Copyright

Thorsons

An imprint of HarperCollinsPublishers

1 London Bridge Street

London SE1 9GF

www.harpercollins.co.uk

This edition published by Thorsons 2017

FIRST EDITION

Text © Dr Rupy Aujla 2017

Food photography © Faith Mason 2017

Cover layout design ©HarperCollinsPublishers Ltd 2017

Cover photograph © Faith Mason 2017

A catalogue record of this book is available from the British Library

Dr Rupy Aujla asserts the moral right to be identified as the author of this work

All rights reserved under International and Pan-American Copyright Conventions. By payment of the required fees, you have been granted the nonexclusive, non-transferable right to access and read the text of this e-book on screen. No part of this text may be reproduced, transmitted, downloaded, decompiled, reverse engineered, or stored in or introduced into any information storage retrieval system, in any form or by any means, whether electronic or mechanical, now known or hereinafter invented, without the express written permission of HarperCollins e-books.

While the author of this work has made every effort to ensure that the information contained in this book is as accurate and up-to-date as possible at the time of publication, medical and pharmaceutical knowledge is constantly changing and the application of it to particular circumstances depends on many factors. Therefore it is recommended that readers always consult a qualified medical specialist for individual advice. This book should not be used as an alternative to seeking specialist medical advice, which should be sought before any action is taken. The author and publishers cannot be held responsible for any errors and omissions that may be found in the text, or any actions that may be taken by a reader as a result of any reliance on the information contained in the text which is taken entirely at the reader’s own risk.

Find out about HarperCollins and the environment at www.harpercollins.co.uk/green

Source ISBN 9780008239336

Ebook Edition © December 2017 ISBN: 9780008239343

Version 2017-12-20

Instagram @doctors_kitchen

Twitter @doctors_kitchen

Facebook @thedoctorskitchen

www.thedoctorskitchen.com

Dedication

To my mother. Without her love and guidance I would not be the doctor I am today … or a cook. I owe her everything.

Contents

Cover

Title Page

Copyright

Dedication

Introduction: Food as Medicine

1 Breakfast

2 Sides and small plates

3 Mains

4 Desserts

5 Spices, dressings and pastes

References

Index of searchable terms

Acknowledgements

About the Publisher

Introduction: Food as Medicine

Hi, I’m Rupy. I love practising medicine as a doctor in the NHS and I also have a real passion for showing my patients and colleagues the health benefits of food.

I believe what you choose to put on your plate is the most important health intervention anyone can make.

Imagine a world where everybody appreciates the true impact of diet and lifestyle on disease and is empowered to make permanent, simple changes. Some of the most prevalent illnesses can be alleviated and managed by making educated modifications to what we eat and how we live. We have been conditioned to believe that the sole purpose of going to the doctor is to get prescriptions and pills to cure us when we are sick, but my aspiration is to teach patients to take control of their health and prevent illness from occurring in the first place by using a lifestyle medicine approach.

Every day, we make choices that either positively or negatively impact our bodies. But I haven’t written this book to scare you into a restrictive and bland way of life. I’m here to welcome you on a journey of colour, flavour and cultures that makes healthy eating delicious and accessible to everyone. I want to introduce you to the medicinal effects of food, while showing you how it can be vibrant and easy to slot into a hectic lifestyle.

As a GP in the NHS, I see hundreds of patients every week. From my desk I witness the outcome of poor diet and lifestyle time and time again: high blood pressure, low mood, chronic pain, diabetes, cognitive decline. The reality is, we are not taught the immense value of nutrition in our communities, or even as students at medical school. Addressing this problem will combat some of the most common and preventable illnesses in society.

I’m still practising as a doctor, so I understand that a busy working life and a lack of cooking skills have an impact on what we choose to eat. If we learn about the importance of food, we can stop it from slipping down our list of priorities. I’m here to help you navigate those roadblocks and motivate you to experiment with ingredients that have amazing benefits. You’ll discover the health qualities of everyday ingredients and discover the tools to cook delicious meals all the time.

After spending 15 years training in medicine, learning about human biochemistry and the effects of disease, my attention is now focused on the study of nutrition, the impact of food on our genes, our brain and our gut, and the power of a healthy lifestyle. As well as explaining the science, I aim to educate and inspire you to want to cook. You’ll realise why I believe a good understanding of nutrition is essential for everybody, at all stages of life. The foundation for your health journey starts on your plate and it’s more powerful than any pill I can prescribe.

The foundation for your health journey starts on your plate and it’s more powerful than any pill I can prescribe.

Nature has some incredible foods that ancient cultures have appreciated for thousands of years. Furthermore, the use of spices and herbs adds a wealth of aroma, warmth and enjoyment to cooking, and the intricate chemistry of these ingredients has a profound effect on our bodies. I hope to persuade you that adding these types of foods to your diet is fundamental to feeling energetic and youthful long into your life.

I’m here to smash the preconception that a healthy way of life is expensive and shed the pretence that any single book can be a ‘one-stop shop’ to changing your entire life. Today is simply the starting point. I will guide you through living-well principles so that you can create a plan of change yourself (if you need one at all) that suits your needs, motivation and lifestyle. Everyone stands to benefit from the recipes and tips in this book.

This is my unbiased, current and evidence-based medical opinion on healthy eating. Today’s ‘wellness’ industry can lack scientific credibility and has occasionally spread misinformation that is harmful to your health. The overwhelming, conflicting messages can be difficult to navigate, especially to those who are just starting out. It’s time we moved away from cherry-picking strands of evidence to support faddy diets and finally provide everyone with the wealth of knowledge available. Using science and my clinical perspective as guiding principles, this book gives you the delicious recipes and life tools that you need to feel fantastic and stay well.

You don’t need to know the fancy chemistry, the correct proportions of ‘macros’ or how to use calorie counters and scales. The majority of us just need to stick to sound diet and lifestyle principles (that I’ll introduce you to in this book), and our health will flourish.

Expect to feel happier with your weight, calmer in your mind and, overall, more content knowing that the changes you make are sustainable for life. The ability to reverse disease, improve mental health and feel fantastic has never tasted so good.

My story

Food and medicine go hand in hand and sometimes changing our diet can be the best intervention.

At the age of 12, I witnessed my mother take control of her medical condition that had baffled multiple physicians. She used to suffer random anaphylaxis attacks; the worst form of allergy where your airway can close and your blood pressure drops. The attacks are life threatening and require treatment with an adrenaline shot. After undergoing a barrage of medical tests to find a cause, none was found. As a last resort, her doctors recommended lifelong allergy medications, which unfortunately have a range of side effects. These included crushing fatigue and intolerable nausea but, worst of all, they didn’t completely eradicate the attacks. The daily unease of potentially having an episode was incredibly stressful for her.

Not content with being reliant on drugs that weren’t completely working, she decided to make radical changes to her daily life. Her Indian upbringing had instilled in her the value of food. As a trained lawyer, she used her research skills and analytical approach to examine the scientific literature and create a plan of action. I watched her completely overhaul her diet and lifestyle, while simultaneously running her businesses, our household and raising two demanding children. Her daily ‘prescription’ included a wholefoods diet packed with vegetables, good sleep patterns, exercise and meditation. She became more confident, stronger and gradually came off all medications with the support of her doctors. Thankfully, she has never needed to use an adrenaline shot again. This was my earliest introduction to the power of ‘food as medicine’.

My mother’s experience drove me to want to be a doctor. I worked hard to earn myself a place at Imperial College London. I started medical school with the understanding and strong belief that food could be as powerful as pharmaceuticals. However, despite being intrigued by ‘alternative therapies’ at a young age, I wanted to immerse myself in conventional medical training. The body has always fascinated me. Learning the anatomy, biochemistry and foundations of how we function was an incredible experience, but noticeably lacking from the curricula was an emphasis on nutrition. What we put into our bodies on a daily basis is just as important as medication, but I wasn’t taught to appreciate the power of lifestyle and food. Only when I became ill myself would I remember what inspired me to become a doctor in the first place.

After medical school, I experienced two gruelling years as a junior doctor in central London hospitals. The stress and responsibility on a newly trained medic is unfathomable. Within two weeks of qualifying, I found myself wandering the corridors of a hospital alone, at night, armed with nothing but a stethoscope and two bleeps, providing the sole junior cover for medical wards. No amount of book smart prepares you for hospital life.

I began to realise how self-sacrificing healthcare workers are for the service. We eat poorly, work awkward hours and the stress is intense. Our environment often dictates what we can eat, and in the interest of convenience, the choice is often a poor one. It’s no wonder that on average our lives are shorter, we’re more likely to suffer mental-health issues and obesity is greater among us than the general population. We are certainly not pillars of good health to look up to!

I remember vividly, in the last few hours of my weekend shift (after working for 12 consecutive days), I noticed I was having palpitations. I asked my registrar to check my pulse and within the hour I was admitted to the acute medical unit. They found I was in fast atrial fibrillation (AF), a condition where your heart beats irregularly, inefficiently and, in my case, very fast. Up to 200 beats per minute. Luckily, I didn’t require emergency treatment (a cardioversion, where an electronic shock is used to revert the heart rhythm back to a normal one), but this episode of atrial fibrillation was to be the first of many over the next two years.

For the next year I focused on my lifestyle and replaced elements in my diet, all while juggling the hectic job of being a junior doctor.

I went on to suffer AF episodes weekly throughout my junior doctor training. I would often have to take medication to revert my heart rhythm, which had some unpleasant side effects. Despite these episodes I continued to work – nothing was going to stand in the way of me being a doctor. My condition was rare in someone of my age, so I was a very unusual case. I underwent multiple investigations to find a cause; stress tests, ECGs, cardiac MRIs, bloods, electrophysiology testing, echocardiograms, none of which revealed a reason for it. According to my doctors I was otherwise in ‘great health’.

