BONUS EPISODE: Diverse ingredients with Dr Megan Rossi RD

Aaron Boysen: 0:00

Dr. Megan Rossi highlights the importance of diverse ingredients in collaboration with PepsiCo Health and Nutrition Sciences. She's a gut health expert. And she's come to talk to us today to explain that it's not just about the total grams of fiber you consume, but also the sources of that fiber that make an impact on your health.

Unknown: 0:17

She is an award winning PhD in gut health who can help you say bye bye to bloating

Dr Megan Rossi: 0:24

combining different dietary fibers actually could make certain prebiotics less fermentable fibers more tolerable UK based Aussie dietitian and the go to in gut health and Dr. Megan Rossi, Olympic athletes and these people had all these chronic conditions, we're all coming to be complaining of the guy. Why not set up social media? If I get like 100 followers, I'd be doing more of a service for science communication than just sitting away and in my scientific world complaining about the lack of translation. Come on, let's do something. Are we getting something from the super six? You know, most days most of us aren't.

Aaron Boysen: 0:56

Dr. Megan Rossi is a world renowned gut health expert and a registered dietician. She conducts research into gut health at King's College in London. She has been researching and writing about gut health for over a decade, and has published several books on the subject, including her best selling book, eat yourself healthy. We have a great conversation about her career to this date, and also about some of the findings from the latest research on gut health. And we learn how we can best support our patients. So without further ado, my name is Aaron Boysen. This is the dietetics digest podcast. So ensure you chew it thoroughly as a lot to digest here. So your career so far do you do so many things? And you obviously have moved from Australia to the UK and now work at King's College London? Have you always wanted to be a health expert?

Dr Megan Rossi: 1:44

Yeah. Look, Aaron certainly when I was in my early 20s, I didn't think I'd spent it analyzing people's poop samples. So absolutely not, I didn't really have any future plans to get into gut health IT I fell into it in a way based on a personal experience. So in my final year, studying nutrition and dietetics actually lost my grandma to bowel cancer. So actually, my first conscious encounter with the guy was quite a negative one. And I was like, God, what's going on, like, obviously, in our degree, we learned a little bit about bowel cancer, but not in any real detailed level. It felt like the mechanisms kind of were missing, we chatted a bit about bacteria, but no one quite understood what it was all about. So I was like I was a bit angry at the guard February through the chemo, the surgery and then obviously taking a life. And then I started I graduated and started working as a clinical dietitian, both in the hospital setting seeing all different types of conditions I was on the renal Ward oncology did some weight management. But also I was actually very fortunate to also be the nutritionist for the Australian Olympic synchronized swimming team. Just by chance I fell into that. And I found it so striking that all these people from very different backgrounds, so these Olympic athletes, and these people had all these chronic conditions were all coming to me complaining of the gut. And I was like, God, what is it about this organism? It's haunting me, and that was around 2010. So there hadn't been a whole lot of gut health research really come to the forefront just started to be a little bit more niggly in the in terms of the literature, but certainly in our textbooks, it was really lacking. And I thought you know what I owe it to my grandma and to my patients to find out more about this organ, because I feel like there's just such a gap there. So I embarked on a PhD, looking at whether we could target the gut through the right nutrition, specifically, it was a combination of pre and probiotics and synbiotics. Looking at whether we can improve the health of not just things like gut symptoms, but also things systemically like kidney function, mental health, and it was really that PhD that just transformed everything. For me, I was like, wow, actually, the gut is incredibly powerful. And I think we've just misunderstood it, and the way that we treat it the way we manage it, and I could see that if I was ever going to have my impact. It was going to be via the gut, because it was just it was a landmark scientific discovery. And I was fortunate enough to really be at the forefront of that research. So it was really Yeah, that PhD and then I was like, obviously want to continue in the research field and contributes I looked around the world who was doing the most innovative gut health research. And it was King's College in London. So I essentially begged Professor Whelan, I think a lot of listeners will know who he is for a job. And interestingly enough, I think just a bit of a side note, but I actually didn't get the job I applied for at Kings. So if you get kind of knocked down, don't worry, just you know, build your resilience. And actually, I was fortunate enough then for him to say, you know, you didn't get that job, but you know, I think you could be really good at in this other area. And, and so yeah, he gave me that opportunity. And yeah, so I just moved over by by kind of that job offering I never a bit bit ignorant in Australia, typically in terms of traveling overseas, no ambition at all growing up. And so I was just like, Yeah, I'll do it for A year fine. And then yeah, the research opportunities in the UK for nutrition based research is just unbelievable at the moment. So I got stuck here based on like amazing research grants that we

Aaron Boysen: 5:11

got. We're happy to have you as well done Professor Whelan good choice. Probably, yeah, we could argue whether he should have picked your first or not, but I'm sure that was a great candidate as well. So, but I wanted to ask what have you What have you done in that role? So far? It was obviously back in 2010. It's now 2023. When we're recording this, what have you been able to do in that role in that in the 13 years?

