Dietary advice seems to be increasingly confusing, aggravated by a plethora of so-called “experts” and influencers with no expertise on social media, many in relation to fad diets, which of course, being January, millions of people will no doubt be adopting over the next few weeks.
Prof Tim Spector, qualified as a doctor, having various interests in different branches of medicine before focusing on epidemiology. As with many people a variety of life events started to push him into a different direction, with his focus more recently on the gut microbiome. The gut microbiome is the collection of billions if not trillions of bugs in our gut, usually the colon, but not just bacteria. They are increasingly being studied in regard to their impact on health.
I’ve been following his work for a number of years, my first blog about him was in 2019:
https://www.thehealthequation.co.uk/why-your-gut-is-responsible-for-your-happiness/
It was great to sit down today (a bank holiday) for an hour and a half, uninterrupted, to listen to this interview but interspersed by adverts including a nutritional product, which seemed to me at least, to go against the grain of what Spector was trying to say, so I’m not going to publish the link to the actual interview.
I’ll share below some of the main themes of the interview
The aim of a balanced varied diet is to eat a wide variety of food groups.
Increasingly many people are seeming to adopt a very narrow vocabulary of foods to the detriment of their health. The gluten-free industry is one of the examples and Spector suggests, and I would tend to agree, that many people who are adopting gluten free diets probably do not need to, as they are probably not gluten intolerant. Given that many gluten-free products are processed this will also be detrimental to health. Just because you have avoided a particular food that contains gluten does not mean you are gluten intolerant! That particular food might contain other proteins that you may be reacting to, and so excluding multiple other foods, just because they contain gluten, may not actually be beneficial for your health. Especially since the gluten-free industry tend to produce many highly processed products.
Probiotics get destroyed in the stomach because of the acid content, Not True.
Foods which contain probiotics tend to be things like yoghurt, fermented foods, and, of course, nutritional supplementation probiotics. Because they tend to contain billions of mostly beneficial bacteria, many of them will get past the gut and start to work in the colon.
Calorie counting for weight reduction is a complete waste of time.
Government and industry have spent so much time and energy and money pushing this particular viewpoint and I guess it’s going to be very hard for them to let it go. Spector gave many examples from research where calorie counting in order to lose weight simply doesn’t work. We started asking patients to forget about calories about 20+ years ago!
Exercise does not help weight loss.
There is almost no evidence to suggest that increasing activity/exercise is beneficial for weight reduction strategies, although there is some evidence to say that exercise can be helpful for weight maintenance and, of course, exercise is helpful for other reasons such as mental health, cardiovascular fitness, etc. However, there is some research that says certain exercise such as weight resistance and high interval intensity training (HIIT) can be beneficial as part of a weight reduction strategy.
Artificial sweeteners may well be as bad as sugars.
There is no evidence that adopting sugar-free products that contain artificial sweeteners are helpful for weight loss and, in fact, artificial sweeteners can alter glucose dysregulation and adversely impact the gut microbiome causing other health problems.
30 different plants a week
This is actually not as difficult as it sounds, as it includes, fruits, vegetables, seeds, nuts, herbs and spices.
Colours
Try and choose a variety of different colours with your fruits and vegetables. Many of the foods you eat are loaded with polyphenols: plant-based compounds that are anti-oxidant, anti-inflammatory and anti-infection. Polyphenols are considered non-nutritional, meaning that they help prevent disease and keep you healthy in a different way than vitamins, minerals, or other nutrients like carbohydrates, fats, and protein. Polyphenols are a type of phytochemical, the colourful chemicals in plants that confer a variety of health benefits.
Ultra-processed foods.
Unbelievably 70% of the children in the UK will have a diet consisting of ultra-processed foods and up to 50% of UK adults, similarly. Ultra-processed foods are significantly harmful to the gut microbiome.
The availability of funding into nutritional research has simply been abysmal. Most research funding is provided by and targeted at companies/products that actually make money, big pharma, food giants etc There is no real commercial incentive to giving people advice on eating real foods.
Most nutritional supplements are a waste of money.
Spector admits that this particular viewpoint is challenged by many people and is by me as well! However, his overall theme, is that we should try to get most of the nutrients we need by eating a balanced varied diet, something I would agree with. He did give some good examples of the adverse effects of certain types of supplements, including calcium, which is a particular bugbear of mine, particularly in menopausal women and still routinely prescribed on the NHS. High levels of calcium, particularly unopposed, if not taken with magnesium, can lay down extra calcium in internal body tissues, especially vascular structures. He also goes on to say that taking extra calcium has no impact in either preventing or treating osteoporosis. And this, of course, is the main reason why calcium supplementation is given in the UK and many Western countries.
