Ep. 522 Menopause Is Wrecking Your Gut – The Best Nutrition Fixes for Midlife Women with Dr. Sarah Berry
- Cynthia Thurlow
- 16 hours ago
- 42 min read
I am delighted to connect with Dr. Sarah Berry today. She is a professor at King's College London and the Chief Scientist at the science and nutrition company, Zoe. As an academic leader in nutrition science, Sarah has conducted over 35 human nutritional studies, and she currently leads the world's largest in-depth nutrition research project, the ZOE Predict Study. Her research is at the forefront of personalized nutrition, deepening our understanding of fats and the structure of food. Her recent studies explore menopause, snacking, cardiometabolic health, and more.
In our conversation today, we explore the general tendency of social and other media to misrepresent nutrition and discuss the importance of the food landscape, the food matrix, and fiber in addition to bioindividuality and personalized nutrition. Dr. Berry explains why bowel cancer rates in young adults are increasing and the potential drivers of that, and we dive into the impact of the exposome, the influence of menopause on our microbiome, and cardiometabolic risk factors. We examine the importance of polyphenols and other bioactive compounds, the demonization of fats and cholesterol, and we tackle the misinformation surrounding seed oils, clarifying why we should remain open-minded. We also share some simple swaps that women in perimenopause and menopause can apply.
This conversation with Dr. Sarah Berry is rich and thought-provoking, so you will likely want to listen to it more than once.
IN THIS EPISODE, YOU WILL LEARN:
How food labelling is so often misleading
Why you should be cautious about taking nutritional advice from medical influencers
The importance of considering the underlying factors that determine how healthy a particular food is
Why fiber is essential for a healthy microbiome
How to avoid discomfort by spreading your fiber intake throughout the day
The importance of personalized nutrition
Potential drivers of early-onset colorectal cancer
How the microbiome composition changes after menopause
The value of polyphenols and dietary fat
Dr. Berry debunks common misconceptions about seed oils versus butter
Some simple swaps to help women in perimenopause and menopause get enough fiber into their diets
Bio:
Professor Sarah Berry
Sarah is a Professor at King’s College London and Chief Scientist at ZOE, the science and nutrition company. As an academic leader in Nutrition Science, Sarah has conducted over 35 human nutrition studies and currently leads the world's largest in-depth nutrition research program, the ZOE PREDICT study. Her research is at the forefront of personalised nutrition, our understanding of fats, and the food structure. Sarah’s recent studies explore topics such as menopause, snacking, and cardiometabolic health.
She’s often featured as an expert on ZOE's own podcast, ZOE Science and Nutrition, and regularly appears on television and radio to translate complex science into useful advice.
“What is on the label does not tell you the true health impact of that food.”
– Dr. Sarah Berry
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Connect with Dr. Sarah Berry
Transcript:
Cynthia Thurlow: [00:00:02] Welcome to Everyday Wellness Podcast. I'm your host, Nurse Practitioner Cynthia Thurlow. This podcast is designed to educate, empower and inspire you to achieve your health and wellness goals. My goal and intent is to provide you with the best content and conversations from leaders in the health and wellness industry each week and impact over a million lives.
[00:00:28] Today, I had the honor of connecting with Dr. Sarah Berry. She's a Professor at King's College London and Chief Scientist at ZOE, the science and nutrition company. An academic leader in nutrition science, Sarah has run more than 35 human nutritional studies and currently leads the world's largest in-depth nutrition research project, the ZOE Predict Study.
[00:00:51] Her research is at the forefront of personalized nutrition, our understanding of fats and the food structure, and recent studies explore topics such as menopause, snacking and cardio metabolic health. And for good reason, she has been a guest I've been looking forward to interviewing for quite a while.
[00:01:06] Today, we spoke about how social media and the media, in general, can misrepresent nutrition in general, why the food landscape is so important as well as the food matrix, the importance of fiber, as well as bio individuality and personalized nutrition, why we're seeing more bowel cancer in young adults and what might be driving that, the impact of the exposome, the influence of menopause on our microbiome, as well as the cardiometabolic risk factors, the importance of polyphenols and other bioactive compounds, the demonization of fats and cholesterol, misinformation around the impact of seed oils and why we all need to be open minded.
[00:01:52] I'll be the first person to say there was a lot of compelling information that Dr. Berry shared that may influence my perspective on how to view cold-pressed seed oils versus processed seed oils. And last, but not least, advice and simple swaps for women navigating perimenopause and beyond. This is a really insightful, informative conversation, one you will likely want to listen to more than once.
[00:02:20] Well, Sarah, it's such a pleasure to connect with you. I've really been looking forward to this discussion. I would love to start the conversation, because I know this is the basis with where your research really started. Let's talk a little bit about misleading ideas around food labeling. I know here in the United States, we don't do such a stellar job about identifying things we should avoid. I know the UK and other parts of the world do. What are some of the most misleading aspects of the nutrition labels that trip up even the most conscientious health consumers?
Dr. Sarah Berry: [00:02:51] Gosh. I think that there's so much miscommunication generally around nutrition. Not just on labels, but in social media, in magazines, in all of our social feeds. It's mental. The more people are talking about it, the more miscommunication there is, unfortunately, which is why it's good that there's podcasts like yours that are bringing evidence-based nutrition to the forefront.
[00:03:15] I actually think it's the miscommunication on social media. That's the biggest problem rather than miscommunication on nutrition labels. Because certainly in the UK to a certain extent as well in the US, there are regulations, either what you can talk about or what you can claim. I think the biggest challenge is, is that what is on the labels, in my opinion, doesn't tell you the true health impact of that food. And so, we can put all sorts of things on the labels that I think can either give it a health halo. Like, particularly in the US, I know everyone's talking about protein, stick protein on it. People think, “Whoa, it must be healthy.” Absolutely not. That doesn't mean that's the case.
