Before You Eat Breakfast! - #1 Nutrition Mistake People 40+ Make Causing Disease, Fat & Inflammation

Dr. Rangan Chatterjee 0:00 In your brand new book, Rupy, Healthy High Protein, which I absolutely love, you make the case that many of us are under-eating protein. I wanted to start today by talking about breakfast-

Dr. Rupy Aujla 0:13 Mm

Dr. Rangan Chatterjee 0:13 ... because I think this is a meal where many people are probably massively under-eating protein.

Dr. Rupy Aujla 0:20 Yeah.

Dr. Rangan Chatterjee 0:20 So first of all, why is it, do you think, that many of us are under-eating protein? What are the consequences of us doing so?

Dr. Rupy Aujla 0:28 Mm.

Dr. Rangan Chatterjee 0:29 And how should that play into our breakfast?

Dr. Rupy Aujla 0:32 I think breakfast is a great place to start because, like you said, we tend to under-consume protein at breakfast, and that sets us up for the rest of the day. And if you think about typical breakfast foods, and if anyone's listening or watching this, they can probably conjure up croissants, cereals, oats. While some of those are healthy or healthier than other options, they have a common denominator in that they tend to be quite low in protein unless we supplement with certain elements. And what that does is it does not replenish what we've been breaking down overnight. So when you wake up first thing in the morning, you're in a fasted state, and in that fasted state during sleep, you're breaking down your proteins, you're repurposing those, you're rebuilding them up into all these different structures, some of which are muscles, other which are enzymes and hormones. And you need to replenish that store of amino acids, which are the building blocks of proteins. And so breakfast offers a prime opportunity to replenish those amino acids that your body has been breaking down. The other thing that I think a lot of people fall into the trap of is when you don't have protein at breakfast, you tend to have hunger mid-morning. Everyone's had that-

Dr. Rangan Chatterjee 1:57 Mm

Dr. Rupy Aujla 1:58 ... time where they've had something quick, maybe a cereal or, or something on the go, and then by mid-morning, you're hungry again. You're like, "I've just eaten. Why is that?" Well, protein is incredibly satiating, so it signals to your brain when you've had enough protein. It's... There's a signal to your brain that says, "I've had enough food. I don't need to crave any more food." So it curbs your cravings, and there is something called the protein leverage hypothesis that perhaps some of your listeners have heard, which is your body will continue to signal to you to keep eating until you've met your personal protein threshold.

Dr. Rangan Chatterjee 2:36 Yeah.

Dr. Rupy Aujla 2:37 And unless you've hit that personal protein threshold, you will continue to be hungry, hence why you're reaching for the biscuits, you're reaching for something sugary, even though you've just eaten a couple of hours before. Does that make sense?

Dr. Rangan Chatterjee 2:50 Yeah. Let's just bring in ultra-processed foods here-

Dr. Rupy Aujla 2:52 Mm

Dr. Rangan Chatterjee 2:52 ... because that protein leverage hypothesis is really interesting. There's... You talk about it. Ted Naiman's been talking about it for years, um, this idea that we'll keep consuming-

Dr. Rupy Aujla 3:05 Mm

Dr. Rangan Chatterjee 3:06 ... food until we get enough protein. Okay? And then we think about the modern food environments and all these ultra-processed foods, which usually are very low in protein.

Dr. Rupy Aujla 3:16 Mm.

Dr. Rangan Chatterjee 3:17 So when we think about ultra-processed foods and the fact that they drive us to overconsume, do you think one of the reasons why that is, is because of their low protein requirements?

Dr. Rupy Aujla 3:32 Absolutely, without a shadow of a doubt. I think there are a lot of issues with ultra-processed and processed foods in general, one of which is the protein content of them, and people might think to themselves initially, "Okay, well then I'll just go for some of those protei- processed foods that label themselves as high protein, having twenty grams or twenty-five grams of protein." And that's not what I'm suggesting whatsoever. I think the majority of the processed foods that we see on supermarket shelves are not only deficient in protein, but they're also have ingredients that are remarkably different from the initial ingredients that they were generated from, whether that's from wheat or grain, et cetera. And that processing makes it super easy to absorb the carbohydrates, the sugars within that food, and that leads to sugar spikes and corresponding crashes, but it's also not satiating. And what happens when you eat protein is that not only does it signal to your brain that you've... you're having enough food, and it's, it has the satiating effect, but it also delays something called gastric emptying as well. So when you consume food, if you eat something, you swallow it, it goes into your stomach. That is bathed in acids and other enzymes to break down that food, and if you're having protein in that mix, it delays that gastric emptying, so it spreads out the absorption of those ingredients over time so you don't get these big spikes in carbohydrates and sugars.

Dr. Rangan Chatterjee 5:04 Yeah, this has got implications, doesn't it, beyond just energy-

Dr. Rupy Aujla 5:07 Mm

Dr. Rangan Chatterjee 5:07 ... because of course, um, two hours after you've had a sugary bowl of cereal-

Dr. Rupy Aujla 5:12 Yeah

Dr. Rangan Chatterjee 5:12 ... which is, you know... There, there's many issues potentially with that, one of them being it's low in protein. You have that mid-morning hunger-

Dr. Rupy Aujla 5:21 Mm-hmm

Dr. Rangan Chatterjee 5:21 ... where you think, "You know, why am I still hungry?" You know, I used to have this many years ago before I fundamentally changed the way that I eat. And I think it's so common, and breakfast cereals are still such a common food.

Dr. Rupy Aujla 5:34 Mm.

Dr. Rangan Chatterjee 5:35 And it's, you know, it's interesting, yes, that mid-morning hunger, but also what many people are trying to lose a bit of excess fat off their bodies, aren't they?

Dr. Rupy Aujla 5:43 Yeah.

Dr. Rangan Chatterjee 5:43 And of course, not consuming continually throughout the day is probably gonna be a good thing for them.

Dr. Rupy Aujla 5:50 Yeah.

Dr. Rangan Chatterjee 5:50 But if you eat the wrong thing at breakfast, that's gonna make it really, really difficult, isn't it?

Dr. Rupy Aujla 5:55 Absolutely, and I think we can't disentangle what you're alluding to, energy balance, out of this equation of fat loss. So if you're gonna be consuming something that is low in protein and that leads you to crave and overconsume food during your day, then that's gonna put you in an energy surplus, which means you overeat, and we tend to Store that excess energy-

Dr. Rangan Chatterjee 6:20 Yeah

Dr. Rupy Aujla 6:20 ... as fat. And with protein in the morning, not only is it gonna be satiating, it's gonna lead to less hunger, reduce those cravings so you don't overeat, but it's also gonna give you the best possible chance to actually consume enough protein for your needs over the course of twenty-four hours. Because as you said right at the start of this, my belief is that our protein recommendations currently in the UK and the US are too low. And actually, if we look at the latest research over the last four or five years from protein researchers that are using more sensitive techniques that are true reflections of our protein requirements, we tend to need more per day, and I think that even increases as we go into older age, as we'll get into a little bit later. So if you're not having enough protein at breakfast, and you have to compensate at lunch and dinner, you're less likely to hit your overall target, and over time, you can see how easy it is to underconsume-

Dr. Rangan Chatterjee 7:29 Yeah

Dr. Rupy Aujla 7:30 ... for your, for your requirements.

Dr. Rangan Chatterjee 7:32 Would you say we've got it the wrong way round in modern society? What I mean by that, Rupy, is I think if you were just to go on the street now and talk to Joe Public about protein-

Dr. Rupy Aujla 7:45 Mm

Dr. Rangan Chatterjee 7:46 ... I think a few things would come to mind, like meats and fish probably would come to mind for a lot of people. And I hypothesize that most people, when they think about protein, would be thinking about their evening meal. So you talk about, um, the amount of protein we need in a twenty-four-hour period, but a hypothetical question for you is, do you think that if we just flipped what we were doing, right? So let's say we didn't increase the amount of protein we were having in twenty-four hours, but we just flipped it so the evening protein that many of us are having, we had in the morning instead, in theory, do you think that would lead to better health outcomes?

Dr. Rupy Aujla 8:28 It's a very good question. Um, and I'm not too sure if there is any evidence that I can point to that's actually done that ex- that experiment. What I do and have come across are studies where they emphasize breakfast protein, and what tends to happen is people consume less, and they tend to lose weight. Whether or not that has impacted-

Dr. Rangan Chatterjee 8:53 Mm

Dr. Rupy Aujla 8:53 ... what they eat in the evenings, I'm not sure. But there are also benefits of having evening protein as well.

Dr. Rangan Chatterjee 9:02 Yeah.

Dr. Rupy Aujla 9:02 So particularly if you are someone who exercises, goes for walks, resistance trains, et cetera, you need a collection of amino acids, which are the building blocks of proteins, to be present for you as you go into that rested state where actually your body is repairing and replenishing a lot of those protein structures in your body overnight as well.

Dr. Rangan Chatterjee 9:29 Yeah.

Dr. Rupy Aujla 9:29 And actually, let's take a step back because I think people, like you said, assume when we talk about protein, we're talking about meat and fish. And whilst those are great protein sources, I think people need to really reestablish, uh, a new understanding about what protein is. 'Cause we tend to think about protein and muscle, right? When you think about meat and fish, you think of bodybuilders, you think of strength training, you think of rippling abs. And whilst that's all true, proteins are the macro and microstructures of life. They are the most incredible biomolecules that are responsible for so many parts of our physiology. Everything from our DNA, our collagen, our skin, our hair, our enzymes, our transport molecules, hemoglobin that transports oxygen to our cells, and nutrients, the receptors of signal molecules, hormones that are on the surface of our cells, this is all protein. And to think that protein just equates to muscles, I think is a naive assumption. And actually, when you think about protein, when you consume protein, only about a quarter of that actually goes to skeletal muscle. The majority of the protein that you consume is actually being broken down and being used for those other structures that I just talked about, enzymes, signaling molecules, hormones. This is where the majority of your protein is going. And our need for protein every single day is insatiable. We go through around three hundred grams of protein every single day, not necessarily from our diet, but from breaking down and repurposing those different amino acids in our body.

Dr. Rangan Chatterjee 11:25 Let me just pause you there a minute-

Dr. Rupy Aujla 11:26 Mm

Dr. Rangan Chatterjee 11:26 ... 'cause that's, that's really interesting. We go through about three hundred grams of protein per day. Some people may hear that and go, "So what you're saying, Rupy, I have to eat three hundred grams of protein a day?" 'Cause I don't think you're quite saying that, are you?

Dr. Rupy Aujla 11:38 No. No, not at all.

Dr. Rangan Chatterjee 11:39 'Cause that's a lot of protein.

Dr. Rupy Aujla 11:40 It's a lot of protein.

Dr. Rangan Chatterjee 11:41 Even for a tall guy like me-

Dr. Rupy Aujla 11:42 100% [laughs]

Dr. Rangan Chatterjee 11:43 ... that's, that's a lot.

Dr. Rupy Aujla 11:44 Yeah, so to put that into context, that is around a kilogram of chicken breast, if we're just looking at proteins. And whilst the need of proteins are around that level, it's between two hundred and fifty grams to three hundred grams, regardless of your age, regardless of whe- whether you exercise or not, your body is like this intelligent recycling plant. You are constantly breaking down big proteins into their constituent parts and then rebuilding them. And the analogy that gets bandied around a lot, which I think is useful, is kind of like Lego blocks. So if you think when you used to play with Lego, I'm probably gonna start playing with Lego again because I have a son, um- You could make these incredible structures that are as simple as a little car with twenty Lego blocks. You could also make something as magnificent as a cathedral or a big spaceship with the same twenty Lego blocks, as long as you had enough of them.

Dr. Rangan Chatterjee 12:43 Mm.

Dr. Rupy Aujla 12:43 It's the same thing with amino acids. Depending on how we sequence them, depending on how we fold them into these big 3D structures, we can create micro, uh, structures like enzymes, and we can create big molecules like our collagen, our skin, our muscles.

Dr. Rangan Chatterjee 13:00 Yeah.

Dr. Rupy Aujla 13:00 It is phenomenal. So I think that the, the, the idea of using simple structures, simple sequences to build something much bigger than, you know, a, a very simple input is an important realization for people. Because I think people think protein muscle, and that's not how we should be thinking about proteins.

Dr. Rangan Chatterjee 13:23 Yeah. It's a take home then from this Lego analogy that, look, these building blocks are really, really important.

Dr. Rupy Aujla 13:31 Mm.

Dr. Rangan Chatterjee 13:31 Right? And if you're not consuming enough of these building blocks, you're not going to have the capacity for all these incredible benefits of protein.

Dr. Rupy Aujla 13:42 Absolutely.

Dr. Rangan Chatterjee 13:42 Right.

Dr. Rupy Aujla 13:42 So the... And, and this is a realization that I, I only came to quite recently, I would say. I assumed that most people, particularly in the UK and the US, were consuming more than enough protein. And if you look at the current recommendations of how much protein we should be consuming every single day, and the actual amounts, looking at national dietary statistics and data, we overconsume or we have more than enough c- uh, protein in our diets. But actually, if you look at the more recent research studies to d- that determine that we should be consuming more protein, we underconsume. And there is obviously a big range as well of people, and if you look at the typical diets that are largely ultra-processed, that are low in protein and low in nutrients, you can see how this plays out in the long term. And I think protein, whilst it's not the only thing, it plays a really important role because of the magnitude of things that proteins are responsible for. Our satiety levels, our cravings, but also our hormones, our weight maintenance, and even our immune cells. These are all built from protein. So we need to give ourselves the best building blocks-

Dr. Rangan Chatterjee 15:06 Yeah

Dr. Rupy Aujla 15:06 ... to ensure that our health thrives.

Dr. Rangan Chatterjee 15:09 Okay. So it's really interesting because you, you write about this, you've just shared it now that you have changed your mind about protein. Do you remember the exact moment when that happens? But because I think there's a couple of things. Protein, I think, has become this quite controversial-

Dr. Rupy Aujla 15:26 Mm

Dr. Rangan Chatterjee 15:27 ... macronutrient. Okay? As you say, I think many str- most of us recognize it's important for muscle. But in the start of your book, and I, I honestly think it's the best writing you've done to date, honestly. I think it's beautifully written the way you, you write about protein in your new book. You talk about these short-term and long-term benefits. You talk about the short term, fewer sugar cravings.

Dr. Rupy Aujla 15:48 Mm.

Dr. Rangan Chatterjee 15:48 Uh, it can help with weight loss, energy, focus, better sleep. You also talk about the long-term benefits for your bone and your muscle health.

Dr. Rupy Aujla 15:55 Yeah.

Dr. Rangan Chatterjee 15:55 Right?

Dr. Rupy Aujla 15:56 Mm.

Dr. Rangan Chatterjee 15:56 So y- you really make this compelling case that we need enough protein. But let's say in the longevity space, for example, there's been people saying, "No, no, we're, we're eating enough protein."

Dr. Rupy Aujla 16:06 Yeah.

Dr. Rangan Chatterjee 16:07 "We're over prioritizing this at the expense of other things." So help us understand, when did you change your opinion? Why did you change your opinion? And help us navigate this controversy which many of us are seeing online.

