Ben: And the idea is not to demonise anyone, it's not to say doctors on the NHS are bad or functional medicine is bad. It's that they all have merit and they all can be utilised together. And integrating those approaches, functional medicine, doctors, dietitians, nutritionists, nutritional therapists, all these onto one platform is the idea of functional health.
Dr Rupy: Welcome to the Doctor's Kitchen podcast with me, Dr Rupy, where we discuss the most important topics and concepts in the medicinal qualities of food and lifestyle. Functional medicine practitioners, nutritional therapists, nutritionists, dietitians, doctors of all different specialities all provide unique perspectives and patient-derived treatment protocols. And this is Ben's unique perspective on how a holistic and functional approach to health is fundamental to optimal wellbeing. From his unique perspective of having both a formal qualification in nutrition, a degree in biomedical sciences, he has a deep appreciation for how we can work more collaboratively with the common goal of improving patient outcomes. We have an incredibly candid conversation about the controversies around what functional health or functional medicine actually means and how a united approach amongst professionals is necessary to change the landscape of healthcare. I think you're going to really like Ben's perspective on things. Like I said, he has a unique perspective being both a formally qualified nutritionist as well as someone who has a deep appreciation for lifestyle and functional medicine. He hosts his own functional medicine health podcast and is setting up a platform at functionalmedicineinfo.com to promote the integration of all health professionals. You can find the recipe video that I cooked for Ben, the crab, leek and pea pasta on my YouTube channel at thedoctorskitchen.com and you can see how delicious and easy it was to make even whilst recording a podcast. If you like this podcast, give us a five-star review, it really helps, but for now, on to our chat. Ben, it's such a pleasure having you here in the kitchen today. Welcome to the Doctor's Kitchen.
Ben: Thank you very much for having me, man.
Dr Rupy: No worries. I'm really excited about this dish because this is something that I love to eat on like a Sunday. It's super quick, easy. It's a leek and pea crab pasta with watercress, lemon, chilli, garlic, and we've got some gluten-free spaghetti. I eat everything, but this for those who don't eat gluten is probably one of the best pastas I've ever come across. It's genuine, it's by an Italian company. You would not guess it's gluten-free. And I use like whole bean pastas as well sometimes that have a bit more fibre, a bit more protein content, and they're just as satisfying as well. So.
Ben: They have a different texture as well.
Dr Rupy: Exactly. Yeah. So hopefully you're going to agree that this is a healthy meal, but you can tell me about that in a bit. We're going to start off with some extra virgin olive oil in the pan with a little bit of garlic, and I'm going to throw in the pasta into the boiling water that I've got behind us, which is salted, a little bit of oil in it as well to make sure it doesn't clump together. And we're going to bring it all together after I've cooked down the leeks and peas and everything. Sound good?
Ben: Perfect, sounds amazing.
Dr Rupy: Good, man. All right, so tell us a bit about you because I've been on your podcast and I absolutely, I love being on your podcast. And the reason why I agreed to to to go on and and, because I don't think we hadn't really known each other that much before. I think we passed each other in like a BBC Good Food and that kind of stuff. Yeah. But you're formally trained as a nutritionist, you're registered with the AfN and you have an appreciation for functional health as well, right?
Ben: Functional medicine. Yeah.
Dr Rupy: Yeah. So tell us a bit about your background, man. So how did you get into this? Like where did your journey start?
Ben: Okay, so I'll tell you a little bit about my interest in nutrition and how that came about. I guess everyone has their like background or certain story to how they got interested in nutrition and kind of nutritional medicine. Rupy, yours is very well known, right? But for me, I didn't really have like a condition. I was just an overweight child that wanted to change his body weight, right? So at the age of 16, I started going to the gym. And then got made friends with a few people who were interested in bodybuilding. So my diet quickly shifted to try and lose weight. So I was doing a diet which bodybuilders traditionally used to cut or like get leaner.
Dr Rupy: I hear that all the time. It's like cut, bulk, lean. Yeah, yeah, yeah.
Ben: Yeah, right? And a lot of bro science. So not really based on science, but it seems to work. So my diet ended up being like a really high protein diet and vegetables, but it lacked essential fatty acids and carbohydrates and was I was restricting calories as well. So what happened is I got leaner, I looked good, but I felt awful, right? Because I was not taking in the fatty acids you need and carbohydrates just to function normally or optimally. And then as I got into university, I realised I started falling asleep in class even after a coffee. I was absolutely exhausted. And I wanted to increase my sports performance. So I added more carbohydrates into my diet, more fats as well. And not only felt much better and performed better, but also improved my cognition, my ability to perform in class, etc.
Dr Rupy: So it was eating more, sorry, sorry, it was eating more carbohydrates and okay, interesting. Yeah.
Ben: So it was the idea that, I don't know why it never occurred to me before, that my diet could change the way I looked, but also the way I think and the way I perform. So I got interested in that. And a lot of my friends,
Dr Rupy: What were you studying at university at the time?
Ben: Biomedical science.
Dr Rupy: Got you.
Ben: Yeah. And a lot of my friends or parents of friends started having these chronic illnesses. And we were just chatting about them casually. And I was interested in them, given my background, given what I was studying. So I started researching it. And it seemed like a lot of these conditions, high blood pressure, high cholesterol, can kind of be mitigated through diet and nutrition. So I started with a performance element and like worrying about aesthetics and eventually got interested in like what nutrients can do and how it can change your body and how it can help treat certain conditions.
Dr Rupy: Yeah, yeah.
