Dr Rupy: There was a famous thing called slip, slap, slop in Australia to stop get people to slip on a hat, slop on the sun cream. Nobody mentioned food or smoking. You know, if you smoke in the sun, you've got two lots of carcinogen damaging your sun and it's been shown over and over again that that increases skin damage. On the other hand, if you drink a glass of red wine, eat some hummus and some olives, those counterbalance the direct damage from the sun.
Voiceover: Welcome to the Doctor's Kitchen podcast. The show about food, lifestyle, medicine and how to improve your health today. I'm Dr Rupy, your host. I'm a medical doctor, I study nutrition and I'm a firm believer in the power of food and lifestyle as medicine. Join me and my expert guests where we discuss the multiple determinants of what allows you to lead your best life.
Dr Rupy: I am so excited about today's podcast episode. Professor Robert is on the pod talking about his incredible new book, How to Live. I've recommended his previous books that have focused on the topic of cancer, such as Keep Healthy After Cancer, but this new book appears to cover every FAQ I've come across throughout the years of lecturing, speaking and demoing across the country and internationally. I highly, highly recommend this book. With over 500 references in the back, but explained in plain language in the text, Prof has really created a book that is super engaging and cuts through the noise, but it also tackles some of the most controversial topics in an open-minded manner, which I think is incredibly useful in today's misinformation environment. On today's pod, you will learn about toxins in food, chemicals in household products and whether to be worried about those, hormone disruption and what toxic load refers to, milk and cancer, xenoestrogens, which are synthetic oestrogens, what they actually mean and how to avoid them, EMF and whether there's evidence of harm, that's electromagnetic frequency, the beauty and utility of colourful food, why the gut is central to health and well-being, and tips and actions for you to take today to live better. As a reminder, Professor Robert Thomas is a consultant oncologist at Bedford and Addenbrooke's Hospitals, a clinical teacher at Cambridge University and visiting professor of sports and nutritional science at the University of Bedfordshire. He is life's lead of a lifestyle and cancer research unit and he has also a medical adviser to the website cancernet.co.uk. This is a brilliant podcast episode. I really hope you enjoy it and onto the pod.
Dr Rupy: Okay, I want to talk about your book. First of all, how on earth did you find the time to to write this book? Because it is, if I could describe it in a word, it's comprehensive. You know, you've got over 500 references in this and as I know, this is going to be the skimmed down version of the book. You must have written, you know, upwards of twice the amount of content to get it down into here. What what was that, what was that experience like?
Professor Robert Thomas: Well, as you know, you've written several books. It's it's, you know, it's it's satisfying because when you when you search for information and when you give a talk or write a paper, you know, you really have to understand the subject quite well. So it's a good way of educating yourself in the writing process. I mean, fortunately, we, you know, I've been doing lifestyle related research for over 20 years and written a fair amount of papers, up to 100 papers on different subjects, whether that's exercise, polyphenols, gut health, sugar, you know, I was getting so much criticism from people saying you shouldn't stop people eating sugar, but obviously the only way to defend yourself is to write an evidence review so you can have an intelligent argument. So all that data was essentially there. We added some and we had contributions from various people, like someone from the Royal Horticultural Society looking at the benefits of plants, etc. So I did get some great help from people. But it but it's it's the it's the process of changing a medical paper into a into a book which is aimed at the general public is the challenge. And I I wouldn't say I'm naturally gifted in writing, so that took a lot longer. But of course, it is through a publisher, so they do cover your back and rewrite chapters of sort of scientific blah, blah and convert it into lay language. So I was very grateful for that and that's why I think compared to my previous books, it's much more readable.
Dr Rupy: Yeah, because your previous books I always recommend to friends and colleagues. And unfortunately I've had a number of of people, as you know, that unfortunately have been diagnosed with cancer and they they look straight away to to me and other people, you know, to to offer some advice. And I always recommend your your your other books because they they are brilliant and they, like you said, they're a bit more medically focused. They they don't shy away from the science, which I think a lot of people appreciate. But this is almost like, you know, an FAQ section of the commonest questions that I get asked about, covering everything from the environment. You don't shy away from subjects here. You you talk about the environment, you talk about toxins, you talk about fats and cholesterol and all these different elements that I'm I'm sure you get asked about pretty much daily in clinic.