Dr. Rupy Aujla 16:20 Yeah. I think this is a really good point, and I think this is where it pays dividends to lean into both clinical experience as well as reading the academic literature and looking at the mechanistic evidence. And there's sort of two protein camps, right? So in certain longevity fields that are bullish on low calorie diets, not overconsuming energy in total, and not overconsuming protein, they're focused on this idea that if you reduce protein intake, you reduce the signals that trigger growth, and that potentially can have some anticancer benefits, and it can also train your body to be a lot more efficient with the nutrients it receives.

Dr. Rangan Chatterjee 17:14 Mm.

Dr. Rupy Aujla 17:14 So-

Dr. Rangan Chatterjee 17:15 Which kind of makes sense

Dr. Rupy Aujla 17:16 ... completely makes sense, 'cause that is also net anti-inflammatory. Right? Completely understand that perspective, and I think there are specific cases where this kind of thinking could be quite useful in combination with, say, anticancer treatments, chemotherapy, for example. There are some human trials going on right now where they're doing what's deemed fasting mimicking diets in combination with conventional therapies and actually having some quite interesting results. Small studies, but interesting nonetheless. And then with my clinical hat on, and I think of this as more of a pragmatist perspective, what is the commonest thing that we tend to see in older age? It's frailty, and that's exacerbated when someone has a fall, and they're off their legs for a few weeks, and then you see this massive reduction-

Dr. Rangan Chatterjee 18:11 Mm

Dr. Rupy Aujla 18:11 ... in muscle bulk. And then after that, there are some stats to suggest that your mortality almost doubles within 18 months. So there is a lot of what I look at in the literature and I appreciate, but then there's also what I see when I'm a, when I'm practicing, when I'm seeing patients, and I'm leaning more towards the pragmatic view that actually maintaining muscle bulk As a, uh, way of ensuring metabolic health, as a mean- a way of ensuring strength, particularly in our older age groups, is something that we should be paying much more attention to. And I also think it's quite easy to be fooled by mechanistic studies and looking at specific pathways or... and not really leaning into the, the major problems-

Dr. Rangan Chatterjee 19:05 Yeah

Dr. Rupy Aujla 19:05 ... that affect people of certain age groups. And this isn't just an old age, uh, problem. You know, there are, there are some stats, I couldn't find any for the UK, but the rates of sarcopenia in those over the age of 50 in the States is around 40%. So sarcopenia is essentially where your muscles waste, where you have reduced strength, where you increase frailty. It can put you about further risk of metabolic disease because your muscles are not just there for strength, they're also sinks for your sugar, your glucose.

Dr. Rangan Chatterjee 19:43 When you said it's when your muscles waste, I think that a lot of people will hear that and go, "That doesn't apply to me."

Dr. Rupy Aujla 19:50 Mm.

Dr. Rangan Chatterjee 19:50 You know, muscle wasting, oh yeah, maybe my grandma, maybe, you know, elderly people who I see, you know, walking around with their stick. Oh, they've got muscle wasting. That doesn't apply to me. But that's not the case, is it?

Dr. Rupy Aujla 20:03 No. So over the age of 50, the prevalence of sarcopenia is around 40% in the States, and 10% of people in their 20s have sarcopenia.

Dr. Rangan Chatterjee 20:17 Okay. I think we need to pause on these stats, right?

Dr. Rupy Aujla 20:19 Uh-huh.

Dr. Rangan Chatterjee 20:19 Because I think they really hammer home why you've dedicated a new book to this topic.

Dr. Rupy Aujla 20:24 Yeah.

Dr. Rangan Chatterjee 20:25 Right? In America, 40% of the adult population above the age of 50 have sarcopenia.

Dr. Rupy Aujla 20:30 Yeah.

Dr. Rangan Chatterjee 20:30 And you're saying 10% of 20-year-olds, and you've also said that sarcopenia is muscle wasting. These are quite high numbers-

Dr. Rupy Aujla 20:38 Mm

Dr. Rangan Chatterjee 20:38 ... right? How much of this can we attribute to inadequate protein intake versus inadequate resistance training?

Dr. Rupy Aujla 20:47 Exactly. That's a very good question, and it will be very hard for me to ascertain the amount that we, of sarcopenia that we can attribute to low protein intake versus sedentary lifestyles, and it's definitely gonna be a combination of both. I would say if I was to hazard a guess, the, uh, weight and the contribution of sedentary lifestyles is going to be more than simply low protein. And the reason why I can say that with some degree of confidence is because when we look at this process called muscle protein synthesis, that I'll define in a second, the stimulus for muscle protein building tends to come more so from exercise and resistance training versus just providing your body with amino acids. Muscle protein synthesis is the biological pathway by which we build muscles, and muscle protein breakdown is the counter to that. And ideally, what we want to be in is a balance between the two, and what happens in sarcopenia is we have more breakdown versus more synthesis. So we have a net negative in terms of our muscle, uh, health.

Dr. Rangan Chatterjee 22:01 H- how might someone know if they've got sarcopenia?

Dr. Rupy Aujla 22:05 It's a really good question. Um, and in terms... if we want to get clinical about it, doing a great history, ensuring that we are asking them questions about how much they can, uh, exercise, grip strength, falls, frailty, how far they can walk, for example.

Dr. Rangan Chatterjee 22:25 I mean, that's, that's from a clinician's perspective.

Dr. Rupy Aujla 22:27 Yeah.

Dr. Rangan Chatterjee 22:27 But for, but for someone listening who has basically heard those stats-

Dr. Rupy Aujla 22:32 Mm

Dr. Rangan Chatterjee 22:33 ... and have just gone, "Wait a minute, maybe I'm sarcopenic."

Dr. Rupy Aujla 22:37 Mm.

Dr. Rangan Chatterjee 22:37 Is there s- is there anything they can do to ask themselves?

Dr. Rupy Aujla 22:43 It's... Yeah, I think, I think it really comes down to a subjective feeling of how strong you are. So how much can you feasibly lift in a gym? How easy is it for you to hold your bags of shopping and take them to the car, put them on the bus? Do you have to make, uh, changes to the way you walk around, uh, you know, just to do your activities of daily living, for example? And if you wanna get really clinical about it, then there are certain investigations that you can do to actually look at the bulk of your muscle.

Dr. Rangan Chatterjee 23:22 Mm.

Dr. Rupy Aujla 23:22 And this is something that can be hidden with our obesity issues.

Dr. Rangan Chatterjee 23:27 Yeah.

Dr. Rupy Aujla 23:27 So you can be sarcopenic, or you can have quite low muscle bulk, but you can still be overweight.

Dr. Rangan Chatterjee 23:33 Mm.

Dr. Rupy Aujla 23:34 And there's this, this, this big issue, and this is why I believe it's understandable when you think about the obesity issues and the obesity crisis, particularly in the States, that there is so much muscle wasting in 20-year-olds. This is something that we would have never have seen 40, 50 years ago.

Dr. Rangan Chatterjee 23:50 What about, um, Gabrielle Lyon's work? Gabrielle, um, has been very passionate for a number of years about talking about this idea that we're focusing on the wrong thing when it comes to the obesity epidemic. Instead of focusing on the amount of fat on our body, she's basically saying that we're, we're not over fat, we're under muscled.

Dr. Rupy Aujla 24:11 Mm.

Dr. Rangan Chatterjee 24:11 What's your perspective on that?

Dr. Rupy Aujla 24:13 I completely agree. I really think muscle health should be the focus of, uh, what public health strategies should be concentrated a- around if we are to tackle the obesity crisis. I think it's very easy to simply put calorie counts on menus and tell people to eat less without really thinking about muscle health. Because- As a side effect of focusing on muscle health, strength, resistance training, exercise, and coupling that with protein, you improve your weight control. You improve things like satiety, which is why we have, you know, studies that look at if we just simply increase protein without even changing the amount of energy some people consume, you naturally see a reduction in weight, and the reason why is because you feel more satiated. There's the thermic effect of protein that we'll get to a little bit later, and we're focusing on the right thing. So I, I, I completely agree with the idea that muscle health should be the focus, and against the backdrop of medications-

Dr. Rangan Chatterjee 25:28 Mm

Dr. Rupy Aujla 25:28 ... that are gonna revolutionize healthcare, uh, Ozempic, GLP-1 agonists, that chemically induce anorexia, which is... You know, I know it sounds extreme, but that's essentially what they're doing. We're going to become under-proteined even more so, because we won't be able to have the appetite to tolerate the amount of food that we require for-

Dr. Rangan Chatterjee 25:51 Okay

Dr. Rupy Aujla 25:51 ... our muscles and our, and for our health.

Dr. Rangan Chatterjee 25:53 Yeah. I think this highlights, Rupy, one of the, the big issues, right? It's quite hard to know if we're sarcopenic.

Dr. Rupy Aujla 26:03 Mm.

Dr. Rangan Chatterjee 26:03 Right? So we can see if we're carrying excess weight on our body, right? If we're concerned about our blood sugar, we can go to the doctor and get a blood sugar test, right? But actually, you know, we don't have that readily accessible test to tell us if we're sarcopenic, right? So first of all, the awareness of it gets tricky for people. I think so far what you're saying, and correct me if I've, if I've misunderstood anything, you're saying basically that for muscle protein synthesis, which is very important, there are two things we need to think about. We need to think about the amount of resistance training we're doing, and the amount of protein we're consuming. If we go back to breakfast then, right, and talk about these common foods that people are having-

Dr. Rupy Aujla 26:51 Mm-hmm

Dr. Rangan Chatterjee 26:52 ... which, as we've already outlined, are gonna be low in protein.

Dr. Rupy Aujla 26:55 Yeah.

Dr. Rangan Chatterjee 26:55 Let's go through a few of those, like oatmeal-

Dr. Rupy Aujla 26:58 Yeah

Dr. Rangan Chatterjee 26:58 ... like croissants, like breakfast cereals, and then perhaps you can suggest how we might change that up.

Dr. Rupy Aujla 27:07 Yeah.

Dr. Rangan Chatterjee 27:07 Right?

Dr. Rupy Aujla 27:07 Yeah.

Dr. Rangan Chatterjee 27:08 Both for meat eaters and for, uh, vegans. Yeah, and I know your book's got loads of recipes to help people with this, but I think that might be quite a useful way to help people understand what they could start doing immediately.

Dr. Rupy Aujla 27:20 Completely. Yeah, I agree. I think just to hammer home that point about trying to determine whether someone is sarcopenic or, uh, someone who has less muscle bulk than they should do at this point in time, there are a few questions you can ask yourself. Have you lost confidence in your ability to, uh, uh, push heavy weights? Uh, are you feeling that you've lost strength in your upper body or your lower legs? Does it take you a little while to bend down to get something on the floor, for example?

Dr. Rangan Chatterjee 27:56 Compared to what? Six months ago?

Dr. Rupy Aujla 27:58 Compared to a year ago, a couple of years ago. Perhaps you've got grandkids, and now you're struggling to get up from the floor.

Dr. Rangan Chatterjee 28:07 Can I just say on that though, Rupy-

Dr. Rupy Aujla 28:08 Mm

Dr. Rangan Chatterjee 28:08 ... some people will go, "Yeah, but I'm getting older."

Dr. Rupy Aujla 28:12 Mm.

Dr. Rangan Chatterjee 28:12 "So that's normal, because I see all around me as people get older, they get frail." So it, it, it becomes tricky. These, these kind of societal narratives then become self-fulfilling. Oh, I can't do it like I could six months ago. It must be because I'm getting older.

Dr. Rupy Aujla 28:27 Exactly, and I think this idea that we excuse frailty because we are getting older I, I think is detrimental-

Dr. Rangan Chatterjee 28:36 Yeah

Dr. Rupy Aujla 28:36 ... if we wanna thrive in our later years. And I think now it... people are coming around to this idea, particularly people who listen to your podcast and mine, that it's not good enough to just expect to naturally decay as we get older. That's gonna happen, but we can certainly bend the curve towards our favor. We can be stronger and more energetic in our later years, and we deserve to, because we're living in an era where we've never been more... uh, we've never had more access to medicine. We've ne- never had more access to the ability to look after our bodies. We now have more access to healthy food, healthy lifestyles. We should be really thinking about our older years as a time where we can be stronger and, uh, and, and healthier in general. I, I don't think it's-

Dr. Rangan Chatterjee 29:25 Yeah.

Dr. Rupy Aujla 29:26 I think a lot more people are coming to this idea of actually wanting to thrive in their 60s, 70s and 80s.

Dr. Rangan Chatterjee 29:31 Yeah. And, and I guess the other way of looking at it is whether you currently have sarcopenia or not, chances are, in this modern world, if you're not actively doing something about it-

Dr. Rupy Aujla 29:44 Yeah

Dr. Rangan Chatterjee 29:44 ... as you get older, you're probably going to get it.

Dr. Rupy Aujla 29:47 Yeah, absolutely, and I think there are lots of things that we'll come back to that you can do to improve your muscle health. It doesn't have to be this general decline, and I think, you know, giving people the confidence and the tools, one of which is through diet, one of which is through exercise, and there are a few other things that we can do as well. I think, you know, people can begin to, to, uh, aspire-

Dr. Rangan Chatterjee 30:12 Yeah

Dr. Rupy Aujla 30:12 ... to thrive in their, in their later years.

Dr. Rangan Chatterjee 30:14 Well, let me... And before we get back to breakfast-

Dr. Rupy Aujla 30:15 Yeah

Dr. Rangan Chatterjee 30:16 ... like, when we think about weight training, I think I s- I said this when I came on your show-

Dr. Rupy Aujla 30:19 Mm

Dr. Rangan Chatterjee 30:19 ... a few, few weeks ago. Like, one thing I have done for many years is our local supermarket, the car park is on the second floor.

Dr. Rupy Aujla 30:27 Mm.

Dr. Rangan Chatterjee 30:27 Okay? So yeah, sometimes I'll walk, but often if it's the way back from the kids at school or something, we'll park on the second floor, get the stairs down. I don't think I've taken the lift in the last five years. I mean, I will not take the lift. Even if I've got a ton of bags, I will literally carry them up those two flights of stairs, and it's just an internal decision I've made to go, "No, no, no. I'm not outsourcing my body's ability to shift weight and move it to the second floor to this elevator-

Dr. Rupy Aujla 31:02 Hmm

Dr. Rangan Chatterjee 31:02 ... to this lift." Right? Walking up with three bags in your hand up two flights of stairs, you know, you're feeling it on the final bit. That's strength training without going to the gym, isn't it?

Dr. Rupy Aujla 31:14 Completely. Completely.

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Dr. Rupy Aujla 32:31 And the way I think about it, and maybe this is sort of like my nerdy, analytical mind, is when, when you think about the stimuli for muscle protein synthesis, this process that builds muscle, you have a few key things that accelerate that, one of which is exercise, both resistance and aerobics. So every, every time you have your heavy shopping and you take it up those stairs, what are you doing? You're using and engaging your upper body muscles to stabilize those bags. You're using your large muscles, the bulk of which are in your glutes and your, and your hamstrings and your thighs, and you're going up stairs, so that is resistance training. And you're basically shearing those muscles and giving the signals to your body, "These are now broken." It's sort of like, you know, you've got a, a structure of Lego bricks, and you smash it down. I don't know about you, but I always have an impetus to, like, build that straight back up again. That's essentially what your body's doing, and you're gonna build it up stronger the second time round.

Dr. Rangan Chatterjee 33:31 Mm.