After discussing my case with some respected cardiologists, I was offered a choice of lifelong medication or a relatively new intervention called an ablation, a procedure where an area near the heart is ‘burnt’ using an accurate fine laser. It carries some serious potential complications including stroke, perforation to the heart and death. Despite the seriousness of the condition, I could control the episodes with high-dose drugs while I decided whether to opt for the ablation. With the blessing of my cardiologists, I followed in the footsteps of my mother and self-experimented with some alternatives while I weighed up the option of having a procedure.

For the next year I focused on my lifestyle and replaced elements in my diet, all while juggling the hectic job of being a junior doctor. I read everything I could on associations between diet and my condition, and entered a new world of wellness. Out went cereals and toast for breakfast, in came dark green leafy vegetables with miso, nuts and seeds. Gone were the soggy sandwiches at lunch: I never left for work without my Tupperware brimming with cruciferous vegetables cooked in delicious spices and tasty fats. I began to realise the impact of stress on my heart, so I started meditating. I appreciated the importance of sleep, so I made sure (when I wasn’t on night shifts!) I was tucked up on time. More importantly, I never sacrificed my enjoyment for life. I wasn’t to be owned or dictated to by a condition. I wanted to take control of it … if I could.

My AF episodes reduced from one or two a week to zero.

On discussing my experiences with cardiologists, general physicians and lifestyle medicine practitioners it was hard to retrospectively pinpoint exactly what had happened to make the AF episodes stop. My increased vegetable intake likely replaced electrolytes and vitamins in my cells that were lacking. Eating cruciferous vegetables on a daily basis flooded my body with plant chemicals that we now understand have profound effects on DNA. I continued to drink alcohol on occasion, but I removed sugary drinks completely. My added dietary fibre is likely to have improved the functioning of my gut bacteria, which can lower inflammation via a variety of chemical pathways. I potentially attenuated the stress in my life triggered by poor sleep and a demanding job by increasing essential fatty acids in my food and practising mindfulness.

Rather than focusing on ridding myself of a condition, I had concentrated my efforts on providing my body with the best environment I could. I worked at being well in mind and body as much as possible. The complex interplay of food on our physiology, our DNA and even the microbes residing in our gut is a universe of science in itself. Without delving further into the analysis, what my experience reaffirmed for me was the immense power of lifestyle and the incredible ability of the body to ‘self heal’ if given the correct nutrition.

My family’s story, my personal story and those of the thousands of patients across the world who have managed to reverse and prevent disease using lifestyle medicine is my motivation for writing this book. This is my opportunity to share the information I’ve gleaned on my journey so far, and the journey I am still on.

Medical experience

My GP training was brilliant. I was experienced in multiple medical specialities, equipped to diagnose and skilled at providing emotional support. However, I was horribly inept at addressing the root cause of the biggest problems facing primary care across the globe: lifestyle-related illness, including diabetes, obesity and heart disease.

Beyond the ineffective recommendations of a low-fat, low-calorie diet we propose for weight loss and cholesterol control, there are no tailored diets for conditions. From my personal experience, I knew there was much more to food than just a collection of macronutrients and the simplistic view that we eat for energy purposes. I was ill equipped to give advice because nutrition training at medical school was lacklustre. So, to help myself and my patients, I decided to do the research.

I scoured journals, watched presentations, attended international nutrition conferences and began to unravel a magnitude of clinical evidence highlighting the impact of food on disease. I read thousands of papers, studies, editorials and books dedicated to nutritional medicine, and was shocked that medical schools cover this entire body of evidence in just a few uninspiring lectures.

I began to start my consultations by enquiring what patients would eat on a daily basis: how do you start your day? What time do you eat at night? Do you snack incessantly after meals? My clinics were more engaging and my patients loved the emphasis on nutrition. Convincing them that the key to longevity and good health was accessible using delicious recipes that I would tailor to their lifestyle, was motivational. I was able to inspire people to take control of their conditions through food in a way I hadn’t done before with just medications. I began to focus on promoting wellness habits, rather than just diagnosing disease.

My diabetic patients would improve their blood-sugar control, arthritic patients would lose weight and become more active and even those who had no significant change in their body composition felt better in themselves. Realising that I could combine my passion for recipe creating and flavour with a career dedicated to healing people was a revelation for me.

But, I couldn’t keep writing recipes for every patient in my consulting room. I was seeing over 40 patients a day, plus home visits, plus paperwork and prescriptions. It was just not sustainable. And that’s when the idea of ‘The Doctor’s Kitchen’ was born: a multi-platform resource inspiring patients to appreciate the beauty of food and the medicinal effects of eating well. A YouTube channel, Instagram account and blog where I could confidently direct patients to gain evidence-based information, lend my perspective on healthy eating and teach them how to cook their way to health.

An accumulation of poor dietary and lifestyle choices often leads patients to the emergency room and it’s partly my experience in A&E that’s brought me on this journey. It’s often a surprise to patients when their emergency doctor starts enquiring about their dietary habits, but acute care and chronic disease are related in many ways. Sometimes it’s a culmination of factors that results in tragedies like a heart attack, stroke or even a nasty skin infection that’s linked to poor diabetes control. Separating diet and lifestyle from acute medicine blinds us to the solution for our overburdened healthcare systems. I truly believe the answer lies in the quality of our community care where food plays a pivotal role. Practising good nutrition and lifestyle medicine means we can pre-empt disease rather than react to it in the emergency department.

Plates over pills

I want to make this clear so there is no doubt on this statement: food is medicine. It’s not my opinion, I’m not saying it because it’s fashionable and trendy, it’s quite frankly a fact.

We have a library of studies that demonstrate the effectiveness of nutritional interventions on lifestyle diseases that are society’s biggest killers. My job is to give you a flavour of the science and encourage you to value the importance of mealtimes. We need to understand that what we put into our bodies dictates how they function and deal with illness.

When I refer to food as ‘medicine’ I’m not talking about simply using ‘natural medications’ or food supplements instead of pharmaceuticals. I don’t advocate swapping your cholesterol-lowering drugs for a bag of nuts if you have abnormal biochemistry, for example. A traditional pharmaceutical model of healthcare where symptoms are treated individually is not the answer to our Western healthcare woes. It’s important that we don’t look at food like a ‘pill’. No magic bullet in the form of turmeric supplements, green tea shots or pomegranate juice exists, I’m afraid.

A complex interplay of diet, sleep, exercise and stress underlies the root cause of disease. This relationship between our environment and human biochemistry is alien to most conventionally trained doctors like myself, and we must redress the balance.¹ The reason why I’m so nutrition focused and I believe in the power of ‘plates over pills’ is because it’s the easiest, most cost-effective and evidence-based method of preventing and reversing disease. The effect of a Mediterranean diet on cancer,² diabetes³ and cardiovascular risk4,5 is a simple example of this statement in action. By improving patients’ diets we can drastically reduce the likelihood of all three common debilitating conditions to a far greater degree than any number of pills or surgical interventions.2,5

This is the direction in which medicine should be heading. Nutrition, along with other lifestyle factors, is where we need to concentrate our studies and resources. I’ve come across enough research and had enough personal experience in clinic with patients to judge that nutritional medicine is not a fringe concept. Dietary strategies are being trialled to reverse diabetes6,7 and even address the tricky and controversial subject of dementia.⁸ The added advantage of taking a nutritional approach to tackling disease is the beneficial upshot of eating well, compared to the many side effects associated with medications. I’m always plagued with guilt whenever a patient suffers an adverse side effect from medication, of which there are many examples, from swollen legs as a result of blood-pressure drugs to an increased risk of fractures related to antacid medications.⁹

In general practice there is a clear need for medications, but where a cost-effective, evidence-based alternative exists and has a plausible mechanism of action I would encourage us as a scientific community to investigate and embrace it. I urge physicians and patients to explore the multitude of other treatment methods before we succumb to medications for chronic conditions. This needs to happen. Healthcare systems across the Western world are crumbling under the weight of growing financial demands10,11 and no matter how much we invest in novel therapeutics we must always start with simple diet and lifestyle measures. I am here to empower you.

Discovering the plethora of studies demonstrating how effective lifestyle interventions are was revolutionary to me. In fact, our current guidelines for some of the most common lifestyle-related diseases reflect this. The first step to tackling diabetes, hypertension and high cholesterol according to the National Institute for Health and Care Excellence is ‘Lifestyle Change’.12,13,14 Yet most doctors wouldn’t know where to start when it comes to giving dietary advice and this poor ability to motivate our patients to embrace a healthy outlook is reflected by how over-medicated we are as a population. I’m convinced that our indulgence in pills over plates is a product of poor nutrition training in the medical curricula, which still stands at less than 20 hours of teaching during a five-year medical degree.15,16 If medical students were encouraged to learn more about the impact of lifestyle, we’d have a much healthier nation.17,18 Our lack of knowledge, short consultation times and patient demand for a quick fix creates a scenario where the easiest option is to provide pharmaceuticals. But, the first thing we should be asking before reaching for that prescription pad is, ‘What are you eating?’

Our population is plagued by obesity, stress and cardiovascular disease, and the prevalence of these conditions is rising fast.¹⁹ The answer to our epidemic of chronic disease is staring at us from the grocery aisles. I want to prevent the need for invasive devices, powerful prescription medications or painful procedures and offer a delightful alternative: eating fresh produce, colourful plants and igniting a passion for flavour! Best of all, the creativity and pleasure of preparing and eating good food is attainable for everyone.

The answer to our epidemic of chronic disease is staring at us from the grocery aisles.

Rather than using this section to bombard you with myriad papers, details of trials and large studies to prove a point, I’ve speckled all the recipes with bite-sized chunks of information to give you a sense of this interesting research. I’ve also included amongst the recipes some further information on my favourite ingredients and their amazing health benefits (see here). You might expect ‘health food’ to be bland and lacking variety, but I’m going to show you it’s the exact opposite. Flavour as well as function is what I’m passionate about, and diversity of ingredients is essential. Our health depends on it.

