How to Eat for Health: Science-Backed Tips from ZOE’s Head of Nutrition, Dr. Federica Amati

Dr Federica FINAL CUT

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Arthur: Dr. Federica Ammar, it's such privilege to have you on. You are head of the nutrition at Zoe. Among so many things, author you've published two books everybody Should know This which is a recent book of yours, and then previously Recipes for a Better Menopause.

How would you describe your interest in nutrition?

Federica: so thanks for having me by the way, Arthur. It's lovely to be here. And I think for me, nutrition is the best tool to help people improve their health. So not only at an individual level, but actually at population level as well. So my background is in public health and medical science and nutrition was actually my last degree and my last specialization I spent over a decade working in public health and looking at how we can help predict and improve patient outcomes by focusing on. Personalized approach, that's something I've always been really interested in. And then as I was doing this work, what came through, quite clearly was [00:01:00] that nutrition has such a massive impact on health and it's something that people tend to have some agency over.

So the food that you choose to eat every day and that you choose to buy at the supermarket and that you choose to make available in your home for your kids, for example, there's varying degrees of agency, depending mostly on socioeconomic status, but most people have some agency and what's, so that made me really interested in nutrition as a really efficient way to help people.

And also one that's kind enjoyable. So most most of us enjoy food. It's a delicious part of our day. We've evolved very much around food. So as a species, food has played such a pivotal role to why we are here. And so it's one of these things that, that just made a lot of sense to me to hone in as, to hone it in, to become the main tool that I believe I can offer to help people improve their health.

But the core mission I have is really like an improvement in public [00:02:00] health. So how can we help as many people as possible to improve their health, quality of life? Sure. Longevity, like we all want to live as long as possible, but I think for me it's much more about the quality of the life that you live whilst you're here.

Because whilst we can help reduce the risk of early death, things happen, like life is super unpredictable. So it's really a lot about the quality of life that you have while you're here and Yeah. And the studies I've done and the sort of. Experience I have has brought me to nutrition as the most efficient and the most delicious and empowering tool we can offer.

Arthur: And it touches on everything in our life. You've talked a bit about you, things like energy , what are the sort of blanket main takeaways you tell people, if somebody's on the, on the tube you get chatting about nutrition, what are the sort of four or five things you're like, this are, these are things I would I give you?

Federica: Yeah. So I think the key things at the moment certainly with the way that [00:03:00] our population health is, and the way we're eating is try not to fear food too much. Like people are quite scared at the moment, I think they're not sure what to eat. They're quite scared of the ultra processed food narrative.

They're worried that, if they get it wrong, it's going to be really bad. And there's a lot of guilt associated with food. So I think my first message is try to reconnect with food as actually a source of joy. So how, what can you do to, even if it's just one meal a week where you really make something you love and sit down and really enjoy it.

So reconnect with food as something that's actually, it's a powerful tool to improve our health. It's not something to be feared. It certainly isn't something to be replaced with pills and to try and supplement your way out of. It's really there. Food is there to help us with our health and with our enjoyment.

The second thing is eat more fiber. So the most recent NDNS survey, which is like a national data survey, which we look to, to understand trends in [00:04:00] nutrition across the population. The most recent actually. Showed us that fiber intake has gone down. So it used to be that 90% of adults weren't getting enough fiber and it's now 96%.

So we've managed to get worse. So 96% of adults in the uk, and it's the same in the us don't reach the minimum dietary recommendation of 30 grams a day. And people are often worried about deficiencies and they'll be supplementing with say, vitamin C, for example. But actually the only deficiency that truly affects the vast majority of the population is fiber.

So eat more fiber is core message.

Arthur: what are the foods that have fiber?

Federica: So plants have fiber in them. So it's a key con component of plants. And when you think about what are the highest fiber foods? It's nuts and seeds. Legumes. So chickpeas, lentils, beans then whole grains. So oat. And spelts and barley and rye. And [00:05:00] then you do, of course, fruits and vegetables also have fiber in them.

But those three groups, the nuts and seeds, the whole grains and the pulses have the highest amount. Most of us don't eat those three groups every day. So starting there with those three groups of food, like really high fiber food is a really good idea. Just start introducing those in. There's also, fiber supplements that can help, but the key is to try and get it from your food.

Then I've designed a fiber supplement with Zoe, which is designed to deliver five grams of fiber and a variety of plants. But then you can also, go to boots and buy like asylum husk, which is well researched and tolerated, and it's only one plant type, so it doesn't offer the diversity, but certainly helps with increasing the fiber intake.

So do what you need to do. But the, the thing with fiber is it's one of these, components of her diet that more is more. So 30 grams is a minimum and more benefits of 50 grams. And in some [00:06:00]interventions where groups have put participants through trials that are high fiber diet up to 90 grams a day still shows more benefit.

So we are really behind on the health benefits we could get if we increased our fiber. So that's and also, we evolved very much to eat more fiber than we are now. So important to have more fiber. That's always a real big one. Then I guess the third one would be, it depends who I'm talking to, right?

Because different health goals require, so these two, those two are for most people. The third one, especially in the UK, would be rethink your relationship with alcohol. If you're drinking it every day or if you're drinking it most days or the week, really think about reducing that. I'm not suggesting everybody needs to go teetotal, but there is no real benefit to alcohol apart from you might like the flavor, you might enjoy having it with a nice meal, which is absolutely fine.

