Dr Rupy: On today's episode of the Doctor's Kitchen, I sit down with Sakina Akoko, science writer and researcher at Doctor's Kitchen, to discuss the most impactful tips from recent podcasts, including topics like brain fog, gut health, alcohol and how to reduce alcohol, spices to beat colds and more. And the reason why we're doing this episode is because we have so many fascinating conversations with experts in their fields who not only expand our understanding of specific topics, but also inspire us to change or add certain habits in, even in the office, actually, like micro stretching and mini naps and making sure that we're getting out and exposing ourselves to nature as often as possible. But with so much content that we're putting out every single week, sometimes multiple times a week, via the newsletter, via the podcast, via YouTube, there's not always enough time to listen to every single discussion. So, what we've done is we've pulled together our favorite insights from our most recent episodes over the last quarter. So you've got everything you need to know in one place. But if you want to dive into the full podcast episodes, you can check them out in the podcast description. These are from episode 267, Brain Health with Dr. Louisa Nicola, uh, 263, Gut Health with Dr. James Kinross, a bonus episode with Cami Vidal on mindful drinking, and healing herbs and spices with Simon Mills. That was episode 253. You know, one of the things that I'm always asked about on socials and feedback to the newsletter is how to use dot dot dot this seasonal ingredient. It could be squash that I'm really getting into right now, or cavolo nero or kale or something that comes up in your farmer's market or your supermarket, you just don't know what to do with it. Do yourself a favor, go to the doctorskitchen.com, hit the search bar, or open the app on your Android device or iPhone and just type in that ingredient that you just want to get some inspiration for. We are adding tons of recipes and when you hit an ingredient, you put it into that search bar, you're going to be served with a ton of delicious, healthy, nourishing recipes that we have constructed with a nutritional medicine academic evidence in mind. And we are transparent about all that stuff. If you look on that recipe page, you'll see why this might be anti-inflammatory or good for menopausal health because we have done all the due diligence for you. So do yourself a favor, go to the doctorskitchen.com or download the app and mess around with the app. It's one of the best things and the things that I'm probably most proud of as well. For now, please enjoy my conversation with Dr. I was going to say doctor there. Sakina Akoko, she's not a doctor yet, but I'm sure she will be one day, about the previous episodes that we have been most inspired by over the preceding quarter.
Dr Rupy: All right, we are live.
Sakina: Good, live.
Dr Rupy: Live. Sort of live.
Sakina: Um, so, uh, today we want to do a, a quarterly review or like a kind of, uh, summary of the best conversations we've had on the podcast in the past few months. And we have so many of these conversations. We talk to so many experts. They bring a lot to our knowledge and also they give us tips that we want to add to our daily lives. So I feel like we come out of discussions and we want to add stuff in the studio and we want to try new things. But there's not a lot of time. And so there's not always enough time to listen to an hour conversation or plus, um, talking about specific topics. So I think we want to start and do these things where we give quick takeaways and the biggest impact, um, insight for us, the most impactful insight. So I'm going to ask you a few questions today.
Dr Rupy: Yeah.
Sakina: I'm going to be interviewing you.
Dr Rupy: Okay, cool.
Sakina: About, um, four of the podcasts that we did in the past three months, I think.
Dr Rupy: Okay.
Sakina: And I'm going to ask you about what pain point it addresses. So what's a problem or a common question that is addressed in this podcast and one big idea or like a health insight, uh, something that has helped you deepen your understanding of a topic. And a key habit that you maybe taught someone to do or you apply to your own life after that podcast.
Dr Rupy: Okay. Sounds great.
Sakina: Is it good?
Dr Rupy: That's great. This is a great, I think it's a really good idea to do like, um, a quarterly review of the previous pods and the most impactful ones that we've, um, recorded, um, as a means of sort of like distilling the information into quick actionable tips. Yeah. Particularly the more technical podcasts that are like longer, um, that not everyone has time to listen to. So, it's a great idea.
Sakina: And I think I want to try this, um, because we've been talking about, it's a bit of an insight in the Doctor's Kitchen, but we've been talking a lot about, um, push and pull and anxiety scores for the app. So we're trying to identify people's problems and, um, push towards needing a solution related to nutrition and healthy eating. Um, and so I thought a good format for this podcast would be this problem solution structure of like, what's a common problem people have and what's the solution that was brought by the podcast. Um, so we're going to try that and see how it goes.
Dr Rupy: Cool. All right. What's the first one?
Sakina: So the first one is the most recent one. It came out last week, actually. With Louisa Nicola about brain health. Yeah.
Dr Rupy: Oh, yeah.
Sakina: Um, so maybe you can introduce her a bit or.
Dr Rupy: Yeah, so she's, um, she's a doctor, Dr. Louisa Nicola. She is a neurophysiologist, originally from Australia, now lives in New York, and she's been studying the brain for years. She's actually doing a doctorate in, um, Alzheimer's at Washington, I believe. And she has spent a lot of her academic career just looking at MRI scans of the brain, um, researching the why behind, um, the rise in dementia. And in the pod, she does a really good job, I think, of distilling what's going wrong in the brain and the, uh, the acceleration of this condition. Um, so Alzheimer's, vascular dementia, and the different types of dementia. Um, and what could be, uh, used in a preventative manner or a manner to delay, uh, dementia as well. Because it's not inevitable, but it is becoming a lot more common. Um, so I, I, I mean, the main takeaways for me were the impact of exercise. Yeah. And the fact that you can do exercise at any age and have a meaningful impact on, um, delaying and preventing, uh, dementia. Now, I'm a food guy, so obviously, you know, we have a bias here in the Doctor's Kitchen where we're, we're more about food, but as someone who exercises consistently, most days, because I ruthlessly prioritize, uh, exercise more so for my mental health benefits as well as, uh, cardiovascular health benefits. And quite frankly, aesthetics, but now I can go to the gym with the added sort of, uh, uh, the added benefit, the added knowledge of how much good this is actually doing for my, my brain.
Sakina: It's such a motivating factor. I actually remember going on a run because I've been starting to try, um, running a bit more. And I went on a run after that podcast, like a few days after, and I was literally thinking in my head, like, this is making my brain bigger. This is increasing my volume. This is increasing my BDNF. Could you talk to us about some of the mechanisms? Like maybe one of them that really stood out to you of how movement, exercise can impact the brain?
Dr Rupy: Well, one of the biggest insights that I got into from Dr. Louisa was how long we've known about the impact of exercise on hippocampal volume. So the hippocampus is an area that we, uh, observe shrinking, uh, and that association between, um, dementia as well. And so when she was talking to us about the insights of, uh, exercise medicine and how we've known that exercise can increase hippocampal volume since the 60s, I was kind of blown away because I never was taught that at med school. I had no insight into, you know, how something that we could encourage people to do today in their 20s, 30s and 40s as a means of preventing dementia could be so overlooked in medical education. So I was really, really interested in that element of it. Um, so there's the sort of physical mechanism of improving blood flow. There's the hormonal mechanism of improving things like, um, BDNF, so brain derived neurotrophic factor. I mean, BDNF gets banded around quite a bit. There are a number of other neurotrophic factors, but quite colloquially, we refer to them as like, uh, miracle grow for your brain cells. I don't think it's as, uh, simple to say it in, in those, uh, terms. There are different factors that will encourage the, um, efficiency and the, the proliferation of your neuronal cells. Something that I don't think we were, um, that cognizant of, uh, previously in, in, in research. So those are sort of the main things. But then there are also added benefits of lowering inflammation, lowering oxidative stress. Um, these are all things that we know increase, uh, with, um, dementia and can put you at high risk of dementia as well. Um, and then there are, there are knock on effects on, uh, mood, on sleep, you know, things that I've sort of already known about, but now when you put it in the context of dementia as sort of, uh, an added tool of, of improving all aspects of your life and your physiology that could, that could reduce the risk and prevent dementia. I thought it's just a really interesting, um, uh, perspective on it that is very, very much needed.
Sakina: Hearing all those, um, specific mechanisms and really picturing it in your head of how just the, the, the action of doing exercise and pushing your body a bit to its limits has that impact on your brain function. Do you think that would have an impact day to day as well on like focus, concentration? Like if you're feeling a bit, you're lacking concentration or you're struggling to focus, would that also help?
Dr Rupy: Yeah, you know, we did, um, a podcast recently, actually, no, it's a YouTube video. I think it's going to go out in a couple of weeks time. And we were looking at exercise as a means of ensuring that your blood sugar regulation is nice and, um, efficient. So your muscles are incredible sinks, uh, or storage units for sugar. And if you do a bout of exercise, the benefits to your metabolism and your ability to store any sugar that goes into your bloodstream as a result, as a result of consuming it via food, um, it increases and lasts for 24 to 48 hours after that bout of exercise. So if you do exercise in pulses throughout the week on a Monday and a Wednesday and a Thursday, compared to just doing everything on a Saturday and Sunday, you're getting this, uh, the, the spacing out of the dose of, of exercise that has those benefits on your blood sugar regulation. And so it would stand to reason that you get less oscillations in your blood sugar levels. And we know everyone's had that experience of like having a bit of a sugar high and then a corresponding crash that can impact your concentration, that can impact your appetite, that can lead to more cravings, that can have a knock on effect on your sleep and your, and your mood and your ability to concentrate. So I think there's definitely some, some added benefits there of exercise to concentration and mood, um, that could extend beyond just preventing dementia in the long run.
Sakina: So that would be another mechanism by removing or preventing those really large rises in blood sugar levels or making your body more efficient at handling, um, blood sugar after meals.