Health is not a privilege

As a GP in the NHS, I’m passionate about accessible healthcare for everyone. I am fully aware that people’s circumstances are different and there is a perception that using fresh produce and eating well is expensive and attainable only for the privileged. It doesn’t have to be.

Well-branded supplements, yoga on top of luxury hotels and eye-wateringly expensive turmeric lattes … You’d be forgiven for thinking a ‘healthy’ life was akin to an exclusive, invite-only club. Most of my colleagues expect me to cynically dismiss this trend. After all, it’s damaging to people’s self-esteem, it promotes an unhealthy attitude towards body image and excludes those in society that are the most vulnerable. But, actually, I believe we need to think beyond a ‘them’ and ‘us’ attitude. Despite its many flaws and shortcomings, the wellness industry has done an unbelievable job of motivating a generation of millennials to drink green smoothies, include kale as a staple in their shopping baskets, and exercise. No number of doctor visits could create such impressive behavioural change!

Without the allure of healthy living promoted by aspirational figures, ‘food in medicine’ wouldn’t have gained such attention in recent years. So, while doctors and health professionals can be damning of the industry, I’m grateful for the spotlight and want to know, where we can steer this trend in the future?

My aim is to make healthy eating inclusive and accessible to all. I personally witness a sense of elitism around eating well and many of my patients associate health with wealth. I’m constantly challenged in the consulting room by patients who believe they don’t have the time or money for a good diet. I see patients from all walks of life and let me share this with you: just because you are well off doesn’t automatically make you healthy, even if you can afford expensive ingredients.

Forget all of your preconceptions of ‘wellness’.

The most nutritionally dense foods are the least expensive on the shelf. These are the real ‘superfoods’ available in supermarkets, and that’s why I focus on them. Once you understand the principles of eating well, health doesn’t become a privilege. It’s a choice no more expensive than the average household can afford.

The most nutritionally dense foods are the least expensive on the shelf.

I’m proud to work with a lottery-funded community kitchen, Made in Hackney, to dispel these myths. We inform people about where to get local organic produce, veg drop boxes and, ultimately, how to use wholesome ingredients in our daily life cheaply and efficiently. As the only doctor in the organisation, I lend a clinical perspective to the kitchen sessions. It’s humbling to have the opportunity to explore people’s experiences of food in medicine and break the cycle of ‘can’t cook, won’t cook’ attitudes.

Think of the repercussions for public health if everybody nationwide had access to simple nutritional advice and was taught the fundamentals of healthy living? Healthy eating is attainable whatever your background. This isn’t an exclusive club; it’s how we shape the future of wellness.

Why I eat ‘plant-focused’

On social media people often mistake me for a vegetarian or vegan because I get so excitable about vegetables. I do actually eat all types of meat and fish but I focus my diet around plants.

Rest assured there is logical reasoning underpinning my enthusiasm for chicory, cabbages and – of course – the greens! Abundant in vitamins and minerals, everybody generally knows they’re ‘good for us’, but the story goes a lot deeper.

Phytochemicals, the chemicals found in plants, are another explanation for the incredible health benefits of fruits and vegetables.²⁰ These are what give plants their pigment, smell and, importantly, flavour.²¹ It’s the study of these chemicals that ignited my passion for nutritional medicine. A number of research papers look at their effect on inflammation,²² bone health²³ and even cancer.²⁴ We have only scratched the surface when it comes to investigating just how influential these thousands of bioactive compounds are to human health. But, looking at the associations between food and disease, the positive impact of diets largely based on plants and whole foods is indisputable.²⁵ This is why they make up the bulk of my daily plate and why they should feature heavily on yours, too.

Eat mostly plants and you’ll stand a better chance at living a healthier, more vibrant and fulfilling life, free of disease.

These compounds exist in a multitude of produce that is commonplace in grocery stores nationwide. Everything from a simple carrot to your basic apple is brimming with phytochemicals like quercetin and carotene.²⁶ These simple, affordable and accessible ingredients are key to good health. What’s more, eating plates of a variety of colourful plants is the easiest way to guarantee a complete range of these phytochemicals,²⁷ which is why my dishes appear so vibrant. Using a multitude of herbs and spices (which have their own health benefits) to complement the ingredients is an easy undertaking for a home cook once you know how.

Having sifted through piles of studies involving thousands of people (followed up for years) and experiments examining the biological mechanisms behind the health-promoting effect of food, I can tell you the evidence is convincing. You can lower your risk of stroke, cancer and heart disease by increasing your fruit and vegetable intake.28,25,29,30 Eat mostly plants and you’ll stand a better chance at living a healthier, more vibrant and fulfilling life, free of disease.

I enjoy animal protein of all varieties – fish, poultry, chicken, game and beef – about once or twice a week. Animal products are an easy and delicious source of complete proteins. Key micronutrients such as zinc and vitamin B12 are nutritional qualities very hard to obtain in purely plant-based diets.³¹ But, I see meat and animal products as a luxury item in the same way our ancestors would have treated them.32,33

On the subject of meat, I do have concerns about the harmful effects of cheaper mass-produced livestock on our health and the environment. On balance, a stressed, improperly reared animal is not likely to be good for us despite the benefits of convenient protein and nutrients. The type of feed, use of medications and the space an animal has been allowed to roam in all have an impact on their health and can negatively impact ours.³⁴

The most well-studied diet we have access to has examined the eating habits of thousands of patients over decades. That is the Mediterranean diet. I am unapologetic for it not being a new, sexy, alternative eating plan that will grab headlines. Instead, it’s solid, evidence-based nutritional advice about how the majority of us would benefit from eating.³⁵ It’s a launch-pad to start a healthy lifestyle journey, I know it’s safe and … it’s actually quite vegetarian! It doesn’t mean piles of pasta, bread and quick-releasing carbohydrates. It focuses on plant-based sources of protein and fibre, such as nuts and legumes, good-quality fat and a limit on meat intake.³⁶

Eating based on the principles of a Mediterranean diet is a good starting point, and is one I personally follow. For these science-grounded arguments, I think focusing meals around plants is a good, well-established entry point for most people.

Instead of pushing a particular dietary dogma I want to encourage you to choose a fitter lifestyle by tempting your taste buds rather than making you eat vegetables because you feel you ought to. This way of eating doesn’t have to be boring. I’m using the principles of this diet to create enticing multi-ethnic dishes that you can tweak according to your preferences. This journey is not limited in its culinary scope and I hope to show you why it’s also medicinal.

Plant-based protein

As I eat a largely plant-based diet I’m all too familiar with the question, ‘So where do you get your protein from?’ It’s imperative to bring attention to all the amazing sources of plant-based protein available to us. A more pressing public health concern is actually the lack of nutrient density in our diets, not to mention a lack of fibre. Fortunately, plants that are high in protein also have a large amount of fibre and a wealth of other health-promoting plant chemicals. I still enjoy meat and fish, but the majority of my protein comes from a selection of these wonderfully delicious plant sources. Here are some of my favourites.

Health is in the gut of the beholder

I want to take you on a journey through recent scientific discoveries in nutrition that are shaping our knowledge of food in medicine. We could not start anywhere more exciting than with our digestive system.

Despite the exhausting and confusing gut-health messages in the media, the science behind our microbiome (the population of microbes that live in or around the body) is compelling. Studies looking at the microbiome have accelerated over the last decade and doctors are calling it ‘the forgotten organ’.³⁷

The trillions of microbes (including fungi, bacteria and viruses) largely concentrated in our colon are thought to protect us from infections,³⁸ break down molecules of food,³⁹ create neurotransmitters and even alter our immune system.40,41 These microbes could impact diseases as far-ranging as dementia⁴² and diabetes.⁴³ Neurologists, endocrinologists and psychiatrists are all looking at gut-focused treatments for a range of conditions we never thought were related. Even critical-care specialists who work in intensive care are getting involved in the conversation about how the gut impacts treatment of the sickest patients in hospital.⁴⁴

The hype is real. Gut health is very important and the current discussion in medicine is going far beyond the expensive yoghurt drinks on supermarket shelves. Rather than a fad, I see the popularity of foods to help our microbiome as a return to traditional methods of eating that our ancestors developed. And there’s evidence for this across all cultural backgrounds. In Japan, pickled ginger is consumed with sushi and miso broth is prepared before large meals. Indians drink fermented yoghurt-based drinks (‘lassi’) and eat a range of pickles with curries. Middle Easterners enjoy kefir, Nordics have smörgåsgurka and Koreans love their kimchi. Spotting a trend? Fermented foods have a long, well-established history throughout different societies’ eating habits, but a lot has changed in Western diets.

Food just doesn’t have the same qualities it used to. We pasteurise, radiate and add a ton of additives to processed foods to make them sterile for convenience and shelf life. All of which have been shown to negatively impact the microbiome.⁴⁵

This concept of bacteria being beneficial is alien to a lot of people because we’re taught to think of them as harmful. But the vast majority of bacteria that live in our body are performing vital functions that allow us to maintain our health. These bacteria are in constant communication with our own cells and it’s important we look after them. I want to encourage you to eat foods that protect and boost your microbiome while introducing bacteria back into your diet.

Eating a diet that nurtures our microbiome is what the current research lends itself toward, but that does not necessarily mean you need to consume expensive supplements and tinctures. Instead, here are some evidence-based and safe dietary interventions to improve your gut health … deliciously!

Eating a diet that nurtures our microbiome is what the current research lends itself toward, but that does not necessarily mean you need to consume expensive supplements and tinctures.