But in terms of its impact on our health, [00:07:00] it doesn't have a positive impact. So alcohol is something we need to just reconsider our relationship with and reduce in our lives. A really unpopular opinion, whenever I say this people have best comments like, oh my God, you're so boring, and oh, she must be fun at a dinner party.

And it's okay. And it's just lots of people have already started doing this. But it's really important that we take a look. So especially if you're somebody, the real magic happens if you're somebody who drinks quite a lot. So if you're having, several bottles of wine or several pints a week, and you are in that higher category of consumption.

Reducing even a bit has like a huge impact. It's not a linear improvement, it's a J curve. So if you're a high consumption person, if you reduce your intake, the improvement is drastic. And then when you get towards the bottom of the J curve, so if you're somebody who already drinks moderately, you can see a bit of an improvement if you reduce further.

But the real improvement comes from [00:08:00] people who drink quite a lot. So it's what if you're in that group and that's anyone who drinks any alcohol more than three or four times a week. And in one sitting, if you're drinking more than two glasses.

Arthur: also the cognitive impact seems to be pretty big. Obviously for the, the next day, but it seems to carry on for a long time. Is there a book or an article that you feel very clearly demonstrates all the facts as to Hey, listen, like I'm gonna do you a favor and the, these are the takeaways and why you should drink in a different way, or a, or not drink?

Federica: so Professor David Nutt's book called Drink is amazing, and he's like the leading expert on the impact of drugs on our health. And that book outlines all of the data, all of the evidence that we have about alcohol and its dangers, and also how resilient our body is if we actually drink less.

So it, alcohol does a lot of liver damage. It does do brain damage, but if you reduce your alcohol intake, both your brain and your liver can recover pretty well. So [00:09:00] it's not all doom and gloom, but it's just it's just it's a choice, right? It it's a choice. And, but unfortunately. The choice is really hard to make for you, then that's a sign of an issue as well.

But yeah, so that there's drink by Professor David Nutt. My husband has a podcast called, this Is Powerful, which goes into a lot of detail about drink and al sorry alcohol and other drugs from a lived experience and from experts, so that's an interesting one as well. And the World Cancer Research Fund, this year they did a whole campaign on alcohol and cancer, which is really interesting.

So their website has lots of resources as well.

Arthur: Fantastic. Thanks so much for that. Are there some basic things one should think about when approaching, let's say breakfast lunch and dinner.

Federica: Yeah, I think the simplest way to put it is to try and eat as many whole foods as possible. So try to buy as many of the original ingredients as you can. So I'll give a an example. If you are thinking about buying a readymade pasta [00:10:00] sauce, why don't you try and buy just some tin tomatoes, some basil, some garlic, some onion, and make your own.

That's a one example, but there's lots of them. So if you are going to buy like a frozen lasagna, why don't you try to make your own and then freeze it? And the big problem here is that many of us, most of us have no education in food 'cause it was removed from the curriculum mostly. So there's no, actually, it's a life skill that's not available to all of us, which is really sad because it's a life skill that impacts all of us.

To your point. Kind of everyone is interested in nutrition because we all eat every day, so that breeds interest. It also breeds armchair experts because just because I eat, I know what I'm talking about type thing, which is another problem, but the biggest, one of the biggest shifts we've seen in the past 50 years or so is people buy readymade foods way more than they buy whole ingredients.

Just like [00:11:00] your celery, your carrot, your onion, your potato. So trying to just think, okay, how, what can I make for myself from scratch is a really good first step? And then buying those ingredients. It doesn't have to be complicated. It can be super simple, right? It could be that you're actually gonna make scrambled eggs, you're gonna cut, you're gonna saute some mushrooms with it, and you're going to have some.

Put it in a wrap with some cheese. Something simple. It doesn't have to be super complicated, but then if you're buying, if you're making that and taking it with you or eating it, instead of buying like the prep equivalent that's already made for you, you've already done something for yourself.

Arthur: you are clearly a very mission driven woman and you've, you're very lucky. You know what that, that mission is, and it is it clear to you that the world could, feed everyone in a way that is, nutritionally sustainable and Correct. Obviously, economies and countries are so different in [00:12:00]it, in every way, but how do you, are there some like quick shifts you can see that we should be doing?

And what I'm particularly interested in is how you plan on having the biggest impact from now going forward.

Federica: So yeah, so sustainable food systems is a huge topic. I'm not an expert in it, but there's plenty of my colleagues who dedicate their lives to this. And there, there have been some really good, honestly, there's hundreds of policies that have been put forward as solutions. What's missing is not the brain power.

What's missing is not the solution driven approach. What's missing is political will. So you can have, some countries have done better than us in adopting these things, like Singapore has done a good job. There's some of the Nordic countries have a much more sustainable food system already, so certain countries have already taken the steps to do it.

We have very little poli political will actually, there's a little bit more political will now towards sustainable agriculture. So [00:13:00] agriculture's having a little bit of love. Not enough though, if we were to actually support our farmers to grow crops and animals sustainably, then we would be making a huge improvement to the environment and to our food system, and to the healthfulness of the foods as well. So there's lots of different ways to think about it. I think thinking about it at a local level and then branching out is probably best just because logistically it's quite tricky otherwise. And what we've seen, for example, with slaughter houses in the UK is that a lot of the supermarkets try to centralize their pro their supply from just a couple of laughter houses.

And so then the downstream effect of that is that many animals had to travel. Very long distances to get to the sorter house. And that's not good for the animals. And it's actually not good for the farmers either because they end up having more of a loss of the, and some of the animals that don't make it there.

