Food is not the enemy (Podcast Transcript)


 

Host: Casey Beros

Guest Expert: Dr. Joanna McMillan

 

Introduction:

Hands up if you’ve ever been on a diet… or been unhappy with your weight. Maybe you’d admit that your relationship with food is… somewhat complicated. That makes you, me and pretty much every other person I know, and it’s why I’m so excited to introduce you to my guest today. You’ve no doubt seen her face on your morning TV, or heard her Scottish accent giving you no-nonsense nutrition advice across, well, pretty much every facet of the media. Her name is Dr Joanna McMillan and let’s get stuck into our chat so you can enjoy the dulcet tones of her, actual Scottish accent, rather than my feeble attempt at one.

Casey Beros:

Jo you and I do a little bit of work together and I was telling you the other day that sometimes I write scripts or when I write copy for us to do work together, in my head I say things like ‘yoghurt’ and ‘legumes’ – to try and feel like you…

Dr. Joanna McMillan:

JM: You’ve got my little Scottish accent coming through… nice!

Casey Beros:

You’ve been so embraced by Australia – I know that you’ve been here for a long time – but you’ve been really warmly welcomed here, particularly in the media. How does that feel?

Dr. Joanna McMillan:

Yeah, you know, look - this is now my home. This year actually it’s 20 years that I’ll have been in Australia. I’ve always had a connection with Australia because I had Australian cousins – one of my mum’s sisters married an Australian, brought her family up in Perth, so I’ve always had this little connection with Australia. And so yeah look I feel like it’s a lovely relationship, I’m very much at home here. I talk about going home when I go to Scotland and then going home when I come back. So, you know its lovely and I’m thankful that Australia has embraced me. I feel like in the early days I perhaps missed out on a couple of jobs because of my accent but overall, I think it’s been a plus as long as everyone can always understand what I’m saying, get their head around the accent, then we get on absolutely famously.

Casey Beros:
I think it’s your no-nonsense approach. And that’s exactly what this podcast is all about. I want to kind of myth bust some of the things that we commonly hear particularly in the media. So, I want to get your thoughts today on a handful of popular diets and you can tell us whether you think they’re worth giving it a go or whether they’re sort of a waste of time, but before we do that – eating is such a huge part of our lives. It’s something that we really can’t get away from and you seem to have this really beautiful handle on enjoying food for everything that it is worth from a nutritional perspective but not getting kind of too caught up in that. And that’s something that I don’t think a lot of us have the fortune of being able to enjoy such a good relationship with food. Can you tell us where that’s come from?

Dr. Joanna McMillan:

I think a lot of that has come from my upbringing. I grew up in the countryside in Scotland. My mum was a Domestic Science teacher or I think it’s Home Economics now. It’s probably changed name again since I was at school. So, my mum was a cook. We had a veggie patch. Lots of my uncles were in farming and my distant relatives were in farming. So I grew up very much with the idea – and mum was a great cook and hosted and dinner parties with fabulous food but then we had our everyday food. Food was very much a big part of my upbringing but with my feet very firmly on the ground. And when I became a teenager and got interested in doing aerobics and became interested in the way that my body looked and paranoid you know worrying about whether if I was too big or too skinny or too this or too that, you know my parents were very good at keeping me grounded and making me always see the sort of health side of it and the fact that food should be an enjoyable part of life. So a big part of my work now is actually trying to bring that in, especially to the next generation because it does greatly concern me when I speak to young women and to teenagers who tell me about how depressed they are when they follow their Instagram feed and everything is about the bikini body instead of it actually being about enjoyment and pleasure of food and about the way that you feel and health from the inside out and that’s the message I’m really trying to drive here, that we’ve got to cut through the nonsense and really see food as a positive role in our lives - not as food as the enemy.

Casey Beros:

Where do so many of us go wrong? Because it’s a lovely position but so many of us and certainly myself included and you’ve just said that you struggled too when you were younger… So many of us can’t seem to take such a no-nonsense approach so where are so many of us going wrong?  