• Prebiotic foods are where the power is! These are specialised types of fibre that are indigestible by the human intestine, but our microbes are able to break them down. Prebiotic fibres essentially feed our microbes and keep them healthy. Not only are they cheap and accessible, they bring a wealth of different flavours and textures to a meal. Jerusalem artichokes, asparagus stem, flax, chicory, wholegrains and pulses are great examples of fibre-rich foods your bugs and taste buds will love, and this book is full of examples of how to get them into your diet. I make everything from stews, meatballs and roasts from these ingredients. This ‘health’ food is delicious and easy to incorporate into your way of eating. Plus, by generally increasing all types of fibre, we can potentially reduce the incidence of cancers, cardiovascular disease and inflammation of the bowel.⁴⁶

• Probiotic foods taste delicious and are a natural way of introducing live bacteria into your body. Despite the popularity of probiotic capsules and powders it’s important to remember that none of these products is created equal. It’s true that some research has shown benefits for urinary-tract disorders⁴⁷ and irritable bowel,⁴⁸ but the study of which bugs can potentially impact a condition is still very much in its infancy.49,50

For now, I encourage experimenting with different ingredients like traditionally prepared kimchi, sauerkrauts and probiotic yoghurts that are full of different strains of bacteria that may have benefits.51,52,53 Look for unpasteurised varieties usually found in the fridge section of supermarkets. Experiment by folding them through salads or simply adding them to the side of a dish as a garnish. They can complement the simplest of dishes and add another dimension of flavour.

I see the popularity of foods to help our microbiome as a return to traditional methods of eating …

• Polyphenol-rich foods like cacao, dark green leafy vegetables, beetroot and green tea are richly coloured and intensely flavoured ingredients that bring a host of benefits to your body.⁵⁴ Polyphenols are chemicals we find in plants of which there are literally thousands. Some of them have been shown to improve the gut lining, encourage growth of microbe patterns that are beneficial as well as have other advantages to general health. My recipes are designed to incorporate as many different polyphenol-rich foods as possible.

• Spice your food. Turmeric, cumin, sumac, cinnamon and caraway are just some of the ingredients that improve the aroma and taste of foods, but spices in general are another source of polyphenols. We’ll talk more about them in the Medicinal Spices section (see here), but for now consider that the inclusion of these fabulous ingredients could potentially have positive effects on your gut bugs by reducing inflammation.⁵⁵

• A varied diet is key. Your microbes thrive on new, interesting foods, which is why eating seasonally, for example, may encourage you to change things up throughout the year. We want to make sure your microbes are not bored with having the same meals and studies suggest they tend to favour diversity!56,57 There appears to be an improvement in the range of gut bacteria populations when a variety of foods are consumed, so here’s yet another reason to try out some gorgeous, colourful recipes and mix things up.

• Raw foods. I’m not a raw foodist, nor do I advocate a completely raw diet. And, contrary to popular belief, cooking doesn’t destroy all the micronutrients in foods. Sometimes, cooking can actually increase the availability of phytochemicals,⁵⁸ like in the case of tomatoes⁵⁹ and broccoli.⁶⁰ But, having some raw foods in your diet like celery, kohlrabi or radicchio is great for the bugs. It makes another argument for not overcooking your vegetables and keeping a little more texture to your food, too. Nobody likes overcooked sprouts!

When it comes to a holistic approach of how to look after our microbiomes there are some other suggestions outside of our diets that I encourage patients to think about as well.

• Avoid antibiotics. Your doctor is trained to recognise and prescribe these when there is a clear need for them, but far too often we see them used inappropriately.⁶¹ Antibiotic medications indiscriminately remove large proportions of bacteria including the beneficial types that are good for us,⁶² so I always encourage a reserved attitude to using and requesting them. You are more likely to convince your doctor to hand them over inappropriately by pressuring them, than if you trust their pragmatic and informed decision.

The Royal Colleges of medicine and editors of medical journals are very aware of the growing problem of antibiotic resistance.⁶³ The huge impact on our gut microbe population64–67 is another reason why the medical community is trying very hard to reduce antibiotic use. Our microbiome is integral to health and antibiotics have far-reaching implications that we are just beginning to realise the magnitude of. So, for now, trust your doctor’s opinion and keep in mind that while you’re on antibiotics it’s even more important to follow my suggestions to keep your microbiome as nurtured as possible.

• Refined carbohydrates, sugars and sweeteners all have a number of links with poor health outcomes. Their effect on your microbiome is an addition to the growing list. I would exercise caution for any ‘diet’ versions of popular drinks and any foods with synthetic sweeteners as they can adversely affect your microbes.⁶⁸ I still use a little sugar in recipes as an ingredient to heighten flavour and taste because it’s not a bad thing when used sparingly. But there are clear disadvantages to consuming it in excess, and indulgence will affect your microbiome population for the worse.⁶⁹

• Exercise, laughter and mindfulness are not what you’d typically expect on a conventionally trained doctor’s prescription pad, but it’s definitely on mine! As well as the wealth of positive effects on mental health and wellbeing, daily meditation and exercise may also have a positive impact on the microbiome.⁷⁰ You don’t need to wear fluorescent leggings and stare blankly into the abyss. Mindfulness is any action that quietens your inner thoughts and allows active mental rest. Try a guided meditation app, breathing exercises or simply gardening as a way of releasing inner tension and letting the mind relax.

The science examining our microbiome is accelerating at an incredible pace. I’m sure we will learn more in the coming years about how to nurture this inner population that is inseparable from our wellbeing. I truly believe that future approaches to medicine will involve a significant appreciation for ‘gut health’. My recipes will show you how to keep your gut bugs happy, which will ultimately have a wealth of good effects for you.

I’ve written more about these lifestyle changes on my website: www.thedoctorskitchen.com

Fibre champions

We need a greater awareness of where we can get fibre into our diets, and these are some of my absolute favourite fibre-rich ingredients. The official recommendation is at least 30g of fibre per day, but I see that amount as the bare minimum.

Food is information

Our culinary journey through food in medicine could not be complete without visiting the topic of how food and lifestyle affect the very foundations of our existence.

Genes, made up of DNA, are what we inherit from our parents. They are the molecular code for characteristics such as how we look, the likelihood that we will get a chronic disease and even our behavioural traits. They also regulate intricate processes in the body, such as how we deal with inflammation and remove cancer cells. Vitamins and minerals, as well as things such as sleep quality and stress, can all impact the factors that alter the expression of our genes for better, or worse, health.

What has this got to do with food? Everything.

Micronutrition and the timing of when we eat as can alter our gene expression.71,72 Our food is constantly communicating with our DNA.

This area of research is adding yet another layer of complexity to the scientific study of why and how what we eat affects our health. There is a wealth of information available on this subject far beyond the remit of this cookbook! If you are interested, I have extra information on my website, www.thedoctorskitchen.com, including links to reading materials on subjects such as nutrigenomics, nutrigenetics and epigenetics.

Despite its complexity, I included this section because I want you to appreciate the incredible effect food has on our longevity. I want to share some insight into the fascinating studies that have framed my understanding of how food has positive effects on our bodies.73,74 It explains why I try to weave certain ingredients into my dishes that tick the boxes for both flavour and function. By including these delicious ingredients in our diet we can potentially affect our genetic functioning for the better.⁷⁵ Today, we can start this colourful and enjoyable journey toward good health.

I hope this motivates and inspires you to look at adapting your diet as a powerful, positive intervention. On a personal note, learning more about this field of study encouraged me to increase my intake of certain foods and explore lifestyle practices that may improve the functioning of my body. I believe that if we focus on wellness and introducing health-promoting foods and activities, the body has incredible potential to look after itself, as has been my personal experience. It’s so empowering to know that despite our genes, we have the ability to steer the direction of our destiny using lifestyle.71,76 Food is integral to this process. It is the cornerstone of healthcare and one of the biggest joys in life.

So, what do we need to eat to improve our gene functioning? In a very general sense, ensuring we have a variety of micronutrients (vitamins and minerals) is the best way to ensure proper functioning of our cells and expression of our genes. Our understanding is still basic and there’s a long road ahead, but there are some key diet and lifestyle measures that we can all incorporate to ensure the correct functioning of our bodies. The good news is, these micronutrient-dense foods are tasty, cheap and easy to cook with. Here are some examples of foods I encourage my patients to eat regularly, and a snapshot of the science that explains why.

+ A WORD OF WARNING

Already, there are tools you can buy that can read your genetic profile and claim to give you tailored nutrition advice online, but I suggest treating these with caution. Simply looking at genetic profiling in isolation is a narrow perspective to take and it’s not as simple as ‘eating to beat your genes’. Health outcomes are the result of a complex interplay of food, gut health, environmental stressors and many other variables. The future of medicine is definitely personal⁷⁷ and I’m certain it will soon become the norm to have these tests, but they have to be taken in the context of the individual’s circumstances. We are sophisticated machines with multiple pathways beyond our genes that we need to consider, but it doesn’t stop me from getting excited about the future application of these tools for practitioners.

Greens for your genes

Romanesco cauliflower, cabbages of all kinds, pak choy, rocket leaves, broccoli, broccoli sprouts, Brussels sprouts, cavolo nero, kale, chard…

Everyone knows that these greens are ‘good for us’. It has been drilled into our heads since childhood. But, apart from fibre and vitamins, greens have a wealth of other properties. Cruciferous vegetables (also known as brassicas), in particular, are known for their sulforaphane content. Sulforaphane is a plant chemical currently being researched for its ability to stabilise cells and protect against cancer. It also appears to impact a master regulator of genes involved in reducing cancer activity.⁷⁸

But this is merely one of the hundreds of compounds involved in the mechanism of why greens are ‘good for us’. Cauliflower, broccoli, broccoli sprouts and rocket leaves all contain sulforaphane, plus a whole lot more that hasn’t yet been fully investigated. And these vegetables don’t just contain novel chemicals; they are also full of micronutrients like magnesium and folate which are vital for repairing and producing DNA.79,80

One of the key features of the influential Dean Ornish study⁷³ that showed lifestyle changes could promote genes that fight cancer, was a plant-focused diet high in cruciferous vegetables. Best of all, these ingredients can taste wonderful with the right spices, herbs and cooking techniques to moderate their naturally bitter taste. You’ll want to have these affordable foods every day.