Dr Megan Rossi: 5:33

Yeah, so I actually didn't move over to 2015. So 2010, when it was when I embarked on my PhD, so then moved over 2015. And here my first research grant was for the MRC for Medical Research Council, where we were looking at whether different types of dietary fibers could actually help people with irritable bowel syndrome. So we know as dieticians that a lot of people who have IBS, they have a very hypersensitive gut to fiber and bacterial fermentation, what we wanted to understand is whether we combine different fibers, whether that would actually make them more tolerable in the gut, and sweet and amazing, so we literally still haven't published the final paper for that, which just highlights how long research takes to get to publication stage. But they've done amazing pilot studies to test things as well as MRI studies, which essentially is where it's like my favorite type of research, we've collaborated with some colleagues in Nottingham, where we feed volunteers, different types of fibers, and we have this functional MRI scan of their gut looking at colonic gas production, like how much gas is being produced, how much fluid is being drawn in there, and then correlate that with people's symptoms. And from that MRI work, we show that actually combining different dietary fibers actually could make certain prebiotics, less fermentable fibers more tolerable in this cohort, because we know with IBS, that if we learn up on prebiotics, I can get more gut symptoms, but we know that also freemax are so beneficial. And perhaps if we feed people with IBS, prebiotics, we can actually help resolve their IBS we needed to kind of overcome the symptoms side of things. And then we've moved that into a clinical trial actually international one. So we collaborate with Mexico as well. So they recruited half the participants. Yeah, that research is being written up at the moment.

Aaron Boysen: 7:18

Sounds very, very exciting. I mean, could you just clarify for the audience what a prebiotic is?

Dr Megan Rossi: 7:22

Yeah, absolutely. So prebiotic, essentially, is a fertilizer for our good gut bacteria, because they're mostly types of fiber. But actually, the definition of a prebiotic has recently been updated to include not just types of fibers, other types of plant chemicals. There's other types of phytochemicals, which can also have benefits. And prebiotics are in so many of our foods that are readily accessible. In fact, legumes and I'm sure we'll talk more about them, because they're one of my favorite plant categories that are made because they're just such powerhouses that are really accessible. And they're actually one of the best sources of dietary prebiotics.

Aaron Boysen: 7:55

It sounds like you've done quite a bit of work. And obviously, it takes time to get things written up and stuff within academia. However, you don't just work at King's College London, you also do a few other things, too. So you're, you've got quite a large following on your website, social media channels, you've got your own clinic, you also a columnist at the Mail on Sunday. Did you see your career going down this path and doing so many things? Or did you fall into it?

Dr Megan Rossi: 8:18

Yeah, no, not at all. I was very much in my head, a researcher. But it was probably about about, yeah, about a year, I would say working at Kings as a research fellow, and loving working there, loving the research. But you know, I just have to get frustrated, essentially, that despite the amazing work that was being done, it wasn't being translated. And actually, it took so long to translate some of the things that we knew, right? Like I just said, seven years, and we saw them on their landmark paper for it. So I thought, you know, what, how can I do my bit for science communication? How can I help translate some of these key concepts more effectively or efficiently? So I thought, You know what, why not set up social media. If I get like 100 followers, I'd be doing more of a service for science communication than just sitting away. And in my scientific world, complaining about the lack of translation. Come on, let's do something good. I'll try to anyway. So yep, so that's social media didn't expect much at all. But I think it was just really good timing in terms of how salad came out in the media more, and people were looking for a credible source of information to try to get their heads around what was happening in terms of this landmark scientific discovery. So yeah, it was it was great timing. And, yeah, in terms of the gut health clinic, I always continued working as a clinician so even as a research I always did some private practice because, you know, every each their own but I always felt it made my research more relevant because I was keeping my hand and understanding what people what issues people were faced with and what they're experiencing. So yeah, it's just through demand in terms of people like I've got an issue. I really need some support. So yeah, I felt that when I started working Holly street which can be incredibly dodgy. And I was like, You know what, there's not enough qualified clinicians here. And people were going to like, crazy unqualified nutritionists and all this sort of stuff. And on crazy supplements winning so much on these crazy tests, I thought I need to bring kind of credibility to this area. So yeah, brought from my team from Kings who also clinicians, and yeah, now we've grown to about 10 of us.

