Dr Rupy: There's a lot to unpack I think. You know when I was thinking about what I wanted to chat about with you today was really about your early interests in nutrition. And then we can go into the food because I imagine, very similar to my upbringing, food was probably going to be like one of those things that was just from the moment you were born, you were just surrounded by spices and food and you know this like deep sort of cultural heritage that we share. But when it comes to nutrition and preventative medicine and how we can utilise those aspects of food, I wonder if you could talk to us a little bit about those sort of early parts of your journey.
Dr Saliha: Yeah, I think for me the interest in nutrition did start at medical school, quite by chance, I would say. You're right, I mean just like you, I grew up in a really foody house, food was extremely important and in university I was one of those people who was constantly fascinated by food, eating out a lot, reading about food, etc. I'd send a picture of lobster thermidor with my dad's bank card next to it, before and after. That's who I was. But I think for me, the real turning point, which is one index event that I really remember very well. I walked into the lecture theatre and I was one of these front five row kind of girls, okay, so that means I was quite nerdy, okay.
Dr Rupy: It's all right. You're laughing because you sat on the back row, didn't you? I was definitely back row.
Dr Saliha: So I was front five row kind of girl and once I walked, I was quite slim. I think medical school you just working hard and you're very young as well, so you have a good metabolism and I was quite thin and I was eating a Galaxy bar. And as I walked past, the lecturer on the stage was also an expert in nutrition and the lecture was going to be on nutrient macro and micronutrients. And I walked past and I saw her staring at me and I thought, oh my god, I better hide this chocolate. Maybe we're not allowed food in the lecture theatre. And then she proceeded to reference me eating chocolate through the entire lecture. Not saying who I was, but one of the comments that she made was, if you're a thin person and you eat chocolate, nobody thinks anything, but if you're obese and you're eating chocolate, people will judge you. And that immediately made me think about humans in the context of what they eat, how one gains weight, the perceptions of people around obesity. And really it made me think, well, you know, I do love chocolate, but actually that doesn't represent who I am nutritionally and what my overall food intake is and, you know, is it not okay for people to just be considered fine when they're eating chocolate? I had all these questions that suddenly came in my brain. And I found that as I asked those questions, I didn't actually have answers for them, or I didn't have people giving me the answers to them. I had to search myself for the answers. So it started, it stemmed from an experience of essentially what was, I think, fatphobia, stemming in a very institutional way, to me then realising that the profile of nutrition within medicine is actually quite poor. And it progressed. I'd go on to wards and I'd see elderly patients in my care of the elderly placements, for example, and I'd think, oh my god, you know, she's not eating any of her food, she's just wasting away. We should be trying to give her something more appetising, or, you know, I'd do my obstetrics placement and I'd think, oh my goodness, you know, these pregnant women, we need to inform them more about what healthy eating in pregnancy looks like, or I'd do my paediatrics and I'd see children with rotting teeth and I'd think, oh my goodness, you know, look at the amount of sugar that these children are consuming. So I think it was a personal interest and then I saw this huge deficit. And that was probably one of the reasons why I eventually ended up choosing gastroenterology as a career. Not because gastroenterologists talk about food, it's quite the opposite. Most gastroenterologists do not talk about food at all, but for me it was the one career where food needed to be talked about most, so I felt that I could really make a difference to the speciality. And that's how I've sort of found myself here through like, you know, an extraordinary journey of finding gaps in knowledge and thinking that there's a need for them to be fulfilled.
Dr Rupy: Yeah, that I mean that that's such a lovely sort of arc of of your sort of professional journey. And I just wanted to pick up on the fact that isn't it crazy how gastroenterologists where you should really be talking about or even taught about nutrition from day one, don't tend to talk about food in the context of what their patients should be eating, but also what could be exacerbating certain conditions. I wonder if you can give us some insight into that and perhaps in 2022/2023, what might be changing in the mindset of, you know, a gastroenterologist who is just starting out.
