Dr Rupy: Welcome to the Doctor's Kitchen podcast with me, Dr Rupy, where we discuss the most important topics and concepts in the medicinal qualities of food and lifestyle. This is going to be the final podcast for 2019 and I realised I've had the pleasure of producing over 40 of these podcasts now. We have had some incredible guests talking about everything from mental health, behaviour change, plants, the impact on inflammatory bowel disease, stress, diabetes, eating for your brain, eating for women's health. It has really, really been my privilege to deliver this by interviewing some of the world's best and most well-renowned speakers and researchers in their fields. And so what I thought I'd do is create a bit of a best of catalogue for this final episode of 2019 to give you an overview of the kind of stuff that we've talked about and give you some pointers on how to eat generally healthy for yourself, but also how to complement that with lifestyle measures. We're going to kick off by speaking, well I'm not going to speak with them, but I'm going to play you a couple of segments from some of the earliest podcasts back in 2017 when we started. The first is with Alexandra Swaka, who's a public health researcher, used to work at the WHO collaboration centre, Imperial College, my old university, and a common voice on the podcast, Dr Anita Mîță, who is the Gynae Geek on Instagram and also author of The Gynae Geek, which you can find in all good bookstores and definitely, definitely recommend that. Um, talking about eating whole and why eating colourful is a good thing. Check it out. My first question really is, what does eating whole actually mean? I think we need to get this probably defined early before we actually start talking about being whole or eating whole. So what does eating whole actually mean?
Alexandra: Absolutely. Well, that's a great question. So eating whole refers to foods that are as close to their natural form as possible and haven't undergone any chemical changes. So fruits, vegetables, whole grains, meat, if you eat it, dairy, again, if you eat it. So in comparison, some examples would be grilled chicken breast as opposed to chicken nuggets. So chicken nuggets have obviously undergone extensive processing, contain additives, whereas a chicken breast basically comes right off the chicken and you cook it.
Dr Rupy: Got you. Okay. So it's kind of like a whole eating exists on a continuum or a spectrum, right? So it's super hard to have the most whole form as possible because I suppose by process of heating, steaming, cooking of any element or even chewing, something becomes processed.
Alexandra: Right. Yes.
Dr Rupy: But we're talking about as closer to the sort of whole form as possible.
Alexandra: Yeah, and I think something important to note is when in doubt, look at the ingredients and if there aren't any, that's a good sign.
Dr Rupy: Absolutely, yeah. So I know that a lot of the time people require something just really simple ideas of how they can eat more whole. And I know in clinic when I when I talk to them about the addition of oil and salt and sugar to certain items that really they shouldn't really be there. That's an indication that it's probably a little bit more processed right on the spectrum of whole versus processed.
Alexandra: Exactly. Yes. So the more you have to add things, the more processed the food becomes.
Dr Rupy: Got you. And so what are the benefits of eating less processed and convenience foods?
Alexandra: Right. Okay, so by eating whole foods, foods that are less processed, you are eating foods that have been perfected by nature and they are already in their integral and perfect form. They contain the perfect water to fibre ratio for optimum digestion and the correct chemical composition for the body to absorb all the nutrients that it needs.
Anita: So I actually did a degree in medical biochemistry before I went to medical school. So I spent three years just being a pure science geek. Um, and in the last year, I worked in a research lab, and it was a cancer chemo prevention research lab. So what we did was we looked at the exact mechanism of how different chemicals that we find in foods are anti-inflammatory and anti-cancer agents. And then we also translated some of this research into clinical studies where we actually looked at how they can be used for patients undergoing cancer therapy at the time. So pretty interesting. So yeah, I spent a couple of years actually working in that lab. And it's kind of how I also became interested in lifestyle medicine in general. Because it's when I first started to really realise that what you eat really does matter and it's not just about how many carbohydrates or how many calories you're putting in or whatever. It's about the quality of what you're eating as well.
Dr Rupy: Exactly. And that's kind of how we bonded as well. This love of plant chemicals and phytochemicals and all that kind of stuff.
Anita: Exactly. Exactly. That's how Rupy and I met by Instagram. I think Instagram's like the new Tinder for people who are interested in wellness.
Dr Rupy: That's so funny. Yeah, I'm referred to as her Instagram boyfriend. But she does have a partner. It's not me. Just to make sure. No rumours here. Anyway, what are we going on? Loads of people are scratching their heads again. What is a phytochemical exactly? Can we define that?
Anita: Yeah, so as someone who's currently learning Greek, I'll tell you that phyto is the Greek word for plant. So it's basically a chemical or a nutrient that you get from a plant. And so there's loads of different kinds of phytonutrients or phytochemicals, which I don't think we'll go into too much detail. But the different kinds depend basically on the on the chemical structure.
Dr Rupy: And just that changing that chemical structure very, very subtly can have massive effects, right? On like the the quality of the colour, the smell, that kind of stuff, right?
Anita: Exactly. Yeah, absolutely. The reason that plants have phytonutrients is basically because they're part of the plant's immune system. And so they are usually typically found in the skins, if if a if a plant has a skin, you'll find generally speaking the highest concentration there because they're just there to protect the plant and it's a great side effect for humans that they are really healthy for us.
Dr Rupy: Great. Okay. So they're concentrated in the skins. That's why we try and keep the skins as much as possible as long as you can tolerate them. So what is the difference in between micronutrients and phytochemical or phytonutrients as they're sometimes referred to as?
Anita: So a phytochemical always has to come from a plant, but micronutrients can come from animal-based products as well. And they just tend to have slightly different properties.
Dr Rupy: Yeah. And I I foresee a future where at the moment we we look at vitamins and minerals and we say, you know, you need to have X amount as your recommended daily allowance. I think in the future we'll probably have a recommended daily allowance of a phytochemical. I mean, right now we have five a day or 10 a day depending on which school of thinking you're coming from. But that's certainly something I foresee in the future with all these different phytos.
Anita: Exactly. And I think really we don't know what the right concentrations of phytonutrients are for humans at the moment. But I think that the five or the 10 a day rule is a really kind of handy surrogate marker and it's just a way of saying like, are you kind of grossly speaking eating enough of these compounds? Because they are one of the predominant reasons why we should eat five or 10 a day to make sure that you're getting these compounds.