[00:03:56] You can say high in fiber. Well, it only has to have about a certain amount of fiber to be able to say that, but every other ingredient could be really, really unhealthy for you. And so, I think that's where we have to be really cautious, that we need to think about the overall healthiness of the food and not just look at-- I don't know, low in salt or high in fiber or high in protein. And think more holistically, what is the food as a whole? What is the structure of a food? Does it resemble the original food it's from? What else is in the food and so forth.
Cynthia Thurlow: [00:04:29] No, you bring up such a good point, because I was trying to talk-- I have teenagers and I was talking to them about how social media wasn't a thing when I was growing up, nor was it a thing in college, even graduate school. But the influence of, and I'll use the term influencers, oftentimes people who don't have any science training or aren't licensed medical professionals that come off as experts. And in many instances, I think it can be potentially harmful, because I have boys, but they'll come to me with information, I'm like, “Oh, that's completely inaccurate. Let's talk about why. That is not the way that you go about building a healthy plate.”
[00:05:06] And to your point, there is such an emphasis on-- The processed food industry is a great example. I mean, what did they do to lure us in? If it says protein [unintelligible 00:05:18], high fiber, low carb, no carb, whatever is the focus of the particular consumer that's looking at these products. We use the term greenwashing, like something that makes us believe it's actually healthy when in fact it's not. And to your point about the fact that is this a food like substance or is this actually a food that in and of itself intrinsically has nutritional value to it.
[00:05:42] When you are having conversations with friends and family about all of the misinformation, or the greenwashing or the suggestions that something is healthy when it's not, what are some of the strategies that you like to suggest to help them better understand? If they're choosing to eat something that's in a box, a bag or a can, how can they delineate? Is it actually nutrient devoid, or is it actually something that's nutrient dense?
Dr. Sarah Berry: [00:06:08] The first piece of advice I would give is, be careful of what I call med influencers. Just because they've got doctor before their name, it doesn't mean that they actually understand how to interpret scientific evidence or particularly nutrition related evidence. I think that's a huge problem. So, firstly, be very cautious of most influencers, but also be careful of these med influences.
[00:06:31] And then, I would also suggest to people, if it looks too good to be true, it ain't likely to be true. [Cynthia laughs] There is no silver bullet. Unfortunately, it does go back to healthy eating principles in terms of what's the best food, what's the best diet. It's boring, I know. We'd all like to listen to someone that's got that silver bullet, that's got the answer “Just have this, it will cure you of everything.” That's not the reality. And so, I would caution people against finding that silver bullet.
[00:07:03] I would advise people that actually it is a little bit boring sometimes eating healthy. It is back to those principles of having plenty of fiber, plenty of diversity, plenty of food that resembles its original matrix. Limiting heavily processed foods, limiting red meat. It's all the stuff that I think many of us know. I think it's too easy to be confused by these health halos, by these different food labels.
[00:07:29] But I think that a really good principle that I would also advocate to people, is let's think about what is it that underpins how healthy a food is and what is it that underpins how-- For example, the modern food landscape could negatively impact our health. What we know can negatively impact our health? There're certain types of processing, certain levels of processing. But not all processing is created equally, not all processing is bad for us. And so, being able to identify what it is about the processing that's bad for us I think is a real challenge. It's something that despite 25 years of expertise as nutrition science, I struggle with. That's because the way food is processed and the way it therefore impacts our health is really complicated.
[00:08:18] Processing impacts food structure, which has lots of knock-on effects in terms of how it impacts our health, as well as it impacting the nutritional quality of the food. So, we know that heavily processed food tends to have less fiber, tends to have less bioactives like polyphenols, tends to be higher in salt and saturated fat, and may also have lots of additives and emulsifiers.
[00:08:40] And so, what I would suggest to people, is go back to those healthy eating principles. Does it have plenty of fiber? Is it plant-based in its original structure? And also, look at the back of pack labeling. Does it have lots and lots of ingredients you don't recognize? Now, it doesn't mean just because it's got a few additives or emulsifiers is bad for you. Some of these can actually have positive health effects. But if you see a label that's just got 100 different ingredients, loads of these different chemicals you don't recognize, the food doesn't resemble the original structure within which it came, I would be a little bit cautious. But my top tip to people really is focus on fiber. Focus on getting enough fiber into your diet, ideally from whole plant-based foods. I think if you can get that right, the rest will just follow.
Cynthia Thurlow: [00:09:29] Well, and it's interesting, because if we look at the statistics here in the United States, most individuals are eating a fiber devoid diet, because most people are eating ultra processed food, to your point, are devoid of fiber. What is it about fiber that is so important for us to understand in terms of health effects and the microbiome?
Dr. Sarah Berry: [00:09:50] So, fiber, you're right, is something that most of us don't get enough of. In the UK and the US, 95% of people don't get enough fiber. So, we recommend you should be aiming for at least 30 grams a day. But actually the average is less than 20 grams and only 5% of people are actually reaching that 30 grams a day.
[00:10:09] I think it's quite helpful to think about fiber in two different ways. One, in terms of the structural role it plays for food. Because fiber or most fibers are actually cell walls of foods, of plant-based foods. It has a very important structural role that then impacts how a food is metabolized, where it's metabolized, how quickly it's metabolized and how much is metabolized.
[00:10:32] But fiber also has a really important role in terms of the gut microbiome in providing food for our gut microbiome. We now know that our gut microbiome has so many wide-reaching impacts on our health. And so, knowing that fiber is feeding these trillions of bugs that reside in our gut, and that these trillion bugs are producing all sorts of chemicals and short chain fatty acids and also involved in metabolizing lots and lots of other chemicals, whether it's estrogen, in terms of its impact on the microbiome, polyphenols and how that impacts heart health.
[00:11:09] We now know that if we can feed our gut microbiome the right food-- This comes mainly in the form of fiber, but also in other nutrients as well. But if we can feed it plenty of fiber, we know that it can create a healthier microbiome which can impact so many different health aspects related to, from our brain to our gut to our heart and so forth.
