Dr Rupy: Welcome to the Doctor's Kitchen podcast with me Dr Rupy where I'll be discussing the most important topics and concepts in the medicinal qualities of food and lifestyle. These are some of the things that I wrote about in my first book, The Doctor's Kitchen, blending together the science with delicious recipes inspired by cuisines from around the world. The aim of this show is to demonstrate the intersection between nutrition and lifestyle across the breadth of different medical specialities. And today I'm really, really excited to invite one of my close friends in this crazy field of lifestyle medicine that is burgeoning right now. He is an international bestseller of the book Four Pillar Plan, which I highly recommend you get. He's also the star of the BBC show Doctor in the House where he actually lived with patients for 30 to 60 days at a time and really tried to understand what was driving the root cause of their conditions. And he's also co-founder of Prescribing Lifestyle Medicine course, the first RCGP accredited course, that's the Royal College of GP accredited course on lifestyle medicine, making a lot of the information accessible to practitioners up and down the country and globally as well. Rangan, welcome to the show, mate.
Dr Rangan Chatterjee: Rupy, thanks very much for having me on. I'm looking forward to this.
Dr Rupy: Yeah, mate, totally. And I think it's it's really interesting because the intro of my first podcast, I talked a bit about how I got into this field myself. I had my own cardiac condition, something called atrial fibrillation. I was offered multiple different treatments by cardiologists and and medical physicians. And it was my mum that actually convinced me to optimise my lifestyle as much as possible. So I essentially did a lot of the things that you talk about in your book. I optimised my nutrition first of all. I concentrated on sleep and hygiene. I essentially tried to put my mindset in the best position I could as well. And by optimising my and body's physiology, I was able to overcome something that you wouldn't really associate with lifestyle. And there seems to be like a bit of a running joke that most medics who get into this field have sort of their personal story. And it'd be great to share if you have the same anecdote.
Dr Rangan Chatterjee: Yeah, well Rupy, I mean, I think when I've heard your you talk about your story before, what's incredible for me is that you know, your goal actually from recollection wasn't to actually reverse your condition, it was just to optimise your health to get you in the best state possible to have the procedure done. But yeah, in the process, your your sort of condition, well, vanished really. It sort of went away. You're right, the doctors that I see in this field tend to have a personal story somewhere. And certainly that's the same for me. To put it in context, I had been working as a doctor for a number of years. I thought I was going to be a specialist. I did all my specialist examinations and was working in kidney medicine and I was getting a bit frustrated at how super specialised I thought medicine was becoming. So I moved to general practice to get a bit more of a broad overview. I wanted to see everything, how did different symptoms from different parts of the body relate to each other and how does that have an impact on on someone's health. I moved there to general practice, really enjoying my job. And then something happened really, you know, I was on holiday with my wife, it's a holiday with my at the time six-month-old baby boy, and he had a convulsion. His eyes went back and it was a very scary time there. We were in a place called Chamonix in France and you know, honestly, I thought my son might be choking. So I, you know, I I grabbed him, I turned him over, I tried to slap him on the back, try to clear his airway. And you know, really in that moment, I froze. My wife sort of rushed, you know, she screamed, we've got to get to hospital. We rushed to the hospital. You could see that the doctors and nurses were incredibly worried because as you know, Rupy, like six-month-old babies often will have a convulsion if they've got a fever, what we call a febrile convulsion, but he didn't have a fever. And so the big issue was was why is this going on. So, you know, we we got moved to a different hospital. He had two lumbar punctures. And then a few hours later, the doctor came to see us and said, look, what's happened here is that his his calcium level in his body is low. And when I say low, I mean really low. So in that hospital, very much like here, the the normal calcium level is 2.2 to 2.6. His was 0.97. So just incredibly low. That's what caused his convulsion. But then a few hours later to that, they said, we know the reason why. And that's because he had no vitamin D in his body. So, you know, without going into all the ins and outs of that case, in a in a nutshell, a vitamin D deficiency is a fully preventable deficiency. And I couldn't get my head around the fact that with all my training, with my immunology degree, with my specialist training, with my general practice training, my son, you know, nearly died from a preventable vitamin deficiency. Modern medicine saved his life, right? But they didn't teach me what to do about it. It was it was case of, okay, we've dealt with the acute problem. We've given him intravenous calcium, we've given him vitamin D, you know, off you go. And I thought, well, let me look into this a little bit more. And the more I studied about vitamin D, I more I realized, well, hold on, that's a critical nutrient for the development of our immune system. So has he been low for the past six months? Has he been low in the womb potentially? Could this be why he's got such bad eczema? You know, because eczema is in some way a slight misfiring of the immune system. And I went on a mission to basically learn more. I thought, okay, I felt very guilty, if I'm honest, that that happened to my son. I