Professor Robert Thomas: Well, what I what I get, I mean, patients like, you know, they want to help themselves. The vast majority of patients. So, you know, the days of paternalism have gone. You know, if you had time, they would love to have a conversation, what they can do when they leave clinic, how, you know, and and the more I think people understand that these things do actually work, they're more likely to to change. Where people get confused is one doctor's telling them not to exercise or not or eat as much sugar as you want, and another doctor's telling them another thing and they feel, you know, demotivated. But if they they get a clear message which they believe in, they're more likely to to change. And you know, I am getting patients from around the country saying, you know, they've gone to their doctors and the doctor said, oh no, there's nothing you can do. It's just a genetic disease. And that could be talking about, you know, cholesterol, blood pressure, cancer, joint pains, anything. But they're told there's nothing they can do. It's a genetic disease. You just have to take the medication. And people are pushing back and saying, no, you know, I'm not going to go on to that statin. I mean, I saw a guy yesterday who had a cholesterol of 6.8 and declined statins and he followed the the guidelines. Okay, it took him 18 months, but he's got a cholesterol of 4.1 now and feels great. I know, you know, he's a particularly motivated individual. But nobody would say, oh, you're you're you're putting that man at risk with that advice because he's now not on a statin. It's better that he's not on a statin and has a low cholesterol. Um, you know, the same applies for cancer. We know that, um, you know, a lot, a lot of very unfortunate young people or any people get cancer and it comes back and it's dreadful. But the evidence is there that if you change your lifestyle, you do have a reduced risk of the cancer coming back. You have reduced risk of the serious chronic diseases you get after cancer treatments. So it's all about reducing your odds. And, uh, you know, I I believe most people want to hear those odds. They want to know what to do.
Dr Rupy: Yeah, absolutely. I think it's that, you know, that delicate combination of compassion and empathy for one's situation with the tools and the information. And I think the way you've presented it as well is very accessible and it just gives people the impetus and the motivation to make changes because, you know, like you said, that that sort of traditional paternalism that has been inbuilt in the medical education system, particularly perhaps when you were at medical school as well, you know, that that is slowly dying off and it and it should do because we need to have a bit more of a compatible relationship with people.
Professor Robert Thomas: Yeah, no, it's and and you know, it is changing, but I think it's changing too slowly. And and it is frustrating, you know, you've got a busy practice, someone comes in, blood pressure a bit raised. You have a chat, you know, they come back a month later. I mean, GPs don't rush into giving drugs. I have to say, I'm not criticizing, but you know, they're limited time and a lot of people don't change. But I found with persistence and and um, you know, with knowledge, they can. I mean, for example, I I I took a non-steroidal, this is about 20 years ago before a marathon, the worst thing you can do, by the way, because you get dehydrated and it concentrates. And I had high blood pressure for a year and there's no way I was going to go on antihypertensives. I knew what I'd done wrong and I just, you know, took celery and and beetroot smoothies and cut down my salt. And now my blood, you know, a year later, blood pressure is 119 over 65, you know, so, uh, I know that's a case of one, uh, but, but, you know, and I hear stories from lots of other motivated people. And it's such a shame when when you get a patient coming up to you and going, I said, what medication you on? And they say, just the usual doc, you know, the usual, as you know, is, you know, anti-indigestion, anti-blood pressure, laxatives, statins, anti-diabetic, costing themselves a lot of trauma and side effects, but also the country billions of pounds a year in medication which could be avoided.
Dr Rupy: Yeah, you know what? I I I literally had a patient like that on Sunday night who came into A&E and we, you know, he came for an unrelated issue and I asked him about his medication list. And I think it's because they've been on these meds for so long that it's just become habitual and become normalised. And he was like, bit of blood pressure, bit of diabetes, bit of GORD, you know, a little bit of the stomach. And you look at the list and you're like, oh my god, there's just so many on here. I mean, I know he came in for a completely different reason. But I think this time, particularly in a post-pandemic era, it marks a a a moment where it it could almost be like our Aneurin Bevan moment where we actually create something within our culture that encourages people to, yes, with compassion, take control of our lifestyles and our health such that we reduce the burden on the NHS and we actually give people the power and the tools to do so by changing our food landscape and getting a government in that actually encourages that as well. It makes a real, real effort to do so.