Dr Rupy: Yeah, there's, um, there is a relationship between poor metabolism and, uh, high levels of, of sugar, uh, in the bloodstream consistently and persistently over time and a greater risk of dementia. Um, so there's definitely a metabolic element to, to dementia that perhaps has been overlooked, um, up until now. So the exercise benefits as well as having the impact on inflammation, the impact on mood, the impact on BDNF, the impact on, on, uh, volume and, uh, the specific areas of your brain, um, will certainly have an impact on metabolism as well, which will, which will hopefully prevent, uh, dementia.
Sakina: Okay. So in that podcast with Louisa, you talk, she talked about, um, different recommendations for how, what type of exercise and how much to do in a week, how often, what zone two, like all the specific, I guess she was talking about the ideal amount if you want to promote brain health, prevent dementia, what's the ideal amount we should be aiming for. But I, I summarized some of it in the, the newsletter that came out the same week. And some of the feedback we got was that it seemed a bit unachievable for some people and it was a bit overwhelming and scary to look at this list of exercise we should be doing, knowing that we're in a context where we spend a lot of time sitting and we don't have a lot of time. And so doing three to five sessions of cardio plus two sessions of strength training plus, it just seems a bit, you know, unachievable. So do you think that if we look at this long list and we just do a little bit, is that, is there still a benefit? Is there a minimum dose required for exercise? Or do you think we should really be aiming for more?
Dr Rupy: It's a really good question. And I think the way we laid it out in the newsletter and on the podcast is, look, here's a smorgasbord of everything and this is the ideal dose if you wanted to achieve perfection. So if, if what, what 100% looks like is two to three strength training workout sessions per week, three to five cardiovascular sessions per week, each lasting at least 30 to 45 minutes. And then you've got like a sting session of high intensity interval training. But then also throughout the day, you want to be moving, you want to be exercise snacking, you want to ensure that you're not having prolonged periods of sitting down. Um, and this is all obviously going to be complemented by great sleep and great, um, food as well. This is a big time investment and a lot of people cannot achieve absolutely everything. And in fact, I, as someone who again, prioritizes their brain, their mental well being and staving off things like dementia, I can't even get to everything on this list either. So I would say start where you feel that you can achieve the, the biggest dose of consistency. So whether that is resistance or cardiovascular training in, in the first instance, and then stack on those extra habits as you go along. So as a minimum effective dose, it's quite hard to demonstrate the minimum effective dose because any exercise is going to be beneficial. Um, but I would say is as a minimum, you don't want to be sitting down for long periods of time of more than an hour to two hours in any one stint. So a minimum effective dose would essentially be getting up every single hour or hour and a half to walk around. I know friends of mine, uh, who in clinic have actually got a kettlebell. And it's a really good exercise tool for them, but it's also a bit of, um, uh, a demonstration to their patients of like, look, I'm stuck in this clinic or this surgery all day long, and even I'm figuring out a way in which to add some resistance training and some movement to my day to day. So, you know, getting, getting up every hour and a half to go and collect a patient versus calling them via Tannoy, um, is, you know, just a glib example of like how you can actually exercise snack as well. Um, and, you know, I did this thing in front of the whiteboard the other day that everyone was laughing at where I was doing squats whilst I was like pretending to make my tea or, uh, I was like doing lunges across the, the office floor just to show you that you can work your exercise, your, your, um, large muscles, which are the ones that you really do want to be working out throughout the day, you know, without having to go to a gym. Um, because the biggest blocker, I think for most people is that they think that this requires specialist equipment and you have to go to a gym. And look, in the perfectionist world, absolutely, you know, using weights and other, um, uh, obstacles and and and technology would be the way to go. But if you can instigate any of these in your day to day using the things that you have available to you, that I would say is, is going to be just as good.
Sakina: Yeah, I think it's such a good point and it does add up. I feel like we underestimate the impact of small movement throughout the day because it, it feels so small. It's like five minutes of moving around. Does it really have an impact? But then if you add up those five minutes through a day, it does add up to, to significant movement.
Dr Rupy: You know, there was a really interesting, um, study, I think it was done at Stanford, um, where they had, um, two, uh, sets of cleaners cleaning a, um, a hotel, uh, um, a number of hotel rooms. Um, and they informed one group of cleaners that the exercise that they're, the act of cleaning is a form of exercise and that actually they're contributing to better cardiovascular health, better mental health. Um, they basically told them about like what the benefits are of pushing this cart around all day long and being on their feet versus the other one, they didn't tell them anything. They just, you know, monitored like how they felt and all the rest of it. And they found that the calorie consumption, uh, and the strength of the, of the cleaners that they told were actually performing exercise went up. There are other parameters as well of improved cardiovascular, uh, health that that also improved. So this belief effect, I think is really, really important. So what you tell yourself about that five minute exercise snack or walking to the tube or, you know, the walk in the park in the middle of your day versus just sat at your desk. How you approach that form of exercise, I think is really, really important. Um, so it really just speaks to this the power of belief.
Sakina: Yeah, and it can have an immediate impact as well. I feel like if you're stuck at work and you're feeling a bit like a productivity slump or something like that and you wake, you get up and you do a few, a bit of exercise like jumping jacks or you might look a little bit silly or something, but actually it can give you an immediate instant boost, um, in your productivity and your focus as well.
Dr Rupy: You do this all the time in the office. It's great.
Sakina: But I actually, yeah, I do a lot of stretching, but I want to start doing more like squats and stuff like that, like more strength thing because it does, it helps me so much.
Dr Rupy: We can bring a kettlebell in. There's no, there's no matter. So it's up to you. We have space.
Sakina: We want to do actually like a series of like healthy working and how you can integrate all these habits at work. Um, because it is also about creativity and, um, inspiration and, and talking about the practical way to do it, which is why we're doing this podcast as well. It's like, we're talking about all these exercise, but how can you integrate it to different lifestyles? So that's kind of one thing I wanted to ask you if maybe we could talk through three different types of lifestyles and how you would suggest adding a bit more exercise.
Dr Rupy: Yeah.
Sakina: So if we're talking about like a busy, um, mom or dad, like in a family, which you're going to be soon. Yeah. Um, in a family setting, someone who has their kids to look after, they need to drop them off and, you know, they have really busy lifestyles. What is one exercise habit that they could add now to their week to increase their movement?
Dr Rupy: I've actually thought about this because I'm going to be doing like a lot of, uh, bottle washing or like formula mixing or like, you know, uh, putting muslin cloths into the, um, into the dryer or whatever. Um, so, uh, I'm going to be doing a lot of squats in those elements. So even though I'm going to be cooped up in my house and like confinement mode, I'm going to be adding like squats to my daily activity like every hour. And just wait, like weightless squats, so just body weight squats. Um, just to ensure that I'm doing, because I do a lot of exercise and I feel that my, uh, mood is going to, uh, take a bit of a hit if I can't find ways to exercise to the same intensity that I currently do right now. So I'm making efforts to think of ways in which I can exercise snack throughout my day. So that doing squats during the day is actually going to be a hack that I'm going to be personally doing. I should probably do some content around that. Yeah, in the house. Yeah, yeah, yeah.
Sakina: How you're going to be exercising with your newborn. What about, um, an older adult? So someone who maybe doesn't have the habit of exercising that much and maybe is a bit scared of of of exercising and, you know, for balance and and, um, falls and all of that. What would be one way to exercise that you would recommend?
Dr Rupy: So balance, I think is really important. Um, particularly, I'm trying to get my own parents involved in this actually and just trying to strengthen up their lower leg muscles and increase coordination. There was a study looking at Pilates. Um, and just like floor, mat Pilates, not the reformer where you've got these like springs and this machine. My wife loves that. I've done a couple of classes. I can't get on board with it. It's just so difficult. Um, uh, but just floor Pilates, I think are fantastic. And there are lots of different, uh, classes that you can do for older adults and less able people as well. Um, but the other thing I would say is, uh, YouTube is a treasure trove of content. And I know Joe Wicks has done a whole series on, um, uh, older adult exercises that you can do from the comfort of your own chair. And you, you'd be surprised at how impactful literally just doing leg raises whilst seated could be, just using your own body weight as well. Because you are encouraging the use of those large muscles, your gastrocnemius, your hamstrings, your quads. Um, and even though you're not using weight, you're still stressing that muscle and any stress to that muscle will ultimately lead to hypertrophy and preservation of that muscle. When you combine that with enough protein that I'll be talking about a lot in the next book, um, you get muscle protein synthesis, a fancy word for basically the generation of new muscle. And this generation of new muscle makes you more metabolically healthy, it lowers inflammation, it has added benefits to reducing your fall risk as well. So I would look for content in that, in that domain because even though it looks quite easy, um, for a lot of people, it can be quite, uh, a challenge. And as long as you're challenging your body to the point at which you, you feel a bit of discomfort, that's where you want to get to.
Sakina: That's a very good tip. And there are so many videos as well. And yeah, joining a class if that's something that is accessible is also really good because it puts you in a schedule of having something to go to and you have to commit to it because you've, you know, you've signed up. So that can be really helpful. Yeah. I find that, um, any sort of activities that combine multiple things are really helpful for me as well. Like any sport that combines cardio and strength and potentially even like brain challenges. Like she talked about, uh, tennis or any ball, um, exercises activities. And she says that it's neurocognitive training because it also requires hand and eye coordination. So it's good for the brain because of the exercise element, cardio, but also because of the coordination and brain challenge element. So any, do you think, can you think of any other activities like that that would be, if you can't work out, you don't have a lot of time to exercise, you choose one activity that will give you both cardio, strength, and also kind of a brain challenge.