thought, how with all my training have I allowed that to happen? So that guilt drove me on. I started reading about vitamin D, about the immune system, two, three hours a day. That led me to reading more about the gut microbiome, about nutrition, about lifestyle. And I thought, wait a minute, there's a whole ton of science out there on things that I think are going to help my son, are going to help my patients. Yet, as a doctor, I don't know anything about that. And that was quite scary for me. I thought, why do I not know about this? And so literally what drove me on was the desire to get my son back to optimal health as if this had never happened. And I'm, you know, pleased to say, you know, he's nearly eight years old. He's thriving. He's doing really well. He doesn't have eczema anymore. You know, all these things, you know, that I've I've applied with him. I've applied the same principles on myself and my family, and I feel as good as I've ever felt. Then I've been applying for years now those principles with my patients, and I'm finding that more and more, I'm able to get to the root cause of a patient's problem, or or even if I don't get to the absolute root cause, just by applying some simple changes to their lifestyle, whatever condition they've got can be vastly improved. And so yes, I've got a personal story. That's probably quite a long-winded answer for you, Rupy, but you know, that is really where, you know, if I'm honest, before that incident had happened, I've always had that preference to use lifestyle. You know, I've always had that, but that moment changed everything for me in an instant because I thought, right, I I mean, very few things, I think, motivate you in life than either a personal illness or when one of your children is ill. You know, that's a pretty powerful motivating factor.
Dr Rupy: I love the word you used mission there. And this is obviously something you started about eight years ago. Now, you went on a mission to learn as much as you could, not just about vitamin D, but actually why this actually happened. And that led you down, you know, opened a can of worms of all the different research studies, how this relates to the gut microbiome, how it relates to a skin disease that you would never really associate with it. And how this isn't really reflected in current medical curriculum. It's something that despite all your specialty training, the fact that you were a medical registrar, one of the toughest jobs in the hospital, you you didn't have that experience in. This must have been the trigger for you to try and open up this information to your patients. It must have really reflected in the current practice or in the practice that you had thereafter.
Dr Rangan Chatterjee: Yeah, absolutely. Because as a as a medical doctor who, you know, like many of us, we go into this job to help people in as safer way as possible. You can't unlearn this information. Once you know it, you can't pretend you don't know it. You know, there's an ethical obligation to actually utilize those skills and those those new techniques with your patients. And then when you see that actually most of what I recommend now is in the worst case, right, worst case scenario is you're no better, but you've done no harm. And then I compare that to a lot of the pharmaceuticals that I used to prescribe on a on a routine basis and you look at their side effect profile. And and you know, even the safest drugs that we prescribe have got some pretty nasty side effects, you know. And again, I'm not anti-drugs at all. I'm for using the least harmful recommendation first with my patients and and then progressively move it up. You know, the way I see it is that medical school training is brilliant. I'm very proud of my training, but I fundamentally think that it's brilliant primarily for acute disease. And I think, you know, I I kind of often wonder 30, 40 years ago, when you went to see a doctor, I think the bulk of what a doctor was seeing was acute disease. So I think our medical training was brilliant for what the health landscape of this country used to be. But I think over the last 30, 40 years, the health landscape has dramatically shifted, whereas now what is putting the NHS under strain and what is coming into your surgery or my surgery every day is basically a lot of problems that are chronic that in some way is related to our collective modern lifestyles. I'm keen to say I'm not putting blame on people. I'm just saying the way society is set up now makes it very hard for many of us to make those healthy choices. And you know, this is I'm very lucky to be able to have showcased on on BBC One's Doctor in the House that a whole variety of different conditions, whether it's type two diabetes, fibromyalgia, mental health problems like anxiety, insomnia, gut problems, menopausal symptoms, right, in some cases I managed to reverse these problems in six weeks, but in every other case, even if they weren't reversed, they were substantially reduced. Like anxiety attacks and panic attacks have gone down by 70%, right? By applying small changes in four key areas of our lifestyle. So I'm passionate that we undervalue both as doctors but across the public as well, we undervalue how beneficial lifestyle changes can be. You know, the science of lifestyle medicine is quite profound actually. And I think I think we underestimate its therapeutic importance because actually some of the take homes are actually quite simple. You know, we'll probably talk about sleep later, but you know, you can go into sleep and go, actually, when you go into the science of what happens when you sleep, it is incredible. But the take home is you've got to prioritize sleep and get more sleep. Exactly. You know what I mean? And so it doesn't it's not quite as fashionable as some of the the high-tech new medical interventions, but the basics of good health frankly haven't changed in probably hundreds of years. What has changed is our modern environment.