[00:11:33] The evidence now is showing very clearly that every five grams of fiber that you can increase in your diet, you can significantly reduce your risk of many chronic diseases, of diseases such as cardiovascular disease, type 2 diabetes, but also of cancer. We know that particularly some of the cancers that unfortunately people are now suffering at earlier ages, like early-onset-colorectal cancer, that fiber is probably one of the biggest preventative nutrients you can take to try and reduce your risk of early-onset-colorectal cancer.
[00:12:06] So, it has a really important role and that's mediated by the microbiome. But fiber also, particularly what we call insoluble fiber, is essentially the cell walls of plants. This is what I spent a lot of my career looking at how the fiber that makes up the cell walls, that therefore gives what we call the structural integrity of the plants, can therefore modulate the health effects of that plant. I can give you a couple of really quick, simple examples.
[00:12:34] We've done studies where we fed people whole almonds or ground almonds. And so, what we've done is we fed people foods that have identical composition, identical ingredients. They would have identical back-of-pack labeling on the food. All we've done is change the structure. So, we've actually broken up the cell walls, so we've broken up the fiber, so we've destroyed that original structural role that the fiber is playing. And by doing that, you change how many calories are absorbed. So, in whole almonds, the structural role that the fiber plays means that there is less of the calories absorbed, about 30% is excreted, because those that fiber is quite rigid, it's quite resistant to digestion. And so, it plays a really important structural role in changing how you digest the food.
[00:13:21] We've also done studies, for example, where we feed people large particles of wheat flour, for example. If you feed that in the large particles where most of the cell wall structure, so the fiber is intact, you have a very blunted, slow rise in circulating glucose, a very slow decline. You have more sustained levels of energy, of fullness and lower levels of hunger. If you break up that fiber structure-- So, again, you've still got identical ingredients, but you change the structure, so you're breaking up the fiber, then what happens is, is you have very quickly digest that food. So, you have a very big peak, you have a dip, you feel full for only a short period of time, you're hungry a lot sooner, you have a slow, less release of your fullness hormones, etc.
[00:14:11] And so, fiber has, in my opinion, there’s two roles, very important structural role, which is why when I talk about processing, I'm always talking about the food structure. But in addition to that structural role, it has this other role in terms of the gut microbe. That's why often I will talk about the benefits of having whole food in the original structure within which it was created. Because the examples that I've given you are foods that have in each case identical amount of fiber, but because the structural role the fibers played has been destroyed, how your body metabolizes it and the subsequent health effects of it, way different.
Cynthia Thurlow: [00:14:49] I think it's so fascinating, because I feel like fiber is so controversial. I say this, because as an example, carnivore has become a very popular nutritional paradigm. And for full disclosure, after I was hospitalized and had six weeks of antibiotics and antifungals, I was carnivore for nine months, because I couldn't tolerate anything else. And then, I've now gotten back to being able to eat vegetables and fruits with no issues. But I think there are a lot of people out there, and I say it is healthcare providers, it is influencers who talk about, “You don't need fiber.”
[00:15:21] You made a very important argument, and this is an interest of mine as well. So, this is why I'm really wanting to hone this point home, is that for each one of us, eating a more nutrient dense diet is obviously very important, but helping people understand that you are better off eating the whole food source than you are in taking something that's already broken down, if we're looking to garner the biggest benefits from fiber. So, to your point, a whole almond versus almond flour or ground almonds is going to have a very different impact on the body.
[00:15:55] When you're talking to patients or you're again talking on podcasts, I find that a lot of my patients will tell me, there's a very fine line with fiber, and they'll say, “If I eat two cups of Brussels sprouts, I get gas, I get bloating, I get digestive distress.” I'll oftentimes say, “This is a great example of the quantity of the food certainly matters. So, maybe that's too much fiber bolus in one meal, but over the course of the day.” So, when people suggest to you, “Oh, fiber makes me bloated,” I think it is oftentimes a direct reflection of the portion or the choice of fiber that they're consuming more, so that they're intolerant. I'll hear patients tell me, “I'm intolerant to fiber.” And I'm like, “No, no. You're not intolerant. It might just be the wrong food for you. It could be the quantity. It could be how quickly you ate. There're so many other variables.”
[00:16:47] In your research, are you finding that there's a degree of bio individuality in terms of tolerance to boluses of fiber rich foods?
Dr. Sarah Berry: [00:16:57] So, this is something we spent a lot of time looking at, not related to fiber, but into individual variability. So, variability in how I respond to food versus how you respond, but also variability how I might respond one day versus another day. We've published a lot of research on this where we see huge variability. This is really interesting, because it underpins that premise of personalized nutrition.
[00:17:20] We haven't specifically looked to fiber in terms of the questions that you've just asked me. I'm also not a dietitian, I'm a research scientist, so I don't interface with patients in the way that you do. What we do know, however, is that you do have to have an adjustment period when you're increasing your fiber intake. You can't go from really low intakes to suddenly having large intakes, whether it's spread throughout the day or at one meal. Doing that big jump is going to cause most people some sort of discomfort. So, you need to slowly increase your intake. And yes, ideally not have it in one big bolus, like you've said, spread it throughout the day, but the key is to slowly build up.
[00:17:58] We also now starting to understand that different types of fibers might have different impacts on our health. There's lots of different types of fibers in food. And so, my recommendation again to people when they're thinking about fiber, is absolutely, in my opinion, the evidence is unequivocal that fiber is without doubt one of the best nutrients that you could have to improve your health span, your longevity.
[00:18:22] But also, let's start thinking about the types of fiber. And this, again, is why we're talking about more and more about diversity of different foods. Not focusing just one fiber source or just one fruit or just one vegetables, because we believe now that different fibers may feed different gut microbes, which may have different beneficial impacts on different pathways in our body. This new area of research, hence I was caveat it, as most scientists do with a may, But yeah, with the individual variability, it is fascinating.