Spice your DNA

Herbs and spices are what make cooking and eating so pleasurable. In Middle Eastern cuisines, they often serve fresh herbs alongside tagines and stews to complement the rich, earthy flavours. Vietnamese food is commonly presented with a side plate brimming with mint leaves and whole coriander stems. Our Indian version of a salad (see here) includes sliced red onion, fresh lemons and, of course, raw chilli. As a child, I would watch in awe as my father ate small bites of whole green chilli with his meals. I still haven’t quite acquired the taste for this level of heat!

Fresh leaves are more than just sharp flavour notes to accompany a meal. Simple herbs like parsley, for example, contain plant chemicals called flavones.⁸¹ These are known to promote the activity of genes that are responsible for suppressing inflammation,82,83 a key feature in conditions like cancer and diabetes.

And it’s not just parsley … rosemary, turmeric, ginger, oregano, onion and garlic are also abundant with health-promoting chemicals including epigalletins, quercetin, luteolin and others with equally long and confusing names.⁸⁴ To cover just our limited knowledge of all these compounds and their potential uses would fill volumes of books.

I don’t want to steer you in the direction of only eating particular foods to alter your gene activity – I simply want you to appreciate the immense power of everyday ingredients. Herbs and spices are very much part of that line-up. So, when you look at my recipes, notice how highly flavoured and spiced they are. There is a method behind these flavour-packed dishes.

Colour your plate

I’m passionate about colours. They truly represent the complexity and beauty of food. Beyond their spectacular visual display and abundance of antioxidants, colourful foods are exceptionally important for us for their effects on our genes.⁷⁵ Plant chemicals (also called phytochemicals and phytonutrients) are responsible for these beautiful pigments and are usually found concentrated in the skins of fruits and vegetables.

We know that reducing inflammation is hugely important when it comes to longevity and reducing the risk of diseases ranging from dementia to depression.⁸⁵ An example of a plant chemical that gives food a vibrant, red colour is anthocyanin.⁸⁶ You’ll find this in everything from beetroot and wild berries to red onion (not just pomegranate juice and acai powder!). Anthocyanins are known to activate the gene responsible for heightening antioxidant activity which can prevent against cancer.⁸⁷ It is an incredible ingredient, but one of literally thousands that could be just as impressive.

Rather than using a reductionist approach to the science that concentrates on the benefits of singular compounds, I implore you to remember that all foods have a number of chemicals in varying amounts that are wonderful.⁸⁸ Variety and nutrient density is the goal here. Don’t focus too much on exact lists of ingredients and their chemical attributes. Choose vibrant colours and foods that you and your family will enjoy to reap the benefits of nature’s gifts. And remember … don’t throw away the skins!

The power of your microbiome

The microbiome is a feature of our health that we’ve already visited (see here). It is the name we give to the trillions of microbes (mostly bacteria) that reside all over our body but mainly in the gut. Because of the sheer number of microbes in this population, your microbiome consists of over 100 times more genetic material than your own.⁸⁹ This population has immense impact on the health of your body and mind because the microbiome genetic code is quite literally communicating and interacting with your own.90,91 The scientific community has only started appreciating this information over the last 20 years. The most exciting feature is that although we cannot change our own genetic information, the genes and health of our microbial population can be altered by environment and that affects the expression of our DNA.⁹²

This may all sound quite fantastical – the fact that our destiny is in our hands. We are quite far away from precision treatments that alter the microbiome for specific health outcomes, but science tells us that if we eat and live according to principles that help our microbiome population thrive, we live healthier lives and are less likely to suffer disease. One of the probable reasons for this is because the microbiome has an ability to positively affect the expression of our DNA. Nurturing your gut health (see here) could prove vital in disease prevention and treatment.

Lifestyle for genes

• Sleep is integral to health. It’s also very impactful on our microbiome and our circadian rhythms that affect our biology and gene expression.⁹³ Melatonin is a hormone (produced during adequate sleep) which activates and regulates hundreds of genes involved in repair, antioxidant function and, you guessed it, inflammation.94,95 Sleep does far more than just let your muscles repair and brain recuperate; it’s essential for protecting you against disease. So, practise good sleep hygiene: try not to eat or use electronic stimuli two hours before bed, and sleep your way to health.

• Fasting is a practice made popular by diets like 5:2 and proponents of ‘ancestral eating’ that aim to mimic the lifestyles of former hunter-gatherer populations. While I take issue with blindly following a standard diet, fasting is a component of these regimes that may have some legs. Incorporating a fasting practice into your eating habits has been shown to improve the expression of genes that are responsible for removing oxidants that cause inflammation and turning on genes that fight cancer cells.96,97 But fasting doesn’t need to be a tedious feat where you remove all sources of energy for a 24-hour period. I’m a fan of defining your eating period to 10–11 hours per day. For example, if you were to eat breakfast at 8am, try not to eat dinner later than 7pm. Getting into a routine where you have the same ‘defined eating period’ on a daily basis may have benefits by heightening the expression of genes that control sugar and lead to greater longevity.98,99,97 Most of the studies also found that participants lost weight and this has obviously generated a lot of attention, but in my opinion losing weight isn’t necessarily always the goal. If we focus on introducing health-promoting habits and wonderful nutrition I am certain you will lose weight, but more importantly it will be enjoyable, safer and much better for your overall health. Wellness is the goal rather than a desired number on a set of scales.

• Mindfulness doesn’t have to be cliché. My father grew up on a farm. He would wake up before dawn every single day and in his sleepy state make the short walk to the farm where he would duly milk the cows for the family’s breakfast and butter-churning routine. This could be considered an example of mindfulness. An activity which removes thought and reason, and incorporates routine. Where the mind is quiet, restful and unstimulated.

Buddhists sweep. Beach bums surf. Commuters listen to smartphone apps. However you decide to practise it, mindfulness has never been so important as it is in now, in today’s world of excessive electronic use and hyperactivity.

We live in a perpetual state of anxiety, provoked by constant stimuli, and I believe meditation is key. One of the most impressive research studies I have come across was a small experiment looking at a group of people taught to meditate over a three-week period. Using a specific gene marker to measure the inevitable ageing process, they discovered that the meditation had improved the marker that was expected to naturally worsen.100,101 Meditation has been hypothesised to have a literal anti-ageing effect.¹⁰² If an intervention can alter gene activity to that extent, it has a place as a ‘medicine’ in my opinion. So, decide on your meditative strategy and practise it for at least 10–20 minutes each day. You should find it has a calming effect on your mood, even if we can’t conclusively prove its effect on wrinkles.

We live in a perpetual state of anxiety, provoked by constant stimuli, and I believe meditation is key.

Diet choice fatigue

I’ll let you into a secret you probably already know by now: there is no such thing as a ‘perfect diet’.

We are all unique as a result of our cultural backgrounds, genetic variations and even gut microbe populations. Our physical attributes are the sum of so many variables, it is unfathomable to think that any one regimen would be suitable for an entire population.

Our diets are fluid, ever-changing interactions that involve the environment and even our life cycle. The food we eat is dictated by geography, convenience and personal choices. Our nutritional needs are determined by age, hormone profile and emotional state, and that’s before we even start considering medical conditions. We are complicated beings. Forcing ourselves to rigidly stick to a list of foods that are labelled ‘good’ or ‘bad’ will never reflect the intricacies of our requirements.

My goal is for you to enjoy food and appreciate the phenomenal effects it can have on your body, your mental outlook and overall health. I’m not here to scaremonger you or belittle any successes you may have had with previous experiences of diets; if you have used one of these in the past and felt better, that’s fantastic! As long as you feel healthy, it fits into your lifestyle, and it doesn’t lead to a nutritional deficiency or personal risk of disease, you’re doing a great job. I’m not here to warn you off a way of eating that works for you and I’m very open-minded to the success of certain diets for different people. As a doctor, I just want to make sure you’re safe and healthy.

If you’re new to this world, I want you to understand the importance of individuality. I would rather empower you to create a unique way of eating that caters for your requirements, than suggest you follow a ‘one-size-fits-all’ approach.

Eating is a lifestyle, not an uncompromising ‘diet’. It’s a personal and experimental process that needs adapting as you and your environment change. This book, or any other book for that matter, will not contain the answer to everyone’s dietary requirements. But don’t despair! I’ve included principles of eating here that I think are applicable to most people, then the tweaking of elements really depends on you. Seek appropriate advice and get a second opinion if you have concerns about a specific medical condition.

Most diets out there promote a way of eating that is generally better than the typical Western diet of refined carbohydrates and a lack of fibre and micronutrients. So, no wonder there are so many success stories with a lot of them! This doesn’t necessarily validate these diets as a way of eating for all of us. But, it’s likely that you’ll incorporate elements and principles from a variety of diets to create the perfect way of eating for you. Because I get asked about these in clinic all the time, I’ve decided to give you my opinion on the most popular diets around: the good, the bad and the science that doesn’t always stack up.

Just cut the carbs!

+ Paleo, Low-carb high-fat, Atkins, South Beach, Ketogenic I know proponents of each of these diets will argue that these shouldn’t be grouped together because there are slight variations between each, but for simplicity’s sake, I have. Patients don’t appear to differentiate between them and lately I’ve been hearing the same line in my surgery: ‘So, Doctor, I’ve decided to cut out carbs. That’s good, isn’t it?’ Well, not necessarily.

