Dr Megan Rossi: After one particularly hard shift, he went and got a big Mac and he saw me in clinic about two weeks later and the look on his face as he described how disappointed he was that he just didn't get that buzz like he used to. It was like I'm taking something away from him. But then, you know, when we've talked it through, he was like, obviously I see the benefit. It's like, it was kind of like magic in a way that it just after the, you know, the five to six weeks, my taste buds just changed. And I'm like, you know what, it's not magic, it's based on science.
Dr Rupy: Yeah.
Dr Megan Rossi: We know that our microbes in our mouth as well as our taste buds really do change according to what we feed them.
Dr Rupy: 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. The benefits of a diverse and colourful diet are huge. And here with me to talk about it today is my good friend and colleague, Dr Megan Rossi, who is a registered dietitian with an award winning PhD in gut health and she's also a research fellow at King's College London. Megan is currently investigating nutrition based therapies in gut health, including pre and probiotics, dietary fibres, the low FODMAP diet and food additives, as well as running a gut health clinic in Harley Street. Plus, she's a brand new mum with a 10 month old called Archie, who is the cutest thing ever. And she has a little pup, Pistachio, as well. What an amazing feat that she has. Plus she's also got Bio-Me and a whole bunch of other things, including her latest book, Eat More, Live Well, which is a Sunday Times bestseller for good reasons. It's a brilliant resource for people wanting to learn more about the benefits of a happy gut, how it can improve mood, energy, weight, all the things that we talk about on the podcast really come down to a healthy microbiota. And she's included some brilliant meal plans for different gut needs as well. Today, we talk about a whole bunch of topics, but just to give you some top line ones, the benefits of a diverse diet, where and why the 30 plant points a week came from, training your taste buds to prefer plants. This is something that's super interesting. And we talk about the regeneration of taste receptors on in and around your mouth. What a healthy microbiota actually looks like and the role of testing, probiotics for immune support and skin conditions as well as skin ageing, and also how to reduce bloating when you're eating more plants. We talk about a whole bunch of more as well. I think you're really going to dig this episode. Plus, I'm doing a new thing, which is our podcast recipe of the week. Drum roll. I need to get a drum roll and put it in there. It's a recipe that reflects the topic of the conversation on the podcast. And this week's recipe is my easy coconut chickpea dahl, which you can find on the app on iPhone only. I'm sorry, Android users, please bear with me. You can get a seven day free trial with the app as well. We've got a ton of recipes that you can tailor according to your health needs using our simple but smart algorithm. There's a seven day free trial and all that kind of stuff. Plus, there are step by step images for every single recipe. So it's super easy to make recipes that align with your health goals. And the reason why I chose a coconut chickpea dahl is because it has over eight plant points, which, if you don't know what they are, you're going to find out on today's podcast. Check out the newsletter as well on the doctorskitchen.com. And if you enjoy these episodes, please do give us a five star review on Apple or wherever you get your podcast because it really does help. On to the podcast. Megan, thank you so much for coming back on the pod. So much has happened over the last couple of years since the last time you were here. Fill us in, what has been going on in your world?
Dr Megan Rossi: Gosh, what has it been about two years or so?
Dr Rupy: Yeah, two years.
Dr Megan Rossi: And then we can talk about that virus. In terms of I guess my research world, you know, COVID-19 has had such a huge impact on our ability to recruit to studies. You know, so a lot of our research studies looking at different things like food additives and inflammatory bowel disease, and looking at different fibres in IBS have actually had to be put on hold because, you know, we couldn't get the the participants to come in. Um so thankfully things are starting to open back up. Outside of that, I mean, the gut health clinic has has been a really exciting area that we've developed further. So we've got a team of now nine gut specialist dietitians.
Dr Rupy: Wow.
Dr Megan Rossi: Uh where, you know, it's just this huge demand for people to get, you know, quality support for for gut issues. And we know that, you know, 20% of people suffer with some sort of gut issue. So for me, it was really important, I guess, to create, you know, a team of people who actually know what they're talking about and very much evidence based and and can help people. What else has happened? Personal life, I've had a baby.
Dr Rupy: Yeah. Yeah, just that small addition. Yeah.
Dr Megan Rossi: Which is probably been the biggest rollercoaster of my life. Um yeah, absolutely. A little Archie, he's now 10 months old. Time flies as everyone always says. I'm going to be completely honest and say that it was incredibly hard, harder than what I thought to kind of juggle, you know, the work side of things, but then also, you know, trying to be a really dedicated mum. I think like, you know, four weeks after he was born, I had to do some media work for for Bio-Me, which is my food company as well that got launched. So, yeah, it was a lot to deal with. But I mean, there's nothing more special than when he looks up at you and you're just like having a really crappy day and you're like, okay, that's fine. I can handle having a crappy work day when I've got you to kind of play with at the end of the day.
Dr Rupy: Megan, you're such an inspiration, honestly. If you're like, if people only knew like the behind the scenes, just the just the the front of everything, just the the facade of of everything that you're doing with your gut clinic and your products and your books and everything. But the behind the scenes is even busier and that's like, it's just so amazing to see you juggle everything. I mean, I know I know it's a struggle, but still.
Dr Megan Rossi: Rupy, I mean, the same with you. We were just, you know, talking offline. There is just so much that goes on the back end where, you know, the hours that you have to put in to kind of, I guess, do your job justice and, you know, we both have the same message of trying to really help people live their, you know, healthiest, happiest self. And to do that, yeah, there's a lot of work behind the scenes, but it's all worth it, isn't it? At the end of the day.
Dr Rupy: Totally. Yeah, yeah. And I'm glad I I uh I do want to say here, I did predict uh I think I might have even said it on the podcast actually the last time we were on, I did predict that you're going to have a food brand. And I'm glad I I planted that seed subconsciously and it's grown.
Dr Megan Rossi: I reckon that was probably you because like I said, I I didn't really have any, you know, conscious ambitions of doing that. It just opportunities came up and I'm like, there's clearly a gap in the market. So, um, yeah, maybe you should get some shares in the company then.
Dr Rupy: Yeah, yeah, maybe. Well, if you if you do uh uh put any out for crowdfunding, then I'll definitely be the first one in the line. And and Rochelle actually did remind me to say that she absolutely loves the granola. We've got some in our in our kitchen. We always have it stocked, so it's it's amazing.
Dr Megan Rossi: And you got engaged.
Dr Rupy: Yeah, yeah. Yeah, I got engaged. And Nutmeg. I mean, what's happened in your world?
Dr Megan Rossi: Totally. Nutmeg and Pistachio still need to uh to meet. It's a very good combination that.
Dr Rupy: It is a good combo. Yeah, yeah, very Italian. You've got this new book, Eat More, Live Well. I absolutely love it. I've got a copy here. I've read the whole thing. You've got 80 new recipes in it. They're all look amazing. Um we're going to talk a bit about the front part of the book, which is where you've did done a a deep dive into something that you describe as the diversity diet that I want to ask you about. Why don't we start there actually? What what do you mean by the diversity diet and uh and and what's this been based on in terms of what the latest uh evidence is in the gut microbiota?
