Transcript  

Dr Louise Newson [00:00:02] Hello. I'm Dr Louise Newson, and welcome to my podcast. I'm a GP menopause specialist and founder of the free balance app. My mission: to break the taboos around women's health and hormones, shining a light on the issues we've been too afraid to talk about, from contraception, sex and testosterone to menopause related addictions and beyond. We're covering it all. I'll also be joined by experts and inspiring guests, sharing insights and real stories, as well as answering your questions and tackling the topics that matter to you the most.  

Dr Louise Newson [00:00:43] So, on the podcast today, I've got with me one of my really dear friends, Dr Rupy, who’s brought out this great new book Healthy High Protein. We talk about protein of course, but we also talk about fibre and most excitingly we talk about inflammation. And the important role of reducing inflammation in our bodies for our health and future health as well. It’s a great warm, friendly chat so I hope you enjoy it.

Dr Louise Newson [00:01:12] So, I'm super excited, Rupy, to have you back. You haven't been here before, and I'm quite excited because you have a bit of podcast studio envy, because this space is great, isn't it?

Dr Rupy Aujla [00:01:23] Yeah, it’s gorgeous, I feel like I’m in your living room, which is exactly how a podcast studio should be.

Dr Louise Newson [00:01:29] Yeah, yeah. So you're here. I'm also very delighted that you've chosen the colours to, like, my website's got this exact sort of green

Dr Rupy Aujla [00:01:35] Has it?

Dr Louise Newson [00:01:37] Apart from it's got lime green. So, you could have maybe changed this to lime green

Dr Rupy Aujla [00:01:39] Okay, I will. There’s also room for the second and third print.

Dr Louise Newson [00:01:44] But, but otherwise, it's like blending pretty well. So you've made this book for me.

Dr Rupy Aujla [00:01:48] Yeah, it does suit the aesthetic very well

Dr Louise Newson [00:01:50] It does, so thank you

Rupy Aujla [00:01:51] I’d like to say it was intentional, but I had to pick those colours like over a year ago so

Dr Louise Newson [00:01:54] So well, there you go. We obviously think the same. But the other reason that you've, I think, written this for me, is that I've, I sort of really, I'm a lot better with my diet than I used to be, I was cooped up in a boarding school for many years, And then my mum's a very meat and two veg type person, and then I sort of ate, like most students do, as a medical student. I was taught as a medical student about protein, fat, carbohydrate, amino acids, that was probably all, probably same as you, that's all I got taught. You can wing anything when you're 18, 20s, that's fine. And then once I had children, I thought, “Oh, my goodness, I need to be really responsible to how I eat.” So I really changed how I ate. Then I got pancreatitis, and I was really ill, and I thought, right, I need to eat even better and better. And that's helped me, like, mentally, physically, like migraines, everything else. But then I thought, I don't really enjoy meat. I've been brought up with meat and two veg. So I thought, “oh, just wait. I don't miss it. I don't want it. My mum's not cooking for me anymore. I don't have to have it.” So I've carried on eating fish. But my ferritin, my iron, is always a bit low. I do a lot of yoga, but I've been doing some more weight, you know, weights and things. And then I keep thinking, “Oh”, and when you mentioned to me a while ago, your book was coming out about protein, I was like, “Oh, I really need to read this”, because I see so many women who are vegan as well. And this podcast is not about promoting any sort of diet, by the way. And they think they're doing really well, but they're not having enough protein. Or there's other people that just are having so much protein, they're forgetting all the other sort of basic food groups and, and, like, food is in my mind, like the most important medicine. Like, I just feel really cross that I wasn't taught enough about nutrition. Is that

Dr Rupy Aujla [00:03:39] That completely resonates with me, and I think we've chatted loads of times about how the lack of nutritional medicine knowledge during our medical education has really put us on the back foot

Dr Louise Newson [00:03:51] Yeah

Dr Rupy Aujla [00:03:52] And it's only until you see thousands of patients that you realise. “Oh”, the penny drops

Dr Louise Newson [00:03:57] Yeah

Dr Rupy Aujla [00:03:57] I was lucky in a way, where the impact of nutrition was brought to my attention through personal experience.