[00:18:52] We've published quite a bit of research where we've looked at how people respond to foods, particularly in relation to their blood glucose or their blood fat responses. We see a threefold difference between how one person versus another person might respond in terms of how a standardized meal, so giving people exactly the same meal in the same conditions, having them fasted overnight, how some people might have a really big blood sugar response and dip to that particular meal, whereas other people might almost have no response.
[00:19:22] What we've been doing over the last eight years with our research is trying to look at, well, what's explaining that variability? Can we deliver advice personalized to those individuals that is based on these different variables that explain why one person responds differently to another person.
Cynthia Thurlow: [00:19:40] This is why I think it's so important for all of us to just experiment with what makes our bodies feel good intrinsically and why it's so challenging to make big blanket recommendations like, “Everyone should do paleo or everyone should do keto. It's really coming down to us as bio individuals.”
[00:19:57] Earlier in the conversation, you mentioned bowel cancer, so colorectal cancer. What do you think are some of the suspected drivers of why we're seeing colorectal cancer in younger patients? I'll preemptively say that my personal gastroenterologist was saying that, she's gotten to a point now where if anyone in their 30s comes in with symptoms, she's automatically going to colonoscopies, because she's been diagnosing more and more colorectal cancer in younger patients. And she's like, “I've been in practice for 25 years, and this is almost unprecedented.”
Dr. Sarah Berry: [00:20:31] Yeah. So, the rise in early-onset-colorectal cancer is really alarming. I'm actually very lucky to be part of a huge multinational research project called PROSPECT, which is led by colleagues in the US. This is a Cancer Grand Challenges project that's funded by lots of different cancer charities throughout the world, where we're looking at what is it that's responsible for this sudden increase early-onset-colorectal cancer, by that we mean colorectal cancer under the age of 50 years.
[00:21:03] Now, we know that there are some risk factors that are common for both late and early onset colorectal cancer. So, lack of fiber is a risk factor, excess alcohol is a risk factor, processed red meat, sugar, sweetened beverages, these are all very important risk factors for colorectal cancer at any age. Why there's an increase in early onset? We don't know yet. It might be that there's just even higher exposure to some of these risks’ factors. But one of the areas that I think is really interesting is looking at the relationship with the microbiome. So, through this work that we're doing, we're starting to see that there's a certain signature, so to say, of microbial species that are linked to early-onset-colorectal cancer.
[00:21:50] And so, this, again, is really promising area of research, because one of the projects that we're doing through a clinical trial is seeing if we can modulate these species linked early-onset-colorectal cancer through diet and whether that may have the subsequent impact on future early-onset-colorectal cancer occurrence and incidence.
[00:22:09] So, I think that there's lots of different factors that we're also looking at as part of this. We use the word exposome. So, you could have someone that still does some exercise, but has many hours that they're sedentary sitting at their desk. There's some evidence to suggest excess sitting, for example could also increase risk. There's lots of new areas of research that I think are really interesting. I think the fundamentals are really important. So, cutting down your alcohol, cutting down your processed red meat, cutting down your sugar sweetened beverages and having more fiber.
[00:22:42] One of the clinical trials we're running is looking at increasing fiber to 40 grams a day and increasing the diversity of fiber, because we believe that that will favorably impact the microbiome signature, which will favorably impact downstream risk of early-onset-colorectal cancer. But it's something we don't yet fully understand why we suddenly seeing this quite alarming increase in people at very young ages.
Cynthia Thurlow: [00:23:07] Yeah, it's interesting. Like I had mentioned earlier, my gastroenterologist said that she now has such a low threshold. She said, “I am so quick to scope younger patients that are having symptoms, whereas before I would have worked them up properly regardless.” But she said, “I was much less apt to scope them and now, I'll push for a colonoscopy or an endoscopy a whole lot sooner because of this.” In fact, she said, “The last three patients that I diagnosed with colorectal cancer were under the age of 35,” which blew my mind. I live outside of Washington D.C. So, still a very large populous city. And to hear that from her was incredibly alarming.
[00:23:44] When we're talking about food frequency, whether it's time restricted eating, we know that people are eating more frequently, they're eating throughout the day, they're eating oftentimes, again, a lot of ultra processed foods. What are your thoughts on intermittent fasting or time restricted eating as being a strategy to reset the gut microbiome or to improve the habitus of the microbiome itself?
Dr. Sarah Berry: [00:24:08] So, I think time restricted eating is a really fascinating example of the importance of how we eat our food. I think as nutrition scientists, we've spent a lot of our time focusing on what we eat, the nutrients we eat, the foods that we eat, the chemicals that we eat. This whole area of how we eat I think is fascinating, and it's something that I'm really passionate about and have really focused on the last five years. You know, how sleep impacts, how we process food, how the frequency of snacking, how the timing of the eating, as well as the duration of the eating. So, the eating window, which is where time restricted eating fits in. Eating speed as well, is another example. All of these we know can have quite profound impacts on how we process the food and therefore subsequent health effects.
[00:24:56] And so, I think it's really, really important that when we think about how healthy our diet is, we don't just think about the food that we're eating, we think about how we're eating. And time restricted eating, I think is a lovely example of how if it works for you, if you like doing it, if it fits within your culture, your social setting, etc., your family, then that could be a great way to, on top of thinking about what you eat, to improve the healthfulness of your dietary habits. I think that the evidence that's out there is very consistent to show that time restricted eating does improve health outcomes.
[00:25:36] That yes, part of it's mediated by the fact that for many people, they might be subconsciously reducing their calorie intake. I think recent estimates show that most people practicing time restricted eating subconsciously reduce their energy intake by about 300 calories. But I think the evidence that shows from trials where people practice time restricted eating, so they're eating in a smaller eating window, fasting for a longer period overnight, even when its energy matched. So, where they are in a clinical metabolic setting and given the exact same meals that actually just by changing that fast period, there are still improvements in health outcomes, improvements inflammation for example.