Dr Megan Rossi: Yeah, so essentially it's a a way of eating. So it's not like, you know, those restrictive diets. It's a principle backed by five key principles that essentially, I guess, taps into the latest scientific evidence about not only how our body works best, but our gut microbes work best. And I think that's, you know, been a really big, you know, missing part in how we understand food and nutrition impacts our overall health in terms of chronic diseases, but also longevity. And it's been the discovery of our gut microbiome, those trillions of microbes and how food impacts them is kind of like that missing kind of key in our understanding. And essentially it's that that made me write the new book in terms of trying to bring together, you know, that latest scientific evidence about what are the key principles, what things should we be thinking about in terms of not only nourishing our body, but also our gut microbes. And like I said, it's those five key principles, things like eating mostly plants, doesn't necessarily mean only plants, um focusing on inclusion, not necessarily exclusion, going for whole not refined, thinking about enjoying your food. So cultivating kind of that community around our nutrition because we know that actually that can have a really big impact on our digestion and also our relationship with food, which I think shouldn't be overlooked. Certainly, you know, as a clinician, I've I've seen for the past decade, people's relationship with food really is an important thing to tackle for long term overall health.
Dr Rupy: Yeah, yeah. I'm really glad and it's really refreshing to see that community element come into uh some of those principles because I think certainly as clinicians, we have a tendency to stick to what we believe is going to be a harder evidence, i.e. the calories or the amount of fibre down to the gram and stuff. But the communal aspect of eating and the method of eating and and even your beliefs about what you're eating can certainly have a demonstrable impact on on our physiology.
Dr Megan Rossi: Absolutely. I mean, you know very well about this nocebo effect. So the opposite of placebo. Placebo, if you, you know, take a supplement or eat a food and you think it's going to do you good, then, you know, about 30% of people do feel better. The nocebo effect essentially is the opposite of that, where if you're ingesting something which you think is bad for you, then you can physically manifest symptoms. And we see it all the time in our clinical trials at King's where we do blinded trials um in specifically in people with irritable bowel syndrome. If they have a belief that gluten is bad for them, uh even if we give them a non gluten food, but we they believe that that has gluten in it, they can actually physically manifest symptoms.
Dr Rupy: Wow.
Dr Megan Rossi: Um and it's not like, you know, people being crazy and it's all in their head. It's our body's natural protection. You know, if we get food poisoning because, you know, we have some off chicken, a lot of people can't ever eat chicken again, even if it's, you know, not off because they've got this association with that food. So, you know, the nocebo effect is such a huge one uh that I think we need to discuss more about um with all of these media headlines, you know, saying that these foods are really evil or they're really bad for you. Um yeah, because we know it plays out in in physiology like you said.
Dr Rupy: Yeah, yeah. And I think you're right, the vernacular that we use um particularly in the media uh can certainly have an impact as well. So we have to be uh cautious uh about how we describe foods. And and I think that's what you've done really excellently with, you know, your dismissal of things like super foods because there's a beautiful image, one of my favourite pages in the front end of the apple sliced in half and looking at all these different attributes, the micronutrients, the phytochemicals, the fibre and all that kind of stuff. And it makes you really appreciate these like humble hero foods that we kind of disregard as like average or regular, whereas you dive a little bit deeper, look under a microscope and you see just how amazing these foods can be. And and that's I guess the the sort of foundation of what the diversity principles are in terms of in terms of the diet.
Dr Megan Rossi: Absolutely. So each different type of, you know, plant food and when we say plants, a lot of people think, oh, it's just, you know, your fruit and your veg. But I talk about these super six. So you've got your whole grains, your nuts and seeds, your fruit, your veg, your legumes, your beans and your pulses and your herbs and your spices. And each different category provides your body with an array of different plant chemicals. Like you said, that humble apple contains over 300 plant chemicals, you know, 100 million bacteria in each and every apple. Um and there's just so many facets and that's, you know, just an apple. If you extrapolate that out to all the other foods available, you start to appreciate how, you know, amazing, you know, mother nature is. And therefore, to really maximize the nutrition you can give not only your body but the gut bacteria, you need to think about not just having apples every day, you know, mixing it up with things like buckwheat, quinoa, you know, bananas, peaches, all of that sort of stuff. So I I do recommend on the diversity diet for people to aim for at least 30 different types of plants per week. Um which, you know, for some people might be like, oh my god, that sounds horrendous. I could, you know, I'm not going to do all that shopping, it's going to cost more. But that's honestly not the case. So many, you know, simple hacks instead of just getting things like your can chickpeas, get your can three bean mix. Instead of just getting your pumpkin seeds, get your, you know, four seed mix. It's just wherever you can think diversity because each different type of plant will give your body different nutrients.
Dr Rupy: That's a really good point actually. Uh so I'm going to opt for garam masala rather than just standard cumin next time.
Dr Megan Rossi: Well, absolutely. I mean, that's that's kind of what the science is highlighting. And you know, it's not just I guess these different individual chemicals, but also there's this amazing synergistic effect of combining different foods. So we know that things like good sources of magnesium um and good sources of prebiotics. If you combine them together, actually the prebiotic, which is specific types of typically fibres that feed the good bacteria, actually help your body absorb magnesium more efficiently. So that's why if you get the date, you know, dates that contains the prebiotics and add some nut butter, that's contains the magnesium, you really that's like a winning combination. So this synergistic effect of food as well is, you know, another reason why we should start to think diversity wherever we can.
Dr Rupy: Yeah, definitely. And so so you mentioned these 30 plant uh plants a week and you've got plant points for every recipe that I think is a really nice uh sort of trigger for people to think about, okay, how am I getting diversity in in in this recipe? Where did the uh the research come from looking at these plant points? I know we've heard a lot from from different people in the gut sphere in both America and and over here as well in King's. Um what what where was the sort of foundation for that and and how do we see and what what sort of associations did we see with that?
Dr Megan Rossi: Yeah, so the key research came from Rob Knight's group in the US. Um and they brought together, they they collect a lot of microbiome data. So they have all of these volunteers sharing uh their stool samples um and also their dietary intake. And what they they found is that people who ate at least 30 different types of food um per week had better gut health, so more diverse range of microbiome, which is a bit of a marker for for gut health, um compared to those who ate the same 10 on repeat. Now, I think they they did a really great job because what they did is looked a little bit deeper and compared people who were vegan, so 100% plant based versus those who are omnivores. So still ate plenty of plants, but also ate animal products. And actually what they found is that despite all the myth or the rumors out there, being vegan didn't mean that people had better gut health. The key predictor was that diversity. And again, that's why, you know, when I'm talking about the diversity diet, the the concept is mostly plants, but it doesn't necessarily have to be only plants. Um I completely understand for, you know, cultural, environmental, religious, animal cruelty reasons, etc, why someone might want to go plants only. But actually, in terms of, you know, human health, the science doesn't necessarily say it's any healthier. In fact, as you are very aware, Rupy, if you are going 100% plant based, you do need to be careful of some key nutrients like things like choline, um long chain omega 3s, selenium, iron, all of those sorts of things. So you can get not all of them, but most of them from plants, but you have to be, you know, quite savvy with your nutrition.
Dr Rupy: Yeah, yeah. And I I really appreciate that perspective actually because even though I'm largely plant based as well, uh well, let's say largely 100% whole food plant based, I do still believe that for an optimal human diet, it does require uh different animal products and and there's evidence to show that. Whereas when we deal with diet, we're not just dealing with the food that we put on our plates, like you eloquently said, it's about the environment, your religious and cultural beliefs, your um your understanding of of how food impacts sustainability and and all these other elements. So unfortunately that can almost cloud uh the findings or the interpretation of findings that you'll find on social media. And it's um it's a difficult one to navigate. I mean, what what's your experience been uh like that regard especially as a lot of people might have jumped onto the term plant based to mean 100% uh whole food plant based, i.e. vegan.