Dr Louise Newson [00:04:04] Yeah, yeah

Dr Rupy Aujla [00:04:06] In a similar way to your pancreatitis episode. With me, it was atrial fibrillation when I became a junior doctor that forced me to reconcile the quality of my diet and also my lifestyle as well. And I feel like I'm having a moment again where I adopted a plant predominant diet similar to yourself right, focusing on beans and legumes, ensuring that I'm getting lots of diversity, looking after my gut, probiotics, and et cetera. It was only during my nutritional medicine Master’s that the penny dropped for me again, where I realised I was under consuming protein.

Dr Louise Newson [00:04:40] Yeah

Dr Rupy Aujla [00:04:40] Kind of sounds embarrassing to think about because protein is literally the primary macronutrient.

Dr Louise Newson [00:04:46] Yeah

Dr Rupy Aujla [00:04:46] That we were probably taught about at medical school to emphasise. It's so true, but even with all the knowledge, and even by looking at all the studies, I didn't pick up on the fact that I was under consuming this critical micronutrient myself, and so my recovery after working out was less than it should have been. My energy levels, my focus, all that kind of stuff could have been improved by just doing the simple act of increasing protein. And also this kind of forced me to realise that the guidelines that we have around protein today are far too low, and in a similar way to the drum and the message that you've been going on and bringing to everyone's attention, those studies that determined the protein requirements from like 30 or 40 years ago were done on young males, using metabolic war studies, great, very impressive in terms of the accuracy, but it's not reflective of the population, nor is it reflective of different life stages. And looking at the research, I'll get off my soapbox in a second here, but looking at the research over the last five to 10 years, it's abundantly clear that we should be reassessing those protein guidelines, particularly for women, particularly post menopause, and particularly for the older adult population as well.

Dr Louise Newson [00:06:12] The other thing is, though, like about protein. There's different types of protein. Like, it's a bit like me talking about hormones. You know, there are natural hormones that we produce ourselves. When we prescribe HRT, hormone replacement therapy, we give exactly the same, like for like, like, if I don't know about protein at all, like I could go and buy a protein bar or protein shake, or I could go to the butchers and buy some meat like, surely, they have different effects in the body.

Dr Rupy Aujla [00:06:39] Yeah. So, let's, let's actually dive into what we mean by proteins. And I think most people have this idea of protein just being about meat and muscle

Dr Louise Newson [00:06:47] Yeah

Dr Rupy Aujla [00:06:48] And protein is a lot more than just those two things. So, I always use the analogy of Lego. So, remember when you used to play with Lego?

Dr Louise Newson [00:06:56] Yep

Dr Rupy Aujla [00:06:56] The beauty of Lego was that you could build anything from a little toy car to a massive skyscraper or cathedral using simple 15 to 20 different Lego blocks. As long as you had enough of those blocks, anything was in the realm of possibility. So, Lego are the building blocks in the world of toys, in the same way proteins, or more specifically, amino acids, are the building blocks in the world of amino, the building blocks in the world of biological materials.

Dr Louise Newson [00:07:26] Yeah

Rupy Aujla [00:07:26] So simple proteins, like linear structures where you just put amino acids in a long chain. Simple amine hormones, as an example, make that a little bit more complicated, and you build a 3D structure with some amino acids. You've got enzyme receptors, enzymes themselves. You've got bigger hormones, make even bigger structures with the same amino acids. Then you've got things like muscle, yes, but also bone, nail, all these different things, organs. So the magnitude of protein and its use in our body is much more than muscles. In fact, when you consume protein, only 25% of that protein goes towards muscles.

Dr Louise Newson [00:08:09] Yeah

Dr Rupy Aujla [00:08:09] The vast majority of it is going for all those other biological materials and processes in our body. But we don't really make the connect with it with protein.

Dr Louise Newson [00:08:18] But it also helps with energy, doesn't it? It helps the mitochondria to work.

Dr Rupy Aujla [00:08:21] Absolutely

Dr Louise Newson [00:08:21] It helps our immune system. It's, it's really important. I think people think you eat it, and you build muscle

Dr Rupy Aujla [00:08:26] Exactly

Dr Louise Newson [00:08:26] And you only need it if you're exercising somehow

Dr Rupy Aujla [00:08:29] Yeah. And the reality is, we all need protein, all these other support systems.

