Heal Your Brain: How Your Gut Secretly Controls Your Brain Health - Dietitian Sophie Medlin
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Oh, by the way, before we get into this episode, I would love to tell you a little bit about Life Notes. Now, Life Notes is a weekly-ish email that I send completely for free to my subscribers, and it contains my notes from life. So notes from books that I've read, podcasts I'm listening to, conversations I'm having, and experiences I'm having in work and in life. And around once a week, I write these up and share them in an email with my subscribers. So if you would like to get an email from me that contains the stuff that I'm learning, almost in real time as I'm learning it, you might like to subscribe. There is a link down in the show notes or in the video description.

If your gut is not quite working optimally, even though you might not have any specific symptoms, it can still have an impact on your mental health and your mental performance. When people are busy and they're working too hard and they're doing a side hustle and everything else is high pressure, people tend to make their diet quite small. So they might end up eating the same types of foods on repeat. And inevitably, those ways of eating have an impact on your gut health, whether you feel it in your gut or not.

This episode is an interview with one of the UK's leading experts on gut health. Her name is Sophie Medlin and she is a dietician. She's also the chair of the British Dietetic Association for London. And she works as a lecturer at King's College London and is actually also on TV these days as an expert for Channel 4 show, which is all about the science of the gut.

Anyway, I learned so much in this episode and you're going to learn so much as well about the gut and about healthy nutrition and about what are all the myths around things like seed oils and should you eat carbs and is fried food bad for you and what are the things that we can do to help improve our gut health and how the gut-brain axis works and how like our gut health contributes to all of the other aspects of our life. Inevitably, if it's not happy, it's going to be screaming at your brain all the time and that is noisy and difficult for your brain to cope with and that can lead to things like brain fog and struggling with focus and concentration, for example.

Similarly, if your gut isn't happy, but you don't really know from other symptoms, but you're getting loads of bugs, infections, viruses all the time, you notice you're really susceptible, that's a good time to start looking at your gut health. And I think, I guess for this audience, what's really important to recognise is this connection between your gut and your brain and how they are constantly communicating with each other for better or worse.

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Sophie, thank you so much for joining us. Thank you for having me. You're an expert on gut health. I am, yeah. I'm the poo expert. The poo expert, yeah. And you've been on TV talking about poo and I would love to talk about poo and everything about the gut. But I guess as a starting point, how did we get here? How did you come to become the gut expert? What's kind of a blitz of your life story? Yeah, great question. So I was a weird 15-year-old child that knew I wanted to be a dietitian. So I was very lucky to kind of have this direction from a very young age. I was studying...

catering at GCSE and I had a catering teacher who was a nutritionist and we did some stuff on like celiac disease and adapting diets a little bit and I thought yeah I think that's something I might like to do so I did a little bit of reading and thought well I could be a nutritionist which is a bit quicker to train to do but that won't necessarily open up all the doors to me and then I read about being a dietitian knowing that I could then go and work in the NHS and do all sorts of other things within the world of nutrition I thought well I might as well keep all the doors open and

And at this point, I was predicted Ds and Es and Us in my GCSEs. So I thought, I better do some work and make sure I get the grades I need to get into university. But it was a really good motivator. And I managed to turn that all around and got good enough grades to get in and studied nutrition and dietetics.

And the story starts from there. Most dietitians start working in the NHS and that's what I did. So I was in the NHS for about eight years. I did some interesting stuff in elderly medicine where you get really good at kind of understanding about nutrition support, which is basically supporting under nutrition, so malnutrition, doing lots of tube feeding, making difficult decisions about whether people should be tube fed or whether that's the best thing for them or not, given it might be the end of their life, that sort of thing.

I then did head and neck cancer where you look after people who have all kinds of horrific tumors in their mouth and their throat and all sorts of different places where obviously eating is massively compromised.

And at that same time, I was doing a split role with intestinal failure. And then I went on to do a full-time intestinal failure role where I was, you know, just super inspired by amazing colorectal surgeons doing incredible things. Amazing specialist nurses, stoma nurses, people who were just turning people's lives around and people who were in their most sort of vulnerable moments of their life. And nutrition...

has a massive impact on what comes out your bottom right what you put in the top end has an impact on what comes out the bottom and when you've had any kind of bowel surgery or you are suffering in terms of your digestion what you put in has a huge impact not only on your nutritional status but also on your on your quality of life so your experience of eating so if you eat the wrong things and inverted commas you're going to be potentially incontinent and having all sorts of terrible problems that really affect your quality of life and make your life very small and

And when I was able to see what a massive difference I could make in that environment to people's quality of life, to their experience of living, to their experience of eating, their relationship with food, I was like, this is what I want to do forever. So I've stuck with that very much in terms of my clinical expertise. I was then a lecturer and researcher for five years, most recently at King's College in London. And at that time, I was struggling a bit with kind of, I love academia. I love teaching. I love working with students. Makes me really happy. I love that kind of mentoring aspect of it.

But I was struggling with some of the kind of things that other people found easy, the admin side of things, timetabling, that kind of thing. Things that might seem like they don't really matter because you should have admin support, but you just don't in those kinds of environments. And it's things that, you know, upset the students because they don't necessarily know where they're supposed to be. And so I was talking to my mentor and she was saying, look, you know, if you were a student, we'd say to you, why don't you get tested for like dyslexia and other conditions like that?

And I thought, well, that's probably a good idea. So I got tested and I found out that I've got dyslexia, dyspraxia and ADHD. So full hat trick. And at this point in my life, I was trying to make a decision as to whether I wanted to pursue a bit more private practice and see more patients, which I'd continue to do through my academic practice and maybe do some TV work, which I'd started to do a bit of and work with the media a bit more and do some consultancy or whether to do my PhD.

And getting that diagnosis made me realize that actually I could torture myself for three years and four years trying to do my PhD, or I could make this decision to focus on the things that I'm naturally good at, the things I don't find so challenging, the things that come to me easily, rather than trying to push in a direction that's always going to be a difficulty for me. So that's what I did. I quit my job at King's, which was a massive deal, set up the business a couple of years before that, did both at the same time for a long time, which was far too much.

much. But yeah, I've been running my clinic business called City Dietitians for about four years now outside of King's and I've got a team of 10 or 11, maybe even 12 dietitians now with our own specialities. I also run a consultancy company where we design vitamins and probiotic products for different companies and yeah, do some TV work, media work, things like this.

Fantastic. That's like the most coherent kind of answer to that question I've ever heard. It's great. Yeah.

you've clearly had practice in front of a camera um what is a dietitian yeah great question lovely place to start so a dietitian is like the we're like the medical nutrition people is what i would usually say so if you have a medical problem that you want advice on in terms of your diet you need a dietitian only a dietitian in the uk you wouldn't want to see a nutritionist for that nutritionists aren't medically trained you wouldn't want to see a nutritional therapist they're much more on the alternative therapy spectrum

So dietitians are the medical nutrition people. We're the only people who are allowed to work in hospitals, in the NHS, that kind of stuff. Nutritionists are basically there to help healthy people get healthier. So they're amazing at public health, incredible at research, but really important to remember that anyone can call themselves a nutritionist. So in this country, the term nutritionist isn't regulated, which means that there are some people who have just done a quick, you know, 30 pound nutritionist diet.

I don't know, training course online and now are calling themselves a nutritionist. You have to be a little bit careful with the credentials of a nutritionist that you're taking advice from. But that doesn't mean to say there aren't incredible nutritionists out there doing amazing work in lots of different areas. So I don't mean to diminish them as colleagues. They just do a different job to us. Yeah. And so what sort of medical training do you have as a dietitian?

A bit like if you think about a physiotherapist, you would say, okay, so a physiotherapist is different to like a massage therapist or a sports therapist. They're qualified people who've gone in and done placements in hospitals and worked alongside doctors and nurses to learn their trade. That's the same as dietitians. So we do three long placements as part of our university training where we go into the hospitals and learn from other dietitians on the job. And then we are registered

with the HTPC, the Healthcare Professions Agency, and they help us to regulate everything that we do. So if I do something wrong, I'm accountable and I can lose my registration like a doctor or a nurse could do.

unlike other people within the profession sort of the nutrition profession at large where there's no accountability so they could say anything at all and something could go really wrong and it's not their fault because there's no one regulating them nice yeah i think nutrition is one of those things where occasionally people would ask me hey you know you're a doctor therefore like what should i do about xyz i'd be like that sounds like nutrition we had like two lectures on it yeah and the start of first year no one cared about it ever since then

And the only contact I had with dietitians was, oh, we're feeding this patient through a tube, let's call the dietitian and then get them to do some alchemy and tell us what formula to prescribe. Or there would often be cardiac arrest calls downstairs to the dietitians because a lot of them would faint in the morning. So I'm really unfamiliar with the nutrition side of, I guess, medicine and life. And also with, I guess, the job of a dietitian. But I guess I'm, you know, for people listening to this who maybe do not have

officially diagnosed colorectal problems or bowel problems or stomas and things like that. What does a dietician do for a, I guess, normal healthy person? So dieticians don't get involved very much with normal healthy people. We're mostly dealing with disease or problems. So most of my patients would have a problem with their bowel. It might not be like a diagnosed thing. They might say, I get this really unpleasant wind and it's really bothering me and we can work on that.

but generally people will have a problem before they come and see me. In my kind of public facing work, I guess we're talking about gut health education and trying to get people to look after their guts so that we don't end up in the situation where they're in my clinic with a physical problem with their bowel or in surgery because of a physical problem with their bowel. So that's where we talk about how we can really optimize gut health

not only for our bowel health let's call it but also for our general health because our gut has a massive impact on our mental health and on our physical health and our risk of loads of different diseases and disorders and actually the more we look at gut health the more we realize that it isn't impacting every part of our body and every system in our body.

How does gut health impact all the... The thing that's always struck me whenever I've listened to podcasts where they're talking about the gut is that it seems like the gut is kind of this sort of black box. We don't quite know what's going on, but we know that it impacts literally everything.

I wonder if you can kind of break open that black box a bit. To what extent does the gut impact all these things that you've talked about? Yeah, I'd love to. Let's talk about that. So obviously on a very basic level, your gut is where all of your nutrition is absorbed and every bit of your body is physically made from the foods that you're eating.

So if you imagine your skin is made from proteins and lipids that come from your diet, the things that you're consuming, you're basically just a big walking blob of protein with other bits and pieces floating around in there. So actually everything that we eat has an impact on the structure and function of the whole of our body. So if your gut...

in terms of its general function, isn't great, then we can have real big problems. And these are kind of things, potentially even things like gallstones, which are super common, other bits and pieces, generally just not consuming a very balanced diet. So then your gut has to work harder for various different things. We're using different pathways. So having a healthy gut is super important to the structure and function of the whole of your body and how it's working. But that's mainly, we're talking about kind of the first bit of the small bowel. So the bowel

the first bit of the bowel, which is a small bowel, which is meters and meters and meters long, travels into the colon. And in the colon, you've got like this amazing ecosystem of bacteria and other microorganisms that are constantly communicating with the rest of our body. And this is the bit that we really have been learning more and more about over the last 30 years or so, but it's really come into the fore now. How our microbiome, so the bacteria that live in our colon, are interacting with the rest of our body.

And how that works is that when we eat various different foods, so let's take plant fiber as an example, you eat some fruits and vegetables, they travel, the bits of it that you can't digest, the bits we can't break down, travel through to our colon where they're fermented by different species of bacteria and yeasts and other types of microorganisms. And in that fermentation process, they produce some gas and they produce other things, but they really importantly produce some metabolites.

some things that interact with our bodies. So things like short chain fatty acids, for example, butyrate is the sort of strongest research example that we have. When butyrate is released by probiotic bacteria in the colon, that travels through into the rest of our bloodstream and interacts with the rest of our body. It helps to control inflammation. We've seen incredible work with butyrate production being controlling of the inflammatory cascade associated with COVID, for example. So butyrate is controlling inflammation in the body and

Other metabolites interact with our immune system. So 70% of our immune cells live in our bowel, in our colon, and your gut bacteria are constantly interacting with them.

And we also produce 95% of the body's serotonin in the gut, which links to our brain health, our mental health and how we're feeling. So your gut is constantly interacting with the rest of your body. And it's physically, chemically and hormonally connected to all the other systems in your body. Wow, that's a lot going on. Do any patients come to mind or have you seen any stories where someone has had like, quote, bad gut health and then...

It's been transformed into good gut health and then their whole life has changed. I wonder if you can kind of paint one of those pictures for us. Oh my God, yeah. Every week in clinic, it's transformative for people. And we've been lucky enough to showcase some of that on the recent Channel 4 show that I've been on, which I'm sure we'll talk about later. But just if you imagine somebody who cannot control their stools, so their gut health and potentially their rectal muscles, for example, are badly damaged by maybe childbirth or just by the aging process.

And so everything that they put in the top end, they're constantly fearing having incontinence, faecal incontinence in a supermarket, on the bus, wherever they go. And to be clear with you, this isn't just old people. This happens to young people, people of all ages and stages of their life can experience this for all sorts of different reasons. I think that's probably the biggest example of where what I do as a dietician can make the biggest difference, because if we can help someone to control their bowels so they're no longer fearing having an accident, then

that obviously has a huge impact on their quality of life. And it's not just things like that. You know, we can get people out of pain through adjusting their diet. If you've got kind of problems with the structure of your bowel, something like diverticular disease, for example, which is a super common condition, unfortunately, it creates problems with the structure of the bowel and that can create a great deal of pain when you're eating particular foods. So we can adjust the diet and get people out of physical pain. And often when I'm working with patients who have things like inflammatory bowel disease,

I'll say to them, look, I can't cure your IBD. I can't cure your Crohn's disease or your ulcerative colitis, but I can probably help you to get out of pain and reduce the symptoms. And for them, that's perfect. That's all they're asking for. They're not looking to me to try and fix the problem. They just want some symptom management that they're not necessarily getting medically. And yeah, those are the sorts of things that we deal with every week in clinic. And I guess IBS is probably the biggest one that we see a lot of. And that is

less debilitating for some people but for some people it's incredibly debilitating with really painful bloating and gas and things like that which they find very difficult. Yeah okay so let's say let's say someone's listening to this and they're thinking hmm maybe I have a problem with my gut but I'm not really like what what are the sorts of signs and symptoms that someone

who is not diagnosed with inflammatory bowel disease or something might have to make them think, huh, maybe I should see a dietician? Yeah, great question. So I would say what's helpful is to start with what's normal because we don't talk about poo, right? So people don't know what's normal. And what we found in general is kind of

actually people just might live with symptoms that they don't actually have to live with, but they just get used to them, partly because they're embarrassed to talk to anyone about it, but also they've never checked what's normal. So in terms of normal bowel function, we would say that anything between, so passing stool, anything between three times a day and three times a week is normal.

If that changes for you, so for example you start off being a three times a day person and suddenly you're a three times a week person, that's when you need to get some help. Something's not quite right there. So we call that a change in bowel habit. And I'm not talking about having diarrhea occasionally because you've eaten something the night before or had too much to drink. I'm talking about it being consistent. So over about a two week period if you notice your bowel habits change significantly for you, that's the time to go and get some help.

The consistency of your stool is the next thing to think about. So what we're looking for is kind of like a smooth sausage shaped poo that holds together when it goes into the toilet itself. So most of the time, that's kind of what we want. Most people will be somewhere either end of that spectrum fluctuating between the two. So sometimes it's too hard, sometimes it's too soft. And that's okay as long as kind of your median range is kind of in that soft sausage snake-like poo territory.

And then we think about kind of wider symptoms beyond that. So things like urgency, for example, if you notice that you when you need a poo, you really have to rush and you are worried about that. And it comes on very suddenly, for example, that's when you could get some help. If you find that your poo is really hard and difficult to pass and you're feeling uncomfortable or you're developing hemorrhoids or piles or you're getting anal fissures or like tears in the bottom. Those are things that we could help people with for sure.