Dr Rupy: And I think, you know, the program, Doctor in the House, resonated so well with lots of different medics, particularly GPs, because I know personally after having my own experience being a patient, being someone that had to be reliant on medications to control something that was out of my out of my look sort of control and understanding as well. There wasn't a clear trigger as to why I was having this heart condition. There wasn't a clear reason as to why it was being perpetuated. When when you're in that situation, you you managed to improve it yourself, and then you go and see patients, you know, you you want to try and apply these principles as much as possible and and deliver this information. You get very frustrated with the current arsenal that you have, the current tools in your toolkit of it just being pharmaceuticals when you know in in from your experience that actually if you just apply these principles of lifestyle, a lot of things can be improved if not reversed.
Dr Rangan Chatterjee: Yeah, and and Rupy, you just I I remember when you, um, you know, when we got in touch, I remember it was just before my first series or maybe it was as the first series of of my show went out. I seem to recall you were you were probably just started the Doctor's Kitchen. And you were contacting me on social media and saying hi and saying you love the program and stuff. And I I know I always got a really nice warm vibe. You know how you can tell on social media sometimes, you know, social media is another world all together, but you can sometimes tell when there's someone who's probably got a similar ethos to you and a similar temperament and um, you know, just just a similar mission. And I always I always remember those those sort of contacts from you and thinking, oh, there's this there's this guy in Australia who's kind of Doctor's Kitchen thing, you know. So, you know, just remind me, how did you, you know, what what was the impetus for you to set that the Doctor's Kitchen up?
Dr Rupy: I felt very frustrated that I wasn't able to deliver as much information as I could to my patients. So what I found was that, you know, when you entertain these conversations about sleep and and lifestyle, you take a little bit longer. Specifically for me, I was writing down recipes for my patients. I thought there's got to be an easier way to do this. So that's when the idea of the Doctor's Kitchen was born. It was probably about six, seven years ago now, where I could direct patients towards a website where I can motivate them to eat their way to health and actually heighten their knowledge of the clinical research behind the ingredients that I would use to inspire people about how their plates are positive health interventions. So that's when I started it, but then, you know, in an era where talking about food and medicine, particularly six, seven years ago, was very, very niche for a conventional doctor. I didn't want to be labeled as someone that was a bit cavalier, a bit like a cowboy. So that's why I actually took me a while. It took me, well, four years later after having the idea to actually gain the confidence, get behind a camera, start talking about it with as much confidence as I could. I started on YouTube and and Instagram as you know, and and we connected a couple of months afterwards when I came back from Sydney. Um, and it's kind of just gone from there, but it's it's really good to be able to connect using social media. I know it's got a lot of caveats as well, but using social media to connect with other doctors who are of this same mind because it only strengthens the public's understanding of of how impactful lifestyle can be.