[00:26:16] I think that part of its problem probably mediated by the gut microbiome. I think, again, we need to understand more about this, but I think there's interesting evidence emerging there. It's giving your gut microbes a rest, but it's also giving the rest of your body a rest. Every cell in our body has its own little body clock, its own little clock. I think if we're getting every cell to work all day long, we need to eat firstly in line with that clock, but we also need to give every cell in our body a little bit of a rest some of the time.
[00:26:48] And so, I think it's something that for many people can fit in with their lifestyle. I don't think we need to go to extreme. We did a study at ZOE called The Big IF Study, it's the big intermittent fasting study. This was a study in 150,000 people where we said to people, “Okay, there's this great evidence to show that time restricted eating works in these tightly controlled metabolic settings. But in these metabolic settings they're normally asked you know eat within a six-hour window.”
[00:27:17] What about if we look how it works in the real world against the noisy way that we live our lives, with all of the other stuff that's going on in our lives and eating in quite what I think is a more feasible eating window, so that you eat in a 10-hour window, so you might have your breakfast and let's say 9 o'clock and your last meal at 7 o'clock. So, you're giving yourself body a 14-hour fast period, 14-hour repair period, 14-hour period for your gut microbes and all these other cells to rest.
[00:27:45] What we found was those people who did practice the time restricted eating, reducing their eating window to 10 hours felt better. They had better energy, they had better mood, they had less hunger. And interestingly as well, they lost lots of weight without us saying. We didn't guide them, we didn't say, “Oh, can you change the types of food?” We said, “Just try and reduce it just by an hour or so.” And so, on average, people were only reducing their eating window by an hour and a half.
[00:28:12] What's also interesting is we found that early time restricted eating, which means those people who were starting little bit earlier, but finishing earlier, those seem to benefit the most. This fits in with lots of our other research. I know lots of other published research that shows if you shift to early time restricted eating, it has an even greater benefit. This is because you're eating more in line with all of those billions of cells with their little clocks. But you're also impacting lots of pathways related to your metabolism, your hunger. For example, there's fascinating data showing that actually if you eat later at night, you tend to wake up more hungry in the morning than if you eat earlier in the day.
Cynthia Thurlow: [00:28:53] It's really fascinating. I think circadian biology and understanding intrinsically how all of that works. I always use my teenagers as an example. They are now at a stage of life. They go to bed later, they eat later, sometimes they eat two dinners when we've eaten once with them and then they eat independently a second time. What's interesting is when we were on vacation and we were all eating at the same time, all eating three meals every day all together, my kids would talk about-- Even though they are very athletic and healthy, they would talk about, “Oh, I feel like less bloating. I feel I had a better sleep, because I'm not eating right before I go to bed.”
[00:29:30] And so I think for a lot of individuals, having just building awareness around when we are not eating, when we are eating. I think the pandemic, maybe the gift of the pandemic was people started shifting around when they were eating. I found for myself personally, I actually feel better when I eat a late-- Maybe my last meal of the day is 5 o’clock or 6 o’clock at night, not 07:00 or 08:00. That's closer to buffering up to bedtime.
[00:29:54] When I think about intermittent fasting as a strategy, or time restricted eating or digestive rest, however we want to coin it, or what that looks like for each one of us, it brings to pass how much influence women in perimenopause and menopause feel as they are navigating bodily changes, making lifestyle changes. And so, I feel like, this is a particularly vulnerable population. You mentioned earlier that there's a lot of influencers and social media pressure that everyone probably feels, but not the least of which I think middle-aged women feel tremendous pressure, as they're navigating all the changes in body composition.
[00:30:32] What are some of the things that are unique to women as they are navigating changes in sex hormones in terms of the microbiome, and how we respond to nutrient dense foods or some of these nutrient sensing signals and molecules like polyphenols or even postbiotics?
Dr. Sarah Berry: [00:30:52] Yeah. So, I think this is another area of fascinating research and this seems to be a common theme that my answers to your question, but something we don't know much about yet, but we're starting to understand. So, we know that the gut microbiome composition seems to change postmenopausally. So, there has been some interesting research that shows that microbiome composition in premenopausal women is different to the microbiome composition of an age matched male.
[00:31:20] What happens is, is post-menopausally, the microbiome composition seems to reflect an age matched male. Alongside that, we see lots of other things happening. Obviously, you've got decline in estrogen alongside that, you've got these huge changes in what we call cardiometabolic risk factors. So, women are doing really well compared to men in of terms of not just their microbiome, but in terms of all of these intermediary risk factors for cardiovascular and other chronic diseases. And so, they tend to have for an age matched male. We've published research on this. They have lower blood pressure, they have lower cholesterol, they have lower inflammation. Hit the menopause stage or perimenopause and post-menopause, suddenly their blood pressure goes up, suddenly their cholesterol goes up, suddenly their inflammation goes up. And so, many other of these intermediary risk factors.
[00:32:09] Now, it might be the part of this is mediated by the microbiome. This is something that we've been looking at in our research. We do see that the microbiome seems to play a mediating role in this peri--sorry, in this peri and postmenopausal increase inflammation in visceral adiposities. So, the weight change that you see happening because of the loss of estrogen around your tummy, etc. We know that the microbiome though is also involved, not just in mediating some of these changes but also involved in processing estrogen. We call it the estrobolome. So, we have different microbes involved in how it recycles estrogen. This isn't something I have a lot of expertise in, but there's fascinating research in Ireland going on this.
[00:32:56] We've done some research also looking at how the microbiome is linked to symptoms. So, when I think about menopause and I think about health. I think about it in two areas. I think about it in terms of our disease risk, so our increase in cholesterol, blood pressure, inflammation, our increased risk, for example, of osteoporosis and so forth. And then, we need to think about the increase that we have in symptoms. So, suddenly, we have all of these symptoms. We've done some research in now hundreds of thousands of women showing the prevalence of symptoms. We see that 99% of women have at least one symptom if they're in the perimenopausal phase. We see that 60% of women have 12 or more symptoms. We see that 85% of women suffer from sleep disturbances, anxiety, brain fog, memory loss and so forth.