And then if you think the color of your poo might be a bit funny, it's an interesting thing to talk about. But the color of your poo needs to be like a medium brown color is normal. Occasionally you might eat loads of sweet potato and it might be a bit more orange or you might have a green smoothie and it might be a bit more green. That's fine. But as an average, if it's kind of a medium brown color, that's great.

and we don't want it to actually be ridiculously smelly so if your poo is like really foul smelling we would think that maybe you're not absorbing everything from your food and that's something to look at or you might have a really affected microbiome that needs some work if you've got loads of gas that's really uncomfortable for you and or it's particularly smelly that's the time that we can do some things to make that better for you if you've got any abdominal pain at all really important time to get some help even if it's that kind of pain that you're thinking oh

I know it comes and goes. I think it's probably okay. Definitely go and chat to somebody about that because there's things that we can do to make it better. So in terms of normal and things that you could get help with, I think that kind of covers the basics of what people might be living with and just putting up with that actually they could get some help with. And there are probably signs that something's not quite right in terms of their gut health.

As you were describing the snake-like, snake sausage consistency, I was thinking that my poo was often a lot softer than that until I started taking the Heights prebiotic, probiotic tablet thing. And now I'm always surprised that, oh, this looks like a normal poo. It looks like what I think a normal poo is. That's been nice. What if someone feels like their poo is normal based on all these kind of parameters that we've talked about?

Is there any reason for someone with normal poo to be thinking about their diet and nutrition in that sense? Are there optimizations that

healthy people without gut problems can make to improve like productivity performance that kind of thing yeah for sure so if your gut is not quite working optimally then that can even though you might not have any specific symptoms it can still have an impact on your mental health and your mental performance right so your gut is such an integral part of your whole body system and ecosystem and inevitably if it's not happy it's going to be screaming at your brain all the time and that is noisy and difficult for your brain to cope with and that can lead to things like brain fog and struggling with focus and concentration for example so

Similarly, if your gut isn't happy but you don't really know from other symptoms but you're getting loads of bugs, infections, viruses all the time, you notice you're really susceptible, that's a good time to start looking at your gut health. And I think, I guess for this audience, what's really important to recognise is this connection between your gut and your brain and how they are constantly communicating with each other for better or worse. So there is a very strong line of communication between your gut and your brain which we refer to as the gut-brain axis.

And again, they are chemically connected through neurotransmitters that are produced in the gut. They are hormonally connected by the HPA axis and they are physically connected by the vagus nerve. And the chattiest organ between your brain and your gut is your gut. Your gut is constantly telling your brain all sorts of different things and throwing messages up that it's got to deal with. And people might think, oh, it's your brain, your gut's not really doing anything, but actually your brain is busy and it's communicating and it's a lot through those microbes that live in your colon. Sick.

you're very good at this thanks not my first time like you've got the whole like I'm just like wow um so what can I do for example as a proxy for people listening to this my poo is fine once a day you know medium brown color not overly smelly I think but everyone likes to smell their own poo apparently um but

Obviously, I want to kind of maximize my performance and my focus. And actually, one question we get so often from our audience is people struggling to focus. And I think often people are like, I struggle to focus with my schoolwork or with my whatever web design side hustle. I must have ADHD as like,

an immediate option, but I wonder if there's gut stuff we can do before we get to that point. Yeah, definitely. I mean, your gut health is, so because your gut is constantly communicating with your brain, again, if your gut is not happy, things are communicating differently, but also you could just not be producing enough serotonin for various different reasons, or your gut might not be sending the right signals up

your brain so you might have if we looked at your microbiome and it's certainly not necessary to do that we can do this in clinic without testing but if we looked at your microbiome we might find that you've just not got enough of these bacteria that are doing this particular important job with brain connection stuff

So what we would suggest then is to really optimize the gut. And you know, what happens, Ali, as you know, is when people are busy and they're working too hard and they're doing a side hustle and everything else is high pressure or they've got a family and everything else, people tend to make their diet quite small, not necessarily in terms of volume, but the types of foods that they're eating. So they might end up eating the same types of foods on repeat.

What I see is people, there's kind of two camps here, the people who do like the meal prep stuff and they eat the same foods five days a week and they think they're being super healthy, eating sweet potato and broccoli every day. Or you have the people who are just living meal to meal prep, you know, it's wherever they're going every day, the same sorts of things, but just various different places and nothing's particularly planned or thought through. And inevitably, both of those ways of eating have an impact on your gut health, whether you feel it in your gut or not.

So that way of eating limits the types of fibres that your gut bacteria are being fed. And the most important thing for your gut health is that you're eating 30 different plants a week. So trying to eat loads of variety of different types of plants. That includes fruit and veg, but also nuts and whole grains, different types of grains. We're super fixated in this country on like oats and wheat, but actually there's so many different types of grains that our gut really benefits from.

So, when you're busy and you're struggling and you're eating meal to meal or you're eating the same foods on repeat, what happens is your gut health, your gut sort of function might not change, but your gut health is inevitably not optimized. And that's when you can have these problems with lack of concentration, focus, energy, getting bugs all the time, that kind of stuff.

And really interestingly, your gut bacteria communicate with your hypothalamus, so that bit of your brain that controls things like cortisol production. So really early in your life, your gut bacteria dictate where your sort of HPA axis is set, so how much cortisol you release under given circumstances. And we all need some cortisol, right?

but we don't want loads and loads of cortisol because we've got loads of anxiety and stress all the time. We can really struggle to concentrate and to focus. So we can use our gut bacteria to try and reduce that and make things a little bit better in that department. We can use them and harness their powers to get more serotonin, which helps us with better sleep and concentration and focus and all those important things, those happy hormones.

And we can also just try and calm down those messages from our gut to our brain, which are distracting our brain all the time. And your gut bacteria are going to be saying, we need more plants. And you're going to be not reading that properly and giving them more sushi. And that's not quite what they want. Wow. So it sounds like you're saying, and please correct me if this is an oversimplification, that changing up what you eat can have a massive impact on your

focus productivity performance happiness absolutely because all of those things are linked gut brain everything yeah fundamentally i mean and proven in amazing research and science yeah

What kind of research has been done on this? I guess I'm thinking healthy people rather than people with official gut problems. Yeah. So the amazing work of John Kryan is a really good place to start looking at this stuff if people are interested. And he's written an amazing book called The Psychobiotic Revolution. So psychobiotics are these gut bacteria that communicate with our brain. So they're the ones that we're particularly interested in when we develop the high smart probiotic, for example. So work that's been done in that area to start within rodent models is

they used a model of an autistic mouse and a model of a non-autistic mouse, so a sociable mouse, and they took the microbiome. So they took a sample and gave the microbiome of the autistic mouse to the sociable mouse. And the sociable mouse starts to show autistic traits. Okay. And when they swap them over, the autistic mouse starts to become a sociable mouse just because its gut microbiome has changed.

So that was the early work that they did trying to understand how much our gut microbiome is impacting our mental health, our mental performance, how our brain is working. So similar studies to that have then been replicated in humans, in other places. And to be clear, that autistic spectrum disorder stuff in humans is so complex and we can't replicate that exactly in humans as yet. But there's certainly something going on there, which is what we generally learn from rodent studies.

We've also got some great data showing things like increase in production of serotonin when we use particular probiotic species. There's great data showing that using particular probiotic species within treatment diets and things like that, so within treatment within studies, in controlled studies, is

improves anxiety, depression, all of these kinds of symptoms. And wider nutrients within this world, if we think about things like omega-3s and B vitamins, they've been used in place of anxiety and depression medications, SSRIs, that kind of stuff. And they work as effectively in some people some of the time in studies. So we can use all of these things. And a similar work has been done with the two strains we use in the smart probiotic,

in terms of seeing whether they work as effectively as common anti-depression, anti-anxiety medications. And they do. So much so that there's health claims on them in Canada that people can say these are definitely shown to improve anxiety and depression. So there's great data. It's a young field of research, but it's super exciting. And it's very solid research just showing the magic that we can harness from our gut. Nice. Yeah.

sweet so clearly there's a lot going on uh one of the things you said um nice actionable takeaway for me and anyone listening to this 30 different plants a week i know that's a lot it sounds like a lot but actually if you break it down into days you're looking for about five different plants a day so what you would say is like for example for

breakfast if you had like a multi-grain cereal or a whole grain cereal you're going to have loads of different in there in there chuck some seeds in chuck some nuts in chuck some dried fruit and I love freeze-dried berries amazing chuck some of that stuff in and actually you're kind of already there with at least five different plants in there then at lunchtime maybe between your lunch and your breakfast you could have a handful of nuts there and

lunchtime make sure you're having at least a couple of different veg in there maybe chuck some seeds on top and then in the afternoon you want to have some fruit as a snack and in the evening make sure you're having some veg like actually if you spread it out like that it's totally achievable for people unless you're doing one of these funny restrictive diets that you know nobody would recommend anyway

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It's available on iPhone and Android, and you can check it out by typing in Trading212 into your respective app store. So thank you so much, Trading212, for sponsoring this episode. Yeah, at the moment, I'm trying to do a sort of high-protein, low-calorie thing to cut with my health coach and all this kind of stuff, but...

you know his thing is like you know at least for a while let's just try and eat the same thing every day broadly so that you know what's coming into your body and then we can see how that affects your weight all that kind of stuff I mean you can see me cringing right absolutely terrible advice so I literally I've got some content planned for this week around what terrible advice I see from personal trainers and I'm sure your guy knows what he's doing in terms of personal training but

the worst things that personal trainers do, there's three things I see them doing regularly to people. One is putting them on the same foods on repeat because you're starving off your essential gut bacteria. And some of those really important gut bacteria are actually protecting you from obesity. So they're working to help you to control your body weight. And so if you're starving them, you're making your life much more difficult in the long run. Secondly, it's like this

really low fiber diet typically. And so that's just as a measure of them cutting out carbohydrates. Nobody's looked to check because they don't know what they don't know, right? No one's checked that there's at least 30 grams of fiber in there, which is what we all need every day for healthy stools and a healthy bowel. Usually they're around 16 grams of fiber when we calculate them. It's just half of what we need.

And then the other thing is having loads of red meat or loads of animal products generally. So the World Cancer Research Fund says we should only have three portions of red meat per week. And that's 500 grams, 350 to 500 grams in total. Otherwise, we're putting ourselves in total. Not like every day. No, 350 to 500 grams total a week.

otherwise we're putting ourselves at higher risk of bowel cancer and so again these meal plans that people are given actually are starving your gut bacteria which puts you at risk of loads of different problems putting you at higher risk of things like cancer which nobody wants and all kinds of other things but it's it's not the fault of the personal trainer it's we're going circling back to this conversation of nutrition people in the nutrition space giving advice on things they just

shouldn't really be giving advice on right so if you want nutrition advice and tailored specific nutrition advice for you you need to see we've got an amazing sports dietitian on the team at city dietitians who can tailor all these things for you and give you a proper tailored plan that note that you can actually manage in terms of everything as opposed to just thinking about that one thing which is the aesthetics which everyone gets fixated on oh that's handy i'll book an appointment with that'll be good um

30 grams of fiber. What does 30 grams of fiber look like in a diet? Well, it's about half of what the average person is getting. Sorry, it's about double what the average person is getting. So most people in England eat less than half of what they actually need in terms of fiber every day. So most people are getting around 15 grams of fiber a day.

So we need to make sure we're adding lots of extra things in. Things have happened within the social media space that have made that happen. So for example, people now demonize breakfast cereals where actually loads of us got loads of fiber from breakfast cereals every day. Women were mainly dependent on breakfast cereals for iron for a long time and slightly different now. But actually we cut these things out because an influencer tells us to.

And actually there's consequences for everything that we move around in our diet, right? So thinking about where your sources of fiber are. So we're talking about whole grains, fruits and vegetables, nuts and seeds, that kind of stuff. Where are your sources of those in your diet and could you maximize them? So for example, swapping white rice for whole grain rice is a really great step in the right direction. White rice for whole grain pasta, right?

If you're having like mince, for example, so mince beef, add some lentils in there, just bulking up the fiber a little bit, leave the skin on your vegetables, on root vegetables, that kind of stuff, leave the skin on, you get a bit more fiber there, make sure you snack on fruit, those kinds of things. It's basically the stuff that your mum would have told you to do when you were a kid. It's all that stuff we need to do to try and boost our fiber intake and most people just aren't getting enough.

What's the deal with breakfast cereal? My influencer adult understanding is breakfast cereal is bad because lots of sugar and American advertising companies convinced us that breakfast was the most important meal of the day. That's BS. We should all be intermittent fasting and just skipping breakfast in the morning anyway, because 16-8 fasting is good for you. So therefore, breakfast cereal is evil.

Yeah, sure. Yeah, I mean, I hear all those things as well. I think the key thing with breakfast cereal is it can very easily become what we might call an ultra processed food. And that's where it's just got loads of extra additives in it that you wouldn't recognize in your kitchen, preservatives, emulsifiers, that kind of stuff. Lots of extra sugar, salt, all those kinds of things. So we want to avoid those ones. So the ones that look like they're super commercial, we probably want to push them out the window.

But you can add things in, in terms of making your own sort of breakfast cereal. You can toast some oats, toast some stuff to make granola, that kind of stuff. Some of the more natural granolas would be a good choice for you. But in terms of fasting, there's no evidence of any benefits of fasting beyond weight control. So there is some reasonable data to show that fasting can improve weight control, but

But also there's this counteracting data coming through now where people who don't eat enough in the morning tend to overcompensate and eat much more in the evening. And that's worse for us from a metabolic perspective. We've kind of got this biological night of around 9pm where all of our processing of everything slows right down. So things can sit around in our bloodstream a lot longer and cause more trouble if we're eating too late at night. So actually, if you're someone who wakes up hungry and you're dragging yourself through till 12 o'clock,

into your eating window and you're feeling terribly, you've got headaches and you feel awful, that's obviously not the right way for you to be eating your body. And we're all different from a circadian rhythm perspective, right? Our body clock is all different. So if you're someone who feels hungry in the morning, you should eat in the morning. Just listen to your body, be a normal person. If you are someone who just doesn't feel very hungry at night, you might find it easier to finish eating at six o'clock and that might work really well for you.

But really importantly, if you're trying intermittent fasting and you notice that you're really loading those calories later in the day, it's probably not right for you. Most studies will show that actually if you have some calories in the morning and front load your calories a little bit, you'll reduce your calories later in the day, which is metabolically a bit better for us. What about things like chicken and fish? What are like...

How much chicken and fish should I be eating? Great question. So your body, your bowel doesn't particularly like red meat. It certainly doesn't like processed meat. So the data on processed meat says little, if any, processed meat for protection of bowel cancer. So processed meat would be things like sausages, bacon, even things like cured meats, that kind of stuff is just not great for our bowel health. Any animal meat, any animal proteins, our bowel can quickly find that too much.

So a good example that people might recognize is if you ate like a meat feast pizza or like had a massively heavy meaty meal, usually your gas the next day or later that evening is going to be pretty foul smelling. And that's because when we have too much animal protein in particular, it's then some of that leftover protein that we can't absorb and digest is being fermented by really bad types of bacteria. They're really not good guys that we don't want to be feeding. And when they ferment stuff, they release methane and sulfur and these bad smelling gases.

So if you're having really foul smelling wind, the chances are you might be overfeeding those guys that you don't want to be feeding them too much. So we can help to balance that out clinically and with treatment.

Um, so excess protein from any source, excess animal protein from any source is not ideal for people. So your gut health, your gut bacteria also really like plant protein. So things like soya and tofu, that kind of thing. So ultimately it's about getting that balance right. And if you're someone who is having meat for lunch, like twice a day, you're probably having too much meat. Hmm. Yeah. Okay. Um, how...

How do I get my protein, if not from meat? Great question. So you can use plant sources of protein. So like tofu, soy and products, that kind of stuff. And obviously we want it to also not be ultra processed. So I'm not talking about that Beyond Meat burger or that highly processed vegan product. What I'm talking about is adding tofu to your stir fry, for example, using the minimally processed soy and mince in place of beef mince, for example.

still great sources of protein for you and absolutely no harm. Eggs are slightly less dramatic in terms of your bowel function than meat is, so a bit easier for you to digest. And fish is even better. So if you're having fish regularly, that's great for you in terms of protein source, also great for your brain. Lots of benefits to having fish a bit more regularly than meat. - What are the benefits of fish?