Dr Rupy: Totally, yeah. So there's this concept of plant hormesis that I want to introduce to the listeners. It's where cells or organisms are challenged by noxious chemical and they are literally noxious chemicals that we find in plants that enable the cell to respond adaptively. So actually what we do is when we ingest these sorts of plant compounds, they elicit a response that's adaptive by our body and that reduces overall inflammation that leads to health benefits. It's quite difficult to get your head around that ingesting these sorts of plant chemicals are having initially a stressing effect on the body, but that leads to health benefits. It's kind of, I use the analogy of exercise. So exercise is essentially an inflammation producing and a stressing producing activity that we do, but we know overall it leads to health benefits, improves our cardiovascular function. It essentially conditions our body to deal with more stress going forward. So there are tons of different benefits of consuming these different plant chemicals.
Anita: Well, first and foremost, we've always known that we should eat plants, fruits and vegetables because they contain antioxidants. So antioxidants are useful because as part of the normal metabolism of the body, you do make these things called free radicals and you don't want to have lots of free radicals in your system because they contribute to aging, they can promote inflammation and they can also increase your risk of getting cancer, partly on their own, but also because chronic inflammation also is one of the major causes of cancers.
Dr Rupy: I think you picked up something really important there that I just want to emphasize to the listeners. It's normal to have free radicals as a byproduct of normal metabolism. So the ways our cells respire is going to have a waste product at the end of it. And it's the excess of these waste products that we need to sort of balance, right?
Anita: Yeah, exactly. I think free radicals have got this really bad name and it's kind of like it's like lactic acid in your muscles at the end of exercise. It's the same thing. It's just as you said, it's a waste product and we just need to get rid of it. So by eating foods that contain antioxidants, then we can we can help the body to get rid of these and reduce their effects. As well as being antioxidants, there's lots of scientific data out there to show that these chemicals can actually act directly on pathways that are working in the body all the time. So there are lots of sort of inflammatory pathways that you can have, lots of pathways that cause the cell to divide and renew. So for tissue homeostasis, we call it, so maintaining your tissues. And then if certain pathways are affected in the wrong way, that can lead to development of a cancer or a disease that's associated with excess inflammation, for example. So these compounds are really clever and able to actually act directly on these pathways to make sure that we don't have the wrong kind of tissue activity going on.
Dr Rupy: That's incredible, isn't it? Remember, you can catch all the episodes, the full episodes by just looking down the catalogue on the website, thedoctorskitchen.com or on Spotify, iTunes or wherever you get your podcasts from. Next, we're going to listen to Ben. We're going to hear from what he has to say about eating largely plants and the differences between all these seemingly opposing diets. Check it out. So I thought we'd talk about the huge similarity across multiple diets, including those as seemingly opposing as paleo and vegan and Atkins and Mediterranean and why they might have similar health benefits. What do you reckon?
Ben: I mean, that is such a a great question and observation at the same time. And you know, one of the things you really notice in, you know, anyone who's got an interest in nutrition is that there are diet wars. You know, everyone thinks they've got the best diet and they get a bit standoffish about it. But actually, it's, you know, there are similarities across these seemingly different diets that are responsible for the health benefits. And they're actually quite generalizable. In fact, there was a fantastic study by Dr. David Katz at Yale University where they did exactly what you've just asked is they pulled together all the research on these different diets like paleo diets, Mediterranean diet, vegan diet, vegetarian diet, low carb diet, low fat diet. There's so many. Yeah, and there's more than that. But what they did is they pulled all the because there's a lot of studies on these now, they pulled all the data together and said, well, what are the things that explain the health benefits of these diets? And actually they came up with one shared commonality across all of them. Mostly plants.
Dr Rupy: Mostly plants. Exactly. Yeah. Yeah.
Ben: So whether you're paleo or vegetarian, it's the plants.
Dr Rupy: Yeah, exactly. Yeah, yeah. And I think like you're right, there's so much infighting between these different sorts of dietary dogmas. And a lot of the things, you know, apart from eating just more plants is limiting things like refined sugar and refined carbohydrates and eating a variety of fruits and vegetables. If you just to do those two things alone, it can probably explain a lot of the successes of these apparently completely opposite diets.
Ben: Yeah, 100% actually. And that's another finding that they came up with is that a, you know, a commonality across these also is you avoid rubbish. You know, so you, you know, it's been said that there's no such thing as junk food, there's food and there's junk. And avoiding this highly processed, highly refined food that's associated very clearly with poor health is one of the best things you can do. You know, so we need to get away from naming ourselves based on the food that we eat and just talk about real food.
Dr Rupy: I think one of the the first studies that I came across where I noticed that regardless of what diet you kind of utilize, you're going to have very similar outcomes. And one of them is called the A to Z diet that you've probably come across, a guy from Stanford, Professor Gardner. And they found that after 12 months of of these different diets, all the participants lost weight. Some to a different degree, but all of them lost weight. So it really comes down to the individual. It's more about how you feel on that diet, what is more convenient for you as well. And you know, weight isn't the best outcome to measure across health benefits, but it's still, you know, one of the things that is quite easy to measure. And I just found that absolutely fascinating.
Ben: Yeah.
Dr Rupy: Okay, so we've established that diets that largely consist of plants are the healthiest. Are there any that you've come across that have specific protection against things like stroke and blood pressure and cancer and stuff like that?
Ben: Yeah, I mean, that's really pertinent because these illnesses you've just mentioned are some of the major causes of death and disability in society today. So understanding which diets offer the most protection is a really important question. And there has been a lot of work done in this area, both observational studies, which is mean, you know, they look at what people eat and associate risk with disease, or there's also clinical intervention studies where they get nutritionists and, you know, health professionals to counsel people in diet and follow them for years, see what happens. And one of the best studied dietary approaches in this particular area is what we call the traditional Mediterranean style diet, which doesn't actually exist. It's just a it's just a model for healthy eating. So it's like mostly plants, olive oil, nuts and seeds, legumes, not too much red meat, that kind of stuff. But there are studies where they've used this for what we call both primary and secondary prevention of cardiovascular disease, right? And the effects are really striking. Like if you look at primary prevention studies, so that's in people who haven't had a previous cardiovascular event, you're really looking at within about four years time of following this kind of diet, about a 30% reduction in risk of death from cardiovascular disease. That is enormous. Like you can't understate those figures. And then for secondary prevention, people at high risk, you're looking at upwards of around 70% risk reduction, which is just incredible. Like this food stops people dying.
