The role of food in health | Dr Rupy Aujla | TEDxBristol
Summary
TLDRIn this powerful talk, NHS doctor Rupi explains how lifestyle-related illnesses like heart disease and diabetes are preventable through diet. She advocates for a diet rich in plants, fiber, and quality fats, highlighting the overlapping principles of various popular diets. Rupi emphasizes the importance of food in health and calls for a food-focused approach to prevent disease, urging individuals to make small, consistent dietary improvements for significant health benefits.
Takeaways
- 💔 The speaker recalls their first experience of losing a patient as a junior doctor, a 60-year-old woman who had a heart attack and could not be saved despite all medical efforts.
- 📊 Heart attacks are common, with over 100,000 occurring annually in the UK, alongside 30,000 cardiac arrests, most of which happen out of hospitals with low survival rates.
- ⚠️ The speaker emphasizes that many lifestyle-related illnesses, like heart disease and stroke, are preventable with early intervention, especially through diet and lifestyle changes.
- 🥗 The speaker, a doctor, advocates for using food as medicine to prevent lifestyle-related diseases, stating that proper nutrition can reduce risks for millions of people worldwide.
- 🥑 Although there are numerous diets that seem to contradict each other, many share common principles like reducing processed foods and including more plants, fiber, healthy fats, and colorful foods.
- 🌱 The importance of micronutrients, phytochemicals, and fiber found in plant-based foods is emphasized as they help with cellular regeneration, reduce inflammation, and support gut health.
- 🧠 Healthy fats, such as those found in nuts and seeds, are crucial for brain health and hormone production, while colorful foods can even influence gene expression through nutrigenetics.
- 🍽️ Nutritional education is lacking in medical training and schools, resulting in a lack of basic cooking skills among patients, hindering them from adopting healthier diets.
- 👩🍳 The speaker discusses a movement in the UK to incorporate culinary medicine into medical education, highlighting a local program that teaches doctors how to cook and counsel patients on healthy eating.
- 🍎 The speaker concludes by advising people to add 'just one more' portion of healthy food to their meals, emphasizing that small, consistent changes in diet can lead to significant health improvements over time.
Q & A
What was the speaker's first experience with a patient's death?
-The speaker's first experience with a patient's death involved a 60-year-old lady who had a cardiac arrest, likely due to a heart attack. Despite resuscitation efforts by the ambulance crew and the hospital team, she passed away.
How frequently do heart attacks occur in the UK according to the speaker?
-The speaker states that heart attacks occur in the UK at a rate of one every five minutes, with over a hundred thousand cases annually.
What is the survival rate for out-of-hospital cardiac arrests as mentioned in the script?
-The survival rate for out-of-hospital cardiac arrests is less than one in ten.
What is the main focus of the speaker's 15-minute talk?
-The speaker's talk is focused on preventing the deaths of adults due to preventable lifestyle-related illnesses, such as heart disease, stroke, and metabolic disease complications.
What does the speaker prescribe as a 'medicine' in the context of the talk?
-The speaker prescribes 'food' as a form of medicine, emphasizing the importance of diet in preventing and treating ill health.
What common principles do the speaker find among various popular diets?
-The common principles among various popular diets include the removal of junk food, processed foods, and excess sugar, as well as the inclusion of plants, fiber, quality fats, and a variety of colors.
How does the speaker describe the role of plants in a healthy diet?
-The speaker describes plants as a source of micronutrients, vitamins, minerals, and phytochemicals that can help regenerate human cells, signal between them, and change their function.
What is the significance of fiber in the diets discussed by the speaker?
-Fiber, particularly from whole grains, beans, and legumes, feeds the microbiota, which is crucial for maintaining health by releasing nutrients, digesting food, balancing inflammation, and regulating sugar levels.
What is the field of study that explores how food can interact with our DNA?
-The field of study that explores how food can interact with our DNA is called nutrigenetics.
What is one practical piece of advice the speaker gives to the audience for improving their diet?
-The speaker advises the audience to add 'just one more' colorful vegetable, portion of nuts or seeds, or fruit at every mealtime to improve their diet.
What initiative is the speaker involved in to educate future doctors about nutrition?
-The speaker is involved in a movement that includes teaching future doctors about the foundations of nutrition and how to cook, through the UK's first culinary medicine course.
Outlines
🏥 Medical Reality and the Power of Prevention
The speaker, a junior doctor, recounts a formative experience witnessing a patient's death from a heart attack despite resuscitation efforts. This event led to a realization about the limitations of medical intervention once a disease has progressed. The doctor then pivots to emphasize the importance of preventative medicine, particularly through diet, to combat lifestyle-related illnesses. The narrative highlights the startling statistics of heart attacks and cardiac arrests in the UK, underscoring the need for a proactive approach to health. The speaker, Rupee, an NHS doctor, introduces the concept of 'food as medicine,' suggesting that dietary choices can significantly impact health outcomes.