Dr Rupy: Yeah. Um, the one that comes to mind is like, uh, literally juggling. Yeah, true. So I think, I don't know if we talked about it on the podcast, but juggling, um, and these reaction based, uh, sports as well. So whether it's ping pong or, or just like paddle, catch, you know, using your left hand, actually, um, providing a challenge like brushing your teeth with your left hand. These are all things that actually challenge your brain in a different way. And that's a form of neurocognitive training. In fact, I know that they do this in, um, stroke rehab. So stroke rehabilitation, you're stressing your brain cells in a, in a way that is, um, trying to increase, uh, uh, proliferation of these cells. Um, and so the, these are actually genuine challenges. And if anyone's like tried to like stand on their, on one leg whilst brushing their teeth, for example, with their left hand, it's actually quite challenging. Uh, and so it's these little like, you know, insights into your day where you can actually do things that, that push you in a, in a slightly different way. There, there are other like sort of activities. I know you're into your, um, martial arts and stuff.
Sakina: I think martial arts are great because it does combine is cardio and it is strength. Um, and it is also quite, it's hard for the brain to remember combinations of pad work. Like it is quite challenging for us.
Dr Rupy: I actually find it really stressful. I'm doing like, uh, boxing and like, you know, you got to do a jab, jab and then hook. Like I'm always like, is it a hook, jab, jab? And I always mess up. I always mess up.
Sakina: It's hard to remember. It's like dancing as well. Like all those sports where you have to remember combinations and move your body in a certain way and remember how to do that are actually quite challenging for us and we're not really used to doing that a lot. We don't really use our body in that way. Um, so that's, those are pretty good maybe.
Dr Rupy: Yeah, I would say those are probably the ways in which I would, you know, try and stress my, um, my brain in a healthy way.
Sakina: Yeah. Nice. Cool. So the next one I, um, I thought we could talk through was the one with Dr. James Kinross about, uh, the gut microbiome and he wrote a great book. Maybe you can tell us more about the book and the title because I love the title of that book.
Dr Rupy: Yeah, Dark Matter, uh, by Dr. James Kinross. This is episode 263. And he's a, a GI surgeon. He's also an academic, uh, a microbiota researcher. Um, and, gosh, I mean, there was so much in his book that I wanted to talk about. We just didn't get time because the book is probably the best book I've read from a consumer point of view that really educates at an in-depth level what's going on in our guts. Um, and I would say the biggest takeaway from having that conversation with, uh, Dr. James was that we need to think like conservationists. And think about our guts in the same way we think about climate change. So how we are witnessing, uh, an unprecedented gradual destruction of our forests, um, polluting of our oceans, uh, global warming, etc. The same thing is going on in our guts. Um, and this is a result of environmental exposures, uh, drug overuse, particularly antibiotics, and also a rapid shift in the quality, uh, and the quantity of food that we consume every single day. And so when you think about it through that lens, it really paints this, uh, I mean, it's a bit of a bleak picture, but it's a very clear picture of why we might be witnessing an increase in a number of different conditions. One of which is dementia that we've just mentioned, but also cardiovascular disease, obesity, obviously, um, metabolic problems, uh, there's just a whole host of things that unfortunately go array when our guts are under attack. Um, and so, you know, this was, I mean, a fascinating read because he really goes through the sort of the life cycle of, of humans and the world and there's this beautiful parallel that he has in the book. Um, and he's just like a wonderful writer as well. So that was, that was sort of like my biggest insight of our guts as being like a miniature planet, uh, a miniature planet. It's not even miniature, there are literally trillions, but of these microbes, but we've got to think about our guts like a planet that is under attack, that is experiencing an existential crisis, and we need to do some pretty rapid and, and, um, bold things to ensure that we're protecting that environment.
Sakina: I love the image of, it is, it is a bleak, um, image of thinking about it about an entire, he said an internal climate crisis, but at the same time, I think it's necessary to confront it in that way. But he also talks about how our gut microbes are like a forest, you know, like a luscious forest that, um, needs to thrive and needs to be looked after. And also has a very delicate balance that we can't really control as much as we think we do. Um, and I feel like for me, the big biggest takeaway from the recent research and his opinion on the gut microbiome is also that we don't really know what good and bad is. It's not as simple as this is a good bacteria, this is a bad bacteria. If you get rid of all of these, you're going to be in perfect health. It's a very complex and, um, delicate ecosystem that we need to look after and nurture and make sure that we're feeding right so that it can thrive in its own way. And I really like that idea. Like I keep thinking about my gut microbes now in this, in this way of this all these plants working together and that we need to nourish.
Dr Rupy: Yeah. I think it and it's it's testament to our naivety that we think, uh, using the climate change example, that if we just do this one thing, we sort out climate change. In the same way with our guts, we think, oh, if we just add some probiotics, we sort out our like our guts. And it's it's no nowhere near as simple as that, unfortunately. And, you know, Dr. James is someone who uses microbiota testing kits. It's someone who uses probiotics clinically and with a very targeted approach that I really resonate with. But to see these tools as something that everyone should should have, um, I think is a little bit misguided. Uh, or it gives people a false impression that it's simple to sort your gut health out. There are simple things that we can do, in the same way there are simple things we can do to protect our environment, but it's that consistency of changes and it's ensuring that we are more cognizant of the things that are at the detriment of our gut health and the things that could, uh, improve and and help it flourish.
Sakina: So you, yeah, I'm glad you brought up probiotics. So do you think that it's worth it to buy a, a probiotic brand, a supplement that you would take every day? And if so, how would you do that?
Dr Rupy: Uh, so I personally don't think a everyday probiotics is necessary. And you'll hear a lot of folks online talk about, okay, well my probiotic is a proven to, uh, survive the digestive tract journey and, you know, they're, they're living in when they by the time they get to the large intestine. And this is literally what we said in the podcast. We're like, okay, so what? So, so what if your microbe is alive? What does that mean? Is that actually having a tangible impact on the metabolites that are produced? And if it does produce metabolites, is that having a tangible impact on inflammation or your leaky gut, your, uh, hyperpermeability of your intestinal lining? You know, there are lots of questions, I think with a lot more questions around probiotic daily use that I don't feel are fully answered right now for me to recommend that everyone should be having them in their diet. However, probiotic foods, prebiotic and fiber rich foods in general, a largely plant-based diet, ensuring that your foods are whole and unprocessed. These are things that I think we have a lot more evidence on and I'd be really comfortable promoting those over probiotics. Where I reserve judgment is actually in, uh, scenarios where people's guts have been erroneously attacked from overuse of antibiotics, uh, or, um, they need to be replenished because of recent infections. Um, I think there's probably use cases there. Um, but then there's so much in the world of probiotics that we just don't know. The reason why bifidobacteria and lactobacilli are so commonplace in these probiotics is because they're really easy to grow. So the ones that are really hard to grow, things like Akkermansia, for example, you don't find them in many, uh, probiotic supplements just because they're just so freaking hard to grow. Does that mean that that's better or not? I don't, I don't actually know. But I just think there's, it's a bit of a minefield right now with, um, everyday probiotics.
Sakina: So, to recap your position on that, it would be that you, you think that there could be a use for specific contexts like after antibiotics or after an illness, but most likely it would be in the best scenario would be with a clinician, someone who knows how to use them. And for day-to-day use supplements, there's other things that we can do that will have a bigger impact most likely.
Dr Rupy: I think so, yeah. And I think, um, we can't discount the placebo effect with some of these products as well. Because, um, you know, I know plenty of people that have taken green supplements or, um, you know, other insert supplement, whether it's zinc or copper or whatever, and they feel great because they're investing in this quite expensive product. It's well branded, and they, they read the label and they, they, you know, they, they believe that this is going to improve their sleep or whatever. And I don't think we can discount that. I don't think that's a bad thing. But I think that can potentially explain a lot of what people are so evangelical about when they take some of these products and they talk to their friends about it. Um, so, yeah. And I, I'm yet to find, um, clear evidence that an everyday probiotic is going to be beneficial for most people.
Sakina: Okay. So if we are to do one thing then, day daily to, um, support gut microbes, our gut microbiome and, um, and our gut health, what would you think that should be?
Dr Rupy: Uh, it's fiber. Fiber, fiber, fiber. But I would say probably the, to to whittle it down even more, I would say the meal time that requires fiber the most is most likely going to be breakfast time. Uh, a lot of granolas and croissants and all this kind of stuff, like they have some fiber in, um, but not a lot. And actually a lot of breakfast, uh, cereals that are marketed as healthy, generally don't have that much fiber in, uh, either. So we want to be really careful about where you get your fiber from and ensuring that you're getting it first thing in the in, in the day, your, your first meal. Um, think about it from the perspective of your microbes, right? They, they slave away for our benefit 24 hours a day. We've fasted them overnight. Um, you know, it might have been 12, in my case, it's usually 12 hours since they've had their last meal. And they're going to be ravenous. And, you know, they're ready to start producing those short chain fatty acids to nourish the colonic cells, to reduce inflammation for us. And so the first thing I want to be making sure is that my microbes are fed well. So in the morning, I'm having things like apple or fruit. I'm having leftovers. I'm having beans. I'm having, um, broccoli. What did I have this morning? You saw, did you see what I had this morning?
Sakina: I didn't, did you have that bread, the like, um,
Dr Rupy: I had the bread, yeah.