Time Restricted Eating
It is a step up to try to get people to stop snacking in between meals, and for many people this is still very difficult as they are glucose dysregulated. Normally takes about two weeks for people to not be hungry in between meals once they stop snacking, as long as the main meals of the day, breakfast, lunch and dinner contain good quality, protein, adequate, dietary fat and low, glycaemic, load carbohydrates, predominantly vegetables. One of the main principles behind the Metabolic Balance nutritional program is to not snack in between meals to manage insulin better. Since the launch of MB there have been a variety of different variations on fasting. The 5:2 diet, intermittent fasting and now Time Restricted Eating (TRE). Spector suggests that TRE does have some good research evidence as part of a weight management strategy. However, I have not found it necessary with the majority of my Metabolic Balance patients. It seems that not snacking in between meals is often enough for most people.
Individualised diets are the way forward.
The cynics might think that because his commercial company, Zoe, having just achieved a £200 million valuation after a recent funding round and the main theme of the company is providing personalised diets to patients, then perhaps he has ulterior motives. However, after providing Metabolic Balance individualised nutritional plans to my patients, there is no doubt I would agree with him. (Which interestingly also focus on many of the themes above, and by the way, have done since its inception around 20 years ago, so prior to Spector’s books and App). That is why there is no one size fits all when giving dietary advice. There are certain principles we can give, but we all have unique genetic make ups and unique physiologies and what works best in health are individualised approaches and diet there is no exception. However, I fully appreciate there are cost Implications to this.
Pick food and lifestyle changes that are going to last a lifetime not something that you’re doing for quick fix, such as losing a stone to get into the bikini for the summer holiday. Yo-yo dieting is particularly bad for metabolism and over the years of I have seen a few people with a metabolism so disturbed by constant yo-yo dieting over many years that is incredibly difficult to improve their physiology.
Have the “bad things” as an occasional treat.
I’ve always had a 70:30 principal. As long as I’m eating well 70% of the time I can afford to choose some not so good things, perhaps 30% of the time. This is similar to other aspects of lifestyle and habits, there are very few people who adopt 100% “healthy habits” all the time!
Different people can react differently to sugar and fat.
This was one of his suggestions, that I’m going to have to think about and do my own research! Part of his program on the Zoe app, tests blood glucose and fat levels and I guess this is part of his thing. Monitoring glucose levels is essentially a downstream marker. Glucose is controlled in the body via insulin and I’m slightly surprised that insulin wasn’t mentioned in the entire interview. Insulin desensitisation occurs over many months and years, and therefore measuring people’s glucose levels may not necessarily be affected just because of what they have eaten but more about how well, or not so well, insulin is working within their bodies. The best way of keeping your insulin levels healthy and sensitised is not snacking in between meals. Fat metabolism is also mostly controlled by the liver/gallbladder mechanism. For example, people who are known to have gallstones or who have had their gallbladder removed are advised to significantly limit fat intake in their diets. Fats are not equal, there are different types of fats, including trans fats, saturated fats and unsaturated (mono and poly) fats. Most experts would agree trans fats are awful and should really be avoided at all costs. The NHS still pushes on their website the advice to adopt low saturated fat diets. This is being increasingly questioned by researchers and clinicians.
So, what about holistic health?
Whilst our gut health and our food are incredibly important to our overall health, it is, of course, just one part of the many factors that make us healthy or not so healthy and Spector confirms this.
For many of you who read my blogs, you’ll probably know I’m a big fan of optimising breathing and the autonomic nervous system.
The autonomic nervous system is about 90% of our central nervous system activity and controls almost everything that goes on inside us. It used to be thought that they were just two parts of the autonomic nervous system, the sympathetic or stress part of the nervous system (SNS) and the parasympathetic relaxation part of the nervous system (PNS). Some researchers are now adding a third pathway, essentially something called the “gut brain axis”, or the enteric part of the autonomic nervous system (ENS). And it works both ways. There is no doubt that having a healthy gut microbiome feeds upwards into the brain and nervous system and can impact symptoms affecting us on a mental health level. But the downward pathway is also important, there is also increasing research showing how changes within the autonomic nervous system can affect the gut microbiome and numerous neurological and chemical/hormonal pathways within the body.
Clinicians, practitioners and scientists tend to end up focusing on one particular speciality and patients still think that specialists have all the answers. Wouldn’t it be amazing if clinicians, practitioners and scientists really thought in a holistic way and conveyed that thinking to patients. I have lost track of the number of so-called holistic and integrated medicine practitioners out there, their main weakness is tending to be solely focused on their main discipline without enough of an understanding of the connection between anatomy, physiology and all the systems of the body, including how the mind and nervous system plays such an important part in our health and, of course, how our body structure works (paying attribute to my original training as an Osteopath and its Philosophy of helping me understand the importance of structure and function).