is highly refined. They've stripped off anything on the outside that would stop it becoming instantly absorbed into your body. All those good bits have been thrown away. You're just left with a very sugary center bit that dissolves instantly in the water or microwaves away and then goes straight to produce sugar. Sugar in your system. Whereas these old ones have got all that coating there that is part of all these. What we're now discovering are the crucial bits.
Jonathan Wolf
That's really interesting. We did a podcast on oatmeal where we actually got to do a live experiment looking on what was happening to our blood sugar as we were eating these different sorts of oatmeals. And I feel here you're describing something which is a whole level, both more nutritious but also less processed than, you know, any sort of oatmeal. You know, forget about the stone ground version. This is sort of like more fibrous to start with. It sounds like a grain which itself is probably, you know, closer to its original form in nature, I guess, than the sort of oats and grains that we typically eat in the west, if.
Dr. Quirine Demast
I may add, Jonathan. So what's worrisome is that more and more people are making these porridges from imported refined maize, for example. So Africa is importing lots of staples nowadays. Refined maize, wheat, rice. It's cheaper. So their local agriculture, indeed, it's transitioning more and more to mono crops and also cash crops for exports. So tea, coffee production. So lots of these maize nowadays is.
Tim Spector
Being important because countries like the US have an excess of maize and they get subsidies from the government to produce it really cheaply, and they end up Dumping it in third world countries where it overtakes the traditional types of grain and the local farmers who are growing it can't compete. And so they're sort of being forced to transition into these less healthy grains that they're not traditionally used to cooking with anyway and have all these health disadvantages. So, yeah, it's a real sort of geopolitical problem at the moment. And when there's famines, it happens even more.
Dr. Quirine Demast
Yeah. So there was a very rich tradition of small scale subsistence farming, but it's really declining nowadays.
Jonathan Wolf
So you're seeing this big transformation, it sounds like just literally over the 20 years that you've been visiting, from this very traditional diet to a diet that looks rather similar to the one that I might be eating from my local supermarket.
Dr. Quirine Demast
Correct? Yes.
Jonathan Wolf
So I think the results of the study are amazing. I think the fact that you can see an impact just in two weeks is fascinating. And I know that Tim is incredibly excited by your fermented test as well, since he is.
Tim Spector
Yeah, definitely want to try that one.
Jonathan Wolf
He's the world's biggest promoter of more fermented food. I would love to now sort of try and transition into actionable advice for our listeners. And so, you know, they're not living in Africa. This is not probably their traditional diet for the vast majority of people are listening. So I'm really interested, maybe to start by just describing a little bit more like what you might eat in a day on a traditional African diet. And then I'd like to start to talk about what could that mean for someone listening and how could they try and get the benefits from this, given the reality of what you might get from your local supermarket.
Dr. Quirine Demast
So what could we learn from their diets? So I think point one is their biodiversity. I think Africa. They, they have thousands and thousands of very interesting edible plants, many of them still underutilized. We don't know their health effects yet. I mean, there's so much we can still learn diet wise from, from all the indigenous knowledge from Africa. So I already mentioned these, these traditional grains. I think they're very interesting. One of these traditional grains, teff, it's more and more being used here and also claimed to be one of the, you know, called superfoods.
Jonathan Wolf
And quirine. How do you, how do you spell teff?
Dr. Quirine Demast
Teff. T, E, F, F. So it's an.
Tim Spector
Ancient grain coming from Ethiopia, which is supposed to be one of the precursors to wheat and what we're currently having as our main grains. And you can get teff flour here. Now you can make breads with it and with Einkorn as another sort of ancient grain that I think you also see in Africa, don't you? As well?
Dr. Quirine Demast
Yes, yeah.
Tim Spector
So going back to these ancient grains, rather than this highly evolved wheat that we currently have in its current form going back many generations could actually help us, you know, even just making bread in better ways.
