Weight loss, diabetes and menopause with Dr Clare Bailey and Dr Michael Mosley

Dr Clare Bailey is a GP and health columnist with extensive experience in helping people lose weight and improve their health. Dr Michael Mosley is a science presenter, journalist and executive television producer. Together, they have authored several bestselling books on weight loss, diet and diabetes and created the popular 5:2 and fast 800 diets.

In this episode, the guests describe the evidence showing the positive effects of incorporating principles such as the Mediterranean style diet and time-restricted eating into your lifestyle and how the fast 800 diet can dramatically improve your health outcomes, particularly in reversing type 2 diabetes. The ‘metabolic car crash’ of poor sleep, low hormones, poor diet and weight gain for women during the perimenopause and menopause are also discussed.

Clare and Michel’s top tips:

1. Enjoy olive oil. You don’t have to be stingy with it – it’s good for you!
2. Eat oily fish – remember SMASH: Sardines, Mackerel, Anchovies, Salmon, Herring.
3. Avoid snacks (especially in the evenings) or if you have to, reach for a few nuts.

For more information on Clare and Michael’s diet books and the fast 800 diet, visit thefast800.com

Follow Clare’s recipes on Instagram @drclarebailey

Episode Transcript:

Dr Louise Newson [00:00:09] Hello. I’m Dr. Louise Newson and welcome to my podcast. I’m a GP and menopause specialist and I run the Newson Health Menopause and Wellbeing Centre here in Stratford upon Avon. I’m also the founder of The Menopause Charity and the menopause support app called balance. On the podcast, I will be joined each week by an exciting guest to help provide evidence, based information and advice about both the perimenopause and the menopause.

Dr Louise Newson [00:00:45] So today on the podcast, I have two people with me in the studio, which is doubly exciting. So I have two people that I hold in very high respect actually as well. So I’m actually a bit nervous here. So I’ve got in front of me Michael Mosley, who I have known and respected for many years, and his good wife, Clare, who works very closely with him. And I think a lot of people maybe and I didn’t until recently, quite how closely she works and helps with his work.

Dr Michael Mosley [00:01:11] Yeah.

Dr Louise Newson [00:01:12] So thank you so much for joining me today.

Dr Michael Mosley [00:01:14] Pleasure. Great to be here.

Dr Louise Newson [00:01:16] Thank you. So I don’t know whether you both know if I wasn’t doing menopause, which takes up 100 and plus percent of my time, I would actually be doing something in nutrition because it’s one of the well, one of the many things, actually, that we’re not taught at medical school that would be very useful to know. And I don’t know about you both, but I certainly didn’t know what I do now about nutrition. And I thought fats were bad. I went to medical school in the eighties, so there was lots about do not eat fat and how wrong we were really. So things have changed, but there’s so much confusion, isn’t there, out there? And it’s really worrying for everyone. But obviously I particularly worry about menopausal and perimenopausal women who are often really, really struggling with their diet because of the metabolic changes that occur. And then they find that this overwhelming information – that often isn’t right – is very scary. So you’ve done some great work, but before we talk about all the work you’re doing now, can I just unpick a bit and just find out how you got into what you’re doing now?

Dr Michael Mosley [00:02:23] Sure. So Clare and I also graduated from medical school in the mid-eighties. And in fact, we met at medical school in 1980, which would be.

Dr Clare Bailey [00:02:34] Quite a few years ago.

Dr Louise Newson [00:02:36] So is that the beginning of medical school?

Dr Michael Mosley [00:02:38] Yes. Yes, and very early on. In fact, on the first day we were at Royal Free and it was about 50-50 male and female, and about 100 of us in the year. And the Dean said that statistically, four people in the room who had never met each other would marry. And so there you go.

Dr Louise Newson [00:02:54] Yeah, because I met my husband in Freshers’ week actually in the eighties, so not realising I would still be with him many years later.