Sakina: The seed bread. Yeah.
Dr Rupy: The seed bread that's from the app. I had beans.
Sakina: I'm going to guess beans, yeah.
Dr Rupy: Yeah, yeah. I had, uh, we had, um, Karen O'Donoghue in last week and she made this, uh, she loosely called it a bolognese. It's definitely not a bolognese. It's got loads of different.
Sakina: Controversial bolognese.
Dr Rupy: Yeah, it's got loads of peas in. Um, so we, we had haricot beans, um, peas, flamingo beans, I think they're called flamingo beans. Uh, coral lentils, all these random legumes that I've never even heard of. We soaked them overnight, we cooked them up, we put them in a passata with some harissa. We made a real big batch and we even put some extra nuts in that as well. And I literally had that on toast with some parsley. So like, that for me, that's a great breakfast. I'm probably getting around 10 grams of fiber in that meal alone. Um, so, you know, probably more than that actually. But yeah, I'm always thinking about fiber for breakfast.
Sakina: And different types. I think, um, I remember reading this, this kind of survey about the main sources of fiber in our diet in the UK. And often they come from the same, you know, a handful of sources, like potatoes and and that not, not that there's anything wrong with those sources, but it's just a lack of diversity of the different types of fibers because all different grains and legumes, all different sources of fiber contain different types of fibers that have different effects and different benefits. So it's like mixing up. And in that breakfast, you have so many different types of fibers.
Dr Rupy: Yeah, yeah. Definitely. I mean, uh, I'm always looking for diversity and the best way to get diversity of your fiber intake is just eat a selection of different seasonal ingredients. I mean, we do a great job of seasonal Sundays, trying to highlight, you know, the different sources of fruits and vegetables that we have available to us and the relevant, you know, fiber content of that as well. Um, so thinking about the, the breadth of fiber rich ingredients that we have. And there are so many different subtypes of fiber to your point, right? So, you know, there's all these different, uh, polysaccharides, the different types of complex sugars, um, and they're in various amounts in, uh, peas and lentils and and beans, but you can also get them in tender stem, courgette, um, probably less so in courgette. Um, asparagus, chicory, endive. Do you say endive or is that endive?
Sakina: Yes, endive.
Dr Rupy: I say it right. There you go. Um, so yeah, you that's where I'd be thinking about getting my my fibers from. And nuts and seeds as well.
Sakina: Okay. So, just, um, if five, your five favorite sources of fiber that people need to add today basket or, you know, what would be your top five?
Dr Rupy: Okay. So the probably the most common five that I get are, um, it's going to sound so bougie. Flax. So I get flax seed because I put that in my bread recipe, um, that you can get on the app. Um, chia. I get chia quite a bit. Chia is a real powerhouse. I love it. And actually, if you think about the quantity required for a recipe like overnight, uh, chia oats, for example, or in the bread recipe, um, it actually goes a long way. So even though it's slightly on the bougie, more expensive side, it's actually, uh, really, really, um, it it it goes a long way. Um, lentils of various types. So puy lentils and beluga lentils. I have those packets from Merchant Gourmet. I wish Merchant Gourmet would sponsor us. They're so good. I use them all the time.
Sakina: I hope they listen to this.
Dr Rupy: Yeah, yeah, yeah. So I throw those into lunches all the time. Uh, I also get it from my green vegetables. So either a collection of Swiss chard, cavolo nero, um, or, uh, spinach leaves, but the, the English spinach, which has the stem, I always use that. Um, and then the fifth one is probably, uh, beans like borlotti beans or cannellini beans.
Sakina: I love borlotti beans.
Dr Rupy: They're great for breakfast.
Sakina: Really good for breakfast, yeah.
Dr Rupy: And like, you know, we did this recipe, I think on socials recently where I basically blended it up into, um, a green smush, like kind of like avocado and toast, but it was made from, uh, edamame and peas and then blended up with a bit of tahini and some, some spices and just put that all over, um, bread. I mean, with a bit of chili or like, that's a great breakfast.
Sakina: I think what's great about all of these as well is that they're so easy to add to things you already make. I know that my brother, for example, since listening to your advice and your podcast, he's been, um, he, he likes his meat, he likes to work out, he'll have like a big, you know, bolognese is probably a like a key meal for him. Um, and but he will now, now throw in some lentils in that as well. So he'll combine the red meat, which is also good for combining plant protein with, um, animal protein, but also it adds fiber to a meal that maybe would not have a lot of fiber in the first place.
Dr Rupy: It's a really good point. And this is something that we've been thinking about for the app for a little while with our recipes because, um, I've never really done recipes with red meat in, um, no lamb, no, uh, beef or anything like that. But we get asked a lot about how to sort of pimp out like recipes in a healthy way or convince their, uh, better halves at home or their kids that their ragu or their bolognese can be enhanced with a few extra ingredients. So we're actually doing a recipe, uh, testing right now. Ola is doing it right now with, um, uh, two versions, a completely vegan or vegetarian version, which is like a tempeh based, um, shepherd's pie. And then we're doing another one with, with, uh, lean mints, but we're adding a ton of lentils to it. Um, so it's showing you that whilst, yes, this has got red meat in and stuff, um, you can still healthify it in a way by increasing the fiber content and maintaining some of that protein content as well. So this is something that we've been asked about a lot. And I think it's one of those things that we should get more comfortable with because we're not going to be able to change everyone's perspective on, uh, meat and that's not really our job either. It's to ensure that we are pushing the boundaries a little bit for folks who are at a different stage of their journey.
Sakina: And it's quick. It doesn't, it means that you don't have to change everything at once. It's like we're saying, we're saying now with this conversation, eat more fiber is good for your gut microbes. And you can do that in a way that's literally just adding a few things to the things you already eat. Like the chia seed, adding that to your morning oats. That's a quite quick, um, and simple tweak, but that increases the fiber content in a significant way. Same with adding an apple to it or adding lentils to your pasta sauce or stuff like that.
Dr Rupy: The only thing with the chia, I always say you've got to soak it overnight. Um, and, you know, Karen O'Donoghue is a big advocate of soaking and ensuring that you're getting the maximum nutrition, nutritional value, sorry, um, from, from the raw ingredients. Um, but chia is something I always say you want to soak. And it always kind of annoys me when people like use it as like a sprinkle or as a garnish because it definitely needs to be, it definitely needs to be soaked.
Sakina: So overnight oats, for example.
Dr Rupy: Overnight oats would be a great way of using it. Yeah. And it kind of like, because it becomes gelatinous and it, it brings it all, yeah.
Sakina: Together. So how much fiber are we talking every day?
Dr Rupy: I would say over 30 grams is the minimum. Um, in reality, I have a lot more than that. And I think, uh, folks need to, uh, increase their, uh, tolerance of fiber if, particularly if they have a relatively low fiber diet in the first instance to tolerate a lot more, uh, fiber in their diet. So I wouldn't go really hard on like, you know, start having beans for breakfast like me. Um, you want to try and, uh, just, just push it up slightly, um, at each meal time. Um, so aiming for a minimum of 30 grams of fiber, I think is great, considering the average is half that and even lower in the US. Um, and the way to do that is just trying to sneak in more plants at every meal time. Just one more.
Sakina: Yeah. So, I thought maybe we could go through, um, one last thing would be like a traditional day of having 30 gram plus of fiber. What does that look like? Because I think for me, when I hear 30 grams, I'm like, what, what does that even mean? You know, like, okay, 30 grams, but that sounds like a lot. Is it a lot? How do you get that? So just, just for context, for example, um, a handful of almonds is going to be around 4 grams. Um, a cup of raspberries is going to be around 8 grams. A half a cup of lentils.
Dr Rupy: What's a, what's a cup of raspberries? Is that like a...
Sakina: 123 grams. So like, um, uh, American cup.
Dr Rupy: Okay. So it's like a big handful.
Sakina: Yeah. Yeah. A big handful. Um, so if we look at a day, for example, I, I just selected three recipes from the app and I looked at the fiber content in each of them and summed it up, summed, um, the total for the day. So for breakfast, if you were to have overnight oats, for example, in the recipes, there's 30 grams of oats, there's a handful of mixed nuts, mixed berries, a half an apple that's diced or grated, a tablespoon of chia seeds, pumpkin seeds and shelled hemp seeds. And that's already 11 grams per serving. So that's for breakfast, which is, it's not, you know, it's not beans for breakfast, but it's a quite accessible breakfast, I think. And that's already starting your day with 11 grams of, of fiber.
Dr Rupy: Yeah. That's actually one of my favorite recipes.
Sakina: Is it? I think it's great as well. It's overnight, so it's soaked.
Dr Rupy: Yeah. I make this in a batch actually. And I, I actually add, um, a bit more of the nuts because it has about 19 grams of protein in this, which is pretty good. Um, for me, my protein needs are quite, uh, a little bit higher. So I add, um, some more peanut butter to this and I, you know, I basically will boost it with, um, some, some other things.
Sakina: And you could add Greek yogurt to make it more protein and also potential probiotics as well. So that's like a another gut benefit.
Dr Rupy: Natural probiotics.
Sakina: Natural probiotics. Um, and then for the lunch, for example, what, you know, I, we could have an example of a kind of easy diversity bowl, you throw in lots of leftovers. And if you have rocket with that and a vegetable like fennel, another handful of nuts, beluga lentils, roasted sweet potatoes, and you just throw in all these random leftover ingredients, that could be up to 15 grams per serving as well of fiber. So we're already pretty high. And that's just with two meals. And then for dinner, I selected the salmon and lentil, um, one pot that Ola did recently. And so it's like a very delicious, uh, salmon one pot recipe with lentils in there and a few vegetables. And that was 12 grams per serving. So for a day, we, we're already without snacks, we're already at 38 grams. And that's with three kind of regular meals that just have those extra elements of lentils, nuts, seeds, um, and plants in them.