Dr. Quirine Demast
Yeah. So in Ethiopia, it's being used to make, they ferment actually the teff and make it into a kind of a bread. It's called injera and that's the main staple. And it's interesting. It's also, it's gluten free and as that contains a lot of fiber, a lot of polyphenols. So that's one thing. So the traditional grains. But also I think there are some green leafy vegetables which are interesting. An example that's commonly being consumed in Tanzania looks like a spinach. It's called amaranth. It's also sometimes called or referred to as African spinach. And last, it's the fermented products. Although there are of course important challenges. I mean, if you would like to consume like a banana beverage that we used in our study, it's difficult with all the regulations that we have. So because you, yeah, here it should be pasteurized and then you lose, you basically you kill a lot of the microbes that are in these fermented beverages.
Tim Spector
But the example might be kombuchas.
Dr. Quirine Demast
Sure.
Tim Spector
Other things that we do have in the west that could have similar advantages if they have many yeast and microbes in them, like I guess this. Did you do any microbiome testing of the beer?
Dr. Quirine Demast
Yeah, well, there are some. We know some from earlier studies from literature. So it's indeed it contains a lot of lactobacilla and also Saccharomachia cevisiae, which is kind of a good yeast, a healthy yeast. So it's important for your gut microbiome. And that said, I mean, I think it's. If we look, we have some earlier data from the microbiome of people in this region and what was very interesting is in that people consuming this traditional diet that we found quite some yeast in their microbiome. And yeast, I think their role is really underestimated and the role in gut health, they're only a very small percentage of the microbes in our gut microbiome are yielding yeast. But yeast have such a strong immune modulating effects, you know, with our current industrialized diets, the loss of yeast in our microbiome could have strong health effects.
Tim Spector
In many countries, doctors are trying to eliminate yeast from people's guts because it's been got a bad name. So the candida, many specialists say, oh, it's all down to having too much yeast in your gut. And what we're hearing, the latest research is saying the opposite is true. You need more yeast in your guts to give you really good immune benefits.
Jonathan Wolf
Having yeast in my gut could be a good thing.
Tim Spector
Absolutely, yes. All the evidence is pointing in that direction. There are a few rare exceptions where you get yeast overgrowth, but for the vast majority of time we want to have more yeast, we want to stop killing them and, and we wanna be eating foods that introduce them into our guts. We don't know enough about them, but we think they have a crucial role for our immune health and dampening down inflammation.
Jonathan Wolf
So this is fascinating thing we come back to on this podcast a lot where maybe originally with good intentions, we've ended up eating something completely different from the diet that we sort of evolved with. And then we're having like these terrible side effects is how I understand this. And that you can see within sort of two weeks from switching back to a more traditional diet or away from the traditional diet towards our new sort of industrialized, big food driven.
Tim Spector
Yeah, and you've got to realize is that we've also lost a lot of our microbes because we all originated from Tanzania or Kenya, that bit of East Africa. And when you look at those indigenous populations, they have twice as many species as we do in the west, and that includes the yeast and other parasites as well as the regular microbes. So we've lost a lot. We need to learn again to relearn how to regain them and how to keep them happy.
Jonathan Wolf
Do you know someone who wants to improve their diet but hates olive oil? Maybe these tips from the traditional African diet will be a better fit and they could see health benefits in just two weeks. Share this episode with them now. I know they'll thank you. So I'd love to talk. Maybe Tim, you can share, having listened to this, a bit more about what a listener might be able to do if they're saying, I would like to eat more in line with the African diet and maybe take me through some like easy swaps listening to this that you might be able to make. Maybe, you know, starting with where somebody may be today.
Tim Spector
Yeah, well, I think the first lesson is you've got to increase your fiber intake. In this study we compared, you know, 30 grams a day, which is the recommended level, you know, up to 90 grams. So we need to go beyond the recommended levels of fiber in the West.
Jonathan Wolf
And can you give some examples of what that might mean for somebody maybe eating the traditional very meat heavy process?