Dr Michael Mosley [00:03:02] So that was kind of when we met. And rather like you, neither of us were taught anything or frankly were that interested in nutrition. And I think probably the precipitating event, in a funny way, in both our lives was in 2012, when I got diagnosed with Type two diabetes and my GP understandably said, ‘Let’s start you on medication’. And I said, ‘I’m not sure I want to go down that road because my Dad had had diabetes around the same age and had then died of complications – things like heart failure and also early signs of cognitive decline at the age of 74, pretty young. So I thought, this is not good. And that’s when I made a Horizon programme with myself as the subject called ‘Eat Fast, Live Longer’.

Dr Louise Newson [00:03:48] Yeah, it was an amazing programme.

Dr Michael Mosley [00:03:50] I remember sending Clare an email from the States where I’d been talking to some of the academics there, and I said, ‘I think this is going to be huge’. That was kind of when, if you like, I invented the 5:2 diet. But I was also fascinated by the link between diabetes and weight, which people were not talking about. And so yeah, I sent Clare an email saying ‘this is going to be huge’ and I think it has been, hasn’t it?

Dr Clare Bailey [00:04:12] It has been extraordinary and the impact of it I think.

Dr Louise Newson [00:04:16] Yeah. And it’s amazing. So let’s just spend a second talking about diabetes because there might be people who don’t know. I speak to a lot of people who have hypo’s, they feel a bit light-headed and they say, ‘I want to be tested for diabetes’. And we know that diabetes is raised sugar, isn’t it? If you’re untreated, you’re going to have raised. But there’s type 1 and type 2. So do you mind just explaining the difference to people?

Dr Michael Mosley [00:04:39] Sure. In fact, there are lots of other variants, including, you know, linked to pregnancy. But the primary ones, type 1, type 2. Type 1 tends to be more what used to be known as a sort of young person’s disease as a genetic element. Although type 2, which is more closely linked with central obesity, is also seen in younger and younger people. In fact, I was talking to a paediatrician recently who said she’d seen it in a four year old because we have increasingly obese kids. And what is very clear now is that type 2 diabetes – which is like 90 to 95% of all cases of diabetes in the UK – is primarily caused by too much fat around the tummy. Visceral fat goes into your liver, goes into your pancreas, clogs them up, and conversely, losing that fat through a rapid weight loss diet, which is being pioneered largely by Professor Roy Taylor up in Newcastle, has been shown to rapidly reverse that and in my case, I lost about 9 kilos in eight weeks. So that’s.

Dr Louise Newson [00:05:44] Gosh that’s very rapid, isn’t it?

Dr Michael Mosley [00:05:45] It is, and my blood sugar went back to normal where they’ve stayed ever since – though Clare has been obviously keeping an eye on me to make sure I stay on the diet.

Dr Clare Bailey [00:05:53] Sweet tooth to contend with.

Dr Michael Mosley [00:05:55] Yeah, so I don’t think either Clare or I had the slightest clue, really, about the fact that type 2 diabetes could be reversed, put into remission, or indeed as I’ve said, been that interested in nutrition. But Clare got very engaged after that and with her patients as a GP.

Dr Clare Bailey [00:06:11] Yes. I mean, it was at a time when we just said ‘eat less and move more’. And that went on for years and years and years. And it wasn’t until I saw what happened with Michael that I realised quite how powerful the impact could be. But it still, you know, I’ve been working with patients eight years and initially the really – people just thought every person who managed to get the blood sugars down reversed their diabetes was an exception.

Dr Louise Newson [00:06:40] Yes.

Dr Clare Bailey [00:06:41] But eventually I think over the last five years it’s now become very much pushing at an open door. People get it, they know much more about it. They are much better informed, I think, about diet and the impact it can have.