Dr Rupy: Yeah. And this is why I get so passionate about it because it's when you look at those sorts of numbers, it's not even like I need to qualify food as medicine. Food is medicine. And we could do a lot of good by actually heightening people's awareness of just how powerful our lifestyles can be. And listening to those stories and and the anecdotes of patients as well as the large scale studies is something that compounds my belief. But that's absolutely fascinating, hey.
Ben: Yeah, absolutely. And I mean, that's such a great point is that food is medicine. We just need to get the message out.
Dr Rupy: Ben definitely makes the case for eating largely plants and the fact that most diets are saying that very central thing. Make sure you check out his podcast, The Positive Health Podcast on iTunes. It is a very technical podcast where he interviews researchers from all over the world about some quite in-depth subjects. It is fascinating. Please go check that out. Next, we're going to hear from our good friend Dr Megan Rossi, who has been on the podcast twice. She's got a fantastic book, Eat Yourself Healthy, that is out now. And we have a chat about what the microbiota is and why fibre is so essential to health.
Megan: Gut health actually relates to the functioning of our entire digestive tract. So the tube that delivers food all the way from entry to exit. And it's really important that we remember that because things like our nutrient absorption is really important for our overall health and wellbeing. But of course, you're right, a lot of people are excited about the trillions of microorganisms living in our large intestine, known as a sciencey word I like to call it, a gut microbiota.
Dr Rupy: So the microbes that we know that are essentially so, so healthy for us, where do they actually come from? Where did we actually get covered in these microbes from?
Megan: Well, Rupy, until recently, we actually thought that we were born sterile. So we we thought that in our mum's tummy, we actually had no bacteria in us and it was a vaginal birth where we started, you know, to grow these bacteria. But we actually find out that we contain bacteria while we're living in our in our mum's tummy. So we actually have some already to start with, which come from our mum. But of course, very few and very low diversity. Most of our microbes come into us when we're birthed. So we're inoculated by our mother's vaginal and fecal microbiota as well. So that's why there's quite a vast difference in our bacteria if you're born vaginally or via C-section. But that's only for the first couple of months. We then through breast milk also increase the diversity of our gut bacteria. And then things like food. You know, there is actually quite a lot of different microorganisms in food, as well as the the prebiotics in certain types of food which feed the bacteria and grow. And the most important one is really the environment. So, you know, if we grow out in the farm, we're playing with dirt, which is actually really important.
Dr Rupy: Did you grow up on a farm?
Megan: I did. I did. I certainly did. I was playing with some pretty gross things very early on in life, which I attribute now to my pretty good immune system, I think. Um, so yeah, you know, letting the kids get a little bit dirty is actually quite good for the diversity of their gut microbiota. But by the age of around three, we think our microbiota is quite stable. And what, you know, is really intriguing is that diet is the number one, you know, influencer of our gut microbiota. So what we eat has a huge impact.
Dr Rupy: Yeah, that's amazing. I mean, you you mentioned the word microbiota. We've also heard the the term microbiome as well. What what actually is the microbiota?
Megan: Yeah, so the microbiota is the trillions of microorganisms, which includes not just bacteria, although I know a lot of people refer to just the bacteria, but it's other things like parasites, viruses, and even fungi like yeast. And together, they're actually really beneficial. I know a lot of people freak out when they hear, oh my god, a virus. But together, they have this synergistic relationship as well as with human cells, and they work together really, you know, to help us be healthy.
Dr Rupy: That's quite a foreign.
Megan: If we look after them, that is.
Dr Rupy: If we look after them. Yeah. It's quite a foreign subject, isn't it? To think of these microbes, like you said, different types of bacteria, but also viruses, nematodes, etc. as helping us, as something that is beneficial for us. What kind of proportion are we talking about? Like how many what percentage of these microbes are actually helping us versus the ones that are pathogenic or detrimental to our health?
Megan: Yeah, so over 95% of the bacteria that we're aware of are actually really beneficial. That's incredible. Yeah, and the ones living in us, I'd say 99%. And it's not just necessarily about saying that a bacteria is bad or good. It's about the environment that it's in. And if it's growing too much, then it could become bad. But if it's in a, you know, a smaller ratio, it's actually probably doing us some benefit. So it's not so black and white to say that something's bad or good. It's just, you know, in the right environment. Which comes again back to what we feed it, right?
Dr Rupy: Yeah, totally. Yeah. And it's quite strange again, like during medical school, I learned a lot about different types of bacteria and how we need to kill them. But now I'm learning about, okay, these types of bacteria can actually serve a benefit to the human host if in the right quantities and they're actually in balance with other ones. That's that's quite amazing.
Megan: Yeah, it is. It is such an amazing discovery. And I think it was in the 19th century when they first thought, you know, bacteria were completely bad. They'd killed millions of people from, you know, infections such as anthrax and things like that. And they were having vaccines. So they were really trying to kill all the bacteria. And then, you know, a couple of years after that, actually, Elie Metchnikoff, Elie Metchnikoff, right? Yeah. Um, he was the founder, I guess, of the probiotic concept, kind of started to identify that, hey guys, maybe some bacteria are actually good. We shouldn't be killing them all. And so from then on, we started to have this thought that, you know what, these living organisms in us, we can actually, you know, utilize them and work with them.
Dr Rupy: So is it really since then that we've known a bit more about the microbiota? Like what what's like a a whistle stop tour in the research and and when did it actually start accelerating?
Megan: Yeah, so I guess if you look all the way back when we first discovered bacteria, so that was in the 1700s and we found out that there are these microscopic things we can't see in the eye. And then it was the, you know, I think it was two centuries after that where pasteurization, you know, become a technique that they were using around killing all the bacteria. And that was around when the vaccines came out and everything really trying to, you know, stamp out bacteria. And then the concept of probiotics came around fermented milk particularly around having some benefit. So that was all in the 19th century, you know, from quite a long time we've known about it. Yeah, absolutely. But it's only been in the past 10 years or so where we've really started to appreciate just the the size and the potential impact that our gut microbes can really have on us. And that's just because, you know, the technology has developed so that we can now identify the different bacteria living in us. Before that, we couldn't really grow them and we couldn't really identify, you know, what was going on where. Whereas now we've got the special sequencing techniques, we can identify which bacteria. And what's even more exciting, and this is only more recently coming out, is their function.
Dr Rupy: Right. Okay.
Megan: So it's no longer just about what bacteria you have living in you, it's about how they actually act.
Dr Rupy: Got you. Yeah.