Professor Robert Thomas: Yeah, no, I I I think that's uh, you know, it's it's it's I always present, um, I mean, apart from being on your show, which is, you know, the highlight of my year, I have to say, you know, I've stopped being invited by drug companies to conferences because all I do is tell people not to take drugs. So, you know, I'm not I'm not going to any fans from the drug industry. But, you know, I always show in my talks, a guy who came to me with prostate cancer, just low-grade prostate cancer, and he was he was suitable for active surveillance. So, you know, we can just watch, see how he goes. But he was on the usual, you know, he had 10 different medications. So I was had the fortune of meeting him every three or four months for the first two years. And every time he came, he managed to stop one of his medications. And 18 months later, we managed to get him off everything. And it was so rewarding. And at the same time, his PSA and his prostate cancer got better. So most of the conversation wasn't about his prostate cancer, it was about, you know, you know, indigestion, doing these other things. And he was really grateful. Um, so, you know, sometimes, um, you know, having a disease which gets you into the medical profession or seeing a doctor like yourself gives you the opportunity to sort of work on the whole picture, not just one of the issues, because they're all they're all related at the end of the day, aren't they? You know, it's all chronic disease.
Dr Rupy: Yeah, absolutely. Yeah, you talk about the relationship actually between a whole bunch of different lifestyle related illnesses in the book as well. And I think, you know, it's uh, the the the challenge is scaling up that scenario that you've just described right there. And I think it comes down to, yes, a lot more medics talking about this as we are at the moment on this pod, but also giving people the tools and incentivising it and, you know, even subsidising things like fruits and vegetables or cook alongs or, you know, all these different lateral thinking movements that we we can't do on an individual level. We have to rely on on a government level.
Professor Robert Thomas: Yeah, and and some doctors are worried about the medical legal issues that if you stop a statin and they get a heart attack, they'll be sued. And I think that there needs to be a built-in protection from that. Um, so I've only had two complaints in the last 10 years and one was an end-stage bladder cancer and I did say, look, there's no point in having chemo, it's very toxic, it's only likely to help you. And I tried to talk about lifestyle. And they actually sort of made a complaint. They said, all the doctor was talking about was getting me to eat better. Fortunately, that was upheld by the ombudsman and that was encouraging. But still many doctors are sort of worried about stopping treatment and if they then go on to develop an issue. But that should be, you know, I don't I don't think they need to be, but that should be emphasized in training that, you know, it's it's it's you're not going to get sued if you don't start a statin or a blood pressure pill. It's perfectly appropriate to give the lifestyle. And lifestyle should be seen as a, you know, an integrative part of the management and just as important or even more important. And I love your comment about the, you know, most of the lifestyle things we do prevent a disease which might be 10 years away. Um, so, you know, we all think, oh, well, I'll I'll do it tomorrow, you know, but with COVID, it's likely, and I there's some my strong belief that if you change your lifestyle now, you might reduce the risk of an infection tomorrow. So it might give that extra incentive for people to say, well, now, you know, now we're in lockdown, now we're not doing much else, maybe concentrate more on my health. I hope so, anyway.
Dr Rupy: I really hope so. Yeah. No, I I echo that belief and um, I I think you hit on a a really important point there about the culture within medicine and the fear of being, um, you know, taken to the GMC or strung up in front of people for for giving lifestyle advice when the the patient themselves demanded a pill or, you know, a proper, quote unquote, intervention. Um, and that that is echoed by a lot of my colleagues who are not privy to nutritional medicine and lifestyle medicine and all the other adjuncts that we have to traditional therapies.
Dr Rupy: Let's talk about um, dietary toxins. I know I don't want to start because your your book is very positive and I love the title how to live. Um, but you but you do start talking about dietary toxins, which um, I I stay clear of because um, a lot of people might think, you know, I'm scaremongering or whatever, but I think it it really does warrant a conversation because a lot of people are not aware of where they lurk in food and and what things we need to actually be a bit more vocal about when when it comes to telling people what to avoid.
Professor Robert Thomas: Um, yeah, so as you say, the the advice in the book could really be split up into, you know, what to do more of and what to do less of. And dietary toxins could be carcinogens or pro-inflammatory chemicals or even things like processed sugar. Um, so yeah, just coming back to your point about the title, you'd be surprised how many meetings we had about the title. I mean, I'm sure you know this with your one, two, three cook, which I love. I think it's called one, two, three cook or something.