Ben: So I went on to study my masters in nutrition.
Dr Rupy: Got you. Where did you study your masters?
Ben: King's College, London.
Dr Rupy: Nice.
Ben: Yeah.
Dr Rupy: Epic, man.
Ben: That was really good.
Dr Rupy: So you've got two degrees?
Ben: Yes.
Dr Rupy: Biomedical sciences and nutrition masters. And how how was that experience at King's? Like what what was sort of your journey then? Because were you still bodybuilding? Were you still like doing performance nutrition or?
Ben: Yeah, I was. I powerlifting was like my thing. I didn't compete or anything like that. But I like given my my stature, I'm quite short and stocky. So like lifting weights. I've got a good stature. You've got a good presence about you, mate. Oh, that's good. Thanks, man. But it's one of those things where I could just, it's a short distance of movement, right? So I kind of benefited from that and capitalized on it. But I like a challenge. So when I got into university, I signed up for a half marathon and I'm not a runner by any means. And kind of did that and was successful, completed. And then afterwards, after my course, did a marathon, Brighton marathon.
Dr Rupy: Oh, nice.
Ben: Right? So really changing it up.
Dr Rupy: You know, I used to live in Brighton.
Ben: Oh, did you?
Dr Rupy: Yeah, yeah. Brighton marathon is awesome. I love it. It's, oh, it's such a, I mean, it's a gorgeous town, city. The people are like very, very warm, welcoming. You get, you've got a really diverse community as well. And a lot of like, sort of health and environmentally conscious people I found just living down there. I don't know if you spent any time there, whether you just did the marathon, but.
Ben: Yeah, I just did the day before and like a little bit. Tried to enjoy it a bit.
Dr Rupy: Yeah, yeah.
Ben: That was my first time there and it's beautiful. It really is. The coastline's amazing.
Dr Rupy: Did you do the marathon, did you say?
Ben: No, I didn't do the marathon, but I I did my general practice training there for three years. And so I used to live by the the hospital, the Royal Sussex County. I did my pediatric training there, my placements during GP. And mental health units, you know, it's just a beautiful part of the world actually and it's only like an hour from London. So, yeah. I feel like I'm in the Brighton tourist board here.
Ben: So you did, so you did your half marathon, your full marathon.
Dr Rupy: Yes.
Ben: And continued, I kind of got interested in functional medicine. I mean, everyone's heard this and I think people have mentioned it on your podcast previously and certainly in mine, where like the current medical model is almost, not emergency medicine, it's not what I'm talking about, but chronic illness is almost treating the symptoms approach. So you're putting a band-aid on a symptom, then you are treating the root cause of the problem. And I got interested in what the root cause of that problem was. And that's, I guess, I found it naturally through nutrition, right? You realise that a diet which is high in processed foods, processed fats, trans fats, for example, I know they're not really in our diet anymore, but we know they're they're linked to heart disease quite strongly. And sugars as well. And then I came across plant foods and the protective compounds which are in there. I mean, if you take a blueberry, for example, I always find this fascinating, is that yes, it's got vitamins and minerals in it, but it's also got a range of antioxidants and phytochemicals as well, especially a polyphenol called anthocyanidin. And these chemicals not only help to improve vascular function by, they basically act on a on an enzyme called nitric oxide synthase. Now, the name isn't important, but it helps to secrete nitric oxide and that helps the vascular function. So it improves vascular function even in culinary doses. And I came across a slew of papers by Dr. Ana Rodriguez-Mateos, also at King's. And she was looking at how blueberries helped with brain function by increasing like blood flow to the brain and all all things like this. So you've got protective elements in food as well as food's ability to cause a lot of the problems that we see today in the in the general population.
Dr Rupy: I think she's lectured on my master's course at the moment.
Ben: Oh, she is?
Dr Rupy: Yeah, in Surrey, University of Surrey. Yeah, yeah, I'm pretty sure that's her. She's got a quite a strong accent from from memory. I'll have to double check that and link to some of her work. But I find that fascinating because that is very similar to how I got into it. I mean, bar my own medical issues and stuff and my realisation of being able to help patients to a better degree by taking a lifestyle and holistic approach. Phytochemicals absolutely fascinated me. And it was that kind of research that borders on reductionism and too much emphasis on in vivo and in vitro studies and mechanistic pathways. But I still find it absolutely fascinating. And I think it's because as a medic, we like to know about cause and effect. We like to know about the pathogenesis or the the mechanisms by which we can uh or diseases are formed, but also how we can treat people as well. And pharmacology was always a subject that I found pretty interesting myself. And the knowledge that food contains an array of chemicals that can impact multitude of different pathways is just fascinating. And that's what sort of piqued my interest.
Ben: Yeah. And my the thing that fascinated me most is like the synergy between these foods and the synergy between these chemicals have a greater health benefit than the sum of their parts. Meaning that these foods eaten together have a greater health benefit than eating them alone. And I found that amazing. And when we look at nature, like almost nature knows best in some respects.
Dr Rupy: Yeah, absolutely. And hopefully I'm sort of painting the picture of synergistic compounds here by adding lots of different ingredients to your your lunch here, mate. It's a big advert for the diversity, right? Yeah. Just to just to go back to this recipe, I've just put in some leeks and peas, the garlic that I sauteed for a couple of minutes before to get a bit of colour on there. Um, extra virgin olive oil in that. The pasta that I'm keeping an eye on, half an eye on over here. I always like to cook pasta al dente. So that's essentially a minute or two less than what the packet instructions are. And the reason why is because this is going to go into the pan with the rest of the ingredients that are cooking away behind me. And it's going to cook a little bit more. So you don't want, there's nothing worse than soggy overcooked pasta. It's honestly one of my pet peeves. And and luckily, you know, that doesn't happen often, but whilst I'm doing a podcast and trying to cook leeks at the same time, it might happen. So apologies if it does, but yeah.