Aaron Boysen: 10:23

I personally, I'm going to be honest with you, when I've got so many different things to focus on. It's hard to sometimes manage it all. How do you sounds like a cliche? Sounds like such a cliche question. Basically, what what sort of, so there might be other dieticians who are interested in or nutritionist who are interested in do going down a similar path and doing loads of different things? Is there any suggestions you would make to them? Or things they need to consider before they go down that route?

Dr Megan Rossi: 10:49

Yeah, look, I think I am really happy, I had quite a strong, like clinical Foundation, because I do have a few students that I mentor from dietetics. And they're just so keen to get into a science communication or start their own clinic. And they lack that initial foundation of that hardcore clinical expertise that you learn on the job I take degrees, I think are great, but they don't give you that hands on experience. So I was really happy that I had like the four years really to solidify my SpaceX skills, I think that's probably an important one. And then in terms of juggling different things, for me, it's team like having a brilliant team, I certainly am not the only the only one that's the girl doctor or the girl clinic, I have a brilliant team that I can really trust. And I know we share the same passion and goals to empower everyone with evidence based practice and support. So yeah, for me, making sure you've got a supportive group of colleagues around you.

Aaron Boysen: 11:42

Definitely, I'd say the team or just people not necessarily to support you, but almost to motivate you as well, and push you forward and see new opportunities and things like that, I definitely mirror that. I'm going to be honest with you. Now, in regards to gut health and things like that, when I talked to lots of dieticians, mostly work within the National Health Service, the NHS. We know gut health is important. And you can say it all day gut health is really important and things like that. But most the time in their consultations, they might not be thinking about gut health, they're thinking about the nutritional problem, and how they can solve that problem. Or it could be poor nutritional intake, excessive nutritional intake, it could be possibly working on more specialist diet, do you think it's important to actually still think about gut health within that patient cohort? Or is this just from people to people on the street? Would you say who don't have any other problems?

Dr Megan Rossi: 12:28

Yeah, and that's a really great question. And I completely understand when you are a full time clinician to keep on top of this research that literally is churning over every week, new things that come into the forefront, it can be really hard to keep on top of it. So I completely understand from that side. But like you've said, it is actually quite important, or that you've asked it is quite important, because it's kind of fundamental shift into the power of nutrition, I actually wrote a great paper for the British nutrition foundation, I think it was 2019, where it go through it's like nutrition in new lattice. I mean, anyway, we can link it to the to the show notes if helpful. But the paper kind of explains the concept that we always knew that nutrition had an impact on human health, like we always knew that through human metabolism, food could be really powerful. But through the discovery of our gut microbiota, these trillions of micro organisms, we've now discovered a new pathway to which food is impacting human health. It's not just through human metabolism, it's through microbial metabolism. And this is rebirth, this array of understanding and mechanisms to how food can really have these far reaching health benefits. For example, things like plant diversity, which I'm sure we'll talk into as concepts, but historically, as nutritionists, dieticians feel like, it doesn't really matter, as long as they're getting their 30 grams of fiber in who cares at the source, right? But actually wouldn't because of the microbiome, it's opened up this new mechanism, this new understanding that each different fiber functionally feeds different micro organisms, and therefore we need that diversity to have the optimal health outcomes. So actually, it has really, I think, changed, you know, as a profession, our perception of how powerful food can be. So it actually should start to be integrated, I think, into all of our understandings of, of, you know, the power of nutrition, whether you're treating or managing, you know, cancer patients or osteoporosis. You know, for example, we know that prebiotics, when we spoke with the fertilizers, the gut, gut bacteria, actually caught administration of them with calcium increases calcium absorption our body. So, you know, there is a lot to say, for the mechanisms underpinning, I guess, you know, nutrition or therapeutic nutrition, you know, via the gut microbiome.

Aaron Boysen: 14:49

Yeah, so it should be thought about as well as the nutritional problem in the background, at least as a concept and we need to ensure that we're actually fostering people's good gut health with those diverse ingredients now, what sort of benefits can come from having diverse ingredients, particularly talking about diverse fibres? And not just hitting that 30 gram a day limit?