Dr Megan Rossi: Yeah, so there there is a bit of a conversation to have. And again, that's, you know, something I I talk about in the book that the plant based is very much a spectrum. And the kind of the clue is in the name. So it's plant based. So the base of your diet is plants and whatever you choose to add on top of that is up to you. It's not necessarily plants only. Um and I think, you know, with social media, we have tended to kind of really latch on to um, you know, a title of of how we eat. So, you know, there are a lot of people who follow a vegan diet very strictly. Um and for for someone like me who, you know, talks about the evidence behind gut health to say that actually some animal products, things like oily fish and fermented dairy are beneficial for our health, they can get a little bit aggressive and upset um that that's not in line with I guess their beliefs and maybe what they've read from Dr Google. So there is kind of a fine line about, yeah, again, sharing that evidence based information but being cautious of other people's beliefs. Um and yeah, I guess that fine line between beliefs versus the evidence, which yeah, is something that hopefully we can use social media to kind of politely share um in an evidence based way.
Dr Rupy: It's a tricky environment to work in. I mean, you've been in this environment now for years as have I. So I I think uh we're sort of developing thicker skins when it comes to conversation. I mean, I I was just saying offline, like I I I'm actually looking forward to the day where I don't need to utilize social media as much as I have to at the moment because uh it you know, most of our uh environment is now moving digital. Like we already sort of living in the metaverse uh for want of a better word. So, yeah, I I just think curating that is is something that I think will give me personally a lot of head space. That will probably help my microbiota as well.
Dr Megan Rossi: Yeah, we absolutely know the stress of social media uh can have a negative impact on our gut microbes. Um yeah, and I mean it's the catch 22. We know that social media can be a really powerful platform for us to get our messages out there and reach people that perhaps we wouldn't have historically. But also, yeah, it it can be a hungry beast and it can be a bit frustrating when people can spread myths like wildfire and where, you know, working so hard to get some of the evidence out there and it doesn't quite uh I guess land as well as these myths.
Dr Rupy: Yeah, definitely. Um you mentioned uh the plant based index uh in the intro as well. I wonder if you could talk a bit about the plant based index. There's so many indices out there, like there's a dietary inflammatory index, there's uh healthy eating index. What I I don't think I've actually come across the plant based index before.
Dr Megan Rossi: Yeah, so this was um developed by some researchers, I guess, to prove the point or to investigate the point of whether um, you know, eating plants necessarily means you're any healthier. Um and what they did is I guess categorize the different types of plants out there. And essentially it was whole plants, so things like, you know, whole grains, whole fruit versus refined plants. So things like um, you know, sucrose added table sugar, fruit juices, you know, pastries and those sorts of things. And so they categorized the different plants. So the healthy uh plant food index versus the unhealthy plant food index. And they have a massive cohort of of um participants, so thousands of patients. Um and they looked at where their diet kind of indexed on these two different types, the healthy index versus the unhealthy index. Um and with the healthy index, they showed that the top tier of people on, you know, following quite a high healthy plant based index, i.e. whole plant foods, like I talk about in the diversity diet, um had a 25% lower risk of heart disease compared to those in the bottom half of those healthy um kind of diets. Uh sorry, unhealthy um plant index. And then they kind of reversed it and found again, people who were eating a lot of the unhealthy plant foods actually had a much higher risk of um things like heart disease. Just because you are vegan, you know, doesn't necessarily mean that you're healthy. It's about looking at the types of plant foods you're having. Um now, that's not to say that, hey, you can't have some added sugar. Absolutely. And I think that's one of the key principles on the diversity diet. It's not, you know, thinking about cutting out foods, it's just about basing your diet on these whole plants. And hey, if you want to add some treat foods in there, absolutely. But what I find when people start to move towards eating more plants, their taste buds actually do start to to change. Um and you know, I talk about the case study in the book where it was actually an A&E reg um who, you know, was very much into stopping at, you know, takeaway on the way home after a hard shift and maybe you can relate to that, Rupy, yourself. I know my husband.
Dr Rupy: I totally relate to that. Totally relate to that.
Dr Megan Rossi: Yeah. And then over time, we started to add more plants into his diet and he was, you know, less inclined to um get fast food. After one particularly hard shift, he went and got a big Mac and he saw me in clinic about two weeks later and the look on his face as he described how disappointed he was that he just didn't get that buzz like he used to. It was like I'm taking something away from him. But then, you know, when we've talked it through, he was like, obviously I see the benefit. It's like, it was kind of like magic in a way that it just after the, you know, the five to six weeks, my taste buds just changed. And I'm like, you know what, it's not magic, it's based on science. We know that our microbes in our mouth as well as our taste buds really do change according to what we feed them.
Dr Rupy: Yeah, and this is a really good point I think from the behaviour change aspect uh in clinic because I mean, I I try and encourage people uh every time to, you know, try and include diversity in their diet and mix it up with all those preventative uh health uh properties. And um I I was quite surprised to hear about the regeneration of our taste buds and how that can uh change so rapidly. And that explains of what I see anecdotally uh during my clinical practice. So I wonder if we could talk a bit about how your taste buds regenerate in relationship to the habitual diet that you have um and and why that's related to repeated exposure. Uh and I guess it's it's pretty intuitive for people to think about when we think about how we've evolved from childhood, uh adolescence and uh young adulthood and our and our taste buds have changed to appreciate different things.
Dr Megan Rossi: Yeah, I mean, remember your first drink of wine or coffee? It was like, oh, or dark chocolate even. I was like, get that away from me. Um but absolutely, you know, that that kind of exposure, that ongoing exposure, your taste buds really do kind of get used to it and even start to crave it. So we know that our taste buds regenerate every 10 or so days. And there is, you know, amazing.
Dr Rupy: 10 or so days. That's like incredible.
Dr Megan Rossi: Yeah, I know. It's the turnover. And I mean, you know, if you burn your tongue, actually your tongue does heal quite fast.
Dr Rupy: Yes, it does.
Dr Megan Rossi: I actually um, you know, back in the day, I had my tongue pierced.
Dr Rupy: Oh, did you?
Dr Megan Rossi: I remember. Yeah, I mean, in Australia, we all, I think Australians, it was like a cool thing to do in my teens. Anyway, my mum was horrified. Um but actually, I noticed that when I would take it out, after like one or two days, it would start to close up, whereas like every other piercing, like your ears pierced, your belly button pierced, wouldn't do that.
Dr Rupy: Yeah.
Dr Megan Rossi: So our tongue is, you know, it it does turn over quite rapidly.
Dr Rupy: Actually, that that's a really good point because in A&E, whenever we have buckle injuries, um it can look pretty uh pretty gnarly for want of a better term. Um uh you know, as long as it's not completely through or completely through the tongue or anything like that, it does heal very quickly and you have to remind them that, you know, it's going to be stingy for a little while, you might need to use a bit of local anaesthetic, but it does heal. And on the subject of piercings, a lot of people don't realize this. During uh med school, I actually had an eyebrow piercing. Can you imagine?
Dr Megan Rossi: No way.
Dr Rupy: Yeah, I had an eyebrow piercing. But my uh it only lasted like six months. My body just would not just would not keep it. It was like over here. I still got a tiny scar there. People think sometimes that I like shave my eyebrow. I do not shave my eyebrow.
Dr Megan Rossi: That looks like a very good. It does. It looks like that's your kind of your mark, your trademark.
Dr Rupy: Yeah, my trademark. Trying to be a pop star in a former life. No. Um but yeah, you know, just a little anecdote about the the mouth. It does it does turn over really quickly. And so I guess that makes sense.
