The Simple Nutrient That Could Transform Your Gut Health, Brain Power & Longevity with Dr Emily Leeming #658

32:17And actually, if you can go to, for example, a dietician 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 you know better but when and i think you know people are going to say this they 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 which is completely debilitating as well and i think you've got to really recognize 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.

33:15So I think if we could, you know, have a lot more support of people being able to connect with getting that support from a dietician, 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. So very much, you know, what's going to help you. Yeah, yeah, I really like that approach. So why don't 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 pretty damn solid and pretty overwhelming.

33:59If 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, oh, I'm not good with fiber. It's like, hold on a minute, why don't we just try it? 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 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.

34:38Anything else you want to say on that? You mentioned short-chain fatty acids, anything else that's worth commenting on? Yeah, so I think, I mean, again, it's going back to that kind of whole body health. And we know that, you know, low, 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 we, you know, you might just be not feeling quite right, or we might not kind of notice that's happening. I talk about it a little bit like you're, you know, a train going around a track. And if it's going too much at high speed, you know, that track might start kind of the the wheels are going to start squeaking and, you know, maybe there's some sparks happening and your body is just getting a little bit too much stress and pressure.

35:18And so what we see is that people in terms of like 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, you know, connected with different disease states. And so it's something that we kind of very much see as like a potential kind of early warning fire for what could happen later down the line. Wow. When we think about the topic of gut health, yes, fibre 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 fibre?

36:06There 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 seven 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, funny enough, in that study, they didn't necessarily see that there was inflammation, a 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.

36:46But I think we've got to really program into, is it that fiber 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 probably be eating that way for years and years. 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.

37:21and 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 kind of a likely influence. 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.

38:07And I think it was like 19 inflammatory markers I measured. It was lower. But I think, you know, 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 benefits but what we're really looking for is long-term changes you know 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? 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.

38:43If you think about kimchi, sauerkraut, you know, all these like fantastic fermented vegetables, they aren't just containing those kind of live microbes. They've got, you know, this kind of plethora of other benefits that are within them. And I think, again, this is why science is so kind of fun for us scientists and clinicians, is that we'll look at different studies and it's just pulling that overall body of evidence together and also, you know, taking, okay, can I just think about this through a nuanced understanding that background how can I then interpret the findings from that and I 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 then 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 see what the results of that are.

39:39Is that Eat Fibre study also to try and assess bowel cancer risk in under 50s? Yes, this is a kind of huge project and initiative, which is a£20 million funding, which is fronted by Harvard, and it's a Cancer Grand Challenges initiative. And we are looking at why is bowel cancer rising in people under 50? How long has it been rising for? 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, the risk is increasing. So for example, in the UK in 2017, 5 % of the cases of bowel cancer were people who were under 50.

40:24Now 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 you know it's been very much a cancer of of old people and yet levels seem to be stabilizing in 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 we're in babies and children.

41:06So there's lots of different potential things. Is it microplastic? Is there dietary influence? Because we know with bowel cancer that diet is probably one of the most central players in terms of the different cancers because your gut is directly interacting with the food. You just mentioned an increase in rates from 2017, but were rates going up before that? Yes, it's quite scary in a way of how the rates are increasing. So if you're 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.

41:48So this has been happening for quite some time. And so this Eat Fiber study, you're basically trying to see if you can figure out what some of the causes of that might be? 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 fiber, but also looking at a variety of fiber.

42:26So 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 you know instrumental is that we've so wanted to design this study to have very simple actual 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 you know depending obviously if we get you know positive findings can we give people simple actual 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.

43:28In 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? 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, you know, looking at all types of bowel cancer here. So one of the reasons for that is that, you know, so we have all these different types of fibres. There are certain types of fibres called insoluble fibres. And these are kind of the ones that bulk out your poo and also get things moving through your gut at a timely pace.

44:10You 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, you know, getting things to move on. and that is very important if we have potentially you know 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 is kind of what's it could be kind of triggering cancer in some people with this.