Dr Megan Rossi: 15:08

Yeah, look, well, we know most of us are getting less than 20 grams. So we do have a while to get to the 30. In terms of, of those 30 grams, the source has become really quite important. So there's been some really great research done by many different groups out there now starting to look at the health benefits of different types of fiber based on this one systematic review looked at the benefit of I think, of dietary fiber, but on colon cancer risk, and they showed for every 10 grams increase in total fiber, you decrease your risk of colon cancer by 10%. A lot of us have heard that before. But what they then did is looked at the source of fiber, and they looked at Whole grain fiber and showed that for every 10 grams increase in wholegrain. Fiber, they were having a 10% decrease in colon cancer, but then they looked at fiber from fruit. And they found that that fiber from fruit didn't seem to have that protective effect on colon cancer, unlike the whole grain fiber. Now, that's certainly not to say that whole grain fiber is any more beneficial than the fiber fruit, or the veggie sorry, the fiber from Veg or fiber from fruit, but highlights mechanistically, they do different things. Because we know that actually the fruit have got all these other phytochemicals, which can be really protective against other types of cancer. So I think we're starting to appreciate that each different kind of category. And even subspecies of plant has a array of different benefits. A lot of those benefits come from feeding different types of micro organisms, which essentially do different things. They send different messages throughout the body that can protect us against, you know, different types of sort of, you know, source of inflammation, but as well as things like, you know, mutations types of cancers.

Aaron Boysen: 16:50

Awesome. Definitely, I think so what you're saying is, basically, it doesn't, it's not just about the 30 gram in that 30 gram limit from whatever source possible, it's actually about where that comes from, and diversifying those ingredients just as much as just hitting that threshold cap. So you could argue that sometimes the fiber supplements or things like psyllium husk and things like that, possibly wouldn't have a lot of the same benefits. Or if they're not part of a diverse diet, they wouldn't have those benefits. Is that correct? Yeah,

Dr Megan Rossi: 17:20

essentially, each the fibers are doing things, different things. So we actually know that psyllium husk is incredibly helpful for constipation, because it's a unique fiber that gets hydrates in the colon, and therefore has that luxating effect. But the interesting thing about psyllium husk because this is one of the fibers that we were researching, is that the bacteria can't ferment it. So very poorly fermented, which is why actually it's well tolerated. And people with more sensitive guts like IBS, because there's no gas formed. So actually, it doesn't really feed the gut bacteria, it's got more of a functional kind of an effect on the kind of the muscles of the gut versus the mechanism of actually nourishing and feeding bacteria, which then produce things like the short chain fatty acids, which communicate with the rest of our body to look after us. So absolutely right, in terms of the different fibers are doing different things. And that's what you may have heard, we talked about the Super six for fall. So there's six different plant based food categories. And I'm a big advocate that people really try and focus on having something from the super six most days where they can, Erin, I'm going to put you on the spot here. What are the super six? How much research have you been doing?

Aaron Boysen: 18:26

The Super six, in what?

Dr Megan Rossi: 18:29

plant based food groups? Okay, I'll start whole grains, whole

Aaron Boysen: 18:34

grains, would you say beans and legumes? Absolutely. green leafy vegetables,

Dr Megan Rossi: 18:38

just veggies in general, as other

Aaron Boysen: 18:41

fruits be its own category? Absolutely. We've already said whole grains. Got some seeds, herbs and spices, herbs and spices. But there's a six different

Dr Megan Rossi: 18:51

categories. And I think it's important we start to try things in our own diets. Are we getting something from the super sex? You know, most days? Most of us aren't, we're actually cutting out complete food groups that we know actually have unique benefits. And one of the most common ones, which a lot of studies have highlighted is the legume group, in terms of a lot of the data from the 2015 have shown that most of us don't need any legumes at all.

Aaron Boysen: 19:19

Yeah, I think definitely, you've shown that I probably aren't as aware of the SuperSix as I should be. And I should probably increase the amount of particularly I should focus on SuperSix. Definitely. There you go there. I've learned something from this podcast, at least obviously, your work at King's College is definitely academic and you look at things from an academic perspective. It takes time because there's lots of rigor and peer review involved within those that research. What recent research studies have you seen that particularly impactful in terms of the ways of healthcare professionals on the ground, view the importance of these diverse ingredients? Yeah, absolutely.