Dr Megan Rossi: Yeah. And I mean, if we look at, you know, food industry, um there was a big move around reducing salt. And actually took out about 40% of the salt in cereals. So it was like, I think it was like 240 tons of salt over several years. And most consumers, I know back in the day, that was my kind of breakfast as a kid growing up. None of us really noticed that change because it was just a a slow gradual change. And and that's um, you know, one of the key mechanisms. But I guess more recently with our understanding of our our microbiome, so we not only have the gut microbiome, we have our oral microbiome. So the the billions of bacteria that live in our mouth is actually the research is showing that they also are thought to um have a role in our taste perception. And we know that when we change our diet, our microbes in our mouth also start to change. In fact, you know, I'm sure you're aware of this that um, you know, the the important roles of nitrates for blood pressure regulation. So things like beetroot, actually our oral microbiome are the ones that kind of transform that nitrate into um nitrites so then our body can absorb it and have that benefit. And that comes down to our microbes. So, you know, there's so much coming out highlighting how important these microorganisms throughout our entire body are. Um and that's just yeah, one example around taste perception. But for those who, you know, I gave that anecdote about, you know, the client and you you've seen in clinic as well, there there is actually hard research um showing that adding more plants into your diet after just two weeks, people became more um sweet sensitive, more salt sensitive. So these ultra processed foods kind of didn't sit as well. And they also started to have a more um kind of higher craving rates for plant based foods. So for the people who say to me, oh, I just I could never, you know, eat more plants, like my husband at the start, I'm like, you'll see, you'll see. Um and then and Rupy, I think the other point that people are like, oh god, they're talking about plants, they're just so boring. You know, as you know, you know, you cook amazing recipes, there is a world of difference between soggy beetroot, oh sorry, not beetroot, soggy Brussels sprouts and, you know, a Brussels sprout pesto um with, you know, walnuts and pine nuts kind of blended in. And, you know, any food can taste bad if it's not prepped right. And the same goes with plants, same goes with meat, a steak, you know, if you cook it too much, it can taste disgusting. So it's about how you work with some of the simple flavours and and that's one of the things I hope eat more live well does is shows just very simple tweaks to flavours of plants can really enhance their overall flavour and make you start to crave plants even if you didn't think that was possible.
Dr Rupy: Hey, yeah, you've got to you've got to have some good tasting plant based food to appreciate that. And the second thing is you can certainly uh appreciate the complexity, uh the bitter notes, the natural sweetness in whole foods a lot more. I mean, people always laugh because I like I crave greens on the side of my meal now. I crave like having something seasonal and fresh with with whatever I'm eating. And you will start to appreciate that as you move to a more habitual way of eating that has naturally a lot more plants in in in your diet. So uh it is really interesting to see that there is research to to suggest that your taste buds will change, that's mediated by the gut microbiota and the microbiota in different areas. Uh and it is possible to appreciate tender stem broccoli or uh whatever greens you like.
Dr Megan Rossi: Yeah. And, you know, that is coming from also my husband's experience. Um so, Rupy, you're a you're a health guru. I mean, everyone probably expects that you'd crave greens. My husband, massive uh meat eater, you know, would eat out every night. Um but, you know, even last night, he was making a bolognese and I noticed without me saying anything, he added in four plant points. So he had a tin of mixed beans, um and then also added in some um peas and mushrooms all on his own. And he would never ever have done that before. Um and didn't know that I was watching him either. So it is possible, guys, it really is.
Dr Rupy: The gut health police, that's brilliant. Um we we've mentioned um uh the words, the gut microbiota, uh the microbiome. You've got a really nice section where you define exactly what all these different terms are. I I wonder if you could just sort of take us through exactly what happens when you consume fibre and the steps of digestion and how that interacts with all those different uh names of of areas that we've been we've been talking about, just to give the listener a bit of an anchor of what we're talking about. And then we can go into what actually a healthy gut might look like.
Dr Megan Rossi: Yeah, no, I think that's a great one. Um because, you know, thanks to the, you know, the public guidelines out there, I think we all know that we need to eat more dietary fibre. In fact, in the in the UK, we have less than 20 grams of fibre. The government says we need to have at least 30 grams of fibre. The clinical trials showing this really uh important brain boosting and and mental health boosting effect of dietary fibre had 50 grams of fibre in that diet per day. So, you know, fibre is a bit of a buzz word, but I think people don't necessarily understand why it's beneficial for them. And having that understanding, I think really can help people increase, I guess, the motivation and their focus on it. So dietary fibre, which is like the backbone of all those plant foods. So I mentioned those super six, they're all a great source of dietary fibre if you eat the whole form of them. And when we think about our digestive tract, it's a 9 meter long tube that delivers the food from entry all the way to exit. And dietary fibre actually travels through most of that digestive tract undigested. So things like most carbs, proteins and fats get digested higher up that digestive tract by human enzymes. We break that down, get into small little particles that then gets from our gut to our blood and that then filters through our, you know, feeds our heart, liver, you know, muscles, etc. Now, the thing about fibre is that human cells don't have the enzymes to break down and digest that fibre. So like I said, it travels through most of our 9 meter digestive tract undigested until it makes its way to the last 1.5 meters and that's called the large intestine. Now, historically, no one wanted to talk about the large intestine because that's where poop is made. Um but now we appreciate that actually that last 1.5 meters is where most of our gut microbes live. So most of the bacteria live there. And the amazing thing about them is they have those specific enzymes to break down fibre. So without these bacteria, we wouldn't be able to get the benefits from dietary fibre. So the bacteria ferment the the dietary fibre and release, you know, a range of different chemicals including these things called short chain fatty acids. And these are like, you know, magic kind of chemicals. They help strengthen our gut lining, they help strengthen our immune system. They are thought to be important in regulating things like our appetite hormones, uh you know, glucose release, our our brain um access, all of those sorts of things is thought to be in part due to these chemicals.
Dr Rupy: Yeah, yeah. One of my favourite lines in your book, do you want to know what it is?
Dr Megan Rossi: Tell me.
Dr Rupy: Your microbes are foodies by nature. I love that line. It's so, you know what, I've got I've got this image of like uh a microbe version of Jay Rayner or like Grace Slater in your gut just like, you know, looking through, oh no, no, no, I'm not going to have that. Oh yes, I'll have this. Yeah, yeah. So that that's like a really nice way of describing it. And I've heard you say in previous um talks and stuff that, you know, instead of thinking about what you and your body and your muscles need for energy and uh recreation and and all the rest of it for the function, think about it from the lens of what your microbes require for them to do their job such that they can look after you and your and your body. Um that's a really nice way of sort of uh giving people the perspective into how we should really be thinking about food on top of everything else as well.
Dr Megan Rossi: Yeah, and I mean, it's it's not about forgoing your favourite foods. Like you've said, it's just about thinking, okay, what am I feeding my taste buds? But what am I also going to feed my gut bacteria? So every meal, every snack, that's literally as a nerd, what I think in my head, I'm like, yeah, I'm going to have some, you know, some chocolate here. But hey, why don't I add some mixed nuts or mixed seeds in it, those plant foods to then feed the gut bacteria at the same time because they are working incredibly hard for our body. And you know, the research is highlighting that you want a really good, solid working team of gut bacteria in you if you want to be your optimal, you know, performance, even athletic performance, but things like your mental health and longevity as well.
Dr Rupy: Yeah, yeah, yeah. I like a different points in the in the book, you know, you're talking about how your microbes can boost your energy, improve your mood, regulate digestion, uh even involved in weight control. And I guess you can break it down into uh these different axes and how they interact with each other. You talked about a whole bunch of them. So we're just going to like look at a couple that I think um perhaps we haven't given as much attention on on the show. So why don't we talk about the uh gut skin axis or uh more accurately maybe the microbiota uh gut skin axis as it's been referred to now in the literature.