The principles of Paleo, South Beach and Atkins are quite similar. They revolve around reducing your intake of carbohydrate and replacing it with varying proportions of protein and fats, with ‘low-carb high-fat’ (aka LCHF) and Ketogenic diets being the most excessive in terms of fat consumption. They’ve been reported in clinical studies to improve markers of diabetes103,104 and famously autoimmune disease¹⁰⁵ in a number of protocols. The most exciting promise for Ketogenic diets is in treating childhood epilepsy and chronic pain.106,107

I think these types of diets do have a place for certain people looking to re-sensitise themselves to insulin after a longstanding over-indulgence in refined carbohydrates and sugar. There is small-scale evidence to show its potential in improving diabetes, insulin sensitivity¹⁰⁸ and symptoms of PCOS.109,110

However, there is some evidence pointing toward high protein intake being similarly harmful as high carbohydrate intake, which is the trap a lot of people fall into when following these diets.¹¹¹

And let’s not forget the side effects that include: constipation, halitosis, nausea, renal stones, osteoporosis and a potentially increased risk of bowel cancer (among many others).

A lot of people can’t maintain the diet for these reasons, and when they return to eating carbohydrate there appears to be a trend toward regaining all the weight they had lost with potentially worse outcomes and health risks than before they began.

On balance, long-term evidence to advocate these diets is lacking. Essentially, it’s a temporary fix. I appreciate the potential therapeutic value of these diets as a short-term strategy, but personally, I think a diet concentrated on plant nutrition far outweighs one focused on meat. More research is needed to validate the claims of these diets that drastically remove beneficial carbohydrate sources, and the lack of fruit, vegetables and fibre is something that would concern me. We know fibre is essential for proper functioning of our digestive system: our microbes feed off these materials and lack of fibre puts us at risk of bowel cancer.¹¹² For those reasons, I can’t condone low-carb lifestyles long-term, but I don’t doubt that some people have found them beneficial and they may have a role in clinical care.

SIRT diet

While I welcome excitement about foods that have the potential to impact our genetic make-up, the SIRT diet’s focus on a small list of foods impacting some genetic pathways detracts from how multifaceted and complicated human nutrition is. ‘SIRT’ genes are what this diet is named after and increasing the activity of these genes (and the proteins they code for) is thought to reduce inflammation, control blood sugar and has been linked to reducing cancer risk.¹¹³

Yes, parsley, dark chocolate and green tea all increase SIRT gene expression but they also contain catechins, luteolin and a host of micronutrients that are essential for processes in our body’s cells. As do lupini beans, cavolo nero, broccoli, coriander, chilli and a whole bunch of foods that don’t fit a particular list. I think it completely misses the point to focus on an exclusive group of ingredients, and it doesn’t encourage a healthy relationship with food. Every ingredient deserves a platform.

Our grocery aisles are lined with unbelievable health-promoting foods, our seasons provide constant variety and our multicultural society introduces spices and herbs from across the planet. As I alluded to in the previous section, we are merely scratching the surface when it comes to the importance of different interactions between ingredients and our genes. I could have quite easily picked out a few fruits, vegetables and spices affecting one of many inflammatory pathways and called it the ‘NRF2 diet’, or how about the ‘TNF diet’? The Telomere diet? Do these sound scientifically valid enough?

The interaction between food and our genetics is a fascinating field.¹¹⁴ But it is one layer of a multi-faceted process that I haven’t made the cavalier attempt of trying to explain in its entirety. It certainly cannot be explained with one set of genes. Don’t let yourselves be patronised. Our understanding of these pathways is minuscule at best¹¹⁵ … and don’t get me started on ‘juice cleanses’!

The interaction between food and our genetics is a fascinating field.

5:2 diet

The science used to formulate intermittent fasting diets like the 5:2 diet is impressive.¹¹⁶ There appear to be benefits of cyclical fasting,117,118 but our way of eating needs to be sustainable¹¹⁹ and more importantly, enjoyable. Who wants to endure restricting themselves on a weekly basis … for life? I am convinced that some people have found benefits from this practice,¹²⁰ but if I were to tell the majority of patients I see in clinic to reduce their calories to 500 for two whole days, I know exactly where they’d be telling me to go!

And this brings me nicely to another topic. I don’t count calories. For the majority of people it’s a complete waste of time because it shifts the focus toward indiscriminate numbers on packets of food and away from what is actually important: the quality of food we introduce into our body. Clearly, a bag of sugar compared to an equal calorie content of spinach is going to have drastically different effects on our body. Calorie counting does not account for this difference. It focuses unnecessarily on a logic that was once thought to be scientifically accurate but is now shown to be flawed in many ways.

+ A NOTE ON CALORIES

The long-held idea that excessive calorie consumption leads to weight gain and reducing calories leads to weight loss is simply not accurate. Also, the metabolism of food is likely to differ from person to person depending on a host of factors such as their microbiome population, their genes, activity level, timing of meals and many other variables. A 200-calorie lunch isn’t necessarily ‘healthier’ than the 500-calorie one, and two identical calorie meals can have entirely different metabolic effects. The majority of people I see in clinic do not need to diligently measure and obsess about these numbers.

When we encourage concentrating on calories, or even the Glycaemic Index (GI) of foods, we lose sight of the bigger picture. People find themselves picking up ready-made desserts and putting down bananas. This is madness. There is a huge difference between the metabolic effect of packaged meals and a whole food. Diets that promote this are not educative and they serve to confuse rather than inspire, with dire consequences. Relax, cook as often as possible at home using whole ingredients, and put the calorie counters away.

Fasting, and the variations of fasting practices¹²⁰, is an interesting area and warrants further research. But, what I think is potentially as effective and easier to incorporate into daily working life is the concept of defined eating periods.¹²¹ A time period during the day when you eat versus a period when you do not eat. Research also shows that the simple effort of ensuring you eat at regular times and within a 10–11-hour window can reduce your risk of diabetes and cardiovascular disease.¹²² It stabilises insulin release and leads to less fat around the organs (which is dangerous). It makes logical sense to me and a lot of my patients are easily able to slot this convenient ‘fasting’ practice into their eating habits that doesn’t require obsessive calorie counting or restriction.

Alkaline diet

I’m going to give you some insight as to why there is such a divide between physicians and the wellness industry. When non-medically trained, self-styled, health ‘gurus’ are given a platform to influence people into believing they can change their blood pH with a diet high in alkaline foods, it is incredibly frustrating. You can change the pH of your urine using food, but the suggestion that this diet has a miraculous, transformational total-body effect is a huge oversimplification of the science.¹²³

Fundamentally, this diet encourages us to eat more dark green leafy vegetables and generally healthier foods, which isn’t a bad thing.124,125 However, people deserve to be educated and told the truth about how food interacts with our biochemistry, instead of being duped into thinking this is how our bodies work. When you’ve spent time in intensive care, learnt about the complexities of acid-base balance in ill patients and tried to get your head around how complicated pH control is,126,127 you can understand why the use of alkaline theories to promote products annoy doctors all round. We have intelligently evolved organs that precisely control our blood pH using mechanisms that still continue to amaze me.

Introducing ‘alkaline’ foods such as brassica vegetables and colourful fruits is fantastic, but rather than just focusing on ‘alkalinity’, we should appreciate the phytochemical content, the fibre and micronutrients like folate and magnesium. We also need to consider the relatively low sugar content and the endless chemicals that we haven’t yet fully investigated. Focusing on ‘alkalinity’ confuses the matter and I fear it will create an obsession among patients akin to calorie counting. I am an open-minded doctor, so perhaps one day we will learn more about ‘alkalinity’, but for now the science just does not support these claims.128,123,129 I would have great reservations for the liberal use of these ideas, especially by those who cannot appreciate the scientific controversy.

Low Fat/Slimming World/NHS Choices

The medical profession’s obsession with reducing the fat content of our food and encouraging processed, low-fat options over the past few decades has probably been the most effective, yet destructive, health campaign of all time. It’s a message I myself have been guilty of promoting. An over-indulgence in calories, particularly from fat, combined with apathy toward exercise was the generally accepted explanation for why patients were overweight and sick. It was arrogant and naïve to accept this assumption that gluttony was the underlying cause of patients’ illnesses and not question its legitimacy. It’s obvious, now, that this was not correct.130,131

Hydrogenated fats, ‘cholesterol-lowering’ products and sugar-laden alternatives that we promoted are terrible options for the vulnerable cohort of patients we were trying to help.132–135 The recommendations for extreme restriction of saturated fat, cholesterol and total fat are now becoming obsolete and further analysis is proving fat not to be as detrimental to health as we once thought.136,137 The morbid result of our fixation with replacing fats with refined carbohydrates and sugar is exemplified by our current lifestyle-related disease epidemic.¹³⁸

However, the restricted fat message still exists, particularly among supporters of plant-based lifestyles. To their credit, some small studies demonstrate remarkable cardiovascular disease reversal and cancer improvement using fat restriction and lifestyle change.139,73 On the other hand, the Mediterranean diet, one of the largest and longest studied of eating habits, comprises three times more fat than ‘fat-restricted’ diets with – again – impressive cardiovascular, cancer and diabetes protective effects.50,48

My honest opinion is that we shouldn’t fear fat. We don’t exactly know why some people thrive on low fat intake while others suffer, but I’m certain it comes down to the individual.¹⁴⁰ Your environment, gut microbes and ancestry play a major role in predicting the success of any given diet and lowering your risk of disease, but I believe a good proportion of good-quality fats are essential to health.