Tim Spector
The more meat you've got on your plate, the harder it is to increase your fiber because there's no, there's no fiber in meat dishes. So if you're just having dairy and meat, you're getting no fiber at all. So reducing that and upping your level of high fiber vegetables is what you need to be doing. And in Africa, they have a lot of legumes and that's the easiest way to get both protein and fiber. So legumes are beans, they're lentils. You know, there's hundreds of varieties of these sort of plants that we don't eat nearly as much of as we should be. And they're all pretty much good for you. Getting a mixture of them is great.
Jonathan Wolf
We've been talking about some grains that are quite exotic to most of us in terms of what we buy from the supermarket. If I was instead eating different sorts of beans or chickpeas or lentils or things that are more familiar in terms of being able to get them in tins from the supermarket, are they likely to have similar effects or are they likely to be much less effective than this, this African diet that we're talking about?
Tim Spector
No, I think they should be pretty much as effective. What we also need to realize is that Africans have their own gut microbiome. Each population has their own specific microbiome. Remember, we only share less than 20% of our microbes with each other, even in every country, because we're going to share it less with someone in another country. So we mustn't assume that what works perfectly in one population will work for everyone else. But we can take some general principles, and I think that's really important and realize that it's also personalized. But I think we can take some broad principles here, see which ones do cross country, wide borders, and use those examples. So fibo seems to work everywhere. How you get it may depend on what's good in your country and how your microbes get on with them.
Dr. Quirine Demast
There is a clear seasonal effect on what people eat. So it really depends on harvest time, availability of fresh products, for example, fresh crops. So people change their diet throughout the.
Jonathan Wolf
Year, which is so different from my experience, which is even through my life. I remember as a kid feeling that the, the fruits and vegetables in the supermarket changed through the year. And now actually, whatever you want, Strawberries asparagus It's there all year round. It's just flown from some different part of the. Of the world.
Dr. Quirine Demast
Yeah, correct.
Tim Spector
Well, that's true in the uk. It is true in the US and other similar countries. But if you go to the southern Mediterranean, it is very seasonal. You know, they have certain fruits that they only have in winter. You know, your apples and your pears and they will have the peaches and other things, but you wouldn't get them out of season, and they don't eat them out of season.
Jonathan Wolf
So that might support more diversity of microbes. Because I'm having these different things that my different bugs like.
Tim Spector
Exactly. You're not having the same fruit every single week of the year.
Dr. Quirine Demast
So what's interesting, Jonathan. So in an earlier study in Tanzania, we found this very clear seasonal effect also of the function of the immune system and of inflammation. And we could relate that to the products that people would eat during, you know, after the wet season and after the dry season. So when you have the fresh products, then we would see that the immune system, the inflammation would go down. So you wouldn't expect that in an area so close to the equator.
Jonathan Wolf
As they're changing their diet, and particularly when they're eating more fresh produce, you actually see that their inflammation decreases and their immune system is sort of working better.
Dr. Quirine Demast
Yeah. So after harvest, when they have all these fresh products and fresh vegetables, we saw a reduction in inflammation.
Jonathan Wolf
That's amazing.
Dr. Quirine Demast
Yes.
Tim Spector
And that could be due to things like the polyphenols being at their highest level in the really fresh produce when they're really bright and they've got all the defense chemicals in there, and the longer you leave them, the more you lose those defense chemicals. So we don't yet know the answer. This is speculation, but it's really fascinating, these observations.
Jonathan Wolf
You've mentioned polyphenols quite a lot, but can you remind our listeners what they are and why they might be declining after I take this plant from the field?
