Dr Rupy: Hello and welcome back to the Doctor's Kitchen podcast. Today we're going to be talking about our first principle of healthy eating: eat colourful. I'm here with Dr Anita Mitra, who in all her glamour has just stepped off a plane from Amsterdam, having presented at an international conference. She's an obstetrics and gynaecology trainee with a PhD studying the vaginal microbiome in cervical pre-cancer and training in medical biochemistry. Stick around to the end of the pod for tips on how to eat more colourful on a daily basis, but right now, let's get into talking about why we should eat colourful. A lot of people are probably scratching their heads right now as to why Dr Rupy has got a gynaecologist to talk about plant chemicals. He's completely lost it, the book writing process has taken over him, he doesn't know what he's doing. Do you want to explain to the listeners as to why I've had the pleasure of having you in?
Dr Anita Mitra: Yeah, so, hi everyone. So I know a lot of people don't believe in past lives necessarily, but I have definitely had one. So, I actually did a degree in medical biochemistry before I went to medical school, so I spent three years just being a pure science geek. And in the last year, I worked in a research lab, and it was a cancer chemo-prevention research lab. So what we did was we looked at the exact mechanism of how different chemicals that we find in foods are anti-inflammatory and anti-cancer agents. And then we also translated some of this research into clinical studies where we actually looked at how they can be used for patients undergoing cancer therapy at the time. So pretty interesting. So yeah, I spent a couple of years actually working in that lab. And it's kind of how I also became interested in lifestyle medicine in general, because it's when I first started to really realise that what you eat really does matter and it's not just about how many carbohydrates or how many calories you're putting in or whatever, it's about the quality of what you're eating as well.
Dr Rupy: Exactly. And that's kind of how we bonded as well. This love of plant chemicals and phytochemicals and all that kind of stuff.
Dr Anita Mitra: Exactly. That's how Rupy and I met, via Instagram. I think like Instagram's like the new Tinder for people who are interested in wellness.
Dr Rupy: That's so funny. Yeah, I'm referred to as her Instagram boyfriend, but she does have a partner. It's not me. Just to make sure. No rumours here.
Dr Anita Mitra: Yeah, no rumours.
Dr Rupy: Anyway, why don't we get on? Loads of people are scratching their heads again. What is a phytochemical exactly? Can we define that?
Dr Anita Mitra: Yeah, so as someone who's currently learning Greek, I'll tell you that phyto is the Greek word for plant. So it's basically a chemical or a nutrient that you get from a plant. And so there's loads of different kinds of phytonutrients or phytochemicals, which I don't think we'll go into too much detail, but the different kinds depend basically on the chemical structure.
Dr Rupy: And just that changing that chemical structure very, very subtly can have massive effects, right, on like the quality of the colour, the smell.
Dr Anita Mitra: Exactly.
Dr Rupy: That kind of stuff, right?
Dr Anita Mitra: Exactly, yeah, absolutely. The reason that plants have phytonutrients is basically because they're part of the plant's immune system. And so they are usually typically found in the skins, if a plant has a skin, you'll find generally speaking the highest concentration there because they're just there to protect the plant and it's a great side effect for humans that they are really healthy for us.
Dr Rupy: Great. Okay. So they're concentrated in the skins, that's why we try and keep the skins as much as possible, as long as you can tolerate them. So what is the difference in between micronutrients and phytochemicals or phytonutrients as they're sometimes referred to as?
Dr Anita Mitra: So a phytochemical always has to come from a plant, but micronutrients can come from animal-based products as well. And they just tend to have slightly different properties.
Dr Rupy: Yeah. And I foresee a future where at the moment we look at vitamins and minerals and we say, you need to have X amount as your recommended daily allowance. I think in the future we'll probably have a recommended daily allowance of phytochemicals. I mean, right now we have five a day or ten a day, depending on which school of thinking you're coming from, but that's certainly something I foresee in the future with all these different phytos.
Dr Anita Mitra: Exactly. And I think really we don't know what the right concentrations of phytonutrients are for humans at the moment. But I think that the five or the ten a day rule is a really kind of handy surrogate marker and it's just a way of saying like, are you kind of grossly speaking eating enough of these compounds? Because they are one of the predominant reasons why we should eat five or ten a day, to make sure that you're getting these compounds.