Dr Megan Rossi: Yeah, so I I mean, this area really excites me uh in terms of the the science which highlights we literally have like the second skin of of the billions of microbes on our skin, i.e. our skin microbiome. Um and it's this microbiome that's thought to be actually really important for things like inflammatory states of the skin. So things like psoriasis and eczema, um and you know, things like acne, you know, as as a medic that, you know, the first line therapy for um acne is antibiotics, both topical and and oral. Um and that's because we know that this dysbiosis of the types of skin microbiome uh can, you know, create uh the active, you know, uh components of acne. Of course, there's a genetic element which then changes the hormones on your skin, which then changes your skin microbiome. But I guess how we see the gut microbes and the skin connecting is, you know, this really, I guess, new and and fascinating area. Um and I think probably anyone who's listening to this can relate that if they go one too many days without many plant based foods, you know, it can it plays out on their skin. Um and there's some really great research highlighting that these plant chemicals, so specific polyphenols and things like dark chocolate, um some, you know, really robust clinical trials shows that ingesting them in high doses actually had measurable impacts on skin elasticity uh as well as, you know, the appearance of wrinkles in a, you know, blinded uh clinical trial. Uh so, you know, I I joke in the book about, hey, should I get more Botox or just eat more plants? Um but you know, there is good evidence to highlight that how we nourish our gut bacteria can really impact um our our skin, uh our skin health as well. And the the microbes on our skin, you know, they have been used as a better predictor of our age compared to things like our gut microbiome, highlighting that, you know, I think the future of, you know, maximizing our youthful appearance, obviously internally through diet, but externally through really nourishing um our our skin microbiome. Although, you know, just be cautious, there's a lot of companies out there now um that's jumped onto this pre probiotic kind of skin regime without any clinical trials. So just being cautious that if you are going to invest money in, you know, skin products, you say, has there been a clinical or human trial showing that this product is going to really help my skin microbiome? So just being savvy there, I think until we have that really hard evidence.
Dr Rupy: Yeah, no, for sure. Without naming company names, uh are there any particular ingredients that you're excited about, have a future or perhaps uh are even things that we could do right now in terms of nourishing the skin from the outside? Obviously, taking into account the fact that we're obviously going to be doing it inside as well.
Dr Megan Rossi: Yeah, yeah, yeah. So I think inside is definitely where we've got the most evidence, but there has been um a a company who I've I've started to work with behind the scenes, um who are actually undertaking clinical trials uh looking at these topical um prebiotics, so specific types of inulin, uh which can help, I guess, nourish those those topical uh topical bacteria on the face. Um and then also postbiotics. So they're not the live bacteria. So this is another key word people might start to hear is the word postbiotics. So it's the chemicals the bacteria have actually produced. Um because we obviously know that probiotics, the live microbes, that's the definition, they have to be alive to be called a probiotic. Um that's quite hard to keep, you know, for a skin product unless you're going to keep it in the fridge and all that sort of stuff or you choose the strains that are uh heat stable. Um so they're just taking the the chemicals the bacteria are producing and putting them into products. Um so yeah, no, there is some really uh exciting research being being done at the moment to look at at that sort of thing. In fact, there's other research um looking for people who suffer with things like eczema. Because actually, I mean, I don't want to get too much down a rabbit hole, but I think, you know, so many people are affected by eczema and there's really good scientific evidence that if you have a family history of eczema, um and you are looking to conceive, um to take a specific type of probiotic throughout your pregnancy and for six months after, reduces your baby's risk of putting eczema by 50%.
Dr Rupy: Wow.
Dr Megan Rossi: So it's really, really strong evidence and I talk more about I guess that that probiotic prescription in the first book, eat yourself healthy. Um but we can just put it in the show notes after. I talk about the, you know, what dose, what type of bacteria, duration, all that sort of stuff. Um but a lot of people say, well, hey, I've got eczema, can I take a probiotic? And actually the evidence is saying that probably not helpful as a treatment so far in the probiotics being tested. We know different probiotics do different things. But as a treatment, there has been a small um clinical trial looking at a skin uh microbiome transplant where they take those microbes from someone without eczema, um and then they put them onto someone with eczema and that treatment actually had a really um significant clinical importance uh in reducing their their eczema as a flare up. Um so I think this whole area of targeting the skin microbiome is is going to be huge in the next couple of years for treating skin conditions.
Dr Rupy: Do you reckon you're going to get loads of people with eczema just trying to hug people?
Dr Megan Rossi: I mean, if I suffered with eczema, I'd be like very tempted to every day to my partner just rub and rub. I mean, obviously for a skin transplant, you need to go through like specific protocols. So it's not a case of just rubbing on them. You need to reduce down what you've got and then lay it on top, kind of like a fecal transplant, right? Yes. Um but yeah, no, I want people, I guess, to be excited about the potential of this area, but then also I think be savvy um about where they're, you know, where they're investing their money because this is still very much in the research stages and this stuff can take a couple of years to translate. So, uh yeah, be be uh careful about where you're investing your money.
Dr Rupy: I certainly see this particularly in the wellness industry where you see um buzz words being used to advertise the product or maybe they've got something in there that resembles a probiotic even though it's unlikely to be live. Um and then just, you know, it flying off the shelves because of like a an N of 15 study or something like that where they've obviously, you know, not done it uh rigorously enough. And I I wonder so so you've got prebiotics and that's sort of understandable in terms of uh feeding that that microbiome that lives on your skin. And um the metabolites of uh healthy microbes, are there are there certain metabolites that spring to mind or things that you think we should be looking out for specifically in terms of their chemical names or is that still?
Dr Megan Rossi: So a lot like I mentioned before, those short chain fatty acids seem to be one of the key uh metabolites that we're looking at and investigating. So the butyrate, the propionate and things like that. Um however, so you you might even start to see companies advertising um these postbiotics in oral form. So, hey, why don't we bypass the need for prebiotics to feed the bacteria and bypass the the bacteria themselves and just have those postbiotics. But actually, to for those postbiotics to actually get to the right spot, that large intestine to really work their magic, they have to pass through obviously the acidic gut, go through a lot of enzymatic change, which actually is thought to denature them. So I do think, you know, with enteric coated capsules, this will be an area again in the next few years, we may have a more targeted response to, but at the moment, not not so much.
Dr Rupy: Yeah, fascinating. Uh definitely an area to watch and I think there's certainly a lot of things that we can do right now, um but certainly a lot of things to look forward to in that space as well. And that's really exciting that you're working with a company um that's actually doing rigorous trials. I can't wait for you for that to go out, for that to go public.
Dr Megan Rossi: Yeah, no, I mean, it's, I'm sure you're the same whenever you're looking at um working with companies, there's so many on the market. Literally every day, I'm sure you get the same company saying, hey, endorse this and do that. Um so when I heard about this company uh actually doing clinical trials, I was like, I need to work with you. This is hugely exciting. Um so yeah.
Dr Rupy: Brilliant, brilliant. Okay, well, let's talk about that virus. Um everyone is looking to, you know, bolster their defenses, um and uh there's a lot of um talk about the microbiota being uh particularly important when it comes to uh reducing the severity or even reducing the chances of contracting uh lots of different viruses that are that are just within the communities, but specifically with regard to COVID-19 and the negative effects of that. Um are there any things uh beyond uh diet that could potentially help with with lowering the risk of um upper respiratory tract infections and and COVID-19 in particular?