+ RETHINKING FATS

Fats, including cholesterol, are vital to the functioning of our brains, the composition of cell structures and essential for hormone synthesis. Reducing them to ‘good’ and ‘bad’ fats completely negates the science and lacks an appreciation for how complicated our bodies are. My belief is that a high-sugar, refined-carbohydrate diet in combination with poor-quality fats is the cause of ill health.¹⁴¹ This toxic blend causes inflammation and a cascade of medical problems thereafter, but like a lot of topics in nutrition, the explanation is fraught with complexity. Our thinking about how dietary cholesterol affects heart disease is also changing.142,143,144 Consuming cholesterol, which is only found in animal products, does not necessarily increase the level of cholesterol found in your blood nor increase your risk of heart disease. I know this is quite hard for a lot of people to accept, given the dietary dogma most of us have been subjected to over the last 40 years, but it is based on evidence. Equally, I don’t recommend people actively try to consume more cholesterol. We need to learn from our past mistakes of damning an entire macronutrient to the extent that people are scared into radically removing it, but what I am witnessing now is a swing of the metaphorical pendulum in the opposite direction! Even though butter has been exonerated to some degree, you won’t find me spooning it into my coffee – I like my Americano freshly brewed without lipid-rich particles floating in it, thank you very much. For simplicity’s sake, I stick to the types of fats found in the Mediterranean diet which is packed with nuts, seeds and, of course, extra-virgin olive oil. My simple mantra to patients is: eat whole food and stay away from anything that’s marketed as ‘low fat’ or ‘a healthier alternative to …’ Your body is worth more than those cheap, tasteless alternatives. Some quality fats to enjoy in the context of a whole-foods diet include those found in flaxseeds, nuts, seeds, avocado, extra-virgin olive oil, butter from grass-fed cows, full-fat yoghurt and delicious dark chocolate.

Veganism

In recent times plant-based eating has become exceptionally popular. A number of documentaries have convinced many people of the supposed health benefits of veganism and the health risks of red meat. They do have a lot of successes to feel smug about, that are well documented in the literature. Lower rates of cancer,¹⁴⁵ diabetes,¹⁴⁶ cardiovascular disease¹⁴⁷… the list goes on. It’s compelling stuff and, obviously, I’m a huge supporter of a diet largely made up of fruits and vegetables, but pure veganism doesn’t come without its caveats. B vitamins are noticeably lacking in vegans, as well as zinc, essential fatty acids and vitamin D.¹⁴⁸ Careful supplementation with extra nutrients is something I would advise all 100-per-cent plant-based eaters to discuss with their health practitioner.

Also, it’s important to remember that just because you go vegan doesn’t automatically turn you into a dementia-proof, cancer-kicking superhuman with spotless arteries. If I lived on chips and pasta with tomato sauce I could feel pretty ethically minded about not having killed an animal for my dinner, but I probably wouldn’t live for very long to tell people about it.

Ultimately, I have a deep respect for those who choose to live a life on plants alone, whatever their reasons, but my priority would be to make sure everyone is doing it safely.

Wrapping up

What a lot of these diets have in common is a focus on weight loss as a positive outcome, but is this what we should be striving for? Is weight management a reliable biomarker of general health and should this be the common denominator against which we judge the success of a diet? BMI is such a poor predictor of outcomes yet many studies continue to use this as a standard.¹⁴⁹

Everyone has the ability to lose weight, tone up and feel lighter, but sometimes it’s at the expense of health rather than in pursuit of it. I want you to feel ‘well’. I’m convinced that good health, contrary to popular belief, is independent of size and especially weight.¹⁵⁰ I think we could all do with a little less emphasis on weight as an outcome and more of a focus on wellbeing. Health and wellness conjure images of slim, vivacious, young 20-somethings, but a focus on this as the ultimate goal detracts from why we are trying to achieve a healthier life. I believe it is for the sum of our daily interactions to be positive in mind and physicality. It is to live a fulfilling and happy life. This doesn’t necessarily correspond to a certain number on a machine, even though an industry, and perhaps even your doctor, is trying to convince you it does. Your focus should be on health goals and habits rather than a physical endpoint.

There are endless ways in which you can add nutrient-dense foods to your diet on a daily basis and I want to encourage people to think along these lines. We have an opportunity to be truly nourished, rather than skip from diet to diet in the hope that we hit the ‘carb-protein-fat ratio jackpot’ and achieve that dazzling ‘perfect weight’.

I’m convinced that good health, contrary to popular belief, is independent of size and especially weight.

Medicinal spices

Growing up in an Indian household, I was constantly surrounded by spices, herbs and folk medicines. Everything from sore throats to constipation seemed treatable with the contents of our kitchen cupboards!

Most second-generation kids will concur: Indian families seem to have an encyclopaedic knowledge for complementary health cures. I have vivid memories of being fed a spoonful of toasted spices and salt whenever I had tummy ache. My father would always make a mixture of almonds, clarified butter and sugar during my exams, claiming it was ‘brain food’. And, of course, my mother was years ahead of the ‘Spiced Turmeric Latte’ trend.

You can imagine the number of ‘I told you so’s’ I got when I started researching the clinical validity of traditional treatments. My Indian heritage is steeped in Ayurvedic tradition and what fascinates me is the premise of ‘alternative therapies’ having the potential to become recognised treatment in the battle against chronic disease. Learning about the marriage of flavour and medicinal property was revolutionary for me.

The positive clinical effects of food are unlikely to be caused by a single ingredient, like a spice or herb, so it’s important to maintain a holistic perspective. Remember that any benefit from the inclusion of an ingredient has to be taken in the context of a ‘good diet’. Reiterating what I stated at the start of this book: do not treat food like a pill. Concoctions from herbalists or ‘natural’ food supplements are not panaceas or cure-alls, in exactly the same way that anti-diabetic medications will not manage a patient’s condition if they don’t make changes in their lifestyle to complement treatment. Nonetheless, this does not stop me getting excited about the incredible effects of spices.

Spices make food visibly enticing by adding colour and enhancing the flavour and aroma of the most uninspiring ingredients. Using precise techniques, we can quantify their high antioxidant capacity and activity, which explains why we’ve used spice as a preservative for centuries. There is enough evidence to support the daily inclusion of nature’s wonderful spices and here are some staples I believe everyone should have in the store cupboard and the clinical evidence as to why.

Turmeric

Turmeric is probably one of the most extensively researched spices we have in nutritional science and it’s now commonly accepted that daily dietary inclusion can prevent bowel cancer. There’s also evidence that it could be beneficial for helping dementia, chronic pain syndromes and inflammatory conditions.¹⁵¹ It’s astonishing what effects a single ingredient can potentially have on the body.

As is usually the case in nutritional therapy, supplementation using high doses of one of turmeric’s active compounds, ‘curcumin’, has had mixed results.152,153 Turmeric is not just curcumin. The spice is made up of hundreds of different plant chemicals of which curcumin is just one. These studies teach us a lesson: use whole plants as much as possible rather than isolated chemicals. A single component is not likely to be responsible for their health benefits; it’s the complex arrangement of molecules in whole ingredients that we find in nature.

Herbs and spices

These are some of my favourite herbs and spices to use when I’m cooking. I always have these in my kitchen and I highly recommend that you get as many of them as you can into your diet.

I use ground turmeric in everything from Malaysian curry pastes to soups and stews; and if you can get hold of the fresh stuff that looks like ginger with bright orange flesh, even better. Using fresh turmeric in cooking with other ingredients like chilli and black pepper (that contain capsaicin and piperine) heightens its effect and availability in the body.¹⁵⁴ If nothing else gets you interested in ‘food as medicine’, this herbaceous plant from the ginger family should.

Garlic

I’ve been raised to expect garlic to be used in most dishes cooked at home. But even now, whether I’m cooking Italian, Chinese or Moroccan food, garlic forms the flavour base for most of my meals. Enough research has been published for me to believe that it can lower your risk of cancer, and laboratory studies demonstrate its anti-bacterial and anti-viral properties.155–158 It may have a positive impact on human gut microbe populations159,160 too, and it’s so easy to incorporate into meals. It’s definitely an ingredient I get into my food on a daily basis (you’ll notice how often it’s used in my recipes).

Garlic is also so versatile. You can simply cut the top off a whole bulb, drizzle it with olive oil and roast it for 20 minutes, squeezing the cooked pulp out of its papery skins and storing it in the fridge. I use it as a spread or flavour enhancer when making quick meals. Look out for fresh, smoked garlic and my current favourite, black garlic: it has a sweet balsamic vinegary taste and is a wonder ingredient in pesto and sauces.

Ginger

Here’s another spice often used in Indian cooking, with a host of studies examining its effect on everything from cancer prevention to nausea.161,162 Gingerols, shagoals and zingerones are all antioxidants thought to be responsible for its health effects.¹⁶³ I use fresh ginger as much as possible for its pungent taste and powerful volatile compounds. It’s a staple base for lots of my recipes and sometimes I’ll boil some up with honey to treat a sore throat. There are many innovative ways to use ginger in drinks, tonics, sauces and curries. My recipes will show you how easy it is to get this marvellous spice into your system.

There are well recognised polyphenol compounds in ginger and it’s been suggested in the research that we class it as a functional food because of its effects on the body. I use it in my Medicinal Broth (see here), I pop ginger skin into tea, I grate it into Asian-style dressings (see here) and it’s cheap and available to everyone. Get it into your kitchen.

Sumac

This vibrant burgundy-coloured spice has the most wonderful, warm citrus flavour. It’s used in Iranian and Turkish cuisines in tagines and stews or simply to garnish plates with a sour note. It also happens to be one of the most antioxidant-rich ingredients on the planet.164,165 It’s been used in traditional medicine to treat everything from diabetes¹⁶⁶ to cardiac disease, but unfortunately the extent of research we currently have to support these claims is mainly performed in a petri dish or on animals.¹⁶⁷ The research is one to watch.¹⁶⁸

Made from drying a species of the plant genus Rhus, sumac is generally underutilised in cooking, but I use it all the time for its incredible flavour profile and vibrancy. A sprinkle will transform everything from poached eggs to natural yoghurt. Try it out in some of my Middle Eastern-inspired dishes (see Persian Chicken Thighs here, and Spicy Baked Eggs here).