Dr Rupy: 3, 2, 1.
Professor Robert Thomas: Oh, that's the one. Sorry. Um, so, um, you know, it wasn't meant to be, you know, me sort of telling everyone how to live, you know, it's it's actually it was a bit of play on words. There's another popular book called How Not to Die. And we I thought, well, it's not just about how not to die, it's how to live, you know, without having on being on multiple medications, how to live without having a chronic disease, how to live with less fatigue, more ability to exercise. So that's what it's meant meant to be. It's not meant to be, you know, a a guide book for life. But anyway, that's that's a side issue. So I hope I hope people see that. Um, so yeah, so in avoiding toxins, you know, it's it's quite it's quite fascinating. If you look on the um, WHO website or uh, National Institute of Health website, you know, carcinogens are are really major um, etiology of of cancer, but other diseases like dementia, um, arthritis. And they're sort of, although we talk about them, I'm not sure how many people take them seriously. Um, and they they can stem from, you know, how the food is grown, you know, with pesticides, herbicides. So going on to organic will reduce that, although on a global perspective, I'm not sure how practical that is or whether it's needed. Um, don't forget it's uh, then is the cooking process. You know, if you if you get meat and and burn it on a griddle, as you know, the fat is converted into carcinogens. If you get sugary foods or or processed carbohydrates and then then heat them to a high temperatures in the oven, you get acrylamides, which are carcinogenic. So it's not just about the food themselves, it's how it's cooked. And then finally, it's how uh, what you eat them with. I love that a study from Maryland, which was a barbecue where they got um, half a half the sort of meals which was the standard, you know, you shove a a bit of meat onto a barbecue, you fry it to smithereens, it's completely black. You eat it on its own or maybe with some crisps and some sugary drink. And they measured the the uh, there's there's you can measure blood um, a blood test which looks at the number of um, sort of potential mutations which have developed, um, and also the number of carcinogens. And that was almost five times higher than people who'd had a similar amount of meat, but they'd cooked it more slowly, they hadn't burnt it, they'd marinated it with herbs and spices or in that trial particularly rosemary, and they'd eaten it with a salad. So, you know, it's it's about how you eat it, what you combine things with. So we're not telling to people, you can't eat this thing, you can't go for a barbecue, but just combine it with healthy things which are the natural antidotes. And then the other category, of course, are things you've put in cosmetics and, you know, we can't do a lot about air pollution perhaps, unless you move away from a main road. But you can choose to jog in a park rather than alongside of a road. You can reduce the amount of um, chemicals we use in the house, keep the windows open, have more house plants. Um, so on a daily basis, there is quite a lot you can do to reduce your um, your toxin exposure.
Dr Rupy: Yeah. This whole concept of toxin load is something I think I'm learning a bit more about myself because um, I I don't use many beauty products. Uh, I might use a a face wash and a and a moisturizer, but that that's about it. But how much do you think we need to be wary of what we put on our skin, what we wash ourselves with, and the other products that we use in our household? I mean, it's probably become even more important considering the last year where we spent most of the time in our houses.
Professor Robert Thomas: Yeah, yeah, a lot there's a lot of. There's there's some very good data on on this and I think I quote one in the study where if you looked at say a shampoo or or something which has got some parabens or a deodorant's got a bit of um, aluminium and you look at that on its own and you say, look, you know, they're very tiny amounts of chemicals and the data, you know, there's no significant link. And it's true, you know, if you just use that item with nothing else, the risk would be infinitesimally small. However, we don't, do we? We we have a shower gel, we then um, you know, maybe have a shampoo, maybe a deodorant. And there's a very good paper looking at the, as you just said, the toxic load throughout the day. And you combine that with maybe some phytoestrogens in your in your or xenoestrogens in your food, um, some aluminium or or maybe parabens. Um, and that total load has been investigated and it's the total load which matters. And that's not published on the back of individual products. They don't often compare their product in combination with 10 others which are similar. Uh, and that's where they get by, you know, that's why they don't get banned. But I always say to people, look, if you want to reduce, you know, I actually make my own cream, you know, I I wouldn't I don't buy commercial creams. Um, hence I've not been sponsored by L'Oreal to give a talk on this, obviously. Um, so I just get, you know, extra virgin olive oil, um, and some essential oils, uh, and some, you know, unprocessed or un um, there's there's like shea butter you can get which has not been uh, industrially processed. And you just mix it up with some um, emulsifiers and and that's what we use. I use it on my kids who've got a bit of eczema. Um, because it's got no polyphenols and no preservatives, no scent apart from what's in the essential oils. Um, but of course, they're very difficult to make commercially because they go off, you know, they get fungus on top of them within four weeks. Um, so, you know, I think there I think it's important, you know, and that's what I emphasize in the book, you know, try to limit the amount if if you have a daughter, if you take deodorant, just use them on days which really matter, you know, if you've got your first date or an important business meeting, uh, but don't just slap them on every day, you know, because it's the amount of you're taking every day of your your life, isn't it?