So it's a horrible, it's not a good thing. So we just need to let, in [00:14:00] some ways we need to allow those who know exactly how this could work to crack on and make it better. And food waste is a massive problem in the uk. Like we waste a huge proportion of the food that's created in the UK just goes to landfill.

Which is such a shame. And it's especially embarrassing when we have such growing numbers of food insecurity. So there's households that can't afford to eat and we're putting food in the bin at the same time. It just doesn't make sense. So there's lots of gaps, lots of room for improvement, and there are some really great people working hard to try and fix this.

Patrick Holden is one of those people who is dedicating his life from the Sustainable Food Trust and Henry Dimbleby. There's lots of great people who are working hard. So that's, and that's something that definitely needs to happen and that's what I would call like the systems level approach needs to change.

Franco Fini, who runs Na Torah has proven, he's created his own food system, food supply to bring the products he [00:15:00] believes should be sold to his customers. So he's quite a maverick in that he's done that. It's doable, right? But it needs to have the political will and it, you need to let people who know what they're talking about, get on with it and sort it out.

Where I see myself having more of an impact is certainly supporting this work that these great people are doing and lending, lending my expertise if I can. But actually I work very much with people one-on-one. So I have a clinical role with well Founded Health as well as my Zoe role, and I teach at Imperial College.

So I teach medical students. And so I see a lot of power in giving people the agency to feel that they're well informed to make good choices with their food. So because we're not educating children on food or how to cook, we need to actually give adults now that power and say, look, these are the principles.

This is how you can improve your health. These are the things to [00:16:00] consider. It's quite a lot of information, but the thing that I am quite strong on is the science is pretty complex. Like nutrition science is actually pretty complex, right? There's lots of mechanisms, things shift. We understand something better than we used to, but actually the advice is simple and it's the same.

So like regardless of which mechanism we look at, right? The advice is the. The advice of eating a whole food diet that has plenty of plants in it, and that doesn't have added sugars in the diet. So from like sodas or just added sweetened cereals and things like that those sit, those recommendations sit across all of the mechanistic insights, right?

Evidence-based. So even though I feel a lot of the time on, especially online, some influencers try to make it sound really complex and they try to explain insulin resistant does this, and [00:17:00] then this pathway activates this. In the mitochondria, it sounds super like sci-fi, but the advice is the same.

And actually that's what you need at individual level. People need to understand how can I eat to support my health? And the principles of healthy eating are the same across any kind of mechanism. Getting enough fiber from a variety of plants, eating whole foods as much as you can. It's very hard to eat a completely whole food diet in the current food environment.

So I'm not suggesting that it's possible to do every single meal and every single snack from scratch, but really try to get to a point where more than half, more than 75%, ideally of the food you eat is from scratch. Choose foods that provide some of the essential nutrients that are necessary for us, like Omega-3 fatty acids.

These are found in fish and they've also found in seaweed and algal supplements. If you don't eat fish, but really worth getting that in your diet, we know that. Then essentially we can't make them. And then focus on the quality [00:18:00] of what you eat. So the quality ties in with the whole food approach though.

So if I'm saying make sure you have good quality fats, they come from olives, they come from nuts. They come from extra virgin olive oil. They come from like kefi and yogurt, right? These are all whole. So you don't have to overthink the quality thing if you are eating whole foods similar with proteins, right?

If you're having shellfish and oily fish and nuts and seeds and you are having whole grains, then you're eating like a chicken breast, then I'm not worried about the quality of the protein you're getting because it's going to be from Whole Foods. Protein quality starts to degrade when we're thinking about, protein bars and eating protein, cereal and protein, ice cream and processed meats.

That's where it starts to fall and it's not good quality anymore. So quality in Whole Foods does go hand in hand quite heavily. And so like I think the core message there is [00:19:00] that even though we haven't been taught this at school, even though we're a lot of us are actually lacking this core life skill, you don't have to have a PhD to understand it. The science is complex, but the advice is simple. So the trick is how do you make sure that you can follow the advice in a consistent way? And this is where I believe, like what the biggest impact I can have in terms of numbers is through what we're doing at Zoe. So Zoe has created this app, which literally helps you to actually create these healthy eating habits that stick, and it does it in a way that's very easy.

So there's very little friction for the person who's having to do it. And that has been the goal. The goal is like, how can we make this as easy as possible, but also fun, enjoyable, and something that people can come back to and just stick to it and be consistent. [00:20:00] That's where the magic happens. When you're consistent with this approach, then yes you feel better.

Your energy is better, your sleep is better. There is nothing that isn't touched by our nutritional status. So yeah, we've done studies, we've shown in randomized controlled trials that our approach helps with these important clinical health outcomes. But fundamentally, it's also how you feel, right?

So there's nothing that, apart from, let's say sleep is up there as well, if you have a bad night's sleep, you feel crap like nutrition. What you eat like touches every aspect of how you feel and how you operate, whether it's cognitive or physical. So it's honest. It's once you do it and you see the difference is you you're like, okay, this is, I'm staying in this lane because I feel so much better.

Federica: it's really exciting.

Arthur: ' cause it seems to be as though it tells you how you respond to foods, and that makes it [00:21:00] very clear that people respond differently.

Federica: Yeah.

Arthur: Surely. In a world where we are, so resources are limited, with the NHS for example, does it make sense for, everyone to have a test of some sort?