Cumin

Cumin is a functional spice that contains myriad compounds thought to be anti-bacterial and blood-sugar regulating (among many other claims of traditional medicine).¹⁶⁹ Unfortunately, again, there are not many human clinical trials examining the exact effect of this spice and when there are, they’re not conducted well.¹⁷⁰ What we do know is that it contains a really high antioxidant capacity as well as particular compounds that have been implicated in reducing inflammation and fighting cancer.169,171,172

I couldn’t cook without cumin (or ‘jeera’, as it’s known in my kitchen). Used as ground seeds or whole seeds, it has an assertive taste that is distinctly Indian in my mind, but is very easily incorporated into a variety of dishes. Use it to transform your roast dinners, spice up your omelette or add an exotic hint to any meal. And, if you use it frequently, buy a bag of it from your local Indian store, not a thimble-sized jar!

Cinnamon

Another aromatic, antioxidant-packed, flavour bomb. The compounds in cinnamon have been investigated in order to explain why this spice has anti-inflammatory effects and improves metabolic syndrome.¹⁷³ Study after study reports potential mechanisms of action, and the biology, for someone interested in why spices have medicinal benefits, is groundbreaking. Reading some of the texts is like going back into pharmacology lectures at medical school. It’s a fascinating field of research that I hope will unravel more information, but for now, experiment with cinnamon in my spices, dressings and pastes (see here) to elevate simple dishes.

Its versatility permeates through savoury and sweet dishes, drinks and dressings, modern European cuisine to rural Indian meals. It’s no wonder cinnamon used to be more valuable than gold in Egyptian times. Invest in a large, high-quality tub of it – you cannot have a kitchen without this spice.

Basil, rosemary, thyme

The incredible health properties of herbs and spices are not exclusive to those shipped in from the Far East or Africa. We have some amazing flavour enhancers that are easy to grow here in the UK in a pot in the kitchen, and that have as much functional benefit as the most expensive and beautiful saffron from Iran.

Basil, rosemary and thyme may seem unassuming, but the library of chemicals held within their leaves is inspiring. At the average ‘doses’ that we tend to use in cooking, they contain exceptionally important dietary sources of chemicals that reduce oxidative stress and attenuate inflammation.¹⁷⁴ The theories of heightened inflammation and its role in lifestyle-related disease, such as blood pressure, stroke and diabetes, is very fashionable in medical conferences these days.¹⁷⁵ Any inclusion of foods that can reduce our inflammatory burden is welcome, and these delicious, cheap, widely available herbs are worth every stalk.¹⁷⁶

Adding roughly chopped basil to Italian recipes adds an extra depth of flavour. Thyme, perhaps one of the first herbs to be recognised for its medicinal qualities, is in everything, from my fresh barbecue rubs (see here) to my twist on shakshuka (see here). Pestos, marinades, green curry pastes, aioli … the options are limitless and, as a doctor, I cannot recommend highly enough that you include these herbs in your daily diet.

Any inclusion of foods that can reduce our inflammatory burden are welcome, and these delicious, cheap, widely available herbs are worth every stalk.

Seeing past the herb garden

We really need to start investigating spice compounds further. We know that they are safe for consumption because we’ve essentially been testing them by including them in our diets for years,¹⁷⁷ and exciting early research suggests a potential role for their use in treating different conditions.²² Don’t get too fixated on the exact amounts of antioxidants or measurements of compounds in an individual spice. First, not all the evidence looks at specific ‘dosing’ of ingredients, and second, they have varying effects in our body. The best advice is to consume a complement of different herbs and spices daily. Their synergistic effects have been shown to heighten their physiological properties,¹⁷³ as well as adding a delicious complexity to food.

These are some of my favourite spices, but it’s by no means an exhaustive list. I’ve also written a section on spice combinations in the recipes section (see here) to help you get creative. Label your own spice blends – it’ll impress your friends and help get kids into the kitchen!

Worth the extra spend?

Patients often ask me whether they should spend money on ‘health foods’.

I’m encouraged by the fact that more people are interested in food, experimenting with different ingredients and at least attempting to live healthier lives, but the ‘superfood’ trend has its downsides. It has tainted the image of organic as something only attainable for conscientious middle classes, and perusing the aisles of ‘health’ sections in major supermarkets, you can forgive people for thinking eating well is costly. Some ingredients that caught media attention in recent years are incredibly expensive, and are backed by ‘research’ which is questionable in a lot of cases. I often get asked ‘which ones are worth the money’?

As a foodie, I’ve probably tried most of them. But, importantly, I judge them on the evidence base of their supposed health benefits as well as their taste. If we choose to spend an exorbitant amount of money on these ingredients, they’d better be worthwhile! Bitter gourd juice has been shown to improve glucose control in diabetics, but the taste is frightful! And I can’t see Western palates taking to ‘Amla’ powder any time soon.

However, the following ‘health’ ingredients, add flavour and texture and I believe are worth the extra pounds on your weekly shopping bill.

Hemp seeds

These are one of the most concentrated sources of plant-based protein available. The seeds have a whopping amount of fibre and a great fatty acid profile to make them a potentially heart-health-promoting product.178,179 The Omega-3 fatty acids they contain are an important source of fats for largely plant-based eaters like myself.¹⁷⁸

The nutty and slight oily texture of the seeds makes them a great addition to smoothies or granola, and toasted with spices they make an awesome salad topper. The seeds are easier on your digestion than most processed protein powders and far more nutritionally dense.¹⁸⁰ In fact, I don’t use protein powders any more in my post-workout smoothies because shelled hemp seeds are brilliant and, on balance, much cheaper than those outrageously large tubs I used to buy.

Cacao powder

Raw cocoa beans are roasted and ground to create this bitter, antioxidant- and flavanol-rich product that I use in everything from Mexican Mole (see here) to vegan ice cream. Most people aren’t aware of its incredible amino acid profile. It’s a complete protein (i.e. it contains all nine essential amino acids) and its phytochemical profile is off the charts!¹⁸¹ It’s thought to potentially reduce the risk of stroke,¹⁸² elevate mood by preventing tryptophan destruction¹⁸³ (an amino acid used in synthesis of the neurotransmitter serotonin) and improve cardiac function by increasing nitric oxide levels in the blood.¹⁸⁴ It is even suggested that cacao has a positive effect in neurocognitive disorders like dementia,¹⁸⁵ but while I welcome this fascination surrounding polyphenol-rich foods, I wouldn’t get too overexcited. Cacao may have potential applications in the future of medicine, but for now, let’s focus on its culinary uses!

Once you know how to use cacao, it becomes worth the expense, and since the ‘drink of gods’ has become so popular, it has also become a lot cheaper! The lengthy process of making the raw powder justifies its price, and the depth of flavour it offers makes it a worthwhile purchase. Look for 100 per cent powder, not cocoa with added dried milk products and sugar. Follow some of my simple recipes (see here and here) to discover how versatile it is in both savoury and sweet dishes and acquire the taste for this wonderful ingredient. You can get the same nutritional benefits from using high-quality dark chocolate powder, which I don’t think I could live without (75 per cent cocoa solids or higher is ideal).

Quinoa

I still get some eye rolling when I mention quinoa to my colleagues! But quinoa in all its coloured varieties is a really worthwhile addition to your diet. It’s good value and widely available, it’s easy to cook and it has a better nutritional profile than rice, bread or pasta (higher in protein, with more vitamins and minerals¹⁸⁶), plus we even produce some right here in the UK! It contains all essential amino acids and the dark varieties possess even more antioxidants than the white.

It has been labelled as a potential ‘functional food’, because it may help reduce the incidence of high blood pressure, metabolic syndrome and stroke.¹⁸⁷ This is quite a claim to make, given the lack of human studies testing these theories,¹⁸⁸ but is certainly an area to watch.

Note, however, that these potential benefits don’t extend to every product just because it has quinoa in it. If a chocolate bar has some sprinkled puffed quinoa grains on top, this does not automatically make it a protein-rich, blood-pressure-reducing functional food! I recommend cooking with whole quinoa, and using it in both savoury and sweet dishes.

Extra-virgin olive oil

A cornerstone of the Mediterranean diet, the popularity of this polyphenol-rich fat has fluctuated in recent years, as it has found itself caught up in the battle of opinion on what constitutes a healthy plate, but I use good-quality olive oil liberally.

In the context of a low-sugar, nutrient-dense diet, olive oil has been shown to potentially be protective of heart health¹⁸⁹ and, importantly, makes food so much more enjoyable. ‘EVOO’, as it’s affectionately called by health bloggers, is thought to reduce oxidative stress because of its good fatty acid content¹⁹⁰ and rich diversity of phenolics.¹⁹¹ The role of oxidation and inflammation in heart disease has become well recognised in the medical community, so it’s probably the antioxidant effect of EVOO that makes it a heart-healthy ingredient.

It’s a staple in my store cupboard and fat of choice for lightly sautéing food, dressing dishes and making pestos. It remains stable (the chemical bonds do not break down) up to reasonable cooking temperatures around 170°C¹⁹² and the difference in taste between poor- and high-quality EVOO is noticeable to even the least refined of palates. Spend a few extra pounds on organic, cold-pressed¹⁹³ olive oil – your heart will thank you for it.

Конец ознакомительного фрагмента.

Текст предоставлен ООО «ЛитРес».

Прочитайте эту книгу целиком, купив полную легальную версию на ЛитРес.

Безопасно оплатить книгу можно банковской картой Visa, MasterCard, Maestro, со счета мобильного телефона, с платежного терминала, в салоне МТС или Связной, через PayPal, WebMoney, Яндекс.Деньги, QIWI Кошелек, бонусными картами или другим удобным Вам способом.