Dr Megan Rossi: 19:52

I think one of my favorite studies I think can be quite powerful on public health perspective was published in Lancet 2009. I think and what they showed was a systematic review. And they showed that for every eight grams of fiber increase per day, we could reduce our risk of heart disease by 19%, our risk of type two diabetes by 15%, and risk of colon cancer by about 8%. And that was just that eight grams of fiber. So what I love helping patients to cleanse unscented is eight grams of fiber is literally like a cup of beans, that's eight grams of fiber. Add that to your your Indian takeaway, if you're having that for dinner, or to your Bolognese that's quite accessible and easy for most people do. So highlighting that yeah, or, you know, some veggie sticks and some hummus, another eight grams of fat. So eight grams of fiber is really attainable. So I think for clinicians, as well as understanding that these small changes to people's diets can actually have quite significant improvements on their risk of these really common chronic conditions. And then there was also more for kind of, I guess, the world category, looking at people who want to increase longevity, a paper published by University of Bergen last year. And what they did is looked at how we could extend lives. And they showed that we could extend lives by up to a decade by changing tweaking your diet in some sort of way. And what they showed was the biggest contributor in terms of he looked at the supersets and they showed that adding legumes, beans and pulses into people's diets could increase your longevity by two and a half years, which is quite significant. And that was and then it was under that was whole grains, then nuts in terms of I think wholegrains might have been like too quick, two years, adding nuts to your diet, daily diet was like 1.9 years or something like that. So they did it like that. And so it was a really nice way to see again, the importance of getting that diverse range of plants into people's diets for that, you know, longevity, I mean, we all want to live longer and happier and healthier, right? So

Aaron Boysen: 21:50

definitely sounds like I can understand why you like beans and pulses. So if you want to pick a hierarchy of the super six, the leader is definitely lead by impulses. But

Dr Megan Rossi: 21:59

the reason for that is not necessarily because they're more powerful than the others. It's because we've missed them out. There's been this like, kind of push away from them. So it's the easiest wins because we're having so little of them.

Aaron Boysen: 22:13

I definitely think historically there was definitely a push away from them. I do think recently, particularly with younger, more sort of health savvy consumers, they've been a bit more and much more diet literate, influenced by evidence based professionals getting online, whether it be dieticians, nutritionists getting online and sharing a message. Rarely. Would you say that the interest in the subject of diverse ingredients from an academic perspective and a clinical perspective, has sped up over the last five to 10 years, obviously, back in 2015. King's College were steaming ahead and probably pioneers in this area. But would you say the others are catching up in the area? And there's lots more interest in this field academically?

Dr Megan Rossi: 22:49

Yeah, look, absolutely, I would say probably not 510. I would say in the past two years, the interest has really grown in terms of this concept and this mechanistic understanding of, of why diversity is important. So we're like, Okay, now we get it we because it's nourishing the different micro organisms. So now we need to match the measure the clinical impact of it. Yeah, absolutely. It's a great example of I think how public's interest, and even food industry for that matter, in terms of really integrating this concept of ASD into the food supply is made the academic world go Oh, actually, yeah, let's really start to measure this and look in more detail about how it's all working.

Aaron Boysen: 23:32

I think particularly when you think about the You've mentioned a lot of the physical health benefits of adding extra fiber to your diet, but I remember when I was at a New Scientist conference, you were talking about the other benefits to having adding extra fiber to your diet. Do you mind discussing those the audience cuz I don't always think people think about those benefits.

Dr Megan Rossi: 23:49

Yeah, which are incredibly important. Specifically, things like mental health, because the stats show that one in four of us every single year will have some sort of mental health event. It's something that affects so many people yet, I don't think nutritionally. We chat about the power of it that much. And I understand this landmark study paper coming out in 2017. Before that, I was really nervous to ever promise that nutrition could help with a mental health condition. I thought, maybe a little bit I didn't want to overstep the line, but there's amazing paper, the smiles trials for those who haven't read it, do check it out by Felice jackers group in Australia actually. And all good things come from Australia and it was amazing paper and it gave me confidence as a clinician that actually I could start to say, You know what, if you nourish your gut through a really loads of plants, not just plants only I think that's probably a myth that's started to penetrate but it was a Mediterranean diet. So pretty much included the super six most days with fermented dairy, oily fish and things like that. And what they showed is that following this way of eating for 12 weeks, and people had moderate severe depression actually resulted I think it's like a 32% improvement and people's know If, at the end of those 12 weeks 32% of those participants had such a significant improvement in their mental health scores, that they would have been medically classified as no longer clinically depressed based on the questionnaires that they used. And that was just by changing their diet was incredibly powerful. And I always like to caution that everyone stayed on their their medications, that antidepressant medication. So if anyone's listening to this, I'm certainly would never say, you know, ditch the medications go cold turkey, but it just shows it as an adjunct therapy, diet can be incredibly powerful. And certainly in my own clinical practice. Since that papers come out, I've now worked with psychiatrists actually get some patients who really want to come off their medications completely off them, just by focusing on diet, obviously, that's a process and you need to make sure it's put the support of of psychiatrists or the prescribing doctor, we've got the data to back up how powerful dietary approach can be.