Dr Michael Mosley [00:06:55] And I’ve got to say, there’s a very clear link with the menopause in the sense that as women go through the menopause, it doubles their risk of developing metabolic syndrome, which is a combination of the large waist, high blood pressure, high blood sugars as you know, and high blood fat. In that, whereas type 2 diabetes is relatively rarer in women before the menopause, it becomes increasingly common. And that seems to be largely to do with the fact that as women go through menopause, they’re at greater risk of laying down visceral fat, the fat shifts, if you like, towards the abdominal area. And that’s the high-risk fat.

Dr Louise Newson [00:07:30] Yeah. And it’s so interesting isn’t it because a lot of women, myself included, actually when I was perimenopausal, I’d look down at my waist and I’d be driving a car and think ‘Oh, gosh, where’s that come from?’ And this sort of midline change is often because the body needs estrogen, doesn’t it? So the fat cells produce not really a nice type of estrogen, estrogen that can be quite pro-inflammatory, but it’s all it’s got. And then, as you quite rightly say, Michael, the metabolic changes occurring not only increase our risk of type 2 diabetes, but also cardiovascular disease, dementia, osteoporosis and even clinical depression are thought to be inflammatory diseases now. So it’s really crucial that we not just wait till we’ve got type 2 diabetes and then look at our weight, but it’s trying to reduce metabolic syndrome and everything else as well. And certainly one of the first line treatments for type 2 diabetes is lifestyle. And I don’t know about you both, but I’ve certainly had patients in front of me diagnosed with type 2 diabetes and it’s really difficult in a ten minute consultation as a GP to talk to them about how they need to stop smoking, that they’ve smoke for the last 30 years, how they’ve got to reduce their alcohol, but more importantly to really change their diet. And in three months it’s not much time for a lot of people when they’ve had 20 years of eating, you know, takeaways and goodness knows what. So what’s your advice? How do you start? Because it’s the hardest thing is starting a change, isn’t it?

Dr Clare Bailey [00:09:00] I think in terms of starting a change is asking people what difference it’s going to make to them. How would their life change? How would they see it in three months time? Really, the kind of issue is, you know, how much of a difference it can make to how they feel, to their mental health. And it’s often recommended to tell people that they’re going to be doing it and making those changes. With rapid weight loss, it’s incredibly rewarding for people because they see the change very quickly, they feel better, their mood improves and it becomes a sort of self-fulfilling thing. You know, for most people, it sounds making dietary changes, it sounds challenging, putting people on a lower calorie diet. But when they see the impact, it really does motivate them.

Dr Michael Mosley [00:09:52] We have written a number of books together, including the Fast 800, and we have a website called thefast800.com. So if you go there, then you can get some pretty detailed information because I think success with any weight loss regime is largely about the planning. It’s about the understanding as well. Why am I doing this? What are the benefits, what are the pitfalls and really getting to grips with it before you begin, rather than sort of dashing madly into some crazy diet. So it’s about getting everyone else on board, you know, your family, your partners, your friends so they can support you because this can be quite tough. And in the books, we detail a lot of the scientific research so you kind of know that there’s something behind it. But it is about things like, as Clare saying, why are you doing it? Listing the reasons, having good, compelling reasons for wanting to do it and also, as I said, recruiting as many friends and neighbours, whatever, to take part. Clearing the junk out of the cupboards and then getting, if you like, almost a bit of practice in doing some recipes, menus and stuff like that. And the thing that distresses me is there are so many clinical trials that have been done over recent years. Oxford University has done a number, as has Roy Taylor, up in Manchester, I’m sorry Newcastle, and they’ve all consistently shown that compared to standard advice, a sort of rapid weight loss, lowish carb, Mediterranean style diet always scores better. And indeed, the Oxford Group recently put the NHS weight loss app to the test where they randomly allocated people to either following that advice or just, you know, carrying on as normal. And at the end of eight weeks, there was no difference between the two groups, no significant difference at all using the app, it made no difference. And when you look at it and I’ve looked at the menus on it, I can understand why, because they are low in protein, low in fat. They seem to have a lot of sort of not what I call terribly good quality carbs in it. And so it’s kind of weird. They spent a lot of money doing this thing but not evaluating it. And so it was down to the Oxford group to evaluate it.