Fish is magical. We've all kind of evolved to need a lot of fish in our diet. And in England, we just like nobody eats the two portions of oily fish a week that was recommended, right? If we did, the supermarkets would be sold out tomorrow. We need two portions of oily fish a week for our brain health. It's really, really important for controlling inflammation in the brain, the structure of your brain.

My very clever colleague, Kimberly Wilson says that if you take out, if you don't eat oily fish, it's a bit like taking out 25% of the bricks of your house and replacing them with polystyrene. 25% of your brain wants to be made from oily fish, right?

So if you take it out of your diet, it's a bit like replacing 25% of the bricks in your house with polystyrene. It kind of looks the same structurally, but under a strong wind, you can have a real problem. And it's very much the same with our brain health. So you really want to make sure you're getting at least two portions of oily fish a week or taking an omega-3 supplement. If you're a vegan, that could come from an algae oil source, and that's equally as good in terms of our brain function.

But also your gut bacteria love omega-3s. So it's really good for helping to promote the populations of beneficial bacteria that helps control inflammation in the body, all that kind of stuff. So omega-3 from fish is super, super important for our bodies, but it's also a great source of lean protein. What do we mean by oily fish?

So oily fish is like the ones that taste a bit more fishy, but salmon is a great example that people find really accessible. So that's good. But also mackerel is perfect. We could use sardines, that kind of stuff. The ones that are in tins, they're a bit more fishy. Those are the ones that people would benefit from the most. Tinned tuna? No, unfortunately not an oily fish. Oh, I know. That's annoying. And that's what we all eat, right? Yeah. Okay. So salmon twice a week would be good for me. Perfect. Fantastic. I like salmon. Salmon is tasty. To what extent can I just be like, you know what?

I accept all this stuff, but I can't be asked to change my diet too much. If I just take the appropriate number of supplements, I'm good, right?

Yeah, no, it doesn't really work like that, unfortunately. So we need to think of supplements as being like the icing on the cake, right? So we still need to do the foundational work if we want those supplements to be working for us. So it doesn't matter how many pills you pop. Ultimately, if your diet is terrible, you're really stressed all the time. You're not looking after your mental health. You're not exercising. You're not looking after your body. You're still going to struggle. You're still going to suffer. So you need to be doing some of those foundational things and then taking your supplements on top.

to try and get things in line. And with probiotics, that's even more important because you can take as many probiotic bacteria as you like in capsule form or as kefir or however you want to. But if you're not feeding them with plant fiber when they get to your colon, they're not going to survive. There's nothing there for them to eat. So we have to make sure that we feed them when they get there.

Some people will put prebiotics of food for good bacteria in their supplements, but actually need quite a lot of that prebiotic fiber to make any difference. And actually the best way of getting that prebiotic fiber is from your food, from the food that you're eating. So it's really important to encourage people to still maintain a healthy diet and look after the other things because we need to do all the things, unfortunately. Nice. Okay. So-

Less than, well, 500 grams of red meat per week, preferably two portions. Less than 500 grams, yeah? 350 to 500? You've got that down? I've got it down, yep. I'm like, it's like a single steak, it's like...

Half that. 30 grams of fiber a day, which most of us are not getting. So we need to add more seeds, grains, whole grains, fruit, veg, that has like texture and stuff to it because that's fiber. Two portions of oily fish a week. Adding in soy mince and tofu to replace animal products some of the time. Anything else? What are some other...

Your gut bacteria does not like processed food. So we think that things like, well, if you imagine preservatives that are put in processed food are there to make sure the bacteria doesn't grow, you can then extrapolate that and think, okay, well, what's that doing in my body? So when I'm consuming these foods with preservatives, actually, are they killing off my good bacteria or at least stopping them from growing? So that's something to think about. Emulsifiers that are in lots of processed foods and also in lots of foods that are

I've got a bit of a health halo like protein shakes and protein products, that kind of stuff. Emulsifiers, we think are disrupting the lining of people's bowels. So when we have too much of those kinds of things, the tight junctions between the cells in your bowel wall, we think are being disrupted and opening up a little bit, allowing too much inflammation into the body and causing all kinds of different problems, but also disrupting that really important mucosal layer in the bowel that is the home for our good bacteria. So emulsifiers, not great.

They're in plant milks and stuff like that, so we need to keep a little eye out for those. Anything that is kind of an added ingredient that you don't recognise is something that we want to be a little bit careful of. And there's this amazing data now about ultra-processed foods and how much they are impacting our risk of cancers and all kinds of other conditions. So an ultra-processed food is something that we do want to consider trying to avoid. Again, lots of vegan products would end up in that ultra-processed.

processed food category, even though they've got this health halo. So we need to watch out for ultra processed foods defined by all of these ingredients that you don't recognize. We want to think about your gut bacteria just don't like them for lots of different reasons, but that's part of it. Processed meats in particular, gut bacteria really don't like those.

When we're stressed, when we're really anxious all the time, we produce more stomach acid. We produce more enzymes. Things happen differently in our gut. Lots of people will recognize that when they're stressed, they maybe have diarrhea or wind or they're bloated or they're uncomfortable. And so that's because when you're stressed, your structure and function of your gut changes slightly and everything is more difficult. But also when it's a more acidic environment, that changes the pH of the gut significantly.

When the pH of the gut is changed, that has an impact on which bacteria can thrive and survive. And ultimately, if you've got too much stomach acid and there's too much of an acidic environment, you're going to develop more of the gut bacteria that are associated with more stress, more inflammation, worse health outcomes. So stress management, careful with ultra processed food and processed food in general, and also drinking enough water. Gut bacteria really like to be very well hydrated.

So there's things that you can do as well as adding things in just to be a little bit wary of. But one of the nice things about gut health is really I'm talking to people about adding things in. What more do you need to take in as opposed to taking things away, which is kind of what ultra diet culture is all about, right? So it's mostly about adding things in. And ultimately what we see from the data is when people add more plants in, it displaces some of these less healthy things in their diet anyway. So if you're snacking on nuts and fruit, you're not going to be snacking so much on protein bars and stuff like that. So that helps people to move into these healthier patterns anyway.

Love it. Does tea, coffee count as hydration or does it have to be like water, water? So tea is quite good for hydration and coffee and tea both contain something called polyphenols, which will gut bacteria love. Polyphenols are these kind of plant compounds that are in all different plants. And really importantly and interestingly, the different coloured plants all have different polyphenols in. So like the purple ones are great for your brain health and the orange and yellow ones are great for controlling inflammation and diabetes and stuff like that.

So they all have slightly different jobs in our bodies. And tea and coffee contain important polyphenols that are really healthy and helpful for us. But coffee, you lose a bit of hydration every time you drink a coffee. So it kind of has a net negative effect in terms of your overall hydration. And that's because it's a diuretic, same as tea. So it makes you wee more and you lose more water and then you end up not as well hydrated. So what I recommend to all my patients is that while they're making a cup of tea or they're making a coffee, just drink a small glass of water on the side. And then you know that you've got enough going in.

and also just trying to make sure people are drinking water through the day. Right, so the 300 mils of...

fluid in this i'm net like less than that well the data is not quite perfect but i would say you're probably only getting maybe about 25 mils from that really something like that yeah damn okay i should drink more water you should cool we all should um what how how do i know if a food is processed what are some rules of thumb i mean essentially if it comes in a packet if it's been through a factory and it's come in a packet it's going to be processed to some degree sausages

sausages, any kind of like ready meal type stuff. There's lots of white bread that would fall, general breads that would fall into that ultra processed category because to make bread you need flour and you need yeast and you need salt and you need water but the ingredients list on some of the breads that you might pick up on the supermarket shelf is going to be so long and so complicated and have all kinds of preservatives and emulsifiers and stuff like that in it that actually ends up being an ultra processed food.

And we're in a difficult time, Ali, because people are struggling, right? It's a financial crisis. People are struggling to eat anything at all. So it's really important that we are careful about not demonizing food staples that people can afford. If you're living off food from a food bank and all you can get your hands on is baked beans and ultra processed bread and cereal, you've got to eat it, right? I don't want anyone to take away from this that it's so harmful for their health they should go hungry. That's not the case at all.

We're talking really here about refining health as opposed to people who are struggling, right? So there are ultra-processed foods that we need to be careful of and we need to look at those labels. It's about those long ingredients lists with emulsifiers, things that have got a code like colorings, e-numbers, that kind of stuff. Those are the sorts of things to look out for. And that would be your clue that that's an ultra-processed food. Nice. So let's say you and I go to a local, I don't know, grilled chicken shop after this and we're going to get a takeaway. Yeah.

Or just in general, when out at a restaurant, what are some good rules of thumbs for what people should order or should avoid ordering? I think if you're eating out, unless you're eating out every day or super, super regularly, you should enjoy it, right? It's an important thing to be able to eat socially and to be relaxed when you're eating and not to worry about it too much. But the same kinds of rules would apply. So try to eat as many plants as you can, even if that means ordering an extra side of broccoli or spinach or whatever it is on the side of what you're having.

We know that frying potatoes, for example, has an impact on our health in general. So fried potato products are not great for us. So trying to limit those a little bit. I mean, chips are literally my favorite thing. So trying to limit those a little bit is helpful and important for people. So just sort of thinking, especially if you're eating out really regularly, where are my sources of vegetables here? Am I getting enough? Am I getting some lean protein? And trying to kind of piece things together in your mind about what's going on. If you zoom out of your diet a little bit, what have I had to eat today? What do I need more of? What do I not need so much of?

of is helpful but if you're eating out you should enjoy it and have a nice time nice um what's the deal with organic food yeah i mean nothing really it's just really a marketing term so

There's no great data to suggest that eating an organic diet is going to have any significant health benefits for you. The pesticides and stuff that are used in the food chain now are very carefully researched. There's very little data to show there's anything that might do you any harm. What is potentially more interesting in that field, which isn't really talked about, is that...

When soil has been really heavily commercially farmed, it becomes less rich in nutrients, then your fruit and vegetables can become less rich in nutrients. Whereas if we scale that down to kind of buying locally, so from your local farmer's market, for example, less heavily farmed land, more nutrients in soil, more nutrients in your fruits and vegetables. And also food miles. So any food that's been through various different lorries and everything else or aeroplanes to get to your plate,

that's going to have a depletion of those nutrients over time so if you can buy local as much as you can that's much more relevant really to our nutritional status than buying organic necessarily is oh nice um

What's the deal with Diet Coke and other non-sugar, zero sugar, but lots of artificial sweetener type drinks? Yeah, your gut bacteria don't like artificial sweeteners, unfortunately. And, you know, they're safe from a cancer perspective and all that kind of stuff. There's not so much work. Don't worry too much about that kind of hype. But what we do know is that when we have artificial sweeteners, our body is anticipating having sugar and

things change to get ready to have that sugar. And when it doesn't come, that has an impact. So there's data to suggest that it increases our insulin production, for example, which makes us ultimately a bit hungrier and can have an impact on our general health as well. So ideally, sweeteners need to go in the no thank you bucket as well, which is difficult for people, right? Because, you know, when people are trying to get off sugar, sweeteners seem to be a good thing. And to be clear, if you're someone who is having loads of sugar,

right now you're better off having some sweeteners and trying to wean yourself down a little bit rather than kind of trying to go cold turkey which will ultimately probably fail when i speak to people who have lots of diet coke in their diet or diet drinks in general i generally say all right let's swap one let's do like an alternate thing so if you're having four a day at the moment let's go for like swap one for like a sparkling water then have one next time then have a sparkling water and have another one and just try to reduce it slightly rather than taking them away altogether what's the deal with fruit juices

So fruit juice can have some benefits, right? It's got loads of vitamins and minerals in it and stuff like that. So some useful stuff, but also it's still like a slightly processed food. And that means that our body handles it differently to how it would handle the whole fruit, for example. So if you eat, you'd struggle to eat like five oranges, but

But you could have a glass of orange juice, even quite a small one that's got the juice from five oranges in it. So it actually ends up being quite a lot of fructose, the fruit sugar there. And it's just a bit more difficult for our body to process it. Then we just end up having a bit more of a blood sugar spike and that kind of stuff that we don't really want to be encouraging. So a small glass of fruit juice every day is great. We're talking about something like 150 mils. But most people are chugging like a big bottle of fruit juice. And that can end up being just more sugar than you want to be consuming in one go, basically. Yeah.

Is tomato juice special? So there's some interesting data around lycopene from tomatoes, which is a polyphenol, and it's protection against things like prostate cancer, for example, in men. So there are some benefits to that kind of stuff. Lycopene is also really good for your eyes and other organs in your body. And of course, tomatoes have a lot less sugar in them than oranges or apples or whatever other sort of juice you might have. So again, a small glass of tomato juice would be good. You're still better off eating the tomatoes themselves because you get all the fiber and all the other benefits then.

- I'm just gonna throw some bait at you because all the health camps I've heard, bananas are bad 'cause they don't have fiber.

Bananas are great for you. There's a medical conference a few years ago where, and it's famed now, where there's all this sort of really famed like low carb community there. And we can talk a bit more about low carb and why it's a bit dangerous, but like the low carb community have demonized bananas. And there was a medical conference with proper doctors and everyone booed a banana when someone said, and then I ate a banana and this is what it did to my blood sugars. Everyone in the audience booed. They booed a banana. This is how messed up.

This whole world has become, that is wild to me. You know, let's say five years ago, we could all just at least agree that everyone needs to eat more fruits and vegetables. And now the low-carb is in the carnivores have come along. And even when I say you just need to eat more vegetables, but those people are like, no, no, not true. You shouldn't be eating this, you shouldn't be eating that. Nonsense. More plants, the better. Nice. Because I love bananas and I've been being like, oh, banana bad because carb and low-carb. No, no, you're all good. Low-carb.

What's going on there? Just starving off your colonic friends. I see lots and lots of patients in clinic who have had, who've been on a ketogenic diet, in inverted commas, or been on a very low carbohydrate diet and ended up with really terrible IBS, ended up with horrendous piles because they were so constipated.

end up with all kinds of trouble. And the whole grains that we need to eat in order for our gut bacteria to be as healthy as possible come from all sorts of different sources of whole grains. And so when we cut out carbs altogether, we're not having any grains whatsoever in our diet. And then we're starving off like really crucial species of probiotic bacteria

that do these amazing things in our body that we talked about before. So when you go on a low carb diet, you're starving off some of your really important friends in your colon, you're not feeding them. And that leads to all kinds of trouble, including overpopulation of negative types of bacteria, which have negative consequences on our health. So eating a wide variety of foods, including grains and pulses and all that kind of stuff is really, really important for our overall health and particular about health. So if I am trying to

If I'm trying to get shredded and, you know, keep the protein fairly high, reduce the calories. My tactics so far has been avoid anything that remotely looks like a carb unless a friend has got chips because it doesn't count if I steal a few of theirs. It sounds like you're suggesting the carbohydrates are evil approach is kind of bad. And instead I should be like, maybe I'll have...

a little bit less rice than I normally would, but I've still got that in my system. Yeah, totally. Or have whole grain rice because you just can't physically eat as much of it. So whole grain carbohydrates keep us full for a long time like protein does. So when we're trying to manage our weight, satiety, being full is really, really important. So having higher protein diet, good. Having higher whole grains, really good for maintaining satiety, keeping you full between meals, stopping you snacking. And when people move to like having a small piece of fish and then loads of green veg, just starving all the time, like it's miserable. I

and it's not good for you ultimately so let's try and balance that out a little bit get some whole grain carbohydrates in there and I'm not talking about you going and eating a massive bowl of white rice or having a massive bowl of pasta we're talking about having introducing some more whole grain carbohydrates in your diet to feed your friends keep you fuller for longer and also try to manage your weight in the way that you want it to be managed.

All right, we're going to take a very quick break from this episode to introduce our sponsor, which is Brilliant.org. I've been using Brilliant for the last several years, and they're a fantastic online platform for courses in maths and science and computer science. Brilliant is a fantastic resource for anyone who wants to develop new skills, but especially if you work or you want to work in a STEM-related field, it's an absolute no-brainer for being able to level up your knowledge of these topics. Brilliant has an enormous library of courses that cover all sorts of topics, and the courses are particularly good because they take a very first principles approach to the topic that they're trying to teach.