Dr Rupy: Yeah, absolutely. You know, I I'm really glad we're having this conversation. As a side note, I I know you you say that you can't cook, but if you were to do another book, it sounds like you could do a beauty book with creams and potions and everything else.
Professor Robert Thomas: Um, yeah, I think um, you know, it it it is a bug bear that you you you go to a dermatologist and instantly you get, you know, steroid cream and you look at the bases in the cream and it's all hydrocarbons, scents, preservatives, pesticides. Nobody seems to talk about that. Um, you know, I think there's a, you know, there are there are other people interested in this, but uh, I think this is where commercialism isn't good, you know, if you everyone's worried about the price and and these big companies have to make hundreds of thousands of a product and it has to last for three or four years in order for them to make any money, which is they need to. Um, but, you know, I think there's a role for these smaller, more bespoke companies who can make some sort of fresh products without these chemicals added.
Dr Rupy: Yeah, it's almost like um, there's a a local beauty industry that's waiting to revolutionize currently how we buy beauty products because like you said, you know, if you were to just mix all those products into a little pot and then put it on the shelf, it would go it would go off, which is why you need those preservatives um, to make it shelf stable and drive the price down. But these products would would be pretty fantastically expensive otherwise.
Professor Robert Thomas: Yeah, well, it depends, you know, if you if we're more used to buying locally and uh, buying off small wholesalers. So, you know, it might it I think there is a there it is possible.
Dr Rupy: Yeah. This is probably going to be a difficult question to answer, but do you think uh, obviously in combination with the other effects of sedentary lifestyle, low vitamin D, poor diets, um, would that toxic load have an impact on lifestyle related illnesses that we're seeing today?
Professor Robert Thomas: Um, yes, I mean, it's I I think with the exception of um, dementia, which which is sort of going going up, as you know, it's it's it's it's a very rapidly increasing disease, not just because people are getting older. Um, you know, I think if you've got toxins, I think they they can directly affect the brain even if you're healthy in other ways. Um, but for other diseases such as diabetes, heart disease, pancreatitis, I think there is clearly a balance, you know, you can you you know, you can get away with it. It's a bit like the barbecue story, you can get away with it. I mean, I probably drink a couple of glasses too too too many on a on a Friday evening. Um, you know, I I have tried to convince myself it's just the resveratrol, but you know, there are lots of negatives in alcohol. Alcohol itself is a toxin, you know, let's not fool ourselves. Um, but you know, it's a balance. If you if you eat that with lot, you know, if you have a good meal with it, um, you know, and then you go for a run the next day, it's all about the balance, you know, and and getting the balance right rather than putting people in a, you know, in a sort of on a pedestal and criticizing every move move they take. And I believe balance is, and you know, the same with sunbathing. I what I there was a famous thing called slip, slap, slop in Australia to stop get people to slip on a hat, slop on the sun cream. Nobody mentioned food and or smoking. You know, if you smoke in the sun, you've got two lots of carcinogen damaging your sun and it's been shown over and over again that that increases skin damage. On the other hand, if you drink a glass of red wine, eat some hummus and some olives, those counterbalance the direct damage from the sun. In fact, I saw a paper the other day saying, um, something like dietary sunscreens, they're called. So, you know, if you're going to go in the sun, which we all enjoy and it's good for you to a certain extent, you know, make sure you, you know, you have fruit and vegetables and herbs and spices that day.