Dr Louise Newson [00:08:29] Yeah

Dr Rupy Aujla [00:08:34] I'm not saying that you like, kind of magically build a brand new spanking immune system or new hormones. If you eat enough protein, it's part of the puzzle.

Dr Louise Newson [00:08:44] Yeah

Dr Rupy Aujla [00:08:45] It's part of all the other lifestyle factors that you talk about as well. But it is critical to at least appreciate that protein is much more than just muscle building and for bodybuilders. And the fact is, when you look at population data, there is this sort of myth out there that we eat enough protein at a population level, if you're looking at the lower amount of 0.8 grams per kilogram of body weight, then yes, we definitely meet that threshold. The majority of us do. When you look at the threshold that I believe should be the minimum of 1.2 grams, the vast majority of people under consume protein, and protein you can get from multiple different sources as well. So I've addressed the muscle myth. The meat myth is another thing I think we need to address as well. Because whilst it is true, chicken, fish, lean red meat, are great sources of protein. They've got all these nine essential amino acids in good amounts that people always look at when we try and assess the quality of protein products. We also have those same amino acids in things like nuts, seeds, even things like raw cacao. You’ve got them in beans, you’ve got them in lentils, you have them in whole grains. You do have them in all plants as well, but in much lower amounts. So what I want to teach people about is, yes, we need enough protein, but what I would encourage people to think about is, let's get our protein from a multitude of sources and let's eat more overall.

Dr Louise Newson [00:10:15] And that's really important, isn't it? You know, I've always cooked meat for my children, and I'm now eating meat, but I would much prefer to have really good quality meat where I know it's where it's from, but then pad it out with beans and vegetables and everything else as well. And even now my older children, I will still sometimes use my blender because there's some vegetables they don't like, but it doesn't matter. You know, having that smooth pasta sauce, fine.

Dr Rupy Aujla [00:10:38] How old are your chil…

Dr Louise Newson [00:10:39] Oh don't even ask, like we've got a joke. They're 22, 20 and 13. But they make this like tomato pasta sauce. And I made it for them for years, and I just always batch cook and put it all in the freezer so they come and we can add lots of stuff to it, but I just put any vegetables under the sun in it, with tomato and basil and Parmesan. So it's quite sweet. Blend it all up. They have no idea what they're, it's just brilliant. It's just a great hack. But also, like, if I'm doing mince meat, I will put in lentils. I will put in, like, diced, I don't know, whatever's in there, carrot, sweet potato. It doesn't really matter. It's just all goes in there. So it means that I, because meat's really expensive, I'm spending less on my meat, because it's going a really long way. Because actually, it's a bit like, you know, saying protein is not the same. Chicken breast is not the same depending on where you buy it from. And there is a problem, isn't there with the farming where the meat is coming from. People think vegetables are better, but then it depends what pesticides, where they grow. And it's really hard, actually, isn't it, when you try and really work out, I want to have as natural as possible

Rupy Aujla [00:11:42] Yeah, we’ll go into the amounts that people should be consuming in a little bit but to address that point, I have a very simple formula that I like to tell people about so they can increase their protein without necessarily increasing their meat consumption. So I would start off with, it's like a three-step plan with any meal. You want to start off with a core protein source is. You can choose whatever that core protein source is. If you eat fish, it could be cod or hake. Could be chicken, it could be beef mince. If you're vegan or vegetarian, it could be eggs, it could be tempeh or tofu. Think of a core protein source that is typically quite high in protein. All of those ones that I've just mentioned are around 20 grams of protein per 100 grams of product. That's your core protein. Then you want to have a plant-based partner. Plant based partner can be things like legumes and beans. It could be like tahini, peanut butter. These are all great things that you can just put into stews and casseroles to bolster up the protein content ever so slightly, whilst adding some texture as well. And then you want a protein topper. Your protein topper, it could be pumpkin seeds, it could be peanuts. It could be shelled hemp seeds, for example. These are all quite high protein as well. I mean, you look at like some really interesting dishes from around the world, particularly from South East Asia, India, where a lot of my cooking inspiration comes from. They have this kind of formula. They have a core protein, then plant-based protein, so you're blending different proteins together, and they always have a topper, and it's, you know, like peanuts,

Dr Louise Newson [00:13:16] Yes, yeah

Dr Rupy Aujla [00:13:16] On the top of pad Thai for example, we see this pattern every now and then. It's just a very easy thing for people to get their head round when it comes to increasing protein without having to rely on just increasing the chicken or increasing the fish.