Dr. Joanna McMillan:

Well I think a lot of it is coming from self-confidence and about body image and we have to try to change that. What is a beautiful body? It’s a healthy beautiful body. We have to lose the singular definition that we have of what we define as being beautiful. And part of it I feel is that we have to look outside ourselves. I sometimes wonder if we’ve become a very self-obsessed nation where everything is about the way you look, you feel, your symptoms – you’re this, you’re that. Instead of us being able to look at a much bigger picture. And I worry sometimes about, you know, we become a bit elitist with nutrition. It’s almost as if we’ve got so many choices facing us, we get information – and misinformation from so many different places too, that leads to a whole world of confusion but it also leads to this sort of constant inner looking for: ‘Well what is the right diet for me?’

Casey Beros:

What’s the answer? The silver bullet…

Dr. Joanna McMillan:

Whereas one of my brothers lives in Africa and you know when I visit there and I talk to some of the women in some of the establishments that he’s involved with there, they’re feeding their families what’s available to them and it’s the local foods from the farms and there’s a lot of vegetables and it’s actually a pretty healthy diet but they don’t have this vast amount of choice. So sometimes I’m worried that this level of choice that we have over what diet to follow, and we have to remember that’s a privilege - it’s an enormous privilege to be able to say well I choose to be... And I know that we’re going to get on to talk about some different diets. There is some scope for individualisation and of course some people have to follow a very particular diet if they’ve got an allergy for example. But for many of us it’s a personal choice and we have to remember that.

Casey Beros:

Let’s talk through some of those choices. I’m going to give you some diets that we’re hearing a lot about in the media at the moment, or we have over the last kind of few years and that many people who are listening may have tried or be thinking about giving a go. And I would love for you just to sort of give me your take on them and whether or not they might be appropriate to try. And let’s give them a little rating, maybe out of 5 carrots. How many carrots does each diet get? So the first one I’m interested in is Intermittent Fasting.

Dr. Joanna McMillan:

Okay. Well look let’s give it a score first. I’m going to give that 4 carrots….

Casey Beros:

Four carrots – that’s good!

Dr. Joanna McMillan:

That’s a good one. Look I think there is really something in Intermittent Fasting. But again, with most of the diets we are going to talk about, there is misinterpretation of what it exactly is. And the truth is that the research is in very early days and we really don’t know what the optimum regime is. So the 2 most popular are the 5:2 so you eat pretty normally 5 days of the week and the other 2 days you restrict your calories or your kilojoules right down or you do something that is more technically called restricted time feeding and that’s where you extend your overnight fast. The most popular probably is  the 16:8, so you fast for 16 hours and then you eat all of your food within an 8 hour window or whatever time you choose actually during the day. We don’t really know which one of those regimes is better, we’ve got very few long-term studies. The one study that we do have with the 5:2 shows it is at least as effective over a year as more conventional dieting but not better. So, I think it’s a good choice. If we take weight loss out of it Intermittent Fasting certainly seems to have some benefits for the gut. I think it’s a great thing just to give your body a break. And it helps people to just realise it’s okay to be a little bit hungry. So that one gets a good 4 carrots, it won’t work for everyone. Might not suit you, there’s lots of people that it doesn’t suit. But if it appeals to you – give it a go.

Casey Beros:

What about high fat low carb diets? Atkins was popular many moons ago and now Keto sort of seems to be the ‘modern’ application of that.

Dr. Joanna McMillan:

Sure. Well there’s a range of different diets there within that category because there’s a range of different carbohydrate intakes. So there’s definitely a place for lower carb diets. Keto I’m going to give 1 carrot if we’re talking about for general health. The ketogenic diet definitely has some therapeutic uses. Clinical dieticians have been using it to treat epilepsy, for example, for over 100 years. And there are some trials underway, it might be useful in things like morbid obesity or in chronic migraine - these are the sorts of things that there’s testing going on, research is going on. But for most of us just looking to just lose a few kilos or perhaps just eat a bit healthily, I’m really worried about what the long-term effects are of Keto. From my work in the microbiome and in gut health we know that very high fat diets, and fibre at the end of the day is carbohydrate. So, if you go very low carb it’s hard to get enough fibre – and its fibre that’s really important for your gut health. I don’t think that for most of us that’s an appropriate way to move forward.