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This episode is very kindly brought to you by WeWork. Now, this is particularly exciting for me because I have been a full-paying customer of WeWork for the last two years now. I discovered it during, you know, when the pandemic was on the verge of being lifted and I'd spent like the whole year just sort of sitting in my room making YouTube videos. But then I discovered WeWork and

I was a member, me and Angus, my team members, we were members of the WeWork in Cambridge and they have like hundreds of other locations worldwide as well. And it was incredible because we had this fantastic, beautifully designed office space to go to, to work. And we found ourselves like every day, just at nine o'clock in the morning, just going to WeWork because it was a way nicer experience working from the coworking space than it was just sitting at home working. These days, what me and everyone on my team has is the all access pass, which means you're not tied to a specific WeWork location, but it means you can use any of their several hundred coworking spaces around London, around the UK, and also around the world.

And one of the things I really love about the coworking setup is that it's fantastic as a bit of a change of scenery. So these days I work from home, I've got the studio at home, but if I need to get some focused writing work done and I'm feeling a bit drained just sitting at my desk all day, I'll just pop over to the local WeWork, which is about a 10 minute walk from where I am. I'll take my laptop with me, I'll get some free coffee from there, I'll get a few snacks. And it's just such a great vibe and you get to meet cool people. I've made a few friends through meeting them at WeWork and it's just really nice being in an environment almost like a library, but kind of nicer because there's like

a little bit of soft music in the background and there's other kind of startup bros and creators and stuff in in there as well and it's just my absolute favorite co-working space of all time it's super easy to book a desk or book a conference room using the app and it's a great place to meet up with team members if you're going to collaborate and you'll live in different places they've got unlimited tea and coffee and herbal teas and drinks on tap and they've got soundproof booths in which to take zoom calls and meetings anyway if you're looking for a co-working space for you or your team then i'd 100 recommend we work like i said i've been a paying customer for theirs for the last two years but

which is why it's particularly exciting that they're now sponsoring this episode. And if you want to get 50% off your first booking, then do head over to we.co forward slash Ali. And you can use the coupon code Ali at checkout ALI to get 50% off your first booking. So thank you so much WeWork for sponsoring this episode. What's the deal with a ketogenic diet? Loads of tech bros are particularly big on that.

I know, I wish they would stop. So the ketogenic diet was developed for children with epilepsy, which I think is a fairly commonly known story now. The only indication for a ketogenic diet is for children and adults who have epilepsy. Really? Yeah, totally. So we use it in clinical practice for that sole purpose, nothing else. And there is some really interesting data and useful data now that suggests that lower carbohydrate diets are helpful for weight control, but there are inevitably consequences to that in terms of microbiome and other things.

So lower carbohydrate diets are useful and generally reasonably sustainable for people who need to lose a lot of weight over a long period of time. But ketogenic diets, where the carbohydrate intake is so low, are...

like almost consistently completely unsustainable for people meaning that they then fail on potentially another diet they feel like they're a failure nothing can happen they can't do anything their kind of self-esteem their self-efficacy goes right down people give up on weight loss and everything gets to be a disaster so

It's all about balance and managing things properly. And no qualified dietitian or other healthcare professional would recommend a ketogenic diet to anyone because we are aware of the consequences. It's just the, I don't know, shouty people that are not properly qualified in this area that are doing it. What are your thoughts on one meal a day?

I mean, can you get 30 plants in one meal a day, Ali? Probably not. Yeah, exactly. That's my thoughts on it. Essentially, that's a summary of my thoughts on it. You cannot possibly get all of the nutrients that you need for one day in one meal because you can't physically fit it into your body.

And so ultimately you're going to be affecting your gut health, affecting your general health. And, you know, if you think about the opportunities that you've got to have oily fish twice a week, for example, you're going to have to think about that over one meal rather than having more than one opportunity to have those really healthy things. So if you think you can fit at least five portions of fruits and vegetables and nuts and seeds and all the other stuff that you need to have to be healthy into one meal a day, hats off to you, but I don't think you'll be able to fit it in your body. Okay.

What's the deal with the carnivore diet? Oh my god, the carnivore diet is just I think one of the worst things that's happened recently, isn't it? It's horrendous for your gut health, right? Horrendous. You're obviously completely starving off your microbiome. These guys are inevitably going to end up with, and it is mostly guys, are going to end up with heart disease, with high cholesterol, with all kinds of problems, but

their colons are going to be an absolute mess because they're basically only feeding those negative bacteria that are having health, negative health consequences because their diet is just protein. So for anyone that doesn't know, and please don't Google it, the carnivore diet is where you just eat meat. And there was this guy, I can't remember what he called himself now, but he was like the king of the carnivores, right? The liver king. Liver king. Oh yeah. This dude was eating like raw brain and testicles and all kinds of stuff and saying that you had to

do this stuff to follow a proper ancestral lifestyle.

And then it's recently come out that, of course, he was actually just taking loads of steroids and loads and like spending something like $15,000 a month on his steroid regime to look the way that he did. Whilst all the time he was amassing like millions of followers claiming that he wasn't taking any steroids at all. And just for a little reminder for anyone who's not sure, anyone who looks like they're taking steroids is definitely taking steroids. Don't doubt it. Just go with your instinct and think, yeah, it would be really difficult to get like that.

just from eating brains and testicles, right? It just doesn't work like that. It's not how the body works. What do you think? So how do dietitians feel about the word diet? Great question. I think it's such a difficult world that we live in. And I guess when the word dietitian came along, it wasn't associated with diet culture and the negative aspects of that that there is now.

And we sort of go through these discussions as a profession about whether dietitian is a good word for us because people often still say to me, oh, so you help people to lose weight. I don't do that at all. We're very medical, as you know, and dietitian might be working in

in with people with kidney problems or I worked in intensive care for a long time we work with cancer patients we just do this medical stuff and none of it is about trying to help people lose weight some some dietitians do work in obesity management but it's maybe I don't know less than 10% of the profession so diet and diet culture are synonymous with bad news and this way that all these diets that we're talking about keto diet carnivore diet all this kind of stuff even fasting is all about making generally healthy people thinner and

and being fixated on thinness as part of people feeling better about themselves because we live in this kind of fat phobic society. It's all very complicated these days and I think one of the things that's important to recognize is that being very overweight and eating a very poor quality diet, not exercising, not looking after your body, being very stressed is really really bad for you but actually all of our bodies are meant to be a different shape and size and sometimes a

bits of our lives are dedicated to being as healthy as we can be and other times in your life you might be raising children or working two jobs or have your side hustle as well and if you add the pressure of being as thin as you possibly can be or shredded as you possibly can be into that mix you're putting so much pressure on yourself and it's just not healthy for you and you're going to be full of cortisol which makes you carry more weight anyway so we have to have kind of a

elevated view on our body shape and size, what's normal and healthy for us might be normal and not be normal and healthy for somebody else. So diet culture and dieting is a complicated and difficult area that is very controversial these days, interestingly. So it's something we, I'm constantly thinking about in terms of my title as a dietitian, because it just feels not quite accurate as to what I do really. How has diet culture evolved over the last, let's say, 20, 30 years? What have been the trends that you've seen or that have

I think that the, so if I think about my mum's generation, all that they were exposed to in terms of female bodies were very, very slim women on magazines, right? So in magazines, in books, on the TV sometimes, but it was very much the thin ideal. So the thinner, the better at all costs. There's no such thing as too thin. Kate Moss generation of like, then sort of a bit later, Kate Moss generation of nothing tastes as good as skinny feels, right?

These are all the messages. Funnily enough, I was in a conversation with my friend this morning about the sidebar of shame, which was basically pictures of, this is more in the 90s, of like Jennifer Lopez with a tiny bit of cellulite on the beach, circled, saying, sidebar of shame in the Daily Mail.

In women's magazines, it was all about the thinner the better and anyone seen to be carrying any additional weight was shamed, circle around the bit that they were saying was not good, all that kind of stuff. And then of course, when women did lose too much weight, they were told they were too skinny and everything was awful and there's something wrong with them, but they've just been shamed into it. And then we had the social media and we had Instagram. And

So if we think about Instagram coming in something like 11 years ago, now young women are exposed to all sorts of different shapes and sizes of bodies now. But the body shape that we're told that we have to have now is this kind of tiny waist, massive bum, big boobs. But you have to have a thigh gap and you have to be able to fit your fingers around, hands around your waist. And you have to do this and you have to have visible abs and everything else.

And a lot of that stuff is obviously, not necessarily, obviously it's physiologically impossible unless you've had surgery, right? So if you're doing loads of squats, unless you have a very specific pelvic shape, if you're doing loads and loads of squats, you're going to build up your inner thigh muscles as well. So you end up without a thigh gap, but you might have a big bum, but you've not got a thigh gap that you wanted. So you keep working, you keep trying, you think I'm not losing enough weight, I'm not doing it right. But actually those people that you're looking at are either posing in a very unnatural way or they've had surgery or they're editing their pictures. So we're now exposed to this kind of

And, you know, even like the Kardashians lead a lot of this body image stuff, in my opinion, and in everyone else's opinion. Now they're going very skinny. And that's really hard because people, women have...

maybe eaten a bit extra to try and bulk up and maybe they've had this surgery to make their bum bigger and now the Kardashians are getting really skinny and they're like oh my god what am I going to do have my bum implants taken out how am I supposed to manage this right so social media has caused this absolute chaos with body image and with diet culture and just like

it's some interesting examples of this like nobody in the world told like from a nutrition professional perspective told people to start drinking plant milk that was almost entirely led by like a social media campaign of people saying you shouldn't be drinking dairy and then plant milk has come along and taken up that space nobody in a nutrition professional perspective has said that's better for you in any capacity than drinking dairy milk because it's not fundamentally dairy's got loads of really important nutrients in that harder to find elsewhere in your diet but

But somebody came along and I could name her, but you might want to edit it out. Deliciously Ella came along and said, everyone should be plant-based and not drink dairy. And now there's this huge market for plant-based milks, right? At that time, so we're talking about kind of 11 years ago, no nutrition qualifications, by the way.

11 years ago, along comes Joe Wicks and tells everyone to eat coconut oil. Coconut oil is full of saturated fat. And we worked so hard as nutrition professionals to get people away from saturated fat and to have more olive oil. And now suddenly everyone's eating loads of coconut oil because Joe Wicks told them to. Again, no nutrition qualifications, absolutely no health benefits to eating coconut oil. But these nutrition trends...

seep into society from influencers and from social media platforms and it causes physical harm so if we get a wave and you know lots of people would say it's inevitable that we have a wave of young women and men who have osteoporosis in their 40s because they never gain the bone density that you get from having dairy in your diet consistently up until the age of 30 is deliciously earlier it's deliciously ella or other influencers culpable for that are they responsible

I think so, but they've not got any governing body that says that they should be. Equally, if we did have a big spike in heart attacks from people having loads of coconut oil, is Joe Wicks responsible? Maybe, but he's not culpable because he's not got any credentials in the area. There's no one governing what he's saying. Social media has become a public health platform now.

But nobody is managing it. Nobody's protecting it. No one's making sure it's okay. Skinny teas, giving people diarrhea, teaching people purging behaviors. Like it's a mess and it's so hard to break through that stuff. And I think dietitians have such an important voice there, but it is really hard to break through. And that is where now diet culture is like on acid and it's so dangerous for people.

I did I've done two DEXA scans in the last sort of 12 months first was in June then was in December and the one in June showed me that I was like 24% body fat or something which was a real shock to my system because I just kind of assumed I was like 17 18% or something just based on how I think I look um and the guy who did the scan uh was like yeah you know

In terms of your upper body, you're sort of median for the sorts of people that have DEXA scans, i.e. generally more health-consciously type people. For your lower body, you're in the 15th percentile, so do more squats kind of thing. But also I had tons of visceral adipose tissue. It was like 70-something. And then I had another scan six months later. I'd lost 3kg. Annoyingly, like 60% of it was muscle rather than fat.

And the guy was like, yeah, it's because not enough protein and not enough actually going to the gym, which is what maintains muscle when you've lost weight. The visceral adipose tissue went down to sort of the 50s from the 70s, which was good. Body fat was still like 23%. And so I was thinking, part of me was thinking, I want to get shredded just for the aesthetic stuff.

But then another part of me, well, when I spoke to this other health coach, he was like, well, it's not really about the six-pack abs, but actually we do want to get this visceral adipose tissue down. And especially with my background, South Asian, basically, apparently a lot of fat congregates around our bellies. And visceral adipose tissue equals bad. Therefore, I should try and reduce my overall body fat because that gets rid of some of the visceral adipose tissue. To what extent?

Is this reasonable strategy or what have I gotten wrong in this analysis? No, no, I mean all of what you've said is true. So visceral fat, which is the fat that collects around your organs, is really not good for our general health. It's very metabolically active and interacts with our body. It creates inflammation in the body, which we know to be really negative for us. So visceral fat is something we need to control. How much visceral fat you have is inevitably going to be linked to your genetics. So you will always have more than perhaps... So when we do these studies...

the DEXA studies to show what's average are mainly done on white people. And so we don't necessarily have a good gauge of what that might look like in South Asian people, for example, what might be normal. So actually, if you did compare that, and BMI is the same, actually. So we give a lower BMI and waist to hip ratio for South Asian people now than we would for white people because South Asian people carry more weight centrally. And that's so you might be lighter, but you might carry more weight centrally, and that's more dangerous. So

actually if we looked at studies that include people from all different backgrounds there might be a slightly different ratio for you of what would be normal right because of your background so that's something to think about I don't believe that data exists but I could be wrong um so it's something to do with thinking practically about what's right for you and whether you can physically do that but focusing on something like visceral facts is a useful measure of thinking okay how am I going to

to improve and impact my long-term health. Unfortunately, most people are only interested in aesthetics to the detriment of all the other things. And then that can end up with all kinds of different problems. So you could get really, really fixated on that number. And actually it's not moving as fast as you want it to. And that can be really difficult for you because you end up in a bit of a pit of going to the gym twice a day and hardly eating anything or just eating protein and go down this spiral. Whereas actually just having a

gauge on it having an eye on it and making sure it's not becoming out of control and in a really unhealthy level is probably the most important thing to think about how do you feel about the visible abs culture i mean i think it's unfortunately i think it's much more dangerous for women than it is for men so that's not fair i think that there's this culture now for men and i really feel sad that women haven't brought men with them on the positive body positivity journey because i think that the

like diet culture journey is really just in its infancy for men really but what I notice is if you watch Netflix for example you'll see men who don't apparently go you might follow this man all through his day and he's doing all sorts of different things but not once has he gone to the gym but when he takes his shirt off in the evening he's got this absolutely ripped six-pack so young men are like oh he's not really going to the gym but somehow he looked like every man has this under their like even lawyers who are clearly working like 24 hours a day

seem to have this amazing six pack. How is that possible? How do I get that? I should have that too. And of course that's not how it is, right? That's just not what the average man looks like, but that's what men are now expected to kind of try and emulate or feel that they're expected to try and emulate. And you know, the lower your body fat percentage goes, the lower your testosterone gets, the more higher risk you have injury. And generally your energy is going to be crap. If you speak to people who are

who've been on the front covers of like men's health and stuff like that and you ask them how they were feeling at the time that they shredded down for that photo shoot, they'll tell you that they felt horrendous, that they were depressed, they felt awful, they hadn't eaten out in ages, hadn't eaten with their wife for ages, hadn't seen their kids for ages because they're just in the gym all the time. You know that and they've not drunk enough water, they've like fasted from water to try and get really shredded.

But that's kind of the panacea. That's what people are aiming for, right? That's what people think they need to be looking like. So that's dangerous and toxic in and of itself. When we think of women actually having visible abs for most women means getting your body fat percentage down to something that we relatively similar to men. So something below like 19%, let's say. But in order for a woman, most women, this is on average looking at the data,

most women need a body fat percentage of at least 22 to 25 to have a regular menstrual cycle. So women are starving themselves down to body fat percentage of somewhere between 17 and 19 to get visible abs, meaning that their menstrual cycle has probably stopped on average, if we look at it. And of course, some women carry a lot more weight on the bottom and not so much in the middle, so they might have leaner abdomens naturally.

But on average, when we look at the data, most women with a six pack probably won't be menstruating. And of course, not having a period is associated with all kinds of really negative health outcomes, not least of all, you know, bone density problems and all sorts of things that are actually long term health things that can cause all kinds of harm. One of the questions that people love to ask, I think, in media type stuff I've seen, and so I'm going to ask it to you with that caveat, with the apology, but is...