Dr Louise Newson [00:13:28] Yeah, so that meat and two veg is really just gone. And it is great, because even when I have a salad and I'm quick and I just get some rocket or something, I always put pumpkin seeds or something, it tastes nicer for a start. You know, it just lifts it, doesn't it?

Dr Rupy Aujla [00:13:39] Yeah, totally

Dr Louise Newson [00:13:39] And actually, like, seeds and nuts are expensive, but often I'll, like, chop the nuts myself, so it makes a bit cheaper. But they do go quite a long way, because you can't eat that many of them without feeling full. Can you?

Dr Rupy Aujla [00:13:49] Yeah totally. And like you know there are cheaper ones, like sunflower seeds. There are some seeds that you can buy in bulk as well organic. You can ensure that they’re from a pesticide free source. One other tip that I always say is, if you are using bulk buying of seeds and nuts, you might want to just gently roast them to get rid of any mould that could be around. The other thing, and I talk about this in the book, actually, to make the most out of your nuts, seeds and grains in general, soak them. So soaking, which is an ancient technique that all cultures have, my mum always bangs on about soaking to me, and soaking lentils and all that kind of stuff. You're essentially starting that germination process, and it releases some of those amino acids and makes them a lot more bioavailable. It’s just an extra step. So if you get, if you've got some raw almonds, for example, soak that in fresh water, leave it overnight. The next day, leave it to dry in like either a low oven on the counter when it’s summer, and then you've got slightly more protein per almond just by that one little thing.

Dr Louise Newson [00:14:53] Interesting, that's really good, isn't it? And you've got your protein calculator that you can get from the book but it's also online as well, isn't it?

Dr Rupy Aujla [00:15:00] Yeah, yeah, it’s free, I really want people to know their number.

Dr Louise Newson [00:15:04] Yeah.

Dr Rupy Aujla [00:15:04] And I want to be careful about, you know, healthy eating and an obsession with healthy eating, also known as orthorexia. I want people to be good guesstimators as to how much protein there is on a plate. Look at a plate, and I can make a judgment as to whether maybe it's got 20 grams or 30 grams. I want people to sort of hone that skill, but I think it is really important to know what your number is. So for me, someone who works out, when I can with a newborn, but works out most days. I'm otherwise fit and healthy, I don't have any particular aspirations of being a bodybuilder, 1.6 grams of protein per kilogram of body weight, for me, per day, split over two to three meals. That works for me. That works out about 120 grams of protein in 24 hours. There's about 40 grams per meal. For women as well, postmenopausal, I would also say the 1.4 to 1.6 grams is also a good starting point as well. The reason why is because protein is critical, not just for muscles, that we've just established, but for bone health and also for metabolism as well. Super, super important. You won't magically lose weight without doing the basics like moving and exercising and resistance training, but that protein is a critical component of ensuring that we are protecting our health as we age as well.

Dr Louise Newson [00:16:31] Yeah, yeah, absolutely. And the other thing with your book, it’s not just about protein. You know, most of us don't eat enough fibre, and fibre sounds like Bran Flakes from the 70s, like do you know what I mean, people get really confused with fibre, don't they, but fibre’s so important, isn't it? Can you just explain like what fibre is?