Dr Louise Newson [00:11:57] So what a missed opportunity then actually, isn’t it, for a lot of people? So talk us through, so you said low fat. A lot of people might think, well, how can you lose weight if you eat fat? So can you explain what that is and also what the Mediterranean diet is? Because as much as we all want to live in the Mediterranean, we can’t. So just can you talk us through both of those? Because that would be really interesting.

Dr Clare Bailey [00:12:18] I mean, the last 40 years, we’ve all been kind of told to spritz olive oil, you know, even not eat eggs. And it’s you know, a generation has grown up on that. And people find it terrifying that, you know, they buy some decent olive oil and they’re scared that they’re going to have a heart attack by the time they’ve finished the bottle. You know, there’s so much myths out there. I mean, for example, with olive oil, we know it has anti-inflammatory properties, reduces certain cancers, lots and lots of benefits and it makes food taste fantastic, makes a huge difference. I mean, in terms of the Mediterranean diet, it’s, you know, very much bringing in fatty fish, nuts, seeds, pulses, and it’s very much about whole foods and dairy– bring back in dairy as long as it’s not highly processed and hasn’t got a lot of a lot of the dairy we’ve been eating has all sorts of thickeners and sweeteners in it, and it’s going back to eating real food.

Dr Michael Mosley [00:13:21] Some Spanish researchers put together an index and you can score yourself. So for example, you get one point if your primary fat is olive oil, you also get points if you eat at least three portions of legumes – that’s beans and things like that a week. The same is true of oily fish, again, three times a week seems to be a good number. Whole grains – they also you get a point, if you eat at least two portions of fruit and veg a day and things like sitting at the kitchen table or the dining room table, if you sit down to eat at least three times a week, you get a point for that and you get a point if you eat some sugary junky, you know, cakes and biscuits less than three times a week. So that’s how they can score it. You get a score out of 14 and using that index, they’re then able to, you know, do all sorts of trials. So, for example, we know that with perimenopausal and menopausal women, those who score highly on the index have much better bones, better strength, less weight, lower risk of heart disease, lower risk of breast cancer, lower risk of cognitive decline. So you can kind of score yourself. And if you’re seven and above, you’re doing pretty well. Similarly with depression, there’s been some wonderful research out of Australia, the Food Mood Centre there, showing that people who score well on the Mediterranean diet are around half as great risk of developing depression and anxiety as those who eat more sort of a junk food diet. So we’re beginning to understand as well just how fundamental food is for your brain as well as your body. The first proper trials of this were not done until 2017, which makes you kind of weep.

Dr Louise Newson [00:15:02] Shocking, isn’t it? Really? It really is shocking, because I think we’ve spent the last, I don’t know, 20-30 years using food as a comfort. And the food, the way it’s advertised, the way how easy it is, it can have short fix comfort, maybe eating a mars bar or a bag of chips or whatever. But it’s not going to help longer term. And it’s not until you change your diet or eat healthily you realise how good you can feel. But it’s quite hard for a lot of people. I completely understand. And so it’s interesting about what we eat and certainly what you’re saying is very clear, and I always think about what we eat. In the seventies growing up we didn’t have any ‘fancy foreign stuff’, my granddad used to say. It’s not even foreign, it’s sort of packaged stuff, isn’t it? If you know what it is you eat, we just used to eat plain meat and two veg really when I grew up, and full fat milk and we’d all fight over the cream at the top really, and butter. We didn’t have – s,o all these low fat labelled foods are actually not the things we should be reaching for are they?

Dr Michael Mosley [00:16:01] No and as I said, there are other things which have come in since the seventies like garlic, which I’m a fan of, but the yoghurt – I think I probably had my first yoghurt when I was about 13. Plain yoghurt again seems to be a necessary ingredient of Mediterranean diet.