Dr Saliha: Yeah, I mean, I remember distinctly doing my first independent gastroenterology outpatient clinic. So this was a clinic which was booked with 10 patients one afternoon, one after the other, they pop in with a range of ailments. And first of all, there was not one patient who did not ask me about food on that clinic. So there was not a single one who didn't ask me about food and eating in that clinic. And there was not a single one that I could answer correctly at that time, okay? I could not give them the right information at that point in time in my career. And I remember one young girl who was very severely affected by intractable, horrible irritable bowel syndrome. And her quality of life was awful because of it and she just wanted to ask about what she could eat to try and alleviate her symptoms. She had to see a dietitian that we'd referred her to, but the waiting list was something like 18 months. So she was living in agony trying to, you know, working towards this eventual dietetics appointment and having all her hopes set on it. And she had done some research and at that point I hadn't done as much research. And she asked me, so what do you think of the FODMAP diet? And I was like, for those who don't know, FODMAP is a very specific diet for patients who've got irritable bowel syndrome with bloating predominant and shouldn't be done on your own, you should do it with a dietitian. It's quite restrictive, but it can be very helpful for a select group of people. Now I know that, yeah. At the time, I was like, oh my god, what does FODMAP even stand for? And the way I had to blag in that consultation, I was like, do you know what? It's an interesting question. I think I'll have to put it to a panel of seniors and see what they think about that. And I went back, I did some reading, I called her back later, had a chat to her about the FODMAP pros, cons. But interestingly, when I went to my senior colleagues, I then also noticed this huge disparity. I mean, FODMAP is one of the few dietary interventions that gastroenterologists do regularly, fairly regularly recommend for patients with IBS, but even amongst my gastroenterology senior colleagues, there was this huge disparity. So I understood, I instantly understood that food becomes this grey area. And you know, a lot of gastroenterologists don't even know what the basic healthy eating advice that's correct that they should be giving people. And then obviously when you add the layer of disease into that, digestive disease, it brings its own layer of complexity, so unpacking that is quite difficult. But I do think that in the last decade, since I've been working certainly, there has been this transition whereby, you know, there is growing consensus that food matters, that patients are interested in food and therefore we should be talking about food. And this growing consensus that particularly in the realm of functional bowel disorders, we're not doing enough by not talking about food and we must talk more about food. So you see like very gently the tone in conferences sort of changing, suddenly, you know, we've got the odd food symposium popping up here or there. You know, suddenly you've got one or two lectures emerging about inflammatory bowel disease and diet. So I just feel that there is a transition and we're sort of on that turning point, but we haven't quite, you know, hit the problem head on and we haven't quite invested ourselves fully, which is where I think I find myself a bit annoyed and stuck because I want to do food related consultations for every single one of my patients if I could, if I can possibly do it. But, you know, logistically we're just not at that level yet, we're not at that point yet. We don't have the materials for people to take away, etc. But we're really missing a trick because for example, you know, I saw someone who has lots of tummy pain because of diverticular disease. They need to increase the amount of fibre they're eating. So we had a long chat about fibre consumption and what they can do and foods, etc. But other patients who haven't had that food related consultation will basically be at a loss until they see a dietitian in the NHS many, many months later, at which point, you know, they'll have months and months of symptoms, the associated mortality, morbidity that comes with all of these problems. So it really, really is an issue. And I am glad that we're at sort of the wave of change is coming, but we're certainly not gone full, fully over it on the other side in any way, shape or form. And until as a profession gastroenterology does, I don't think that we can actually make massive differences to our patients' lives beyond, beyond, you know, the chemicals that we give them.
Dr Rupy: Yeah, yeah, yeah. There's so much there that I really want to unpack and I think this is a really good foundational ground for our discussion today and I'm sure we're going to meander all the time, but you mentioned functional bowel disorders there and I wonder if you could just give us some insight into exactly what we mean when we say functional bowel disorders, as well as the proportion of what you believe you see and perhaps your colleagues see on a weekly basis of functional bowel disorders versus others like diverticular disease, for example.
Dr Saliha: Yeah, I mean, I suppose I simplify this for my patients and I say, if I have a patient who has a functional bowel disorder, they've come to me with a problem and I'll say, I acknowledge you have a problem, okay? You are symptomatic, it's affecting your quality of life, therefore there is an issue. However, the conventional tests that we have done, whatever manner of test that may be, things to look inside, things to measure function, pressure, etc, acid, etc. All of those tests have essentially come back as normal. That does not mean that you don't have a problem. What it means is that we don't have the technology and the basic biochemical level, you know, insight to be able to understand exactly what is causing your problem, but clearly there is something that is causing you symptoms and we need to get to the bottom of it, but our current conventional scientific knowledge and testing ability doesn't allow us to tell you exactly what that is. And therefore we say that you have a functional problem. This means does not mean there isn't a problem, it means that there's a problem that we can't exactly put in a clear cut syndrome or box. So first of all, the key thing is acknowledging that there is a problem for that person and that's that is the single most important thing that you can do for patients because patients feel that they've been listened to, they feel that their symptoms have been acknowledged and they feel that you know that they're not pretending. And a lot of these patients carry the guilt and the weight of having a symptom but no diagnosis to back it up. And when you say to them, I acknowledge you have a problem, we need to get on top of this problem and I'm sorry I can't explain this problem in a conventional way to you. That's the biggest thing that you can do to lift that patient. And then you go on to talking about dietary lifestyle things and chemical things that you can do by