May, maybe it's in a Sheba form, but. It seems like we've, we're not fighting in the right dimensions with regards to health in terms of how impactful nutrition can be and maybe the education piece there as well.

Federica: Yeah. The problem is at the moment the health system is set up to treat disease, and that's how it's been set up for a long time. Primary prevention, which primary prevention is like the magic bullet where if we could focus on primary prevention, we would save hundreds of thousands of lives and billions of pounds, right?

And that's prevention before any risk factor, before any sort of disease crops up. But even at secondary prevention. So when you already have high blood pressure or when you already [00:22:00] have high cholesterol, amazing results and even tertiary prevention, maybe you've already had a heart attack, you've already had a stroke, like you can still make a huge impact on quality of life and avoiding a another episode with nutrition.

So the health system isn't set up for that right now. It's set up for treating the disease like it's, brilliant. If you break an arm and you go into hospital, they will put that arm back. It's great. But we just don't have the infrastructure resource to work in prevention right now. So with Zoe is trying to create an opportunity for people to actually do this themselves.

Now the new Zoe, which is out September doesn't require testing. We have enough data from all of our amazing members. We now have predictive algorithms that can tell us how you respond to sugars and fats without needing to actually take your [00:23:00] blood or have you wear a CGM. So we've moved beyond we've, it's like the next step, right?

We now

Arthur: sound, this sounds like such a big deal. Is this a secret? I

Federica: it is not out yet. It will. So if it's out, if this is out in a month, we're good.

Arthur: Okay.

Federica: yeah. So massive deal. We've working on it for a long time. But but this is what happens when you have, this awesome. We have a science first approach and we've always had what we do rooted in data and in science.

And thanks to the fact that members, Zoe members allow us to use data for science. We've published over 70 papers in scientific journals of the highest impact, which is brilliant. And now we're able to give back to the members themselves by saying, actually. You can just by filling in this questionnaire with some critical questions, our predictive algorithm can tell us your blood fat response, your blood sugar response, and we can actually quite accurately predict your gut microbiome health, [00:24:00] which is cool.

So that's the next step. So actually the new Zoe is, doesn't require a test kit, which means it's also way more accessible. We are now looking at something that for a 12 month membership with the personalization is like nine point 99 a month. So it's an it's per it's amazing. It's so cool to be part of this because the impact we can have here is we've already helped hundreds of thousands of people.

Next up is millions, right? More accessible. More personalized. We've doubled down on the behavioral science side, so the new app is even better at helping people to be consistent with their food choices and rewarding, where they make really excellent choices. So it's really cool. And then we, our gut microbiome test is also evolved.

So if you do want to actually measure the gut microbiome composition, we're still the only company in the world that does full shotgun metagenomic sequencing, [00:25:00] which is a fancy type of DNA sequencing and then analyzes it within our own cohort with health outcomes. So instead of just saying, oh, we found this microbe and based on that person's study over there, we think it's okay or we think it's bad.

All of our gut microbiome analysis actually relates to real data with health outcomes from the same cohort. So like we can, when we do the microbiome analysis. The score that we give and the clusters of gut microbes we've identified directly contribute to things like increased risk of type two diabetes or improved heart health, or improved visceral fat accumulation.

So like our gut microbiome test relates to actual health issues as opposed to we think it might be good, we think it might be bad. Individual microbes very rarely have an effect by themselves. It's the ecosystem and how it works together, and that's what we look at. So we look at the [00:26:00]ecosystem and how it's working together to influence health.

So the next Zoe really offers this much more accessible, personalized behavior change centric mod like app, which can transform your, so the minute you download it, you can start transforming your health right.

Arthur: That's extraordinary.

Federica: And the gut microbiome test, which was already the best one, has evolved further to help people better understand it.

And the gut microbiome test is becoming a real marker of health that is worth tracking because it gives you a real insight. I always say the gut microbiome doesn't lie. I can ask people to take a food diary and ask them about their stress level and ask them about their alcohol consumption, and I can ask them about these things and they might tell me x, right?

But when you look at the gut microbiome composition, like it tells a story. It tells a story of your early childhood exposures. Because early childhood exposures, like how you're born and whether you had antibiotic exposure, a lot in early life, [00:27:00] has an impact on your gut microbiome. But also tells me like, do you live in a polluted area?

Are you exercising enough? Do you have really high stress levels? Are you sleeping? And how's your diet? So it gives you the snapshot. How, like of the exposures that are affecting our health in a way that it's really hard to get with any other metric. So like with any single metric, right? You usually need a variety of panels to, to get that idea.

So it's really exciting and that is for me, this app is available in the us it's available in the uk. We can potentially help millions of people improve their health through their diet with just an app. And that is so cool. That is, I can't, you can't, that for me that is Mo so motivating.

And then hopefully on a smaller scale, the education I do through Imperial College, because I'm educating doctors and future healthcare leaders, I hope that will then trickle down to their patients and [00:28:00] their people. They work. So that's like another way I try to do my best in terms of impact. And then of course like, yeah it's amazing.

I write books. People read them, which is cool. But yeah, like I, to be honest I try all the things, I'm trying to do all the things that can be helpful. And just being, and there's there's there's a really great group of people at the moment who are all working towards this goal of helping people to improve their health and in, at home themselves.

And I think it's just an exciting time to be part of that.

Arthur: but at the same time, there's there's quite interesting things ha happening and someone quite bright told me about how, big changes happen. Some you can see and some you don't see, and you just see the world slowly shifting. And if you look at how people monitor their health with running apps, et cetera, et cetera, and Brian Johnson and the whole kind of longevity movement that it seems like that's gonna be even more linked with how people ease.