[00:33:47] It's really shocking when you see this data just how prevalent these symptoms are. But what I find just a perimenopausal women, even more shocking, is that actually one of the least prevalent symptoms, the symptom that women suffer from the least is the hot flashes, which is what we often talk about, which is what most of the research has done on. Our research has shown that, as well as just how prevalent these symptoms are, that there's a very close relationship with diet, but there's a very close relationship with the gut microbiome as well. We recently published some research where we were able to predict the prevalence of symptoms based on someone's gut microbiome composition.
[00:34:26] Now, I do have to caveat that by saying that we also know that diet is very closely associated with menopause symptoms from our research. And so, it might be that the diet is changing the microbiome, and the microbiome is partly mediating maybe some of the effect the diet has, but diet might be independently also impacting microbiome symptoms. So, I think there's interesting signals, as we call it, in nutrition science, that the microbiome is playing part of a role in the severity of symptoms, in the prevalence of symptoms. But it's very much watch this space, and this is something that we're about to do a really big deep dive. In our cohort, we have a data on about 200,000 peri and postmenopausal women where we also have some symptom data and gut microbiome data.
[00:35:14] I think where it gets really interesting is when you start to look at a few specific nutrients and a few specific scenarios. One of these, and I think you've just mentioned that there, is soy isoflavones. So, soy isoflavones are what we call phytoestrogens. Phytoestrogens basically have a very similar structure to estrogen. And so, they combine to the estrogen receptor in our body. We have estrogen receptors all over our bodies from our head to our toes, hence why we have such wide reaching symptoms during the menopause.
[00:35:51] What we know, is that when you increase your intake of soy isoflavones, you're therefore activating the estrogen receptors and you can have a reduction in some of these symptoms. But what we know, is that the reduction that women experience is hugely variable. Some people have a big reduction in symptoms when they have soy isoflavones. Some people have a small reduction. We believe that this is due to the microbiome.
[00:36:15] And so, there's particular species in our gut that are able to convert the soy isoflavones to a really, really potent kind of estrogen like compound, and that combine really strongly to the estrogen receptors. These are called equol producers. Some people, particularly in East Asia are equol producers. So, they have these species that enable them to process soy isoflavones in such a way that they become really potent estrogen activators, let's call it, using simple terms, about 70% of people in East Asia have these. In the UK, in the US, it's a lot lower. Maybe estimates around 20% to 30%.
[00:37:01] And so, it brings me back to a point that you said earlier about inter-individuality, and what works for one person and what works for another person isn't necessarily the same. Some people might take a soy isoflavone supplement, they might have the gut species that enable them to produce equols. So, they might have a really beneficial effect to the soy isoflavone. Their friend may take exactly the same soy isoflavone supplement, but they might not be equol producers, they might not have the same microbiome composition and therefore, they might not have such a great benefit.
[00:37:34] So, this is why I would always say to people, or rather emphasize what you've just said about a few minutes ago, is that you have to see what works for you. If it works for you, great. But it doesn't mean it's going to work for everyone. And part of this might be related to the gut microbiome.
Cynthia Thurlow: [00:37:51] I find it also fascinating. In preparation for the book that I just finished, just really looking at the microbiome as women are navigating perimenopause and menopause, and understanding that up until we go through puberty and it's a direct influence of our sex hormone changes. Young girls and young boys, microbiomes look very similar. Puberty is that first big shift and largely, I'm sure, related to the impact of estrogen. And then, life comes full circle as women are navigating perimenopause and a menopause, we start having similar shifts in diversity.
[00:38:27] Estrogen is a very important hormone for many things, including immune function. This explains why women-- We use the term immunosenescence. It means aging of our immune system, just like everything else in our bodies ages. As I was understanding, because I do quite a bit of stool testing within my practice, as I was looking at women over the past nine years, I was like, “I'm seeing some common patterns why is this happening? Understanding the role of sex hormones, it is quite profound.” That's why I follow your work at ZOE Nutrition so closely, because I find it to be so interesting, innately interesting and then how we respond to foods specifically.
[00:39:06] You mentioned polyphenols. I think for benefits of listeners, these are brightly pigmented fruits and vegetables. We talk about diversification in the diet. What is the benefit of polyphenols in terms of how we're looking at nutrient density, but also the microbiome's response to that as well?
Dr. Sarah Berry: [00:39:24] Yeah. So, polyphenols, I think, wonderful chemicals. I call them bioactives, because they have this wonderful biologically active role in our body. Again, I have to caveat that this isn't an area of my expertise or something that I've done research on. But we do know that having a high polyphenol intake, and again, having a high diversity of polyphenols, because just like fibers, there's lots of different types of polyphenols can have a really favorable impact on our health.
[00:39:53] Most polyphenols are actually metabolized by our gut microbiome into the active components. And so, this has what we call a synergistic effect. So, if we can feed our gut microbes fiber and polyphenol, then we're really off to I think, a really, really strong start. And then, the polyphenols are feeding the gut microbes, but more importantly, the gut microbes are converting the polyphenols into other subsequent chemicals that can impact many different pathways.
[00:40:24] One of the pathways that some of the metabolites of polyphenols impact is our inflammatory pathways. So, often, we might talk about polyphenols being anti-inflation inflammatory. It's not the polyphenols themselves, it's often the metabolites on the basis of these gut species eating these polyphenols, producing these chemicals and acting on these pathways. So, they have this really strong impact on inflammation. We now know that inflammation underpins most chronic diseases, whether it's cancer, cardiovascular disease, type 2 diabetes and many others.