44:51So that's one of the key reasons that fiber can be really helpful in that sense in terms of preventing. Okay, so we've got so far, fiber is 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've just mentioned cancer. Okay, so I've ticked off four out of the 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?

45:32Yeah, 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. You've 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 are also involved in this as well. And, you know, really a player in every single aspect of the things that we're talking about.

46:05So 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 um time i i feel good now the meal's over i've got what i need um so the gut microbes are also playing a role in that as well 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.

46:42I'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 fiber intake is a very quick and easy win there. 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 a sense that she's wanting to lose weight. She's post-menopausal. She has kind of gained a bit of weight in later life. And she's of the generation where, you know, if you're wanting to lose weight, you make, you know, whatever's on your plate, a tiny, tiny little kind of bird-sized amount of food.

47:25And then she's absolutely ravenous. She's so hungry. And then she's kind of stressing about, okay, well, I just ended up having loads of biscuits because I was so hungry. And I think this is such a different way of eating where if you're putting loads of fiber 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 it's so refreshing versus particularly for women where we're 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.

47:59And it's different, lots of different colors 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 fiber, 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've 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.

48:35And it doesn't feel restrictive. 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? Yes. What do you think that those years of being a chef, people on yachts, what do you think that taught you about nutrition? 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.

49:17And 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, you know, I think on super yachts, there's no such word as no. You know, if somebody says they want to eat bread, but they don't eat grains, you know, I think I had one, I mean, it was a disaster and it was disgusting.

49:55So please no one try this, but, you know, I made bread out of broccoli. I was like, but, but, you know, we made it happen. And so you - Bread without the grains. And it was, so you kind of, you know, where there's a will, there's a way. And, and I think it, I so saw play out time and 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.

50:33And 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. What did they think of your broccoli bread? I think more the deckhands were irate because it crumbled all over the deck and I think and they had to wash it all away.

51:07What do you even put on broccoli bread? Like how do you put jam on it or marmalade? We were racing for a regatta and yeah, I think it was, you know, had all the kind of fillings, but it was just disintegrating as the poor man was trying to eat it. 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 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're doing the development only using one or two pans i was like, no, this is, you know, it's going to be simple.

51:58But 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 before the first mouthful, you see it. I mean, the book is packed with color. I was so felt so, so strongly about that. I was like, fiber, no more of this brown, dull stodge, you You know, now this is, you know, fiber as it should be. It's colorful, vibrant, and it's going to make you feel energized and fantastic. What's your favorite recipe in the book?

52:33Oh, 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. 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 favourites in there. They really are, I guess, a love letter to fibre.

53:16It 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 fiber is 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. 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.

53:54How does it help us do that? 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 that 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 reserves, kind of moving ability than people who were eating the least. And I think that really tracks quite nicely on top. Quite often we see fiber as almost a signal of a general healthy dietary pattern.

54:32So 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. 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.

55:15Maybe they're not smoking as much. And is that not what the Eat Fibre study is trying to address in some ways? It's like a direct intervention on increasing fibre to see prospectively what happens? 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.

55:50So 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 a 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 looking, we're talking about the orchestra, really.

56:20Yeah, 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. 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, you know, what we call like almost like an umbrella. You pull everyone under an umbrella and then you look at what's the general overview.

56:53And I think, you know, we are, this is what's so fantastic about talking about fibre 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 hearing yeah you mentioned heart health before so i'm going to give that a tick mood and mental well-being how does fiber help us here so this is one where there is this is like newer research into how we're looking at it um what we see in terms of mood and uh 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 um what they they saw was that after that intervention and people with depression that 30 percent of people at the end of it still doing their therapy, still taping their medication, but we're 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.

58:14Just 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 as well as those things, there was these rich, diverse arrays of fiber weren't there yeah yeah and i think that that's you know all these foods lots of different colors lots of different textures you're getting an absolute variety of different types of fibers in that um that are supporting how so we think and again if we think about um brain health um being effectively very similar in terms of how we look after our heart health we need to be thinking about um supplying nutrients through you know our kind of blood flow to our brain.