H having said that, you look at, the US [00:29:00] must be the w wealthiest nation in the world, yet so many people, horrifically Britain, got a higher GDP per capita, yet that, one of the highest amounts of processed food being eaten here compared to other countries.

So human behavior is obviously a bit quirky in terms of how people eat and what people do, even though they've got the information. Now, just even thinking about, let's say alcohol. So alcohol for so many different reasons people drink. But it seems like gamification can be quite a powerful tool.

And when you get immediate clarity on, oh, that's already benefiting me, that I've changed my behavior and I'm doing x and Y, could the Zoe thing do the same for people who drink too much? For example, could you see me clear metrics on how it impacts you over time?

Federica: alcohol doesn't score well in Z so if you log it, your score's going down. But there is gamification definitely plays a part. And to your point, giving people instant feedback. So this is [00:30:00] a key learning and a key feature we have is we have the world's first validated photo logging tool.

So you can snap a meal and you get instant feedback on how healthy it is. Or you can scan a barcode and get instant feedback on how healthy that product is within three seconds. People, it's hard work if you have to look things up and search. So we've created a food school which has validated, it's excellent to be honest, at the food school, we've been working for eight years and.

It just takes into account a lot of different aspects of nutrition. So the complicated nutrition science all goes into that score and you get the number simple. So it's exactly what I was saying before, like complex science, but a simple message in terms of advice. And then we also have the Zoe Process Food Risk Scale, which is something we created this share and it was really to help move the conversation forward on, on processed foods.

The Nova classification, which is where Ultra processed foods came from, has been an incredibly useful tool. [00:31:00] It's an epidemiological tool, though it doesn't help consumers make healthier choices. It helps us understand that population level, what people are eating, and it helps us understand how the food environment has changed.

But if you're going to the supermarket and you want to buy something, when more than 60% of the food products are ultra processed. It cuts out a lot of shopping options. Like it's not great. It's not great for consumers, right? So we created something that's more aimed at understanding the health impact of a food. So it's not an epidemiological tool, it is a consumer tool and it's embedded in the app, but it's also, we are working with different public health agencies and governments to help use it to improve, for example, school foods, right? So what we've done is we've identified the different aspects of processed foods that have the worst impact on health, and we've put them into the risk scale.

So you end up with four categories. There's high risk foods, which actually you should try [00:32:00]not to eat regularly. Then there's like moderate risk foods, which shouldn't be a regular part of your diet, but might be okay occasionally. Then you have the low risk foods, which are actually fine to eat, and then the no risk.

'cause some processed foods have absolutely no risk associated with them, so there's no reason to avoid them. And that's been really helpful and it's been really well received because when we run, we have a 2 million food database, right? So we've got a big food database at Zoe, and when we run the risk scale through that, about 25% of foods that people buy at supermarket in the supermarket are considered high risk, but not 60%.

So it suddenly opens up more options that actually could be part of a healthy diet. Right now, of course, the core message is still to try and eat as many whole foods as possible, but at one point we had many people writing in telling us that they were worried about bread. They were like, didn't know what bread to buy for their [00:33:00] families, and they just felt a bit paralyzed by it.

And I remember this one lady wrote in and she said that she'd stopped buying butter because she thought it was ultra processed, and so she just completely stopped buying. So it was really tricky when the message is. Scary, but unclear on how to act on it. And so the risk scale offers something that's a bit more direct, speaking directly to the concerns, right?

People want to buy food that's healthy. The level of processing doesn't automatically tell you how healthy it is. So what we did is how has this processing impacted the healthfulness of the food? And we give that back in the app as well. But you said something earlier which was interesting about the UK and the us, like having high GDP.

Yeah. The problem is, it's not about, it's not quirky human behavior, right? It's actually just a product of our environment. So the foods that you choose to eat are very dictated by the foods that are available to you. [00:34:00] Simple as that. To be able to break out of your food environment and select foods outside of what is available.

Very easily. You have to have money and time to go online and or go to the specific shop that has the better quality foods. So it's not that the Brits and the Americans are strange or like they're just a bit odd. It's not that. It's that the food environment we live in is crap. We have the worst food environment.

So if we compare ourselves to countries that have better metrics on this, like Japan or Italy or like Portugal, their food environment is completely different. Access to whole food, fresh fruit, vegetables is so easy and cheap. So it's not because we are weird, it's because our food environment hasn't been protected for us.

So what, there are policies in place in many of these countries. [00:35:00] Which means that supermarkets cannot sell above a certain threshold of junk food. And there are price incentives for farmers to grow vegetables and fruit. Like it's a food that's a food systems problem, right? So the food system here is not set up for health.

It's set up for maximum profit for multinational corporate firms, basically. So until that changes, until we're like really sorry, you guys are gonna have to take a little bit less money home next year, until that changes and we are like, because we wanna save this money over here with the NHS it's very hard.

Now, as I said, things like Zoe, we are trying to help people make, navigate the food environment better. So like we're trying to help them understand this is better to eat than this. And we're also to add to the noise, right? Is the food environment is set up, is crap. And then there's a food marketing and advertising, which is so mislead.

So [00:36:00] front of pack labeling that has things like high end protein, low in fat. We know that impact impacts and influences consumer behavior. People who are health conscious will pay more money and buy more of are high-end protein food and a low in fat food regardless of the healthfulness of that food.

