The role of food in health | Dr Rupy Aujla | TEDxBristol

Summary

In 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

00:00

🏥 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.

05:01

🥗 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.

10:03

🌱 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.

15:03

🍽️ 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.

Keywords

💡Cardiac Arrest

Cardiac arrest refers to the sudden loss of effective contraction of the heart, causing loss of consciousness and is a medical emergency. In the video, the speaker recounts a personal experience where a 60-year-old lady suffered a cardiac arrest, likely due to a heart attack, and despite resuscitation efforts, she passed away. This incident underscores the theme of the video, which is the critical nature of timely and effective medical intervention and the role of lifestyle in preventing such conditions.

💡Resuscitation

Resuscitation is the process of restoring life to someone whose heart has stopped beating or who is not breathing. The video mentions that the ambulance crew had started resuscitation at the scene of the cardiac arrest, and the medical team continued these efforts in the hospital. This term is central to the video's narrative, highlighting the efforts made to save lives in emergency situations.

💡Preventable Lifestyle-related Illnesses

These are conditions that can be avoided or mitigated through healthy lifestyle choices, such as a balanced diet and regular exercise. The speaker emphasizes that many deaths worldwide are due to such illnesses like heart disease and stroke, which are often linked to poor lifestyle choices. The video's message is that by adopting healthier habits, many of these illnesses can be prevented.

💡Nutritional Medicine

Nutritional medicine is an approach to healthcare that emphasizes the role of diet and nutrition in preventing and treating diseases. The speaker advocates for this approach, suggesting that food can be a form of medicine and that doctors should prescribe healthy diets to their patients. This concept is central to the video's theme of using food as a tool for health promotion and disease prevention.

💡Phytochemicals

Phytochemicals are naturally occurring chemicals found in plants that have health benefits, such as antioxidants and anti-inflammatory properties. The video explains that a diet rich in plant-based foods provides a variety of phytochemicals that can help regenerate human cells and improve overall health. This term is used to illustrate the importance of a plant-based diet in preventing diseases.

💡Fiber

Fiber is a type of carbohydrate that the human body cannot fully digest, and it's found in plant-based foods like whole grains, beans, and legumes. The speaker mentions that fiber feeds the microbiota, which is crucial for maintaining health. In the context of the video, fiber is highlighted as an essential component of a healthy diet that contributes to disease prevention.

💡Microbiota

Microbiota refers to the community of microorganisms living in the human body, particularly in the gut. The video explains that a diet rich in fiber can support a healthy microbiota, which in turn can release nutrients, digest food, balance inflammation, and regulate sugar levels. The concept of microbiota is integral to the video's message about the importance of a balanced diet for overall health.

💡Nutrigenetics

Nutrigenetics is the study of how food and nutrients interact with genes to influence health. The video touches on this field, suggesting that food has the potential to switch genes on or off, thus affecting health outcomes. This concept supports the video's overarching theme that diet plays a significant role in disease prevention and health.

💡Mediterranean Diet

The Mediterranean diet is a heart-healthy eating plan that emphasizes fruits, vegetables, whole grains, legumes, and healthy fats like olive oil. The video lists the Mediterranean diet as one of the popular diets with credible studies, suggesting that it is an effective approach to preventing lifestyle-related illnesses. This term is used to illustrate the video's point that various dietary approaches can lead to similar health benefits.

💡Food as Medicine

The concept of 'food as medicine' is the idea that certain foods can have therapeutic effects and contribute to disease prevention and health promotion. The speaker argues for this concept, advocating for a shift in healthcare where food is recognized as a primary tool for maintaining health. This term encapsulates the video's central message about the power of diet in preventing diseases.

💡Culinary Medicine

Culinary medicine is an emerging field that combines the art of cooking with medical knowledge to promote health and prevent disease. The video describes a course that teaches medical students about nutrition and cooking, aiming to equip future doctors with the skills to advise patients on healthy eating. This term is used to highlight the video's theme of integrating food and nutrition into medical practice.

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