Dr Rupy: Yeah.
Sakina: So I feel like it, it makes it look a bit more achievable, um, hopefully for everyone.
Dr Rupy: I agree. Yeah, yeah. I mean, just choosing any DK recipe, you know, from the website or from books or whatever, like you're, you're generally getting around 10 to 15 grams per serving. And so if you stick to that, like two, three times a day, you're, you're going to get above 30 grams easily. Yeah, yeah. I personally, I don't even think about it. The main thing I have started thinking about a lot more is protein. I get, we'll talk about that another time because I could go off on one. Um, but yeah, I think that's a really good way of setting out for, for people so they, they understand like how achievable it is with these, with these.
Sakina: So we talked about the five top sources and, uh, I guess a way to remember it is also like three plants per meal, which is what you did in your last book.
Dr Rupy: Yeah.
Sakina: Um, not the, the one that's coming out, the one before. So three plants per meal.
Dr Rupy: Oh, even in the one that's coming out as well.
Sakina: Even the one that's coming out.
Dr Rupy: Yeah, generally like we, we try to add three different portions of vegetables per serving in each recipe that we do. Um, just as sort of like a Doctor's Kitchen, um, uh, standard, uh, of how we do recipes, which is, it's quite hard to do actually when we're formulating recipes. I'm always back and forth with all like, there's not enough peas in here or like, there's just not enough carrots and like, you know, we just need to, we always try to amp it up because there's that study that I always bang on about, the one that showed the benefits up to 800 grams. Yeah, it's a great study. It's a good study. And I think like the more it's ingrained to our culture to always think of getting three portions of fruit and vegetables, not just a seed at every meal time, or, you know, at a, at a, at a very minimum level, just thinking, can I add one more? Can I add just one more?
Sakina: Or a side dish, like a side salad or a side lentil bean salad.
Dr Rupy: Exactly. Sides are like the biggest hack for me.
Sakina: I think, yeah, for me too. For me too. Like if I don't want to compromise on the, the flavor of a recipe or I want a traditional bolognese or whatever, having a salad with butter beans in there and grated carrots and seeds and a nice dressing on the side is like, I'm getting my plants, but I still have my traditional bolognese.
Dr Rupy: Yeah, totally. Yeah, yeah. And I, I always get funny looks when I'm in a restaurant and there's like, if there's just like some, uh, some, some pitiful lettuce on the side. I'm like, can you just wilt some spinach for me? Like, even though it's not on the menu. And they're like, they look at me really weird. I'm like, oh, I guess so. Like, oh, great.
Sakina: Waiters must be like, oh, this guy.
Dr Rupy: This guy again. This Doctor's Kitchen guy. Yes. Yeah, that's a good one.
Sakina: All right. So, gut health. Is there anything else that you wanted to talk about?
Dr Rupy: No, I think that's good. I think those, uh, you know, the, the thinking about your, your guts as an, as a climate change, getting fiber in every single day, um, and, and definitely checking out James's book. It's brilliant.
Sakina: Yeah. Yeah, very poetic in a way. Um, all right. The next one that we talked about in the, the past few months, and we also had, um, this guest at our studio launch as well, and she made delicious cocktails, non-alcoholic cocktails for us, is, um, alcohol. So, do you want to introduce her?
Dr Rupy: Yeah. So Cami Vidal is, um, uh, the founder of La Maison Wellness. You'll probably say it better than me. Uh, she is, uh, an expert mixologist and she, uh, she's a good friend of mine. We've known each other for years through Michael, who's one of the most well-known yoga teachers in the UK, uh, in London, particularly. And, um, she, uh, she used to work for a whole bunch of different brands, like Bacardi, she would, uh, often judge a lot of the, um, mixologist, uh, competitions, she'd be involved in creating new menus for certain brands and stuff. And now she's sort of changed her, uh, focus toward no and low alcohol, um, drinks. And this is sort of part in parcel of her own twist and, and her own sort of perspective on drinking herself. I don't think she's ever had like a problem or anything like that, but I think it's the way a lot of people are thinking these days, which is, I like having alcohol, but I also recognize that if I have alcohol, even in small amounts through the week, I'm not feeling my best. And she, she reports some stats on this podcast about how 70 or 75% of people are not looking to go 100% sober, but they are actively trying to reduce their alcohol consumption for whatever reason that might be, whether it's for health reasons, whether it's for mental well being, whether it's for exercise, you know, whatever the, the, um, the reasons behind that might be. And I just thought that was so fascinating because I'm in that bucket. I don't drink anywhere near as much as I would do when I was at med school or even as a junior doctor, uh, throughout my training. I just, um, I just don't think it's part of my lifestyle anymore, really. And not to say that I was a big boozer before, I wasn't really. Um, but I, I don't even have like a glass of wine at a meal anymore, um, like as casually as I would do during the week. I think it's a real luxury for me to even enjoy. And I enjoy it. Like I really enjoy a good glass of red wine. Um, but going to two glasses or three glasses is like, I just, I don't do it anymore. I just don't. Because I, I wear an Oura ring. I, I track my, my performance and I know the impact that it can have on, um, my exercise. And as we've already talked about, like the impact on my performance will may have a detrimental impact on my ability to delay or prevent, um, things like brain disease. So, um, dementia. So, so yeah, so I was fascinated. She's great. She's just, you know, she comes from that world of drinking. She understands why people drink, not just to get drunk, but because of the enjoyment and the refinement of this experience of enjoying, um, a drink with a meal or just to enjoy a cocktail on its own. Um, so she comes at that angle from the angle of pleasure, which I think there's a lot of parallel between what we do in the Doctor's Kitchen. We're not just giving you like recipes because they're healthy and you should be eating them because they're healthy. We want to marry that flavor and function. Um, and I, and I think she does that in the sort of, in the alcohol world.
Sakina: Yeah, I think she's very good at addressing that side of that maybe common problem is like, as you said, maybe you don't feel great if you're having a few drinks in the week or something like that, you're feeling the impact on your sleep or anxiety levels or, um, but then you want to reduce alcohol, but then that's hard to do in social situations, either because you feel a pressure or you feel isolated if you don't drink, or you feel like if you don't go out, if you don't drink, you can't go out and you won't have a good time. And I think she's really good at addressing that problem. Um, so maybe you could tell us about what her key tips were to drink less or drink in moderation. She also talked about moderation versus sobriety. Maybe that's something, um, as well that's quite interesting. But what were her key tips if you want to go out and drink less but still have a good time?
Dr Rupy: Yeah, yeah, exactly. So, uh, she, she came up with so many different tips. I'll just talk to you about the ones that resonate with me. The first one, I thought was really, really, um, impactful is the first drink should always be alcohol free. I thought that was such a good tip because as soon as you have that first, like, think about it from the perspective of you're going out for dinner or you're meeting your friends, it's a bit of an occasion. You're already excited. There is no real need to add the, uh, alcohol to that equation to have a great time. And actually, that sort of added element of alcohol can lead to that excitement that leads you to drink another one and another one and another one. So you want to sort of ground yourself. I think she used the words ground yourself with a non-alcoholic drink to start off your evening or your event, whatever it might be. Which is why actually when we did the, um, Doctor's Kitchen launch the other day, she was right at the front of the door serving everyone a rosé pamplemousse.
Sakina: It's great as well.
Dr Rupy: Yeah, which was, uh, completely alcohol free, had that refinement of that rosé flavor, which is, ah, gorgeous. It wasn't overly sweet. It felt elegant. And it was an, you know, a great welcome to the event. Like everyone's there, it's exciting. You don't miss the alcohol whatsoever. So when I go out, I've been doing this for a little while now is, uh, I will have, uh, soda water with some fresh lime and just a hint of like Angostura bitters, um, which is alcoholic in itself, but the just a dash, like, I mean, it's like less than 0.5% or something. Um, so that's how I start my nights now. And I think that's a really good way of just sort of grounding yourself before going out or, or, uh, uh, before like getting too carried away.
Sakina: It's a good tip. And then is having that order in your mind already before you, I think she was saying that she was like, when you go to the bar and you're, you're panicking a bit, like which I, I get even when I want to order an alcoholic drink, I'm like, what do I order? And then you're, you'll go with what's most familiar to you. So if you're always having a beer, then you'll just always go have a beer or if your friends are having that. But having that order in mind of like, I know I want to start with a non-alcoholic one, which one do I like? And you know that before you get to the bar, so you can start with that and then do whatever you want to do.
Dr Rupy: You just got to have a backup order. Yeah, yeah. So that, that's a really good point. So, so that's two tips. So you're like, your first drink should be non-alcoholic and you should have a backup order in your, in, in the back of your mind, like what do you revert to? Like if you're in the situation like, oh, I don't know what to order, like my, my go to is that soda and lime. Uh, or it could just be like, uh, a water or, um, whatever it might be.
Sakina: Do you have any other favorites for either at the bar or, um, at home, any other favorite drinks?