Ben: Don't worry, I'm not going to hold you to it.
Dr Rupy: So culinary wise, it's interesting you you noted that at culinary doses, you were, there is evidence to suggest that the blueberries can have an important effect on vascular function. Was there anything else that you came across apart from berries?
Ben: Yeah, I mean, apart from berries, I mean, there's numerous different herbs and spices. You've written a lot about them in your book, Eat to Beat Illness, right? And we know that turmeric has like a multitude of benefits, primarily because of its anti-inflammatory properties, right? And so you've got different elements as well. Berries though, and I'm going to focus on berries for a second because I've actually got, I've read a paper recently and I think it was published in 2016. Uh, what was the journal? European Journal of Nutrition or something. I can't remember the title of the paper, but culinary doses of berries. They measured like one cup of berries to two cups of berries, to no cups of berries, the three different groups in children and see if it affected, so I think it was ages 7 to 10 and see if it affected cognitive performance acutely. And what they found was ingestion of those berries increased cognitive performance within three hours.
Dr Rupy: Oh, wow.
Ben: So we know that, I mean, it was a small study, but it was still, as all these studies are.
Dr Rupy: Yeah, right? Because they're so hard to perform.
Ben: Yeah. But it just, it makes, I'm fascinated by it, basically. Absolutely. But then you've got things like turmeric, you've got allicin in garlic, which has got anti-inflammatory but also antimicrobial properties. And as well as quercetin in onions, you've got lycopene in tomatoes, which is good for your prostate health. And there's so many different things. Have you, there was a an oncologist actually, he's called Dr. Robert Thomas or Professor Robert Thomas. So right, you're very familiar with him.
Dr Rupy: He's great.
Ben: Yeah, he's fantastic.
Dr Rupy: He's awesome.
Ben: Yeah. So when I came across his work, he wrote a book about lifestyle and cancer. Yeah. And it was a few years back now, I think it was in 2011 or 2012. And some of the stuff I found in there, like a few servings of broccoli a day can lower prostate specific antigen, which is the marker of prostate cancer, and actually reduce its progression as well. I think it was quite a lot of servings. It might have been four servings a day over a certain period of time, right? So quite hard to get in, but still it shows the power of food.
Dr Rupy: You're right about the pasta. It is absolutely delicious. The pasta is really good. Yeah, it's beautiful flavours and the chilli really, yeah, spices it up and the lemon as well, you get citrus notes, it's really good, man.
Ben: I'm glad. I'm really glad you like it.
Dr Rupy: Thanks for having me. Have you ever had someone who doesn't yet?
Ben: No, I had a couple of guests that were like, the, I think I used walnuts and it was a little bit bitter and they were like, I could have done without the walnuts. I was like, that's cool. That's actually good to know because instead of toasting walnuts that brings out a little bit of the bitter flavour, I know now to kind of turn that back a bit and just just go with raw walnuts that have a little bit more sweetness to it. Or just use something with a different nut like hazelnut, which is a lot more palatable for a lot of people. In fact, that could have done with a little bit of nuts, like a pine nut or hazelnut just to add a little bit more texture to that. So you've got like a various levels of flavours as well as textures. So, yeah. Anyway, I'm glad you like that.
Dr Rupy: Thanks for having me. So we were talking about how you got into nutrition, your fascination with things like plant chemicals, phytochemicals, that kind of stuff. What other things have kind of led you down this path into what your grand vision is that's set out on your website that I love by the way about the collaborative sort of effort between medicine, nutrition, functional health and all those kind of features of wellbeing.
Ben: Yeah, absolutely. So like the the piece on my website is almost like a position statement if you will. Originally that website just started off as a blog for like some of my ideas and I was creating it and I was asking my friends, well, what should it be called, etc. And then I started going to conferences and really asked people, physicians and people presenting like what they thought the medicine space and the nutrition space needed. And it was like a platform for the integration of health professionals. Because at the minute, even though we have doctors and doctors are starting to appreciate nutritionists and dietitians, I feel much more, especially because eating well has become almost fashionable now, which is great.
Dr Rupy: It's very true.
Ben: Yeah. But there was no, there's no real integration. And although it seems quite elitist at the minute because normally you have to pay to see these people, I feel it should be a part of the standard health care. And in order to do that, and or in order for it to be respected, you have to promote the these health professionals, right? And like show people what they do and their merit and their expertise. So that's an idea for the platform is to basically engage people, tell people that these other health professionals are out there so they can seek the advice that they need to hopefully tackle a condition, a certain health condition or disease with multiple modalities, not just one.
Dr Rupy: And I really commend you on that collaborative effort because I think there's a lot that different camps can learn from each other. If you look at just the nutrition world, for example, there's a lot of nutrition wars between paleo versus carnivore versus vegan versus Mediterranean. And actually, you look at the Venn diagram of what the similarities are, and it's about 70, 80% the same. It's eating whole foods, eating quality fats, eating mainly plants, eating low sugar and removing the junk. And it's no wonder each camp can actually claim or put a claim towards improving health conditions because if you just do those things, which all of them do anyway, you're going to have an improved outcome. And I think taking that sort of collaborative approach to the professionals that right now seem to be very antagonistic towards each other online, social media and all that kind of stuff, is something that is very commendable because I think you're in a difficult position if I'm honest. It's going to be a tough uphill struggle from what I've seen to try and get these people to talk to each other and appreciate each other as well.