🥗 The Overlapping Principles of Healthy Diets
Rupee discusses the commonalities among various popular diets, such as Paleo, low carbohydrate, Mediterranean, DASH, and whole food plant-based diets, despite their apparent differences. The speaker points out that these diets share fundamental principles, including the elimination of junk and processed foods, and the inclusion of a variety of plant-based foods, fiber, quality fats, and colorful ingredients. The paragraph delves into the benefits of these dietary components, such as the role of phytochemicals in plant foods, the importance of fiber for gut health, and the impact of food on gene expression through nutrigenetics. The speaker argues that these overlapping themes reveal the underlying principles of a healthy diet that can help prevent chronic diseases.
🌱 The Role of Food in Healthcare and Education
In this paragraph, Rupee addresses the broader context of food and nutrition within healthcare and education. The speaker notes the emotional and cultural significance of food, the lack of nutritional education in medical schools, and the challenges patients face in accessing healthy food options. Rupee shares an anecdote about a patient's struggle to change dietary habits, highlighting the complexity of nutrition advice. The speaker then discusses an initiative at the local medical school to integrate nutrition and cooking education into the curriculum, aiming to equip future doctors with the knowledge to advise patients on dietary changes. The paragraph concludes with a vision for a healthcare system that values food as a central component of health and well-being.
🍽️ Practical Advice for Incorporating Healthy Food Choices
The speaker concludes with practical advice for the audience, encouraging small, incremental changes to dietary habits. Rupee suggests adding 'just one more' serving of vegetables, nuts, seeds, or fruits to each meal as a simple yet effective strategy for improving one's diet. The paragraph emphasizes the potential of these small changes to have significant long-term health benefits. The speaker expresses optimism about the possibility of creating a food-focused approach to health in communities, shifting from a reactive to a proactive stance on disease management. The talk ends on a hopeful note, with the speaker advocating for a healthcare system that recognizes the importance of nutrition in preventing illness and promoting health.
Mindmap
Keywords
💡Cardiac Arrest
💡Resuscitation
💡Preventable Lifestyle-related Illnesses
💡Nutritional Medicine
💡Phytochemicals
💡Fiber
💡Microbiota
💡Nutrigenetics
💡Mediterranean Diet
💡Food as Medicine
💡Culinary Medicine
Highlights
A junior doctor recounts the frustration of losing a patient to a heart attack, highlighting the limitations of reactive medicine.
In the UK, there are over a hundred thousand heart attacks and thirty thousand out-of-hospital cardiac arrests annually.
The speaker, Dr. Rupee, emphasizes the importance of preventive medicine through lifestyle changes, particularly diet.
Despite differing approaches, various diets share underlying principles that contribute to health improvements.
Popular diets like Paleo, low-carb, Mediterranean, DASH, and plant-based diets all advocate for the reduction of processed foods and sugars.
Plant-based diets are praised for their rich micronutrient content, including vitamins, minerals, and phytochemicals.
Fiber from whole grains, beans, and legumes is crucial for feeding and maintaining a healthy gut microbiota.
Quality fats, particularly those found in nuts and seeds, are essential for brain health and hormone production.
Food's interaction with our DNA through nutrigenetics can influence gene expression, promoting health.
A prudent diet, rich in plant foods, can lower the risk of various chronic diseases, including kidney disease and cancer.
The complexity of dietary advice leads to confusion and apathy, hindering motivation for behavior change.
Dr. Rupee shares a personal anecdote about introducing dietary changes to a patient, emphasizing the challenges in nutritional advice.
The lack of nutritional education in medical schools and schools at large contributes to the difficulty in promoting healthy diets.
The speaker describes a pioneering initiative in Bristol to teach future doctors about nutrition and cooking.
Medical students in Bristol are taught to apply nutritional knowledge within the constraints of NHS clinic appointments.
The importance of community involvement in health promotion, such as medical students cooking for the homeless, is discussed.
A call to action for medical schools to include nutrition training as standard, to better equip future healthcare professionals.
The potential for a food-focused approach to health in communities, shifting from reactive to proactive healthcare.
Practical advice is given to the audience: at every meal, ask if you can add just one more portion of colorful vegetables, nuts, seeds, or fruits.
The speaker concludes with a hopeful vision for a healthcare system that prioritizes food as medicine and preventative care.