Dr Rupy: So I've started drinking, um, uh, this, uh, I think I'm, I'm slipping on the name. Uh, oh, Wednesday's domain. I think it's Wednesday's domain. Oh, we tried it in the office. Yeah, the wine. Yeah, yeah. So it's a completely non-alcoholic wine and it has a wonderful flavor, I think. It's got like a dry finish on your palate. And instantly when I had this, I was like, oh, this tastes like wine to me. This is the feeling that I love. And I got really excited. I was like, this is great. I really enjoy this, uh, experience. It looked full bodied. It gave me that pleasure of like drinking wine at home and you're watching TV, but completely without the alcohol. Um, but I tried, I gave it to you guys and you didn't like it, did you?
Sakina: But I think it's, I think it is a mindset thing. And I think that's why, um, Cami's so good because she makes it fun. And as she says on her, maybe she said on the podcast, but she says on her social, she was like, it's food and drinks and spending time together that brings us together and creates a nice moment and nice memories. It's not the alcohol element. But we still tie having a good time with the alcohol. So if you don't, you know, if you don't have it, you're like, oh, it's not going to be as nice and relaxing. But actually, just sharing good food and sharing a drink and having a conversation with people and the setting, the experience is already, um, having, is already great for like enjoyment. So she's very good at making it fun and special, like having nice glassware and adding nice things to your drink and, you know, lime and all of that so that it's still a special moment. And I think with that mindset shift that we're slowly doing, then I think we'll be more comfortable having those drinks and still enjoying them.
Dr Rupy: Yeah, yeah, exactly. And like, just to be clear, like I'm not going to stop drinking that Wednesday's domain because everyone else doesn't like it. Like it's just more for me. But, um, I, I think that's a really good point. Like the setting, the scene and that feeling is what adds value to that experience that you're having, not necessarily the alcohol element to it. And I think people can be nervous about removing alcohol completely from that, from that setting. And, you know, either being seen as someone who's not having fun, because there's a lot of pressure, particularly in the UK to like drink with your buddies and all the rest of it or partake. Um, but also that you won't genuinely have a good experience if you don't have alcohol as a lubricant. And whilst that might be the case for certain people, when you start experimenting with it, um, I think you can have fun without it. Actually, one of my good friends, um, has started taking alcohol out of the equation. He's got a young kid and stuff and starting a new job and, you know, meeting with the team and they're going for drinks and all the rest of it. Hasn't used alcohol and he is really enjoying the experience without the alcohol as that lubricant. Um, so I think this is definitely got legs and I think a lot more people are going to become, um, advocates of this kind of lifestyle where they're not completely abstinent, but they have a more controlled relationship, a grounded relationship with with alcohol as well.
Sakina: I do really like that. And I think, um, I often have conversations with people about different drinking cultures because I, I grew up in France and the drinking culture is a bit different than in the UK. And I do like that kind of mindset of, I think in maybe in hotter countries, like I grew up in the south and in hotter countries, there is that mindset that you do drink quite a lot, but the drinking is way more, um, calm and, and paced in a way. Like you'll have it with food and it's a bit, I don't know, there's like a different type and it encourages you to maybe have less. You still have one, but you have less. And she talks about that. She talks about moderation. For some people, it's removing alcohol completely. And for other people, it's going to be having one drink and then one non-alcoholic one and alternating. And I like that that's also an option. It's not that you have to remove it completely, but actually just having less and fewer drinks also will have a benefit potentially.
Dr Rupy: Yeah, yeah. And I think, um, just going back to that sort of distinction between sobriety and moderation, it's important to obviously, uh, acknowledge that for some people, the minority of people, alcohol cannot fit into the equation whatsoever because of their prior relationship with alcohol or because even their, uh, genetic makeup, their experiences in the past is not conducive to having any alcohol at all in their life. But for a lot of people, moderation, uh, whereby, uh, they're able to have a more grounded relationship with alcohol, I think is something that, um, we should all lean into. Particularly if you look at the stats, you know, the number of A&E, uh, presentations, uh, particularly across, um, the weekends, but also during the week as a result of alcohol abuse is just huge. Um, and this isn't from people who have problematic drinking either. This is from binge drinking and, you know, just having too much. The number of work days lost, uh, the mental health impact, particularly when you look at the state of play of our health today, should alcohol have as much of a presence, this ubiquity in our lives? I don't think it, it should. And I think we're probably going to look back on alcohol in the next 20 or 30 years in horror as to how we allowed them to advertise on sports games and, you know, just be so ingrained into the culture whereby we're, we're seeing it on like morning TV and, you know, it's just sort of everywhere against the backdrop of like how damaging it is to society and health at large.
Sakina: Um, yeah, I think that's a very good point. It's interesting that Cami comes from a background of that industry because she has that insight.
Dr Rupy: She's really refreshing.
Sakina: It's very refreshing. She has that insight. She worked for the industry and she then found a good middle ground with it. So, that's really cool. Any other thoughts on on that podcast?
Dr Rupy: Uh, so the, the tips that I came across, uh, and, and definitely come back to are the starting off with a non-alcoholic drink. Um, having a backup. And then she had another one, uh, which I think she referred to as book ending. And it's where you essentially, um, pace out your alcoholic drinks throughout the day, uh, throughout the, throughout the event or whenever you're drinking. Um, but you also have the last drink is is always non-alcoholic. And I think just from the perspective of trying to minimize or prevent any hangovers, that's a really good strategy. Because dehydration is the main reason why people experience the ill effects of a hangover. It's because your ability to detoxify is impaired because you've basically exceeded the capacity of alcohol dehydrogenase, which is the enzyme in your liver that, uh, that that breaks down alcohol into its constituent parts so it can be excreted via the kidneys. So it's, yeah, it's just, just a very simple strategy that people should be thinking about doing.
Sakina: So starting and ending with a non-alcoholic drink.
Dr Rupy: Absolutely. Yeah.
Sakina: Nice. Cool. All right. So the last one is with Simon Mills about herbal remedies. And I thought, I think it's a, a brilliant one. I think, uh, he's such so good at talking about herbs in a way that is really accessible and convincing. Um, and for me, the main kind of pain point that it addresses is that we have so little knowledge about what we can do for common pains that we have day to day. And if you get a headache or if you have a cold or you're starting to feeling the feel the symptoms of a cold, or you have allergies, or you have menstrual cramps, PMS, the first thing that we reach for, like there's kind of a panic moment, you know, you feel the symptom and you're like, oh my God, I need to go to work. I'm panicking. What do I do? And the first things that they reach for is, um, a medicine that's just going to quickly fix your symptom. And I just think for me, he highlights that there is a middle in between that feeling that symptom, um, and then doing something about it. There is something else that we can do first, um, with using self-care herbs in the context of the home with accessible herbs that can actually help with those symptoms. Um, so he talked, you talked about a few. I thought maybe you could give us a quick, like a quick, um, explanation of how is it that herbs can have such a a quick impact and a powerful impact on symptoms. Like is there a specific mechanism that you think is interesting related to herbs and spices?
Dr Rupy: Yeah, I think, um, just to reiterate that point about there being a middle ground, I think that's really, really, um, impactful for a lot of people because we're led to believe, particularly in medicine, I would say that there is a, a binary situation. You either prescribe or you don't prescribe. You either treat and there is this pressure to treat and this pressure to write something down in your, on your prescription pad, uh, or you allow the symptoms to persist, which is, you know, something that I think a lot of medics have trouble with and, and, and sitting with. Um, particularly when there's like, you know, a demand for some sort of symptom relief. And this middle ground, I think is really appropriate in certain circumstances. This isn't to judge or say, you know, people who have to succumb, uh, quote unquote, for to, um, uh, pharmaceuticals have like failed in some way. Absolutely, if you're having a cluster headache or you are having, you know, some other painful experience, you definitely need to have medications that are going to be quick acting and there is no place for this sort of middle ground like, oh, let's see like what we can do with herbs. Um, however, in a lot of cases, people do become reliant on medications that are quite powerful and are perhaps unnecessarily, uh, risky in terms of looking at risk profile from a side effect profile. Um, where there is a middle ground. And I think the impressive stats and the studies, of which there are limitations to, I I just want to be, um, uh, I want to be respectful of that. Um, it is interesting to see the impact of things like ginger, curcumin, uh, turmeric, um, star anise, clove, these are all very readily accessible ingredients that have powerful anti-inflammatory effects. They have anti-nausea effects. And the mechanisms behind them are in parallel to some of the drugs that we see in a more purified form. The reason why they might not be as effective in certain, uh, instances is because they come as part of an entourage of other chemicals, which give added benefits like anti-inflammatory benefits, for example, but they might not give the targeted pain relieving, um, uh, impact that is the desired outcome, um, for someone who is experiencing a troublesome symptom. Um, but that's not to say that they, like, they're not useful. Um, I think they, they definitely deserve a place in our medicine cabinets or our kitchen cabinets for that use. Um, so, you know, some of the ones that we've discussed previously on the podcast are ginger and the anti-emetic effect of ginger. So ginger is made up of, I don't know, hundreds of different gingerols. It has fiber in it, it has some vitamins as well. But the, the, the really interesting elements of ginger are these polyphenols, um, that have an anti-inflammatory effect, but also an impact on certain, uh, centers of the brain that regulate nausea. And so in studies where they've compared them to quite powerful anti-emetic medications that we've had and we use in medicine, they have comparable effects, which is why it's a popular treatment for, um, pregnancy, uh, and in early stages of pregnancy where we're a little bit more paranoid about using any medications for fear of having any damaging effects to the unborn, um, infant. So there is, there in lies like a very simple example that everyone can get on board with. But then you extend it to like turmeric and, uh, cinnamon that can potentially have effects on things like PMS and mood and, uh, pain. You know, these are things that we could potentially be leaning into a lot more for folks who don't want to be reliant on medications that could put them at risk of other, uh, conditions as well or, or the damaging effects of, um, pain relieving medications. So it's, yeah, it's, it's a really interesting area. Um, and I think the more we learn about them, uh, the more people will get on board. Um, and this is, these are things that we've, we've known about for quite a while as well. Um, I, I mean, I always get like loads of I told you so from my parents and my family members about the use of, um, uh, certain spices, like fennel and cumin and its carminative effects. And this is the reason why we combine these with pulses, so it reduces bloating. You know, there, there is some, some science behind the sort of tradition. Um, and there's this saying, like, uh, traditions are experiments that basically worked, which is why they've lasted so long and this is why they get passed down. I mean, there's obviously a lot of wacky stuff out there as well. I don't want to, you know, give credence to everything that my family might say, but there are some, there are some truths in there.