Ben: Yes.
Dr Rupy: Is that something that that mirrors with what you're thinking is behind that or?
Ben: Yeah, 100%. I think one of the things as well is communicating the science which is out there effectively to people so can people can make their own informed decision of what kind of diet they want to follow, what foods they want to eat. You're right when you're saying there's so many diets out there. And some of them are really diverse. You know, you look at Dr. Dean Ornish's program and he was trying to reverse heart disease and his diet is primarily 80% of your calories come from carbohydrates. Then you've got the ketogenic diet where 80% of your calories come from fatty acids, right? And equally say it doesn't matter what your creed or genes are, it's the perfect diet and like everyone should be doing this or that's, you know, the majority of people say that because they're evangelical about it. And these diets can be great for certain people, but it's not to say that everyone can benefit from them. And even when you look at, I know you had Dr. Steven Lin on your podcast. And I actually met him years ago when he came to tour in his book, The Dental Diet. And we spoke about the work of Weston A. Price. I think you're familiar with him. So like just for the listeners, he was really interested in the epidemiology of dental decay. And what he found, he visited 14 indigenous tribes across the world in different countries and found that each of them had a different diet, but each of them, but all of them had less than 50% of the dental decay of the Western population. And it was thought that because these tribes didn't have the Western medicine or Western dental care or modern dental care, they'd be riddled with tooth decay, it'd be extremely painful. And that was not the case at all. They had perfect teeth, they could fit all the wisdom teeth in their mouth, but they also, what Price found, had very little to no instances of cancer, heart disease, asthma, arthritis, many of the Westernized conditions that we see today in our society. And what's interesting is they all had a different macronutrient profile. So some of them had very little plant foods and, you know, high meat and with high in meat and dairy. And but most of them, and as you said before, most of them were had a plant-based diet. But they had four basic principles, I think Price found is that all of them had some element of raw food, all of them ate raw food. All of them, which is no surprise to anyone, their diet was based on whole and natural and local foods. And no diet, surprisingly, was vegetarian and no diet was low fat. So that's really interesting. And I think it just shows that people are adapted to different diets or can adapt to different diets and there's no one diet for everyone.
Dr Rupy: And I think, you know, the adaptability of the human body to different diets is is quite pressing, right? So there was the um, uh, paper I recently came across because I was researching it for my masters in nutrition about how you swap uh different diets, a Western diet versus a rural um diet. So I think they used some South African volunteers and uh those from African origin living in uh the USA. And they changed their microbiota completely over a two-week dietary exchange, right? So the fact that you can do that is pretty impressive. And and it shows the adaptability of the human body to seemingly completely different diets and what the outcomes can be. And it goes back to the same thing. If you just get rid of the junk, there's a lot of good things that can happen, reducing the incidence of cancer, reducing the incidence of Westernized diseases.
Ben: Yeah. Yeah. Well, that's such an important point. Like one of the things these indigenous cultures didn't have was processed foods or additives or any of the chemicals that we are, we we have in our in our diets today, even the pesticides, right? I don't want to get into that and pesticides, herbicides, larvicides because it's like a whole area which I don't really know, it's not my expertise. But they didn't have that either. So it might not just be they were eating whole foods, but they weren't subject to a lot of the things that we are when we eat from the supermarket.
Dr Rupy: Absolutely, yeah. I think the whole pesticide argument is something that's fraught with controversy because on one hand, you have people overstating the uh potential negative effects of pesticides on our foods. But then I think we're also at risk of understating the potential harms of chemical, agrochemicals that uh could be uh the root of of a lot of issues that we see today. We've seen some sort of agricultural practices that have stung us in the past. Um we have had some recent widely used chemicals uh in our in our food, in our beauty products, etc. only recently being banned. Um and that's why even though I don't promote everyone going organic, I feel that we have the ability to change our food landscape to one that is more pragmatic and one that would potentially has um uh protective benefits. Um the one thing I would say is it's very hard um to to have this conversation without the correct data points and without the evidence base. And then you also don't want to be at risk of scaremongering people. But then also you don't want to be seen to be having doing harm because if in 10 years time we figure out that, you know, if we all eating conventional produce for this, it actually had some detrimental impacts. You know, it's it's a really difficult position to be in in a position of influence, right?
Ben: Yeah, absolutely. It is incredibly difficult because maybe the data isn't out there to suggest that these are harmful. But it is important to know because we mentioned it before just before the podcast started, that because there's a synergy between plant chemicals and the synergy of the different chemicals which are in plants can have a greater health benefit than the sum of their parts. It's not it might not be a far stretch to say that the synergy of the chemicals in our environment and the stuff that's used on our foods and the stuff that we put in foods, additives, preservatives can have a synergistic effect to cause harm.
Dr Rupy: Or the opposite way.
Ben: Or the opposite way. Exactly.
Dr Rupy: I think it's a really nice way of putting it actually because um there is so there is lack of information at a at a population level and I think there is significant worry amongst people, which is why I get asked about it all the time. Um and there are not enough answers. Um I know you don't want to talk about it too much. What I did want to ask you about is there's two things that cropped up when you were when you were talking. One is um low fat. So those these tribes around the world were seem to have low fat. How do we define low fat? Because I think some people think low fat is less than 10%. Other people think low fat is less than 25% of total of total energy content of your your food. So that's quite like an un uh a very grey area. And the other thing is um what a healthy plate looks like considering all these different things.