Food industry knows this obviously. So front of pack labeling, food advertising, and the way it's marketed in store, buy one, get one free end of vial placement. All of this is happening geared towards profit, not public health. So it's not us, it's the environment. And and also it is true though that, for example, Japan, one of my favorite examples is Japan.

They have food education and nutrition ingrained from nursery. They have nutritionists in schools, they do. Food, cooking lessons, food prep, like throughout [00:37:00] school. So it is unheard of that someone doesn't have an understanding education of what is the most basic and fundamental human need. Whereas here, we, math, geography, history or I don't know what else people do at school, but there isn't, there is very little practical advice and skill.

Like people I, I've seen, I've worked with families where the young adults leave school not knowing how to cook anything. Someone once asked me how to boil an egg 'cause they've never done it before. How long is it for? How much water? So that is still a critical problem. But also, we need the education.

We do need people to feel confident to know what to eat because otherwise. Where we are now, and this is very unique to the US and UK actually as well, is that people tend to influencers online, right? They haven't had any food education. We don't trust the government. Less than 1% of us follows dietary guidelines from the government.

So people will say, often [00:38:00] say, oh, the dietary guidelines are killing us. No, they're not. None of us are following them. That's not the problem, okay? It's not because people are eating the eat plate. It's because no one is paying any attention to it. So what happens is there's this huge wave of misinformation.

So we mustn't confuse people's access to misinformation with actual information and education. They're very different in Denmark, where the trust in the food advice from the government is really high. Many of these misinformation influencers have no audience there because they look at it and they're like, nah, that's not true.

Keep looking. So there, there's a, there's gap that's been left. In our minds is being filled with frankly peddlers who are just selling us their product or their whatever it is. And it's a real problem because it's very hard. It's actually really hard to spot who's credible. So like it makes it super [00:39:00] difficult for general population to say, oh, should I trust this person or not?

And so what happens is the loudest voice in the room with the kind of catchiest whatever, or topless supermarket aisle T trawling, gets the millions of views and people actually change their diets. They change their lives following this advice. I've worked with many people one-on-one, who have made a big change to their lives following an influencer and seen quite terrible health effects.

And then come and see myself and my medical team, who I work with to try and fix it. It's not good.

Arthur: A lot of challenges. So we're gonna move into what we're gonna call 'em quick file que quick file questions where someone will just be a statement and we want your thoughts. So salt,

Federica: for most people need to be mindful. Not everyone is salt sensitive. So salt is a problem for high blood pressure. If you have too much sodium in the diet, you're at higher risk of high blood pressure. And high blood [00:40:00] pressure is the single biggest risk factor for heart disease. But about a quarter of us are not sodium sensitive.

So what does that mean practically? Try not to add too much salt to your food if you're adding, like a lot try to reduce, but the key source of added salt in our diet is actually processed foods. It's added to cereals, it's added to sources, it's added to sodas. So that, try to reduce those first 'cause that's probably where biscuit.

Pastries. That's probably where you're actually getting a lot of unwanted and uncounted salt. And then in your home cooking, if you're making like a salty dish, add lots of vegetables, the potassium in the vegetables balances out the sodium, which is also why things like sauerkraut and kimchi are actually really good for us.

'cause there's salt in them, but there's lots of potassium from the vegetables. So top tip is if you're using salt and you're cooking, make sure you're having plenty of veggies, salty veggies. Okay.

Arthur: If [00:41:00] we yeah. If we count it out, that's fine. It doesn't count. What are two unprocessed, reprocessed foods that we wouldn't expect to be ultra processed?

Federica: hopefully it doesn't matter, like ultra processing is super hard to tell. No before is not the way to look at it. Okay. So that's what I've been saying so technically you could consider tofu an ultra processed food. It's not bad for you. So let's just delete that conversation. What we need to be focusing on is what are high risk processed foods that we need to reduce a very quick fire round of.

The ones that are always high risk are sugar sweetened beverages, sodas, fizzy, pop, just cut 'em out of your, they're just not helpful in any way, shape or form. Processed meat products, I don't need to name brands, pepper Army, things like that, like cheap sausages always going to be high risk processed foods.

And another one will be your sort of confectionary candies and your biscuits and so sweet [00:42:00]foods that are, the vast majority of them found in supermarkets are high risk processed foods.

Arthur: coffee you made a very interesting remark, which was around how people can have different amounts. But there was one specific one that I wanna wanted to understand, which is there was a difference between filtered and unfiltered. Could you just explain that?

Federica: Yeah, so when we filter coffee a specific fat is filtered out of the co of the final beverage. Which is good because, so coffee overall, coffee consumption is good for health. People who drink coffee have better health outcomes. It doesn't have to be, you can have decaf coffee and still see health benefits.

Caffeine itself has some health benefits, but the majority comes from the beverage itself. The fermented coffee bean has lots of polyphenols and it has some fiber, which is where we think the magic is coming from. There is this fat that if you don't filter your coffee ends up in your coffee. And if you have that regularly, that, so if you say, if you have three or four cups of [00:43:00] this unfiltered coffee a day, it will increase your LDL cholesterol.

So your what, your less helpful cholesterol. So it's basically a fat that isn't helpful for lipid profile.

Arthur: in Nespresso capsules. Where are they on the

Federica: Yes. They have a filter in them.

Arthur: Thank God.

Federica: . So unfiltered coffee is mostly French press and things like the Turkish coffee, where you literally put the grinds in with the hot water and then you drink it basically.