Can you be overweight and healthy? Yeah, for sure. Yeah, yeah. So some people just are naturally supposed to be heavier than what the BMI tells us to be. And in my practice, I would say that those are the people who notice that they were heavier as children. And maybe they carry a bit more weight on their lower body or on their arms. Maybe they're women who've got quite big breasts, that kind of stuff. They generally just are naturally heavier. Maybe their mom's also a bit heavier and their grandma was a bit heavier. That kind of genetic predisposition to carrying a bit more weight is

But what I'm talking about is women who eat really well, who look after their bodies, who exercise, who love exercise, who are doing really good stuff and who look after their mental health and they're not eating compulsively. They don't feel out of control with their relationship with food. They're eating really healthily, but ultimately they are still heavier than what their doctor might like them to be, right?

And those are healthy people. Those are overweight but healthy people. And what we have is this interesting data around people who are thin on the inside but fat on the outside, toffee, and foaty people who are fat on the outside but thin on the inside.

What does that mean? So thin, you could be thin on the outside, but fat on the inside, like with this visceral fat we're talking about. You could be a naturally very thin person, but maybe you're smoking, maybe you're drinking too much. Maybe you, you know, don't eat well, don't look after yourself, you never exercise. So you might look thin. So your doctor goes, sure, you can have IVF, you can have all this treatment, you can do these things.

But you're actually a very, very unhealthy person and just some small lifestyle changes might sort everything out for you. But you could be an overweight person, overweight in inverted commas, who looks after their body, everything beautifully, doesn't have hardly any visceral fat, but they are naturally a heavier set person. And they're denied treatment for things like infertility and that kind of stuff because their BMI isn't what the GP wants it to be. So it's a big kettle of fish and it's very difficult. But yes, you can absolutely be heavier than the society would like you to be and be a very healthy person.

I've heard on a couple of usually kind of men-centric podcasts, this idea of, and usually right-wingy type podcast that, oh my God, Woke Culture has gone mad. Look at that plus size model on that, on that Instagram page. Look at that plus size model on that magazine cover.

Yes, we get that like body shaming bad. Yes, we get that like super, super skinny also bad. But like, come on, surely you're encouraging women to become fat. That's that kind of narrative. Yeah, I mean, when we think about my mum's generation again, where they only saw very, very skinny women, and certainly to the early stages of social media, where we only saw a very particular shape and size of women. And we still see that on TV on average and everything else. When

When we see that and we don't see any other body shapes and sizes represented, it means that the women who can never be that shape and size, despite however much exercise and healthy eating or whatever else they do,

they just feel completely unrepresented. And those people who, you know, you might follow the latest diet trends, every new one that comes out, but it's not working for you because you're just never supposed to be that shape and size. It's not healthy for you. It's impossible for you to maintain, get there or maintain it. So you either develop an eating disorder or you develop what we call disordered eating where you're, you're

feeling terrible about your body shape and size all the time. You're bouncing from, you know, either completely restricting or overeating all the time and struggling to maintain a healthy relationship with food. You're constantly thinking about food. It's the only thing you're ever thinking about. You're hating your body and thinking about food all the time, occupying all of your brain space. Imagine what you could do with all that brain space if it stopped.

When we don't have any representation, that's the two camps that people fall into. So they either stay super, super skinny or they really struggle with disordered eating relationship with food in their body. What we need is this representation. And of course, we don't need any glorification of poor health. But what I see from these girls that, you know, these plus size models who are on the cover of Cosmopolitan, if you look on their Instagram, they're skipping, they're doing yoga, they're doing amazing things. They're doing incredible stuff. They're not generally the people who are shown, I'm not the people who are on YouTube showing

eating excessively and everything else right those are that's a really niche kind of fetishy category actually but I think that these heavier women who are naturally heavier and a plus size models are being grouped in with them and that's certainly not how it is in reality.

All right. So we took a little bit of a tea break. I did the thing that you suggested. While I was waiting for the tea to steep or brew or whatever the hell that's called, I poured myself a glass of water and I drank it. Perfect. And that's such an easy thing. It's so nice when you can like attach a habit to something else. Definitely. I think that's where dietitians come in really handy because we understand like...

if you see a different sort of nutrition professional sometimes you're given this like idealized diet of the perfect things you should be eating and drinking and it's just completely unrealistic whereas because we work in hospitals with people who just don't have access to funds and stuff like that for the majority of our career you kind of understand what people actually eat like and how they really behave and you can really help people to kind of change those behaviors rather than just going here's your diet plan off you go yeah um uh on on that note are there any other sort of

easy tips that someone can take away that will just level up their life. I think like snacking on nuts and seeds and stuff like that is just so helpful. Just add things in. Put like a jar, like if you're someone who eats in the car and you notice you eat unhealthy things in the car, put like a jar of trail mix in the car. Go to a health food store or wherever you can afford to. You can go to

Poundland and get loads of different nuts and seeds and stuff and mix them up in a big jar and put that in your car and it will help you to kind of keep full for ages and have nice things to snack on. Interesting. So I've always thought like I really like nuts, but then I think, oh, nuts, high calorie, bad. So interestingly, there's great data to show that the less you chew nuts, the less nutrition, the less fat you absorb from them.

So don't choke, but if you... Just swallow them. Yeah, swallow them all. You just can't, they're very difficult to digest in a really positive way. So ultimately, if you eat nuts, you just don't, you probably absorb 50% of the fat from the nuts that you actually eat because most of us aren't chewing it down. If you have peanut butter, for example, then you end up absorbing much more of the fat because obviously it's processed and you can eat it better. Yeah, because when I'm driving, especially, I'll stop at a service, charge the car or whatever, and then I'll be like, oh...

I really want to eat something. Yeah. And I'll sometimes default to like Smarties, but like, I think replacing that with like just a nut mix option. Yeah. Perfect. Yeah. And even put some, like put a few chocolate raisins in there. Why not treat yourself, you know, make it nice. Okay. So the water thing, the nut thing. Nut things. I mean, nuts are so great for your microbiome, but they're also great for like general healthy fats. And they're also super positive, keeping you full and all that kind of stuff. So really good for satiety. Yeah.

I think it is a little bit about counting your fruits and veg. So just going, all right, how many plants have I got in this meal? How many plants have I got in that meal? And one of the things that I do habitually is just, as I said before, just zoom out on my diet a little bit and go, okay, I haven't really had any fish this week. I'm in a restaurant, I'm trying to make a decision. Have I eaten chicken this week? Have I eaten fish? Have I eaten meat? What have I had? For me, I'm also thinking, where am I in my menstrual cycle? Do I need some red meat? Do I need a bit more iron? That kind of stuff.

It's just sort of trying to think a little bit more strategically about your diet without having really strict rules because that's important and helps you with your general mental health and well-being. Nice. I like that. Yeah, I find often when I go to a restaurant, I'm paralyzed by choice. But if I zoom out and think, huh, I've only had one portion of fish this week. Great. That makes sense. That's easy. Yeah, exactly. Fantastic.

You looked up a few studies while we were taking a break. Let's pretend I just knew them off the top of my head though, yeah? Nice. I am joking, you can keep that in. Yeah, so what are some fun studies that you, I love hearing about studies. Yeah, so there's some great research on probiotics and both the gut-brain axis, so how when we're stressed, we have these gut symptoms and how probiotics can help to control those gut symptoms. So one in particular, so there's 55 healthy volunteers given a probiotic, another group are given a placebo, so we can measure the difference.

The ones who have the probiotic have a significant reduction of psychological stress, significant reduction in cortisol. So these like chemical parameters of stress and anxiety that we can measure. So it's not just how people say they're feeling, it's these objective measures. So I'm talking about Cerebiome, which is these two combination of two particular probiotic bacteria, which we have in the smart probiotic shown to significantly reduce cortisol in people who are taking it in comparison to placebo, magic.

People don't believe this stuff until they see some of this research, right? It's so important to look at it. And they also see a decrease in depression scores. So people's perceived how they're feeling, mood scores, that kind of stuff, which is pretty magic.

I think one of the really important things that we often miss when we're thinking about productivity and focus and concentration is that anxiety is like the anti-focus concentration hormone, right? When you're anxious, you generally procrastinate. You don't want to do anything. You get really fidgety, so you can't concentrate on anything at all. So really, with a lens of thinking about why we struggle with focus and concentration, we've got to think about anxiety.

So if we can reduce anxiety and reduce cortisol, we're going to be in a much better flow state. We're going to be able to focus much better. So if we're focusing our thoughts about this on reducing cortisol, we can think that then the counteraction of that will be that you'll be able to concentrate and focus much better.

We've also done some great research on depressed patients given probiotics and seeing improvement in anxiety, sleep quality, stress. And in that study in particular, they were given the probiotic for eight weeks and those results lasted for eight weeks longer once they stopped taking the probiotic.

which is pretty magic. So your gut bacteria adapt and change over time, and then they can become a less stressed microbiome. So your ecosystem in your colon sort of evolves with you. So it evolves depending on what you feed it, and it evolves depending on what external factors are going on. So if there is a lot of stress, you become a more stressed ecosystem, including your colon, and that then helps to release more cortisol, makes you a more stressed person. So it's this feedback loop between your gut and your environment.

whereas if we can break that feedback loop by introducing some probiotic bacteria that help to control stress it can help to have long lasting effects in your colon which is magic

And then we've got another great study with 75 healthy volunteers given placebo or probiotics. And again, really significant reduction in stress-induced GI symptoms. So that diarrhea that you get when you're feeling anxious and stressed, we can see that reduce just with taking these two particular strains of probiotics, which is pretty magic. That's really cool. Sick. I'm going to take this more...

regularly now yeah every day cut that out because one thing that is common for people to hear if they go to a doctor about some any kind of bowel symptoms is oh you've got a bit of IBS yeah sure what does a bit of IBS mean nothing really I think it's really important that everyone knows that if a doctor is trying to give you a diagnosis of IBS diagnosis of IBS is a diagnosis of elimination and

So your job as a doctor is to eliminate all the other things that it could be before you say it's IBS. So that means that at the very least, someone should be having a blood test to rule out any sort of inflammatory condition. And they should be having a stool test, again, to look at inflammation in the stool, but also to look for any blood in the stool, which is associated with bowel cancers. And unfortunately, bowel cancer is affecting more and more young people.

We also, with women, we would think about things like endometriosis and other gynecological problems that could cause disruption to digestion, but also bloating and that kind of stuff. You know, cervical cancers can lead to bloating, those sorts of things. So it's so, so important that your doctor does that process of elimination before they give you that diagnosis of IBS. And I think it can be quite empowering for people to know that actually the NICE guidelines, so that the guidelines that tell doctors what to do,

that is in there they have to do this process of elimination before they say it's just a bit of IBS because there is a risk that you'll miss other much more serious things and a lot of my patients will have seen their doctor multiple times before they see me and then they come and they say my doctor said I've got IBS and then I say actually I just think we need to do a few more tests I don't think this has been ruled out and they end up having something more serious and that's you know it could have been diagnosed years ago. What can we learn about gut from poo testing and blood testing? So

stool testing at your GP so if someone comes to see me and I think I think we need some more stool tests the sorts of stool tests I might ask for would be things like um it's called a fecal calprotectin so it measures how much inflammation is in your poo and that tells us if there's actual inflammation in your bowel someone who has IBS should never have inflammation in their bowel it's just not part of the IBS picture but people who have inflammatory bowel disease for example may well have what will have inflammation in their bowel itself when they're in have active disease so

We can also look for things like parasites. So sometimes people come and they've got like IBS that developed when they went on holiday somewhere. And actually they've got some residual Giardia or another parasite that they picked up, that kind of thing. We can also look for things like H. pylori, which is a particular type of bug that lives in your stomach lining and that can cause reflux and those kinds of things. And it's again, a simple stool test that can be done for that.

So there are lots of medical level stool tests we can do. We can check your pancreatic function with your stool test, that kind of thing. But the sort of stool tests that people are really interested in now are these microbiome tests that you can have done. So these are available commercially and they are interesting. So in the last week, I've been analysing a load of stool tests as part of the Heights Probiotic Trial and we're looking at people's stool tests, but there's real limitations to them. So we've got really interesting raw data and

What we need to do with that data is pair it up with what people are eating, what their lifestyle is like, try to use the clues from their clinical conversation with them to then look at their stool test and try and match up why this particular thing is different for them. So, for example, you could look and you could say, oh, this person's got higher levels of some pathogenic bacteria and you need to say,

Did you have food poisoning any time in the last kind of few years or so? And then we can go, okay, that's probably why. But it might also just be a bit high because their levels of good bacteria are a bit too low and we need to balance it all out. So it's all about ratios.

And I guess the main thing to take from this is that if you're going to do it on your own, the chances are you're going to end up with a load of information that you don't know what to do with. And it can be potentially really frightening. And if you have existing gastrointestinal problems, the more anxious and worried you are, the worse your problems are going to be, right? So it's not necessarily helpful to do it if you are someone who is feeling anxious and you think that might be contributing to your gut symptoms.

Ultimately, there's really no point in doing it if you're someone who lives with any kind of gut condition, because we just don't have data for what is normal for someone who has IBS, for example. So we've got loads of data for what's normal in healthy people or what's average in healthy people, but we don't have data on people who've got IBS, IBD, that kind of stuff. So it's just not a good idea to do it if you've got any kind of gut symptoms or

And actually, if you come and see someone like myself or someone from my team, we can, based on your symptoms and what's going on for you, have a really good guess at what's going on bacteria-wise, right? So if you say to me, I'm passing really foul-smelling gas, I'll say, what does it smell like? And they might say it smells really eggy. And I'll say, you've got too many of the ones that produce too much sulfur. Let's work on managing those. And if you say I've got really bad bloating, I'll say, well, you probably just got really loads of rapid fermenting bacteria in there. And we can try and modulate the proportions of those so that things get a bit more comfortable.

So you really don't need to have one ever. But sort of academically speaking, they're always quite fascinating. So I was in Miami a couple of days ago and everyone there seemed to have some kind of longevity regimen with their NADs and NMNs and all their stacks and all this kind of stuff. And one thing that they all, sauna use, cold showers, ice plungers, hyperbaric chambers, even some of them. One thing that they all seem to have done was some kind, I think this sort of microbiome stool testing, because they were like, oh, I did my stool test and it told me that

actually for me, avocados are really bad. And for my mate, avocados are good. Like what, I was a bit like, what? How does that work? What's going on there? - I think that what they are referring to is some personalized nutrition program that does stool testing, but also does blood testing and genetic testing. So they're looking at the full parameters of things.

And whilst that's interesting, ultimately the vast majority of the advice, both on microbiome testing, but also on genetic testing and everything else, it's going to be roughly the same, right? Roughly the same, which means that

So you've got a slightly higher propensity to me for cardiovascular disease, for example, and I have a slightly higher propensity for diabetes. But the dietary advice for those two things is going to be the same. Eat loads of plants, have some oily fish, be careful with high fat foods, that kind of stuff. Yeah. So the dietary advice is going to be roughly the same regardless of what's going on. And some people might find out from that kind of stuff that they don't handle

fats very well. So they might find out that actually for them avocado, too much avocado isn't a good thing. But most people aren't out there smashing so much avocado that it's going to have a negative impact on their health, right? So ultimately those tests are interesting and some people find them useful. But in practice, for most people, it creates this kind of real anxiety. And that's where people can end up booing bananas in a lecture theatre, right? That's where people get too fixated on it and worried about things that actually in the grand scheme of things are not something you need to be worrying about.

These are generally just, sorry to interrupt you. These are generally people with far too much time on their hands to think about their longevity and they're not people who

are living in the real world but their influence is huge on all of us right because they are the sort of top tier in terms of uh financials and so we kind of emulate them and we think that that's part of what got them to where they are but actually it's the years of them grafting and eating delivery every night that got them to where they are it's not them focusing on hyperbaric chambers and all that kind of stuff yeah these guys all have way too much money way too much money and way

I was having a chat with my girlfriend last night and we were talking about sauna use because there's all this stuff around like, oh, heat shock proteins and heat shock therapy and all that kind of stuff. And I was thinking, yeah, you know, you know, they say like on Huberman Lab, he says four times a day and we can't quite remember whether it was 13 minutes or 14 minutes and 15 minutes. And she made a very good point. She was like, well, if you don't go to the sauna at all.