Ben: Two massive questions.
Dr Rupy: Two massive questions. You probably come back to the second one a little bit. So the low fat thing, that's been a debate which has gone on for many years now, right? So what is low fat? What's defined as low fat? And even in the medical literature, low fat was considered less than 35% of calories and still is in some studies. And it depends where you are in the world, what they consider low fat and not.
Dr Rupy: 35%? I mean, that's a huge.
Ben: Yeah, it's a massive amount, right? And like less than 20% of calories in some studies or if you look at um Dr. Dean Ornish's work or um some advocates, I'm blanking on the names now, but some advocates.
Dr Rupy: Neil Barnard.
Ben: Yeah, Dr. Neil Barnard, right? So they look at more than 80 10 10 approach. 80% of your calories come from carbs, 10% from fats, 10% from protein. And they think 10% from fat is low low fat. Anything above that is high or moderate and then high. Um so it's a really hard thing to say. And I think when you're personalizing it to yourself, you do have to tinker with these macronutrients and see what suits you. Um just to put a personal spin on it, like I benefit or I feel I benefit from a higher fat breakfast in the morning. Um mainly from monounsaturated fats. So I use a lot of olive oil if I can, eggs, um avocado if I make a smoothie, chia seeds and things of that nature, which is more polyunsaturated. Um and I feel like my energy levels are more consistent throughout the day if I do that and have carbohydrates later in the day. Um but I fair better on a diet which is around 35% calories from fat. I know some of my friends that fair better on 80 10 10. Yeah. Um but your original question was how do you find define low fat? And I don't know if there's a a definition, a specific definition. And I think it depends where you are and what country you're in as to what they define as low fat.
Dr Rupy: Absolutely. And I think personally, I think less than 10% fat uh is really low. Um far too low. Uh and I think there's so much nutrition to be had from good fat sources like nuts and seeds and like good quality olive oils and oils in general. Um and certain animal products as well in in moderate amounts. Um that we would be risking harm if I think everyone went into that. Um that's my sort of personal spin on it. Um but then again, you know, it's hard to argue against some of the very limited data that people have with 80 10 10, um particularly like, you know, Ornish and colleagues and stuff like that. So, you know, and Caldwell Esselstyn and stuff like that. So, yeah, absolutely. So, yeah, it's a I think like you have to be quite intuitive about these things and figure out what is best for you, um and whether, you know, that kind of lifestyle is something that suits what you want to eat as well. There was a really interesting study looking at um it was specifically looking at weight loss as a primary outcome, but they found and on seemingly like four or five different diets, and they found those who were more likely to adhere to whatever diet it was, all lost the same amount of weight. And it's it so it kind of speaks to the the elephant in the room. If you're more likely to stick to something that is removing all the junk food and increasing your consumption of plant fibres and good quality ingredients, you're going to have a good outcome whatever, whether you measure that by weight loss, whether you measure it by other biomarkers or or biometrics, then yeah.
Ben: Yeah, and had a beneficial effect on waist to hip ratio, blood pressure, other markers of metabolic syndrome. I remember the study. It was like Frank Gardner or something like that. I think it was Harvard. Yeah, yeah. Good study though. Yeah. And then very recently you got the diet fit study, which is looking at but that was only two diets, low fat and low fat and high fat or low carb. Yeah. I found exactly the same thing. It didn't really matter what diet you you follow, you're still going to lose weight if you're in a caloric restriction or a lower calorie to your baseline.
Dr Rupy: What I find interesting about your work is that you're trying to combine um traditional nutrition, um which is your your background, um medicine and functional health as well. Functional health is a dirty term in the UK, right? It really is a dirty term. Like, you know, as soon as you say functional medicine, people get their backup straight away because they think of the figureheads in the US that they have an issue with. And I can understand both sides of the argument. When you're trying to communicate things at a public level using um you know, snappy one liners or like uh just very short uh uh digestible bites of information, it's going to be misinterpreted by some people. So eat real food, for example, can be a very useful term for some people, can be a very, very detrimental term to people who have an unhealthy obsession with healthy eating, right? And define real, right? Exactly, and define real. What is real? You know, uh ingredients that have less than four uh products that have less than four ingredients. Well, you know, it depends on what the ingredients are and depends on, you know, nothing that's wrapped in a plastic. You know, those sort of points that can be quite helpful for a lot of people, but actually unhelpful in certain circumstances. So that's me going on a tangent. What is your opinion of it? Because I'm sure you've had to deal with this, right? The controversies around functional health.
Ben: Yeah. No, you're completely right. And there is a lot of controversy around functional medicine. But I think despite,
Dr Rupy: Should we define it first of all?
Ben: Functional medicine?
Dr Rupy: Yeah, yeah. Should we just like, what what does it even mean?