Dr Rupy: Totally, yeah. So there's this concept of plant hormesis that I want to introduce to the listeners. It's where cells or organisms are challenged by noxious chemicals. And they are literally noxious chemicals that we find in plants that enable the cell to respond adaptively. So actually what we do is when we ingest these sorts of plant compounds, they elicit a response that's adaptive by our body and that reduces overall inflammation that leads to health benefits. It's quite difficult to get your head around that ingesting these sorts of plant chemicals are having initially a stressing effect on the body, but that leads to health benefits. It's kind of, I use the analogy of exercise. So exercise is essentially an inflammation producing and a stressing producing activity that we do, but we know overall it leads to health benefits, improves our cardiovascular function. It essentially conditions our body to deal with more stress going forward. So there are tons of different benefits of consuming these different plant chemicals.
Dr Anita Mitra: Well, first and foremost, we've always known that we should eat plants, fruits and vegetables because they contain antioxidants. So antioxidants are useful because as part of the normal sort of metabolism of the body, you do make these things called free radicals. And you don't want to have lots of free radicals in your system because they contribute to ageing, they can promote inflammation, and they can also increase your risk of getting cancer, partly on their own, but also because chronic inflammation also is one of the major causes of cancers.
Dr Rupy: I think you picked up something really important there that I just want to emphasise to the listeners. It's normal to have free radicals as a byproduct of normal metabolism. So the ways our cells respire is going to have a waste product at the end of it. And it's the excess of these waste products that we need to sort of balance, right?
Dr Anita Mitra: Yeah, exactly. I think free radicals have got this really bad name and it's kind of like lactic acid in your muscles at the end of exercise. It's the same thing. It's just, as you said, it's a waste product and we just need to get rid of it. So by eating foods that contain antioxidants, then we can help the body to get rid of these and reduce their effects. As well as being antioxidants, there's lots of scientific data out there to show that these chemicals can actually act directly on pathways that are working in the body all the time. So there are lots of sort of inflammatory pathways that you can have, lots of pathways that cause the cell to divide and renew, so for tissue homeostasis we call it, so maintaining your tissues. And then if certain pathways are affected in the wrong way, that can lead to development of a cancer or a disease that's associated with excess inflammation, for example. So these compounds are really clever and able to actually act directly on these pathways to make sure that we don't have the wrong kind of tissue activity going on.
Dr Rupy: That's incredible, isn't it? Like the degree of technology that we find in these naturally occurring plant compounds just completely overshadows anything that we've created synthetically in medicine, right? Not to say that there is one that's superior to the other, but it's just absolutely fascinating that it can have these health promoting effects.
Dr Anita Mitra: Yeah, exactly. It's incredible. Exactly. And so some of the research that I was doing previously was looking at particularly I worked with curcumin.
Dr Rupy: Okay. Which we find in… I wanted to talk to you about turmeric because I always, I always get asked about, is turmeric a thing? Is this real? Is it, is it just rubbish? Is it just a trend?
Dr Anita Mitra: Well, I think that it is really important. And it's a really good example as a case study of phytonutrients and how they're applicable to human health and disease. So we knew from epidemiological data, so that means data that's been collected looking at the effect of an agent on a population and the disease that they get. And we know that curcumin appears to have, amongst other properties, anti-cancer properties. So in the lab where I was working…
Dr Rupy: Curcumin being a chemical that we find in turmeric.
Dr Anita Mitra: Exactly. Yeah. So curcumin being one of the main phytochemicals that's found in turmeric. So what we did was we were using different cell lines, so it's cells in a petri dish from different tissues of the body. And so what we used to do is put different concentrations of curcumin, so pure curcumin, onto the cells and see how they changed different parts of the cell cycle. So that's how the cells divide. And so we and also looking at other kind of cancer pathways to try and understand how exactly this compound has anti-cancer effects. And we found some really interesting information and we used that information to translate that into a clinical study which is ongoing, looking at how curcumin can actually be used to help people who have bowel cancer who are undergoing chemotherapy. And so if you can understand exactly how it works, then you can start to apply it to humans. But there's a couple of things I want to say really. So just because something works in a petri dish doesn't mean it works in a human. Because what I was doing was literally getting some curcumin out of a jar and putting it onto cells. It doesn't quite work like that in humans because first of all, you can have great basic science studies like that, but it doesn't mean that the concentrations that you're putting on your cells in that dish apply to what you're getting when you go and eat your, I don't know, like some dhal or a curry or something with your curcumin. So that's one thing. Second of all, there are other phytochemicals in turmeric and these probably also have an effect. And also it's what you eat your phytochemical with. So if you have whole turmeric, you're putting it in a dish and you might be putting other things in. And black pepper is a great example. So curcumin will be much better absorbed when you have it with black pepper. And there was a really interesting study on a TV show last year. Was it on one of the BBC…
Dr Rupy: Yeah, Trust Me, I'm a Doctor.