Tim Spector
Well, polyphenols used to be called some antioxidants, but they're chemicals within the plant that are there to keep it safe from damage, from sun, from wind, and also predators. And it turns out that when we eat these plants, we ingest them and they act as fuel for our gut microbes. They can process them and then convert them into energy, and they use it to then replicate. And it turns out that the effects on the body are really via the gut microbes. There's very few effects that are direct. So the gut microbes are there to Break them down. So they're very keenly sensitive to the levels in them. And we know, we did a podcast, if you remember, Jonathan, on olive oil and know that as soon as that olive oil is made, the polyphenol count is at its highest. So really quite bitter, makes you cough, really strong flavors. But if you leave it a year or two, it's only down to half the levels. So we know there's a general dropping off in the chemicals. They like to be there on the living plant and then they decrease. Same with wine. So you really want to be having the fresher the vegetables, the higher the polyphenol count. And that's generally true. So these stored ones made in factories. So that's why most commercially produced foods have very little polyphenols in them, unless they've added them back in.
Jonathan Wolf
Quirin Imagine somebody's listening to this and said, I'm going to try this tomorrow. I'm going to try and make my own version of your study. Switching towards this traditional African diet, adding in all of these different foods that are going to give them much more fiber and polyphenol and all the rest of it. It you were able to measure a change in two weeks. Could they expect to see or feel any results at home if they did this?
Dr. Quirine Demast
Yeah, I think so. So I think they can feel a difference in, for example, their bowel habits, you know, with, with increased fiber intake. But maybe people also start feeling more fit after. Yeah, indeed. Short time.
Jonathan Wolf
And how have you changed your diet?
Dr. Quirine Demast
I get that question quite often. Well, unfortunately I haven't started yet. Brewing my own banana beer at home. But how I changed my diet is so I clearly increased my intake of vegetables, tried to eat more legumes, have more lentils, we reduced meat intake, limit processed foods. I was quite surprised. I mean, I hadn't expected these effects that we observed in these studies. So I work as an internist. I knew of course the importance of what you eat, but that the effects are so pronounced, I hadn't expected to be honest.
Jonathan Wolf
Final question, queerrain. Let's imagine that our listener finishes this episode and they immediately call their friend to share just one thing, which is like the most impactful thing from your research that could help them improve their health. What would you want that one thing to be?
Dr. Quirine Demast
I think what we've seen in Africa and what it learns us is the importance of, of switching your western type diet to a whole food plant based diet. It has such a clear health benefit. So that will be my take and my message from this study you see across Africa, meat intake has really increased in recent times. But traditionally, I mean, they didn't eat that much meat.
Jonathan Wolf
I would like to try and do a quick summary. I mean, the first thing that pops up to mind is that for your research, what you did is you built a pop up restaurant halfway up Kilimanjaro, which is the most entertaining study I think we've ever had on the, on the podcast in order to understand how the traditional African diet works. And what you found is that switching to it in just two weeks can transform the way that your immune system works such that it's much better if you move away from a traditional Western diet. On the other hand, rather depressingly, you could be on this traditional African diet for 20 years and just two weeks on this sort of highly processed Western diet. And suddenly you test what happens if you come into contact with something like tuberculosis and your immune system is working much less well. So that's really extraordinary. The other thing I took away is that the sorts of diets that people are eating in Africa has transformed in the 20 years that you've been visiting. And so actually many, many people are now eating exactly the same sort of highly processed food that we're all eating in America or Britain. And with that, you've seen this explosion of diabetes and obesity and heart disease. And so there isn't just this one good diet like the Mediterranean diet. There's probably a set of these traditional diets, but. But they have a lot of things in common. And the key things I guess that I took away from this is they have a very big variety. And Tim, you said this thing about like, your microbes are fussy, so you need to have a wide variety of different fibers to feed all of these different microbes. And your African diet has all of those different plants, many of which we just have sort of lost in the diets that we eat today. But also interesting that you do the specific task test around fermented drink, this M Baguette, the banana beer, and you found that even if you were still on the Western diet, and you just added that it had a really beneficial impact. So again, something that's come up quite a few times on the podcast with completely different sorts of fermented foods is that it has this really beneficial impact. You talked about polyphenols. It's not just the fiber in the food or the diversity, it's also these polyphenols, these sort of defenses, chemicals. And that what you saw was that when the diet is fresher and so these have been sort of harvested more recently, actually. That lowers your inflammation and improves your immune system. And in terms of what you could do, I took one takeaway is I want to go and try and see if I can source teff as this ancient grain that apparently I could find, you know, quite possibly in my supermarket as an alternative to wheat that I could try for baking. But also in a simpler way. I don't need to eat these very specific millets and things that might be unfamiliar, actually. Beans, chickpeas, lentils, all of these things that I can find in a tin in my supermarket. You know, if I were to use a lot more of those, I can get much closer to this African diet, but with food that's familiar. And I think what I heard is you think I could have the same benefits that you saw in this study, you know, halfway up Kilimanjaro.