Ben: I think it's finding out the root cause of illness based on like if you have a functional problem which is causing your condition. And that's kind of what they're trying to do. And they look at the the body holistically, sorry. And also your um kind of health journey on a timeline. And this includes preconception all the way up to the present day. So in a doctor's office, I mean, you know this, you've got 10 minutes with your patients. How often are you sitting down with them and saying, well, did your mother take antibiotics when you were like in the womb, right? Or like, did you take, how many times did you take antibiotics when you were younger? Um what were the family issues? You know, things of that nature. Were you did you move house? Did you travel? You know, is it possible that you had a parasitic infection or a gut infection or, you know, these kinds of things which you wouldn't normally delve into. But it helps paint a bigger picture, especially with conditions which aren't either addressed or aren't solved. I'm using solved, but you know, is by the conventional um medical profession or the conventional model that we have today. And the idea is not to demonize anyone. It's not to say doctors on the NHS are bad or functional medicine is bad. It's that they all have merit and they all can be utilised together. And integrating those approaches, functional medicine, doctors, dietitians, nutritionists, nutritional therapists, all these onto one platform is the idea of functional health. So that's why I didn't call it functional med info, right? So functional health info. Yeah.
Dr Rupy: And I I find that um because I've done like um a few courses now in functional medicine, the FMCP and involved in some of the stuff they're doing in the UK as well. One of the most important uh takeaways I think from from functional medicine is the timeline. So taking a step back out of the situation, instead of focusing on the symptom, figuring out what the patient's journey has been up to to this point here. And when you do that, honestly, the insights you gain are phenomenal. I had a patient um recently who had uh autoimmune condition uh diagnosed at 32, she's 36 now. Um and everyone's focusing on the AI condition, right? What happened from 32 years onward. Whereas actually, if you take a proper history and take a step back, you'll realise there was psychological issues before, a whole bunch of different uh antibiotics that she was using, a whole bunch of other potential triggers, genetically in the family history. So there's lots of explanation as to why this might have happened to that person. A skeptic might say, so what? The the issue is that she has this issue right now and that's what we need to treat. The positive aspect of it is you're giving that patient a lot more understanding of why this is happening to them. That alone is very powerful. Second of all, it gives you some insights into how you potentially manage this issue and potentially, not always reverse it, definitely not, but certainly improve the outcomes so that we rely less on medicines alone. And when I say medicines, I mean pharmaceutical medicines or surgical interventions. So I think, you know, for all the bad press it's had, functional medicine definitely has um a place in in just general health care. And I, you know, I think, you know, the definition of nutrition being over here, food being over here, functional medicine being here, traditional medicine being there, you know, it it should all come under the umbrella of medicine really because what is medicine? It's the treatment and prevention of ill health.
Ben: Yes. Yeah, I couldn't agree more with that. I couldn't really couldn't agree more. And and when you were saying the timeline, like these um symptoms would have started when she was 32. But there might have been biomarkers years and years before that, right? Which weren't tested for. So understanding when this condition might have started might allow us a greater understanding and how to prevent these conditions in the first place and also understanding who's susceptible to them. Um which I think is hugely important as well.
Dr Rupy: Absolutely. And that collaborative approach that you you're starting with functional health info at the moment. What does that project look like at the moment and what do you aspire it to be in the future?
Ben: Okay, great. So thank you very much for asking. So one element of it is the podcast. And the idea of the podcast really is to share information from different health professionals from all different backgrounds. So I've had chefs on there, doctors, nutritionists, personal trainers, fitness models, even talking about body dysmorphia, things of that nature. Um as well as a chiropractor, a guy called Dr. Tom O'Bryan from the US who who's on one of the, he's a uh an instructor on the functional medicine training program. And he was talking about autoimmune conditions. So the idea is getting the um the information out there to people that there are different expertise in different areas. It's not just doctors that you can go to, which I think is incredibly important. And what I would like to do is develop a platform, almost an educational platform if you will. And it is a sign posting thing at the at this present time where which I'm developing, where you can know where to learn uh nutrition, sorry, educate you about nutrition, uh whether where to become a dietitian, nutritional therapy, functional medicine and other diploma courses as well. Um and it's to really understand people, it doesn't matter what background you're from, if you want to learn about these things, they are accessible to you. Um and that's that's where I'm going with that. As well as having articles from different people, a blog by myself, understanding getting my opinion on the latest research which is out there. And hopefully developing it further. Right now I'm at the early stages. And I see it going somewhere, but I want to adapt to what the industry needs.
Dr Rupy: Yeah, absolutely. What do you say to the people that suggest functional medicine is all about dairy, gluten avoiders and those who want to pedal supplements? Which is something that, you know, is a real concern for a lot of people. And on the face of it, a lot of people are like, yeah, these guys are just selling snake oil.
Ben: Yeah. Well, I think because people will argue like you're giving these guys a platform and all they're trying to do is like make a quick buck. It's just a quite a difficult conversation to have obviously, but I think it's important to address this.