medications. And I tend to unpack it and say, well look, these are, this is what the medicines say, these are the things we can do to help you. You know, these are the side effects, you might want to consider it. And then we talk about diet and lifestyle. Invariably, we have a long discussion about the person, who they are, where they find themselves in their life and whether they feel that stress compounds a lot of their symptoms. And when I really, I know I've hit the right sort of footing with a patient because I instantly have a connection with them and I, they will then tell me something or divulge some information to me about their personal life, you know, financial difficulty, personal relationship difficulties, past stresses, etc. And they will say, you know, I have this, this in my life and no doubt when this is worse, this stress is worse, my symptom is also worse. And we have then a conversation about how the brain and the gut are incredibly connected. The fact that they have these symptoms is completely natural because, you know, you have butterflies in your tummy when you do an exam, if you have anxiety long term, then, you know, you expect those symptoms to happen. You know, we it's it's very nuanced according to the specific symptoms that that person has, but, you know, you do have these breakthrough moments where people realise, you know, what that they have to change something in their life in order to have some alleviation of their symptoms. So I, I, I said, I actually said to one of my patients the other day, you know, I prescribe you a holiday. Be it Bognor Regis, you must, must get away from everything that you are doing to be able to try and lift this cloud away from you. And it's those patients where I've had that personal connection to be able to understand where stress is in their life and and how functional symptoms overlap with that that I've had the most success, who've thanked me most, who I feel most proud of in my career for helping. So, yeah, I think there's a great amount of pride that you can take when you've treated someone who has a long-standing functional bowel disorder well. Be that, you know, intractable acid reflux, be that horrendous bloating, be that terrible other IBS symptoms, diarrhoea, constipation, abdominal pain that cramps them so bad that they end up spending half their life at home and not being able to fulfill their entire potential. It's incredible how important your gut is to your overall life's function. I just cannot, I cannot, I feel almost emotional when I talk about how important your gut is to your successful functioning life.
Dr Rupy: Yeah, yeah, absolutely. And and and like it's music to my ears to hear you mention all the other sort of lifestyle factors that really have a drastic input into all conditions, but in particular, I think for people suffering with functional bowel disorders, it's so, so important to hear. And with regards to the proportion of people that you're seeing with these disorders, would you say it's growing? I mean, particularly in today's current climate with, you know, stress through the roof, financial difficulties, increasing rates of poverty, is this something that is is is very noticeable for you on a week by week basis?
Dr Saliha: 100%. And we are seeing more of it. And we see more of it in our clinics, but also remember that I always consider functional bowel disorders and non-functional bowel disorders to exist on a continuum, okay? So people who have non-functional bowel disorders like, you know, real visible diverticular disease, real visible gastric ulcers, real visible Crohn's and colitis, okay? Those diseases exist as proper non-functional identities, but then they overlap somewhere as well with functional bowel disorders. So all those sorts of people will have a functional element to their symptoms. So absolutely everybody, even people with true scientific biological digestive health problems are sufferers of functional health bowel health problems. And I also see it as normal people, you know, people who don't need to see a gastroenterologist, we are all on a continuum somewhere between absolutely normal and floridly IBS, okay? So this is the continuum, normal IBS, okay? And some people spend most of their life on the normal side, some people spend most of their life on the IBS side, but all of us at some point or another will swing towards the IBS side and back and swing and back depending on what's going on in our life and in our guts, most importantly. So to be able to break this thing down and actually normalise it and say, listen, you're functional, I'm functional, we all are functional, you have IBS, I have IBS, everybody in the world has a bit of IBS, you know, that's really, really powerful. So we need to almost normalise these things and say, it is okay, we all have bowel symptoms. There is not a single person in this world who's not been horribly bloated, horribly constipated, you know, have had not had, I don't know anybody who's not had acid reflux at one time or another. So there's this, you know, your digestive system has this sort of universal language of symptoms and we are all familiar with it. So we are seeing more of it, but the compassion for it needs to increase as well, the understanding of it and the normalisation of it also needs to increase at the same time as us seeing more of it.
Dr Rupy: Yeah, absolutely. I I love the way you've painted that picture of the spectrum and I draw a parallel with a conversation I had with Drew Ramsey, who's a psychiatrist in New York. I think he also lives in Indiana as well. And he said, you know, there are some stats that are banded around about how one in four people have mental health. And he was like, four out of four people have mental health. We all have mental health difficulties, but it's that spectrum that you articulated there where, you know, on one side, it is copable and, you know, day-to-day, you are euthymic or you're very happy and content. And on the other side, you're so low in yourself that you can't get yourself out of bed. And we swing in between those two to various degrees. And I think normalising that conversation in the same way you're discussing with functional bowel disorders is a really good framework to think about these things because it makes it a lot more compassionate just like you were saying. Within that is a problem though, because whilst there are many compassionate gastroenterologists like yourself, if you're waiting 12, 16, 18 months to see a specialist dietitian on the NHS, you're going to be exposed to Dr Google. And, you know, Google's great. Don't get me wrong. I think Google has been responsible for a lot of my education, so I'm actually thankful that there are incredible search engines out there. However, if you're not approaching it with an analytical mindset and a scientific methodology, you are prone to misinformation and that's where you get all these different erroneous diets that people, particularly if they don't have positive investigations, are prone to sort of indulging because they don't have any other avenues to to turn to. I don't know if that was what you were going to say next, but but yeah, what are your thoughts on that?