There’s certainly a place – look I’ll give a few more carrots, I might give 3 carrots to a lower carb approach if you do it in the right way. I think what to remember is you can have a really rubbish low carb diet or you could have a really rubbish high carb diet, or a really rubbish low fat diet or a really rubbish high fat diet – it ultimately depends on whether or not your diet is made up of whole foods and if you’ve cut junk food and you’re concentrating on eating lots of whole food, including lots of plant foods, especially your veggies, then you’ve probably got a good diet and we can have a range of carbohydrate and fat intakes – provided you’ve got it from good whole foods.

Casey Beros:

What about sugar? Sugar and added sugar in particular became a bit of a devil in recent years. What do you think about going sugar free?

Dr. Joanna McMillan:

If it’s just about reducing or cutting out added sugars – then absolutely go for your life there’s absolutely no doubt that we have no need – unless you’re a really a massive energy requirement because you’re a professional athlete. In those circumstances you may want some added sugar to help you get through an event. I’ve done a half Iron Man and I can tell you without sugar I was not going to have got through that event. So again, it does but for most of us for general health, wellbeing and weight control then yes absolutely cut out added sugar – that’s just like picking the low hanging fruit of where am I getting excess kilojoules that I really don’t need - let’s get rid of that. Where I think we’ve gone wrong a little bit with sugar is that we can’t help ourselves. We like to point our finger at one thing and it’s allowed us to sort of step back and ‘blame’ sugar and then forget about everything else. I think there’s also a lot of misconfusion. So, I see all the time these recipes that claim to be sugar free and yet I look at the ingredients and there’s brown rice syrup or there’s coconut nectar. These are just sugars extracted from other plants. So why is that any healthier than sugar taken from sugar cane or sugar beet? So, we mustn’t get confused over what exactly is added sugar. And the other part of that is we must make sure that we don’t confuse it with natural sugars present in foods like fruit where you’re getting a whole food matrix along with vitamins, minerals and fibre, antioxidants and other phytochemicals. So, don’t get muddled up between, you know, an apple is really good for you. An apple flavoured lolly is definitely not good for you.

Casey Beros:

What about gluten free? That became very popular a decade or so ago now. People seem to have kind of fallen off the wagon, so to speak, and we know that there’s a big difference between someone who’s coeliac and absolutely cannot have gluten but a lot of other people jumped on the bandwagon thinking that if they cut out gluten then they’d cut out a lot of things they would not be able to eat and therefore would lose weight. What’s been the impact of that have you seen?

Dr. Joanna McMillan:

You’re absolutely right. If you have been diagnosed with coeliac disease then you must be absolutely strictly gluten free. There’s another group of people and this is still relatively controversial because it’s so hard to prove. But it’s thought that there’s a group of people – possibly up to even 30% of us  - who have a kind of gluten sensitivity. And so therefore you don’t need to be strictly gluten free but certainly you are going to feel better with less gluten in your diet. The rest of us, gluten is not the issue, and we’ve got some wonderful double-blinded studies from Monash who are the experts in gut health who’ve shown that a lot of people who think that they were reacting to gluten and that was causing some of their symptoms actually have been shown not to be reacting to gluten at all but be reacting to something called the fructans and these are just little short chain carbohydrates that are present in many cereals so they’re present in the same kinds of food that you’ll find gluten. And it’s the fructans they’re having problems with. And that probably comes down to what kind of gut bugs you’ve got in there and your ability to ferment and break down these because in most of us fructans are great, they’re prebiotics, so that’s what’s really interesting. The other thing I think is happened with gluten is we’ve sort of got confused because gluten free products were in the health aisle in the supermarket. I think it’s because there’s sort of a blurring of lines between is it a health food therefore? Is a biscuit that is gluten free healthier? Well actually, the answer is no. So, we’ve got this really big confusion about gluten I feel and people who say, “Well I cut out gluten and I lost weight,” I always say well what foods did you cut out? And you go well if I can’t have gluten, I can’t have donuts, I can’t have a croissant, I can’t have pastry, I can’t have biscuits. Suddenly you start realising I cut out a whole lot of rubbish food.