[00:40:56] So, polyphenols as well as fiber, I think, are those two which really magical nutrients that we haven't again in nutrition science typically thought about when we think about nutrients. Typically we talk about fat, protein, carbohydrates, but we really need to be thinking as well about polyphenols. And in the UK, there's actually a group of scientists calling for polyphenols to actually have their own dietary recommended value. So, for fiber, there's the recommended value of 30 grams. For other nutrients, there's recommended upper limits or low limits. For lots of different vitamins and minerals, there's recommended nutrient intakes that we should be having.
[00:41:37] There is a call that because of this really now well-established health benefits of polyphenols that we should actually be putting out a DRV, we call it in the UK, a Dietary-Recommended Value for polyphenols. So, let's see whether that actually happens. But I think that's as well why as nutrition scientists or as dietitians or yourself, we would always advocate for that diversity of different colors. We often talk about the rainbow on your plate. And the reason is because it's the polyphenols that give that pigmented color, like you said, to the foods and the different pigments. So, the different colors in the food are often different polyphenols. And having that rainbow gives you different fibers and also different polyphenols.
Cynthia Thurlow: [00:42:18] Yeah. It's so interesting, because I think it is human nature that our palates tend to be more primed for sweet as opposed to bitter, but these bitter plant-based compounds like the polyphenols, in many instances, are providing important information to the microbiome.
[00:42:34] You touched on fat. I can't go without talking about fat. Certainly, at the beginning of my career, fat was still in this bastardized realm, “Fat is bad. Avoid fat. All fat is bad. Eat your margarine and avoid butter,” and all these things. Why do you think dietary fat is so poorly understood? Especially around women, because I was certainly raised in this low-fat culture, non-fat cheese, low-fat yogurt. I still have challenges getting some of my older female family members to consume healthy fats in their diet, because they're still stuck in that mindset of fat is intrinsically a bad thing.
Dr. Sarah Berry: [00:43:16] Yeah, I think fats has been really unfairly demonized in nutrition world. I think that things are starting to change, but I think it's definitely had a bad rap. One of the reasons is, is this misperception that because it's calorie dense. So, we know that one gram of fat has nine calories compared to carbohydrates, where one gram of carbohydrate or one gram of protein only has four calories. So, there's this perception that fat will make you fat. Excuse the expression, but it's an expression that people often use.
[00:43:50] Years ago, when I first started teaching 25 years ago about the health effects of fat, because that was my specialism, you went into any supermarket, low-fat was everywhere. There was this perception that if you consume a low-fat food, then you're having a low-calorie food and therefore, your reduced weight. Yes, it's lower in calories, but typically, it's higher in the wrong type of calories. We also now know that actually it's all about the type of fat you're having and not the total amount of fat.
[00:44:19] So, firstly, we know that switching from a high-fat to a low-fat diet for most people will not help you lose weight, and certainly won't help you sustain any weight loss. Yes, it's highly variable. Some people do respond well to a low-fat diet. But if you are going to go on a low-fat diet, I would very much advocate for avoiding low-fat foods, except for the case of natural yoghurt. I think most low-fat foods have then got all of these other things put in, sugars, refined carbohydrates, goodness knows what else put in that we know is probably not very healthy for you.
[00:44:53] What the research shows is we shouldn't be worrying about the amount of fat that we're having. For most of us, we're having perfectly normal, healthy amounts of fat. In fact, our research shows you can go up to 50% of your energy from fat and still have an incredibly healthy diet. What we should be doing instead is worrying about the type of fat. There’s different types of fat. There's saturated, which we know it generally is linked with poor health outcomes, raises cholesterol, affects inflammation and so forth. There's your mono and polyunsaturated fats that we know can lower cholesterol and generally associated with higher improved health outcomes.
[00:45:30] I think where it gets really interesting about fat, is we're now starting to understand that it's not even just the type of fat that matters, it's the food that the fats in. I think this is why, again, I would always advocate for people to take a food first approach rather than a nutrient first approach. So, if we could use dairy as an example, you could have butter and you could have cheese. They have almost the same fat composition. So, they have the same types of fats. So, they're both quite high in saturated fat, quite low in mono and polyunsaturated fat.
[00:46:01] Yet how butter impacts our health is very different to how cheese impacts our health, and this is because of the food matrix of the structure of cheese. So, there you've got two foods which are high in saturated fat, where butter being high in saturated fat can negatively impact our health. And yet, you've got cheese, which is almost identical in terms of the type of fat, but actually seems to have a neutral effect on our health, because it has a neutral effect on our cholesterol and may actually improve our heart health. And so, that's why I think we need to be really cautious just looking at the back of pack label and saying, “Oh, this is how much saturated mono and polyunsaturated fat there is.”
[00:46:37] But I do think the biggest misperception that's out there about fat, that's doing the rounds on social media that makes me so, so frustrated, is the whole misperception around seed oils, “Seed oils spreads being toxic for you and butter being good for you in comparison.”
Cynthia Thurlow: [00:46:56] And why is that? I've certainly had a physician on who talks a lot about seed oils because of the processing of the seed oils, why that can be problematic versus if there's a sunflower seed oil that's made in small quantities, that's high-quality, very different than the industrialized seed oils that we're seeing. I think that there's so much confusion in this area, which is why I'm asking for a bit more information, because I know that my patients and the consumers and the people that I talk to, there's still so much misinformation and misunderstanding by, I have to believe, well-meaning people in the medical community, as well as on social media, like the people that go into the grocery store and give all these examples of like, “This is a toxic food, and this is a toxic food without providing context.”
Dr. Sarah Berry: [00:47:42] Yeah. So, I think that there's very confusing messages around all types of fat, but particularly around seed oils versus butter. Seed oils are often branded by the med influencers incorrectly, in my opinion, as being toxic. They talk about the evidence in a way that I think is very appealing, but is wrong. And so, for example, they will talk about the evidence showing that rates of chronic diseases, cardiovascular disease, obesity, type 2 diabetes has increased at the same time that our seed oil intake has increased.