Dr. Rupy Aujla 33:31 So if anyone comes and tries to knock them down again, they're gonna take a lot more effort to do that. This is essentially muscle protein synthesis in action every time you do something as simple as that, taking it to the car park. And the other big stimulus is having enough amino acids so you have those building blocks to build up that tower and make it stronger in the first place, otherwise known as hypertrophy or the bulk of muscle, but this is essentially what we're doing every single time as well. This whole process of me doing the research for the book and thinking about how I was fueling myself over the last couple of years, and actually not providing myself with the an, the amino acids that I required for exercise and general wellbeing, it actually made me reflect quite a bit on patients that I've seen during my clinical career. You know, when I was working full time as an NHS general practitioner, you know, I'd see a lot of, uh, women who come in with, with fatigue, right? And you go through all the different things and the differentials in your head. You wanna make sure that it's not a menstruation issue. You wanna make sure there's no red flags. You know, make sure that you're ensuring that you, you've, you've ticked off, uh, any evidence of cancer, bowel issues. One of the simplest things that I think gets brushed over is actually how they're fueling themselves with enough protein. 'Cause if I think back to a lot of, in particular, women, and I know it's not just women, who tend to not have any animal-based products in their diet, and look, it is possible to have enough protein on a, on a vegetarian, vegan diet, but it takes a lot of careful planning. I think back to the reasons as to why they might have had fatigue after we've discounted everything else and done all the tests and ensured that, you know, their B vitamins aren't crushingly low and their vitamin D is all fine, all that kind of stuff. If we didn't find one of those reasons, could it have been protein? And obviously there are, you know, things that we should also be addressing, psychological causes, et cetera. But if we're just thinking about the basics, I should've been inquiring about protein-

Dr. Rangan Chatterjee 35:41 Mm

Dr. Rupy Aujla 35:41 ... at a much earlier stage before getting to the point where we're doing a number of other tests.

Dr. Rangan Chatterjee 35:46 Yeah.

Dr. Rupy Aujla 35:47 And I think that that's gonna be informing, hopefully, other people's medical practice i- in the future.

Dr. Rangan Chatterjee 35:55 Yeah. It, it's really interesting because, you know, a- as you, as you say in your introduction, p- part of the reason for writing this book is you want to reframe how people think about protein. And I guess going alongside that is this idea that ... I don't know if it's, if it's more in the UK than the US. One thing I noticed when you go into the US, they, they ... You know, protein is a term that's used in common parlance, right?

Dr. Rupy Aujla 36:22 Mm.

Dr. Rangan Chatterjee 36:22 So I was in Boston and New York recently, um, and I went to Sweetgreen's in Boston.

Dr. Rupy Aujla 36:29 Okay.

Dr. Rangan Chatterjee 36:30 Right?

Dr. Rupy Aujla 36:30 Yeah, yeah.

Dr. Rangan Chatterjee 36:30 It was near my hotel. And yeah, there's a, there's a thing on the ... You know, you, you pick your protein.

Dr. Rupy Aujla 36:37 Yeah.

Dr. Rangan Chatterjee 36:37 Right? It's a concept in America that I've noticed that we, we, we typically haven't had here in the UK as much, that y- you know, you're almost being driven to, oh, first of all, pick your protein source.

Dr. Rupy Aujla 36:47 Mm-hmm.

Dr. Rangan Chatterjee 36:47 Now, for me, and we did cover this when you came on the show a few weeks ago- Because I'm so tall, those protein amounts are nowhere near-

Dr. Rupy Aujla 36:57 [laughs]

Dr. Rangan Chatterjee 36:57 ... what a 6'7" guy like me needs.

Dr. Rupy Aujla 37:00 Mm-hmm.

Dr. Rangan Chatterjee 37:01 So actually, if I was to get my requirements, I'd need to order two, uh, protein sources.

Dr. Rupy Aujla 37:05 Yeah.

Dr. Rangan Chatterjee 37:05 But I'm saying in the UK, we don't really have that to the same degree, where you're choosing a protein. And so I find that really interesting. But, but beyond that, I think, and it goes back to what we said before about Gabrielle Lyon, right? There's this idea that most people, I think, when they're thinking about food, are thinking about their waistline.

Dr. Rupy Aujla 37:26 Yeah.

Dr. Rangan Chatterjee 37:26 And they're thinking about, you know, I don't want to put on weight, or I want to lose a bit of weight.

Dr. Rupy Aujla 37:30 Mm.

Dr. Rangan Chatterjee 37:31 But you could be losing weight in a variety of different ways, and still not eating enough protein. So you could look at yourself in the mirror or on the scales and think that you're actually winning.

Dr. Rupy Aujla 37:43 Yeah.

Dr. Rangan Chatterjee 37:44 But it could come... Of course, it's interesting. You, Rupy, to me, you've always struck me as someone who looks after themselves. You work out a lot. You, obviously, you, you try to eat well as much as you can, but you recognized a few years ago, didn't you, that you weren't eating enough protein?

Dr. Rupy Aujla 37:59 Absolutely. Yeah. And-

Dr. Rangan Chatterjee 38:00 Which I think will surprise people. They say, "Oh, Rupy's got it all figured out."

Dr. Rupy Aujla 38:03 Yeah.

Dr. Rangan Chatterjee 38:03 And it's like, well, now hold on, even with your medical degree, with your nutrition qualifications, you've written a ton of books on this stuff, you still found that you were under eating protein.

Dr. Rupy Aujla 38:14 Yes. And I think it's because, particularly in the holistic medicine space, we over-index, and we have been over-indexing on things like gut health, which is super important. Things like anti-inflammatory diets, again, super important. Having more plants in our diet, absolutely agree with that. But we've sort of forgot one of the primary things, and I think protein is really coming back into fashion because people understand that you can't just have a focus on plants and gut health and not really think about the core foundation of what makes a diet nutritionally balanced.

Dr. Rangan Chatterjee 38:56 Yeah.

Dr. Rupy Aujla 38:56 And that is protein. And unfortunately, you know, it's a zero-sum game. When you take something away, you need, you need to replace it, otherwise you risk deficiency. And if I think about some breakfasts that you see on Instagram, they look beautiful, and they look colorful, and they're, you know, easy to make. And oatmeal, for example, is one of those, which we'll, we'll talk about in a second. If you do the nutritional analysis on them, whilst they do have a bit of fiber, good carbohydrates, particularly if you're training, you know, if you're doing, uh, endurance training, for example, carbs, uh, from oats can be a great thing, but they tend to be deficient in protein. And the one thing that I think was a stark realization for me is after doing my nutritional medicine masters and completing that, and doing a, a section on endurance training in sports medicine, sports nutrition. But also, um, part of the building of the Doctor's Kitchen app was actually recreating a nutrition calculator from scratch, because I wasn't satisfied that the nutrition data sets from the US, Europe, and the UK were sufficient to cover the bases of all the different ingredients that we were analyzing.

Dr. Rangan Chatterjee 40:15 Mm.

Dr. Rupy Aujla 40:15 And so what we did is we literally line by line looked through every single ingredient to determine what was the most appropriate nutritional analysis for said ingredient. And then we started compiling them together in recipes, and then I realized, of course, some of my recipes are actually quite low in protein. My breakfast is actually quite low in protein. Is this the reason why I feel quite hungry mid-morning?

Dr. Rangan Chatterjee 40:38 Mm.

Dr. Rupy Aujla 40:38 And I'm, I'm a constant snacker. I think that's a part of, like, my nature. You know, being at home and stuff, and I tend to just always look in the cupboards. But also, maybe it's because I'm not having enough protein, and I tend to exercise most days, and I do resistance training, all the right things. And when I started eating more protein, I kid you not, Ryan, I... My snacking fell off a cliff.

Dr. Rangan Chatterjee 41:01 Yeah.

Dr. Rupy Aujla 41:02 And it makes complete sense.

Dr. Rangan Chatterjee 41:05 And it goes back to what you said at the start about the protein leverage hypothesis. Maybe our bodies will just keep on eating whatever it needs to-

Dr. Rupy Aujla 41:13 Exactly

Dr. Rangan Chatterjee 41:13 ... until we've met those protein requirements. And look, there's the research to look at, and then there's clinical experience.

Dr. Rupy Aujla 41:20 Mm.

Dr. Rangan Chatterjee 41:21 I know there's this number at the moment about 30 grams of protein at breakfast, right?

Dr. Rupy Aujla 41:25 Mm.

Dr. Rangan Chatterjee 41:25 Uh, I'd love to get your perspective on that. I've never given that to a patient before.

Dr. Rupy Aujla 41:30 Mm-hmm.

Dr. Rangan Chatterjee 41:31 But I've definitely advised patients to increase protein intake, particularly at breakfast. And the truth is, I've never seen any downsides.

Dr. Rupy Aujla 41:39 Mm.

Dr. Rangan Chatterjee 41:39 Right? I would often say to patients, "Eat your dinner for breakfast."

Dr. Rupy Aujla 41:41 Mm.

Dr. Rangan Chatterjee 41:42 That's a simple way of reframing the way you look at breakfast.

Dr. Rupy Aujla 41:47 Yeah.

Dr. Rangan Chatterjee 41:48 Right? But let, let's go... Le- let's get back to breakfast, right?

Dr. Rupy Aujla 41:51 Yeah.

Dr. Rangan Chatterjee 41:51 Because what, what's interesting about Healthy High Protein, your new book, is these three pillars you talk about, right? Number one, maintain protein.

Dr. Rupy Aujla 42:02 Mm.

Dr. Rangan Chatterjee 42:02 Number two, support gut health. Number three, lower inflammation.

Dr. Rupy Aujla 42:06 Yeah.

Dr. Rangan Chatterjee 42:06 Right? So you just mentioned that in the health world in which we sit, for the last years, there's been a lot of talk about gut health and inflammation, right? And you're not saying they're not important in your book. You're just saying that we need to bring in protein-

Dr. Rupy Aujla 42:23 Absolutely

Dr. Rangan Chatterjee 42:24 ... into the equation, right? And there are three questions in the book you want people to ask themselves when they sit down to eat. Is there enough protein on my plate to meet my requirements? Are there ingredients in this meal that are supporting my gut health? And number three, is the overall impact of this meal going to be anti-inflammatory? Okay, how about this, Rupy? How about we look at breakfast-

Dr. Rupy Aujla 42:47 Mm-hmm

Dr. Rangan Chatterjee 42:47 ... and then try and apply these three questions to certain common breakfast meals? Would that, would... Is that a reasonable way of looking at this?

Dr. Rupy Aujla 42:54 That's a great way of looking at it. So let's imagine oatmeal, right? Oatmeal- It's been touted as super healthy. It's got fibers that lower your cholesterol. It's got fiber that can support your gut health, beta-glucans, et cetera, et cetera. If we look at it through the lens of those three questions, right? Is there enough protein in plain oatmeal? The answer is no.

Dr. Rangan Chatterjee 43:19 No.

Dr. Rupy Aujla 43:19 Because even if you're consuming three hundred grams of total product, let's say, it's about three to four grams per hundred grams of, uh, uh, protein in oats.

Dr. Rangan Chatterjee 43:29 Mm-hmm.

Dr. Rupy Aujla 43:30 So no, i- it's not gonna be enough for folks unless you're super, super small and your protein requirements are very low, which we've established is not the case. Is there... Are there products that, uh, support gut health? Yeah, probably. Yeah, we've got some fibers in there. We've got some beta-glucans. It's probably gonna be, uh, generally quite healthy. Is this gonna be anti-inflammatory? Potentially, but with the blood glucose spiking potential of oats, if you're not having it with berries or you're having any other anti-inflammatory ingredients like cinnamon, TBD, I would say. I wouldn't say it's gonna be a, a home run for inflammation reduction.

Dr. Rangan Chatterjee 44:08 Yeah. Th- this is really interesting. So my bias, based upon what I've seen throughout my career, is that I, I don't generally recommend oats to people for breakfast, right? I, I'm not saying it can't be good for some people.

Dr. Rupy Aujla 44:22 Mm-hmm.

Dr. Rangan Chatterjee 44:22 But of course, my bias will be based on what I've seen, right? So usually people who are coming in to see the doctor, not always.

Dr. Rupy Aujla 44:29 Mm-hmm.

Dr. Rangan Chatterjee 44:29 But usually they've got some degree of health issue-

Dr. Rupy Aujla 44:34 Yeah

Dr. Rangan Chatterjee 44:34 ... that they want help with, right? And if we look at the degree of metabolic dysfunction in society, it is reasonable that a lot of patients who come in to see you or me over the years would have a degree of metabolic dysfunction.

Dr. Rupy Aujla 44:46 Yeah.

Dr. Rangan Chatterjee 44:47 So I've often found, not for everyone, but I've often found oats tend to cause this big blood sugar high, blood sugar low two hours later, people feel hungry again. Now, I know that's not the same for everyone.

Dr. Rupy Aujla 44:59 Mm-hmm.

Dr. Rangan Chatterjee 45:00 And I'm sure that will come down to their microbiome and their state of metabolic health. Some people have-

Dr. Rupy Aujla 45:04 Mm-hmm

Dr. Rangan Chatterjee 45:04 ... a big bowl of oatmeal in the morning, and they're not hungry again for four hours.

Dr. Rupy Aujla 45:09 Mm-hmm.

Dr. Rangan Chatterjee 45:09 So I think metabolically, microbiome wise, there's something different going on.

Dr. Rupy Aujla 45:13 Definitely.

Dr. Rangan Chatterjee 45:14 I personally don't have oats for breakfast, but you do, don't you?

Dr. Rupy Aujla 45:17 Yeah. But I have changed the way I have my-

Dr. Rangan Chatterjee 45:21 Right

Dr. Rupy Aujla 45:21 ... oats in the, in, in, uh, in the morning. And I don't always have oats in the morning. I change it up throughout the week because I think diversity of ingredients is super important as well. The way I have my oats now, and ju- just to riff on your point, you know, there are some endurance runners, for example, people who do triathlons and marathons who love oats because they're using that big store of sugar to efficiently power their muscles. That's not most people.

Dr. Rangan Chatterjee 45:46 Yeah.

Dr. Rupy Aujla 45:46 Most people in today's world are going straight from their oatmeal at breakfast, jumping on the train, and going to work, where they sit down for multiple hours a day. They're not running-

Dr. Rangan Chatterjee 45:58 Exactly

Dr. Rupy Aujla 45:58 ... uphills and doing mountains and-

Dr. Rangan Chatterjee 45:59 And that's the context and nuance that it's, it's missed so much when we talk about this.

Dr. Rupy Aujla 46:06 Totally.

Dr. Rangan Chatterjee 46:06 You know, that diet, that breakfast in the context of what? As you say, if you're really active and you're a, you're a builder, you're a painter-

Dr. Rupy Aujla 46:14 Yeah

Dr. Rangan Chatterjee 46:14 ... you're a decorator.

Dr. Rupy Aujla 46:15 Yeah.

Dr. Rangan Chatterjee 46:16 Okay, your breakfast need may be completely different than if you're actually sat behind a screen for four hours.

Dr. Rupy Aujla 46:23 Totally. I tell you who loves oatmeal, Kipchoge.

Dr. Rangan Chatterjee 46:25 He does?

Dr. Rupy Aujla 46:26 And Kipchoge is [laughs] one of the world's fastest runners at distance.

Dr. Rangan Chatterjee 46:30 Exactly.