Dr Saliha: Yeah, I mean, my thoughts on that is, yeah, Dr Google is is um, is powerful and dangerous at the same time. Um, and I often have this conversation with my patients where I say, right, so what have you read then? Tell me, what have you read? And it's really important to know what they've read because they come out with the most wonderful things you can imagine. Um, and I really, really, I think that's one of the most important questions I have in my toolbox is, right, so tell me what have you read? And we don't ask our patients that enough. When you ask our patients what they've read and what some of the sort of truths they've created in their mind about nutrition are, actually then you realise to work this, we've got to break it all down and start bottom up, which which and then that the question then comes, you know, first of all, how can we point our patients to the right pieces of information? And secondly, what tools can we try and arm the general population with to try and put those people who are swinging in the pendulum from normal to IBS back towards the normal side most of the time, okay? And I think there's a real lack right now of standardized nutrition related materials that doctors, not just gastroenterologists, but other doctors more broadly can utilise for their patients. And these are sort of, you know, British Dietetics Association style sheets, but not done in that sort of facty, facty, facty manner, done in like a practical way with a patient sat down looking at what they eat and saying, well, how actually can we put these recommendations in practice for you, you know, who you are, what your taste preferences are. So there's a lack of that and that's certainly something that I would like to work on in my career going forward to try and help as many people as possible. And then the question is more broadly with the general population, how do we prevent that, you know, swinging towards irritable bowel syndrome or swinging towards functional bowel disorder? And the answer is finding joy in food, okay? Um, food is joy, it is sensory, it's, you know, wonderful, it's amazing, it's the most, it is the most powerful thing and sensory experience that we can do for ourselves. What you eat for breakfast, lunch and dinner is incredibly important to your health going forward in the future. So I think a lot of work that I do is about framing food as this sort of joyous thing and framing food as something that isn't restrictive, framing lifestyle based eating as something that isn't a diet, something that is full of joy, full of hundreds of different ingredients. And that's something that you do really well, Rupy, and which is why your channel is so popular. Because I think you really celebrate food and the joy that it brings to people. You encourage people to eat. You see, because if when a patient comes to you in clinic, they've been avoiding and restricting so many foods that actually life has become quite difficult. It's hard to make food choices when you're stuck in that state. It's hard to be inventive about food and it's hard to foster that really healthy, happy relationship with food when you're suffering with with digestive symptoms. So to empower people and say, we've got to get you thinking about food in a positive way again. Food is joy. What are your favourite things to eat? What do you think healthy actually looks like? Do you think you could design a couple of recipes that fulfill these healthy criteria that I'm telling you about? You know, how can we build it up so you increase the repertoire of what you're eating? And actually when you give that control back to people and you say, wait, hold on, you've been stopping yourself eating. No, no, no, no, no, no. It's not about stopping what you're eating. It's about eating more. More, more, more, more of the good stuff. Yeah, no dieting, no restriction, eating more of the good stuff. That's what I want you to do. And you've got complete control over it. It's not me, I'm not giving you recipes, I'm not giving you rules. What I'm giving you is the tools to be able to look after yourself long term. And the idea and the concept that diets don't work, restriction of food doesn't work, eating a full balanced diet full of colour, um, is what really is going to work for you. Cooking, cooking is so important, the important, you know, putting value on the importance of cooking is so, so is just vital. You know, so encouraging people, yes, food is joy, but cooking is also joy. I mean, I sort of tell people, do you know you're a coctivor? And they're like, what? I'm saying you are, you are a coctivor. And they're like, what does that mean? So coctivor is Latin for one who cooks. So as, if you think about it, take a step back, as human beings, we are the only species who can cook. The only species who inhabit this earth who is able to cook. Cooking changed us, okay? So cooking completely changed us. The ability to digest food that is cooked completely changed us because it meant that our gut shrunk, our brain size increased and we became the human beings that we are today. So in Latin they have this saying, 'coquo ergo sum', which is I cook, therefore I am, you know? And we need, you know, we need to remember that cooking and eating food, a variety of different food is something that we have done for many, many years and on evolutionary terms is something that separates us from all of the other species that inhabit this earth, which is why it is so fundamentally important because, you know, that fox down down in your garden at night, he's not cooking some scavenger stew, right? No monkey is cooking any of their food in the jungle. It is just us and that is why it's so important to not rely on ultra processed foods that you can just pick up. It's important to cook from scratch at home. It gives you a sense of control over what you're eating. You can put a lot better stuff into your body and you can really rekindle that connection that you have with your evolutionary self.