Aaron Boysen: 25:51

Definitely. And I think, obviously, there's lots more research to do. But there's so many things about the gut that we don't fully understand yet the impacts of whole ingredients and things like that. And I think as time goes on, we're definitely discovering that actually. It's not just about the macronutrients, he's not just talking about the macronutrient and micronutrient box, actually, the impact the whole food has on our digestive system on our overall health is what gives us the benefit, not necessarily the sort of tick box ingredient, however much we sometimes wish is clinical dietitians. It was just a tick box ingredient. And I'm sure there's lots of people love that love to package up something that actually is the foods that we need to nourish and build our bodies to be healthier. Now, back at the beginning of the podcast, we mentioned the government recommendations around 30 grams per day, you said that most people are not achieving that they're maybe hitting around 20 grams per day. Now, you've mentioned a figure both in your talk, but in your book, or 50 grams per day for maximum maximal benefit. Would you say now, I don't think I'm alone in sight. I don't think I'm the only one alone in saying this. But most people would really struggle to that. How would you support patients to come closer to this target?

Dr Megan Rossi: 27:01

No, absolutely. I think that's a really great question. Now, the 50 grams that I typically recommend have come from that smiles trial. So remember, I said these people had moderate to severe depression and their diet the kind of Mediterranean diet was gave provided them 50 grams of fiber a day. Now actually, I know it sounds like a lot, but it's really doable in terms of getting in 50 grams of fiber a day. It's just like little tweaks in your diet. So like the legumes, for example, cup of them contains 10 grams of fiber, that's 1/3 Like just done sorted for snacks, I think is a really underrated opportunity. And one pair contains like five grams of fiber, one tablespoon of linseeds contains three and a half grams of fiber, I think we're gonna be having breakfast, sprinkle them across, or if you're having some soup, sprinkle some wooden seeds in it. It's just those little tweaks we can make to whatever we're eating. And if you have a polonaise for dinner, cut out half the minutes, replace it with a can of tin lentils, stuff like that, again, you're going to get an extra 10 grams it and you know what, like a lot of the recipes that I would make they contain at least 15 grams of fiber per serve. Now, of course, if someone is really sick, and they've got a really poor appetite, then of course, it's going to be difficult to get that volume of food in. But actually the vast majority of people I see in clinic, they can easily achieve the 50 grams of fiber. Of course, we never would want someone to go from 20 grams to 50 grams, even in a month that would take around three months for the gut to adjust and really be able to learn to metabolize all the different types of fiber they're getting so slow and steady definitely wins the race. But it's more easy. Oh, it's easier than I think we think if you hear that 50 numbers, oh my God, that's crazy. But whenever you have like porridge greater Khairuddin great, some kojedal and that adds an extra three grams of fiber or something to a bowl of porridge, which already contains about eight grams, little things like that actually really add up to making the 50 grams really achievable. Or you know what if you're at 20 grams, let's just start with aiming for your 30 grams. Let's be really realistic, I think of where you're at.

Aaron Boysen: 29:04

I think one other thing that I've also started using quite recently implemented in my diet, should we say think about a meal you might have meeting, I haven't fully convinced myself to go fully meat, I go fully meat free on some meals. But sometimes I like to still have that sort of experience in my life. So I add in say, for a curry I go, let's have a killer chickpeas into a curry that already has meat, split it in half, save a bit of the money on the meat and also including increase the diversity of the fibers and things like that. I think that's Would you say that's a good option and thinking about different ways you can do that, as you say mentioned about bolognese?

Dr Megan Rossi: 29:37

Absolutely. I think that's a perfect example. And I think we know that 100% plant base is not necessarily healthier. Like I understand environmental and cultural reasons why someone wants to do that. But certainly going 100% plant based doesn't mean that you're healthier or have better gut health than someone who's an omnivore and also eat some animal foods as well. So I think that you know, it's not the extreme diets. Some that maybe we hear on social media are healthier. It's not necessarily true. But again, there's so many examples. And you know, if you're having, you know, takeaway, unlike Yeah, absolutely, I personally have takeaway, I'll have pizza. But what I do is when I have my pizza, I usually get like a can of mixed beans, I find the CANS because they're just so accessible and easy, you know, they cost like ADP, and you know, it just quickly rinse it already cooked. And then I add on top of my pizza, you know, and it's a great way again, to get extra 10 grams of fiber to my pizza that I'm having. So it's just those ways of just tweaking your diets rather than having to have this crazy overhaul of like, oh, I never eat takeaway and stuff like that, which is not realistic for most people.