Dr. Rupy Aujla 46:30 So you know, it gives you the context. You know, just using that very simple example, that's someone who's gonna thrive on oats. I'm not saying that you can't thrive on oats unless you're like a, you know, an ultra-marathon or di- distance runner, but that, that's sort of the ballpark of where people are gonna be thriving on oats.

Dr. Rangan Chatterjee 46:48 So, so how have you changed the way you do oats to, to meet these three criteria?

Dr. Rupy Aujla 46:52 So whilst I'm someone who exercises most days, I have a very simple base formula for my oatmeal in the morning. So I do overnight oats in a big tub, which is literally what I had this morning. I'll have two tablespoons of oats, which isn't actually that much. It's around thirty grams of oats, not a hundred and twenty, a hundred and fifty-

Dr. Rangan Chatterjee 47:11 Okay

Dr. Rupy Aujla 47:11 ... grams of oats. But two tablespoons of oats, two tablespoons of milled flax seed, a tablespoon of chia seed, and a tablespoon of shelled hemp seed. Let's go through the nutritionals. So oats is largely carbohydrates there, right? Quite low in protein. Has some beta-glucans. Milled flax seed is around twenty, twenty-five grams of protein with large amounts of fiber as well. Chia is on the lower side of protein in terms of the different seeds, but it's still quite a rich protein source, around eight grams per hundred grams or something like that. Shelled hemp seeds is thirty grams per hundred grams of protein, and it is, uh, one of those novel plant proteins that has all nine essential amino acids as well. I have that as my base, and then I combine flavors on top of that. So I have raw cacao. Again, another really rich protein source. Sometimes I'll also add a protein powder. I'm sure we're gonna get to protein powders a little bit later, the pros and cons of those. And then I'll have either water or a milk of choice. That, in my case, is either a full-fat dairy or it's a, a plant milk that doesn't have any fillers or any extra sugars in. That compared to a typical overnight oats recipe is much higher in protein.

Dr. Rangan Chatterjee 48:33 It's like two different meals, isn't it?

Dr. Rupy Aujla 48:35 Completely different. When you look at the nutritionals, the one that I've just described to you is around thirty-five grams of protein. The previous one was sub ten.

Dr. Rangan Chatterjee 48:43 Have you noticed a... I think you've already answered this, but let's just highlight the points. You've had times in your life where you'd have a standard bowl of oatmeal.

Dr. Rupy Aujla 48:52 Yeah.

Dr. Rangan Chatterjee 48:54 And how did you feel throughout that morning? Energy, focus, hunger, compared to when you're having your new You know, improved, uh, supercharged, uh, overnight oats basically with, with all these other protein and gut health sources

Dr. Rupy Aujla 49:09 It's like night and day. It really is night and day

Dr. Rangan Chatterjee 49:11 So you can feel the difference?

Dr. Rupy Aujla 49:12 Oh, you can feel the difference. Like, as I'm chatting to you now, I know I've had a couple of cups of coffee, but my focus, my energy is completely steady. I'm not feeling like, "Gosh, I've gotta have another biscuit," or, "Gosh, you know, I wonder if I'm gonna have a snack in between lunchtime," which I used to feel, particularly when I was working full-time in A&E. I now have this steady energy because I'm powering myself first thing in the morning with protein, and that's a mantra that I'm sort of getting people to think about. It's protein first, power all day. If you have protein first in the morning, it will give you power all day. You will be ... You will have better energy, you will have less fatigue and less cravings as well.

Dr. Rangan Chatterjee 49:56 Okay, I'm gonna put another thought experiment on you.

Dr. Rupy Aujla 49:59 Okay [laughs] .

Dr. Rangan Chatterjee 50:01 Okay? Three pillars of eating that you talk about in this book, right?

Dr. Rupy Aujla 50:06 Yeah.

Dr. Rangan Chatterjee 50:06 Number one, maintain protein.

Dr. Rupy Aujla 50:07 Mm-hmm.

Dr. Rangan Chatterjee 50:07 Number two, support gut health. Number three, lower inflammation.

Dr. Rupy Aujla 50:10 Mm-hmm.

Dr. Rangan Chatterjee 50:11 Out of those three, which one do you think is the most important for people to focus on?

Dr. Rupy Aujla 50:18 Oh, gosh, it's so hard to choose. I g- Here's a sneaky way of answering that question, right? If you focus your diet around plant-based sources of protein, you're getting a twofer. So you're getting not only the protein from the ingredients like tempeh or tofu or, you know, hemp seeds, nuts and seeds, that kind of stuff, but you're also getting the fiber combined in that as well. I'm sure we're gonna talk about animal versus plant-based in a bit, but I, I've sort of done it in a sneaky way there.

Dr. Rangan Chatterjee 50:53 Love it. So you've answered the question.

Dr. Rupy Aujla 50:54 Right [laughs] . Yeah.

Dr. Rangan Chatterjee 50:55 [laughs]

Dr. Rupy Aujla 50:56 Because one of the reasons why I still believe, you know, as someone who is an advocate for healthy high protein, I still believe in a plant forward diet, plant focused diet, one that incorporates a lot of diversity and, and gut healthy and high fiber ingredients, that there is a way of marrying the two. And actually for omnivores, there is this elegant solution of ensuring that you have enough high protein whilst also looking after your gut as well.

Dr. Rangan Chatterjee 51:26 Yeah. I love your thought process there. My bias would be, I think maintaining protein is probably the one for people to focus on. I'll tell you why I think that.

Dr. Rupy Aujla 51:34 Mm-hmm.

Dr. Rangan Chatterjee 51:35 It's not that I don't agree with supporting gut health or lower inflammation.

Dr. Rupy Aujla 51:38 Sure.

Dr. Rangan Chatterjee 51:38 Of course I do.

Dr. Rupy Aujla 51:39 Sure, sure [laughs] .

Dr. Rangan Chatterjee 51:39 Uh, like you, I've written about those things on, on multiple occasions. My thing with patients is always thinking about, um ... 'Cause you can think about a million things for your health, and then it gets confusing-

Dr. Rupy Aujla 51:52 Yeah

Dr. Rangan Chatterjee 51:52 ... right? So I'm always trying to think about, well, what's the most important lever to turn that naturally makes the other levers follow suits?

Dr. Rupy Aujla 52:01 Yeah.

Dr. Rangan Chatterjee 52:01 Right? And I think given the stats that you put out there about how many people have got sarcopenia-

Dr. Rupy Aujla 52:07 Yeah

Dr. Rangan Chatterjee 52:07 ... and how many people are not eating enough protein, I kind of feel if you do start prioritizing protein, you're gonna snack less, which is actually gonna end up lowering inflammation, right? And I think the other thing which we don't talk about enough about guts health-

Dr. Rupy Aujla 52:25 Mm

Dr. Rangan Chatterjee 52:25 ... and again, I don't think we've spoken about this before, so you know, I, I'd welcome your perspective on this. We're always thinking about what we can add in to support our gut's health, but it's also a case of like when you came on the show a few weeks ago, one of your principles, one of my principles is to unprocess-

Dr. Rupy Aujla 52:42 Yeah

Dr. Rangan Chatterjee 52:42 ... your diet. If you naturally unprocess your diet and reduce the amount of ultra-processed foods, you're actually improving your gut health anyway-

Dr. Rupy Aujla 52:52 Yeah

Dr. Rangan Chatterjee 52:52 ... even before you start adding in all the fermented foods and those-

Dr. Rupy Aujla 52:55 Yeah

Dr. Rangan Chatterjee 52:55 ... sort of things, right? So again, none, none of us are right or wrong here. We're just expressing our perspective.

Dr. Rupy Aujla 53:01 Yeah.

Dr. Rangan Chatterjee 53:02 I think out of those three, the way I look at things at the moment, I'd probably go for most people, if they really focus on their protein, I think they're probably gonna take care of the other two as well.

Dr. Rupy Aujla 53:11 That's a really, really good point because, uh, ju- just to, uh, echo what you're saying is if you have enough protein, you're not gonna overconsume energy-

Dr. Rangan Chatterjee 53:20 Yeah

Dr. Rupy Aujla 53:20 ... in the form of calories. That's gonna be naturally anti-inflammatory.

Dr. Rangan Chatterjee 53:23 Exactly.

Dr. Rupy Aujla 53:24 You're going to deprocess your diet because you're not gonna be having all those snacks and stuff and sugary drinks and stuff to keep your energy up, and you know, it, it, it's in terms of what I've just been talking about in terms of protein, as it is arguably the most critical macronutrient because of how the downstream effects of protein affect enzyme health, hormonal health, et cetera, that is the thing to prioritize. And if you look at like, you know, traditional, uh, tribespeople, protein is prized in those-

Dr. Rangan Chatterjee 53:56 Yeah

Dr. Rupy Aujla 53:56 ... communities, right? They don't have, you know, a diversity of ingredients. They don't have all the sort of, uh, the grains and the selection of ingredients that we have in our supermarket shops. They have a very simple diet, but they prioritize proteins. They tend to have meat in the morning. They tend to have meat at the end of the day. They so- have that in combination with random ingredients, whether it's berries or tubers-

Dr. Rangan Chatterjee 54:20 Yeah

Dr. Rupy Aujla 54:20 ... or whatever it might be. It's a very, very simple diet, but it works for them.

Dr. Rangan Chatterjee 54:24 Just taking a quick break to give a shout-out to AG1. Now, AG1 is a science-based foundational nutrition supplement that contains 75 whole food sourced nutrients. It contains vitamin C and zinc, which helps support a healthy immune system, and also prebiotics and digestive enzymes, which helps support your gut's health. And one of the best things about AG1 is that all this goodness comes in one convenient daily serving that makes it really easy to fit into your life, no matter how busy you feel, and it's also really, really tasty. What makes AG1 really special is the team of scientists behind it. I speak to them regularly, and I'm really impressed by their commitment to making a high quality product. If you want to try AG1, they are giving my audience a really special offer. One year supply of vitamin D, which is really good for your immune system, and five free travel packs with your first order. You can see all details at drinkag1.com/livemore, or just click on the link below. Now, back to the conversation. And, and that's one of the things I really like about this approach, is that it does simplify eating for people.

Dr. Rupy Aujla 55:43 Mm.

Dr. Rangan Chatterjee 55:43 Right? Even those three questions that you propose-

Dr. Rupy Aujla 55:45 Yeah

Dr. Rangan Chatterjee 55:46 ... right? Is there enough protein on my plate to meet my requirements? Are there ingredients in this meal that are going to support my gut health? Is the overall impact of this meal going to be anti-inflammatory? And, you know, there's a lot more education on that in, in, in your book for people who are interested. But it's not a bad way for people to assess breakfast, lunch, dinner, all their meals frankly, is it?

Dr. Rupy Aujla 56:07 Yeah, yeah.

Dr. Rangan Chatterjee 56:07 It's quite, it's quite a nice, elegant framework to think about your food.

Dr. Rupy Aujla 56:11 Let, let's play with that, because this is why I, I thought a lot about the questions that I ask myself whenever I sit down to eat. I ask myself a lot of questions. Let's imagine you're having lunch, and you've got a meal deal in front of you, right? You've got a sandwich, got some crisps, got a sugar-sweetened beverage, Coke, whatever it might be. If you ask yourself those three questions, even if you're eating something that is deemed as ultra-processed as a meal deal, you can afford to do some tweaks that might help you answer those questions in a positive way. So if you think about protein, okay, what kind of proteins can I add? Can I add maybe some shelled edamame on the side of that, just boost up my protein? That shelled edamame is also gonna have a knock-on effect on, are there gut-healthy ingredients that I'm adding to this meal? Bit of fiber in there as well.

Dr. Rangan Chatterjee 57:03 Mm-hmm.

Dr. Rupy Aujla 57:03 And also from the anti-inflammation perspective, whilst the crisps and all that kind of stuff might be inflammation producing, maybe you can swap those. Maybe instead of having the crisp, you can have some raw nuts. Maybe instead of the sugar-sweetened beverage, you can have water. And so you're tipping the balance towards more protein, higher fiber, less inflammation. It's a very simple way of analyzing any time you sit down to eat, and what's in front of you-

Dr. Rangan Chatterjee 57:30 Mm

Dr. Rupy Aujla 57:30 ... and what's on your plate, and how you can make some very simple tweaks. And I, I do this in the book quite a bit, you know. Can you add just one more? Can you swap this for that? And in terms of proteins, you know, in terms of breakfast, I always think about, are there leftovers that I can have for breakfast? Breakfast, I think, has got this brand of having to be sweet.

Dr. Rangan Chatterjee 57:54 Mm.

Dr. Rupy Aujla 57:54 Whereas actually if you look at traditional diets, they tend to be very savory. Like my traditional, like Punjabi breakfast is definitely a savory affair.

Dr. Rangan Chatterjee 58:04 Mm-hmm.

Dr. Rupy Aujla 58:05 It's whole wheat, it's dal, it's spinach, it's yogurt. These are all high protein ingredients that when combined together will give me enough sustenance for the day. Can you layer different proteins on top of each other? So just like I did with my oatmeal, I'm layering shelled hemp seeds, cacao, chia seeds. Can you use toppers? Can you think about your breakfast in a, in a savory manner? What about savory breakfast? They tend to be higher protein by virtue of the fact they're using savory umami ingredients.

Dr. Rangan Chatterjee 58:38 What about someone who's listening, Rupy, and, you know, they're interested in their health, but, you know, they're, they're busy. They've got to rush out in the morning. They don't have much time for breakfast. And so, I don't know, let's say their current breakfast is two pieces of toast, butter, and strawberry jam. Okay? I don't know how many people who listen to this podcast [laughs]

Dr. Rupy Aujla 58:58 [laughs]

Dr. Rangan Chatterjee 58:58 ... eat a breakfast like that, but I'm sure there are many, right? So if that person came to you and said, "Rupy, okay, listen, I'm hearing what you're saying here. Um, I think from what you're saying, Rupy, that's probably a breakfast low in protein," make the case to that person why they should think about changing it, and if they are gonna change it, can you recommend something for them?

Dr. Rupy Aujla 59:23 Okay. Let's play with this. So let's imagine I'm not really asking you to change anything at all. If you fancy bread in the morning, toasted with butter, fine.

Dr. Rangan Chatterjee 59:34 Sounds delicious.

Dr. Rupy Aujla 59:35 Let's [laughs]

Dr. Rangan Chatterjee 59:35 [laughs]

Dr. Rupy Aujla 59:36 Yeah. Let's think about the bread first off, okay? So stage one is, can we swap that white bread that is devoid of nutrients, and actually they've had them stripped out, and then artificially added in in the flour to meet the recommended, uh, targets that are set by the government? Can we swap that for a slightly higher protein bread? Now, bread doesn't naturally have that much protein in. But if you go for something like a sourdough, because of the fermentation process that has been allowed to actually ab- uh, uh, release a lot of those proteins that are naturally in the grain, your protein absorption actually increases, and the total amount of protein within that bread actually increases as well, by a factor of around 100%. So that's not a bad swap. We're just looking for those marginal gains, and I'm doing the least amount I can for this individual. That's probably something I would suggest.

Dr. Rangan Chatterjee 1:00:31 And do you think that if they're someone who is feeling hungry two hours later, right? They're, they're in a rush, they're having it, but two hours later they are hungry, they need a little snack at work. Do you think, and of course it's highly individual, that even that change alone might perhaps result in them being a bit less hungry mid-morning?