Casey Beros:

So it wasn’t actually the gluten it was what else was in those foods.

Dr. Joanna McMillan:

And one of the most interesting things – I’m actually writing a report, a review of research, on wholegrains at the moment, and one of the things that we see with the microbiome that’s a bit worrying, is that when people follow gluten free diets they get detrimental changes in the microbiome. And so that worries me, I think a lot of people are going gluten free thinking that they are doing something healthy and actually what they are doing is cutting out some really useful fibres from really good whole grains.

Casey Beros:

How many carrots?

Dr. Joanna McMillan:

If you’re coeliac you get 5, but if you’re not coeliac you only get 1 because you really don’t need to cut out gluten. I think you need to focus on other things.

Casey Beros:

And what about Paleo? What are your thoughts on that?

Dr. Joanna McMillan:

Paleo is different and I think it’s interesting because way back when I was doing my PHD, some 15 or so years ago, I actually reviewed a whole lot of the evidence about true Palaeolithic diets because I was researching higher meat diets and so I was interested in that sort of research. So, it’s very interesting from a research perspective and of course we want to look at well how human beings have eaten over time, but there’s lots of confusion there A. in just determining exactly what it is we ate back then and B. are our requirements today – where we live a much longer life on average and we have to remember that Palaeolithic people tend to die of accidents and infections and so on at a much earlier stage of life. Their average age was 40 compared to us today although some of them did live much much longer, we really don’t have good evidence about whether this is the optimal kind of diet for them or not. And the last thing to remember is they actually ate loads of plant food, so their fibre intakes were 3x what our recommendations are, never mind what Australians are actually eating. So, what frustrates me a little bit with Paleo is what I call the “Bondi Paleo” diet which is things like ‘this is a Paleo Brownie and it’s made from avocado and raw cacao and coconut oil’ and then it’s called Paleo. Well that’s not a paleo food at all!

Casey Beros:

I can’t imagine any cave men saying ‘sweetheart sit down, it’s time for our cacao brownie, thanks for gathering the berries!’

Dr. Joanna McMillan:

So, the Bondi Paleo diet gets 1 carrot, but if you’re truly following a Palaeolithic diet which just means I’m going to cut out junk food and I’m going to eat whole foods then you’re probably going to feel a whole lot better and in that case I would give it 3 carrots. I just don’t think that you need to cut out grains and legumes and dairy, these are all foods that offer us a huge amount.

Casey Beros:

Great. Veganism, vegetarianism and probably to your point about the “Bondi Diet” there’s probably a trendy and responsible way to talk about this as well. What are your thoughts on those?

Dr. Joanna McMillan:

For sure. To me, the decision to be vegan in particular is an ethical one or a moral decision and anyone who came to me and said Jo can you help me to put together a really healthy vegan diet then absolutely of course that’s what any dietician would be able to help you do. So, I think it’s an ethical decision. From a nutritional perspective or a nutrition science perspective, I still think it’s beneficial, there are certain nutrients we know we only get from animal foods and so personally I still consume animal foods but you know what I’m really loving is that sort of trend towards plant-based eating, whether or not you also choose to consume animal foods. And I think if all of us collectively just lowered our demand for animal foods and we increased our plant food demand we would help both our own health and the health of our planet. So I think it’s a really hard one to score, but again what I will say is if you’re going to be a vegan particularly, you know a vegetarian - if you’re going to consume dairy and you’re going to consume eggs or you become a pescatarian where you will consume some fish and seafood – these are much easier diets to get the balance right. If you are going to be vegan you do have to think a lot more about the nutritional balance so it might be worth your while visiting a dietician because I’ve seen plenty of vegans over the years who end up iron deficient, they’re zinc deficient, they’re calcium deficient and actually they’re eating a lot of processed foods because they don’t really know how to cook vegan meals. They haven’t really taught themselves about the balance of plant foods to get the nutrients they need and so they end up eating a lot of packaged vegan food which is often highly processed and not really what you want to be eating.