Dr Rangan Chatterjee: Yeah, and actually what you say, Rupy, it's amazing how many doctors who are trying to promote this stuff on social media, it's incredible how many also feel very nervous and scared as to what our colleagues are going to think, you know, because we're we're trained in a system in such a way that you know, these things really bother us. You know, it took me a while to get my head around that, but I think there comes a point when you've studied the science, you know this information, you apply it with your own life, you apply it with patients and you see the benefits. And I kind of feel in some ways ethically obliged to promote this as far and as wide as possible. And I agree with you, the more healthcare professionals that are promoting similar messages, you know, the more it strengthens this idea that this is a thing. You know, social media comes with a lot of criticism. You know, anyone can put advice out there now, right? But I I I probably got a slightly different view to what's the norm about that. I think if you rewind back 15 years ago when we didn't really have, I think around 15 years ago we didn't have social media. For most people, they could only get health information from their doctor or from a university or from a book. And and now what we've got is that there is arguably too much information out there, but there's there's, you know, anybody can access free information on health when they go onto the internet. Now, I don't dispute that there might be some problems with that, but I would say by and large, it's much better to have this free and open access to information than it is to have just it reserved behind these closed institutions. And that's why I have a slight problem with the whole idea that we should police what goes out on the internet because then I think, well, hold on, then we just get back into the same position that we were 20 years ago where the same thing gets churned out by everyone. It's a lot of people, there's a lot of debate over whether medical doctors have been giving the best dietary advice for the past 20, 30 years. Now, you know, it's a separate conversation, but if we go back to just saying that only the official advice can be then replicated by social media influencers, we're not really having that free and open access to information. So I, I know there's challenges, but I think by and large, we're living in a great time where lots of people are getting help without needing to even go and see their doctor, which I think is brilliant.
Dr Rupy: I think that's probably a good thing overall, isn't it? Because I think if people come across this information themselves, it means that they're actually more inspired to learn about their condition and actually overcome it using multiple different ways. And if we were just giving the same dietary information specifically from doctors over the last 20, 30 years, I think some patients would have come to harm. They didn't actually go on those journeys themselves and actually find out different sources of information from, you know, nutritionists and and other people that haven't traditionally been held as reliable sources of information.
Dr Rangan Chatterjee: Yeah, and that's how this movement is gaining traction because what happens is is that people start experimenting and and experiencing benefits in their own lives. I know so many doctors who after they were given a health diagnosis, they weren't happy to go on medication for the rest of their lives. So they then go and make those changes themselves, they feel better, then then they're more invested in recommending those changes to their patients. And look, there's there's pros and cons of of different movements. And I know the low carb movement, for example, is something that is, you know, gaining in popularity. And I think there's a few reasons why that is, and we can maybe discuss that, but I think that movement has come about from a lot of doctors, a lot of patients feeling frustrated with, let's say if they had type two diabetes and they weren't really finding any benefit making the dietary changes that maybe they were being asked to make. And when they change things and and did this sort of so-called low carb diet, they would quickly feel better and find their blood sugar levels come down. So they're like, oh my god, this is amazing. And so they then tell their friends, other doctors, I know some doctors who weren't open to diet and nutrition interventions and their patients have come back to them and said, look, look at my blood results. They're incredible. They're like, wow, yeah, that is incredible actually. You know, can I, you know, tell me more. So I think it's not only about doctors teaching patients. I think if we're truly open-minded as doctors, our patients can start teaching us.
Dr Rupy: Absolutely. And I think that happened with one of our colleagues, Dr. Unwin, who's a quite a well-known low-carber, but he's a very well-experienced GP of 30, 40 years, I can't remember now. And towards the end of his GP career, he's now learning about the therapeutic value of dietary interventions. And that was directly because of patients telling him that kind of story. I've gone on this low carb, I learned about it via the internet. What do you think these are my blood results? And that ignites interest in him as a medical professional into what the validity of this is and how effective it is as well.
Dr Rangan Chatterjee: It's a new it's a new era and a lot of people from the old guard don't like it because it's a new way of information getting spread. I I think from certainly what I've seen and certainly what I see in my clinic, right, most diet and nutrition and lifestyle changes, I think, you know, you can always try them and see how you feel and there's there's very low risk of harm coming from them. That's the way I see it. Now, look, I appreciate that some people, depending on what you see in your clinic, you may, you know, or or another healthcare professional, they might have a slightly skewed view depending on what they see. I may have a skewed view based upon what I see, but I recognize that. You know, but I think by and large, this whole movement is a good thing. And most of these profiles are inspiring people to make healthier choices. So, I think it's a tricky one. I think it's a tricky area.
Dr Rupy: I think it's a good segue into what we are going to be chatting about today on the podcast, which is controlling sugar levels or controlling type two diabetes specifically. And I know you've had really good experiences with this on the TV show and you've managed to reverse type two diabetes twice using some quite different techniques. And I think this is a really good sort of illustration of how multifactorial this condition is because there's not just diet related as as you're, you know, you're very keen to promote, aren't you?