Dr Anita Mitra: Trust Me, I'm a Doctor, yeah, where they were looking not at anti-cancer properties, but they were looking at anti-inflammatory properties of curcumin. And they found that people who had it in food rather than the group who had it as a supplement actually did much better in terms of the outcome that they were looking at with regards to inflammation.
Dr Rupy: That was a really interesting small scale study, wasn't it?
Dr Anita Mitra: Yeah, it was, it was, yeah, it was very small but really interesting. I think it's just a really stark reminder of the fact that you shouldn't necessarily just pick up on a compound and think, right, that's it, that's what I need. It's all about what you eat it with and how you integrate it in your diet and what other compounds you're having with it as well.
Dr Rupy: Absolutely, yeah.
Dr Anita Mitra: So I think, yeah, curcumin is my number one phytochemical in this study.
Dr Rupy: It's one of your number one phytochemicals. Yeah. And it's, yeah, and I think it's fascinating. I think you picked up on something really important there that curcumin is just one of many bioactive compounds that we find in turmeric as a whole plant where there's multiple different curcuminoids. It's the arrangement of those particular molecules, how they relate to the cells, how they relate to our body, what we ingest them with, what our gut bacteria population is saying. I'm actually going to talk about gut bacteria and how that has an effect on health effects on a later episode. But I just want to get back to eating generally and eating the rainbow. And you know, you hear all these things talking about eating. I always get eye rolling from my friends whenever I say eating the rainbow, but I think it's a very simple, easy concept for people to digest, excuse the pun. What does it do for us? Are there benefits of this and you know, does this actually relate to the food that we put on our plates?
Dr Anita Mitra: I think if you look on social media, it's really interesting at the moment. There's so much controversy about dieting rules or like eating rules in general. And I personally think that eat the rainbow or even hashtag eat the rainbow is actually just one of the most constructive pieces of advice that you could give to someone. And particularly with my patients, I always, you know, I have a really short amount of time and they're really not coming to me to talk about their diet. They're coming to me to talk about something completely abstract, but the diet has a really big impact on. So I need to kind of give them a really, really short piece of advice. And so I always say, you know, just something to think about, eat the rainbow. Obviously in context, I don't just say that as they're leaving the room.
Dr Rupy: You don't just eat the rainbow as they leave. Yeah, I'll see you next Tuesday, eat the rainbow.
Dr Anita Mitra: No, but like in context because I think it's something really easy that anybody can do. It doesn't take much thought. And you know, you can be, you know, you have your plate in front of you and you think, how can I make it as colourful as possible? You know, let's be honest, like with the greatest will in the world, you're not always going to sit down and make your menu for the week and then go out and do your shop. But then you might have some kind of like random things in the fridge or the freezer and you just, you're making dinner and you're thinking, hold on a second, how can I make this more colourful? And whatever you add that is natural and colourful, I really don't think you can go wrong because you're always going to add something good to that meal. And all of the kind of like colourful things that have lots of phytonutrients have tons of other really, really good things that we want to be eating. Like most of them contain loads of fibre, which, you know, you can, you know, I don't think many people in this country really eat too much fibre, let's be honest. Everyone, I think pretty much all of us could do with trying to add a bit more fibre in our diet.
Dr Rupy: I think there's a common misconception that like we need to be eating more protein and protein's actually deficient in our diets and protein, protein, protein. But actually fibre, if you look at the studies, is massively deficient in our diets and there's clear benefits of having more fibre in our diets.
Dr Anita Mitra: Exactly. There's many more benefits from having more fibre than there are from having more protein. So, you know, I think, but you know, you're always going to get something else good with those phytonutrients that you're putting on your plate. So just like the tiniest things like, you know, maybe you've got that red pepper kicking around in the back of the fridge. Just like get it out and use it before it goes wrinkly. And you know, just put it on. I mean, there's not many things that red pepper doesn't go with, for example. And you know, you just chuck it in and then, you know.