Dr Megan Rossi: Yeah, well, I mean, in term, I guess, diet, if we talk about probiotics, there's actually really good scientific evidence for taking specific types of probiotics for reducing your risk of the common cold, i.e. the upper respiratory tract infection. In fact, that's where the hypothesis about, hey, could the gut microbiome have a role in COVID came from because there's such robust, it's a review showing that um the the bacteria, Lactobacillus rhamnosus GG and BB B12, those two um combined together have been shown to yeah, reduce people's um duration of the common cold by two days compared to placebo, um as well as reducing the overall risk of getting the common cold. So there actually is really good evidence for that type of virus, so the common cold type of virus. In terms of COVID-19, um there was a pilot study highlighting um what they did is they gave people who had contracted COVID-19 in the hospital setting, so they're quite unwell. Um and so one group got the COVID got the specific probiotic alongside standard medical therapy and the other one just got standard medical therapy. And found that those who had the probiotic in combination actually had a massively reduced risk of needing um respiratory support. Um so that study's now been extrapolated out and there's about 12 other studies currently underway looking at different probiotics and having their effect, as well as uh another study looking at long COVID. So, um one of the the studies which came out again, it was just a pilot study. So for those who don't know much about research, often we do these pilot studies just as I guess a proof of concept, but they're quite small. So you have to kind of interpret them with caution. Um but it looked at again, a different probiotic with uh I think it was a specific type of digestive enzyme and showed that reduced um, you know, symptoms of fatigue in people who reported long COVID. So I think there's going to be a really exciting area of specific probiotics for managing um COVID-19 and the, you know, the symptoms of long COVID. Um but at the moment, I would say there isn't enough convincing evidence for me to recommend specific probiotics, you know, wide widespread. Um and like you said, it's probably going to be coming down to to diet, but also we know that sleep um obviously it directly impacts the immune system, but also after just two days of sleep deprivation, that also has a negative impact on our gut microbiome. Um and then there is some some other studies highlighting that, you know, disrupted dysbiosis uh in the gut microbiome space can also have a negative impact on your sleep. So there is that bidirectional relationship there. Um and and then obviously movement. Uh so we know that that is is another key one. I mean, not to get too much into the the dietary space, um but there was a nice study uh which came out recently in quite, I think it was like a thousand uh participants and showed that people who were eating plant based, uh so not necessarily plants only, but plant based had a much lower risk of becoming unwell with COVID compared to those who are having um a low carb diet or a high protein diet. Again, just looking at how these kind of restrictive diets actually typically do cut out whole plant food groups, um and therefore can really have a negative impact on our gut microbes because we see um often, you know, people on the keto diet, for example, and they say, oh look, I'm getting loads of fibre, it's coming from my veg. And I'm like, yeah, that's great. But actually, we know that the fibre that comes from your whole grains and from your legumes and your fruit are actually very different to the fibres that come from veg and therefore can act very different towards your gut microbiome. So these restrictive diets do have uh a negative impact on gut microbial diversity. So you do need to think about, I guess, the long term kind of consequences on these kind of restrictive diets. And and we think maybe that might be why we see a lot of yo-yo dieting effects of these diets because it's really impacted the gut metabolism axis. Um and therefore when people start to include things like carbs in their diet, that that can do that damage and they not only regain that weight, but much more.
Dr Rupy: Yeah, yeah, it's certainly something commonly seen anecdotally as well whenever I speak to patients who have changed their diets and then they end up going uh trending upwards as well and they're they're constantly changing diet and and uh changing, you know, the the restrictive set of ingredients that they include. Um just going back to the initial uh the one of the studies that you're mentioning about the uh reduction in severe COVID and those needing respiratory support with the multi-strain probiotic. Do do you remember what probiotics they actually gave them and and how they came to those probiotics versus all the other types of probiotics that we we use in clinical settings?
Dr Megan Rossi: Yeah, this is a bit of a frustration uh I think of the of the probiotic world is often it's just whatever is available or what company's going to provide them. So a lot of the key probiotic um formulations do have, you know, the bifidobacteria, the lactobacillus, the different uh strains within them. But um when I read the paper, they didn't to me seem like a whole lot of thought had gone into the, you know, specific selection. Um and you know, I guess I've had the opportunity to see on the researcher side of things is that it's very hard to get a specific probiotic manufactured according to the strains that you want in that. So you have to kind of use what's nearly available for you. Um so the the probiotic that was used, I can I don't know the name of off the top of my head, but I'll I'll I'll let you know for the show notes. Um and and that is now available commercially. Um but the study, there was some dodgy points on the study where some of the reviewers were like, ah, I think I want to see this uh repeated again. And the annoying thing I I mentioned about those 12 different studies currently underway, most of them again are using different probiotics, which is, you know, this whole world of frustration around probiotics is that each different type, as you've highlighted, does different things. So it kind of clouds the potential benefit of probiotics because you get a positive one, a negative study, a positive study, a negative study because they're using different strains which have different mechanistic effects. So we need to move to a place of, you know, being able to go, okay, this strain will be ideal for this specific condition and then kind of building um a combination, uh but that is really difficult from the research world.
Dr Rupy: Yeah, and super expensive, I guess, as well. I I guess you also need to know like what environment you're introducing those probiotics into as well. So the the state of the microbiota before treatment, during treatment and after treatment and how you selected said probiotics. But then getting the enough numbers to make that significant enough is is a huge frustration and a hugely expensive.
Dr Megan Rossi: Yeah. And I mean, that's a really good point around the environment that, you know, you're putting these probiotics to. And this is a reason why actually these commercial microbiome tests, you know, is not something that I currently recommend people do. And yes, we collect stool samples and we do the tests, although much more detailed tests in the in the research setting. But actually, identical bacteria can act very different in two people in two different people's guts. So just seeing the types of bacteria according to these commercial reports that you've got in you doesn't actually provide us with much clinical evidence. Plus it only gives you a very small snapshot. So there's thousands of bacteria that haven't been sequenced and therefore won't show up on the on those tests at the moment. So that's a bit of a side point, but I guess I would say save your money, uh spend it on quality food instead and maybe in, you know, five or so years, we'll have more valid and robust kind of commercial microbiome tests.
Dr Rupy: Yeah. Put putting the clinical side of uh these microbiota tests uh to one side, is there any behavioural change uh positive benefit of seeing someone's microbes change from poorly diverse to more diverse on the basis of, let's say, a a two week change in diet or a four week or an eight week or whatever. Do you think that holds any value at all or do you think that's just actually no, just better not know?
Dr Megan Rossi: Absolutely. I mean, um on a case by case basis, I I often do these tests um with some of my my clients who want uh, you know, quantitative assessment of how diet has impacted their health. And I completely get it, particularly for those more analytical minds, they want data, right? Um so I have actually done these sorts of, you know, tests that at baseline, we'll we'll get the fecal test done. Uh you follow this diet, i.e. I've done the diversity diet with them for four weeks and then you get it again. And then yeah, we get some really cool data to show that you've increased your microbiome alpha diversity by, you know, 25% and you've increased, you know, um the the butyrate production, etc. But firstly, they are expensive. So I only do it with clients who obviously have a lot of money. Um and I tell them at the very start that this is just going to kind of help motivate you versus it going to change my clinical recommendations.
Dr Rupy: Yeah, yeah. I think it's a really good point. And I think, you know, whenever people ask me about these tests, I always say, well, don't do it in isolation because a, they're very hard to interpret and B, you could, you know, uh go down a rabbit hole of trying to perfectly prescribe a diet to increase certain levels of microbes. And like you've said, you don't know all the microbes that are in there because it's not a full assay. And it's uh it can lead to like anxiety behaviours around uh eating specifically for to change the numbers on on a on an investigation. So I think it's a really interesting area, but uh certainly not one that I recommend is ready for prime time.