Dr Rangan Chatterjee: I'm very keen to promote and it's this is really what my my approach is about. This is what my my book is about is about that there are multiple factors in our lifestyle that result in our health. And I think just as I feel medicine has been overly reductionist for for a number of years now with chronic disease, um, I I think something like type two diabetes, we're also often calling it a diet driven condition. And I have issues over that. I think diet is a critical factor in the development of type two diabetes, but I don't think it's the only thing. And if we were having this conversation Rupy five or six years ago, I probably would say, yeah, it's a dietary condition. But as I think about this more and more, and I look, I've got lots of friends in the low carb movement, right? And I think they're doing a lot of good, right? But I don't necessarily agree with absolutely everything. I don't think carbs are evil. If carbs were the only issue in type two diabetes, we have to be able to explain why in Okinawa in Japan, one of the blue zones. So blue zones are these sort of little pockets around the world where we've got these high rates of longevity. So people live to a ripe old age with minimal rates of these chronic diseases like type two diabetes. How can the Okinawans have an 80% high carbohydrate diet and not have type two diabetes? And I think I can explain that. I think the reason is it's not just about carbs, right? So the first thing to say about them is the Okinawans are also very well slept. They've got low levels of stress. They're physically active every day, right? So on the other three pillars except from food, they're maxed out anyway. So they're not doing the other things, right, that would drive insulin resistance, which drives type two diabetes, right? But the other thing is is that the carbs that they're eating are what I would call cellular carbohydrates. So, um, this is there was a great paper by Ian Spreadbury in 2012 where he he sort of hypothesizes are the the helpful carbs primarily the cellular carbs. These are ones where the their structure remains intact, so like sweet potatoes, as opposed to the modern what he calls acellular carbs, such as rice cakes and highly processed grains, for example, where actually the the structure of the plant has been changed. Now I'm not saying that's the perfect way of distributing of of differentiating them, but I think, well, we know that sweet potatoes are very, very good for our gut microbiome. And so, I should probably back up and go, what's the gut microbiome, right?
Dr Rupy: Yeah, yeah. I actually talked about the gut microbiome, the population of microbes living in and around your body, largely concentrated in your gut in a former episode on series one.
Dr Rangan Chatterjee: They might know.
Dr Rupy: They might know, but you can listen to that again. It's with a mutual friend of ours, Dr. Megan Rossi, and we talked about gut health on that one. But yeah, in short.
Dr Rangan Chatterjee: In short, we've got trillions of bugs living inside our guts, right? And we know that the health of those gut bugs is critical for multiple processes in our body. It's critical for our digestion, which is in our gut, but it's also critical for things outside our gut, such as our mood, potentially even skin, potentially even joint pain, potentially even other things such as type two diabetes. And there's some interesting research suggesting that your gut microbes might be implicated in your weight, right? So we're learning more and more. This is a very early science, new science, how important that that collection of gut microbes is. What's interesting for me is that if you look at any healthy eating population around the world, they're all basically following the same principles, not when it comes to fat or carbs, right? Because there's differences. You know, one of the blue zones is Loma Linda in California, and they're vegetarian. But, you know, other blue zones eat animal products. Now, yeah, I know the books say that they don't eat many animal products, but, you know, we were both in Guernsey in June and we I spent some time with Michelle Poulin, who's the Belgian researcher who coined the term blue zone. And guys, in some of those blue zones, they have they have quite a lot of animal products, right? So I think, okay, so, you know, what's the commonality? They're eating minimally processed food. So food that is as close as possible to what we get in nature, right? And I know not everyone loves the term processed or unprocessed food, but, you know, we, you know, no one loves every any term, frankly, you know, you you can't keep everyone happy, you know, I realized that. Minimally processed food, they try and eat locally, they try and eat seasonally, they sit down and have their meals, and they do have treats, right? But they have treats every now and again. They have treats like at Easter or at Christmas. They don't have treats every day after school, for example. Exactly. Yeah, yeah. Right? So, I think when you look at the blue zones, it's this balanced perspective. And I think a good low carbohydrate diet, right? Or what is called a low carbohydrate diet. And again, I'm not a huge fan of the term. I get it that it's easy to understand. But you can have a good quality one where you're having loads and loads of vegetables that feed our gut bugs. And you know, there's some really good studies showing that one of the initial causative events in the development of type two diabetes might be problems with your gut microbiome, right? That's incredible. Right? So if you've got a healthy gut bug population, right? Does that in some ways insulate you? Is that why the Okinawans could have 80% carbs? Exactly. Because they're nourishing their gut bugs. And you know, if you really want to delve deep into it, there's inside our gut bugs, we've all got a compound called LPS, lipopolysaccharide, right? It's sitting inside you now, sitting inside me, sitting inside everyone, we've got LPS. Right, LPS is fine if it stays in your gut. But as we start to damage our gut bug population, and what damages it? Highly processed food, right? Overuse of antibiotics, right? Pollution, right? Often some of these sweeteners now that we're using a lot, they could be quite damaging for the gut microbiome. As we damage that, right? We start to cause issues with the integrity of our gut wall, and lipopolysaccharide, this LPS, suddenly can get into our body. And that's where it's been associated with the development of type two diabetes. It's been developed associated with things like rheumatoid arthritis. It's been associated with Alzheimer's disease and other neurodegenerative diseases. And in many ways, once you start understanding this, you think, wow, our gut, if we can keep that in good shape, right, our gut bugs and our gut health, actually, we in some ways, we're probably going to insulate ourselves from many of these modern different diseases. And how can you do that? Well, diet is a big big role.