Dr Rupy: It's almost like an argument for eating more colour versus counting calories, right? So eating colourful versus counting calories is something I try and promote as much as possible because I think a focus unnecessarily on calories is quite detrimental to a lot of people because it gets them to overly obsess about things.
Dr Anita Mitra: Oh, completely. And I personally have like been there, done that. You know, it's just, it's just too much. And I think as well that you can get really stuck in a rut when you're kind of like counting calories or, you know, you don't kind of explore the supermarket in the same way. And I think if you go to the supermarket with an open mind, or even, you know, farmers market or a market, wherever you're buying your food from, you go there and you just think, okay, great, like what looks really fresh? What's enticing me today? And you know, colour's always going to stand out at you. And you know, if it's there and it's fresh and it looks good, then you know, you're going to buy that and you're going to make something really nice rather than going to the supermarket and thinking, okay, right, so I made this last week, so I need to get these ingredients. It's boring. It's not inspiring. And I think that eating the rainbow is something that you're much more likely to stick to rather than eating, say, 2,000 calories and 40% of these have to be protein or whatever. You know, I think that that's just, it's less strict, it's way more fun. You're going to stick to it.
Dr Rupy: Totally, yeah. And one of the things, bringing it back to being colourful and phytochemicals in general, one of the most exciting discoveries that I had was about a certain type of phytochemical called sulforaphane, which is what we find in brassica vegetables. I find it absolutely fascinating that this can have biological effects that we can actually examine and investigate in a lab and actually show why a diet that is more colourful is healthier for you. We're actually trying to prove the plausible mechanisms behind how these plants actually have benefits. Have you had any experience with sulforaphane or anything like that from your lab experience?
Dr Anita Mitra: Yeah, so I worked with indole-3-carbinol. So I think that's…
Dr Rupy: Which is another component that you find in broccoli and cauliflower and cabbage and that kind of stuff.
Dr Anita Mitra: Yeah, exactly. And I just think that there's so many studies that have shown health effects of indole-3-carbinol. Particularly in terms of gynaecological health as well, which, sorry Rupy, I am going to talk a little bit about.
Dr Rupy: I'm going to go there. You can talk about women's health. That's absolutely fine. I'm a big promoter of it. Please carry on.
Dr Anita Mitra: Yeah. So, indole-3-carbinol is a compound that in particular has been shown to promote metabolism of oestrogens. Okay, so you've got two main female hormones. You've got oestrogen and progesterone. And although we do need oestrogen, a lot of women's health problems that are very prominent these days are due to having a lot of oestrogen. So endometriosis, polycystic ovarian syndrome or PCOS. And then also breast cancers and endometrial cancers are all oestrogen-driven diseases. And they can be really problematic. Or even just having heavy periods, for example. If you have heavy periods and there's no sort of known reason, it's often that you've got lots of oestrogen that's causing your lining to build up over the month and then you have a heavy bleed. And so we get rid of oestrogen in a couple of ways. Firstly, through the GI tract, so through, you know, making sure you're not constipated.
Dr Rupy: So with fibre, yeah.
Dr Anita Mitra: Yeah, exactly. But also the liver breaks down oestrogen. Okay. And so you've got inducible enzymes in your liver. And these help with oestrogen breakdown. And indole-3-carbinol has been shown to actually help the liver to induce these enzymes. But also this particular compound has been shown to actually help in the breakdown itself. So I think it's a really, really good compound to try and get in your diet through eating lots of things like brassicas, you know, like broccoli is my absolute favourite.
Dr Rupy: Definitely, yeah, yeah.
Dr Anita Mitra: Because it is a way of just like helping your body to get rid of excess oestrogens. And you know, then people will think, okay, well, am I going to get deficient in oestrogen? And obviously oestrogen deficiency particularly causes osteoporosis. But if you have it in your diet, it is really not, you know, it would be very unlikely.
Dr Rupy: We're not talking like a medication that's going to drastically reduce your oestrogen levels.
Dr Anita Mitra: Exactly. But then there are some studies that have shown that people who've been taking it as a supplement have actually caused their bones to become a little bit weak.