Dr Rupy: Yeah. I mean, I could listen to you talk emphatically about food all day long and it's so lovely to hear a colleague talk about it in these terms because I sometimes I feel like I'm the only one and I certainly was when I was, you know, a junior GP registrar almost 10 years ago now, like, you know, chatting to patients about it. And I'm just wondering like, where did you get this sort of energy from when describing food and looking at the history of food and sort of how did you manage to teach yourself the basic nutrition from, you know, back in the day where the FODMAP diet sort of like went over your head? Like what what was your journey from from that patient onwards?
Dr Saliha: I mean, I'm very clear, I'm not a dietitian, but I'm a gastroenterologist with an interest in food and I am a chef and author, right? So that is that's where my skill set lies. Also, I'm just really greedy, Rupy. I'm so, so greedy. I just want to eat. I'm obsessed by food. I'm utterly obsessed by food. I have children, I want to feed my children well. I want to feed my husband well. My husband's probably the most well-fed man in England, honestly. You know, and also subject to all of my experimentation. But um, yeah, I think the desire comes from greed, um, food greed. I love food and I will always love food. I will love eating food more than anything. I think I love eating even more than I love cooking, right? So in order to eat the right things, I need to arm myself with the knowledge. Um, and then I think it's scientific curiosity, isn't it? I mean, we all have things that enthuse us, you know, um, my husband loves football and knows so much about it. I love food and know so much about it, you know, it's just that is that curiosity from within to acquire knowledge. And it's also very, very, very empowering when you know that that knowledge has actually made a difference and you've seen that it's made a difference. It's also very empowering to be in a career where you have a USP. You know, so I feel very lucky that yes, I'm sort of different to many other gastroenterologists in a way, but I like to think that as a young gastroenterologist with an interest in health and wellbeing and lifestyle, that I'm making some sort of a difference where others haven't been able to make. So those sort of factors are all things which motivate me because, you know, I actually remember seeing the Doctor's Kitchen or your work for the first time, you know, close to a decade ago, roughly, was it? Was that how long ago you started? Yeah, yeah, yeah, yeah. And I remember seeing your early work some years ago and I was really, really impressed by it even then. And it's really nice to be able to find like-minded people to connect with. And these, this platform that you've grown is really powerful because you can attract people who are looking for the right answers. Um, and I guess one of the other things I'd say is, I'm not arrogant about my abilities to provide answers. And I never overstate the truth with my patients. So nutrition is this incredibly sort of grey area and I think it's one of the areas, I really think it's one of these areas in medicine which will stay very grey for a very, very long time. We're not going to always have the answers for what is the best to eat. And more and more we're finding that, you know, Rupy, what suits you may not be what suits me, you know? We've got very eminent professors, Tim Spector, etc, talking about personalization of nutrition and it's incredible, you know, what nutrition looks like today is 100% not what it will look like in a decade and it's not what it will look like in another 20 years. So, um, we have to recognise that we're in this like, um, flux, we're in the flux and we're also always just aiming towards best practice. So that's what I say to my patients, like I can't give you the answer. Like, I can't tell you that having a bit of grains is not going to give you some bloating. Like I just, I just cannot give you that answer because people often in nutrition want black and white. So, doctor, are you saying it's okay for me to eat oats, but it's not okay for me to eat chickpeas? I'm like, not really. I'm saying is I don't really know. You know, and it's quite hard to deal in grey terms with people. Um, one of the things that I found really helpful is slow changes. Um, so I think when we talk about anything in our life, changing it, you know, I know I've had two children and there's nothing more dramatic as when you have a child and how your life changes and it just sends you wild, you know, like life goes mad all of a sudden. But, you know, I look back at those big transitions and I think I wish people had told me to break it down and take it step by step and just try and enjoy each moment. And it's the same with food and lifestyle and health and nutrition related changes. You know, you have to, you have to do it really, really slowly. So your journey doesn't look like, you know, a life of ultra processed foods and then, you know, being, I'm going to change my life, now I'm going to eat fruit and vegetables, legumes, pulses, nuts and seeds and, you know, cut down on my meat. It just doesn't work like that. Your bowel will go nuts if you do that because it is just not used to what you're putting inside it. You have to build up the change day by day, week by week. You have to really focus on the tangible gains that you've made because these changes, if you want to persist and make them for your life, it's not something that you can change overnight. In the same way that adapting to motherhood, for example, is not something you do overnight. You know, you get good at being a mum with years and years of practice and with making mistakes in between because, you know, my kids eat a fair amount of crisps and chocolate sometimes and, you know, c'est la vie, it just happens. So my point is this, we're not perfect, nutrition as a field is far from perfect. So never sell yourself, this is my motto, I don't sell myself as the answer to everything. I say to people, this is what I think is best, this is what how I think you should do it and these are the tangible gains I think you'll have. See what you think and enjoy the process because when you make those lifestyle changes and you make those food related changes, you will notice an incredible difference to your energy level, your skin, you know, your weight, your ability to do more exercise, etc. It will change. And it is incredibly rewarding to see those people come back and say, yes, slow and steady does win the race. So I think focusing on the individual and their journey slowly and not making dramatic changes is quite important.