Dr Rupy: Yeah, I I think I came across the same paper. It was like the equivalent of two cups of grapes or something like that in combination and it improved the um, what's the word they use? Phyto protective effect, photo protective effects uh, in combination with with uh, skin block as well. So that's super interesting. And I and I agree with you, we should also be talking about diet when it comes to skin too. Let's talk about um, the foods that we should be embracing and specifically those plant nitrates that we were talking about earlier and and what effect those might have versus the the nitrites that you you find in processed food.
Professor Robert Thomas: Yeah, yeah. Um, yeah, I mean, everyone gets super confused about nitrates, nitrites, nitrous oxide, nitric oxide. Um, I mean, I was interviewed um, about there was a paper coming out about processed meats and and the journalist said, but you're you're saying that nitrates are bad for you, but then nitrates are in plants. And and yes, they are. Um, and I was trying to explain that, um, when you have a nitrate in in meat, you're having it with protein and that's then converted into nitrous amines in the stomach, which is actually the carcinogen. But if you have uh, nitrates in plants, the polyphenols and the vitamin C in the plant converts that nitrates into nitric oxide, which actually is beneficial. It causes dilation of the blood pressure, brings your blood um, your blood pressure down, oxygenates your tissues. So it's not it's again, the combination. And obviously, when you have it in meat, you've got other bad things in the meat like uh, aromatic hydrocarbons and if you've burnt it, you've got smoke, or if it's smoked, you've got smoke directly. Um, so, you know, nitrates aren't bad in per se. And you've just mentioned, you know, celery, beetroot, pomegranate, grapes, broccoli, you know, take your pick. I think it's good cherries, um, it's a good idea to to make sure you you really on the day you're exercising, you really load yourself with those. And you will see a benefit as well. I mean, you'll it's not only reducing the free radical, it actually helps with the joint health. So a lot of athletes have to stop because they've pulled a muscle or they've damaged a joint and it protects you against that. Um, so yeah, there is there's a, you know, there's there's it's not just about the exercising, you need to sort of think what you're you're doing at the same time.
Dr Rupy: Yeah, yeah, exactly. And I think, you know, to that point about a high polyphenol rich diet, it's going to improve your gut health, it's going to improve weight control. In fact, I think you've spoken about weight control in in the book as well and um, you know, how it's not just about calorie restriction or energy restriction, it's about introducing things like spices and herbs and and even some some novel fruits as well.
Professor Robert Thomas: Yeah, yeah.
Dr Rupy: Brilliant. Well, Prof, this has been fantastic. I highly recommend people get the book. I'll be shouting about it for the rest of the year as well because I think it's just a a fantastic manual. And the way it's spaced out as well with paragraphs as well, it's not you can you can just dive into it and dive out as well if you have a have a question or you've read a headline, you can go back into reading the book and stuff. And I and I hope you'll you'll update it as well every every few years.
Professor Robert Thomas: Yeah, I hope so. It's a different, you know, some people read it from front to to back, um, and then you'll find there's some sections which might have repeated themselves a little bit. But we also want the chapters to be sort of standalone. So, um, you have to do, you have to repeat it. So if you want to just read about gut health or, you know, how to improve my exercise performance, hopefully you can dip in and just use it as a bit of a reference guide uh, as as well. So I, you know, I'm I'm it was a it was a nice experience to write it. You know, financially, as you know, it's not a big situation. You probably get paid, you know, less than the cleaner in the hospital by far. But it's a satisfying experience and it it's a way of processing your thoughts so that, you know, you can just understand the issues better. So I really it's really nice to have your comment and and comments from other readers which we're getting most days. So thanks for your support.
Dr Rupy: Definitely, of course, of course. I can't wait to continue to support it. Thank you so much, Robert. Honestly, this has been brilliant.
Dr Rupy: Thank you so much for listening to today's pod. I really do hope you get a copy of How to Live. It is a fantastic resource. I'm diving in into it every now and then as well, um, just when I need to refresh something or check up a reference. Uh, and I and I really hope it's going to be one of those books that gets new editions every few years or so just to keep it fresh because it's a brilliant piece of work and I I cannot recommend it enough. Thank you so much for listening to the pod today and I will see you next week.