Dr. Quirine Demast
Correct? Yes. Fully agree.
Jonathan Wolf
Now, if you listen to the show regularly, you already believe that changing how you eat can transform your health. But you can only do so much with general advice from a weekly podcast. If you want to feel much better now and be on the path to live many more healthy years, you need something more. And that's why more than 100,000 members trust Zoe each day to help them make the smartest food choices. Combining our world leading science with your Zoe test results, Zoe is your daily companion to better health for life. So how does it work? Zoe membership starts with at home testing to understand your unique body. Then Zoe's app is your health coach, using weekly check ins and daily guidance to help you shift your food choices to steadily improve your health. I rely on Zoe's advice every day and truly, it has transformed how I feel. Will you give Zoe a try? The first step is easy. Take our free quiz. To find out what Zoe membership could do for you, Simply go to Zoe.com podcast where as a podcast listener, you'll get 10% off. As always, I'm your host, Jonathan Wolf. Zoe Science and Nutrition is produced by Julie Pinero, Sam Durham and Richard Willem. The Zoe Science and Nutrition podcast is not medical advice. And if you have any medical concerns, please please consult your doctor. See you next time.
Podcast Summary: Can a Traditional African Diet Help Protect Against Inflammation?
Title: ZOE Science & Nutrition
Host: Jonathan Wolf
Guests: Dr. Quirine de Mast & Tim Spector
Release Date: July 3, 2025
Episode: Exploring the Impact of a Traditional African Diet on Health
In this episode of ZOE Science & Nutrition, host Jonathan Wolf delves into the potential health benefits of a traditional African diet. Moving beyond popular diets like the Mediterranean or Japanese, the discussion centers on how a traditional African diet rich in fiber, grains, fermented foods, and plants may offer significant protection against inflammation and related chronic diseases. Joining Jonathan are Dr. Quirine de Mast, an infectious disease specialist from Radboud University Medical Center, and renowned nutrition scientist Tim Spector.
Tim Spector opens the conversation by highlighting the detrimental effects of the Western, or Standard American, Diet (SAD):
"[00:03:28] Tim Spector: The Western diet... is responsible for millions of deaths a year through the chronic diseases that it's causing. So obesity, diabetes, heart disease, cancers, autoimmune disease, mental health problems, you name it."
He emphasizes that the issues extend beyond fats and calories, pointing to how certain components of Western foods disrupt immune systems and gut microbiomes.
Dr. Quirine de Mast explains the diversity and key elements of traditional African diets:
"[00:06:32] Dr. Quirine de Mast: It's mainly plant-based, rich in legumes, traditional grains like millet, sorghum, and teff, and includes a strong tradition of fermented foods."
She notes that these diets are high in fiber and polyphenols, which are crucial for maintaining a healthy gut microbiome and reducing inflammation.
Dr. de Mast describes a pioneering study conducted near Mount Kilimanjaro, published in Nature. The study involved three groups of healthy young men:
The intervention entailed switching diets for two weeks, followed by resampling four weeks later to assess long-term effects.