Aaron Boysen: 30:38

Yeah, so it's a lovely approach of just adding to the diet instead of taking away and banning certain things. And I think when, obviously, we're coming to the end of January now, but actually, when thinking about New Year's resolutions, probably a better approach will be to think about adding things rather than taking away actually, how can I add the SuperSix into my day, every single day, can I put beans in this meal lentils in this meal nuts in this one chickpeas in this one, however many, many ways that you can cook it and I think that's such a nice way to think about it. But there's one thing I think about when I think about so I've spent most of my career working within the NHS, working with patients that are wide variety of patients to be honest. And sometimes I feel like these nice meals that I might have come from my own home, or the ones I see on Instagram, with some beans, chickpeas are not always accessible to those who don't have good good cooking skills have poor cooking confidence, or due to other circumstances such as disability or unable to cook for example, it might be an elderly gentleman who possibly his wife passed away and she cooked a lot of the meals. How would you recommend what would you recommend to these kinds of patient cohorts in increasing their fiber intake?

Dr Megan Rossi: 31:47

Yeah, look, I think the bean example a can of lentils, mixed beans, it's such a perfect opportunity for that because they don't need to cook it even if they're having takeaway. They can add that in it's like a really easy win. But also I love the fact that I guess food industry is starting support this concept of increasing plant diversity increasing fiber I know that there is a leading retailer at the moment looking to try to integrate more things like fava beans and other types of legumes into some of their base recipes. So I do hope that food industry really can support those sorts of populations. But I think yeah, it's also comes back to thinking about those easy wins if they can't cook you don't need to cook legumes in the tinned version. It's already done just get the ones without any sort of flavor. Just get the ones and water and stuff like that. And yeah, and it's easy when

Aaron Boysen: 32:34

I've even seen like really font like on the other opposite end of the spectrum really fancy beans cooked in like special. Brian, I think it's definitely becoming more popular all the rage. Now. I think I saw a stat from I think it was one of these research institutes I think it was your own motor into it, nothing to do with cars. But your emotions national said that it was going up to 22%, I think or 25% in 2020 27. I think it's definitely increasing. What do you think the real pushes among the general population? Or is it this research? Or is it other things as well,

Dr Megan Rossi: 33:04

I think it is the health that's a feeding down from the media. So obviously, the research has to be done to highlight the good source of prebiotic and gut health is very on trend. So I think people, if they can see that there is a gut health benefit of something that's actually really low cost, particularly in this kind of economic climate, then people like Hell yeah, I'm gonna jump for that it's really accessible. So I think there is that that benefit of the media, educating the wider public around the health benefits of legumes. And then also, of course, I think food industry making it accessible. They're putting it in foods that I think consumers are, they have already accepted. So if you add some legumes into like a pasture dish that's pre packaged, people are like, Oh, that's new, but I liked the pasture. So maybe I'll try it. And then they go, Oh, actually, I really like it. Whereas there might have been put off by the fact of having to buy a whole can of it. So food industry of just slowly starting to integrate legumes I think has has paid off and people's acceptance of it.

Aaron Boysen: 34:02

Yeah. and adapt. Obviously, people say they're not influenced by marketing or influenced by brand messages. However, I do think having the brand's almost make it appealing and almost sexy brings people into those health benefits. So it's almost using their marketing to push those health benefits to people as well. Because I remember some of these beans you've mentioned today, probably a couple of years ago, you'd have to go to a really nice supermarket, you'd go into the supermarket, get the beans off the shelf, they'll be dried, but actually the fact that being incorporated now I think makes it a lot more accessible for a lot of the cohorts that we've mentioned, and lets them try new things as well.

Dr Megan Rossi: 34:38

Yeah, no, absolutely, I think plays a key role.

Aaron Boysen: 34:43

And so we've touched on, we're focused on using a plant based diet to improve gut health. Now, are there any other ways we can improve gut health that aren't dietary approaches?