Megan: Because what we find is that two bacteria, they can be very different, but some of the functionality actually overlaps. And what's even more interesting, if you feed them different things, they can then also change their functionality. Humans actually don't produce the enzymes needed to break down dietary fibre. So we can't actually, you know, digest it. It's the bacteria that are the ones that digest it. And that's so important for producing really beneficial metabolites, which are compounds such as short chain fatty acids. Some of your listeners may have heard about. And they're shown to be very metabolically active and important and even can, you know, talk to our brain, these metabolites. So that's kind of where we're starting to appreciate that these microbes, yeah, and their functionality is so broad.
Dr Rupy: Yeah.
Dr Michael: So I'm a pediatrician. I've worked with kids for 17 years or so. My interest in sleep started actually because I had a sleep difficulty when I was a teenager. So I had something called sleep paralysis, which is this quite frightening experience that you sometimes get where you wake up and you are partly awake, partly asleep, but you feel like you can't move. And at the time, the doctor that I went to to tell about this didn't really know very much about it. And I went and researched it and it sparked an interest in sleep, which I've then kind of tracked all the way through my career. And ended up where I'm doing that just now.
Dr Rupy: And so what are your current goals with sleep medicine right now? You you're doing a lot of work around this subject, obviously as part of your clinical work, but
Dr Michael: So my day job is I'm a consultant in pediatric sleep medicine. So we are there to support children with sleep difficulties, usually children who have either very complex or refractory sleep difficulties, often in the context of other illnesses. So we look after lots of children who have conditions such as autism or ADHD where sleep problems can be a very big part of the presentation and can really impact the family as a whole. Absolutely, yeah. And we also have responsibility to those children who have the the more unusual so sleep diseases are relatively rare, but illnesses like narcolepsy, for example, are more common than I think many people realize and can often be unrecognized. So we're there to help with the assessment and management of the complex, rare, refractory sleep difficulties. What we're not there for, unfortunately, is to help every family get their toddler to magically sleep through the night. And one of the the interesting things about sleep, while there are broad principles that apply pretty much universally, everybody is very different. So there isn't a one size fits all necessarily for everybody. So thinking about your body clock, for example, most people know if they're a morning person or an evening person, a lark or an owl. And that is genetic. So whether you are ready to get up and go first thing in the morning and then you're probably going to want to go to bed quite early in the evening. Or you're somebody who functions at your best, you know, in the late hours of the night, but then you really don't want to get up in the morning is genetic.
Dr Rupy: So that's the genetic that's a predisposition to what you're
Dr Michael: That's all to do with how your body clock is set. And depending on how your body clock is set, then different strategies if you have sleep problems might be appropriate for you. So it's general principles are very valid, but there is a lot of individual variation that you need to think about when you're trying to help people with sleep difficulties.
Dr Rupy: Absolutely, yeah. That's fascinating. And so what actually happens when we sleep? I know this is a million dollar question, but what what actually happens?
Dr Michael: So one of the the fascinating things about sleep is that we haven't really been able to explore what goes on when we sleep in great detail until relatively recently. So the last 50 to 100 years or so, we've been able to start thinking about what happens when we sleep. When you sleep, what you are doing is you're reducing your awareness of the world around you and there's a lot of functions that go on when we sleep which our body and brain depends on. So sleep is something that you spend, so over the course of your whole lifetime, you're going to spend about a third of your life asleep. From an evolutionary perspective, we don't tend to value things like that unless there is a benefit to them. So you're spending a third of your life doing this, there must be lots of good reason why that's the case. And we are constantly discovering new things that sleep is implicated in. You may have seen in the last week or so the Nobel Prize for medicine and physiology was awarded for researchers who have done a lot of work in the body clock. And one of the things that we're understanding is that the function of our body is quite tightly tied to our body clock. So our body clock tells us we should be awake in the daytime and asleep at nighttime. When we function against our body clock, our bodies don't work the way they should do and that has consequences. But sleep does lots of things. So it's important in children for growth and development, both physical and mental. It's important for consolidating learning, it's important for emotional regulation, it's important for the function of every body system you've got. So if you are mildly chronically sleep deprived, your immune system doesn't function as well as it should do. You're more likely to get trivial colds. Anything that you can pick, I can probably find a way to tell you that sleep is important to it functioning as well as it should do.
Dr Rupy: Absolutely, yeah. So given that we now established sleep is very important, how does eating positively or negatively impact your sleep?
Dr Michael: So sleep and eating, appetite, hunger have quite a complex relationship and it's one that we're increasingly again, it's an area that we're rapidly increasing our understanding of. On a very basic level, sleep is something that depends on good routines and habits. So that body clock that keeps you awake in the daytime, asleep at nighttime. For most people, your body clock is not set to 24 hours. So most people's body clocks run slightly longer, slightly shorter than 24 hours. So you're constantly resetting your body clock. And we do that through regular routine and cues. So the most important of those is light. So exposure to daytime light and as much good quality natural light as you can in the daytime and then darkness at nighttime helps to keep your body clock in tune. That's why you will see people like me harping on quite a lot about the the negative impact of electronic devices at bedtime on sleep quality because they really affect the timing of the body clock.
Dr Rupy: And that's something that's never been more appropriate to talk about, right? In the age of connectivity and social media.
Dr Michael: You know, so the iPhone is only 10 years old. So it's not really been around for a very long, but now if you say to people, I'd like you to go without your iPhone for a day, they just go, oh, there's no way I can do that. We've become very, they've become very integrated into our lives very quickly. And that has, there's a lot of very positive benefits to them. They're brilliant. But particularly for sleep, they are not good and they are contributing to a significant increase in sleep problems and sleep quality, I think that we're seeing both in children and in adults. So light is the most important of those cues, but lots of other things help regulate it. And the more consistent your routine is, the stronger the reinforcement of your wake and sleep rhythm, if you like. And eating is also a very, very powerful social cue. So the more regular your routine is with eating, so, you know, breakfast, lunch, dinner, consistent times, helps to reinforce wake and then that also then helps to support the sleep side of things. The better your routine in the daytime, the better the sleep rhythm is reinforced. So one of the difficulties, for example, around about people who may not have as good eating routines. So if you're somebody who doesn't have regular meal times, you graze, particularly if you then snack and graze late into the evening, into the night, you lose some of that reinforcement of the natural wake sleep rhythm. The other way around though, and again, this is something that we're again, increasingly understanding is that when we are sleep deprived, and probably being honest, most adults in this country are probably sleep deprived by about an hour per week or per night, which doesn't sound very much and most of us are, you know, taking another coffee and cope. But an adult should get about seven to eight hours of sleep per night. So if you're missing an hour of sleep every night, you're missing an entire night sleep over the course of a week. And that begins to have consequences. One of the things that changes when you are sleep deprived is the hormones which help to regulate our appetite and hunger. So leptin and ghrelin, they change when we are sleep deprived to make us more hungry and they also tend to make us crave the foods that we know are less healthy for us, the ones that are going to give us immediate energy, immediate food rush. So if you are sleep deprived, you are more likely to eat more and you are more likely to eat unhealthily. So sleep deprivation is probably a significant factor which historically we've not been aware of, which is contributing to the increasing problem that we're seeing with obesity. So helping people to improve their sleep routines, their sleep habits, to to learn to prioritize sleep in their lives and why might be one of the strategies that will help us deal with obesity as a problem which we are struggling to deal with.