It does not matter at all. Whether you're 55 or 58 minutes, just try and get to the sauna at least once a week first. And then once you're at the point where you're going four times a week, then worry about the optimization. Yeah, sure. I mean, also just remember that like 99% of the population don't have access to a sauna. So, and they're kind of okay. Yeah. I think it illustrates that thing, which like I definitely have a propensity for this where

if i don't have 100 of the information i'm going to go zero percent of the way sure and actually i should just go 80 of the way and then worry about optimizing the final yeah yeah i think that's just generally really good advice isn't it it's like those small steps that you take are the things that last and that are easy and if you try and sort of have it stack that makes a massive difference rather than trying to overhaul everything and get too details oriented nice um okay loads of somewhat unrelated things which are all i mean obviously related to the gut that i want to ask you about so i'm just going to shoot a bunch of questions your way uh what's the deal with protein shakes

It depends on how you're taking them, what you're using them for, but most people don't need them. So most people get plenty of protein in their diet. If you're someone who is trying to build muscle rapidly and you're busy and it's difficult to get enough kind of meals in the day, then fair enough, you could use a protein shake. But it's really important to look for one that doesn't have emulsifiers and colourings and all this stuff in it, preservatives.

because you're just causing yourself more problems for later they've got these health halo that we talked about that people think it's really healthy because it's protein shake when actually it's probably like birthday cake flavored and it's got loads of different things in it that you don't want in your body so i generally recommend to people to either use a whey protein isolate or a pea protein isolate if they're vegan and then you can blend that up with like some berries and maybe some kefir or some berries and some like oats for example and you can make yourself like a

really healthy really good tasting protein shake that's still got the same protein structures in it the thing that you really need for muscle building but it's not going to have any lactose in it it's not gonna have any other additives in it and the things you're trying to avoid nice um any particular brands that you recommend depends on how bougie people are so um the organic protein company have a really great way protein isolate with literally nothing else in it and so no emulsifiers or anything else so that's a really good choice nice but it's expensive

Okay, here's another thing I've heard. Blending veg is bad because you lose a lot of the benefits of veg once it's in a blender. Sure. So when we blend anything, it's kind of a step towards processing it, right? But so is cooking and so is other things that we do that are fine for us. We do lose some of the fibre structure, but we maintain all the nutrients. So if you're talking about kind of putting it in a blender and you have all of it, it's slightly different to if you're juicing something. You lose all the fibre if you're juicing something. But if you're just blending it, you maintain a lot of the fibre.

food that your gut bacteria wants so you're still getting loads of good stuff from that and there's no harm in doing it the harm not harm but the problem that people run into is a bit like when we're talking about oranges and juicing you can end up having way more fruit than you would normally have or be able to physically eat in a sitting but blend it up you can just drink it super easily so i usually recommend people do is add some like spinach in there add some kale in there bulk it out with some veggies and balance that out with some fruit so that it's kind of a bit more of a balance between fruits and vegetables yeah

All right. I'm going to try and find a decent recipe for this stuff. So like I can put some oats, put some organic, whatever protein powder, some frozen berries, some frozen veg. Yeah. Stick some seeds in, stick some peanut, like some mixed nut butter would be great in there. Yes. Fantastic.

On the note of juices and blending and stuff, what's the deal with juice cleanses and like celery juice and like this kind of stuff that people do? I mean, it's an absolutely terrible idea, all of it. So I've got a very good friend, Dr. Rachel Kent, who is, she's an amazing researcher at King's College and she, her sort of journey, she researches the impact of health tech on our general wellbeing and lives. And

And she started that journey into doing that because she did a juice cleanse. She was just doing it for general health, didn't want to lose weight, but she just read that juicing was a really good idea. She cut everything out. She's doing like a bit of a detox type thing in inverted commas and ended up in hospital with terrible kidney stones. It was an intensive care with sepsis and everything because she'd followed this guy's juicing advice that she'd seen online and realized that this was a disaster. And now she does amazing research into the impact of like calorie tracking and that kind of stuff on your general life.

So juice cleansers are dangerous and worrying and something that we definitely shouldn't be doing. Anything that kind of involves

let's say the word detoxing, it's just nonsense. So if you do something like a juice cleanse, you're actually depriving your body of loads of really, really important nutrients, meaning it's got to work much, much harder. And in that process of your body working much harder, it's releasing more things that we might consider to be toxic, like oxidative stress and that kind of stuff, because you're just not allowing your body to work in its normal way. You're making your liver work really hard, you're making your kidneys work really hard. And that means that you're producing more stress in your body, which is actually physically harmful to you.

So I don't have a problem with people having a juice as part of their, you know, adding a few more vitamins into their diet and stuff like that. Fine. But if you're doing like a juice cleanse or detox, really bad news, terrible health consequences for lots of people and absolutely no health benefits.

Nice. There seems to be a lot of advice on TikTok these days about the gut, gut talk. What's your view on gut talk? I mean, I've not seen any good advice on gut talk apart from what me and the girls from the TV show have been trying to produce. There's some really terrible stuff on there, including, you know, I think they call it like a cheer shower, internal shower, that kind of stuff where people are trying to flush themselves out of things. And it's a terrible breeding ground for, you know, a bit like Instagram is a terrible breeding ground for terrible advice that can cause all kinds of trouble.

What's going on with colonic cleanses and colonic irrigation as like a health fad? Yeah, like a really bad idea. So if we take colonic irrigation as an example, most people who are going for colonic irrigation will be going because they have some kind of digestive problem that they're worried about. So it might be that they're just feeling a bit bloated or it might be that they've got a bit of diarrhea or constipation. So they're going to

a beauty salon effectively to have colonic irrigation. And what happens in that is they pass a tube up your bottom and then introduce a lot of water into the bowel. And that essentially kind of flushes out all of the, whatever's in your colon. Your colon's a meter and a half long, right? It's a big organ. And so actually it's got a lot of stuff in there that's supposed to be in there. Stuff that's feeding your microbiome, bits of it that actually are your microbiome that you want to keep in there. They're really important.

um but also if you've got any gut symptoms and then you fill your colon with loads of water and put it under pressure you're at risk of perforation right because the person who's a beauty person who does your colonic irrigation doesn't know doesn't have these skills to find out whether actually you've got a bowel cancer or you've got something structurally wrong with your bowel that is causing those symptoms maybe your gp doesn't even have the skills to do that you might have diverticular disease where the structure is affected and there's narrowings and there's like

bits of the bowel wall that are really vulnerable introduce a load of water into that environment put it under pressure perforations can happen really easily there's absolutely no health benefits to colonic irrigation but loads of reasons that everybody should absolutely avoid it

Fantastic. A lot of people seem to be going on gluten-free diets these days. What's the deal with gluten-free diets? Yeah, super trendy, right? So about 1% of the UK population has celiac disease. So that's where gluten is physically toxic to your bowel wall. So it causes physical damage to the lining of the bowel wall. And that's an autoimmune condition. So it's a generally inherited autoimmune condition.

So in their case, gluten should absolutely be avoided at all costs, including like a tiny crumb of gluten that could be on a chopping board or in the same fryer. So, you know, frying chips and they've got had batter in there, then they can't have chips that are fried in the same thing. So those people have to be super, super careful with gluten.

The rate of celiac disease hasn't increased over the last few years at all, but the number of people on a gluten-free diet has increased exponentially thanks to people like Gwyneth Paltrow and other people who are promoting gluten-free diets as some sort of health elixir. Of course, in reality, that's just a low-carb diet through the back door, right? So people are like, I've lost loads of weight on a gluten-free diet. It's just because you're not eating carbs anymore. That's the reason you've lost weight. It's not good for you. It's not helping you.

Gluten is this tiny little protein molecule that never did anyone any harm apart from this 1% of the population, but it's been completely demonized by the kind of wellness community. And this sort of has pros and cons for the celiac community because now everywhere you go, you can get really good celiac products and gluten-free products, right? Which is great. When I first started working as a dietician, gluten-free bread was horrendous and you couldn't buy gluten-free cake anywhere. And now everywhere you go has gluten-free options, but it's also made gluten

shop owners, so restaurants, that kind of thing, less worried about it. So people think you're just on a gluten-free diet because you're being fussy as opposed to having a true allergy. So they're not necessarily handling things carefully or doing it because it's someone who's got celiac disease. They're doing it because it's someone that they think is just on a fad diet, which causes all kinds of trouble for people who do live with celiac disease. So there are pros and cons to that. We see that in other allergies as well. So like

there's a couple of instances of like vegan food trucks giving people dairy with dairy allergies anaphylaxis because they're just not being that careful because they're just being they're trying to be vegan but they're not careful with contamination so people who have anaphylactic dairy allergy think it's fine but actually it's

It's not. So there's all kinds of trouble with that. But ultimately, again, no benefits to cutting out gluten, loads of downsides, including things like affecting quality of life. So cutting out gluten is not a good idea for anyone and not necessary unless you have celiac disease or some people with IBS do struggle with tolerating gluten. But it's usually not just gluten. So what I find is people have cut out gluten. They're like, oh, I felt a bit better, but it wasn't altogether better. And that's because there's lots of other things that impact symptoms and IBS that we can do as a clinical treatment diet. So would you suggest like, would it be worth it?

random person

just cutting out gluten for a week and seeing seeing what happens or is that like too much of a n equals one bro science yeah i mean not unless they have any symptoms not unless they like massively suspect that gluten is causing the problems and again you know if you have some gut symptoms and you cut out gluten you might feel a bit better and then you might start to feel worse again but the chances are it's not because it was the gluten in the first place it's because you change your diet completely so people might cut out gluten and then they don't eat the burger they don't eat the pizza and they don't eat the other things so they feel better but actually it's not because they cut out gluten it's because they're not eating processed food in the same way

We talked a little bit, we touched a little bit earlier on dairy and kind of dairy is bad and replacing milk with oat milk, almond milk, soy milk, all that jazz. I guess what's the health side of things?

And I guess some people have an aversion to dairy for the animal cruelty side of things. So how do you balance these things? Yeah, I think it's really important to recognize there are lots of different reasons for coming off dairy, for being a vegan, whatever it might be. And if those are ethical or they are environmental or they are for reasons of religion, for example, then obviously that's absolutely the right thing for you.

for you to do and I would never want anyone to listen to this and think that I'm saying that you have to drink milk if it's really in congruence with your ethical beliefs or your religious beliefs for that matter because obviously that would make you feel really unhappy and uncomfortable and that's not the right thing for anyone to do

But if you're doing it for health reasons, there's absolutely no data to show that plant milks are better for you as a human than dairy milk. And in fact, all the data that we have today shows that people who don't consume dairy have much poorer bone health. So people who are vegans have a much higher instance of bone fracture than people who are not vegans.

We have this really interesting period in our lives. So up until the age of 30, we can continue to mineralize our bones. So all the minerals we take in in our diet can be soaked into our bones up until the age of 30. We call that our peak bone density. After the age of 30, it's basically downhill from there. And your bones then act as like a mineral store for your body for the rest of your life.

So within our bodies, we always have to maintain a really careful band of how much calcium and how much magnesium and how much other minerals we have in our body because they're essential for the contraction of our heart and the movement of our lungs and everything else. So blood minerals will always be the same and our body will either take those minerals from the foods that we're eating or it'll leach them from our bones in order to make sure we maintain that really tight level of mineral control in our bloodstream, right? So...

You could spend all of your early 20s, teens not having enough dairy in your diet because someone on the internet told you to not have it because it's not good for you or because of something you've seen and that makes you feel uncomfortable. But you never reach your peak bone mass. And then every day after that, you're just depleting your stores. And so by the time you're 40, your bones could be really brittle. And we see this in children. So even if children who...

have to have even children have to have a dairy-free diet because of dairy allergy they'll never have as strong bones or be as tall as children who consume dairy as they're growing up

So it has a direct impact on our bone health. And people say to me, well, people in China don't eat dairy and they're fine, but they eat like broth with bones in it. So they're constantly having different things in their diet that contain loads of calcium. We're talking about a Western diet type population where we just don't have other good sources of bones, of calcium in our diet. And the matrix of minerals in dairy is really, really important for our bone health.

But it's also one of our main, dairy has been historically and still continues to be one of our main sources of iodine. And iodine has an impact on your thyroid function. And we're seeing loads and loads of young people coming through with iodine deficiency and thyroid problems because they've cut out dairy. And again, I'm going to say it again, the influencers who told you to don't have any, like there's no consequences for them on that. Low iodine can cause infertility. No one's got any, like no one can come back on people that told them to do that. So

Dairy is a very useful food to consume in your diet and if you have cut it out because you think it's healthier for you, you've been misled. If you've cut it out because you've watched documentaries about hormones in cow's milk as well, you've been misled in the UK because we have very different and very careful farming practices in the UK in comparison to America where those documentaries are made.

So let's say someone is vegan for ethical reasons. What can they do to minimize the negative impact of not having dairy? Great question. So what they're willing to be focusing on is making sure that all of their plant-based products are, well, things are fortified with calcium, essentially. You also need to be taking supplements. So you need to be thinking about iodine supplements. You need to be thinking about B vitamin supplements. There's lots of things that you need to be adding in. But dairy, taking out dairy, dairy's got these nine really important nutrients that just are harder to find elsewhere. So if you are someone who has like a,

family history of osteoporosis for example you might want to think about taking some extra supplements getting a bone scan regularly just to make sure you're not doing yourself any harm there but fortified foods are important and supplements are important and making sure you're eating lots of plants that do contain calcium is really important uh changing gears a little bit uh why are some people saying seed oils are evil

I don't know. I think they've just made it up. So there's some interesting rhetoric. I've not done any reading about this, so this is my intake. This is my take on it. There's some interesting rhetoric around how seed oils can have an impact, like a pro-inflammatory impact on our body. And as far as I know, there's no convincing data. And my amazing friends who are incredible researchers in lipids and stuff like that, they say it's all nonsense. So whatever they say, I go, okay, they know way more about this than I do, and they're right. So

There's no data to suggest that seed oils are having this kind of impact that people are worried about, as far as we know to date, and none of it's very convincing. What we do know is if we heat certain oils, they can have a more pro-inflammatory effect in the body. And that's why we think about things like being careful with fried food, for example, because we know that can be less positive for us. We also think about

like manufactured oils as just not being so good for us. So things like trans fats, they're called. So when fats are changed in structure from their natural form, which might be liquid at room temperature to being solid at room temperature, they can make like a margarine. That kind of stuff isn't very good for us. Our body can't recognize it as being a natural thing. So it becomes less positive for us. So there are certainly things in that world that are true, but I think that the seed oils hype is not accurate to date. Nice. I'm just going back to the milk thing. Full fat, semi-skimmed, skimmed milk,

Do you know what? From an obesity perspective, what we see from the data is that people who consume whole milk generally have a lower body weight than people who consume skimmed milk, which is really interesting. There's lots of reasons that that could be, including that people who drink skimmed milk are the people who drink it because they struggle with their body weight in the first place. So we don't know for sure. But actually, it seems to be that the minerals in dairy bind some of the fat and stop it from being absorbed as effectively. So we maybe don't access all of the fat from dairy.

which may also account for like the French paradox stuff where they eat a lot of cheese, but actually they don't necessarily have higher level. They have better cholesterol levels than we do as a population. So there's some interesting stuff in there, but in general, we do recommend that people think about having lower fat dairy products, but I don't mean by that to have like fat free yogurt, that's got loads of sweeteners and other things and flavorings and stuff like that in it. I mean, to try and keep things as natural as possible. Um,

We've touched on the topic of calories quite a lot, but we haven't really, you know, what's your view on calories? Very broad question. I mean, I think they've become this

really like hyper fixated thing. And actually, it's just a unit of measure, right? It's just a unit of energy. It's just a physics thing. So calories in, calories out, we talk about a bit. It's just a unit of energy, how much energy you're burning, how much energy you're taking in. I think that they've become this like thing that we hyper fixate on. And it's worth people remembering that labels for food are allowed to be up to 20%

incorrect so when you're using any kind of tracking app actually it's going to be at least 20% either side so where people are going I've got 10 calories left I'm going to have one more peanut actually that's complete nonsense right yeah well yeah but some people are numbers people right and that's where they can get fixated on things and it makes things worse for them ultimately mental health wise and everything else

nuts we know like the almond story you just can't or the nut story you just can't absorb all of the fat from that so what it says on the label is not going to be what you absorb from it when we cook celery it's got more calories and we don't cook it all these things like have an impact on stuff because of how we can access the calories and like ultimately if we could all go away from the calories and start thinking about are we physically hungry that would be the best way to think about things so

If you're physically hungry, you should eat to your satiety and then you should stop eating until you feel physically hungry again. Right. But most of us are making food decisions based on the fact that we're bored or we're lonely or we're tired or we're having like an emotional reaction to something. So we want to eat or in a restaurant and it's delicious. We eat way beyond our fullness, all that kind of stuff. So the way that we work in clinic with these kinds of things is teaching people to eat.

listen to their hunger cues, listen to their body, trust their hunger hormones a little bit more, which is difficult work and it takes a long time. But counting calories is counterintuitive to you learning to trust your body and having a healthy relationship with food for the rest of your life. So we never recommend calorie counting to anybody because it can have this really undermining impact on your ability to listen to your hunger hormones and listen to your fullness hormones and all that kind of stuff. So let's say someone does want to lose weight.