Dr. Rupy Aujla 1:00:50 Potentially.

Dr. Rangan Chatterjee 1:00:50 Yeah.

Dr. Rupy Aujla 1:00:51 Absolutely.

Dr. Rangan Chatterjee 1:00:51 Okay.

Dr. Rupy Aujla 1:00:51 Potentially. So let's, let's imagine that you're going one step further. I've actually got a recipe in the book-

Dr. Rangan Chatterjee 1:00:57 You do, I was gonna ask about that

Dr. Rupy Aujla 1:00:58 ... for my own bread, right? And that one slice of bread offers around eight grams of protein, and the reason why is because we're using nuts and seeds and psyllium husk, which is naturally high in protein, high in fiber, to deliver what is- A really accessible and easy protein-rich meal in the morning. So if all you've got time for is popping some bread in the, in the toaster or u- under the grill, then that offers you a really easy option. And that bread... I'm not a baker. I do not like baking. I don't do cakes. I don't do anything. That bread recipe, you put everything into a bowl, add a bit of water and oil, put it into a loaf tin and in the oven for about 60 minutes. I do this once a week with me and my wife. We have it every single week, and we absolutely love it. And to go one step further, which is something that I do in the mornings as well, you can use that bread and instead of putting butter on it, maybe try peanut butter. What about tahini? What about some sort of seed butter? Because that, again, pushes your protein slightly higher. And then if you've got a little bit more time, exactly seven minutes, pop a couple of eggs into some boiling water, and that way you are far surpassing the 25 or 30 grams of protein that you may require in the morning. And I almost guarantee, I know I don't make guarantees, but I, I, I'm confident that people who have enough protein in the morning for breakfast will not have those sneaky cravings-

Dr. Rangan Chatterjee 1:02:29 Yeah

Dr. Rupy Aujla 1:02:29 ... mid-morning anymore.

Dr. Rangan Chatterjee 1:02:30 And we've seen it hundreds of times, right, with patients. If all you take from this entire podcast is to eat more protein at breakfast, and then pay attention-

Dr. Rupy Aujla 1:02:40 Mm

Dr. Rangan Chatterjee 1:02:40 ... just pay attention to what happens in the day, I think people will be quite surprised.

Dr. Rupy Aujla 1:02:46 I agree.

Dr. Rangan Chatterjee 1:02:46 And I think there's this wider point, which I think we touched on last time you came on, but you just mentioned your traditional cultural breakfast and what it might be. Breakfast, for some reason, has this real PR issue where when we think of breakfast, we think of cereal-

Dr. Rupy Aujla 1:03:02 Yeah

Dr. Rangan Chatterjee 1:03:02 ... and orange juice and croissants. This is quite a modern thing.

Dr. Rupy Aujla 1:03:06 Yeah, yeah.

Dr. Rangan Chatterjee 1:03:07 It's, it's like breakfast doesn't need to be that. It can be proper foods.

Dr. Rupy Aujla 1:03:11 Yeah.

Dr. Rangan Chatterjee 1:03:11 You know, I had salmon for breakfast this morning.

Dr. Rupy Aujla 1:03:13 Yeah, brilliant.

Dr. Rangan Chatterjee 1:03:14 You know, you know, did dinner last night, try and cook too much. Whatever's in the fridge, I'll heat it up in the morning. You know, that's how I eat because I feel better when I do that.

Dr. Rupy Aujla 1:03:24 100%.

Dr. Rangan Chatterjee 1:03:25 And I think people, they're like, "What? What? For breakfast?"

Dr. Rupy Aujla 1:03:28 Yeah. [laughs]

Dr. Rangan Chatterjee 1:03:28 You know? Yeah, yeah. I can't have that. So you, you can actually, and I bet you if you try that for a little while, you'll go, oh yeah, this... I actually really enjoy this, and I feel much better when I nourish myself properly first thing in the morning.

Dr. Rupy Aujla 1:03:40 It's so funny. The, the... my team, whenever I come in in the morning, they, they look at me... They used to look at me quite strange, because I would literally pile everything into a little frying pan, put the lid on. And my go-to in the mornings is some kale, pumpkin seeds, hot smoked salmon, a little bit of olive oil on top of my protein bread, and I literally just put that on the hob, put the lid on, and it literally, I'm not, I'm not exaggerating, it literally takes me five, six minutes, and I eat it [laughs] straight out the pan because it's actually quite a small saucepan. And they used to think, oh, isn't that funny, like Rupy eating out the pan and stuff like for his breakfast. And, but now they've all started doing it because I espouse these benefits of healthy high protein, and they notice the benefits themselves as well, because they're more intuitive about how they feel mid-morning, and they have a lot more energy.

Dr. Rangan Chatterjee 1:04:33 Yeah. And, and that's one thing that I love about what you've been doing in public, Rupy, for many years now. You're, you're, you're trying to, well, you're trying to encourage people to cook.

Dr. Rupy Aujla 1:04:41 Mm.

Dr. Rangan Chatterjee 1:04:41 You're trying to simplify, going, "It's not as... You guys, it's not as hard as you think." I think you do that really well in all of your books. I think in this one, again, you've done a really great job at helping people. There's, there's quite a few one pan recipes in here.

Dr. Rupy Aujla 1:04:53 Yeah.

Dr. Rangan Chatterjee 1:04:53 I know you did a whole book on one pan stuff-

Dr. Rupy Aujla 1:04:55 Yeah. [laughs]

Dr. Rangan Chatterjee 1:04:55 ... a few years ago, but it's... I think there's that wider point, isn't there, that we've forgotten how to cook.

Dr. Rupy Aujla 1:05:02 Yeah.

Dr. Rangan Chatterjee 1:05:02 You know, when many people don't know what to do. S- so cereal and milk is very easy-

Dr. Rupy Aujla 1:05:09 Yeah

Dr. Rangan Chatterjee 1:05:09 ... and initially is tasty and fills you up at least for an hour or so if you don't know how to cook.

Dr. Rupy Aujla 1:05:16 Yeah.

Dr. Rangan Chatterjee 1:05:16 But as you say, there are ways to do that. What about, um, somebody goes, "Hey, Rupy, listen, I ain't gonna cook in the morning, right? But I hear what you're saying about protein. Why can't I get a protein powder-

Dr. Rupy Aujla 1:05:29 Mm

Dr. Rangan Chatterjee 1:05:30 ... put it in my mixer, and add in some ingredients like the ones you've already mentioned? Is that okay?" So what would you say to that person?

Dr. Rupy Aujla 1:05:39 I'd say, look, I, I hear it and I get it. You know, um, people are time poor, and people don't necessarily have the skills, and so I can see what the appeal of a high protein smoothie or high protein shake, uh, does for, for folks.

Dr. Rangan Chatterjee 1:05:57 I'm, I'm sensing a but.

Dr. Rupy Aujla 1:05:58 [laughs] There is a but coming. Look, I, as someone who does have protein shakes themselves, um, I don't recommend people start their day with a smoothie like that, for a number of different reasons. Whilst it might have protein in, I wouldn't say it qualifies for the second question that you are asking yourself in the morning. Is this gonna be gut supporting? And the reason why is because when you juice or when you smooth your ingredients, you're essentially rapidly and quite destructively changing that 3D complex food matrix. What is the food matrix? Well, it's the, the shape that your berry has when you consume it, or the shape that your apple has when you bite into it. And if you imagine, using the apple, just riffing on that for a second, when you bite into your apple and you are shearing through the pectin, the different cell walls, you're bathing that in the acid in your mouth and then in your stomach, and then your body digests that slowly throughout your intestine, so you absorb the sugar that's naturally found in the apple, the fructose, into your bloodstream and to your liver, you know, that's a very slow process. Whereas if you were to add that to a, a blender and rapidly change that food matrix, then- The amount of work that your body needs to do to break down the apple, whatever you're adding to that smoothie, is far less, so you're gonna be rapidly absorbing those nutrients into your bloodstream. And because of fruits and, and all the, the ingredients that have those natural fructose molecules in, I don't think that's a great strategy from a, from a gut health point of view.

Dr. Rangan Chatterjee 1:07:48 What, what about if someone, um, does it in a, in a smoothie maker? They put in their, you know, their protein powder, their, their milk, their frozen berries-

Dr. Rupy Aujla 1:07:58 Mm-hmm

Dr. Rangan Chatterjee 1:07:58 ... for example. You know?

Dr. Rupy Aujla 1:07:59 Mm-hmm. Yeah.

Dr. Rangan Chatterjee 1:07:59 Gut health supporting.

Dr. Rupy Aujla 1:08:00 Yeah.

Dr. Rangan Chatterjee 1:08:00 You know, although, as you say, you are-

Dr. Rupy Aujla 1:08:02 Yeah

Dr. Rangan Chatterjee 1:08:02 ... gonna crush them right down. Sometimes pick- people can make them in quite a thick way, put them in a bowl, and then add seeds, and nuts, and other gut-supporting nutrients in that way. What's your take on that?

Dr. Rupy Aujla 1:08:15 I think that's better. Ideally, you wanna consume your food in as whole a form as possible, but that's a lovely go-between. And look, as someone who enjoys those kind of smoothie bowls and stuff, I get it. It's, it's, it's a nice way to enjoy your food, but as a strategy, as something that you wanna do every single day, I would say it's probably not optimal. But it is definitely ... And, and what you're describing there, where you're adding the nuts and the seeds and maybe some other ingredients that are in their whole form, like some high fiber ingredients, you're adding complexity to the milieu of what's in that smoothie-

Dr. Rangan Chatterjee 1:08:50 Yeah

Dr. Rupy Aujla 1:08:50 ... itself, and so that's gonna naturally reduce the speed at which you digest said foods.

Dr. Rangan Chatterjee 1:08:56 Okay, so there's, there's optimal-

Dr. Rupy Aujla 1:08:58 Mm-hmm

Dr. Rangan Chatterjee 1:08:58 ... and there's what's practical, right?

Dr. Rupy Aujla 1:09:01 Yeah.

Dr. Rangan Chatterjee 1:09:01 So w- my understanding from what you're saying is that ideally you would like people to think about their protein intake and make sure for their first meal of the day, this very important meal after your overnight fast-

Dr. Rupy Aujla 1:09:14 Mm-hmm

Dr. Rangan Chatterjee 1:09:15 ... that you are eating real food as much as possible-

Dr. Rupy Aujla 1:09:19 Yeah

Dr. Rangan Chatterjee 1:09:19 ... as close to its natural form as possible, uh, where you are prioritizing protein, okay?

Dr. Rupy Aujla 1:09:24 Mm-hmm.

Dr. Rangan Chatterjee 1:09:25 That could be your overnight oats that you have with all those additions.

Dr. Rupy Aujla 1:09:29 Mm-hmm.

Dr. Rangan Chatterjee 1:09:30 It could be the bread that you recommend with the, the higher protein bread with some eggs. I guess it could even be fish.

Dr. Rupy Aujla 1:09:39 Mm.

Dr. Rangan Chatterjee 1:09:40 Meat, roast chicken from the night before heated up, right?

Dr. Rupy Aujla 1:09:43 Yeah.

Dr. Rangan Chatterjee 1:09:44 So that's ideal. You're saying that whilst you understand people buying protein powders and putting them in the smoothie, and yes, they're ... still can tick the protein box of your three questions by having that, it's not ideal for those other reasons.

Dr. Rupy Aujla 1:10:02 Mm.

Dr. Rangan Chatterjee 1:10:02 But if it was a choice of a breakfast cereal, just plain, standard breakfast cereal with milk, versus a smoothie with protein powder, I'm guessing you'd say that smoothie with protein powder, although not perfect-

Dr. Rupy Aujla 1:10:19 Sure

Dr. Rangan Chatterjee 1:10:19 ... is a better choice?

Dr. Rupy Aujla 1:10:20 I would, I would agree. Yeah. I think these are steps to success, right? So let's imagine that you have an individual, it might not be the ... someone listening to this. It might be their friend, or it might be their child that loves their cereal in the morning. And maybe one way in which to just slightly improve that is actually just to add a, a s- uh, a topper, uh, of nuts and seeds or whatever it might be to that cereal in the first instance. Then the next step might be the smoothie that you put in the bowl with, again, the extra toppers, all the way stepping to the success of a high protein breakfast or something that is leftovers. And let's not sleep on, on things like meat and fish for breakfast. They ... I know it sounds a bit strange to some people, but leftovers for breakfast for me are one of the easiest things-

Dr. Rangan Chatterjee 1:11:10 Yeah

Dr. Rupy Aujla 1:11:10 ... and far easier than the other ... And it ... The other thing is, like, when, when we think of cereal, whilst we think, yes, it is a time saver, when you think about the trade-off to your energy-

Dr. Rangan Chatterjee 1:11:24 Yeah

Dr. Rupy Aujla 1:11:24 ... and how you feel the rest of the day, it doesn't make sense.

Dr. Rangan Chatterjee 1:11:27 Yeah.

Dr. Rupy Aujla 1:11:28 It's not a, a, an, an equivalent, and I wouldn't wanna put my personal, uh, feelings and energy levels on the line for a, a quick decision in the morning, a, a, a, a decision that's based on time in the morning.

Dr. Rangan Chatterjee 1:11:46 And I would say, just to highlight something that I think both you and I are passionate about, is this idea ... Actually, you know what? Don't necessarily believe what Rupy's saying or what I'm saying. Try it.

Dr. Rupy Aujla 1:11:57 Mm.

Dr. Rangan Chatterjee 1:11:58 Try it for a week and, and assess for yourself, do you feel better? Because ultimately, that will be ... That's where you find the gold, right?

Dr. Rupy Aujla 1:12:05 Totally.

Dr. Rangan Chatterjee 1:12:06 I'm, I'm not saying ignore us.

Dr. Rupy Aujla 1:12:07 Yeah.

Dr. Rangan Chatterjee 1:12:07 I'm just saying, look, if you're not sure, why don't you make a commitment to yourself for seven days, I'm gonna try a high protein breakfast, and pay attention to how you feel. Okay. Animal protein v. plant protein.

Dr. Rupy Aujla 1:12:20 Controversial. [laughs]

Dr. Rangan Chatterjee 1:12:22 Gotta cover it, mate. We've got to cover it. Okay. A- and you've als- you've also acknowledged that you are a, uh, proponent-

Dr. Rupy Aujla 1:12:31 Mm-hmm

Dr. Rangan Chatterjee 1:12:31 ... of plant focused diets?

Dr. Rupy Aujla 1:12:33 I say plant focused or plant forward, yeah, yeah.

Dr. Rangan Chatterjee 1:12:35 Okay. Right. So one of the things you're drawing attention to in this new book of yours is that this promotion of gut health and plants fiber over the past few years has come at potentially an unappreciated cost. Is that a fair way of saying it?

Dr. Rupy Aujla 1:12:57 That's a really good way of saying it.

Dr. Rangan Chatterjee 1:12:58 Whereby by doing that, some people are not eating enough protein, right? And you tackle that head on. So let's just go through all of that and help people understand the difference between animal protein and plant protein in terms of the amino acids, these Lego building blocks that we need.

Dr. Rupy Aujla 1:13:18 Yeah.

Dr. Rangan Chatterjee 1:13:19 Because the truth is th- this, this does become so controversial for people.