Dr Rupy: Yeah, absolutely. I I totally agree. And I think a lot of what I have to do actually is to re-educate people that it's not an either or, it's an and. And just because, yes, I'm bullish on the impact of food and nutrition as preventative medicine, doesn't mean that, you know, you just completely abandon allopathic medicine or medications. The the the many different disciplines, the many different tools can be used in combination and actually work very well synergistically. Um, and and actually, you know, to to your point about how people always want a food solution, sometimes I find myself reminding people like, you know, it's okay to to have medications. It's not like you failed yourself if you can only use a quote unquote natural way of protecting yourself or improving your immunity or whatever, whatever. You know, these are just extra tools that we have. Um, and and talking of tools and talking about you doing you, boo. I wonder if you could talk to us about how you look after your own health because, you know, like you said, before we went live, the fact that you've been managing your children, your job, you're still working in the NHS, like it's a lot to handle. Like how how are you making sure that you're getting all those different features in your diet, your rainbow diet, your amounts of fibre, you're still sort of, you know, looking after you.
Dr Saliha: I think I have a, I've got some principles that I live that I live by. So, um, I do try and eat as many plant-based items of food as I possibly can within the course of a week. I don't really analyse it. Um, I don't really do counts of it, um, because I feel I don't need to. And if there's a week where I'm a bit short, I know that I'll make up for it in subsequent weeks. Um, so I have this mental, you know, um, I have this mental count, rough, it's not, it's not even a physical count or a tally or anything. It just happens, you know. I'm an expert shopper. I'm an expert shopper. Um, so I know exactly where I'm going to find the bargains. Um, and I take loads of them home. My freezer is shocked to the full with frozen vegetables and fruit. Um, I have an incredible store cupboard, small, but full to the brim with very gut healthy ingredients. I have so many lentils, so many pulses, you know, so many different nuts and seeds and stuff in my store cupboard and I use them to my full avail. I try and make sure that everything gets used, it doesn't just sit at the back of a cupboard. I don't deny that having some cookery expertise means that I am more likely to be able to think creatively about what to do with those ingredients when I do have them. Um, so and that's why I've I've written the recipes, um, written my foodie recipes in my second cookbook, Foodology, and then in a proper cookbook that's coming out in March 2023, um, The Kitchen Prescription, so I can try and teach people how I quickly, efficiently, um, manage to rustle together gut healthy food for myself and for my family. Um, I think I am very wary of budget because I have to be. Um, I make sure that I, uh, buy vegetables in bulk, um, particularly frozen vegetables and I make sure that I use them as creatively as possible. Um, I really, really, really try to get my kids to eat the same thing that we're eating. Um, it can be challenging sometimes and I acknowledge that sometimes I have to cook different things just to please them and get them fed. But most importantly, apart from the key thing of having as much fruit, vegetables, grains, legumes, nuts, seeds and pulses in my diet, I'm not hard on myself, Rupy. I allow myself to have food with that people wouldn't conventionally think is good for you. It is okay to sometimes have a macaroni cheese. It is okay to sometimes have a bowl of pasta because what would life be without a bowl of pasta? It would not be good, okay? Um, I don't restrict carbohydrates. Um, I get carbohydrates from a variety of sources though, like I do get different grains in my diet. I have pearl barley one day, I have bulgur wheat another, I have couscous another, I have pasta another day. But I don't think there's a day in the week where I've had a carbohydrate free day. Let's put it that way. Um, one of the things I've really had to push coming from a Pakistani household, um, where meat is a big focus is how I can reduce the amount of animal-based protein in my diet and my family's diet because I grew up on basically almost having meat every day because that was just the norm of how life food is cooked and vegetarian food was like the day off, you know, it wasn't the norm. So to flip that on itself, I've had to work hard to flip that on itself. Um, and I've had to, you know, change that for my husband as well. Um, so it's, uh, I think I'm not, the key things I would say is, I eat a variety of food, I'm conscious of budget and shop very intelligently and I allow myself like discretions and I allow myself to be naughty sometimes without it affecting my self-esteem or confidence in my ability to eat a healthy diet overall. So I sometimes say like, in a kind of ironic way, you know, I feel like all my like nutrition chakras are aligned and I'm like in this kind of zen space with my eating, um, which is how I want other people to be as well, if they can reach that point where they're comfortable with what they're having and not get too hung up on occasional plates of indulgence. It's okay, you know.