Dr Megan Rossi: 34:54

I look absolutely. I think that's a really good point. And as dietitians we usually do touch on lifestyle factors. So I think it is Part of our kind of toolkit or repertoire to actually look at these non dietary approaches to improving gut health, and I think most dietitians are aware, but I always like to just highlight whenever I say the word plant based, I don't mean plants only, it's that it's based on plants, majority plants, but actually, you can absolutely add animal foods in there if you want to, it's the plants only that kind of people really associate. So just I like to always make sure that it's clarified with people I'm not advocating, we'll go plant so and then in terms of these non dietary approaches, yeah, so we know that there's three other key pillars. So we've got the stress, we know that independent of diet, stress can trigger gut issues, like the symptoms, bloating, constipation, diarrhea, etc. But also it has seemed to have this impact on the diversity of our gut bacteria. And we certainly see that a diverse range of gut bacteria is associated with better overall outcomes, a better gut health, but the mental health, the heart health. So there's this concept of diversity not only in the food we eat, but in the types of bacteria that live in our gut is associated with the health benefits. So stress, 10 minutes of mindfulness each day, if we can, those sorts of things actually can have quite measurable impacts on people's gut health, sleep, we're always bang on of the seven to nine hours. But actually, again, independent of diet, a lack of sleep has been shown to reduce down the diversity of gut bacteria. But also it works both ways. It seems to be bi directional, where actually, if you don't have good gut health, it should also impact your sleep. And then the third pillar outside of diet is movement. So again, independent of diet, so people stay on their diets, but actually, they start moving their bodies more three days a week, some sort of high intensity, or moderate intensity actually, exercise that actually, again, has been shown to increase the diversity of their gut bacteria. Yeah, I know, it's concepts, I guess, as dietitians their lifestyle, blah, blah, sleep pre stress move, but actually, we now understand mechanistically. So there are of course, the patients they see in clinic clients, and they say, Look, I just want to focus on my diet, because I can control it much easier. And I'm like, I get it. But you know, how does matter how perfect how that boosting your data is, if you don't fix those other three domains, you're not going to really reap all those health benefits you can achieve from look at health. So boringly, we do need to look at those other areas as well.

Aaron Boysen: 37:19

Yeah. And it just shows that holistic approach, the longer time take, the longer we move on, actually shows that it's, there's more that everything is just more than the sum of its parts, you can't just focus on one thing, it is very much that holistic approach. And I think as dietitians, we need to understand that and acknowledge that and actually think about where the patient is what they need to do, and what they need to focus on. Because as you said, if they don't, you know, sort out stress or things like that, a lot of other dietary changes might not be as impactful as if you're able to sort out but I do, I do sort of empathize with your clients or patients, that actually it's a lot easier to control what you you eat, rather than the stress you have, which often comes from external factors. And also the way we respond to these external factors, which aren't always conscious. I think it can often be it's not the easy answer. It's not that it's quite a simple answer, but it's definitely not easy to put into action.

Dr Megan Rossi: 38:17

Yeah, absolutely not. And I think again, like as dieticians, we do need, we don't necessarily get the training at university. But we do need to think about, you know, what are some evidence based quick hacks, we can add on to people's diets to deal with the sleep issues to deal with that the lack of exercise to deal with the stress. And, you know, there is now pretty good research out there highlighting, you know, some sleep hygiene techniques. So my colleagues from Kings actually did a really great clinical trial, showing how people followed these nine sleep hygiene strategies, they put them on this kind of cohort, I think it was for like, eight weeks or something. If they followed those nine sleep hygiene techniques, they actually had significantly improved sleep quality, compared to those who just got told to sleep more. So you know, there are a lot of strategies out there that we know are evidence base that can add extra, you know, sleep quality, as well as duration by just making those those small tweaks. So it is I think, important that we don't just fixate on diet as dietitians to look at that whole picture.

Aaron Boysen: 39:24

Definitely. And I think on that note, I think I think we should take away the things you've said today about the holistic approach, but also those super six and I will put the super six in the show notes and Megan is not allowed to tell me what the super six are I have to sort of put them in the show notes and then she can obviously review it and see if I'm right or not or everyone else can review it and see if I'm right or not, but hopefully it will it will be able to grasp the messages and re listen to the recording, do the editing but thank you so much for your time today. Thank you for your help for your Inspirational sort of yourself and the things you've done within your career, the knowledge that you've shared with people who might be having gut issues, but also the knowledge that you've given me today and things I need to work on to improve my own gut health. And hopefully the audience has got it too. And they're going to sort of digest on that and move forward.

Dr Megan Rossi: 40:18

Yeah, look, it's absolute pleasure. I love sharing the science and helping people feel more empowered to make the decision that's right for them, right. No one's got the perfect diet. But if you could make a small little tweak, and know what's going to improve not just how you feel physically, but emotionally as well, I think it's quite a convincing case.