58:55And 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 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 fibers 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 mean, average kind of 60 years old kind of females.

59:39After, 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 checkings 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.

1:00:29Wow. 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?

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1:04:37So prebiotics, so you have types of, I'm going to talk about it in terms of fiber because a prebiotic can also not be fiber. if we talk about it, you have fermentable fibers, which are really the group of fibers that feed your gut microbes. These aren't necessarily what we call prebiotic fibers. They're actually slightly different. That's because those fermentable fibers as a whole are just generally supporting your gut microbiome. They're generally feeding them. The slight unique difference there is that prebiotic fibers 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.

1:05:20So these tend to be things like inulin, galactooligosaccharides. And yes, we talk about supplements and I think there's so many 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. 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? Yeah and I think that's what I think we are so bombarded with take this expensive supplement buy this amazing product and you'll you know it's essential for your gut health and it's going to make all these huge differences I really really think the you know the benefit you're going to get for most of these you know unless it's something that's you know clinically you know you had a clinician really recommend it for a certain problem, you know, so small, and yet you're spending a lot of money on it.

1:06:30Yet 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 great. You know, it is just you know those those everyday delicious um things that we enjoy and and just recognizing i think you know maybe onions need to be the the superfood of the year um they don't ever seem to register on anyone's um you know health list but they're very good for you i love cooking with red onions yeah like i absolutely love it and they make 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 so someone's heard up to this point, Emily, and they're like, right, that's me.

1:07:20I'm going to get on my fiber game now. And they come and see you. What do you say to them? 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 no, I think I talked about this last time around the podcast, but I'm going to do it again. But I talk about the BGBGs. BGBGs. So these stand for, so B, berries. Now, when I'm highlighting berries in particular, it's because any fruit that has some seeds in it are going to be naturally higher in fiber 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 fiber 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 fiber.

1:08:35So 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 fiber. 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. That's one thing I remember from our first conversation very well is that avocado has got quite a high amount of fiber in it, which I don't think I knew up until that point.

1:09:12I think like many people associate it with, you know, so-called healthy fats, but it's also rich in fiber. It's one of the highest, I mean, again, if we put it in the vegetable category, it's one of the highest ones in fiber 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 fiber in them as well. 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 fiber. Yeah, these are really like your high fiber heroes that I just kind of want to make them regular features on your plate.

1:09:51When you're 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. Like for example, with 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 do you know if hard pears are different in fiber content in any way than when it's sort of super ripe there is this change i think particularly that 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.

1:10:54So they've looked at actually the resistant starch content of that banana, that different kind of phase of the banana's life. And resistant starch is kind of newly added into the fiber family. And from 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 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 flavors as that banana ripens so that kind of level of overall fiber 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.

1:11:50I 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. But potentially has a little bit more fibre. Yeah, exactly. So win-win. So it's win-win. So it totally fits the book, right? I love it. Okay, we've got B for berries, G for green veg, then there's another B.

1:12:23What's that? And then so now we're in like the big fibre hitters, okay? Wow, so we've just had like a warm-up. We've had, this has been the warm-up. Like the opening act. 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 fiber 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 fiber of course these are all things that listen to what works for you your your tastes you know if you don't like um you know nuts and seeds you can shift to something else um but i but i really like it's it's just easy tools to be like okay well actually i'm gonna have some more beans and beans can be things like 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 um 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.

1:13:39And you're automatically boosting that fiber 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 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, you know, Mediterranean.

1:14:27Actually, 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. Absolutely. And I really felt so strongly 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.

1:15:07You 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 fiber 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, you know, a full recipe itself?

1:15:49For 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?

1:16:30I think this is really like, we just need to bring fiber 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 fibers 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.