The study revealed significant changes in immune function and inflammation:
Switching to a Western Diet:
"[00:23:38] Dr. Quirine de Mast: We saw that they developed more inflammation within two weeks."
Additionally, immune cells became more activated and produced more inflammatory proteins, impairing the body's ability to respond to pathogens effectively.
Switching to a Traditional Diet:
"[00:25:03] Tim Spector: It is extremely beneficial... reducing inflammation and improving immune balance."
Fermented Beverage Impact:
The fermented banana beverage demonstrated anti-inflammatory effects, though not as comprehensive as the full traditional diet.
Tim Spector adds:
"[00:25:53] Tim Spector: ... we're getting now a new idea of the mechanisms of why foods are good for you... it's about their interaction with the gut microbes and our immune system."
Dr. de Mast elaborates on the connection between chronic inflammation and diseases:
"[00:29:33] Dr. Quirine de Mast: Chronic inflammation is when your immune system is continuously activated, leading to diseases like cardiovascular disease, cancer, and dementia."
Tim Spector uses an analogy to clarify:
"[00:30:06] Tim Spector: It's like your car running on the wrong petrol, making it inefficient."
This chronic state of inflammation disrupts metabolism and immune responses, increasing susceptibility to infections and metabolic disorders.
The traditional African diet's benefits stem from its combination of diverse, fiber-rich foods and fermented products:
High Fiber Intake:
Traditional diets can provide up to 90 grams of fiber per day compared to the Western average of 30 grams.
Diverse Grains:
Grains like millet, sorghum, and teff are unrefined, high in fiber and polyphenols, and have a low glycemic index.
Fermented Foods:
Fermented beverages like Mbege introduce beneficial microbes, including lactobacilli and yeasts, which play a crucial role in gut health and immune modulation.
Dr. de Mast notes:
"[00:32:06] Dr. Quirine de Mast: It's the combination of fibers, polyphenols, fermented products, and diverse vegetables that contribute to the health benefits."
Listeners interested in adopting elements of the traditional African diet can consider the following:
Increase Fiber Intake:
Incorporate more legumes such as beans, lentils, and chickpeas into meals to boost fiber consumption.
Introduce Diverse Grains:
Experiment with ancient grains like teff and millet, which are rich in fiber and polyphenols. These can often be found in health food stores or international sections of supermarkets.
Include Fermented Foods:
Add fermented beverages or foods like kombucha, sauerkraut, or kimchi to support a healthy gut microbiome. Homemade fermented banana beverages can also be explored.
Emphasize Plant-Based Foods:
Incorporate a variety of vegetables, especially green leafy types like amaranth, and consume more fruits high in polyphenols.
Limit Processed Foods and Red Meat:
Reduce intake of processed meats and high-sugar, high-fat foods typical of the Western diet.
Tim Spector advises:
"[00:45:15] Tim Spector: Increase your fiber intake by upping high fiber vegetables and legumes."
The episode underscores the profound impact that dietary patterns have on immune function and chronic disease prevention. The traditional African diet, with its emphasis on high fiber, diverse grains, and fermented foods, presents a compelling alternative to the Western diet's inflammatory tendencies. Key takeaways include:
Dietary Diversity: Embracing a wide variety of plant-based foods supports a balanced gut microbiome and reduces chronic inflammation.
Fast-Acting Benefits: Positive changes in immune function and inflammation can occur within just two weeks of adopting dietary modifications.
Holistic Approach: It's the combination of high fiber, polyphenols, and fermented foods that collectively contribute to improved health outcomes.
Dr. Quirine de Mast concludes:
"[00:53:33] Dr. Quirine de Mast: The importance of switching your western type diet to a whole food plant-based diet has such a clear health benefit."
Final Thought:
Adopting elements of the traditional African diet can lead to significant health improvements. By increasing fiber intake, incorporating diverse and ancient grains, and including fermented foods, listeners can emulate the study's positive outcomes and enhance their immune health.