Dr Rupy: Yeah. And I think as science communicators, which I certainly see you as one, Rupy, especially with your books, you make complex biological mechanisms understandable for people. I want to give people the information, the complex science. I mean, we have a we have a thing in health care and nutrition where we make the simple complex and the complex incomprehensible. And I really want to make the incomprehensible and the complex stuff simple. So what I'm trying to do is speak to these people, understand what they're doing and share the information with individuals so they can make their own choices of what um modality modality they wish to follow based on all the evidence they have. But they need that information there to make their choice. You know, you don't know what you don't know. Right? And uh, you know, if you're choosing one, I'm getting I'm going to use a Bruce Lee quote and you're going to probably hate me for it, right? But there's an idea is that you absorb what's useful, you discard what's useless and you add in what's specifically your own. So when you have all the information there, you can use what's what applies to you, discard what you think is absolutely rubbish and doesn't apply. If you're thriving off eating dairy and wheat, then I would suggest you probably don't need to cut it out of your diet, right? And talking about gluten and things, that could be a whole different podcast. But it depends who you speak to. Um dairy, cutting out dairy and wheat isn't the end all and be all. And um so as I said, if you're thriving off wheat, you don't need to cut it from your diet. And people get, they read something on the internet and they get overwhelmed. You know, they can look at, well, they know and people that cut out certain things in their diet and they might be because they've heard that there's anti-nutrients in certain food, right? You've got phytic acid in nuts, seeds and grains, right? And people are like, well, I'm not eating that because I'm not going to absorb my calcium, my magnesium, my zinc and my iron, right? Or you've got oxalates, which is in leafy greens and we know leafy greens are really good for you. But if you get fixated on these things, you're going to cut them from your diet. And the same with um if you've heard of lectins, right? Carbohydrate binding proteins. So they can cause problems for some people. Don't get me wrong. And they are in vegetables and certain night shades, potatoes and things like that. They can cause people to basically have a quick bowel movement or some digestive distress. And people right now might be thinking, well, Ben's just listed basically everything that I eat and I'm now worried. And the good news is, it doesn't affect everyone, right? And most of the time, people don't have these sensitivities. But what what people need to know is be mindful that these things are out there and it's most people aren't affected. So don't worry if you hear it or you read it, just as I said with Bruce Lee said, discard what's useless, but take in the information which might be useful to you. So if you're eating an aubergine, right? And you're eating an aubergine and you're bloated, you're you're lethargic afterwards, you've got a digestive distress. Well, even though it's got antioxidants in it and vitamins and minerals, maybe that food isn't serving you, right? And that's just all about being intuitive. And when you were saying about functional medicine peddling certain supplements, they do cut certain foods out of the diet and certain problem foods. Um you know, that I'll come back to the supplements in a second, but just looking at the certain problem foods, there's six foods which normally are cut out and it's basically because they find sensitivities for certain people. Eggs, nuts, soy, wheat, dairy and legumes, right? Now, not to say everyone's going to have a problem with these foods, but you can sometimes pinpoint them. And you said in, I think it was your first book that you can go through an elimination diet. Normally, I would normally recommend if you're going to do that, you do it under the supervision of a health professional because you become nutrient deficient if you do it for a long time. Eliminate these foods and add them in one by one. And if you're eliminating dairy, maybe include ghee first, right? Because it's absent of some of the proteins and carbohydrates that some people could be allergic to. Then build up to maybe cheese, yogurt, milk and see how you fair. Yeah. Um over a few days.
Dr Rupy: I'm really glad we talked about this actually because I think a lot of people are scared by the names attached to lectins, anti-nutrients, all these different things. And actually when you look at it, it's not the scariest sounding names. It's it's there's so many benefits of these said anti-nutrients in your food. When you cook legumes properly, you reduce the lectin content and that can actually have a potentially beneficial hormetic effect on your on your body. When you consume turmeric, for example, that's actually causing a mild stress that's actually allowing your body to respond and create resilience. In the same way, when you exercise, you're causing mild stresses to actually lead to improved outcomes over a long period of time. So I think it's a scary space for people who don't understand the nuance of nutritional science. And like what you essentially said there very eloquently, it's about intuition. It's about finding what works for you and what doesn't work for you. And elimination diets I've found in the past can work very well for patients and then gently introducing them back into the diet. But they're certainly not for everyone. And I know on the converse side, loads of people just become scared of food in general. It's a common thing with IBD patients. I don't know if you've come across this at all, but those who have been told they have to be in a low residue diet, Crohn's and UC. And then they realise, you know, if I eat oats, if I eat tomatoes, if I eat carrots, it just makes me go straight away. So I can't have that. I see it in my stool, I'm not digesting it. And then what they end up doing is just being on a fast food diet because that's the only thing that they feel that they can consume without having to run to the toilet.
Ben: Such a shame.
Dr Rupy: It's terrible, isn't it? And unfortunately, it was the position that was repeated to them by a lot of specialists in the past where we used to believe that, you know, fast food is all like a low residue diet was the best diet for them because it's going to reduce flares and stuff like that. Whereas actually, it's not not the case at all. Um and there's only, you know, I've talked about this uh on another podcast with Dr. Alan Desmond, who's a gastroenterologist who's a plant focused. And um yeah, he we talked a bit more at length about that. But uh it it's quite upsetting to see just how carried away these messages can can be taken by patients. I don't know if that's been your experience yourself.
Ben: Yeah. It you're right in terms of it can be quite scary for people, especially when they dive into it. And some people can read one article and take it as gospel. And I think you've got a lot of very health conscious and people have health anxiety. They read one thing or um they eat wheat and suddenly they think they're having a reaction because of the gluten that's in it. And they might not actually be having a reaction to the gluten. It's just an effect because you you've read that there is possibly a thing of non-celiac gluten sensitivity, not just celiac disease.
Dr Rupy: Classic nocebo effect, right?
Ben: Exactly, exactly. Um and it's something to be really conscious of. And a lot of these things could be psychologically mediated. If you're, because I'm going to go back to this. If you're healthy and you're feeling healthy from the foods that you're eating and you're eating nutrients, um and nutrient rich diet, nutrient dense foods, variety, stuff that's in your book, Rupy. And you're feeling good. You can cut some of them out. If you're feeling good, then you probably don't need to cut it out of your diet, right?
Dr Rupy: So I was going to ask you about um supplementation and multivitamins, right? Given that we're talking about dairy and gluten and how all functional medicine practitioners are just trying to pedal these weird elimination diets that cause nutritional deficiencies. Let's go on with supplements, which is where they make their money. So supplementation, good, bad, where is the um where's the utility and where's the science basis for it? Yeah.