Dr Rupy: Yeah, yeah. It aligns very, I mean, I feel like my nutrition chakras are aligned now that you just said that. It really that really resonates with me because I don't count anything. I don't count calories, I don't count, you know, portion sizes, I don't do any of that kind of stuff. But just naturally, if I were to examine my diet on a on a daily or weekly basis, it's just like chalk full of like variety, diversity, all the different types of foods. But like if I'm thinking about what I had yesterday after I had Sunday lunch with my mum, dad and um, uh, partner, we shared a chocolate croissant with like a um, an almond sort of glave on top and it was amazing. It was so good. It was freshly made, it was warm, it was delicious. It had hints of cinnamon on because it's like Christmasy time. So, you know, I still enjoy those things and sometimes I feel like I have to post that kind of stuff on social media to remind people that it is okay. You don't have to eat, you know, 100% clean the entire time. You know, it's actually important to introduce some some uh, uh, like healthy treats or not not healthy treats, but just treats into your diet and I don't really see it as a treat. I just see it as like, well, this is just how I'm going to eat.
Dr Saliha: Totally, because, you know, you have to see where you live, like which world we live in and indulgence is a part of life, you know, people, you know, people still consider going out for a steak, for example, being as a celebratory thing to do, for example. So, you know, therefore, are you going to stop eating steaks because it's got lots of saturated fat and is an animal-based protein? Well, for me, no, because I'm not a vegan either. I, I see the merits of vegan eating, um, and I understand the, um, I understand the ethical reasons for vegan eating, but I'm not a vegan at this stage in my life. Um, and so I, I do eat animal protein and I do enjoy it, but it's a, it's something to be had on occasions, right? So it's not something that's for every single day. So it's when those, it's when you're eating that pattern of food all the time that actually the pleasure from it has gone. That's one of the reasons, Rupy, why that croissant was so joyous, yeah, was because you do eat such a lovely, wonderful diet normally, which gives you great pleasure. So when you have that item that has that lovely sugar and fat and those nuts and spices in it, and tastes so utterly wonderful, you can appreciate it. It's like life with contrast, isn't it? You have to, you have to have sadness to appreciate joy, not that the other food you eat is sad, but you know what I mean, like there's always got to be, there's always got to be like, when you have the contrast, that's when you appreciate the other type of food more. And I'm talking about this and that type of food, but actually, you know, we shouldn't think about it like that, but, you know, all food has its place. I mean, when I wrote my first cookbook, Foodology, I sort of wrote chapters examining why we love crisps. You know, I wrote a recipe for an egg sandwich stuffed with ready salted crisps in my book as testament to the fact that crisps taste so good in sandwiches, right? Um, I have written recipes with with steak in them. Um, I've written recipes with potatoes, um, because these are the things that we absolutely love. I've written buttery recipes, but in contrast, I've also written recipes which are, you know, lush in brassicas and, you know, eating the whole rainbow or teaching people how to use grains, etc. Because every type of food has a place in our life and it's important to not forget that all those different foods do have a place in your life. I mean, I wrote chapters on chocolate, for example, and, you know, why chocolate is so addictive and the benefits of chocolate and, you know, that 50/50 mix of sugar and fat and what it does for your taste buds and, you know, I've written about and, you know, what effect sugar has on the brain's reward pathways and why it is that you love a Magnum so much, you know, when you crunch into a Magnum and the chocolate breaks, what is it about the texture and taste of that that makes it so desirable? So a true food lover, a really true food lover who's found their gastronomic zen and all their chakras have aligned, will not see healthy and unhealthy foods as two disparate objects. They will see all food lying on a continuum and they will allow themselves to eat everything in moderation and actually will by virtue of that eat an incredibly good variety of food overall.
Dr Rupy: Yeah, absolutely. When you mentioned Magnum, I just got like a, an image of Mo Gilligan's latest stand-up. I don't know if you've seen it. He talks about how when he was a kid, he took extra money from his mom and went to go buy a Magnum and he describes eating the Magnum, the crunch of it, and then you get down to the stick and then you get to the stick and then you're like biting off the chocolate off the wooden part of it. And like when he's describing it, I'm literally like, oh my god, that's literally my childhood right there, the Magnum, amazing, amazing. You're going to check it out, it's really good. Um, I'm going to ask you two more things. So, everyone who who's listening, who's got kids, they're going to want to know some of your hacks for getting vegetables and variety into their diet. So you must have come up with a few since having since having children. So what what are some of your sort of top tips for uh, for sneaking veggies into kids and nutrition?