Casey Beros:

It’s challenging to get good vegan food on the run I assume and we’re all about convenience these days. So, Jo – diets aside – and aside from the big macronutrients that we know that we need - what are some of the things specifically women should make sure is in their shopping basket every time they go to the shops?

Dr. Joanna McMillan:

One of the things I’m going to say actually is steak. Or red meat of some sort. Of course, what you can get, I’m thinking about iron, it always strikes me as ironical that we’ve got the men who have the huge steak and they hardly eat any veggies. And of course, we know that too much red meat is certainly not good for your gut and it raises your risk of colon cancer. Processed meat is even worse, so you want to cut out or limit things like your processed meats like bacon and rubbish sausages and that kind of stuff. But red meat is often what women cut out because we tend to be the ones who will go vegetarian or we’ll go for the fish option when we’re eating out and we avoid so much of the steak but actually it’s women who have enormously high iron requirements at least until we go through menopause. So, if you’re struggling to meet iron requirements it makes you tired, you can feel the cold a lot, you can struggle to exercise to any intensity, it affects your mood, it affects your immune system so you might pick up frequent coughs and colds. And often if you’re just mildly deficient – you’ll pick up if you’re really anaemic – but if you’re just mildly deficient often that can go on for years and years and years and women really don’t know until something dips them down into being anaemic so I think I’m going to pick red meat for the girls as being one of them. As a second food I’m going to pick legumes because I really think legumes are going to be the superfoods of the next few years. We’ve got such a shift towards plant-based eating and we’ve had this negative stuff from the Paleo movement about things like grains and legumes. And actually, when we look at the evidence it’s so strong for eating legumes and it’s a food that we’re under eating here in Australia. It’s budget friendly, it’s convenient and you can buy cans and have them in the pantry. We know that substituting some animal protein with some plant protein has good health outcomes and its full of these fermentable fibres that are so so good for the bugs living in your gut and for your overall gut health. So I think legumes would be a second thing. And probably the 3rd thing I’m going to pick would be leafy greens. We should be eating leafy greens every single day and I’ll include in that herbs so things like basil and fresh parsley and fresh coriander. All of these kinds of foods are really really good and the bottom line is that most of us are failing to meet the 5 serves of veggies a day and really one of those serves at least should be leafy greens.

Casey Beros:

And what about men? What are the things - they might not be going to the shops as frequently as we are, although I hate to stereotype - what are the things that they absolutely need to be getting?

Dr. Joanna McMillan:

Well, you can’t go past veggies. For men, this is my job and my career, and I still have to hassle my husband about how many veggies he eats. Boys you have to eat your veggies, you can have your steak, but I think for men a lot of it is actually what they need to cut down on, they’re very much focused on having, and I think that men go overboard with how much, particularly if they’re going to the gym and they’re trying to be fit, they go so overboard with protein and they completely forget about everything else. So I would say to the boys: get off the highly processed protein powders and the enormous steaks and all of the processed meat and really think about getting more plant food in your diet. So, for the boys it’s definitely going to be about getting more veggies, having some wholegrains – don’t be scared of carbs. Carbs are a nutrient that’s present in foods and we can’t lump every single food that contains carbohydrates into the same basket. So, if we just look at grains the evidence is very very clear - the two have almost opposing effects. So, we know that refined grains, things made with flour and too much added sugar – these things are not good for you. But wholegrains, where the grain is intact, you’re getting all of the fibre and actually what people don’t realise you’re getting a whole bunch of antioxidants type – and what we call phytochemicals and ‘phyto’ just means ‘plant’. So, these are things like antioxidants and other protective compounds that are present in plants and they’re in really high quantities in wholegrains but they’re present in that outer layer in the fibrous kind of layers of the grains, you need to have them as wholegrains. So, for the boys it’s got to be things like, you know brown rice is great and quinoa and whole grain sourdough bread, a wholegrain breakfast cereal or rolled oats or muesli and these are the kinds of things that boys tend not to go for because they’re so focused on getting their protein. I didn’t do a third thing did I? That’ll be enough for them…