Dr Louise Newson [00:16:15] Yeah. So important. Yeah. My mother used to have a yoghurt maker actually in the seventies and we had…

Dr Michael Mosley [00:16:21] I have one in the cupboard or rather we have one in the cupboard.

Dr Louise Newson [00:16:22] Yeah, I use one now but we used to just hate it. We used to put so much sugar in it and then it was alright. But actually, that was still probably better than having a sort of low fat fruit yoghurt or whatever. So it’s interesting how things have changed. And obviously olive oil was something I don’t think we ever had in our cupboard in the seventies, eighties or nineties probably. So there are things that are changing, which is great. But the other thing you mentioned at the beginning was the 5:2 diet, which some people might not have heard, you know, the sort of – or the time restriction. Do you mind talking with me about that?

Dr Michael Mosley [00:16:51] So the 5:2 diet essentially is a rapid weight loss diet. And about 40-50,000 people have so far signed up at the website fast800.com and done it. And we’ve had the data analysed from that, an average weight loss of just under ten kilos a year, so weight is one year data, because obviously you can lose stuff in the short term, but it’s kind of how do you do in the long term? And we’re also very interested there in looking at the health benefits. So for example, with the people who came in and were classified as pre-diabetic or type 2 diabetic, around half of them were able to come off medication and are now in remission and as long they keep weight off they should be well. So these are significant improvements. I’d love to and we haven’t looked at it, try and break it down in terms of menopausal benefits as well, because we haven’t looked at that. But certainly anecdotally, really good for snoring. I used to snore like crazy. But essentially you start off with rapid weight loss around 800 to 1000 calories a day, mainly sort of low-ish carb, mid-range style diet. And then you graduate to doing it two or three times a week and then as a way of life. And I think the main thing is the French have a saying that ‘hunger is the best sauce’. So if in the initial stage, when you’re down 800 to a thousand calories, you’re going to be a bit hungry and it generally passes pretty quickly. But if you’re learning to enjoy these foods while you are hungry, then this will translate to later and you’ll, even if you hate vegetables now, you will discover you love vegetables when you’ve been eating them on a low calorie diet.

Dr Clare Bailey [00:18:29] I think one of the other things that is very often people going into ketosis and that’s healthy nutritional ketosis. And with that people often find that they actually have greater clarity and they don’t feel so hungry. So very often have patients saying, you know, ‘I’m just amazed that I’m not feeling hungry all the time’ because one of the problems when people have metabolic syndrome and they’re not getting the feedback, telling them that they’re full after meals, and it’s not that they’re greedy, it’s the hormones are out of kilter. And once you start losing the weight and eating better, people find out they’re not constantly craving. And that makes a huge difference to them.

Dr Michael Mosley [00:19:12] And you also sleep better, obviously, once you begin to lose weight. And clearly, again, perimenopausal menopausal it’s sleep is going dreadfully badly.

Dr Clare Bailey [00:19:22] That’s why I went on HRT. It’s kind of duvet on, duvet off and yeah.

Dr Louise Newson [00:19:27] And we know that poor sleep is associated with all these inflammatory diseases don’t we and so, you know, poor sleep, low hormones, poor diet, obesity. It is a real metabolic car crash actually for people. And it’s looking at what we can change and what we can’t. None of us can reverse our age, but we can reverse our biological age by being more anti-inflammatory. And as you say, Clare, quite rightly, taking HRT, especially with body identical hormones, does reduce inflammation, reduce risk of all these diseases. But diet is absolutely key whether people take HRT or not. We all have to eat. We all have to sleep. And we can make a few choices, certainly about eating. But a lot of feedback I get from some friends actually, as well as patients about your diets and all the recipes, is that they’re just so easy. And I know that’s thanks to you mainly Clare, isn’t it.