Sakina: It's, it's really interesting when you do look at the studies. I know before starting this job, I hadn't read any of these studies about different spices and studies, literally trials where they separate people into groups and they give them a placebo or a drug and a capsule with ginger, for example. And you see a clear effect. And obviously, some of them are funded and there's definitely, we do need like higher quality research, but it is pretty impressive when you do look at the potential mechanisms and the human studies. One thing that, um, you talked about in the podcast as well was one common pushback against some spices like, uh, turmeric, for example, is the availability of the main active compound that, you know, curcumin is not very, curcumin, which is the main active compound in turmeric is not very available. And, um, Simon talked about how it might not matter as much as we once thought because of the impact in the gut. Is that something that you would want to talk about?
Dr Rupy: Yeah, yeah. So, um, the, there is this sort of, um, dismissal of turmeric initially, I think, in it not being bioavailable and you have to either encapsulate it with piperine, which is this, uh, chemical that you find in black pepper that basically irritates the gut lining very slightly that allows for higher absorption of the, uh, turmeric, which is why you always find turmeric and black pepper in curries and all the rest of it, to increase the absorption into the bloodstream. And then sort of more fancy ways that nutraceutical companies are, um, looking into right now by making it liposomal. So that's a fancy way of basically saying we put it into a fat molecule so it can be absorbed better in the bloodstream. Um, but what Simon's perspective is, is actually, you know what, there are some direct effects of, um, curcuminoids, which are these different compounds that you find in turmeric. Um, uh, when they're absorbed in the bloodstream, but there are also some indirect effects. And this goes back to the microbiota. So when you have a population of microbes and you give them polyphenols, um, they create metabolites that have added benefits. So there's a slight indirect effect of what you consume and how that has a positive or negative effect on on the body. And Simon's perspective is, actually, you know what, we might be thinking about turmeric in the wrong way. Instead of trying to constantly think about the availability of turmeric in the bloodstream, maybe we should also be thinking about the ability of our microbes to break down turmeric in the gut and create metabolites that then get absorbed into the bloodstream that we're not currently looking at or, you know, measuring in the bloodstream. So I thought it was a really interesting perspective in, you know, again, speaks to our naivety of constantly trying to have more and more and more high dose of, whereas actually, we just need to take the product in its form that is naturally found in nature with minimal processing perhaps, drying or grating or stewing. Um, and then just allowing our gut microbes to do the work. You know, going back to the sort of conservationist, uh, perspective, there is inherent intelligence in our environment and actually we just do need to do the simple things of ensuring that we're not adding pollutants to the soil, um, leaving things to rewild and, uh, ensuring that, you know, there is enough diversity of wildlife in our, uh, in our, uh, parks and our, um, areas of, uh, of natural beauty. And the same thing can be said of our guts. We need to just give them plenty of fiber, prevent, uh, ultra processed foods from coming into that environment, putting ourselves in, uh, situations where there's less stress, ensuring that we're having enough sleep and exercising. These are all things that will repopulate our gut microbiota more than a very targeted compound isolated.
Sakina: I've been fascinating, yeah, probiotic or like curcumin in isolation. I've been fascinating about, fascinated by this, um, idea of the food matrix. I feel like we keep coming back to it. I feel like with, same as rewilding and the, the new perspectives we have on the natural world is that there's so much we don't understand. So when you take out an isolated compound from a food or a spice, you don't know what impact it's going to have and you don't know what you're losing, um, from not having the whole food. Um, and that impact of all the compounds interacting together, amplifying the effects or, um, reducing the effects for a benefit. Um, and I think with, with spices, it's a, it's a really big one. So does that mean...
Dr Rupy: Just to explain to, to everyone what the food matrix means and how you might explain it to, to someone at home.
Sakina: How would I explain it? Yeah. Um, I think, well, we, we talk about it a lot in the context of foods, like we talked about it in the context of dairy and milk, for example. Um, the way I think about it, I guess it's, uh, it is literally like a, I can visualize it in my head, but it's this idea that food is not an isolated list of nutrients. So you can't just say like, this food contains vitamin C, vitamin B, etc, etc. And that gives it this impact. It's not as straightforward and and simplistic as that. Um, because it's part of a structure, a physical structure and a chemical structure. So all the compounds together in different doses and amounts are all entangled in this very complex structure in the whole food that we cannot really completely understand yet and we can't really completely isolate either. So if you take out one compound from this food, it will have a different impact than if it's part of the whole food in this structure with the other components, some that we don't even know about yet. And so that's why more and more we're looking at whole foods, even for supplements, we're looking at whole food supplements. And that's also why more and more we don't, um, I feel like with dairy, for example, we're not going to say saturated fat is bad in general. We're going to say the whole food matters. And so saturated fat in dairy is not the same as saturated fat in in another source.
Dr Rupy: In another source, yeah.
Sakina: So I think...
Dr Rupy: The, the way I sort of explain it to, to people at home or if I'm trying to get people to visualize it, the food matrix is, imagine like, uh, a peanut and then, uh, peanut butter and then ground peanut flour. Um, it's a, it's a very simple example, but in the peanut, you have this unique complex 3D structure where the fatty acids, the vitamin E, the selenium, the magnesium, um, the unique polyphenols that you find in peanuts, uh, even resveratrol is found in in peanuts and the peanut skins is all constructed and organized in a very specific way. And when you break down that food matrix into a flour, you've completely disrupted a lot of those bonds and you've made some of them more available and it's, uh, it's absorbed differently, which is why the calorie absorption across a peanut in those various forms is completely different. So, you know, it goes against this sort of calories or calorie argument that we, we often hear touted online. But the added sort of element of that is if you were to take the resveratrol out of that peanut or the vitamin E out of that peanut and say that consuming a peanut with X amount of vitamin E and consuming a supplement with a X amount or the same amount of vitamin E are equivalent, that's incorrect because the peanut has obviously packaged with a lot more elements in that complex food matrix compared to a purified form of one element of said peanut. So there are not, I mean, it's a very simple example, but hopefully people can visualize why the food matrix is so, so important when it comes to having a more nuanced conversation about, um, what they should be eating for for their health.
Sakina: So if we come back to herbs and spices, for example, I think, um, the main takeaway from that podcast was also that in, in, in the self-care context, not the herbal medicine of a practitioner, whole spices would probably be the go-to. Um, and in that podcast, you, you, you kept mentioning having a tea book. You were like, oh, I should put this in my tea book. Um, of common remedies. So I thought maybe we could go through, you know, two common illnesses or common pains that people might have and spices or herbs that Simon suggested for them. So the first one would be colds and any like colds, coughs, even cramp, menstrual cramps. He described them as symptoms that you need, you would want to put something warm on. Yeah, you would want to put, you know, a hot water bottle or put on extra clothes because it's a cooling, you have cold symptoms. And so what herbs would you go to and how would you use them if you have any of those symptoms?
Dr Rupy: Yeah, well, he, uh, he gave us that recipe for ginger and cinnamon, which I absolutely love. So he used dry ginger, um, actually, was it dry or was it fresh? I can't remember.
Sakina: I think it was grated fresh.
Dr Rupy: It was grated fresh. Yeah. So grated fresh ginger, although you could use dry, that's fine. Um, and cinnamon. And he put like a big whacking dose of cinnamon in, which I thought was really funny. I thought it was going to taste horrible, but it gave such an incredible sweetness. Like with no sugar, no honey, nothing. And I just thought that was, it tasted wonderful. And I was like, I'm going to use this the next time I have a cough or a cold because I know what these different elements are doing in my body. They're anti-nauseous, they are anti-inflammatory, they potentially have that warming effect. It could, it could have an impact on headaches as well, reducing inflammation and, um, pain relieving, uh, elements. So that I thought was a great, uh, uh, recipe. And it's something that sparked a conversation with us internally about the app and how we should actually have, uh, recipes geared towards people's symptoms. Like if you've got a headache, what should, what should you be eating? You know, or if you're getting the sniffles, like what kind of food should you be thinking about? Or if you have PMS symptoms, like what kind of things can you do in that moment to make you feel a little bit better? Um, from a food context. Obviously, the pharmaceuticals and and other therapies have a role, but I thought that was, that was really,
Sakina: That's one thing that can help. And that's something that a habit that we can build to turn into if you have, you start having this cold symptom. He also was talking about eating raw garlic. You remember?
Dr Rupy: Yeah, raw garlic cloves. I'm not doing that.
Sakina: Um, so yeah, I thought that was quite a good one. And I've actually started to use, uh, the ginger and cinnamon tea quite a lot.
Dr Rupy: Oh, yeah?