Casey Beros:

Tell me about brain food because you wrote a book about this. Lots of people listening to this will think ‘what can I do with food to help increase my performance, my productivity, my mental performance’ in particular. What are some of the top brain foods that we may not consider to be that way?

Dr. Joanna McMillan:

I think when it comes to, what was so interesting about doing the research for brain food, I felt that it was a topic that I really wanted to cover because I became aware of some research that was showing that the over 50s now were getting more concerned about losing their marbles than they were about traditional heart disease and cancer that we’ve always had on our radar. That was really interesting to me because when I thought about it I knew that there was strong research between your diet and your lifestyle and aspects of your brain health and often something I speak about when I’m speaking to corporates is about brain performance. So, it’s not just about long-term brain health in terms of your cognitive functions but also about your short-term ability to focus, to concentrate but also to be creative and give your best at work and in whatever aspects in your social life may also require some creativity or some concentration and attention. And so, then when I started to dig down into the research it was so extraordinary and it makes sense because it’s what’s good for the rest of your body is also good for your brain but the evidence is quite compelling. If you’re following the kind of diet that you know to be good for your heart health and for your gut health, that’s also what’s good for your brain.

One of the most extraordinary things is that connection between the microbiome and what’s going on in terms of inside your gut and your brain, so we’ve got this gut-brain axis that we’re starting to see that the fermentation and what is happening with your microbiome actually influences your mood, influences your cognitive function and long term we know that brain health. What sorts of foods are good? It’s the foods that are fuelling the microbiome, so things that include prebiotic fibres are sometimes the new acronym in nutrition research is MACs – which is microbiota accessible carbohydrates and these are just the particular types of fibre that are really good at boosting the growth of beneficial bacteria in the gut. So, we’ve got legumes in there again, that I’ve spoken about already, wholegrains, lots of veggies, nuts and seeds. It’s those kind of plant foods that are really really good and we see them as also being good for the brain. Other things that stand out are a whole group of foods rich in something called polyphenols and these are sort of bioactive compounds that are present in lots of plant foods that we absorb a few of them, so we absorb maybe between 10-15% of these polyphenols - they may have a direct kind of antioxidant/anti-inflammatory effect and we know that they’re good for brain health, but actually the bulk of them again get converted by the microbiome into more active compounds that we know have very strong links to health so we see this association between blueberries and memory, for example. And other berries seem to be good in that regard. We’ve got other polyphenol rich foods are things like coffee and tea and cocoa. So, you know people always expect me to say you know coffee’s bad but actually coffee seems to be very good for the brain. Now if you’re sensitive to caffeine you probably want to go for decaf or at least restrict your coffee to less than a couple of cups. But if you’re not sensitive to caffeine and you’re quite a good caffeine metaboliser you can be having 3 or 4, or some of the research is even saying 5 cups of coffee can be extraordinarily good for the brain. So, including all of those kinds of plant food based foods are essentially fantastic. And the one that probably most people will think of is oily fish. So, we do know that those long chain Omega 3 fats which are found in predominantly in oily fish like salmon and trout and sardines these fats are very concentrated in the brain and we know that they’re very important for brain function.

Casey Beros:

Amazing! If you couldn’t tell, I love me some Dr Joanna McMillan. She is just a wealth of no-nonsense, good old-fashioned advice and she’s all about helping us learn to love our bodies and the way that we eat and I think that is a message worth spreading. Thank you so much for joining us for this episode of well-thy, I look forward to seeing you next time.

 

Please note: the views expressed in this series are the experts own and shouldn’t replace personal medical advice.

 

 

 

 


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