1:17:05And so all these foods, if we're talking about things like berries, which naturally contain, you know, more kind of sugar in them, but it's a natural sugar that's increased within a structure. So it's going to naturally slow that down. All these things have fiber in them. So I think it's not to say that, you know, any of these things are going to necessarily be problematic for your blood sugar control if we're bringing fiber into the conversation with it. 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 that fiber in their diet what are the key things that we need to remember i would say let's yes fiber 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 fiber into your diet than someone else if you are currently on a low fiber diet, is going to 30 grams a day too much?

1:18:16Would you say go slower than that basically? So the whole four week plan is about taking four weeks to get to 30 grams. 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 going to make you feel much better in terms of your microbes adapting to the new amount of fiber. But also you're going to notice all these fantastic changes on the way to your digestion energy levels.

1:18:52The 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? 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 projects where you're the, you know, participant in your own little study. And so I kind of have trackers of how, you know, 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, you know, how's your poos as well?

1:19:32Like how, how often are you going, you know, 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, you know, keep track of how you've been feeling. And then you can see, you know, has there been shifts and what those shifts are across that four weeks. And I think in particularly for moments where, you know, we all have them and maybe you're like oh just feeling a bit kind 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.

1:20:09Yeah 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 well-being. 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.

1:20:49So 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? So we see that the gut microbiome can change and shift. If you think about this as a kind of living ecosystem in our gut, what we tend to see in that with the difference between boys and girls when they hit puberty, women's microbiome or girls' newly pubescent microbiome will kind of shift and change.

1:21:38And 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 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 might 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.

1:22:27What 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 that kind of bowel movements shift there's kind of things happening where they feel that the body is 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 start 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 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.

1:23:30Gemma has asked, Emily, how can I test my gut health, especially if I don't have the funds for very expensive tests? 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.

1:24:10Everything's coming out. And also that you're going 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 actual 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.

1:24:56But don't feel like it's something 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 going to help to help you directly with your diet if you are experiencing problems. 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? That tends to be something that we see with irritable bowel syndrome in terms of those key foods containing something called FODMAPs.

1:25:37And 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.

1:26:21It hasn't been able to kind of make it back. And then it's just meant that you're 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, 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 fun of, and again, this gut brain connection as well. Paola has asked you to comment on the sauerkrauts and kimchi that are sold in supermarkets. He or she is saying it would appear that most brands pasteurize their products and as such, aren't the beneficial probiotics eradicated by pasteurizing.

1:27:07A lot of these products are pasteurized 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 going to 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 got to 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 thing last time, you know, we're interacting with microbes, we have a microbial cloud all around us.

1:28:06So we are getting microbes from many different sources as well. 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 fibre and its impact on various aspects of our health. But of course, you write a sub stack where you cover all kinds of things relating to all kinds of things, right? 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?

1:28:49Oh, absolutely. So I write every week and I'm very big on breaking down not only the latest science, So if I, you know, 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 a microbiome, it's so fast paced. So, yeah, keeping on top of the latest microbiome scientists. But I also do, you know, my background as a dietician and, you know, also kind of researching nutrition. You know, I very much tackle those key nutrition topics as well. So I think a recent one was, you know, is the advice on soil type data and actually understanding, you know, that kind of key advice behind that.

1:29:26um and lots of other kind of different kind of nutrition and things for your health that's hopefully very you know excuse the pun easily digestible um but yes every week and and it's something i yeah i really enjoy sharing with people yeah brilliant of course the new book is called fiber power transform your energy and feel amazing it's out now so for people who are interested check it out all those delicious recipes you're 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 you know 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?

1:30:18I would say welcome you're in the fiber 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. Yeah. Emily, fantastically empowering message. Thank you so much for coming back on the show. Thank you so much for having me.

1:30:58Really hope you enjoyed that conversation. Do think about one thing that you can take away and apply into 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 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 at drchatterjee.com forward slash 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, movement, weight loss, and so much more.

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1:33:04Making lifestyle change is always worth it, because when you feel better, you live more.