Dr Jenna: When we unlock a lot of the secrets of evolutionary biology, it will yield a lot more in our understanding of why we are the way we are and then how to self-manage that to to fit in with the modern environment because that's not changing. You know, it's not going to go back to our rudimentary way of life anytime soon.
Dr Rupy: I love that. And so you were based in Scotland and then you came all the way down.
Dr Jenna: Yeah, so for some reason as a child, I had an obsession with health and disease. I was just really curious about, maybe it was living on a farm, you see the circle of life, you know. When I was thinking about what to do when I left school, I'd heard about immunology and there was a course at Glasgow University in the medical school where they just do immunology and it's very select, only 20 students. And I just thought, wow, this sounds really interesting. This sounds like this is the foundation of health and disease. And when I got there, I was like, amazing. I found my people. This is what I want to do. And that was almost 20 years ago now. So I've just been in the field ever since and I love it and I think there's always more to learn.
Dr Rupy: Your passion definitely comes through on your blog, on your social social posts and some of the articles that you've done as well for for major magazines. But let's get into it. So I think, and this is something we were talking about before the show, that the vernacular around immunology is very misunderstood and it's misguided, I think, for a lot of people because you'll you'll find lots of articles like, you know, these are the top herbs to boost your immune system and, you know, to to kill a cold and all this kind of stuff. So I think we should strip it right back and actually talk about what we mean by immunity.
Dr Jenna: Yeah, definitely. I think that's really what got me, you know, talking about this so much in the beginning, just hearing so much misinformation. And I think that the first thing to say that the immune system is this huge complex web that's all over our body. It's found everywhere in the brain, in all of your organs, in your blood. And people like to think about it as being a single on-off switch. So you want to switch it on, fight infections, you know, create this force field that's going to keep you well, and then switch it off again. And it's actually more like a series of different switches. And you've got to have the right combinations. So it's a bit like a rheostat that you're constantly adjusting to get it just right. But then something in your environment will change, the season changes, and then you have to kind of tweak it again. So it's not just an on-off switch. I think that's probably a hang up from when people died from infection and that's maybe going back 100 or so years ago. People might not make it to old age because they would die of infection that we don't see just now. So we're constantly thinking, oh, we'll switch on our immune system, be invincible to infection. But it doesn't quite work like that. And it's important to say that immunity is what makes us unique. So it's almost like your fingerprint. Even in identical twins, their immune systems will be different. It's the way that the receptors are recombined. There's a really unique way that the genes work to make the the sort of repertoire of what we call our immune cells and all the different things that they can sense. So viruses, bacteria. So every one of us is unique. And there's a kind of fundamental reason for that because, you know, if if you think about a room full of people and you you throw in a cold virus, if they were all to get sick to the same degree, we'd probably have died out as a species by now. So there's there's a fundamental reason why we're we're immunologically all different because, you know, some people might be more susceptible to bacteria, some of us might be more susceptible to certain viruses or parasites. But if we were all the same, we wouldn't have survived. So there has to be that kind of uniqueness in our immune system.
Dr Rupy: I love that analogy actually because that does tease out a lot about how one thing might work for some person and that could be diet, it could be medications, it could be any sorts of things. And it might not do anything for the other person. And that uniqueness is something that I'm trying to bring out of people as well with the content I put out. It's it's about becoming the expert of not of health, of not of nutrition, but your own health. And how that relates to you. So there's so much information, so much content, but really it's about filtering out that content and and deciding how does that help me in this situation.
Dr Jenna: Yes, exactly. And I think that's another thing that's another important aspect of the immune system is that it's always changing. It's not something that we're born with. I like to think of the immune system as something that's made. So you're born with a quite rudimentary immune system and you're reliant on a lot of what you've got from your mother, both through the placenta and then if you're breastfed. And then your immune system really starts to develop from the moment that you're born. And it continues to develop and change throughout your lifetime into old age. So when people say, oh, I've got a really rubbish immune system, maybe at that moment in time because you've got a cold and you're feeling lousy, but, you know, it's not a fixed thing. There's things you can do to change it. And we know that only a fraction of what determines your immune system is in the genes. A lot of it is the environment, what you're doing. So things that you can actually be in charge of and manage by yourself. So nutrition being only one of those, but also all sorts of lifestyle factors.
Dr Rupy: Definitely, yeah. And we're definitely going to get into that. So your immune system, essentially this complex set of cells. I think a lot of people don't realize that anything that really protects you and helps your your innate sort of homeostatic mechanism, your your balancing mechanism is part of your immunity. So that could be the acid in your stomach. It could be your nasal hairs, your nostril.
Dr Jenna: Secretions on your skin. So it's it's cells, it's molecules, it's it's those barriers to infection. If you think about where you're normally going to get an infection, it's it's breathing things in or swallowing things or through the skin. It's the the bits that are exposed. And it's not just for infection. I think this is again something that people don't think about. It's also the main thing that's involved in repair and adaptation. So if you're going in and working out in the gym, your immune system is helping your muscles adapt, repair, and strengthen. It's involved in pregnancy and the success of of carrying a child. It's it's really a key part of the aging process. It can really determine how well we age. And it's actually the main cancer surveillance that we have in our body. And I think that's again something that not many people think about.
Dr Rupy: Yeah. I I like to I use the analogy in in the next book, Eat to Beat Illness, about how your immune system, instead of being an aggressive military force, it's like a peacekeeper. It's sort of like looking at where there needs to be a little bit more action, a little bit more force, and actually where we need to step back a bit. Because an immune system that is overactive, that is boosted, if you like, is not a good thing.
Dr Jenna: No, exactly.