Yeah, those are the ones. But espresso machines. Espresso soluble. So freeze dried, that's fine too.

Arthur: yeah. Tap water, London tap water.

Federica: Very good. Very good question. So London tap water is a funny one because. It's safe for a lot of things. So like it's safe across a lot of the parameters that we keep an eye on. And so it's safe string. However, we're one of the only countries that doesn't have an upper limit for plastics and for other chemicals.[00:44:00]

And that's emerging to become, to be of a bit of an issue. So like even the US does, even the us but yeah, even they do. And Europe does. So London tap water is London Tap water is still definitely better than drinking a soda or drinking a sports drink is still definitely better than those things. And water is important for health, but the evidence on this is like shaping up now.

So the environmental, like one of the UK's leading environmental groups that works with water is actually asking the government to start putting an upper limit into play in place for these. Forever. Chemicals and plastics.

Arthur: Yeah.

Federica: I have a filtering system at home,

Arthur: So follow that advice everybody. Okay. Is it important to vary your diet? If you are having, carbs varying the type, the where those carbs are from the type of vegetables us

Federica: Yeah. [00:45:00] So variety gives our bodies a better choice of nutrients. So like different foods contain different nutrients in different amounts, not only the traditional micro micronutrients and minerals and vitamins. Also things that we don't know everything about, like bioactive compounds, especially in plants, right?

So there's hundreds of them. Thousands. We're not sure what they do, but they're good. And when you chain switch them up and have them together, they have a synergistic effect. So having a variety of foods is good. Having a variety of plants is really good for our gut microbiome. Our gut microbes like to have a variety of fibers, a variety of polyphenols.

So if you're having a nice varied diet, you're going to have a better gut microbiome composition. So that ecosystem of microbes in your gut is going to be serving you better with more beneficial health outcomes. And one of the easiest way of doing this is to eat seasonally. If you eat seasonally, you have to change the vegetables and the fruits that you eat 'cause it's things are good off season,

Arthur: yeah. And e Energy. Not that I want to get [00:46:00] too distracted by energy lums. I notice like having someone having carb heavy meals can be quite, you can feel pretty sleepy after, but how do people optimize energy? What would be all like two, three quick tips.

Federica: get enough sleep. Sounds obvious. You that's key. I have had, I have young children, so this does not apply if you've got a baby, right? You can't get enough sleep yet. Just hang in there, have some naps, and then eventually you'll sleep. But getting enough sleep is really important. Then the other thing that's critical is, again, quality.

So carb heavy meals. What does that mean? You don't mean carb heavy meals, you mean a high refined carbohydrate meal. So if you're having a big plate of white rice with I don't know, a bit of chicken, it can probably feel a bit rubbish. When you have a carb heavy meal. Carbohydrates include chickpeas, beans, lentils, nuts, seeds, whole grains.

If you are having like a spelt salad with chickpeas and vegetables, you're not gonna have a slump. You're gonna feel good. So [00:47:00] focus on the quality of your diet. Now what we've seen across our trials, which is really interesting, is that increasing your fiber intake helps with energy. We didn't expect that to be one of the biggest metrics that would change, but energy levels consistently increased across the populations that we've looked at.

And we've done several trials with energy with energy as a measure and fibrin intake as a changing factor. It increases energy throughout the day. So if you're getting more fiber in your diet, you will also have more energy, which is so cool. What a nice side effect of eating better. Sleep quality of your food.

Don't just lump all carbohydrates. 'cause I'll tell you, if you only ate chicken breasts for three days, your energy will be rubbish. So it's not carbohydrates, it's the quality of the carbohydrates that's important. And then eat more fiber. You'll get more energy. Great.

Arthur: if you're on a night out and you don't drink, you, you're trying to stay up. Is it just coffee? Because

Federica: if it's [00:48:00] three in the morning. It's just nighttime and you should be sleeping. Hopefully the good company and the music is gonna do some good coffee. Coffee will stop you from feeling sleepy. But honestly, like our bodies have a circadian clock. They have a, they, if it's bedtime, they're like, it's bedtime and your you'll feel tired 'cause your, all your hormones will be help pushing you to sleep.

What coffee does do is delay that a little bit, but only with one of the mechanisms. So the adenosine. Coffee can help, but at some point just go to bed.

Arthur: Creon is a yes rather than a no. Is

Federica: Yeah. Creatine's a good supplement. Creatine's good because it does, it helps with lean muscle. So lean tissue, if you're trying to grow muscle, you're trying to increase your lean mass, it actually does help. It's an incremental help. So what I wanna stress is if you are trying to increase your lean mass, you're trying to grow your muscles, just the creatine isn't gonna do it.

You need to have a good diet you need to have a good, varied diet with plenty of [00:49:00] healthy protein sources. And then the creatine can add that extra bit on top. Like about, it varies with studies, but 1.5% to 5% of lean mass increase with creating. Which is good though, right? Still like a nice increase.

So it's safe, it's tolerated, it's been so studied. It's the most studied supplement we have. So across different populations, the longest running trial, five years with daily consumption, we know it safe. And it's actually the reason I I like it is you can't really get it from food like creatine monohydrate, which is what you buy.

It doesn't come in food, creatine does, but you'd have to eat a lot of meat to get five grams of creatine from your diet. And Parmesan is actually quite high in creatine, which is nice. I love Parmesan. But it's just one of these supplements that don't makes sense. 'cause it's like it's adding something extra.