Dr Rupy: And that goes again to the whole ethos of the Doctor's Kitchen and everything else, to try and get as much as you can from your diet rather than relying on individual supplements in higher doses that you'd normally find in nature.
Dr Anita Mitra: Absolutely.
Dr Rupy: So I always get challenged in GP land about eating healthy being expensive and all that kind of stuff. How do we eat colours on a budget?
Dr Anita Mitra: Well, I think first of all, there's a couple of ways. So, I don't know if I'm allowed to mention supermarkets by name.
Dr Rupy: Yeah, we're going to talk about supermarkets. I mean, other supermarkets are available, but you're going to talk about…
Dr Anita Mitra: I'm going to talk about Aldi and Lidl.
Dr Rupy: Okay. Not sponsored.
Dr Anita Mitra: Not sponsored. If they do want to sponsor… But I think, you know, when you go to places like that, you will find amazing vegetables really cheaply to start with. So sometimes, you know, you might have to go a little bit out of your way because you know, there's always like a little Waitrose on the corner or whatever.
Dr Rupy: There's a little Waitrose everywhere, aren't there?
Dr Anita Mitra: Yeah. And you know, fruit and veg there will be eye-wateringly expensive sometimes because it's convenient. But if you go somewhere, you know, bigger supermarkets and also places like Aldi and Lidl have amazing fruit and veg. So that's one way. Secondly, I think if you're eating what's in season, it's always going to be better. I'm a bit obsessed with courgettes, to be honest with you. I just like, I love the taste of them. But when they're in, when they're out of season, they're disgusting. Because they're just all water and they're horrible. And and so then I just, you know, I maybe I'm not so in touch with what's in season sometimes because you just see it there in the supermarket, but then you taste it and you're like, it's not as good.
Dr Rupy: It's not as good, yeah.
Dr Anita Mitra: And you know then that you're getting something that's kind of, you know, it's been flown from a long way. So obviously it's going to cost more. And it probably doesn't have such good phytonutrient density as well because it's been picked before it's quite ripe.
Dr Rupy: I actually looked into this actually for research in the book because I'm always asked about whether we should eat local, whether it actually has an effect. Does it have an environmental element? I do touch on it in my book as well and I do reference some papers, but there are some benefits of eating more local. On the environment, yes, but maybe on the phytonutrient density of the foods as well because packaging, handling, the atmospheric pressure when they're actually shipped from abroad can have a detrimental effect. Marginal effect, but still an effect. However, that doesn't stop me from buying food that's been shipped in from Mars away if that's what's convenient and what's available because the bigger picture is, let's get colours on our plates first and then let's have a conversation about locality and stuff like that.
Dr Anita Mitra: Yeah, exactly.
Dr Rupy: But it's interesting to to note your opinion on that because I do notice a change in taste. And as these plant chemicals are responsible for colour and smell and flavour, then it does tell you a lot about the nutrient value of your food, right?
Dr Anita Mitra: Yeah, exactly. And then I think another thing that's a quite a good tip is really, um, frozen and like tinned, for example, is not a bad thing.
Dr Rupy: I'm down with the frozen.
Dr Anita Mitra: Exactly. If it means that you're going to eat it, it's much better to have frozen because when you get frozen vegetables, they are picked and they're frozen within hours. So they're going to be so incredibly fresh. If, you know, you can get a bag of frozen like peas, for example, or frozen sweet corn, just have it in your freezer. And then you're cooking something and you think, hey, what can I do to make this more colourful? I'm just going to chuck in some sweet corn. Then that is brilliant. And that's just something easy that you can do because we're all busy.
Dr Rupy: An interesting argument about which foods are actually better in the spectrum of, let's say apples. Like, is the red better for you? Is the green better for you? I'm always asked that actually, you know, which one's healthier. Do you have an opinion on that?
Dr Anita Mitra: Okay, so a red apple has higher levels of certain phytonutrients because, you know, the things that make it red in the skin. But then a green apple, for example, has less sugar and it has more fibre. And so, you know, there's no obvious one is better than the other. But I think the thing you have to bear in mind is if you don't eat that apple, what are you going to eat instead? Are you then going to have a chocolate bar instead? Or you actually want something crunchy, so maybe you're going to have a bag of crisps. So whatever you replace it with is unlikely to be as healthy. And so I think that, you know, if you start really getting into the nitty gritty of it, I think that's when it becomes an obsession and then you're going past the point of enjoyment then again. And so I think, yeah, all about the bigger picture. You know, okay, maybe you want to have the red one, so then maybe you should have something green later. You know, balance it out like that.