And this could be totally wrong, but I was under the impression that, oh, if I'm feeling hungry, it means it's working. Sure. Yeah, yeah, yeah. But I mean, feeling hungry is not a good thing, is it? Because when you're hungry, you're also really stressed and anxious. It's like a cortisol reaction. I find myself watching a lot of food videos when I'm feeling hungry at night time thinking, it's got to be done to get that visceral adipose tissue down.

Yeah, no, you don't have to do that. You don't have to live like that. You don't have to live that way. When you're hungry, you're potentially tapping into your body's fat stores, but also when you're managing your diet properly and your appetite's regulated properly, you'll also be tapping into your body's fat stores and you can do that in many different ways. There's no need for you to

be physically hungry. Going to sleep hungry means you sleep much less well, you feel hungry all night, your body's keeping you awake because it's saying we need to eat something. So actually it's about trying to manage your appetite better through the day so that you're not feeling hungry at any point because when we're hungry and when we're tired and when we're stressed we're much more likely to eat things

that we don't necessarily feel that are in line with our health goals at that time. So for example, when you're stressed or when you're tired, your brain releases much more dopamine in response to eating certain foods than it would if you're not stressed and you're not tired. And there's great studies from King's that show that people who are tired, so sleep deprived, so we sleep deprived them in the lab and then we offer them food freely. When you're sleep deprived, you eat on average 400 to 500 calories a day more than when you're not sleep deprived.

tiredness lights when you eat something particularly something that's high in fat and carbohydrates when you're tired the dopamine receptors in your brain are lit up so much more because your body's saying yes more energy we need more energy to stay awake same with when you're stressed because it's fight or flight your body's saying yes more energy we need to run or fight

So managing stress, managing tiredness, all these kinds of things, those are the things to get out your way. And if your diet regime is making you hungry, so you're really tired, hunger, it also goes through all the anger and cortisol pathways in our brain. So you're more stressed, you're more tired, you're more likely to want to overeat and not regulate your appetite at all. And that's got loads of detrimental impacts on you. To what extent is mindful eating helpful?

Yeah, super helpful, super helpful. So if you think about sitting down with a small amount of food and consuming it mindfully, listening to your body, checking in. So the way that I might work this in practice would be, I would say you can have as much of this, you're gonna make yourself a meal and you can have as much of it as you want to have. But first of all, I'd like you to take away kind of a smallish portion of it, take it to the sofa, eat it properly, engage with it, try not to have lots of distractions around you, chew it properly, take your time away from it. And once you've finished it, have a little check-in. Am I feeling full? Do I want more?

what what do i feel like right now if you still feel hungry great have some more but if you don't let's just pause there go and do something else distract yourself from the food you don't need any more food so it's about kind of tuning in listening chewing properly all those things are really important as part of that sweet bit random but i find that when i eat certain things my belly bloats a little bit it's not to the point of uncomfortableness but it's just sometimes i wake up in the morning and i and i look down i'm like oh you know

you know fairly flat belly and other times i wake up in the morning like this morning and i'm like damn how did i get so fat overnight what's going on there so different foods ferment at different rates and produce different type amounts of gas in our colon and when your colon because it is a meter and a half long it's a big organ when it's full of gas you look bigger then you might go for a poo and pass some gas and you're kind of back to normal right one of the things that we see from this kind of instagram culture stuff is that people think that

these people are maintaining this very flat first thing in the morning belly all day long when actually everything that you eat especially if you're a very slim person everything you eat is almost visible in your tummy so you'll be aware of it and you can see it if you carry a very low body fat percentage so all of the models that are doing the posing are doing it first thing in the morning and they're probably dehydrated and starved because that's when they look most ripped as it were and actually everything you eat has an impact and you can see it so yeah it's normal normal to have a bit of bloating and you know

if you have a bit of bloating after eating beans and lentils and pulses and like garlic and onion and that kind of stuff that's completely normal because your gut bacteria love it and they're fermenting it there's nothing I can be I can be like oh I look more bloated today and I had avocado yesterday therefore avocado is bad for me is it

Is there any kind of bro science there that works? You can think about that. So things that are most likely to ferment in your gut are these, what we call fermentable carbohydrates. And the biggest culprits that we see in clinical practice are onion and garlic, pulses, apples and pears, and some of these kind of quite commonly consumed foods.

So if it's something that bothers you, or if it's certainly causing you any pain, if it's something that's bothering you mentally or physically, it's worth going to see a dietitian because we can tell you exactly what it is that's causing it. And you can choose to avoid it on the days that you don't want to feel bloated, but then you can go out for dinner and eat whatever you like and be okay. Nice.

To what extent is glucose monitoring for glucose spikes useful? Great question. I mean, this is kind of outside of my area of expertise, if I'm honest. My experience of people monitoring their blood glucose is that they get very worried about things that are completely physiologically normal because

because actually our blood sugars are supposed to fluctuate during the day they're supposed to go up and down your body has very good mechanisms of controlling your blood glucose and if you're worried about an increase in your blood glucose that maintains it within the normal range you're worrying about something that you should just be really happy that your body's doing that you don't need to worry about the fact that that's happening so i think it can it attracts people who are hyper fixating on their health anyway and it creates additional anxiety about everything they put in their mouth so ultimately i think it's

really unhelpful particularly in the long term might be interesting as a snapshot for a very short term under supervision with support but I just don't think it's something we need to be encouraging people to do at all so if for example I eat an avocado and it causes me more of a glucose spike than it does my mate did

Does that tell me anything about like the way my body is absorbing avocado is different and therefore I should avoid them or anything like that? It doesn't mean you should avoid them. No, it just means that you might want to think about combining them with other things that has less of an impact. I mean, avocado, just so you know, isn't going to spike anyone's blood sugar. But...

Yeah, it's just something, banana is a better example, right? So if you and your friend both eat a banana and it spikes yours more, are we talking about spiking you outside the normal range, in which case it's worth having a chat with somebody about that? Or are we just talking about increasing it slightly, in which case it's fine? Also really worth remembering that a banana is not a standard food, same as an avocado. Like they all are a different size and shape. If you eat a banana when it's more ripe, it's got more available sugar than when it's less ripe. And as long as your blood sugars are staying, rising and falling within the normal range of what we know to be healthy, you've literally got nothing to worry about.

Nice. Do any research or stuff around things like the longevity side, like people taking metformin or statins and stuff, even though they are in their 20s? Yeah, I mean, there is some stuff around that. So when we developed the Smart Supplement, which is the multivitamin product for heights, we had to unfortunately get a bit involved in that world. And it is like an interesting...

I think, you know, I know from my medical colleagues that some cardiologists just start taking statins to protect themselves from a very young age, even though they haven't got high cholesterol. But there's also real statin deniers in the low carb community who are absolute charlatans and are causing all kinds of harm as well. So it's a real mixed picture, but I think...

Metformin is slightly, you know, can have an impact on your liver and have some more complicated side effects for some people some of the time. So, you know, I just don't think people need to be taking any prescription medications unless they're clinically indicated, obviously. But there is interesting discussions around that world and protecting yourself from high blood, like insulin resistance essentially is what metformin is protecting you from.

may have some benefits but the side effects probably outweigh it we don't have data on healthy people taking it and the potential side effects on that and what's better and what's worse so I would avoid it cool um I have a friend who wanted to lose a load of weight before his wedding day and so he took injections of semaglutide or something like that yeah and he said it was magical because it made suppressed his appetite massively made him feel nauseous every time he ate so he stopped eating basically yeah and he lost a load of weight before his wedding day yeah um

What's going on there? Is this some magical weight loss drug that isn't optically? I mean, you described it beautifully. It makes you feel terrible the whole time you're taking it and really nauseous. And so you don't eat, which then means you can't concentrate on anything. You have headaches. You feel awful. People passing out, all kinds of stuff. So like if you want that...

Fine. But you don't have to go down that route, right? There's so many better, healthier ways of doing it. And what you'll probably notice is your friend puts on all that weight again because as soon as you stop feeling nauseous, you're like, oh my God, food's my friend again. And you haven't learned anything about actually looking after your body, which is what behavior change is all about. Love it.

Just a couple more questions and then I'd love to talk about the probiotic and like the ways you guys made it and all that kind of stuff. We kind of touched a little bit on kind of brain function and mood and concentration and things. I wonder if you could just sort of, you know, if someone was being like, hey, Sophie, how do I

How do I change my diet such that it improves my brain function or improves my mood? What are the top recommendations here? Yeah, great question. So omega-3s are super, super important for our brain structure, as we've talked about, and they can also help to protect us from excess inflammation in the brain, which is linked to anxiety and depression and stuff like that. So either make sure you're having at least two portions of oily fish a week or take your omega-3 supplements.

B vitamins are incredibly important for our brain health. They produce, they make things like serotonin, melatonin, all of our, they make dopamine, GABA, all of these really important brain chemicals that we really need all the time. So B vitamins are really essential for brain function. And we've got some really interesting work showing that you can use B vitamins in

in controlled circumstances, in replacement of SSRIs, so anxiety and depression treatments, and they work in a very similar way in the right doses at the right moment for the right people. So B vitamins are super, super important for general brain function and brain health. And then we also think about things like antioxidants, and particularly the anthocyanins from blueberries are amazing for our brain health. So not just blueberries, but anthocyanins come in like red cabbage, other dark purple vegetables.

And there's some amazing data showing that if children are given a blueberry smoothie before an exam, they perform better in that exam than the children who haven't had a blueberry smoothie. And then when we swap them over and the level of the exam stays the same and the first children are given the blueberry smoothie, not given the blueberry smoothie, second children are, the children who had the blueberry smoothie always perform better than the children who didn't have the blueberry smoothie.

So what we think is happening there is it's getting better blood to your brain. And that is meaning that you can have a better mental performance in a very short period of time. Just having that direct impact on your brain health in that moment. And so with the smart supplement, we've got B vitamins. We've got other things like iodine that are missing from people's diets that have a big impact. But we've also got vitamin D, which you really need for your brain health as well. I should have mentioned that. But we've got amigas, B vitamins and anthocyanins as kind of the core components with the other essential things around it.

and I mean I designed this right and then you you do all the research and you put something together and you think you know I think that's going to work really well given the research that we've got but you always always have this kind of slight skepticism and then when the reviews started coming in for it I was like my god it's really working for people and it really works for me as well I think with my ADHD and stuff those nutrients are so important to me and it really helps in terms of brain function for lots of people and the reviews really kind of speak for themselves on that

Can we zoom into vitamin D? What's going on with vitamin D? Sure. Just so everyone knows, everyone should be taking vitamin D in the winter months in the northern hemisphere because we just don't get enough sunlight. So the darker your skin, the less able you are to synthesize enough vitamin D from the sunlight. So the way that those studies are conducted are that people of all different skin colors are put in the...

Spanish sunshine in the summer for an hour at lunchtime and they see how much vitamin D is increased and they can see that the darker your skin, the longer you need to be in the sun to synthesize the same amount of vitamin D and the lighter your skin, the less amount of time you need to be in the sun to synthesize vitamin D. I'm a ginger. I synthesize more vitamin D than anyone else in the world.

superpowers. So vitamin D is really, really important for loads of different things. We think of it more as being like a hormone now rather than a vitamin. So we see it within that capacity and it helps to protect us from cancer. It helps protect us from, you know, it's really important for our immune function. It's really important for our brain health. Vitamin D is a really, really essential nutrient for all of us. And it speaks to

how our society has changed now that we work indoors and we stay indoors all day that, you know, such a huge percentage of the population are vitamin D deficient, especially at this time of year. So vitamin D supplements are super, super important. I take them all year round.

I think everyone else should too, but the government recommendations are that everyone takes them between October and April. What other supplements do you take? I take Heights, basically. That's all. Nice. Fair enough. Easy. Chicks the box. Okay. Let's talk about how you develop these. But before we go there, why is the word supplement often associated with the word scam? Yeah. I mean, because so much of it is. The industry is honestly the wild west. And so I started working with guys from Heights and

I think probably about five years ago when I was still working at King's and I hadn't really realized what a mess the industry was as a whole. So it's a really complicated thing and a difficult thing to make a really good quality supplement product. So most people just don't bother.

And worryingly, anyone could go to a supplement manufacturer, anyone with no qualifications at all and say, I want to put this much of this thing in a capsule and they can make that and sell it. And no one's necessarily checking that and making sure that it's safe. It's the right quantities. It's suitable for everybody. It's like anyone can do it. And that's why we see all these influencers and stuff like that, flogging supplements and all this sort of stuff, because they can just make their own any day that they want to. It's a really real minefield.

All of the ones that are on the shelves in shops and stuff like that, the quality of them is incredibly variable. Even the more expensive ones, there's some really, like really eye-wateringly expensive supplements now that I look at the formulation, I think, why have you put those things together? They don't work together. They're counteracting each other. They're all trying to do different things and fighting against each other. And that's because they've not had a dietician or a nutritionist, their qualified nutritionist, they're formulating for them and trying to help them to make the right decisions about what's going to work and what's not going to work.

We also have a problem with the supplement industry where something is trying to be right for everybody. So it's like, this is like a supplement for men. And I'm like, well, what about, is it for a man who does a lot of exercise or doesn't do any exercise? For a man who has a sedentary job or an active job? Is it for a man who is in his 70s or in his 30s? All different people, right? Need different things. So it's kind of about tailoring these sorts of things to specifically what you're looking for. But it is a minefield. And there's also...

big population level data to suggest that people who take supplements don't necessarily have better longevity or live longer or anything like that than people who don't like it's talking about have a to z multivitamin but i think that's largely because lots of people history i mean the quality of them has been terrible historically but also people take them as like a they just think that well if i take this i don't have to eat fruits and vegetables i have to do anything else i'm ticking the box and actually that's just not how it really works nice so

Let's say I, as an influencer, decided to shill my own supplement. Yeah. How does one go about making a supplement? So you would go to a supplement manufacturer and you would say, can you, I want to put some stuff in a capsule and sell it to people. And they would go, okay, what do you want to put in? And you might say, well, I think maybe a bit of this and a bit of that. And they would say, all right, well, why don't you also put this in and this in? Because they've got some of that on the shelves. And they go, well, I'll put this, a bit of this and a bit of that. And then they put a load of like

horrible stuff in there anti-caking agents and all kinds of other things you don't really want to be putting in your body um and then your pill is made and off you go oh and so if i were to be like let's let's add a stamp of kind of credibility on this let's consult a qualified dietitian and nutritionist or if i came to you and was like hey sophie can you help me make a supplement yeah

Would you just be like, all right, this is the list of ingredients you want to give to the manufacturer? So we would go, okay, who's it for? What's the target group? What are we looking for? What effect are we trying to have for people? What's the outcome that we want people to say or feel? What are we trying to aim for? Who are we trying to sell it to? Who's your target market? What are they doing? What's their lifestyle like? What foods are they likely to be eating or not eating? Like what does their diet look like roughly on average so that we can see what people are eating enough of and what they're not eating enough of. So they might need a little bit more of this and a bit less of this.