It's safe, it's well tolerated. And also if it just means that, [00:50:00] so like I know this with myself, right? If I've taken creatine in the morning, I will work out. 'cause I'm like, I've taken the creatine, I've gotta do it. So if it helps you to like stick to the habit formation, then great. And it's cheap, it's a cheap thing to make.

So it's cheap to buy. And yeah, and it's one of these things that, it is very rare. One of the very few very rare supplements that I do think is quite good.

Arthur: Th three things that give you joy.

Federica: My children. I'm obsessed with them, love them. Food, unsurprisingly, I literally love food, love eating it, love preparing it, love everything about it, love food so much. And then spending time in Italy when I go home. I'm just really happy. I love it there.

Arthur: Why are you in it to be there?

Federica: I'm from Rome. I love going back to Rome, and my favorite place in the world is Sardinia.

I just love it there. I will retire there eventually. There's no question. I love it there. I love just the colors and the water [00:51:00] and the nature. It's, everything is brilliant

Arthur: a, a ma a mantra you want to embrace now would be a,

Federica: Oh God, I don't, it's not a Nike advert, but just do it. So it comes to mind. It

Arthur: it's nothing to do with the Nike put behind you, is it?

Federica: No. Is there a Nike book? Oh no. I was like, God, do I have that? No, because, so it's because basically I've agreed to run a half marathon and by the time this comes out, I may have run it, but I got the timelines wrong.

So I thought I had an extra month to train and actually I don't, it's literally in four weeks. And, but I was really worried. I was like, am I gonna be able to do this? I don't really run that much anymore. And so this morning I just made myself go for a run, like just to start, like not super long and I just did it and actually I can do it.

So I think often just doing it. Just proves just do it and then you've done it and it's actually, it's never as hard as you think it's gonna be. It's never as hard. It's always much harder in your head. It's the same. Same with changing your diet. So I [00:52:00] like, if you're gonna change your diet, just do it.

Just start with breakfast tomorrow morning. Have a have a really good breakfast. Just start with that. Just do it.

Arthur: One unusual thing that gives you pressure.

Federica: Unusual. Oh God, I'm such a, I'm like a really obvious comfort creature of comfort. There's nothing unusual that gives me pleasure. I love things. I like food, I like baths. I like how nice hotels. There's nothing unusual that other people might think is unusual. Honestly, I can't think, I don't think anything's that odd.

I love reading. I love looking. So we have a whippet. I love taking her for walks, looking after her. I like really helping others as well. So if I can do something useful for someone, but that's not unusual either. I don't know. I like cold showers. My husband thinks that's unusual.

Some people might find how much I love fermented foods unusual, but it's not unusual to me.

Arthur: that's a very good one. I think it's gonna come up again. It may well be a favorite book, film or artist that isn't [00:53:00] obvious.

Federica: one of the most important books I've ever read in terms of it just completely changed. I think it changed my worldview, which, and also how I view myself is the Body Keeps A Score by Bessel VanDerKolk, which is a very popular book. So many people will have heard of it, but it's really worth reading.

 the whole story behind Rodriguez, guys, searching for Sugarman.

That, that whole, that documentary, his life and his lyrics are actually really amazing. It's such a, I think it's a really unique and thought promo. It's a really thought provoking,. And so the combination of the actual documentary and then listening to his music

And I also Maria Callas as well, love Maria call's voice. And then I went to see the movie and I had no idea. Her life was so terrible. So the movie was really insightful to tell the story behind. And then when you re-listened to the music after you've learned a bit more about her life [00:54:00] story, it even, it sounds even more powerful,

Arthur: yeah. What's that film? With the Italian cinema. Do you know the one on cinema Paradi is? Oh, absolute

Federica: yeah. That's an absolute, that's not unexpected though, is it?

Arthur: no, but we're throwing it in

Federica: if you're gonna go for the obvious ones Lata Bella is just one of my absolute favorites. Phil?

Arthur: You've got the opportunity to tell people in a itan expression, that you just you love.

Federica: Okay. Lata Bella is a good one. There's so many an expression that isn't swearing.

Arthur: Yeah.

Federica: I don't know. I'm Roman so there's a lot of we, there's when we expect we're quite slangy as well.

Arthur: Maybe there's one that could be like a tagline for your next book.

Federica: Oh God, no.

Arthur: or, or the documentary,

Federica: yeah, now I've got Love ts Bella in my head because we just stick to that movie. But there's man, I always, I often think, man, Jamal is like, it means let's go and eat together in one word, man, Jamal and I actually [00:55:00] have thought about that for a book

Arthur: a movement. A movement. A culture.

Federica: Yeah, Manja. Because it also, it is, it's the joy of eating together, which is something we need to reconnect with.

So maybe I'll do that one, Manja or it just means, it means let's eat together. And it's a joyful thing. It's a, it's like a, it's get together and eat. So bringing that back, sharing meals with our families, our friends, our colleagues, it doesn't really matter who you share it with, it's just that human connection food gives us this anchor for human connection.

And I think we need to like claim that back.

Arthur: thank you so much for today. What water privilege and hopefully it can change behavior and for sure. It's so many amazing takeaways.

Federica: Yeah. Hopefully people are just inspired to just do it. They to just make a change to just to know that you can make this change in the food you eat and help feel better today and help your future self as

Arthur: And more man, Manja,

Federica: Man.

Arthur: word? Manja.

​[00:56:00]