Dr Rupy: And that's where we lead to people who are suffering with autoimmune issues where your immune system essentially loses the capability to recognize friend from foe.
Dr Jenna: Yeah, exactly. I think that's really important. The immune system doesn't just recognize different pathogens as we call them. So the bugs that are causing infection, but they recognize danger and damage. The immune cells are intimately entwined with all our other systems in the body. So they have receptors for your sex hormones like estrogen, progesterone. So they're affected by different fluctuations in those. Also, they have receptors for stress hormones like cortisol and the neurotransmitters. So if you think about the complete picture, then how you're feeling, your stress, you know, the the different hormone times that are maybe going on, for example, in a woman's body, this is all affecting your immune system as well. So it's it's like the sixth sense, you know, it's really helping us manage our environment and and adapt to that.
Dr Rupy: I think that's a really good analogy actually, being the sixth sense essentially.
Dr Jenna: That's how I like to think about it.
Dr Rupy: And already just from that description of just how complicated and intricate the system is, you can understand why just taking a single supplement is unlikely to be the silver bullet that magically improves your immune system to fight off a cold or whatever you're going through at that point in time. So I think that's like already, you know, a good understanding of of why these things don't necessarily work.
Dr Jenna: Exactly. When I when I start teaching immunology down at the University of Sussex, the first time that the students get any kind of insight, I show them this huge web of all the the cell populations and the sub-populations and then like the sub-sub-populations. And you can just see, you know, the emoji of like the mind-blowing because they're just like, what? It's there's so many different things going on and so many switches that anything to do with the immune system is going to be multi-faceted. So there's going to be a lot of different things going in to give you a certain result. So that's the reason that there's not going to be one single supplement or thing that you can do that's going to give you some immune effect. It's always going to be multi-pronged in your approach.
Dr Rupy: That description of all those different sort of immunological factors brought back loads of painful memories for me actually in medical school trying to figure out, oh god, like all these different T-regulatory cells and MHC complexes.
Dr Jenna: Every year they discover a new subset or the subset of a subset. And then there's like the complement system, which is just like
Dr Rupy: I actually had some people message me on Instagram and social media just saying, can she just describe exactly what a complement is, what is MHC, what are all these different sort of immunological factors, you know, it's quite funny actually. There's a lot of medical students I think that follow me and they're just trying to get like answers for the rest of their essays.
Dr Jenna: I always think I'm I've got to work really hard not to scare people off immunology in the beginning because it does get really interesting later on.
Dr Rupy: Yeah.
Dr Jenna: So now we kind of understand what the immune system is and you're suffering from a cold at the moment.
Dr Rupy: I know, ironically. Somebody said to me the other day, like, I didn't think you would get sick. You're always talking about the immune system. Surely you should be invincible.
Dr Jenna: And this is something I talk to patients about. It's like the very fact that you're sick and you have a temperature and you, you know, you have all these other sort of you have a cough, you have a tickle, you have a throat sensation, shows you that your immune system is actually working.
Dr Rupy: Yeah, exactly.
Dr Jenna: And it's about changing your perspective from one that is annoyed by the fact that you have a cold, which is I I get it, it's super annoying, but you should also be grateful and appreciative of the fact that your immune system is working. And not everyone has an intact immune system that can tolerate that. You're most likely going to be fine in a couple of days.
Dr Rupy: Yeah, that's the thing. Colds and flus are self-limiting. There's so many different varieties, which is why it's normal to get a few every year. And most of the time, we don't even realize your immune system's working. I mean, we live in this really microbial world and every day it's just like fending things off. We don't even notice it. And every now and again, one might slip through the net and then you get sick. And the symptoms are actually your immune system more than the actual infection in most cases. So they might be unpleasant, but you just got to ride them out. And this is again where I think like modern life is hard because, you know, the general message is like go down the pharmacy, buy all the over the counter medications, and then get to work and struggle through the day. And if you actually maybe just took a day off or two and rested, you'd probably get over it a lot quicker.
Dr Jenna: Exactly. Yeah. Our producer is actually we were talking about some cold and flu over the counter medications. I was like, oh, what do you reckon about this one? I don't I can't remember what it was. It was some spray for the back of your throat.
Dr Rupy: It's really funny. Even though I tell this to my husband all the time, he loves himself one of those like, you know, that you put the hot water in and it's like a paracetamol based like decongestant thing. I'm like, that tastes disgusting. Save your money and
Dr Jenna: Yeah, we'll talk about that actually with the the fever sort of um balancing medications and stuff. But now we know how complicated the system is and it's basically everywhere. Are there any particular sites where the immune system will dominate?
Dr Rupy: Yes. Well, I think the one that you can't escape is is the gut. And I think this is
Dr Jenna: It wasn't long until we're going to start talking about the gut.
Dr Rupy: Yes, exactly. You you can't not then talk about the gut when you talk about the immune system. They are completely dependent on each other. And it's that dinner party fact of like, oh, did you know most of your immune system is in the gut? Well, it's true. And um there's good reason for that. I think with a lot of things in biology, the the form follows the function. So the the structure of the digestive tract, the whole architecture, it's optimized for digestion to get the most out of your food. That creates a vulnerability because it's actually the lining of your digestive tract is only one cell thick. So to me, that's like quite fragile. You know, there's there's all sorts of things going into your mouth every day. There's just the general bacteria and and bugs that are in our environment that we're swallowing. Um there's things that could be in our food that could make us sick. And just the food itself, how does the immune system know not to respond to that? So because of that, there's maybe about 70 to 80% of your immune cells that line the the digestive tract and they form all these kind of unique structures that have unique ways to keep a surveillance on what's going on. So that's really quite important.
Dr Jenna: Yeah, absolutely. I think that that sort of um the very fact that the architecture is only one cell thick shows you why it's so important to have immune cells there. Because we're in constant communication with our environment via our 30 cm long digestive sack or the first part of it anyway. Um and and that's why, you know, it's it's just a natural evolution as to why we have immune cells in those areas.
Dr Rupy: Yeah, and and you know, I think it's such a portal for um infection, you know, that we have to have those defenses there. It's interesting then to talk about the microbiome of the gut. This is getting a lot of air time. People are getting more aware of the microbiome. And what we do know that if you do not have a microbiome, then your immune system does not develop. It's it's completely reliant on the colonization after birth of our microbiome to develop fully. So I think that's what another reason why we should take care of our gut microbiome.