And then we would say, okay, these are the things that we think are really important. And then we go, all right, we can't fit all of that in. So let's adjust it. First of all, we'll look at all the research. We'd look at the papers in terms of how much of a B vitamin makes an impact on this, for example. Then we go, okay, well, what can we fit in a capsule? Do you want it to be two capsules or one capsule? What size capsule is right for your market? Is it people that are going to complain about it being too big? In which case we need to go down and are we going to have three a day or two a day? What's right for you? Right?

All this stuff to think about how much can we fit in? What's going to go in there? What's the price point? And what do you want to sell it at? Because some of the ingredients that I like to use are really expensive because they work really well. So it's kind of all of these puzzle pieces that we put in. And so that whole bit of conversation is clearly a lot longer than you going to manufacture and just saying, can you put this in a capsule, please? Right? So there's a lot more to think about if you're making things properly and thoughtfully and trying to have an impact like we've done with height. So it is a much more complicated process, takes a lot of time.

But then I come up with a formula, which then goes to the manufacturer for pricing and kind of whether they can fit it in a capsule. Some things take up more space than other things. You're moving things around a little bit, but that's basically the process of getting it to manufacture with a nutrition professional.

Nice. And so you've been helping to, well, you formulate Heights and also the smart probiotic. How did that process work? So probiotics, it turns out really difficult to make. So arguably more complicated than the smart supplement, even though the smart supplements look super complicated. So probiotics are fussy. So you have to be really careful with the environment that they're produced in. You have to use, it's much better to use what we call proprietary strains. So there'll be a few, there's a few really good probiotic manufacturers across Europe. I'm

and they have their own proprietary strains that all have research on them. So they'll have done specific research on their specific strains, which is important because all the different bacteria are genetically slightly different. So you might grow one in here and it's a bit genetically different to this one, but it might have the same name. So you want to get it from the people who've done the actual research on it. So that happens. Then you have to say, well, can we put these five different strains from your strain bank in combination? And they might say, well, no, because that one fights with that one and they don't get on and then they end up killing each other off. And then you say, okay, well...

this is how long we want to get so the sooner you get probiotic to people the better because if it sits on shelves every day that's on a shelf it's losing probiotic count right so some of the ones that you pick up from the back of a shelf at a health food store they've been sat there for two years there's not gonna be anything left in there realistically

then you have to think about the capsule so we want to make sure it's getting to your colon and not being released in the stomach or in the small bowel because if it gets released in the stomach too much then the acid kills off the probiotic bacteria so you've got to try and make sure it gets to the place where it survives and does its job so it's like a really complicated process and also things like so with vitamins now I'm like familiar with that and I'll say okay I want this much B vitamin and then I want that much of a probiotic but they're like oh it's really fluffy and it takes up loads of space and I'm like

but I don't understand why. And there's no, that's not for me. If you can explain to me why I can't have something, I can work around it. But it was like with that formula, it's like, here's what we want. And they come back and say, I can't do that. And I'm like,

But why? And they can't really properly explain why because it's just like a manufacturing thing. Like it's like that one's too fluffy or it doesn't work with this one or whatever it is. It was complicated. It took us two years to make that. But I'm super proud of it and the results have been amazing. And we're just, as I say, just doing the human trials with it now and listening to everyone's feedback. And it's been really positive. So what's in this? This is like a capsule with like powder and stuff in it? Yes, there's seven strains of probiotic bacteria in there. Okay. Yeah. So just like a load of bacteria? Yeah. So like loads and loads of bacteria.

And bacteria looks like powder? Yeah. Really? Yeah, yeah. So it's freeze-dried. I don't know how they make it work, to be honest. So it's basically loads and loads of probiotic bacteria that are dried, and then they are all coated, so micro-encapsulated. And that means that they can survive in your GI tract as carefully as possible.

- So the capsule is the? - Capsule keeps them alive, but they are also, the powder itself is also microencapsulated to help survivability even further. - Oh, that's fancy. And so what's the benefit of taking one of these? - So there's amazing data on probiotics in terms of, so that one in particular, the strains we focused on are gut-brain axis stuff. So making sure that your gut and your brain are communicating effectively, not over-communicating, but also these studies that we talked about, about anxiety and depression and cortisol levels, reducing cortisol levels, managing those kinds of things.

We've also got some amazing strains for general gut health in there. So you mentioned that you noticed your poo consistency had changed and was more consistent when you were taking it. And that's feedback that we've had from lots of our early customers is that if they had slightly too loose stools before, it was firmer. And if their stools were too hard before, it's more loose. So it's a better consistency for them. So consistency of stool is there. There's lots of stuff around general gut health, but also immunity and inflammation. So we think that inflammation is really, really key to lots of these conditions that we've talked about today. So we've kind of focused

really specifically on the strains that we know to have the effects that they want them to have, which is borne out in kind of all of everything that we do for heights. What you find with other probiotic products, most of them were designed for animals and they've just randomly come across a formula that they can see has some benefits in humans.

But, you know, probiotic research has moved on and we can be really specific and targeted about what we're looking for now. And I can see a world in the future where someone goes, all right, here's my probiotic for immunity. Here's my probiotic for my gut brain axis. Here's my probiotic for this. And they have a sort of piecing together of the different probiotic strains that they want to use rather than this kind of here's your gut health supplement type picture.

Would it be true that in an absolutely ideal world, if someone was getting all of their, like having a super healthy diet and stuff, they wouldn't need to take any supplements or probiotics? Or is there like additional alpha to be had by actually taking one of these?

Yeah. Well, so what we know to be true is that if you are able to eat perfectly every single day, all the things we've talked about already, making sure your diet is perfectly balanced all the time, drinking plenty of water, you're not drinking alcohol, you're not drinking too much tea and coffee, caffeine depletes this, blah, blah, blah. You're not stressed. Your life is ideal and you're super zen.

then probably you don't need a supplement, right? But the reality is most of us are rushing around, we're eating meal to meal, we're not thinking too much about it, we don't wanna think too much about it. We are eating croissants for breakfast instead of the things that we know to be better for us, all this kind of stuff is happening.

and we're stressed, which depletes our nutrients, and we are living in a polluted environment, which means we're using up more antioxidants, and our food is depleted in nutrients, and we are, and, and, and, and, and, we're having too much coffee, alcohol, these things that deplete everything. And so in reality, modern living means that nutritional supplements, vitamin supplements can be really beneficial for lots of people. With probiotics,

We evolved and our microbiome evolved in an environment where we lived much more closely with the earth, where we were growing our own vegetables and picking things from the ground and living much more closely with animals, pigs, sheep, that kind of stuff. And our microbiome was much, much more diverse. We ate seasonally, so we ate different things naturally.

We ate a lot more fermented foods because it was a good way of preserving things. We had a very different diet and lifestyle to what we've evolved to now, which is like a Western type lifestyle where our microbiome population is really, really different to what it was maybe even 50 years ago, certainly 100 years ago. And if we compare a Western microbiome to someone who lives in rural Africa or rural China, we can see ours is just so inferior in so many ways.

And people within that field would say, that's why we're suffering with diabetes, cardiovascular disease, depression, anxiety, because our microbiome is so affected. And if we add into that the way that we eat now,

But also the fact that many of us will have had lots of antibiotics growing up, which just kill off your microbiome. We also do all sorts of things that has an impact. We're more stressed, all that kind of stuff. We disinfect everything. We've spent however many years doing this hand gel stuff now. All of these things, we're careful with disinfectant, everything else. All these things impact our microbiome, preservatives in food, emulsifiers in food, all that stuff. And now we're in a situation where actually our microbiomes are kind of just not doing as good a job as they could do.

So introducing more probiotic strains, especially some of these kind of less commonly found microbial strains, bacterial strains, can obviously reseed our microbiome with lots of these beneficial things that we need and these impacts that they're having on us. So

you know, ideally we will eat beautifully and perfectly all the time. And we go out into nature all the time. We're hugging trees and we're kissing trees and touching the ground and all that kind of stuff and introducing bacteria. But in reality, that's not the world we live in. So I think we have to take a pragmatic look at that and think about what our bodies need, given the lifestyles that we lead.

What does the business of being a dietitian look like? If someone's listening to this and they're thinking, you know what, this dietitian thing sounds interesting, would you recommend it as a career? And then I guess, what does that, I guess, building your own business off the back end look like as well? Yeah, I mean, it's a fantastic career. You can do, I mean, I've done so many different things within dietetics and you can do so many different things. And in theory, if I got bored of talking about the gut, which I never will, but if I did get bored of that tomorrow, I could go and do some work and become a diabetes dietitian. You know, I'd have to do some, go back to a basic level and train again. But

you know, I could go and learn about and completely do have a pivot, you know? So there's so many different things available and now is a great time to get into it because I

you know, everyone's talking about it. It's everywhere and it's becoming more and more important and more and more well-recognized, which is amazing as a profession. One of the things that's super important to remember is that you do a three or four year degree or you do a two year master's, then you need to go into the NHS and learn how to do your job, right? So people, young people now say to me, I just want to do what you do. And I'm like, I'm 15 years deep in my career, right? I've been doing this for a long time, did eight years in the NHS and

five years in academia now I do what I do and like you have got to do like you've got to do that time because every patient that you see in the NHS every colleague connection that you make it's a bit like driving a car you do when you pass your driving test is after that you come across all the different things that you need to learn about and what you need to bring to your practice you

If you as a newly qualified dietitian start trying to see patients in private practice, you're going to do them a massive disservice because you just don't know enough, right? And people are paying you and they're going to be really disappointed and they're going to go away and they're going to say, sorry dietitian, but you should just tell me to eat more vegetables and drink more water because that's all you know about, right?

So you have to do your time, you have to pay your dues. They say 10,000 hours, don't they, that makes you an expert in something. And I think that probably stands to reason with dietetics as well. I have no idea how many years that is, but I think you've got to go and learn on the job realistically. And, you know, in the UK, we're so lucky to have the NHS as a learning place.

facility like you can learn everything you need to know from everything in the NHS it's incredible and most countries would just kill to have the opportunity so as a dietitian it's really important to go and learn your craft find out which area you're really interested in get really passionate about it because otherwise you're going to end up talking about something you don't care about and hopefully it really comes across how much I'm interested and care about what I do because it makes a difference to your everyday life.

So it's really important you pay dues in that way. Then, so as a business, it works. So the way that my business runs, you can do it in lots of different ways, but the way that my business runs is the dietitians that work for me, they mostly all still work in the NHS or work in other areas or work in research, but we do a profit split situation. So we have a ratio that they take and I take. So we attract all the patients and we do the promotion of everybody and we maintain the website. We have a full admin team, all that kind of stuff.

the dieticians come and see their patients and they take a cut of what we take from them so they take a favourable cut compared to other clinics of what we take and that business like is I love it I'm really passionate about it because I really want to bring really great evidence-based nutrition to people who have medical conditions because otherwise they see people and get completely messed up and go in the wrong direction and

But it's not necessarily a hugely profitable business. It's great. I love it. I love seeing patients and I will always do it. But it's not necessarily hugely profitable because you're just working on this profit split situation. So I would say that the dietitians who work for me basically cover the admin and cover the cost. And then I take the profit of the patients that I see essentially, which is fine. Works well for me. Then the consultancy is a much easier way of having consistent revenue. So if a dietitian is listening or someone who's thinking about this is listening, they're

having clinic income. And just to be clear, I only work in clinic two days a week. So I'm always physically present and

from a CEO perspective, always present to run that business. But like in terms of clinic hours, I do two days a week in clinic. Then the other three days a week, I do consultancy and having consultancy income is super, super helpful and important because it's consistent. And it means that you know what you're getting. Whereas particularly when you're building up your clinic business, you are going to end up with maybe three patients one week and no patients the next week. And that's just not something you can live on.

So it takes time to build that up and now I'm fully booked until May because of the show which is amazing but also just a bit overwhelming so yeah so you need a bit of everything and keeping your fingers in pies is really important and now kind of adding more of the media stuff in is really helpful so it's about having those multiple income streams I think but

But really importantly, I think it really helps for them all to be on the same thread because I spend a lot of time trying to do some social media stuff. The more social media stuff I do gets people into clinic. So if I was on social media talking about diabetes, but I only see gut health patients, it's not going to work, is it? So I talk about gut health on there, that feeds into there. All my time is kind of, you know, on the TV talking about gut health, that feeds into clinic and it all works together.

as opposed to it being kind of all over the place. The power of having a niche. Yeah, exactly. Yeah, we talk about this a lot for like YouTube channels and businesses and stuff. Yeah. I mean, it's a business, right? Like your personal brand is as the gut person. Yeah. I mean, it is now. It creates this virtual cycle. Yeah, I never thought it would be, but this is what I'm doing. Yeah.

Final question, how did you end up on TV? What was the story there? So I've always done a little, well, since I was at King's, I've done a little bit of TV work here and there, mainly kind of, you know, on the one show where they go, let's go and talk to our expert Sophie about this particular thing. So we go off and I've done kind of inside the factory and how to lose weight well, these kind of magazine-y type diet shows, that sort of thing. So I've done a fair bit of that, done some bit of live TV.

And then my lovely friends, Alana and Lisa, who run a company called The Gut Stuff, had been pitching this show to Channel 4 or to all production companies for ages.

about trying to bring gut health to the general population get people to understand a bit more about it and they finally got commissioned by the production company monkey and channel 4 took it which we filmed a pilot i obviously screen tested but these are kind of my friends so we wanted to work together screen tested helped them to kind of develop the format a little bit and then in terms of doing a bit more clinical stuff than perhaps i think about doing before

And then we filmed it. So Channel 4 commissioned it. We filmed it over the summer last year. It's kind of the process. Nice. Yeah, it's been amazing. It's like doing clinic, but with all my mates. Right. And we're like...

Do people like recognise you on the street now? Do you know what? I was so worried. This is an embarrassing story. I was so worried about being recognised. And I was saying to my agent, who I got after I got the show, I was like, I'm so worried about this. I'm quite a shy person naturally. Like when I'm talking about work, I'm fine. But when I'm on my own, I'm like always with my dog looking like shit. And like, I don't want people to be like, oh, you're that woman who talks about poo on the TV. The only person who's recognised me so far is the pest control man that was outside my house visiting a neighbour. Oh, nice.

so it's fine that's a good level of fame yeah for sure but you know what's really nice is I I suspect that people are recognizing me because I've heard a few conversations near me about the show and people saying have you seen that show on channel four and stuff like that so maybe people are I guess what I'm doing is not I'm not on love island right so I'm not having to people aren't no one's fangirling me they're just like oh that's interesting yeah I think that's her which is a nice it's a nice way of doing things for sure um any so for someone who's listened to the end of this very long conversation I

I think it would have been like two and a half hours. Sorry. And they're super into this gut stuff. They're like, I really want to find out more. What are some recommended resources that you can point people in the direction of? Listen, the psychobiotic, if you're interested in psychobiotics, Psychobiotic Revolution, John Kryan is an amazing place to start. It's really accessible and so super, super interesting. The gut stuff is,

who are part of the TV show. They have amazing resources on their website in terms of gut health and things like that. We've got loads of blogs on our website, which is citydietitians.co.uk. The girls who run our social media channels at City Dietitians, we've got loads of really interesting information coming up all the time on there. They do an amazing job of running that. And obviously I'm on social media at Sophie Dietitian, lots of stuff on there that people can pick up. But there's, yeah, always sharing stuff so people can come along and find out. Fantastic. Sophie, thank you so much. It's been wonderful. Pleasure. Thank you.

All right, so that's it for this week's episode of Deep Dive. Thank you so much for watching or listening. All the links and resources that we mentioned in the podcast are gonna be linked down in the video description or in the show notes, depending on where you're watching or listening to this. If you're listening to this on a podcast platform, then do please leave us a review on the iTunes store. It really helps other people discover the podcast. Or if you're watching this in full HD or 4K on YouTube, then you can leave a comment down below and ask any questions or any insights or any thoughts about the episode. That would be awesome. And if you enjoyed this episode, you might like to check out this episode here as well, which links in with some of the stuff that we talked about in the episode.

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