Dr Rupy: It's a huge role. Exactly. Yeah. And I think like, we could talk about the gut microbiome in its entirety with all its, yeah, I know, yeah, yeah. Um, but essentially, if we're distilling it into simple principles, whether it is described as low carb or there's there's other diets that are carb rich, like the Okinawan diet, it's really about the quality of those ingredients and keeping it as at least from the ultra processed foods as possible, unless refined as possible, keeping it as whole as possible.
Dr Rangan Chatterjee: Absolutely. You know, you know what it's like, Rupy, when you when you're trying to write a book, you you sort of really have to order your thoughts because it's it's all very well having ideas and when you have to articulate it on paper, you're like, okay, I have to put these thoughts in some kind of order where it makes sense. And I hypothesize that could it be in the modern Western world where we are overstressed, underslept, not moving enough, having a lot of highly processed junk food. Could it be in this environment that this low carb role, that this low carb diet has such a powerful role in some patients? I think it is. I think here now, you know, we both live in the UK, I think the bulk of the junk that is in the British diet is highly processed and refined carbohydrates. So, the question I ask is, when you go on a low carb diet in the UK, are the benefits because you've cut your carbs or you've cut out the highly processed junk? Exactly. That's and and I think that's another way to look at it. And, you know, look, there's no question if you were a type two diabetic patient in my clinic, I may well restrict some of your refined and processed carbohydrates for a couple of months, right? To really get on top of the problem. But then what I'm also trying to do is optimize those other four factors and try and repair that insulin resistance so you become more insulin sensitive and then I start to reintroduce some of those starchy carbohydrates like sweet potatoes and parsnips that, you know, on on some low carb diets, they would they would say eat go away from. But I think they've got a very positive impact on our gut health. So some people can absolutely get away with introducing them in. And I've also got patients if I'm honest who do a low fat vegan diet and reverse their type two diabetes as well.
Dr Rupy: And this is what is interesting because in my book, I actually talked about the validity of different diets or the invalidity of different diets. And I think it really depends on that patient in front of you and the fact that there are quite a few similarities across all of them. Like whether you look at paleo or whether you look at veganism, they have a lot of things in common like concentration on nutrient dense sources of foods, lots of different variety of of vegetables and whole foods as much as possible and removing those things like refined sugary drinks as well as refined processed carbohydrates. So, you know, I think the the diet wars are sort of like uh busying the situation. They actually serve to confuse rather than to educate people. Um and if you stick to those simple principles that you've eloquently um described, um you can do a lot of good.
Dr Rangan Chatterjee: Yeah. Just the last thing to say on type two diabetes is really important I think for people listening is that there's another approach that's got a ton of research behind it. Professor Roy Taylor at Newcastle University has reversed type two diabetes with a liquid 600 calorie diet for a few, I think it's two or three weeks, right? Now, for me, as you just said, Rupy, it comes down to, you know, that's not an approach I use with my patients. A, I don't have access to that. But B, I would much rather they learn some tools in their own lifestyle that they can apply long term. But I also have to recognize that that approach works. So what does that mean? There are multiple ways to use lifestyle to get on top of your type two diabetes. You've got to figure out what works for you. You know, if you're someone who wants to be a vegan and and and have a low fat diet, right, let's say, actually, if you can stick to a low fat diet and a low calorie diet, actually, you've got a good shot at reversing your type two diabetes. The thing I see is that quite a few people struggle to stick to some of these low fat diets, especially if they're highly processed. So there's all this nuance there that I don't think the diet wars really take into consideration.