Dr Rupy Aujla [00:16:53] Yeah, yeah, so fibre is a polysaccharide, so they're carbohydrates actually. They are complex units of carbs that your body actually can't break down. So you rely on this magical population of microbes that we have harnessed since birth and we have grown and evolved with over millennia. And these microbes, which include bacteria, but also viruses, there are more viruses than bacteria, if we look at the genetics, but also nematodes and fungi, they will digest that fibre and create byproducts, short chain fatty acids, other elements in your guts that nourish your intestines, and they also reduce inflammation. They also improve your mood. They can change your skin, very important for hormonal health as well. And so part of this concept of healthy high protein is, yes, trying to get people to eat enough protein, whilst also not forgetting about fibre, and the gut, and also lowering inflammation. So, the three questions I want people to ask themselves at every meal time is, am I getting enough protein? Do I have gut supporting ingredients, i.e. fibre and probiotics in my meal? And is this overall plate going to be pro or anti inflammatory? If you can answer positively to those three things

Dr Louise Newson [00:18:14] You can eat the plate

Dr Rupy Aujla [00:18:14] You’re looking at a very healthy plate. A really really really healthy plate. So fibre is super important for those reasons. The general guidelines are to try and get 30 grams of fibre in every day. I think, to your point, a lot of people might think, “Okay, I just need to get, like, you know, a good dose of Bran Flakes in my morning you know, routine, whatever.” Actually we get fibre from a plethora of plants, beans and lentils are fantastic sources, nuts and seeds also have the extra bang for their buck because not only are they high in protein, but they’re also high in fibre which is why they're so satiating as well. And also you get it from green vegetables, woody vegetables, starchy vegetables, these are all things that we should be encouraging in the diet.

Dr Louise Newson [00:18:51] So you mentioned inflammation

Dr Rupy Aujla [00:18:52] Yes

Dr Louise Newson [00:18:53] Now, I think you know this, I've got a first-class honours degree in pathology, and I spent, I did it in a year, and I spent the whole year learning about macrophages and monocytes and the immune system. And I really enjoyed it, because it was the first time, really

Dr Rupy Aujla [00:19:11] You’re such a geek

Dr Louise Newson [00:19:12] I am really, I'm so sad, but it's the first time probably in my whole career, that I could just dedicate myself, like, really thinking and like, you could intercalate after the first two years, and you could do basic science like, you know, biochemistry, physiology. And I thought, no, I wanted a bit more. So I did a third year, and then I intercalated. And it was, pathology is obviously the study of disease, but you have to know about how the body works and then what goes wrong. And so that's the whole thing about inflammation. And I recently, it sounds really sad. I was looking at my notes, and this is like 1992 I did the degree, I'm very old. I wrote a three-hour essay on “Explain why atheroma is a pre-cancerous condition”. So atheroma is furring of the arteries with atherosclerosis, cardiovascular disease. Cancers, obviously, we know about cancers, but they are associated with inflammation. So my whole three hour, like, essay was all about the macrophages, inflammation, what goes wrong and how they're associated. Now, there was an article in the paper the other day, and it was saying, we don't know how osteoporosis and dementia are linked. It's like, well, think about inflammation, it's not rocket science. And it's like, we're so inflammatory the way we live, that doesn't mean we're angry with each other, but like you say, our diets are more inflammatory than ever before, really. Our lifestyle, what we're putting in our mouth, you know, hormones, they all affect our immune system. And without our immune system, it's not just our ability to fight infections, it's to fight diseases as well. So how would you describe inflammation?

Dr Rupy Aujla [00:20:48] So without diving into the macrophages and the histopathology and all that kind of stuff, the way I describe inflammation is like it is the language of your immune system. And the analogy I use in the book, it's kind of like your internal campfire. It's not a perfect analogy, but I think it proves or explains the point around inflammation that I want people to understand. So when you go on a holiday and you're in the British countryside and you set up for camp, what you really want to do, if you're allowed, is create a lovely campfire to warm yourselves up as it gets colder, to cook your food on, to provide you with a bit of light, to ward off predators. A campfire is a beautiful thing. If your campfire was to get unruly, you could burn yourself, you could overcook your food, you could get it to the point where it could set fire to the entire campsite, maybe even set fire to the entire woodland area. Your immune system and inflammation is very similar. You need enough inflammation, because Inflammation signals to your immune cells. It fights off pathogens. It is a beautiful system that we evolved to have because it protects us from things like environmental pollutants as well. Too much inflammation can do the opposite, and this is where there is a connection between mental health issues, dementia, type two diabetes, osteoporosis, these are all inflammatory conditions as well, where our immune system has gone out of whack

Dr Louise Newson [00:22:26] Yeah.