Ben: I mean, I agree with you in that it should be a food first approach, basically always. If you can get most of your nutrients from food, then that's what you should do. Not only because when you try and extract vitamins and minerals from food and you try and take them in capsule form, if you're trying to extract everything from food, not only is that near impossible, it's very expensive, right? So you're looking at a cost-effective approach, just eat your vegetables mainly. But there are certain people which may be prone to nutrient deficiencies, which they should definitely take them. Vegans, for example, are prone to zinc deficiency, um iron and B12 primarily and vitamin D. So they should definitely supplement. When we're talking about certain conditions, when you're talking about functional medicine and people think they just pedal supplements, they can be useful as nutraceuticals. So as in we use pharmaceuticals in certain doses for a certain response, right? You can use nutraceuticals in a certain way under supervision by a health professional that's been trained to know that, right? So there's certain um herbs, medicinal herbs, etc, which can be used for a whole range of different things. You know, allicin, um which is a substance found in garlic can be used to treat dysbiosis as where the microbiome becomes overgrown with certain bacteria which aren't beneficial for you. Um and there's other elements of it like that. Some of them have uses, some of them, you know, it's been titled that it just causes expensive urine, right? Which I think we need to be cognizant of as well. If you feel that you don't need them, then I don't reckon taking them is is uh going to be useful to you. However, but when you look at it, has it got potential to cause benefit? And if the answer is yes, then you look at has it got potential to cause harm? And if the answer is no, well, if you want to take that, then it's not going to cause you harm and it could have some benefit to you, then maybe that's fine. But always look like Hippocratic oath, first do no harm, right? And that's how everyone should see it. You don't want to take a supplement which may cause you harm, but also might cause you benefit. You want to make sure that it has a possible benefit for you.
Dr Rupy: Exactly. Yeah. And I think the science unfortunately isn't there because we rely on these big studies looking at uh huge numbers of people being supplemented, you know, a high amount of a particular vitamin, like the ACE trials, for example, and how it actually showed that it can increase the incidence of cancers if you have pre-cancerous lesions, um or those who are smokers and taking high dose vitamins, you know, can be actually. Exactly. So, you know, it can be quite scary out there and I and I think a blanket sort of approach to supplementation is just not the way forward and it's about, you know, making sure that you're working with a practitioner who can actually give you uh some proper educated insight into it, which unfortunately sounds like a bit of a shaky science, right? It sounds like it's very, you know, nonchalant. Um but I believe in, you know, what Sackler said in 96 or that that famous paper of the evidence-based medicine being clinical autonomy as well as evidence base as well as patient choice. It's that Venn diagram where you have in the middle is what evidence-based medicine really is. And I think we're almost sort of lean way too much more towards the data side, which although it's very important, it holds equal weight to the other um segments of that.
Ben: Yeah. Absolutely. I mean, people have different diets, so they're going to be different deficient in different nutrients or possibly deficient in different nutrients. So when we look at um randomized clinical control trials, looking at does this supplement affect everyone? Well, maybe it doesn't because maybe some people are deficient, maybe some people have too much of that certain vitamin or nutrient, and maybe some people are somewhere in between, maybe they just hit adequate. Um so yeah, it's really hard to test for. And I think you need to take the right supplement um at the right dose, at the right time for the right reason. And you were exactly right, it needs to be under the supervision of a health professional.
Dr Rupy: Absolutely.
Ben: Can't, it's not a willy-nilly thing.
Dr Rupy: So what's in the future for you, Ben? Like, you've got your functional health info website, you're working with some collaborators to create some great content, you've got your podcast going on. Where do you see the future of this?
Ben: I really want to expand the website because right now it's a bit of a skeleton. So I want to fill it with as much content as humanly possible with articles which give people information. And as I said before, um really empower people to make their own decision about diets and foods, etc. with all the science which is out there. Because as I said, you know, right now some of the science can be very complex and almost incomprehensible and it makes people scared for certain reasons and causes health anxiety. And I want to break that down, make it digestible for people so they can use it for themselves. And I think, you know, culinary medicine UK and the Doctor's Kitchen does that as well. And there's a few other people out there which I would highly recommend that other people look at. Dale Pinnock is one of them in terms of looking at what nutrients are in food. Um and yes, I just want to work collaboratively with these people and go from there.
Dr Rupy: What an awesome chat with Ben Atkinson. I really, really do respect him because he's actually trying to bring a more collaborative approach to sometimes what can be perceived as people working in individual silos. There are actually a lot of benefits behind taking a functional approach, whether that be a timeline, whether it be looking at the root cause. All of these different ways of treating people have their merit. It just depends on whether they're right for the person. I think to summarize the conversation, being intuitive towards what diet or way of eating, I prefer to say, serves you best. I think it's it's a very personal thing. Being aware of the nocebo effect, so a perception that something is doing you harm when actually it's not. And also the pros and cons of things like elimination diets or the messaging around eat real food. Please follow Ben at Functional Health Info on Instagram and functionalhealthinfo.com. He also has a podcast, the Functional Health podcast. And please check out the website thedoctorskitchen.com where you can find all of these show notes plus more and the subscription to the weekly newsletter that gives you science-based recipes plus all the latest news around healthcare and how to live the healthiest, happiest life. Give this podcast a five-star review if you found it helpful. It really does help spread the message and I'll catch you next time.