Dr Rupy: Like I said at the start of the podcast, the Four Pillar Plan, I think is a fantastic book and what you're doing with the prescribing lifestyle medicine course is really equipping the doctors like ourselves, like GPs, but also different specialities to look at conditions in a completely different way and incorporate these really uh simple, yet effective approaches at helping our patients. And I I I can't uh promote your course enough and I think it's going to do fantastically well. Do you have anything coming up over the next, oh, you've got your your book launch in America, obviously.
Dr Rangan Chatterjee: Uh well, the book's about to be launched in America. The US publisher have gone for a slightly different title. They're calling it how to make disease disappear. It's essentially the same book as the Four Pillar Plan. It's got a different introduction. But, you know, having seen the impact that this book is having in the UK, the amount of people who are getting it, who are buying multiple copies for their parents and their work colleagues and their brothers and their sisters. You know, I'm just keen to get this message out as far and as wide as possible. And clearly the US population absolutely need help with lifestyle driven conditions. And I I'd like to think that why my book I think is resonating with people is that it's what I've tried to do is break down and simplify health for people. I think health has become so complicated. I've really tried to use this four pillar framework to simplify it so that people feel inspired that as they're reading, oh god, I want to make that change. I want to make that change. And so I'm excited to see, you know, if this takes off with the US population. But apart from that, you know, just more of the same, more posts on Instagram and Facebook, you know, trying to promote promote this work.
Dr Rupy: Absolutely. Yeah. And thank you so much for your work and um I appreciate you coming on the podcast, buddy. It's been brilliant.
Female Voiceover: That was an awesome chat I had with Dr. Rangan or Rangan as I call him. Um he's an absolute wealth of knowledge. His book's fantastic and I'm I'm really glad that we got to utilize that framework to illustrate why lifestyle is so important. To round up what we were talking about, our sleep is so important. So it's not really about the number of hours, it's about the quality and the mindset that you go into your sleep in. So having a focus on improving your sleep, perhaps by removing electronics an hour to two hours before you go to bed, dimming the lights and making sure that you're not exciting your brain is something that can actually help with sugar regulation. Exercise is very important to maintain overall health, improve your cardiovascular health, but also over exercising and in particular high intensity training too often can be detrimental. So it's something that you want to try and realize whether this is something that you want to do all the time. I think hit training is fantastic. It certainly improves insulin sensitivity. There's really good evidence for that. But having a variety of exercise is super important. So doing things like yoga, stretch, flow, mobility exercises, as well as traditional endurance, whether that be running, cycling, or rowing. Having a mindfulness or meditative strategy is something that a lot of people could do with. And this can be as simple as taking time out of your day, 10 minutes to just allow yourself to experience inner calm, putting away your electronics, making sure that you're giving yourself time to be still within yourself. Some people find using an app is very effective or some people find just going for a walk and being in a green space can be very therapeutic. And there is some evidence to suggest that having this inner calm can improve your stress levels that can improve your ability to deal with sugar. There are so many different ways in which you can improve your diet to improve your sugar regulation. Having a more whole and less processed diet is something that focuses on different sorts of whole vegetables, even things like sweet potato and root vegetables with the skins on as well can be very effective at improving your microbiome but also improving the numbers of different fibers that you have in your diet. Beans, legumes, these are all fantastic at improving your fiber and also regulating sugar in your bloodstream. Having a nutrient dense diet by introducing different sorts of colors, the greens, the yellows, the purples, are ways in which you can improve the anti-inflammatory contents of your diet that can have improvement on your sugar levels as well. If I was to choose a recipe from the book, it would be the borlotti bean soup. It's got lots of different herbs and spices in and it's made up largely of beans which are fantastic from a fiber point of view and a protein source as well. I really hope you like listening to that podcast. There's going to be loads more coming up and make sure you subscribe to The Doctor's Kitchen. You can find my guest, Dr. Rangan Chatterjee at Dr. Chatterjee on Facebook, Instagram, and make sure you check out his book, The Four Pillar Plan, too.