Dr Clare Bailey [00:20:21] Yes. Well, we have a system now of testing and retesting and making sure as much as possible that the ingredients are accessible, they’re easy, they’re tasty, because, you know, if you’re going to be doing a diet, you don’t want to spend ages cooking and faffing around. You want something – I’m busy, I’m impatient. I want to have easy, tasty food that doesn’t take long to prepare.

Dr Louise Newson [00:20:45] And not expensive either because I think that’s really important as well isn’t it.

Dr Clare Bailey [00:20:48] Absolutely.

Dr Michael Mosley [00:20:50] Yes, we’ve kind of broken down the cost of it and it works out at less than what the average Briton spends on a diet because firstly, you’re obviously eating less, but also the ingredients are all incredibly accessible and things like fish, which forms quite a big basis of it, it doesn’t have to be fresh, although that’s nice. It can be frozen. A lot of things like legumes, beans are very cheap. Olive oil, extra virgin is more expensive, but to be honest, you’re not going to be guzzling gallons of the stuff.

Dr Clare Bailey [00:21:16] So a part of it is just making it incredibly doable. So you have the ingredients, tinned food. It’s fresh. It’s incredibly fresh when it’s tinned, it’s healthy, as Michael said, filling freezer, frozen prawns, frozen spinach. Just make life easy for yourself and then you’re more likely to stick to it.

Dr Michael Mosley [00:21:35] And the other thing is that because you can start with a – this is a sort of 800-900 calorie a day dish, but you can if other members of your family, you can just add more stuff, so you pile on the potatoes or the rice or whatever it might be. And you also can even squeeze in a few desserts.

Dr Louise Newson [00:21:51] Not a bad thing, is it?

Dr Michael Mosley [00:21:53] I like this bit.

Dr Louise Newson [00:21:55] It is important because I mean, I don’t eat meat and my children do. So I’m always cooking twice and I’ve just always done it. But to have meals that you can chop and change and add, and also you can vary so you can make double and then you’ve got two or three meals, you know, because everyone’s busy and I think people forget – actually I quite enjoy cooking because it’s a time that I can’t have my phone on because I can’t chop and use my phone, I use it. It’s quite a meditative process actually. And so even if someone said to me, ‘Look, I can deliver food for you every day, that’s fresh’, I think I would turn it down because I quite like the ritualistic behaviour. I don’t like going food shopping, but I have food delivered. It is so easy, isn’t it through supermarkets and actually that way, I used to go shopping when I was hungry and then I’d always buy the wrong foods. So ordering it online, like you say, and I think it’s really clear, Michael, that we have to clear our cupboards. You know, I know when I was a student, I just used to have cups of tea and biscuits all the time when I was hungry. And, you know, if you don’t have biscuits in your cupboards, it’s more of an effort, isn’t it, to go and buy them.

Dr Michael Mosley [00:23:02] Absolutely, and you need perhaps some walnuts or some almonds or something like that. A small handful of nuts I find satisfying, other sort of snack things Clare?

Dr Clare Bailey [00:23:10] Bit of cheese. Yeah, surprisingly filling. And you don’t need very much.

Dr Michael Mosley [00:23:15] I’m a big fan of herbal teas. Again, kind of, you know, quite often when you think you’re hungry, you’re just a bit bored or you’re a bit thirsty or something like that. So you have a cup of herbal tea and the craving something in your mouth, if you like, goes away. And that’s sufficient. It doesn’t have to be a chocolate bar. Fortunately, we live at least a mile away from the nearest shop, so if I’m really desperate, I know I’m going to have to cycle down the hill, cycle up the hill again. The craving’s often passed by the time that passed.

Dr Louise Newson [00:23:42] And then with time-restricted eating. So the 5:2’s great for the more rapid weight loss, as you say, and the 800 calories. But what about sort of trying to get all the time you eat into a shorter time in the 24-hour period?