Dr Rupy: Totally.
Dr Anita Mitra: Or just like, you know, whatever looks the most fresh.
Dr Rupy: I think like sometimes we have a tendency to apply a very reductionist approach to how we eat food. So, yes, a cauliflower that is coloured might have more like a phytonutrient like anthocyanin, for example, in it compared to the white cauliflower. But that doesn't negate the white cauliflower. If that's A, what you have access to, or B, what you prefer as well. The main message is, eat the cauliflower. I mean, it's great, it's brassica vegetable, it's got lots of other phytonutrients in as well. So I think we need to move away from being too prescriptive and appreciate the fascinating science that there is around plant chemicals, but the bigger picture is the main thing.
Dr Anita Mitra: Exactly.
Dr Rupy: I think we've done quite a bit there. What I'm going to do is round up with the Doctor's Kitchen tips for eating more colourful, which reflect some of the dishes that you're going to find in my book. So, first of all, try new ingredients weekly. If you don't recognise an ingredient and it's cheap and it's colourful, buy it. Either Google how to prepare it or tweet me at Doctor's Kitchen and I'll suggest a recipe. The girls from the 90s were right, spice up your life. Do you like that one?
Dr Anita Mitra: That is brilliant.
Dr Rupy: How long did it take you to come up with that one?
Dr Anita Mitra: Not too long.
Dr Rupy: Using different ingredients that have pungent and aromatic flavours and are full of different phytochemicals that we've been discussing. Include garlic and ginger, basil, rosemary, thyme. These herbs are incredible and they do have lots of phytonutrients because of their smell and their colour. Use them as much as possible in cooking, if not just for the wealth of flavour and the warmth that they bring to your meals. Fold in greens. It's so easy personally to fold in spinach at every opportunity. Having eggs, serve it with spinach. Having bolognese, add some spinach. Like stir fries, guess what, so does spinach. Obviously other greens are available, but I hope you get the point. Fall in love with brassica vegetables, one of the healthiest ingredients that we grow in abundance across the UK. Savoy cabbages, cauliflower, purple sprouting broccoli are chock full of all these different phytochemicals, including sulforaphane, one of the most exciting phytochemicals linked to a huge host of benefits. My recipes will teach you how to enjoy them regularly. Savoury up your breakfast. So we're conditioned to almost believe that breakfast is sweet with added sugar and toast. Get used to using leftovers and vegetables sometimes that provide you with another opportunity to use plant-based foods that are colourful as well. I don't always eat savoury, sometimes I like oats, but it's a good way to mix things up during the week. And one thing that I just want to make sure we have at home is that whilst we find phytochemicals and the science behind it really, really interesting, it's still in its infancy and there is loads more research to discover and lots more chemicals to add to the library which include thousands. There is a bigger picture of how these chemicals relate to each other, how they're packaged, how they relate to our cells, and it's something that we'll actually be talking in another pod as well. Is there anything else you want to add, Anita?
Dr Anita Mitra: No, I think we've covered it all, but I think the my final parting comment would be, no one ever died because they didn't eat a green apple. They died because they didn't eat an apple.
Dr Rupy: That's a great way to part. Find my absolute legend of a guest at Gynae Geek on Instagram, Twitter, and her blog, gynaekeek.com, where her specialist interest is women's health and removing the taboo of talking about vaginas, smears, menstruation. And if you're a guy, you need to check it out too, because women's health is not just for women. Make sure you subscribe to the Doctor's Kitchen podcast on iTunes, Audioboom, or whatever your favourite podcast player is for notifications. You don't want to miss new episodes. Give us a five-star rating if you found this pod useful or funny. Spread the word, spread the love. It really helps with ratings. Socials, you can tweet us at Doctor's Kitchen, check out the Instagram, YouTube, and my blog, thedoctorskitchen.com. You can sign up for more information, events, and of course, don't forget to order a copy of my new book. I will personally come to your house with a hamper of phytonutrient-dense vegetables. I probably can't do that, but one day, maybe one day.