Dr Jenna: Yeah. It's one of the reasons why we're seeing with C-sections and versus natural delivery, those babies who have C-sections are more at risk of having ATP, so allergic reactions and issues like asthma and eczema and stuff like that. Not to say that that's a definite, you know, it's a definite case study that you you're definitely going to get asthma, but you're certainly more at risk because of the um issues with poor microbial development in the infant digestive tract.
Dr Rupy: Yes, exactly. And um there's a lot of work trying to unpick those mechanisms because I think that's going to be really important to understand. That leads quite nicely on to the point that much of your immunity is actually set up in childhood. So many people who might be thinking, oh, I've got a terrible immune system, perhaps there are elements of what happened in those very early years that have had downstream consequences. And I think it's always helpful to think about what you can affect and what, you know, instead of focusing on, oh, I was a C-section baby or I wasn't breastfed or these things that you can't change those. So it's better to think about what we can change.
Dr Jenna: Exactly. It's I have a lot of patients actually in general practice who over the last 20 years of their life, young patients, 20 or 30 years old, they had recurrent illnesses as kids. And you can almost map a pattern with antibiotic use and C-section and not breastfed and all the other factors beyond just nutrition and medications that may have led to them having issues with their gut or issues with eczema, dry skin and a whole spectrum of different diseases because of a poor microbial environment. That isn't to say that they are they're sentenced to that for life. But there are certainly things that we'll end up talking about about how we can actually encourage microbial development.
Dr Rupy: Yeah, you might just have a different set point because of those early events that happened because you're you're more or less sterile when you're born. And then you're subsequently colonized as soon as you enter into this microbial world. And it's it it's useful to think of it as, you know, the microbes were there before us. So we've evolved with them. We have to find a way to sort of have a a mutual relationship. So they actually do quite a lot for us in the gut. They themselves are part of our immune defense. So we we talk about the microbial barrier because they out compete with any bad bacteria that could be coming in through the mouth and not giving them any space. And they also make sure that those that delicate barrier of our gut is really strong and really tight. And this is an area of where I used to actually do a lot of research on when I was in Switzerland is this whole idea of leaky gut, which I think is one of those kind of woo woo terms.
Dr Jenna: It is, yeah. But it's it's it's weird because if you type in leaky gut into like PubMed, you you won't get much, but if you type in intestinal hyperpermeability, that's when you get, oh, okay, there is actually a lot of science behind this. Yeah.
Dr Rupy: Exactly. The science has sort of always been there and I guess the leaky gut term kind of existed in a parallel woo woo world and now the two are kind of converging and um yeah, there's
Dr Jenna: So you've actually done some research on this?
Dr Rupy: Yeah, so that was a lot of the work when I I worked out in Switzerland. Um trying to understand, so I actually worked for a pharmaceutical company. I wasn't making drugs, but they employed me to try and understand what was going on in a normal situation in the gut in terms of the immune system to try and figure out, okay, what happens when that's perturbed and then can we intervene with something? So they were kind of hoping that I would give them some drug targets, but I was just like, oh, this is amazing. I can unpick the science, what's going on. And sometimes you have to know what's happening in a normal situation to know how that goes wrong.
Dr Jenna: And in a normal situation, those tight junctions that exist between these these one cell thick lining, they they increase and they decrease, right? They become more leaky and they become less leaky. But that's normal.
Dr Rupy: That's normal. I think that's a really important thing to point out because people can get very confused if they start Dr. Googling leaky gut. But it is a normal physiological phenomenon. There's actually certain um components of our diet that can exacerbate that leakiness. The two really well-known ones are are fat, in particularly saturated fat, and the fructose from fruit sugars. But that's not to say that we should avoid those things because there's actually a lot of evidence that if you're consuming fat or saturated fat or fructose with fiber and with phytonutrients, that is actually fueling the bacteria in your gut, your microbiome to produce particular things, short chain fatty acids being one of those, that help seal up the gut again. So it's actually quite useful to open the gut when you're digesting food to facilitate the whole digestion and getting the nutrients into the body. And then the fiber helps to shut it back back up again.
Dr Jenna: So would you say it's less about having a leaky gut or having a permeability of your gut and more about the timing of how long you expose those tight junctions to be open essentially versus closed.
Dr Rupy: Yes, I think that's the picture that's starting to emerge and that I think ties in quite nicely to dietary patterns rather than focusing on specific nutrients. So, um, how many times a day we're opening up the gut. And one of the reasons that opening the gut up is is detrimental for the body is because the the microbiome that lives inside our gut can slip through those holes into the bloodstream and all around the body. And while those are considered our good bacteria because they live in the gut and they do a lot of good things for us, when they get in the wrong place, they're just the same as any other bad bacteria. They have the same molecular patterns on them that send an alarm signal to the immune system. They switch on inflammation. And this can all be happening at a sort of low level that you wouldn't perhaps even be aware of. There's sort of no firm signs and symptoms of this going on. But I think cumulatively over a long period of time, then it could be that we start to see some damage going on and and things bringing up.
Dr Jenna: It's it's I think it's quite important for for the listeners to understand that um your immune system is very much related to the inflammation response. And it's uh essentially mediated by the immune system. So when you need to have uh a response to uh a bacterial infection, a virus or or even normal colonization of your of your gut, um it will elicit this inflammatory response. And I suppose it goes back to this timing. It's like, okay, you can have a little bit of inflammation when you eat because that is very normal. But when you when you're eating for long periods of time or actually when you're grazing or when you're having the wrong sorts of foods and it's this constant sort of um exposure, that's when you have this low-grade inflammation, exactly, to meta-inflammation in the literature that um can lead to ill health outcomes.
Dr Rupy: Yes.
Dr Jenna: And I think inflammation is another topic that we probably need to spend another podcast talking about.
Dr Rupy: I mean, I think the one key thing maybe to talk about with regard to inflammation is that it's it's acute by design. So it's only ever supposed to be a short-term thing. And then if it's happening all the time, it starts to take its toll on the body. And we we call it chronic. So it's more of a long-term thing. But um yeah, the the leaky gut thing, I think people shouldn't be concerned about. Uh it's normal, but I think that you there's things you can do to prevent leaky gut and fiber and phytonutrients are two of the proven ways that we know help tighten it up again.
Dr Rupy: How do you know that you're about to approach burnout and and what do you do when you think that you are burning out?