Dr Michael Mosley [00:23:55] Absolutely. So as part of the Fast 800 programme, we also recommend you have a go at time restricted eating. And I first came across this in 2012. It’s the brainchild of a Professor at the Salk Institute, Professor Panda. And sometimes people call it 12-12, 14-10, 16-8. But essentially all it means is you try to stop eating earlier in the evening and delay your breakfast by a bit. So, for example, if you were to stop eating at 8:00 at night and then not eat again until 8:00 the next morning, that would be 12 hours of time-restricted eating and I chat regularly with Professor Panda. He reckons probably 14-10 is optimal. He also thinks the best benefits or the most benefits come from stopping eating earlier in the evening. So he actually stopped eating about 6 pm and doesn’t eat again until 8 am. That’s 14-10 and that’s the protocol for much of his research. But there are multiple reasons why this is beneficial, not least of which is that having that late night snack is often the undoing of a lot of people. You know, a bit of this, bit of that. I might have a biscuit, I might do that and you’ve suddenly, you know, knocked back 400 calories without even thinking it. And you’re doing it at a time of day or rather night, which is biologically not good because you are sticking food in your face at a time when your body is trying to close down for the night. And that also seems to be the circadian rhythm seems to be important. There was a study which he told me about where they looked at women with breast cancer recurrence risk, and they found that those who were eating late at night, they had a greater risk of breast cancer recurrence.

Dr Louise Newson [00:25:35] Interesting, isn’t it? And again, I wonder how much is related to this inflammation, but also about there is something about resting the pancreas first, you know the pancreas shouldn’t be churning out insulin all the time. And there’s more spikes, isn’t there, with certain types of food?

Dr Michael Mosley [00:25:51] Absolutely. Also, you want to rest your gut because your gut takes a tremendous pounding. And I sometimes compare it to like a motorway, you can’t repair the motorway if you’ve got the traffic churning down it. But you’re absolutely right. Constantly just getting blood sugar spikes will ultimately lead you probably to prediabetes and ultimately perhaps to diabetes. So once upon a time you referred to 70’s, you know, kids would basically go out and play and they didn’t have snacks all the time. Now the eating opportunities are so much greater. The people just eat all the time.

Dr Clare Bailey [00:26:23] Yes and it’s incredibly frustrating. There’s so much confusing information out there about diets. So, you know, still people are being recommended to eat three meals and then to snack in between, you know, around 11 and in the afternoon. And then before they go to bed and that’s six. You know, they never, the gut’s never recovering. And you’re always in a pool of rising sugar. Yeah.

Dr Louise Newson [00:26:50] Which obviously the trick is really, I think, is to eat food that once you eat and enjoy it, you’re not thinking about it till your next meal.

Dr Clare Bailey [00:26:58] Satiating and that’s where you need particularly the protein and some healthy fats because then you don’t feel hungry.

Dr Louise Newson [00:27:06] Well, that’s exactly right, isn’t it? And I mean, I get migraines, so if I don’t eat, it will always trigger a migraine. Or if I eat the wrong things, you know, if I eat a mars bar and a packet of crisps now, I guarantee I’ll get a migraine later. So it’s great for me because I know I can’t eat those foods, but for other people it’s not so easy. But actually if you think about what it’s doing to your body, like you say to your gut, to your pancreas, to your future health. Then it is worth it, there should be more sort of health warnings, I think, on some of these foods. I was on the train from London yesterday and there was a really healthy looking lady. The train was going up to Edinburgh. She had all her hiking stuff. She sat down, she was just in front of me and then she had her diet Pepsi she had and it was a big packet of crisps that even said larger size something on it and her bought sandwich. And I thought, oh that’s a shame. She’s lovely and young. She looks really fit and she’s getting away with it now. But maybe, you know, like you no disrespect Michael, you know, time catches up doesn’t it? If you don’t.