Sakina: Yeah, definitely. Like as soon as I feel a little symptom of cold or when I have cramps, I will have that ginger tea. And honestly, even just, even if it's just for the effect of, uh, the comfort of a hot drink, even that is already, uh, already has an impact. But I do feel, um, the instant and quite quick effect of of those spices.
Dr Rupy: And you're a scientist, you're a naturalist skeptic.
Sakina: Yeah, I'm quite, yeah, I'm very, I grew up in quite like a open household for these things, but I like to know the mechanisms behind it. I'm like, um, and another one he, uh, he talked about, which, um, I, I want to do more of. I don't think I do it enough, but is, um, leaning into some of these ancient remedies that the Greeks and Romans have always been quite, um, fond of. And that's rosemary and sage in water, um, and hot water as a, as a means to improving your cognition, your memory, uh, reducing brain fog, all these different elements. And I always used to think, ah, this is all like, you know, a bit of BS here. But, um, actually, like rosemary acid, and they've had, they've had some funky studies looking at like memory and cognition tests and all that kind of stuff. And I'm like, yeah, it's not bad. It's, you know, it could have this impact. And if anything, it just means that my water is slightly nicer flavored, you know? It tastes good. Yeah, yeah. There's got to be some method in the madness here. And I think, um, a lot of pharma companies are looking at nutraceuticals as a means to discovering new drugs. I mean, this is, you know, a very well-known playbook. Um, and there's just a mountain of, uh, unknown chemicals out there in forests, in mushrooms. Uh, I learned actually this week, no, it was last week, I did a mushroom panel that I think we're going to be releasing on the podcast. Um, and this researcher from Kew, uh, who have like the biggest, um, species sample of mushrooms in the world. She was saying that there are, uh, 5, no, 250,000 species that they're aware of currently today, but there could be 2.5 million species in total that we just haven't discovered. Um, and I was like, wow, okay. Just think about the drug discovery that we could do by just looking for these different species and testing them and, you know, and in the meantime, you know, leaning into the herbs and spices that we already know about. Um, so yeah.
Sakina: That's fascinating.
Dr Rupy: Yeah, really, really fascinating.
Sakina: That's so interesting. Um, so in our tea book, so for colds, we have, I really want to make that tea book now.
Dr Rupy: We should make it. We'll put it on the app.
Sakina: Yeah, because it is quite, I think it's just also, he described it as self-care. And I think it's also just nice to have those go-to remedies. As you say, it doesn't mean that you're not going to use other tools, but it's one thing to, to turn to when you have those symptoms. So for colds, anything that that you want to put a, a heat pad or, um, get warm for, colds, coughs, cramps, it would be warming spices like ginger and cinnamon. For brain fog or anything that you want to boost your cognition for, it was rosemary or sage, right? What about for, um, digestion or kind of digestive issues like bloating or no, um, yeah, after a big meal, for example, a rich meal.
Dr Rupy: Yeah. What did he talk about for that?
Sakina: Yeah, he talked about, um, these sort of, uh, bitters, uh, and like cooling herbs. And I've, I, I've seen a lot of these in supplement companies, like dandelion root and, um, uh, artichoke leaf and, um, you know, I'm a big coffee.
Dr Rupy: Peppermint, I think.
Sakina: Yeah, was it? Yeah.
Dr Rupy: Peppermint is definitely something that I've seen. Um, and, you know, I'm not fully aware of all the studies and the mechanism of action and stuff, but I think it's definitely something we should probably look into because it comes up time and time again amongst herbalists of like things to eat if you've eaten too much or whatever. And there's a reason why like, you know, in Indian cooking at least, there are, uh, a collection of ingredients that you find commonly, uh, infused together in a meal to sort of mitigate against the bloating effects of pulses, for example. So that's why you always see like fennel and cumin and all these different things. My mom always says things to me as well, like, you know, make sure you have amla and stuff, which is Indian gooseberries that has a very bitter effect. And that's a, that's a digestive in itself. And, you know, we always have pickles, for example. These are all bitter foods that stimulate the gastric juices that can impact how well you can digest foods. Um, and having a coffee after meals, even though I would warn against having caffeinated drinks at the end of a dinner, um, some people can do, tolerate it, not many people can. Uh, but a decaf, uh, coffee, um, I think could be something that could stimulate digestion as well. So bitters, I thought was really interesting.
Sakina: Me too. We should look into it because I remember him saying that the mechanism was also just the taste buds. So the fact that we, we taste a bitter compound and that starts, um, that stimulates the secretion of digestive hormones. So even just that taste element of a bitter, something bitter after a meal, um, could have a an impact on digestion.
Dr Rupy: And you know what, you like most people have had the experience where they taste something sour and you immediately get salivation. You know, this is also sending signals throughout your entire digestive system as well. Uh, it's the same thing where, you know, you're looking at something on screen and suddenly you get really hungry. Well, your stomach is starting to produce, uh, gastric juices in response to the smells and the sights of your meal. So it stands to reason that there are things that you can do to essentially game, uh, your bodily functions and improve digestion in this, in this element.
Sakina: Nice. So if, if, um, I was to ask you your top three herbs and spices that you would have in your cupboards for common small pains of day to day, um, what would they be?
Dr Rupy: Uh, I would say ginger, cinnamon, um, and one that we haven't really talked about is clove. Um, so clove, I think, uh, has a digestive element to it as well. But I'm fascinated, uh, about it being a, a sort of natural chewing gum. So we did, we did a YouTube video on like, you know, what happens if you chew a clove a day and there's all these like studies looking at weight loss and all this kind of stuff. And whilst I don't think those are going to be that impactful, I am really interested in the antimicrobial effect of clove, um, and how having that after a meal, uh, could potentially mitigate against like microbes growing, uh, and creating plaque on on your teeth. And I'm saying this as someone who has, unfortunately, gum recession. It's a genetic thing. Um, so I'm really cognizant of flossing after meals, flossing twice a day, and ensuring that my, I'm getting regular cleans as well. Um, so I would, yeah, I, I, I'm really interested in cloves as an antimicrobial.
Sakina: Um, and lastly, I wanted to ask you about how you store those spices, how you choose them and how you, you store them as well. So cinnamon, for example, would you have it ground or would you choose whole cinnamon?
Dr Rupy: So, uh, I think, um, I'm having it ground, even though that goes against what I generally advise, because I always say go for whole spices where possible and then grind them yourself. But grinding cinnamon is a bit of a, it's a bit of a process and it gets gritty and all the rest of it. And if you're having it in a tea, like ground cinnamon, you want it to sort of somewhat dissolve. Um, so I go for ground and I, I've started using Ren's Kitchen, uh, or Ren's pantry. She was on the pod before talking about spices. She really got me thinking about whole spices and tasting spices before you use them and not burning your spices as well. Because they're so powerful in terms of like the impact on inflammation and oxidation and, and, um, uh, your digestive tract, like you really want to invest in your spices and treat them well. So I'm, I'm actually getting them from her. Um, and I would keep them out of sunlight in glass jars in a cupboard store, uh, which is, um, uh, nice and cool and, uh, and, uh, uh, dry. Um, so that's, and I would change them every three months now. That's one thing because I remember chatting to Simon, I don't think it was on the latest podcast with him, but before he was like, look, if you smell your spices and it's sawdust, there's nothing in it. You might as well be eating sawdust. And it makes, it makes, you know, good sense. So I regularly change my, in the same way I change my coffee beans. Yeah. I change my spices every three months.
Sakina: So to preserve the compounds and make sure that they're still active.
Dr Rupy: Yeah, yeah. We're about to get a whole load. Yeah, yeah.
Sakina: That's, I need to do that. I definitely do not do that, but that's a very good, uh, that's a good tip. All right. I think, yeah, I think that's pretty much, um, the pods. What do you think?
Dr Rupy: This is fun. This is really fun.
Sakina: Is there anything else that you wanted to mention?
Dr Rupy: No, I think like this is a good sort of selection of the previous pods. And I think it's nice to have like a quarterly reflection on like everything. I mean, we've covered, I mean, it's good for me because like on the podcast in the last 90 days, we've covered the microbiota, we've covered brain health, we've covered herbs, alcohol, and we've got so many like incredible ones coming up. Like Tim's pod is coming out soon. We've done one, we did one on coffee, uh, recently, like a deep dive on coffee. We've got one dedicated to type two diabetes, um, that will be out on YouTube first and then on the podcast.
Sakina: The one you did about pregnancy.
Dr Rupy: Pregnancy, we're going to do pre-pregnancy nutrition, post-partum nutrition. So these things will be really interesting for folks. And I, I really like this format as well. I think we should do it.
Sakina: Yeah, me too. It was very fun. It was very good.
Dr Rupy: But we'll leave it to the, the listeners to decide whether they, they like it. If they've listened this far, then maybe they can shoot. Where should they message us?
Sakina: Yeah, tell us what you think. I don't know. That's one thing that we need to figure out how to get more direct feedback from the podcast.
Dr Rupy: Maybe via the newsletter.
Sakina: Yeah, maybe via the newsletter because we're now getting votes through the newsletter. So if you are signed up to the newsletter, seasonal Sunday newsletter, there'll be the link, uh, as well. And we ask for feedback every week. So please reach out, tell us what you think, ask questions, um, give us any areas of improvement. We're always looking, um, to improve and give you what you need and what you want to hear. So that's maybe one way, but maybe we'll find a better way to get feedback from the podcast as well.
Dr Rupy: Nice. This is fun.
Sakina: Lovely.
Dr Rupy: Well, thanks, Sakina.