Dr. Rupy Aujla 1:13:23 Yeah.

Dr. Rangan Chatterjee 1:13:23 Right? And I don't think it really needs to.

Dr. Rupy Aujla 1:13:26 Yeah. Yeah, yeah. I agree. And I think, you know- It really does speak to some of the concepts that you spoke about in your latest book that I really do chime with me, this idea of minimal reliance on experts. Because if we rely completely on, you know, what, what people might listening, be listening to me saying, or another expert that has a different opinion, a plant-based, uh, doctor or nutritionist, a carnivore doctor or nutritionist, a keto advocate, you can get really, really confused and stuck in the weeds. And I think riffing on what you said earlier about, you know, try it and see how you feel and become more intuitive about how this way of eating changes your day, how convenient it is, I think is something that people always need to, to remember. And so with that in mind, let's talk a bit about the difference between animal and plant-based proteins. Putting aside the environmental controversies and the moral and ethics of eating animals that I think are valid and true-

Dr. Rangan Chatterjee 1:14:33 Yeah

Dr. Rupy Aujla 1:14:34 ... but I think we should be able to have a conversation that looks unemotionally at the science. And so with this in mind, animal-based proteins are more bioavailable and-

Dr. Rangan Chatterjee 1:14:49 What does that mean, bioavailable?

Dr. Rupy Aujla 1:14:51 So the accessibility of those building blocks, those amino acids, are a lot easier to access from animal-based proteins, and in sufficient quantities that makes it easier to hit your protein amounts. So putting this into context, if you imagine a bar chart, and along the X-axis you have all your different amino acids laid up, and on the Y-axis you have a dotted line going across, and that gives you your threshold for all your amino acids, your animal-based proteins are all above that threshold. So if you have a piece of chicken, let's say 100 grams, you're gonna be getting 30 grams of very good quality amino acids that will satisfy your body's requirements. If you were to line up the same amount of plant-based protein, let's say tempeh, um, and line up again the amino acids, in terms of the thresholds of amino acids, it's going to be lower, and that's across the board for all plant-based proteins, whether we're talking about beans, corn, grain, um, other sources of, uh, of protein, including nuts and seeds. It's the same story. It's always going to be less in terms of the accessibility and the availability of those amino acids, and the amounts of those amino acids as well. That isn't to say that you can't get there, but it requires a lot more careful planning, particularly if you're a vegetarian or you're on a vegan diet. And we'll go through some strategies to ensure that you can cover all your bases, but these are the unequivocal facts.

Dr. Rangan Chatterjee 1:16:39 Information is not enough to make change in your life. You have to take action. So to help you take action after watching this video, I've created a free nutrition guide for you. This contains the five most important practices I've seen in over two decades of seeing patients. They work for you no matter what your dietary preference. There's a step-by-step action plan to help you implement those changes in your life. If you want to receive that free guide right now, just click on the link in the description box below.

Dr. Rupy Aujla 1:17:09 In the academic literature, we use some digestibility and bioavailability scores to determine the quality of proteins. We don't need to go into that much detail, but this is what people need to realize about animal versus plant-based proteins.

Dr. Rangan Chatterjee 1:17:25 This is where I think we need to be really careful w- when we think about theory versus practical application.

Dr. Rupy Aujla 1:17:33 Mm-hmm.

Dr. Rangan Chatterjee 1:17:34 If we accept what you just said, that, uh, animal protein is more bioavailable for the human body than plant protein as a general rule-

Dr. Rupy Aujla 1:17:45 Mm-hmm

Dr. Rangan Chatterjee 1:17:45 ... then yes, in theory, it's possible to meet your requirements by being very methodical and paying attention to what you're doing on a plant-based diet, and we can talk about some of your strategies for that, and there's plenty of them in the book for people, right?

Dr. Rupy Aujla 1:18:05 Mm-hmm.

Dr. Rangan Chatterjee 1:18:05 But also then we have to superimpose that on the fact that, what is it? 88% of people in the UK have suffered with burnout in the last couple of years.

Dr. Rupy Aujla 1:18:16 Mm-hmm.

Dr. Rangan Chatterjee 1:18:16 Right? So people are living in a stressed out world where people are rushing around. So are they... Although it theoretically may be possible, I bet there will be some people who are listening to this show right now who are massively under-consuming protein, and as you say, they may have, uh, reasons for choosing the diet that they're doing, which I, both of us completely respect.

Dr. Rupy Aujla 1:18:43 Mm-hmm.

Dr. Rangan Chatterjee 1:18:44 But you may not have the time and energy in your life to pay attention to all the things you need to do with your diet to get that. And now-

Dr. Rupy Aujla 1:18:53 Yeah

Dr. Rangan Chatterjee 1:18:53 ... you may also say, actually, for example, if someone's listening and they're eating a, a vegan diet for compassionate reasons, I totally respect that.

Dr. Rupy Aujla 1:19:01 Yeah.

Dr. Rangan Chatterjee 1:19:01 I think we're all individuals. We can all make those decisions. But when it comes to purely health-

Dr. Rupy Aujla 1:19:06 Mm

Dr. Rangan Chatterjee 1:19:07 ... if you're gonna eschew all animal proteins-

Dr. Rupy Aujla 1:19:10 Mm

Dr. Rangan Chatterjee 1:19:10 ... I think what you're saying at least is you've got to be very careful that you're getting enough protein.

Dr. Rupy Aujla 1:19:16 Absolutely, and I say this pretty unequivocally in this chapter within the protein section of the book that if you have intolerances or allergies, or you simply don't like certain high protein plant-based ingredients like soy-based proteins- Tofu, tempeh, um, and nutritional yeast, edamame. I don't recommend you go on a purely plant-based diet because the amount of planning and forethought it's going to take to get you to your protein requirements is gonna be pretty immense. It's not to say that it's impossible, but I feel quite strongly now just looking at the data, that for most people, just like you were saying, given so many people are time poor, a lot of people are suffering burnout, to get to the point where we're gonna be consuming enough quality protein to meet our needs is gonna be really, really tough. Now, I can hear some people probably [laughs] saying, "Well, you know, you just mentioned a few ingredients that aren't indigenous to a number of different cultures. Indian culture, we don't have tempeh and tofu and soy. Like, you know, why, why, why would you say that if you can't eat those, you can't thrive on a, on a vegan diet?" And, uh, the reason why is because those traditional diets actually did a lot of work and a lot of processing to the ingredients that they had available to them to make them higher in protein and make the proteins more bioavailable.

Dr. Rangan Chatterjee 1:20:58 Like what?

Dr. Rupy Aujla 1:20:59 Soaking, germinating, activating, fermentation, combination. So if you think about lentils and dal, I remember vividly, you know, my mum would, um, first get a, a big bag from the, um, the, the Indian grocer's, and then she would methodically pick out the stones-

Dr. Rangan Chatterjee 1:21:18 Yeah

Dr. Rupy Aujla 1:21:18 ... out of the lentils, and then she would throw that into a big pot of water with other lentils as well.

Dr. Rangan Chatterjee 1:21:25 Yeah.

Dr. Rupy Aujla 1:21:26 Soak that overnight, clean that water, pressure cook those lentils, and combine it with some, again, very high quality rice grains, and that combination, the amount that we would consume-

Dr. Rangan Chatterjee 1:21:39 Yeah

Dr. Rupy Aujla 1:21:39 ... that would give you a decent dose of protein.

Dr. Rangan Chatterjee 1:21:41 It's a time-consuming process, right?

Dr. Rupy Aujla 1:21:42 Yeah, extremely.

Dr. Rangan Chatterjee 1:21:42 And that, that, again, speaking about this uncomfortable truth, we're living in this, many of us at least, in this time pressured environment-

Dr. Rupy Aujla 1:21:49 Mm

Dr. Rangan Chatterjee 1:21:50 ... where we're looking at what people used to eat, but not looking at how they used to eat it, how they used to prepare it. I mean, this is not to do with protein, but one thing Vid and I have noticed is that... So my background is Bengali.

Dr. Rupy Aujla 1:22:05 Mm-hmm.

Dr. Rangan Chatterjee 1:22:05 Hers is Gujarati. And the way we prepare rice is different from how she saw it being prepared when she grew up, right? So if I've got white basmati rice, the way my mum taught me how to prepare it is that you, you put the, the rice in a pan.

Dr. Rupy Aujla 1:22:23 Uh-huh.

Dr. Rangan Chatterjee 1:22:24 You soak it in water, um, and then three times at least you'll pour the water out, right? So you pour the water out, then you'll fill it up again.

Dr. Rupy Aujla 1:22:32 Yeah.

Dr. Rangan Chatterjee 1:22:32 Pour the water, and then you'll soak it.

Dr. Rupy Aujla 1:22:34 Yeah. [laughs]

Dr. Rangan Chatterjee 1:22:35 Right? And again, I haven't seen a scientific study on this, but Mum would always say to me, "Oh, it just removes the excess starch," right? People are not doing that at the moment. They're buying the rice, cooking it, um, keeping all that water in it. And again, I'm not saying good or bad.

Dr. Rupy Aujla 1:22:50 Mm.

Dr. Rangan Chatterjee 1:22:50 I'm just saying isn't it interesting how these cultures had ways of, I don't know, ways of doing stuff that-

Dr. Rupy Aujla 1:22:59 Totally

Dr. Rangan Chatterjee 1:23:00 ... some of us don't do anymore, right?

Dr. Rupy Aujla 1:23:01 And, you know, I... There's a bit in the book where I lean into some of these traditional methods and, and, and I looked at some of the studies, right? Looking at the abi- the availability of the amino acids as a result of some of these traditional methods. And what happens, and what your mum was teaching you appropriately, was when you remove the starches, you're getting rid of anything that could disrupt the availability of those proteins. When you cook and when you, when, when you soak overnight as well, and you replenish that water, you're getting rid of these antinutrients. And these antinutrients is a bit of a, a, a misnomer because antinutrients are actually quite healthy for us. But when you reduce them to a point, they no longer disrupt the availability of those amino acids when you cook the rice or cook the lentils, for example. So these traditional methods, whilst they might seem a bit cumbersome and, uh, nonsensical, actually they hold a lot of wisdom. There's a reason why we do this and why we've discovered the cooking techniques of our ancestors, is because it allowed them to do things like absorb more protein-

Dr. Rangan Chatterjee 1:24:11 Yeah

Dr. Rupy Aujla 1:24:11 ... from the limited amount of food that they had.

Dr. Rangan Chatterjee 1:24:12 I'm glad you said my mum did that correctly.

Dr. Rupy Aujla 1:24:14 [laughs]

Dr. Rangan Chatterjee 1:24:14 I'm gonna go round afterwards and say, "You, you've got Rupy's seal of approval."

Dr. Rupy Aujla 1:24:17 I'll send her the paper. [laughs]

Dr. Rangan Chatterjee 1:24:18 You'll send her the paper? Okay then, Rupy, but for people who are choosing to eat plant-based for whatever reason they, they've chosen that for, right? Have you got some top tips for them on how they can, you know, these little tweaks that will increase the amount of protein that they're consuming?

Dr. Rupy Aujla 1:24:37 Totally, yeah. So I would say one of the most important things is combination. So if you imagine, um, going back to that bar chart, and you've got all the different amino acids. In a chicken breast, you've got all the amino acids that you require in decent doses, in decent quantities. With rice, let's say you've got some amino acids that are high. It might be methionine. I actually don't know off the top of my head which amino acids that they're rich in, but they're low in others. Lentils, it might be high in some of the amino acids that rice is low in, but low in some of the amino acids that rice is high in. And so what you're doing is by layering proteins and combining them across your meal, you're covering the bases of the amino acid deficits. In combination to that, the quantity of rice and lentils and beans will need to also be upped as well, because the actual dose of those amino acids is gonna be a lot lower. So you're beginning to see a bit of a picture and some of the conundrum around vegetarian, vegan eating. Not only do you need to be more cognizant about the combination of different proteins, you also need to be consuming a lot more.

Dr. Rangan Chatterjee 1:25:54 Yeah, so an increased amount of calories- Potentially to get what you need protein-wise

Dr. Rupy Aujla 1:26:01 Yes, and I think even more so than calories because plant-based foods tend to be lower in calories anyway compared to animal-based foods. That increase in fiber, as you've probably discovered during your clinical practice, can be completely intolerable for certain people-

Dr. Rangan Chatterjee 1:26:17 Yeah

Dr. Rupy Aujla 1:26:17 ... who aren't used to consuming fiber in the first place, or may have an intolerance to some of the sugars that you find in carbohydrates. Raffinose, verbascos, you know, these are all different-

Dr. Rangan Chatterjee 1:26:28 Mm

Dr. Rupy Aujla 1:26:28 ... types of polysaccharides that can be quite troublesome for people. And so you can see why, particularly if you're not preparing these foods-

Dr. Rangan Chatterjee 1:26:36 Yeah

Dr. Rupy Aujla 1:26:36 ... in the, in the right way, it can be actually quite detrimental to your gut.

Dr. Rangan Chatterjee 1:26:39 Yeah, and there, there's a, there's a, there's a wider point here for me, Rupy, right? So, yes, allergies are on the rise, intolerances are on the rise. Many theories, but of course, one of the big ones is to do with, uh, the decimated state of our gut microbiomes compared to what our ancestors would have had.

Dr. Rupy Aujla 1:26:57 Mm-hmm.

Dr. Rangan Chatterjee 1:26:58 Okay? So you often see this judgmental look at what people are eating online, okay? Uh, uh, obviously nutrition has become quite divisive, not for everyone, but for [laughs] a lot of people whose voices get amplified online, okay? And I think another thing that people forget is that they're not aware of what that other person might be going through, right?

Dr. Rupy Aujla 1:27:25 Mm.

Dr. Rangan Chatterjee 1:27:25 So if you are someone who has had a ton of antibiotics, right, and a ton of stress and childhood trauma, and your gut microbiome is, you know, ha- has been impacted quite significantly. Actually, if that's you, you may struggle to absorb or tolerate large volumes of plant food.

Dr. Rupy Aujla 1:27:46 Yeah.

Dr. Rangan Chatterjee 1:27:46 I've seen that-

Dr. Rupy Aujla 1:27:47 Yeah

Dr. Rangan Chatterjee 1:27:47 ... time and time again. So these are often the people who prefer eating animal-based diets because they feel better.

Dr. Rupy Aujla 1:27:56 Yeah.

Dr. Rangan Chatterjee 1:27:57 Right? But then often someone who's chosen a plant-based diet for com- let's say, compassionate reasons, can be quite judgmental without realizing, hey, wait a minute, maybe that's the only diet that person can tolerate.

Dr. Rupy Aujla 1:28:07 Yeah.

Dr. Rangan Chatterjee 1:28:08 And I don't think, I don't think I've actually said that on the podcast this way before, but I, I, I kind of... You know, both me and you are, are quite interested in compassion-

Dr. Rupy Aujla 1:28:15 Yeah

Dr. Rangan Chatterjee 1:28:15 ... and trying to bridge the gap of all these controversies, and go, actually, some people find that that's the best way of eating for them.