Dr Megan Rossi: Yeah. And and Rupy, we touched on our gut microbiome being mostly bacteria, but we also have the viral component that called the virome, the um the fungal component called the microbiome. We've got the parasite component, which actually all of these different types of microorganisms synergistically work together. Um and although obviously at the moment, everyone is so scared whenever you say the word virus, but actually the vast majority living within us are thought to have that synergistic kind of relationship. And some of uh some early studies looking at things like inflammatory bowel disease and IBS, it's thought to actually be these people are are missing some key protective parasites within their gut. Um so actually these kind of scary names that we've been taught to be, you know, fearful of actually may have a protective benefit on our on our body.
Dr Rupy: Are there particular microbe tests that you warm towards? I what but obviously with the caveat that you should be doing it with a registered dietitian.
Dr Megan Rossi: So I think there's quite a few on the market. Any which looks at the alpha diversity. So I would check that they've got uh that measure because some of them will just give you um things like how much bifidobacteria do you have, how much lactobacillus, but you want that diversity measure because that's kind of the one that we most associate with overall health. Um there are some on the market that do sound really impressive in terms of they'll tell you how much, you know, the of the acetate and the butyrate and the propionate, those um short chain fatty acids that are produced and things like that. But actually what we find is like 95% of these short chain fatty acids are reabsorbed into the body. So the stool samples again might not be a great predictor according to your genetic background and all of that sort of stuff. So I wouldn't worry about investing money in these extra kind of facets of of your stool. I would just go for alpha diversity is probably the key one.
Dr Rupy: Yeah, absolutely. And I wanted to talk a little bit about weight management actually because I'm constantly asked about it and I don't talk about weight management as much. I've been chatting a bit about it recently, obviously because it's the time of year. But um it was really interesting to hear about the impact of microbes on metabolism and how that might be uh well, maybe we can talk a bit about the mechanisms behind that because you talk quite uh clearly about the uh the negative points about calorie counting and how calories I think especially now the government is trying to put it plaster it all over our restaurant menus and stuff. It's going to be really um anxiety provoking for a lot of people. Um why don't we talk a bit about how the microbiota is is uh related to weight management and what the mechanisms behind that are?
Dr Megan Rossi: Yeah, no, I think this is a great point because, yeah, I mean, it is really scary how much the calorie point has been pushed. Um and I know, you know, just as a side point, I mean, we know that the calorie information is actually not all that accurate, particularly for whole foods. And certainly what I see in clinic is a lot of people are avoiding whole foods like, you know, nuts and seeds because like, oh my god, there's so many calories in it. And actually, we know things like almonds provide our body with like 30% less calories than what the label says. Um so the calorie information is not all that accurate to start with. And there is actually really nice um research. One paper was uh undertaken in published in cell metabolism and gave people equivalent um calorie controlled diets, but one was full of whole foods and one was ultra processed foods. So identical calories. And of course, as you'd expect, Rupy, those on the um ultra processed food put on weight, those in the uh whole foods diet actually lost weight even though they were matched for calories. Um and you know, there's many mechanisms, but one is the microbiome. So we know that things like, you know, a Kit Kat and a banana contain, hey, equal calories. So why wouldn't you go the Kit Kat? Little do, you know, do you know or if you're not if you're not thinking about anything but calories, you'll appreciate that actually a banana, um you know, contains the prebiotics which feed the gut bacteria, you know, it's got serotonin in it, the happy hormone, all of those sorts of things. But in terms of I guess the fibre component, we know that like we said, that feeds the gut bacteria, they then produce those magical chemicals, so short chain fatty acids. And those short chain fatty acids have been um shown to have a really direct impact on things like our body's ability to produce glucose, um as well as regulating things like our leptin and hormones, so our appetite hormones. Um so we know that dietary fibre as I'm sure a lot of people anecdotally find if they eat more high fibre foods, actually they feel fuller for longer, um and they're less likely to crave other foods. And that's the key mechanism, those short chain fatty acids uh that are produced when the bacteria break down that fibre.
Dr Rupy: Yeah, I I love using that study as a an example of of how like calorie counting is really flawed. And actually on my app, we do have all the nutritional information in terms of calories as well. And I was I mean, I was loath to to add it because um it we just added it because of popular demand and people utilizing that. You know, each to their own, if some people find calorie counting useful for them and it's been useful for them for for many years, then that's fine. But we're actually working on a feature where you can switch off that information because I personally don't find it useful. Whenever I I look at some of my recipes, I'm like, how is this over 700 calories? Like, you know, and it's just it's because of, you know, it's got nut butter in or it's got some peanuts or it's got, you know, something that pushes the calorie count, but actually is super nutrient dense and something that you want to include in your diet. But even for me, someone who understands the limitations of calories, just seeing that high number is a bit like, oh, how did that happen?
Dr Megan Rossi: Oh, I I'm the same. I love that you're creating that feature, but I also I appreciate that, you know, having a little bit of understanding of calories can be helpful. Um so I don't say that completely ditch the whole concept because for example, when you're, you know, at the supermarket, if you're comparing like for like foods, you know, having a comparison of the calories, um you know, might help you understand actually if that's got extra added sugar in it, although I'd argue maybe the ingredients list is more important to look at. But it can give you some information. Um so it's not completely like, you know, dismissing the whole concept, but it's about showing how flawed it is. And you know, the studies where um people have just added more plants into their diet, a nice, you know, systematic review where they pulled together, I think it was 15 individual studies where people just added more plants into their diet, didn't calorie restrict or portion control, actually they lost significant amount of weight doing that. Um so it shows that absolutely you can be really healthy, probably have a much better relationship with food if you just focus on, you know, the whole nature versus calories. Um you know, you can achieve your weight management goals much easier.
Dr Rupy: Yeah, totally. Um I mean, there's so much more I want to ask you about. I'm going to finish with a couple of points. Uh you you mentioned some of the the key uh complaints or the key sort of obstacles for people including uh price, you know, and we you sort of uh break down that myth as well. One of the um key issues that I come across is people saying, well, I can't eat that because it gives me a lot of bloating or um, you know, every time I add a little bit of fibre into my diet or I change to a largely plant based diet, I I blow up like a balloon and you know, it just doesn't sit well with me. What what are the some of the simple things that people can think about with regards to uh bloating if they experience that when transitioning to uh a more diverse plant based diet?