Dr Saliha: Oh, um, the blender is your best friend. Honestly, the blender is your best friend. One of my top tips is basically hiding it. So I'm not, I'm not going to fool with you, literally. I'm not lying to you and saying, oh, you know, I'm really good at this and your kids will have it if you tell them. No, kids are stubborn. They don't have it when you want them to have it, okay? That is just reality. And if anybody tells you otherwise, they're lying, okay? So the way you have to do it is you have to conceal it and therefore, for example, when I make a tomato sauce, you know, I'll steam some vegetables and blend them and then blend them into the tomato sauce so they've got no idea. I am proper deceitful with my children and I'm proud of it. Um, the other thing is to not give up. I think I once sort of heard a Nigella interview somewhere along the way and I think she had quite a nonchalant kind of relaxed approach and she was like, well, they'll eat when they eat, you know, they will have an appreciation for good food and it will come. And I do believe that. I've got an eight-year-old and a two-year-old and they're on very different food journeys at the moment by virtue of their age. Um, because, you know, children's tastes are very, very different and their taste buds are much more alive than ours are and eating is a far more sensorial experience for them. So we have to remember that as well. So they sometimes are not able to handle food that is incredibly flavoursome that we love in the same way. So just be patient. You just got to keep trying and you've got to be okay with failing with your kids. Like, you've got to be fine with them not eating it, you know, and not be hard on yourself. Like, you're not a failure if they didn't eat your food. That's one of the key things for my kids. Third thing that's important for my kids, I think is, um, to get to take them shopping with me. Um, if you've got kids who grow up, who are growing up, make going to the supermarket really exciting. So I do like really, really nerdy things like, you know, I'll talk to them about the Latin names of different foods. Um, you know, like for example, I'll be like, it's an aubergine, but is it an aubergine? No, it's a Solanum melongena, right? You know, so it's just try and make like some big joke of like where you are and what they're picking so they develop this sort of familiarity with fruits and vegetables and gut healthy ingredients. Um, and a desire to know a bit more about them because they can have a laugh with you about it and, you know, like I sort of make funny days for them, like I call Wednesday Wednes-day, you know, because it's vegetarian food day or, you know, just got to, you got to make it silly, basically, you got to make food silly for your kids. Um, yeah, so I think those would probably be my top tips. So go shopping with them, don't be too hard on them and yourself if you fail at it. Um, and and the last thing I'd say is, um, if they're hungry, they'll eat, okay? So if your kid goes to bed without dinner, they've gone to bed without dinner, okay? If they're hungry, they will eat anything in front of them, yeah? Anything you put in front of a hungry child will be eaten because hungry children eat. So if they've gone to bed without eating dinner, you don't need to be too hard on yourselves, they weren't hungry.
Dr Rupy: Yeah, you know, that is conjuring so many memories for me when I was a kid and I was just like, you know, being stubborn about not eating anything and then my mom would just be like, well, you're not eating. And then eventually, of course I ate. Like, you know, it's just the way, it's what we were grown up with.
Dr Saliha: I mean, I grew up in a family where you were fed dinner and then once you've eaten dinner, my grandma would sit down and be like, right, here's a banana. Now you eat the banana. So like, I was like, oh my god, you know, like we don't need to push it the other way. But um, yeah, I really, really truly believe that when a child is hungry, they will eat and I don't, I really believe that children don't stay hungry intentionally. So lightening the load off yourself, letting them be hungry, like letting them get to the point where they want to eat is really important and making food fun and hiding, hiding those occult vegetables is where it's at.
Dr Rupy: I love that. That's so good. Um, talk to us about the Kitchen Prescription. I love the name and uh, I love the fact that you're going to be talking to us about those sort of strategies and hacks that you can do to introduce delicious diverse foods that support your gut and support every other element of your body, um, on a daily basis. I'm I'm super excited for it.
Dr Saliha: Yeah, I mean, I am too. I'd say it's probably my best set of recipes yet. Um, they are interestingly my easiest recipes as well and they're the sorts of things that I eat most myself. Um, I suppose the subtitle to the kitchen prescription is 101 simple, nutritious, delicious recipes to optimize your gut health or revolutionize your gut health, something like that. And um, it's just what it says on the tin really. It's just the way I eat, you know, all the things we've talked about, how I put them into practice in my kitchen in a cost-effective, family-friendly way. Um, and in a very delicious, delicious way, basically. Um, you know, I sort of take simple things that you'd normally eat like a cottage pie and make it the gut healthy version of it or just teach you how to think in a gut friendly way or gut healthy way. And um, I don't want to complicate what the book does. The message is very simple, actually. Um, there's some reading material as foundation in the beginning of the book and then it's a proper illustrated, fun cookbook, really vibrant. Um, it's got stuff in there for feasts and mezze platters and freezer and store cupboard and lazy dinners and quick lunches that are portable, breakfasts, you know. Um, it's got, it's basically a manual on how I live my life, um, and how I cook. Uh, and I think it will be really helpful to a lot of people.
Dr Rupy: I love that. And the portable lunches just definitely sounds right up my alley because everyone needs some Tupperware ideas and stuff because it can get a bit stale otherwise. So yeah, no, that sounds fab. And when it's out, we should hopefully have a studio where we're going to be doing a lot more sort of filming and all that kind of stuff. So I would love to to to cook one of those recipes, uh,
Dr Saliha: Oh, yeah, let's do it. Let's do it. I'd love that.
Dr Rupy: This has been fantastic. Thank you so much. This is awesome.
Dr Saliha: You're welcome. It was great fun. Thank you.