Dr. Rupy Aujla 1:28:22 You know what? I completely agree, and I'm glad you've said that, because I used to be of the opinion that this sort of hype around bone broths and, you know, drinking and, and, and using an animal-based diet is not rooted in science, right? Maybe five, six years ago. It was sort of fashionable. It wasn't really something that could be explained mechanistically. And when you think about it from the lens of someone who is intolerant to certain fibers, and, you know, they might have tried a high fiber diet, or they might have tried, you know, maybe let's say they're tolerant of certain fibers, but they just haven't figured that out. And then they start doing things like drinking bone broths that are actually very nutrient dense. They might not be that high in protein, but whatever is in the broth is actually a lot more accessible because it's just broken down-

Dr. Rangan Chatterjee 1:29:17 Yeah

Dr. Rupy Aujla 1:29:17 ... and it's very simple. And you combine that with some of those calming anti-inflammatory herbs, for example. You can understand why people become such advocates-

Dr. Rangan Chatterjee 1:29:26 Yeah

Dr. Rupy Aujla 1:29:26 ... for broths and-

Dr. Rangan Chatterjee 1:29:27 Totally

Dr. Rupy Aujla 1:29:27 ... animal-based diets. Absolutely. I can totally see that. And I think, to your point, we definitely need to be respectful of people's individual circumstances, whereby it would be completely unadvisable from a medical or nutritional point of view to recommend that someone go on a plant-based diet because their guts would not be able to tolerate the foods that are being restricted and thus available to them.

Dr. Rangan Chatterjee 1:29:53 Yeah. Which goes back to the point that you talk about, that I often talk about, about trusting yourself, about paying attention-

Dr. Rupy Aujla 1:30:01 Mm

Dr. Rangan Chatterjee 1:30:01 ... and going, actually, not every advice from every bit of expert is relevant for me at this point in my life. And I think we become overly seduced by what the latest science says. It's important, but you don't know for sure that that scientific study is relevant for you as an individual. And I think that's where our, you know, l- many years of clinical practice play in, where we're like, yeah, okay, we love reading research, but we also like what works [laughs] for people when-

Dr. Rupy Aujla 1:30:32 Totally

Dr. Rangan Chatterjee 1:30:32 ... they're struggling.

Dr. Rupy Aujla 1:30:33 Totally.

Dr. Rangan Chatterjee 1:30:34 Now, I eat a lot of plants in my diets, okay?

Dr. Rupy Aujla 1:30:38 Mm-hmm.

Dr. Rangan Chatterjee 1:30:40 Um, I, I'd love your take on this. One thing I really dislike doing is going now to a lot of these new plant-based vegan restaurants, right? I, I did this, I was in LA in November doing interviews for my new book, okay? And we went to supposedly one of the best, uh, vegan, uh, restaurants, because I was out with some friends who are vegan, and it, it was a great night. Except I hardly slept the night after, and I'll tell you why. I didn't know what I was eating, right?

Dr. Rupy Aujla 1:31:10 [laughs]

Dr. Rangan Chatterjee 1:31:10 Everything was like a, um, substitute. It was like a pepperoni pizza plant-based version. Like, all of them, I c- I couldn't see a vegetable, right?

Dr. Rupy Aujla 1:31:20 [laughs]

Dr. Rangan Chatterjee 1:31:21 And I had a headache all night, and I thought, you know what? I would've much rather had a plate of broccoli, a plate of green beans, and like real vegetables-

Dr. Rupy Aujla 1:31:29 Yeah

Dr. Rangan Chatterjee 1:31:29 ... right?

Dr. Rupy Aujla 1:31:30 Yeah, yeah.

Dr. Rangan Chatterjee 1:31:30 So, um, I'm just thinking that some of these places are full of plant substitutes.

Dr. Rupy Aujla 1:31:36 Mm.

Dr. Rangan Chatterjee 1:31:36 Do, do you know what I'm talking about?

Dr. Rupy Aujla 1:31:37 Yeah, yeah. Yeah, and I, you know, one, one of the things I talk about in the book is this rise of plant faux meats and-

Dr. Rangan Chatterjee 1:31:44 Yeah

Dr. Rupy Aujla 1:31:45 ... a lot of these ingredients are actually quite processed. And, and to be honest, like you look at... There was an interesting article, I can't remember where it was now, but about- Whether mission style restaurants are actually serving ultra-processed food that's jazzed up on fancy plates. And, and if you think about it, they use a lot of agar, they use a lot of jellies, they use a lot of emulsifiers, they use a lot of additives. It's probably meeting the criteria of NOVA4 ultra-processed foods, but you're paying like, you know, 10 times the price for it or something. So the same thing is these-

Dr. Rangan Chatterjee 1:32:19 They can just buy you a cookbook, mate.

Dr. Rupy Aujla 1:32:20 Exact- [laughs]

Dr. Rangan Chatterjee 1:32:21 Do you know what I mean? Let's save them money.

Dr. Rupy Aujla 1:32:23 [laughs] And so the same thing is probably happening in some of these plant-based restaurants. But the other thing, and the other trend I think you're alluding to, is the rise of cauliflower steak, or mushroom being seared and being put into a kebab.

Dr. Rangan Chatterjee 1:32:40 What's wrong with that?

Dr. Rupy Aujla 1:32:41 So there is nothing wrong with trying to mimic the flavor and the texture of meat, particularly if you crave that, as we generally all do, and you are plant-based for whatever reason, whether it's ethical, environmental, et cetera. But to equate the protein in that product to a steak or to shredded meat or whatever, I think really does put people at risk of under-consuming protein unless they are supplementing that charred mushroom-

Dr. Rangan Chatterjee 1:33:17 Yeah

Dr. Rupy Aujla 1:33:17 ... or the cauliflower steak with something that is actually of sustenance that satisfies their protein needs.

Dr. Rangan Chatterjee 1:33:24 Yeah. I, I, I honestly think that night I just had an explosion of UPFs, ultra-processed foods.

Dr. Rupy Aujla 1:33:30 Sure.

Dr. Rangan Chatterjee 1:33:31 And again, I'm not, you know, I'm not trying to be critical of those type of restaurants. I'm sure they're trying to meet a need.

Dr. Rupy Aujla 1:33:37 Sure.

Dr. Rangan Chatterjee 1:33:38 I have no issue with having vegan meals, but I'd like it to be a real food vegan meal.

Dr. Rupy Aujla 1:33:43 Mm.

Dr. Rangan Chatterjee 1:33:43 Like, you know, beans that I can see that look like beans, broccoli that looks like broccoli. I kid you not, Rupy, I actually don't know what I ate that night.

Dr. Rupy Aujla 1:33:51 Sure. [laughs]

Dr. Rangan Chatterjee 1:33:51 It was just this mishmash of stuff, but I just felt horrible afterwards.

Dr. Rupy Aujla 1:33:56 Yeah, yeah. And this is the thing, I think a lot of people who unfortunately go vegan, uh, fall into this trap of actually relying on ultra-processed faux meats to meet some of those desires for, for meat, or because that's the most convenient option for them to, to actually consume food when they don't have time in the mornings and they want that bacon sarnie or they want something that gives them the sort of like nostalgia of the meat that they're trying to mimic. And so, and there is a certainly a rise in the labels that you see in supermarkets with the terms plant-based branded all over it. And look, I, I, I think we need these products, but I don't think we can shy away from the fact that these are ultra-processed products that are being snuck into a vegan's diet, uh, under the health guise-

Dr. Rangan Chatterjee 1:34:54 Yeah

Dr. Rupy Aujla 1:34:54 ... of it being good for you because it's plant-based.

Dr. Rangan Chatterjee 1:34:58 Yeah.

Dr. Rupy Aujla 1:34:58 And I think we need to get away from that equivalency, because that's just not true. And look, I'm a, I'm a fan of plant focused eating, as you know. A bunch of the recipes are actually plant based to meet, to help people who are vegan-

Dr. Rangan Chatterjee 1:35:11 Yeah

Dr. Rupy Aujla 1:35:11 ... and vegetarian meet their protein requirements, because I think they need the most help, as well as a whole bunch of recipes that have got meat and fish and all the rest of the animal-based products that people love and, and, and you know, should eat without fear of judgment.

Dr. Rangan Chatterjee 1:35:25 Right. Another tricky question for you. Okay?

Dr. Rupy Aujla 1:35:26 [laughs]

Dr. Rangan Chatterjee 1:35:27 Right? Um-

Dr. Rupy Aujla 1:35:29 I love these

Dr. Rangan Chatterjee 1:35:29 ... for someone who likes to eat meat and/or fish-

Dr. Rupy Aujla 1:35:33 Uh-huh

Dr. Rangan Chatterjee 1:35:33 ... right? Which is the recipe in your new book you'd point them to?

Dr. Rupy Aujla 1:35:38 Oh, that's a really hard question, Rangan. Um-

Dr. Rangan Chatterjee 1:35:41 That's why I asked it, mate.

Dr. Rupy Aujla 1:35:42 So I, I'm a big fan of diversity bowls, right? So it's a really simple, easy way of consuming foods with those three things in mind.

Dr. Rangan Chatterjee 1:35:53 Yeah, okay.

Dr. Rupy Aujla 1:35:53 Is this gonna meet my protein requirements? Is this gonna be gut healthy? Is this gonna be anti-inflammatory? So honestly, the salmon tikka bowls-

Dr. Rangan Chatterjee 1:36:01 [exhales]

Dr. Rupy Aujla 1:36:02 ... which is salmon that's marinated in a very simple tikka sauce, combined with a few greens, a little bit of pickles, uh, some, some, um, uh, lentils. It's, it's just so-

Dr. Rangan Chatterjee 1:36:15 Okay

Dr. Rupy Aujla 1:36:15 ... easy. It's just a bowl of absolute goodness.

Dr. Rangan Chatterjee 1:36:18 I'm in.

Dr. Rupy Aujla 1:36:19 Yeah.

Dr. Rangan Chatterjee 1:36:19 Okay. And if you're a vegan listening-

Dr. Rupy Aujla 1:36:21 Uh-huh

Dr. Rangan Chatterjee 1:36:22 ... right? Which is the recipe you'd point them to?

Dr. Rupy Aujla 1:36:24 So there is-

Dr. Rangan Chatterjee 1:36:25 And you can't have your overnight oats or your breakfast. You've already mentioned them.

Dr. Rupy Aujla 1:36:28 [laughs] So there is a lasagna recipe in the book, okay? And I, I'm calling it lasagna tongue in cheek, and I'm saying this as someone who has an Italian wife with an Italian nonna, an Italian mother-in-law.

Dr. Rangan Chatterjee 1:36:43 [laughs]

Dr. Rupy Aujla 1:36:44 And I've given this recipe to them. I've cooked it for them multiple times, and they absolutely love it, and it's made with tofu. [laughs] Okay? It's gonna get so many Italians, if you have any Italian listeners, as I'm sure you do, it's gonna get their back up completely. But trust me.

Dr. Rangan Chatterjee 1:37:00 Okay.

Dr. Rupy Aujla 1:37:00 Trust the process. This lasagna is gonna be one of the best plant-based lasagnas you have ever tried, and I can, I can say that with full confidence because I've tried it-

Dr. Rangan Chatterjee 1:37:11 Bold statement, mate. Bold statement

Dr. Rupy Aujla 1:37:11 ... with loads of Italians, honestly. And it was so funny 'cause my, my wife's nonna, who sadly passed away now, she's... She was 105 when she passed. I, we talked to her on the phone every Sunday, and I told her about this tofu, and she was like, "What are you talking about?" [laughs]

Dr. Rangan Chatterjee 1:37:26 [laughs]

Dr. Rupy Aujla 1:37:26 Got a little blasted. But, uh, there was definitely an appreciation in her voice. She never got to try it, but her daughter tried it, her dad tried it-

Dr. Rangan Chatterjee 1:37:35 Aw

Dr. Rupy Aujla 1:37:35 ... and everyone, like, sung its praises.

Dr. Rangan Chatterjee 1:37:38 I love it.

Dr. Rupy Aujla 1:37:39 So trust me, there is a plant-based lasagna, and it does work, and it's very high in protein.

Dr. Rangan Chatterjee 1:37:43 Let's finish off talking about supplements-

Dr. Rupy Aujla 1:37:45 Yeah

Dr. Rangan Chatterjee 1:37:45 ... Rupy. Okay? Um, obviously your approach is food first. Are protein supplements necessary? Can they play a role for some people? And if so, what do you recommend people buy?

Dr. Rupy Aujla 1:37:59 It's a really good question. Again, my opinion on this has slightly changed over the last couple of years. I used to be quite anti protein supplements because of this overarching opinion that because we're meeting the government set requirements of .8 grams per kilo of body weight per twenty-four hours, there really isn't a need for any extra protein, whether that's in the form of bars or powders or shakes, especially not in the ready-made, um, bottles that you find in convenience stores. But I've evolved my opinion on this because I feel that those kind of supplements are a convenient option when having a meal is just not on the card. So after going to the gym or a workout or in between meals, or simply to satisfy your twenty-four-hour protein requirements when you can't have chicken or tempeh or tofu at every meal of the day. So I think it's a necessary part of some people's strategy, particularly those who exercise regularly.

Dr. Rangan Chatterjee 1:39:10 Could-- You mentioned the 0.8 grams there. Okay. We don't need to go deep into, um, the recommendations because when you came on my show a few weeks ago-

Dr. Rupy Aujla 1:39:19 Mm-hmm

Dr. Rangan Chatterjee 1:39:19 ... we did cover that.

Dr. Rupy Aujla 1:39:20 Mm-hmm.

Dr. Rangan Chatterjee 1:39:20 You also cover it in your book, but just top line, you're saying that the recommendations used to be, or some of them still are-

Dr. Rupy Aujla 1:39:27 They still are

Dr. Rangan Chatterjee 1:39:27 ... 0.8 grams of protein per?

Dr. Rupy Aujla 1:39:30 So 0.8 grams of protein per kilogram of body weight per twenty-four hours.

Dr. Rangan Chatterjee 1:39:36 Okay. Right. And again, for somebody that's gonna be too technical, they're not gonna want to think about their food in that way.

Dr. Rupy Aujla 1:39:41 Sure. Mm-hmm.

Dr. Rangan Chatterjee 1:39:41 And I, and I know in the book there's all kinds of helpful, uh, ways that you, you ask people to think about this stuff, right?

Dr. Rupy Aujla 1:39:47 Mm-hmm.

Dr. Rangan Chatterjee 1:39:48 Your recommendation now based upon the research is what?

Dr. Rupy Aujla 1:39:51 So it depends. [laughs]

Dr. Rangan Chatterjee 1:39:53 Okay.

Dr. Rupy Aujla 1:39:53 That's a bit... That's too technical, but I believe, and I think this is definitely reflected by other protein researchers in the field, that a minimum requirement of 1.2 grams of protein per kilogram of body weight per twenty-four hours is ideal. And if it's one-- if you are active, i.e. you exercise, you do running, you do resistance training, it should be 1.6 grams of protein per kilogram of body weight per twenty-four hours. And I should say for folks, if this is all sounding quite technical, there is a protein calculator for free that you can use in the book, and it actually personalizes it-

Dr. Rangan Chatterjee 1:40:33 Yeah

Dr. Rupy Aujla 1:40:34 ... to your age, your activity level, whether you're post-menopausal, all sorts of personalization there. So you don't need to, like, try and do the math.