Dr Megan Rossi: Yeah, really important question. I think one one element that can help people is understanding of why they're getting those symptoms because often I see people in clinic where they're experiencing these and they get really fearful. They're like, oh my god, this diet doesn't work for me. It's really bad for me. Look at my body's reaction. So when our bacteria eat the fibre, one of the natural waste products they produce is gas. Um and if you go from eating a little bit of fibre to a lot of fibre in a short period of time, your bacteria essentially have a foodie frenzy. They binge eat and they produce loads of gas. And again, if your gut lining's not used to that, you know, big burst of gas production, then that can trigger um this kind of activation of the gut brain axis and can be more likely to stimulate things like the bloating in your tummy, as well as tummy pain, etc. Um but certainly what we see both in the clinical setting and the research setting that slow introduction of these high fibre foods. So I'm saying instead of, you know, going from 10 grams of fibre to 50 grams of fibre in the space of a month, actually maybe that might take you six months to achieve. Um so maybe on a day to day basis, instead of having, you know, an extra half a cup of legumes, you might want to have a quarter of a cup of legumes, um or instead of having an extra whole piece of fruit, if you are really sensitive, having half a piece of fruit, uh what happens is your gut bacteria actually really do learn to more efficiently metabolize those foods and actually the amount of gas that kind of gets trapped in your tummy is much reduced um because the bacteria can actually break down that gas a little bit more. And also your gut lining can then reabsorb that gas and actually a lot of it gets breathed out through your your breath instead of it being coming out the back end or being trapped in your gut. So slow steady introduction of these high fibre foods. So think about half a portion compared to what you may think is a standard portion. And actually in the book, I do have a sensitive tummy's menu plan for people who experience this. It's kind of that easy way into eating more plants. But the second point I think is a really important one is that you need to have a relaxed gut um to be able to increase the amount of fibre you've you've got in um your diet. And the reason for that is because like I mentioned, um having a very uh stressed gut means that you can't absorb a lot of that gas the bacteria have produced. So if you've got a stressed gut, it gets trapped in your tummy and therefore it triggers triggers the bloating. Whereas if you've got a relaxed gut, then actually that gas that's produced can get into your blood system and then you actually breathe that through your lungs. Um so how do we get a relaxed gut? Things like, you know, the the mindfulness relaxing that gut brain axis. So um whether it might be like five minutes of meditation, going for a gentle walk, but also actually if you've had a gut infection, for example, you can have a stressed gut that way. So again, if you've just had a gut infection, it might be a case of going even more slowly with your reintroduction of fibre because your gut is a little bit damaged. Um and then actually even if you never really thought meditation was important for you, it is actually, uh particularly for those people for the recovery because we know um that even subconsciously stress up here really can strangle how the gut lining really regenerates. So it is is quite important to do. And Rupy, please tell me your app does kind of support uh a little bit of mindfulness elements to it as well.
Dr Rupy: Oh, definitely. Yeah. I mean, we're we're introducing we're introducing a content section at the moment where we're going to be doing little uh tutorial videos on mindset, motivation, as well as the foundations of building a nutritional plate and all that kind of stuff. But um it's interesting. So uh with a lot of us going back to work, a lot of us eat al desko. Uh and I'm I'm guilty of this as well. Like I uh often will eat in front of my computer. I know shock horror, uh watching like reruns of Saturday Kitchen or something like that as I as I always do. Um but what I've done certainly uh to improve my bloating after eating, which obviously happens if I'm eating in a rush as well, is to just take 60 seconds and just breathe through my nose and out through my mouth before I start eating. And then also just slow down the whole eating process because I I tend to scoff food and that certainly helped me. Um and I think also the the concept of the gases being reabsorbed uh via the gut lining and then being breathed out is something that uh I don't think a lot of people understand. And I think I'm I'm really glad you mentioned that because most people think of, okay, I've got this fibre, it's going to increase the gas and that's going to cause the bloating. It's not going to be out to go out any other way other than out the back or out the front. And that's why I'm burping, that's why I'm blowing up. And and so that that concept of actually no, this gas is reabsorbed slower across the the gut lining, really, really important to get that across.
Dr Megan Rossi: Yeah, no, absolutely. And I love those tips about um, you know, the mindful eating aspect, you know, taking that 60 seconds, chewing your food well because they sound like such simple strategies. Um but with a lot of my clients, you know, I say who who are really bad on in terms of like the bloating side of things, I say, look, do this one strategy uh for a week. If you don't get any symptom uh improvement, hey, we'll come back, we'll get something stronger. Um but actually like 30% of people, that is literally it for their really bad bloating. That's all they had to do. Uh so hey, save yourself the clinical appointment, try that strategy uh and yeah, 30% of you will be like, oh my god, it's been a life changer.
Dr Rupy: Yeah, amazing. Well, there's so many tips, so much more as well in your first book um that really takes you through the whole process of assessing, you know, coming to see you in clinic, which I absolutely loved as well. Um we've done a podcast on that before too. So there's so much to get involved in plus uh all your um your great stuff on uh social media, on the newsletter, your inner gut community. Your inner gut community. Tell me a bit about that. Is that is that your newsletter um community that you have?
Dr Megan Rossi: Yeah, absolutely. It's just I guess, you know, giving people that extra level of information, people who don't just want, you know, a short caption on Instagram, but actually want to be updated on, you know, new research, new recipes and I guess embrace the power of the gut to that slightly higher level. So it's completely free to join. Um but I just, yeah, wanted to offer people that extra bit uh because it is such an exciting and landmark space and I want people, you know, to come to the gut health doctor as a first port of call before they, you know, get taken maybe for a ride and try all these crazy diets, you know, ruin their relationship with food, harm their gut microbes, all those sorts of things that I often see um, you know, in clinic. So I want to kind of get to people before uh other people may, yeah.
Dr Rupy: Yeah, no, that's it's yeah, no, totally. Yeah. And I and I I totally respect that mission as well. Um just before we end, what what how do you get probiotics in your diet? I know you get everything else in terms of, but how do you get probiotics in your diet?
Dr Megan Rossi: Yeah, so I um during winter do take uh the probiotic which has the lactobacillus rhamnosus GG and bifidobacterium B12. So I do do that to reduce my risk of the common cold because there is a review on it. So I'm like, yeah, good evidence, let's do this. Um and you have he does work in medicine as well. So you know, he's going to be coming back with. And you've got a little one now. So I mean, I need to defend. Um in terms of dietary elements, now, the whole world of fermented foods, we didn't really dive into this. And historically, a lot of it was based on test tube studies showing that actually these fermented foods contain these bioactive components which could have health benefits, etc. But actually just um a couple of months ago, there was a new paper released showed that people who had a range of different fermented foods in their diet from things like kefir, live yogurt, um kimchi, etc, including them in the diet significantly increased their alpha diversity of their gut microbes. Um so I do personally include a range of different fermented foods in my diet. You know, Bio-Me, we've got a live yogurt. Interestingly, with those two bacteria, lactobacillus rhamnosus and GG and bifidobacterium B12. Um for those immune benefits. Uh but, you know, those sorts of things, um I definitely, yeah, do make a conscious effort to include. And I actually love the flavour of them. For those who aren't, you know, that keen, small amounts, your taste buds again will start to crave them over time. There's nothing better than kimchi and poached eggs on sourdough.
Dr Rupy: Oh my god. I love it. I love it. I was converted to this idea of kimchi scrambled eggs, sourdough. Uh I mean, it's it's a it to to someone who hasn't tried it or is not used to like that sour bitterness, it sounds terrible. But actually for me and even Rochelle as well, we love it. We love that combo. It's it's fantastic.
Dr Megan Rossi: Definitely. Everyone needs to try it before they knock it, I think.
Dr Rupy: Yeah, yeah, absolutely. Um Megan, thank you so much for your time. Honestly, it's been a pleasure to catch up as well and uh I can't wait for this to go out and your book is smashing it. Eat more, live well. Uh it's a brilliant book, tons of recipes and I can't wait to see what you come up with next. I have a few predictions as to to what I think we could be seeing as well. Should I should I say them now?
Dr Megan Rossi: I mean, you need to plant those seeds in my head because
Dr Rupy: Well, I I definitely think uh extending the line of probiotic foods, um so beyond the yogurts uh to things like kimchis and sauerkrauts that are made in a particular method uh that is shown to improve the probiotic uh density of those. Um maybe, maybe, uh this is wild card, going into um uh specific probiotic uh lines as well, yourself at some point in the future. Um and I see a gut health cafe at some point as well.
Dr Megan Rossi: I mean, you've heard it here first, Rupy. We'll have to wait and see. Are you really a fortune teller in which case? We'll be making millions.
Dr Rupy: I know, I should be. I really should be. I should just be like backing it with uh with uh with investment. Anyway, thanks again. I'll see you I'll see you in a year for sure, but we'll we'll definitely meet up uh sooner so Nutmeg and Pistachio can actually meet.
Dr Megan Rossi: It's a must. It's a must.