Dr Michael Mosley [00:28:03] It has well caught up, not so much as has caught! Absolutely and unfortunately we can’t blame our metabolism because we all say ‘oh it’s because my metabolism is slowing down’, there is actually very little evidence that between the ages of 16 and 65, your metabolism genuinely slows down. What happens is you become less active and unfortunately you eat a lot more junk. And tragically – because I recently made the series for Channel 4 on this – apps and things that will make it so much easier to just order up junk food.

Dr Louise Newson [00:28:30] Yes.

Dr Michael Mosley [00:28:31] And we know that on average, when you get a takeaway, you consume twice as many calories as when you cook it yourself. So that’s worth bearing in mind when you order up the next pizza. And I do think that basically the industrialised junk food, which is largely responsible for the fact that we Brits are the second fattest in Europe after Malta. The Maltese blame it on fish and chips, which they say they got off us. And I think we are the fifth fattest in the world, highest rates of obesity. And we love our, you know, takeaways, and our junk food. And that’s something you kind of have to battle with. Like you, we’re huge fans of cooking stuff yourself. And yeah, I’m fortunate that I have somebody sitting right beside me here who is just lovely at kind of conjuring up different – I have these recipe books, Clare just invents stuff.

Dr Louise Newson [00:29:19] Yeah, which is a great. But I think we can all learn and I think, yeah. Ending on that very awful statistic, thinking about how fat we are as a nation and how individually we can all make a difference. But not just to ourselves. I think to our friends and our relatives and our family and anyone that we can cook for and preach to a bit, all these things have a little effect. So I’m really hoping the podcast today has just made people stop and think about little ways that they can change. So just before we end, I’d really like three take home tips. I don’t know how you’re going to do two and one maybe, about just easy ways, people are going to be feeling a bit overwhelmed and a bit maybe guilty because their diet won’t be as good as we’ve been talking. So what three things would be good for them to make a start to continue in a way they want to go.

Dr Clare Bailey [00:30:05] I’m not sure whether this is the sort of tip you’re looking for, but what I would say is enjoy olive oil. It makes food taste fantastic. It keeps you full, it’s anti-inflammatory don’t spritz the oil, glug it.

Dr Louise Newson [00:30:21] Great, that’s a great number one tip.

Dr Michael Mosley [00:30:24] Oily fish and I never was a fan of fish but there’s so much good evidence for the benefits and they call it SMASH: so that’s salmon, mackerel, anchovies and I can’t remember what the other ones are but…

Dr Clare Bailey [00:30:39] Kippers? We love kippers.

Dr Michael Mosley [00:30:40] Herring. So essentially the oily fish, lots of recipes, Clare also has an Instagram account where you can follow her recipes, but lots of wonderful things you can do with fish. And fish is more sustainable at a lower environmental impact than meat as well. So if you’re not a vegetarian, oily fish. Pile it on.

Dr Louise Newson [00:30:59] Great and number three, don’t know who is going to do that?

Dr Clare Bailey [00:31:02] For you. What would you say? I think one thing is probably don’t snack, that really does make a difference. If you’re eating Mediterranean style diet, you won’t need to snack anyway.

Dr Michael Mosley [00:31:14] Or if you do snack go for, you know, nuts, almonds and things like that.

Dr Louise Newson [00:31:18] Yeah.

Dr Michael Mosley [00:31:19] It’s hard not to snack. I have to say no.

Dr Louise Newson [00:31:21] I know it’s very hard, but don’t snack at night time in the evening, I think is a really key message from what you’re saying. So if we are going to snack, just preload ourselves, do it in the day. So I’m so grateful for your time. It’s been really energetic, lovely podcast and lots of nuggets of really useful information. So thanks so much for your time today. It’s been great.

Dr Michael Mosley [00:31:40] Thank you.

Dr Clare Bailey [00:31:40] Thank you.

Dr Louise Newson [00:31:43] For more information about the perimenopause and menopause, please visit my website balance-menopause.com. Or you can download the free balance app which is available to download from the App Store or from Google Play.

END.

Listen to more podcasts.