Transcripts
[Applause]
i was just 24 years old
when i saw a patient die in front of me
for the first time
i was working as a junior doctor in a
busy a department
a 60 year old lady came in having had a
cardiac arrest
most likely a result of a heart attack
the ambulance crew had started
resuscitation at the scene and we
continued
delivering drugs manual compressions
exactly
how we'd all been trained
but despite our best efforts
we ended up calling her death
and i remember leaving
that recess bay feeling so frustrated
this wasn't what i'd been led to believe
medicine was about i wanted to save
lives
not struggle in vain and succumb to
losing patience
and when i went home that night i
refreshed my memory on how many heart
attacks there are in the uk every year
it was slightly less than but now
it's over a hundred thousand
one every five minutes
and thirty thousand cardiac arrests
occur in the same way this poor lady
presented
out of hospital
with less than a one in ten chance that
they'll survive
so the reality was from the moment the
ambulance crew brought her into the
department there wasn't much we could do
at that point we were reacting to
disease that had been untreated
undiagnosed and started long ago
the first presentation of which was her
collapsing to the floor
with a heart attack
but today
i have 15 minutes to save your life
or more specifically i have 15 minutes
to help prevent the deaths of roughly 50
of the adults in this audience today who
will succumb to preventable lifestyle
related illnesses
like heart disease
stroke and complications of metabolic
disease
lifestyle related illnesses that cause
millions of deaths worldwide and in this
country
my name is rupee
i'm a nhs doctor
and the medicine i'm prescribing today
is food
but as more people understand the power
of our diets to help prevent and in some
cases treat ill health the logical
question becomes
doctor
what should i be eating
and if you've looked at the headlines or
scroll through social media you will
notice
meat eaters fighting with vegans paleo
fighting with the diabetes association a
war of attrition between multiple sides
with the losers being the millions of
people just trying to figure out how
best to look after themselves
today i'm going to help you with a
different approach because it seems
strange to me that you can have some
people who decide to eat a plant-based
diet and improve their heart disease
markers
others who choose paleo and improve
their bowel symptoms
while some swear by low carbohydrate and
come off diabetes medications
if these diets are so wildly different
how can they achieve such similar and
frankly remarkable outcomes
and the reason why
is because a lot of the underlying
principles are the same
let's take a visual approach
so i've taken the liberty of excluding
diets that restrict yourself to just
eating cucumbers or just pure meat
luckily they're not that popular and
they lack an evidence base but when we
look at popular diets that have credible
studies
paleo
low carbohydrate mediterranean dash
whole food plant-based and we map out
where the similarities lie you will
notice an abundance of overlapping
themes and it's this exercise that
reveals the principles behind a lot of
them
naturally as you would imagine all of
them remove excess junk food processed
foods excess sugar as well as balancing
for energy control i think we can all
reason with that
but what do they include
largely plants
fiber
quality fats and lots of colors what do
these do
well when you eat largely plants you're
ensuring a selection of micronutrients
vitamins minerals but also
phytochemicals the thousands of
chemicals that we find locked in roots
leaves and grains
we used to think that the benefits of
plants were just because of antioxidants
but it is far more complicated than that
these chemicals can help regenerate our
human cells help signaling between them
as well as changing their function
fiber from whole grains beans legumes
can contain hundreds of different types
of fibers
and these feed your microbiota this
incredible population of microbes that
nurture your health by releasing
nutrients they digest food for you they
balance inflammation they
they
balance excess
sugar and feeding this population with
these sorts of foods is critical to
maintaining them
fats
essential for your brain health the
precursors to hormones that curse
through your bloodstream
quality fats that you find in nuts and
seeds are incredible for benefiting your
health and contain a myriad of different
fatty acids
and
colors food
has the ability to interact with the
very core of our existence our dna
and alongside other lifestyle factors
like stress and sleep food has the
potential to switch genes on and others
off this is the exciting field of
nutrigenetics the power of your food to
change the expression of your genes to
promote health
and we know for the majority of us it is
a diet that consists largely of plants
and lots of colors
many bodies including the world health
organization
recognize that eating a prudent diet
consistent with these features
lowers the risk of chronic kidney
disease autoimmune conditions
inflammatory bowel disease cancer
depression and many more beyond just
obesity and disease your plate
contains a wealth of information that
interacts with your very inner ecosystem
in the most powerful way
and the confusion that surrounds dietary
conflict is actually creating an apathy
toward motivation and behavior change
what we initially assume
as conflicting dietary methods are
actually
adversarial
and complementary in many ways
i want to make it clear here
that food is not a panacea it's not a
cure
or a replacement for the many drugs and
services that i prescribe as an nhs
doctor daily but it is a huge component
of well-being
and it's this conflict that is creating
an issue
i would also love to stand here and
explain to you what you should be eating
and expect you to just do it in the same
way i can prescribe a pill to a patient