Dr. Rangan Chatterjee 1:40:42 Exactly. But the, but the-- I guess the point I'm getting to, c- again, we did it on the last podcast-

Dr. Rupy Aujla 1:40:46 Sure

Dr. Rangan Chatterjee 1:40:46 ... you came on and you've, you've got it in a book for people. You're basically saying that if you subscribe to some of the guidance, which you don't, that the requirement is 0.8 grams of protein per kilogram of body weight per twenty-four hours.

Dr. Rupy Aujla 1:41:02 Mm-hmm.

Dr. Rangan Chatterjee 1:41:02 Back then you thought, actually, I don't really think people need to supplement protein.

Dr. Rupy Aujla 1:41:07 Mm-hmm.

Dr. Rangan Chatterjee 1:41:07 But now that your view on that has changed where you think it's not 0.8 grams, it's 1.2 or even up to 1.5, 1.6.

Dr. Rupy Aujla 1:41:15 Yeah.

Dr. Rangan Chatterjee 1:41:15 You're saying now with those new, um, requirements for people-

Dr. Rupy Aujla 1:41:21 Mm-hmm

Dr. Rangan Chatterjee 1:41:21 ... based upon the latest research, you now think for some people protein supplements, and I guess protein powders, which is how most of them come-

Dr. Rupy Aujla 1:41:30 Yeah

Dr. Rangan Chatterjee 1:41:30 ... or a lot of them come-

Dr. Rupy Aujla 1:41:31 Yeah

Dr. Rangan Chatterjee 1:41:31 ... you think they can be a useful option for some people.

Dr. Rupy Aujla 1:41:35 Absolutely, and I'll give you an example. So for-- yesterday I went to the, the gym in the morning, and I had a high protein breakfast, a really good high protein lunch 'cause I was working from home, and a decent dinner. In that context, I didn't need a protein supplement to get to the level that-

Dr. Rangan Chatterjee 1:41:54 Mm-hmm

Dr. Rupy Aujla 1:41:55 ... I require, which is 1.6. On a day where I'm rushing around, or perhaps I don't have a Tupperware with my lunch in it, or I had to grab something on the go, there are instances where a protein shake that I make or I take with me might be an appropriate, uh, action to ensure that I'm getting protein for my needs.

Dr. Rangan Chatterjee 1:42:20 Mm-hmm.

Dr. Rupy Aujla 1:42:20 Those are the sort of nuances that we need to remember. I don't think it's something that we should use as a crutch, but it is like a sticking plaster if you find yourself in a pinch.

Dr. Rangan Chatterjee 1:42:29 Yeah. I mean, that's how I look at supplements in general.

Dr. Rupy Aujla 1:42:31 Mm-hmm.

Dr. Rangan Chatterjee 1:42:33 Like I, I am a fan of supplements actually.

Dr. Rupy Aujla 1:42:35 Yeah.

Dr. Rangan Chatterjee 1:42:35 Uh, because I think we can think about ideal. My, my, my approach is always food and lifestyle first, but understanding that people are struggling. P- um, the soil quality isn't what it was fifty years ago. So are we even getting the same level of nutrients from a piece of broccoli that we were fifty years ago?

Dr. Rupy Aujla 1:42:51 Mm-hmm.

Dr. Rangan Chatterjee 1:42:52 Probably not. If you're chronically stressed, you're gonna, uh, release less stomach acid perhaps, and are gonna therefore absorb less. So I think all these things are quite useful sometimes for people as a way of navigating this modern world, which frankly is very different from how we've lived for most of our evolution.

Dr. Rupy Aujla 1:43:14 Can we just riff on the previous thing you just said there-

Dr. Rangan Chatterjee 1:43:17 Yeah

Dr. Rupy Aujla 1:43:17 ... about the absorption of proteins? I think this is very important for your audience, particularly those Uh, who are peri- or post-menopausal, and particularly those above the age of 50. Because one of the reasons why I'm so passionate about this is because having, you know, worked on geriatric wards and seeing frail-

Dr. Rangan Chatterjee 1:43:34 Mm

Dr. Rupy Aujla 1:43:34 ... people, I always wondered if there was something that we could do better for folks, particularly as their appetite reduces, but also with this new knowledge that our muscles become less responsive-

Dr. Rangan Chatterjee 1:43:47 Yeah

Dr. Rupy Aujla 1:43:47 ... to protein as we age.

Dr. Rangan Chatterjee 1:43:50 Anabolic resistance.

Dr. Rupy Aujla 1:43:51 Anabolic resistance, exactly. So our... What that means is your muscles become less responsive to the same stimuli of amino acids if you consume that through food-

Dr. Rangan Chatterjee 1:44:03 Mm

Dr. Rupy Aujla 1:44:03 ... than when you consume the same meal as a 20-year-old. So you have the less of this muscle protein synthesis stimuli from the same input of amino acids. And if you couple that with a reduction in your gastric acid and your digestibility, so the ability of you to break down those proteins-

Dr. Rangan Chatterjee 1:44:23 Mm

Dr. Rupy Aujla 1:44:23 ... couple that again with a disruption in your gut microbiota that happens as you age, again with higher rates of inflammation, you can see that it-

Dr. Rangan Chatterjee 1:44:32 Yeah

Dr. Rupy Aujla 1:44:32 ... creates this sort of vicious environment where you see sarcopenia accelerating, which is why you see people who are old and frail, and then they fall off a cliff later on in age. You need to-

Dr. Rangan Chatterjee 1:44:44 Yeah. And, and I, yeah, and I guess just following up from that, Rupy, if someone's listening and they're concerned about an elderly mother or an elderly parent, right? And your parent doesn't want to eat more food and you're concerned about their protein intake, I think protein powders can be incredible in those scenarios. It's a, it's a simple and maybe an easier to absorb way of getting in the protein for someone who's not getting it in other ways.

Dr. Rupy Aujla 1:45:12 Completely agree, and I think-

Dr. Rangan Chatterjee 1:45:13 I did that with my mum when she came out of hospital after her fall two years ago. Like, she was getting protein powders every single day because I was like, "No, no, I'm getting it into her."

Dr. Rupy Aujla 1:45:22 Absolutely. And that's, that is... I'm so glad you brought up that example because I think that is a scenario where absolutely a protein powder is necessary and useful and should be prescribed. Unfortunately, we have a situation in the NHS where we rely on quite ultra-processed, high calorie drinks-

Dr. Rangan Chatterjee 1:45:42 Yeah

Dr. Rupy Aujla 1:45:42 ... that, you know, I, I wouldn't give to anyone. And if you have the opportunity to make a protein shake yourself, even in batch and put it in the freezer so you can use it, and you know it's using minimal ingredients, flavors that you've put in, sweeteners that you understand and you've added yourself, with perhaps a micronutrient, uh, tablet that you can add yourself from whatever source you like, with some healthy fats, avocado, coconut cream, to bolster up their calorie intake because their appetite does go down-

Dr. Rangan Chatterjee 1:46:14 Yeah

Dr. Rupy Aujla 1:46:14 ... unfortunately, as, as we age. These are all things that I think we should be leaning into, absolutely.

Dr. Rangan Chatterjee 1:46:19 What's your take on things like collagen and creatine?

Dr. Rupy Aujla 1:46:23 I think collagen is a really interesting subject. I haven't seen enough evidence in the human literature to suggest that collagen can improve hair, skin, and nails. What collagen is, is very high in certain amino acids, proline, glycine, um, which are useful for those things, skin, hair, and nails, but there isn't human evidence to suggest that it's actually having that effect when you consume it. What it is providing is a good milieu of all those different amino acids. So you can imagine why we see the anecdotes of people taking collagen and then having these, you know, improvements in skin-

Dr. Rangan Chatterjee 1:47:05 Mm

Dr. Rupy Aujla 1:47:05 ... and hair quality. Would we see the same effect if they just simply took a whey or a casein or a plant-based protein powder? Maybe. Uh, we-

Dr. Rangan Chatterjee 1:47:14 Mm.

Dr. Rupy Aujla 1:47:15 I haven't seen any studies that sh- compare like and like. But I would say, um, I anecdotally... If I had an injury, if I had a sprain or I had, if I had a-

Dr. Rangan Chatterjee 1:47:24 Yeah

Dr. Rupy Aujla 1:47:24 ... a, a tendon, uh, issue or a ligament, uh, injury-

Dr. Rangan Chatterjee 1:47:27 Probably take it

Dr. Rupy Aujla 1:47:27 ... I'd probably take it. Yeah, yeah, yeah.

Dr. Rangan Chatterjee 1:47:29 Yeah.

Dr. Rupy Aujla 1:47:29 Without, without clear human evidence, but anecdotes are enough to convince me, and the risks of taking collagen are so low, I'd probably take it.

Dr. Rangan Chatterjee 1:47:39 To add another layer on there.

Dr. Rupy Aujla 1:47:40 [laughs]

Dr. Rangan Chatterjee 1:47:41 Um, I don't know if you're familiar with Ellen Langer's work at Harvard or not. I mean, she's brilliant. You know, she's a professor at Harvard and has been studying the power of the mind-

Dr. Rupy Aujla 1:47:51 Mm

Dr. Rangan Chatterjee 1:47:51 ... on our physiology for decades now. And just to go back to what you said about collagen, right? So you, you're acknowledging that maybe there isn't enough human evidence.

Dr. Rupy Aujla 1:48:01 Mm.

Dr. Rangan Chatterjee 1:48:01 But if you've got an injury, you've seen those anecdotes-

Dr. Rupy Aujla 1:48:04 Yeah

Dr. Rangan Chatterjee 1:48:04 ... and you believe that collagen is going to help you, there's a damn good chance that it is.

Dr. Rupy Aujla 1:48:10 Totally.

Dr. Rangan Chatterjee 1:48:10 Right?

Dr. Rupy Aujla 1:48:10 Yeah.

Dr. Rangan Chatterjee 1:48:10 And she's got really good published research on the power of our mind and our expectation of what we take-

Dr. Rupy Aujla 1:48:17 Mm

Dr. Rangan Chatterjee 1:48:18 ... and its impacts on us. So just, you know, without going down a rabbit hole, I think that's another thing [laughs] we don't think about enough.

Dr. Rupy Aujla 1:48:24 Rangan, I, I completely agree with you, and I need to explore this a lot more on my podcast because I think the power of belief is something that our current, uh, models of doing human trials don't appreciate.

Dr. Rangan Chatterjee 1:48:37 Exactly.

Dr. Rupy Aujla 1:48:38 It, it blows my mind. I can't fathom, like, a mechanistic explanation as to how some of these studies are, are, are explained. I just don't get it.

Dr. Rangan Chatterjee 1:48:47 Well, it's arguably the big elephant in the room-

Dr. Rupy Aujla 1:48:51 Yeah. [laughs]

Dr. Rangan Chatterjee 1:48:51 ... over the way we do medicine.

Dr. Rupy Aujla 1:48:53 Yeah. [laughs]

Dr. Rangan Chatterjee 1:48:54 Right? Now what do we say? Oh, it's just the placebo effect. Wait, whoa, whoa, hold on a minute.

Dr. Rupy Aujla 1:48:58 Mm.

Dr. Rangan Chatterjee 1:48:58 Maybe saying just the placebo effect is half the problem.

Dr. Rupy Aujla 1:49:01 Mm.

Dr. Rangan Chatterjee 1:49:02 Maybe we haven't enough harnessed-

Dr. Rupy Aujla 1:49:04 Yeah

Dr. Rangan Chatterjee 1:49:04 ... the power of the placebo effects. Okay. So we'll, we'll pa- we'll park that there. Uh, creatine is another supplement that's all the rage at the moment. Do you have a perspective on it?

Dr. Rupy Aujla 1:49:16 Yeah. So I've actually recently started taking creatine because I was really convinced by the evidence that it can improve not only strength and power, but potentially it has some brain health benefits and some mood, uh, cognitive enhancing benefits as well, and may even reduce the risk of dementia. Creatine, I think, has had, again, a bit of a branding problem over the last few decades as being really in the realm of the bodybuilding community. And so a lot of women have been scared off taking creatine because of this idea that it makes you bulky and it makes you big, and it's all about muscle hypertrophy, where in reality it improves the health and the function of your muscles that if there's anything that people have learnt from today's conversation is something that we wanna rigorously preserve as we get older. And actually, I think this is kind of a good metaphor for the entire book. The reason why I wrote Healthy High Protein is to bring people who are not naturally aligned or, um, interested in protein because of the bodybuilding fitness community, um, wrapper around it, but would actually benefit from some of the information around improving protein intake, uh, in, in their diets from a holistic, uh, point of view, a medicine point of view, an immune function point of view and menopause, uh, post-menopause po- uh, point of view. So creatine, sorry to go back to my point, creatine one of the most widely studied supplements. I think it's tolerable for most people, and I think you can tolerate 3.5 grams as a minimum. I'm currently taking 10 grams. I dunno if you take creatine-

Dr. Rangan Chatterjee 1:50:59 I don't

Dr. Rupy Aujla 1:50:59 ... or are interested or yeah.

Dr. Rangan Chatterjee 1:51:01 Yeah.

Dr. Rupy Aujla 1:51:01 That's, that's my take on creatine.

Dr. Rangan Chatterjee 1:51:04 Rupy, it's always fun chatting to you. Honestly, I think this has been so insightful. Uh, I'm sure there's plenty for people to take. Genuinely, I think your new book is the best one yet.

Dr. Rupy Aujla 1:51:18 [laughs] Thank you.

Dr. Rangan Chatterjee 1:51:19 Okay? I think the writing's great. The recipes are great. Healthy High Protein: Supercharge Your Energy, Feel Stronger and Live Longer. Who wouldn't want that? Okay.

Dr. Rupy Aujla 1:51:28 [laughs]

Dr. Rangan Chatterjee 1:51:28 Um, to finish off, and maybe this will summarize elements that we've already discussed, but for that person who has had a realization today whilst listening that actually I'm not eating enough protein, what would you say to them?

Dr. Rupy Aujla 1:51:48 I would say first thing is try and get an idea of what your number is. I'm not someone who is recommending people fastidiously measure their macronutrients and weigh their food. I think that's a very detrimental and destructive behavior that I can, I can see leading to eating disorders and, and an unhealthy obsession with healthy eating. But having an idea of what your protein requirements are every single day is something that m- that many people would benefit from. And being a good guesstimator of what protein is in your food that you're eating is something that you can learn through the book as well. So I'd say number one, know your number. Number two, think about breakfast protein. This is the meal that people tend to underconsume protein in, and that sets you up for the rest of the day. And I would say if you are omnivore, you're in a great position because you get the opportunity to layer in all the different types of proteins with animal-based proteins. So you're, you're gonna very easily hit those numbers whilst also answering those three questions positively. Getting enough protein, supporting your gut health, and making sure that your overall dietary pattern is anti-inflammatory.

Dr. Rangan Chatterjee 1:53:12 Rupy, always fun chatting to you. It's a great book. Thanks for coming back on the show.

Dr. Rupy Aujla 1:53:17 Thank you, man. Appreciate you.

Dr. Rangan Chatterjee 1:53:18 If you enjoyed that conversation, then I think you are really going to enjoy this one.

1:53:23 Who wants to live longer if you're not able to have good brain health? You could live to 150, 200, go for it, but if your brain isn't working, it's not worth living.

Dr. Rupy Aujla 1:53:33 Yeah. Yeah.

Dr. Rangan Chatterjee 1:53:33 And I think that the good choices, those little tiny little tweaks we make, they can have a big difference