Dr Rupy Aujla [00:22:26] And when you look at the way we live our lives, ultra processed foods, screen time, lack of sleep, stress, these are all things that tip the balance into a pro-inflammatory state. And diet is one of the ways, not the only way, but I think a core tenant of one of the ways in which we can readdress that balance by being anti-inflammatory, and the way in which we do that is, yes supporting our gut using fibre and probiotics and all the rest of it, but having an antioxidant rich diet that is varied as well. Berries, greens, nuts and seeds, oily fish, these all contain things like fats and resolvins, and there are just wonderful ingredients that will put that balance into our favour. And I think it's never been more important to really think about inflammation in this way, because the links between all these different conditions like you alluded to have never been more apparent. And I think the power that we have to influence inflammation with our diet is there. And I want people to understand that whilst this is a book primarily about protein, I'm not forgetting about our guts and I’m not forgetting about inflammation as well.

Dr Louise Newson [00:23:41] I love the campfire, because also, if it goes out, you are cold, you can't see, you can't do anything, you can't function, and so

Dr Rupy Aujla [00:23:49] Gosh, I should’ve put that in there

Dr Louise Newson [00:23:51] Yeah, come on, next, next, book you can put that in. But I think it's really interesting, because, you know, our immune cells are so important, and one of the things I learned a lot in this year was about how we, they can become pro inflammatory. So it's not just you switch them on or off, they can work against you, like that campfire going out of control. And, you know, obviously oestradiol, progesterone, testosterone receptors on those macrophages are really important, because if we have, don't have, those hormones, same for men not having testosterone, the macrophages become pro inflammatory. Increased inflammation, campfire goes out of control. And you know, more than anyone being a fairly new father is, you don't have much time to, like, cook, you know. But actually, these recipes are so quick and easy, like you say how long it takes, and like, your recipe list is not very long, is it?

Dr Rupy Aujla [00:24:40] (Laughs) No

Dr Louise Newson [00:24:41] But everything's really colourful and really varied.

Dr Rupy Aujla [00:24:44] Honestly, I really tried to keep the ingredients lists low

Dr Louise Newson [00:24:44] So I hope you had that in mind, thinking about us as parents, because it makes a big difference

Dr Rupy Aujla [00:24:49] Yeah, like, huge and that's probably one of the biggest pushbacks that I've had across my journey on social media, is around the ingredients list and ensuring that's as low as possible, because even if they are everyday ingredients, like, you know, paprika or like, red chili flakes, or cumin, most people have in their kitchen, if they see that long list its intimidating.

Dr Louise Newson [00:25:08] You just go no you can't do it, but also, you always want to cook at eight o’clock on a Sunday night, and the supermarkets are closed, and you're just like, oh. So no, I really commend you. It's brilliant. I really and I, you know, and I'm very touched by your message at the front as well. So thank you very much, Rupy. So, but before I end, you're not going to get away without having three take home tips, so I am going to have to ask you three reasons why we need to have healthy high protein.

Dr Rupy Aujla [00:25:33] Okay, so the key reason, I would say breakfast protein, super important, because you need to be able to tackle that 24-hour target for protein. And if you don't have enough protein at breakfast, you're less likely to hit that target. So, don’t skimp on that opportunity to get protein at breakfast. The other thing is, after you fasted overnight, essentially when you are breaking your fast, you need to replenish those amino acids that you’ve utilised. The other thing is, protein is great at staving off cravings, improving your satiety, which is something that we know we all struggle with, particularly in older age as well. I mean, I could go on. But the other thing I would say is when you have enough protein and fibre in your diet, which you will get from all these recipes. Your energy level is steady, you don’t have these big like spikes and troughs of glucose, it will keep you nice and focused, and that’s exactly what I need as a parent to a newborn.

Dr Louise Newson [00:26:35] It’s what we all need, don’t we? And also, our pancreas needs it. We do not want type 2 diabetes if we can avoid it, we want to look after our pancreas that produces insulin, so, great. This has been a really great talk, I’ve really enjoyed it. Thanks so much Rupy. Thank you.

Dr Rupy Aujla [00:26:47] Thank you Louise, it’s been great.

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