and ask them to take it three times a
day
but it's not
i remember around seven years ago when i
started introducing diet into my
consultations i had a 45 year old man
come into my clinic his blood work
showed that he was on the verge of type
2 diabetes and we had a conversation
about how diet and lifestyle can prevent
the progression to type two
he wasn't keen on changing much about
his diet that was full of convenience
foods but i said look let's just start
slow let's just start with one meal and
he said well i have frosted wheaties for
breakfast i don't really like that maybe
that i said great do you like oats he
said i don't mind porridge fantastic
here's a recipe
make some oats put some sunflower seeds
on it add some frozen berries they're
very cheap try that for a couple of
weeks come back and let me know how you
get on i wrote down the ingredients for
him he got up to leave and i thought to
myself wow
roofie i think you've really changed
this guy's life
and then as he left through the door he
turned back to me and he said just one
more thing doctor
how do you make oats
nutrition isn't simple for a number of
other reasons food is an emotive subject
it's how we celebrate it's part of our
culture our history
nutritional medicine isn't being talked
about by us in medicine because most of
the doctors here in this room were not
taught about the importance of food at
medical school
our children are not educated in how to
grow or cook as part of their schooling
which is why i have patients that can't
make the simplest of dishes like
oats
and access to healthy foods depends on
where you live the promotion of
unhealthy options target the most
vulnerable
and whilst i can't pretend to help with
every aspect of this complicated food
environment
i can provide you
with some insight into some hope
there is a movement starting in the uk
and it is starting right here in bristol
because your local medical school is one
of the first in the country to start
teaching future doctors not only the
foundations of nutrition but also how to
cook in 2018 i brought together a group
of nutrition experts and doctors
passionate about reforming nutrition
education and uk medical schools we ran
the uk's first culinary medicine course
an intense
four weeks of culinary activities with a
professional chef
nutrition lectures with a registered
dietitian and teaching on how to apply
this information within the constraints
of an nhs clinic appointment by a gp
this unique collaborative teaching
method took students through the impact
of nutrition on mental health on our
guts on our environment and beyond
we ran the cooking courses in an nhs gp
surgery right here in bristol with its
own fit for purpose community kitchen
we even had students run their own
health promotion clinics
going to families homes and helping them
stock their cupboards with nutritious
affordable ingredients
and arranged by one of your incredible
local gps we even had medical students
cooking for the homeless
talking to them
listening
providing a medicine and its purest
sense
this is a career defining experience
that all health professionals should
have it starts a conversation
a real perspective into the grandeur of
food beyond just whether something is a
carbohydrate or full of vitamins
all health professionals have a role in
nurturing a culture that appreciates the
power of food this
is how we reverse the tidal wave of
lifestyle-related illnesses that
threaten to
completely expend all nhs resources
unless we get to the root cause of what
is causing illness in the first place
and many diet many many studies
point toward diet
as the
contributing factor
today we need to ask ourselves if we
dare to think as radically as we have
done in the past this is not radical
this is the norm in almost 50 percent of
american medical schools but we will
make that the norm here in the uk as
more medical schools wake up to the need
for nutrition training in medicine
but
if we are serious about building the
healthiest population possible
where chronic disease is a rarity type 2
diabetes is uncommon
heart disease affects the minority of
people
if we are serious about giving everybody
access the best possible protection from
disease then we need to start reforming
our food systems and our food
environment
making food as medicine not acute or
quirky concept but the norm
elevating nutritional medicine into a
recognizable mainstream concept in the
pursuit of a proactive healthier
population affiliating all gp surgeries
up and down the country with community
kitchens and investing far much more
research into nutrition
i've talked a bit about how food
can prevent disease
i've talked to you a bit about how
complicated this food environment is and
our little way of mitigating that
and i want to end this talk
in the same way i end my clinical
consultations
with some simple
tangible advice
as i promised i'd help you prevent
disease
just one more
every time you look at a plate of food
or you sit down to eat just ask yourself
can you add
just one more can you eat just one more
colorful vegetable portion of nuts or
seeds or fruit at every meal time just
one more if you're having a curry can
you add some spinach to it if you're
eating an omelette can you serve it with
some green beans and even if you're
enjoying a delicious cornish pasty can
you serve that with a side of butternut
squash mash
it's these collections of small
additions to what our diets lack every
day every week every year that have the
potential for much larger downstream
effects
the opportunity
of having the biggest impact on your
health
is actually in your hands it's not with
a blockbuster drug it's not with a new
pioneering surgical technique it is with
the simplest solution
is how we feed ourselves
and i'm hopeful we can generate a
food-focused approach to health in our
communities
instead of reacting to disease
in our emergency departments
thank you
you
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