Joe: Um, I think it's, yeah, I mean it's it's something that can can affect you and you don't even realize it's coming. You know, if you're having a really busy time at work or you're going through some stress. I use exercise as a tool. Like I'm not someone who sits and meditates and and can really slow my mind down, but when I I I use exercise as a tool and and nutrition to to make me feel good and productive and energized. So if things are getting difficult, I just I'm I'm quite good now at just sort of stepping back and putting my phone down for a few hours and and thinking like, what's the work, let's just say I release a new product or something goes wrong or, you know, something you think's not been a success. I think, well, what's what's really going to happen? Like just slow down and actually think about you're going to be fine. Everything's going to be fine and tomorrow you'll be fine. You'll learn from it. And I don't really let stress and anxiety get to me because it's crippling, isn't it? When you feel it, you feel like so much is on your plate at once, it can be really debilitating. So I'm I'm good at kind of um using exercise as a tool, um stepping away and just having a little breather and yeah, refocusing and also having a down down period. So I don't work 365 days a year. Like I do have a month off here and there where I can just switch off, chill out a little bit and then I re-energize myself to come back to work.
Dr Rupy: Yeah, I've got into the habit of not looking at my phone on Sundays for sure because I'm the first person to admit I am addicted to my phone. I'm addicted to social media.
Joe: What's your screen time a day, do you know? Mine's six hours.
Dr Rupy: It's six hours? Oh, that's that's way too much. That's way more than me. Yeah, mine's like two hours or so.
Joe: Only two hours?
Dr Rupy: Yeah, two hours, yeah.
Joe: That's amazing. That's the lowest I've ever heard.
Dr Rupy: Really? Oh no, mine's mine's about two hours, which I still think is a bit too high. If you think two hours of your waking day, if you're awake for over 12 hours, that's like, you know, a sixth of your day.
Joe: I'm doing half. I'm doing 50% of my day looking at a screen on my phone. It's nuts.
Dr Rupy: But I suppose that that for a lot of people, I mean, that's your business, isn't it? Like and Instagram and social media is our business. So that's sort of the reason why it would be so high. But you know what, there's people out there who do not have businesses on social media and they're just consuming the content. And six hours of consumption of any content is way too much. And I and I know that's having a negative impact on on particularly the younger generations because there's a lot of comparison. Even for me, I'm I'm the first person to admit, I will scroll through my feed and I'll be like, oh, this person's doing this and oh, maybe I should be doing that or, you know, you compare yourself even at a subconscious level.
Joe: Yeah, yeah, constantly, of course.
Dr Rupy: Does it happen to you?
Joe: Yeah, I mean, well, yeah, I suppose it does. I follow a lot of other people and, you know, I get inspired by certain people. But yeah, you are, you're just before it was like it would just be you and your friends and that was all you concerned yourself. And now it's like there's all these people that you follow with certain lifestyles and yeah, you know, you think, what, how have they got that brand deal or how have they got that house and that car and how are they flying around, you know, the world. But you just have to just honestly, it's so important just to focus on yourself and, you know, it doesn't mean they're happy just because they've got, you know, private jets and they're flying around with expensive cars and stuff. But um, yeah, I mean, and that doesn't truly motivate me anyway. I I much rather, you know, I much rather I'm more about family and spending time with and experiences and traveling with family than buying things, material things. I'm not really like a collector of stuff. I think it's just a bit like, yeah, it doesn't really do much for me.
Dr Rupy: There's two things I've got into uh over the last couple of years. One is minimalism, so buying less and actually enjoying more of um of of products and and things that actually give a lot of value. Um and uh like lack of materialism. I I follow Gary V. I don't know you probably heard of Gary V before.
Joe: Yeah, of course, yeah. Does he do that?
Dr Rupy: Yeah, he I mean, he's pretty minimalist anyway, but, you know, the kind of I mean, he's very polarizing though. You either love him or you hate him. I I actually find his content really useful. Um he talks a lot about, you know, falling in love with the game or falling in love with just, you know, your mission essentially. And I think what resonates really well with with yourself is, you know, we both have missions and that's what gets us out of bed in the morning. That's what drives us. If your goal is to have a bigger house or to live in a certain area or, you know, to have a nicer car, those things are pretty transient and they're not going to last. And you actually want to fall in love with doing something that has a much grander purpose, maybe, and I I try and encourage this for myself, is actually to make other people around you happier. As a byproduct, you will become happy yourself. But if you focus on making other people healthy and happy, then that's probably one of the best things you can try and aspire to.
Joe: Yeah, 100%. I'm a massive believer in that and connectivity and community and yeah, like helping helping other people out and giving, that's what I mean, I I feel like I do that with with what I do. I help people, you know, exercise and eat and cook and that makes them feel good. So that is my true calling and that is what I love doing and and what I continue to do. But yeah, I mean, we do, we focus on the wrong things, don't we? There's just so much noise and confusion and advertising and marketing and we're just consuming everything. But sometimes you've got to stop and just be grateful for what you've got and appreciate where you are and you're and you're healthy and, you know, and and focus on helping other people. Yeah, I'm a I truly believe that's that's the key to true happiness, I think.
Dr Rupy: Definitely, yeah. That was actually the second thing I was going to say. First thing is minimalism, the second thing is gratitude, you know, being grateful for the smallest things in life.
Joe: I love your gratitude thing. You did the 100 days of gratitude. It went on forever though. Do you still do it?
Dr Rupy: I still do it. Yeah.
Joe: What what last time I saw it was like 300 days or something.
Dr Rupy: It's like 700 now.
Joe: Wow.
Dr Rupy: Yeah, it's gone over 700.
Joe: Keep going, mate.
Dr Rupy: I don't really know where I'm going to stop. I mean, like, I I just I do it as a force of habit now. I just
Joe: Keep going, mate.
Dr Rupy: I just do it. Yeah. It's just fun. And you know what? The the thing that actually keeps me going, not just doing the exercise because I do that privately anyway, it's other people see that I'm I'm grateful for even the smallest things on a daily basis. And they're like, that's really inspired me. I'm going to start doing that. And I've done it for like, you know, a couple of days now. I feel great. You know, it's just a nice positive thing to end your day on, I find. So yeah.
Joe: Yeah, definitely. I'm I'm definitely and I just stopped to to do that with um with Rosie and Nikki and just to say like, you know, thank you for thank you for your time and being here. Thanks for your, you know, the relationship we have and our friendship and the loyalty and the trust that we've got, you know, these things are so important because that's what relationships are formed on. So, yeah, I'm doing that a lot more now. It's a really nice thing to actually say to someone, like, I really appreciate, you know, our friendship or the way you looked after me this year.