[00:48:18] Well, seed oil is found in a lot of heavily processed, unhealthy foods. About 60% of the seed oil that we consume is in these heavily processed, unhealthy foods or ultra-processed foods. It's not the seed oil that's in them that's causing the problem. It's all this other stuff. It's all the refined carbohydrate, the salt, the other chemicals in it that I believe is a problem.
[00:48:40] The seed oil haters also talk about the evidence relating to inflammation. It's based on theoretical biochemical pathways. In seed oils, one of the main fatty acids, so one of the main types of fat is a particular polyunsaturated fat called omega-6. Omega-6 can be converted in the body to particular chemicals called eicosanoids. Some of these eicosanoids act on inflammatory pathways.
[00:49:10] Now, inflammation is a normal metabolic process. If we didn't have inflammation, if we cut our finger, we wouldn't be able to heal. It's a normal part of healing. If it's in excess in the wrong place at the wrong time and too much, yes, it's a problem. And so, there's this theoretical pathway that we know that polyunsaturated fatty acids that found in seed oils can be converted to these particular chemicals that can act on inflammatory pathways.
[00:49:36] But in reality, our bodies, what we know is very little or almost none of this polyunsaturated fatty acid is converted to the precursors for these chemicals and incorporated into our tissues. What the body of the evidence actually shows from clinical trials, is that when people consume seed oils or consume these particular omega-6 fatty acids that they don't have an increase in circulating inflammatory markers. So, what is a theoretical argument doesn't play out in our human body?
[00:50:12] There's also this whole argument that butter is natural and seed oil is a process like you said, so anything that's natural is better for us. Well, again, the evidence doesn't support that. You have beef tallow, you have butter, they're both very high in saturated fat. Randomized control trials comparing them to seed oils consistently showed they raise cholesterol, they raise other intermediary risk factors related to cardiovascular disease compared to spreads made with seed oils or seed oils themselves.
[00:50:40] I do think that an interesting area of research that we need to be doing more on is looking at processing of seed oils. So, you can have the processed seed oils or you can have what's called cold-pressed seed oils. Cold-pressed seed oils is literally where you squeeze the seed and the oil spurts out in very simple terms. Or, you can have refined seed oil which goes through lots of different processes.
[00:51:05] Now, most of the studies that have been published shown that seed oils are healthy for us are done on refined seed oils. So, I have refined seed oil, I would advocate for refined seed oil, but it might be that the cold-pressed seed oils are even healthier for us. And so, I think that's a really interesting area of research that unfortunately there's no human studies that I'm aware of that comparing cold-press versus refined seed oils. So, if anyone out there's got a spare million dollars and would like to fund me to do an RCT, [laughs] I'd be very happy to do that.
Cynthia Thurlow: [00:51:36] Yeah, thank you for that explanation. Because I'm always of the belief system. I'm not rigidly dogmatic. I'm always looking to learn a new perspective. I'm starting to re-entertain the possibility that we have thrown the baby out with the bath water, as the saying goes, that we have missed the mark. I think when we're speaking to industrialized seed oils, we're oftentimes also speaking to ultra-processed foods, which are things we should limit in our diets anyway. And so, I remain humbly optimistic that some of the opinions that I had in the past may in fact need to be revised.
[00:52:11] When it comes to saturated fat, I think the other thing that's really interesting and to terms of bio individuality-- We know that there are some people, I happen to be one of them. I hyper absorb cholesterol. We've done special testing. It's testing that we even do within the practice. I'm someone that's never done well with higher fat meat or higher fats in general, and the saturated fats in particular. So, for me, personally, I have to eat a lower-saturated diet, because otherwise, it does buffer my cholesterol quite significantly. Now-- [crosstalk]
Dr. Sarah Berry: [00:52:40] I think, Cynthia, that's a really important point. There's a lovely study that was published recently in the UK called RISCK. This was a study where they had people switching from a high-saturated fat diet to a high PUFA diet, but they'd been put on quite a high-saturated fat diet. What they found was there's huge variability in how low in saturated fat impacted LDL cholesterol. So, they found that on average people reduced their LDL cholesterol, I think it was by about half a millimole.
Cynthia Thurlow: [00:53:08] Wow.
Dr. Sarah Berry: [00:53:09] So, they reduced it significantly. But it was highly variable. Some people were reducing it by a couple of millimole. Some people actually even increased their cholesterol. And so, I think this is really important again to remember that huge variability. So, for some people, limiting their cholesterol will have a massive impact. For some people, it will have almost no impact.
Cynthia Thurlow: [00:53:31] Yeah. I think it goes back to that bio individuality piece that for each one of us, it may be pulling different levers to get different results. Now, I want to make sure that we provide some specific suggestions based on your clinical research. If you were going to give one or two pieces of advice to women in perimenopause or menopause, how can they go about getting enough fiber into their diet? Because that's always the crux I get is the pushback of, “Oh, I get bloated,” and so they give up. I'm like, “No, no, we just need to find the right fiber dense foods and find the right amount, so that you are not feeling bloated or feeling like your digestion is off.”
[00:54:11] What would be one or two pieces of advice that you would like to leave listeners with specific to nutrient guidance and middle age and beyond?
Dr. Sarah Berry: [00:54:20] So, I think in relation to fiber, I would say do simple swaps. We can't do an overhaul-- Let me say that again. It's very difficult to overhaul our whole diet. That's really hard to do. Our diet and the food that we eat is part of our culture, it's part of our social interactions, it's part of our habits. And so, where you can, see if you can integrate swaps. If you have refined grains, try and go for whole grain. Whole grain bread instead of white bread. Whole grain pasta instead of white pasta. Whole grain rice instead of white rice. You can even add in some of the really high fiber, other grains or seeds or nuts, for example. If you could switch from your typical snacks to nuts, for example, that additional fiber goes a long way.
[00:55:07] I think that brings me to moving beyond fiber to think about really simple hacks that you can do. If you're a snacker, just changing the snacks that you consume can have a huge impact on your health. So, we know in the US, 25% of people's calories comes from snacks. We've done research at ZOE showing that snacking itself is not a problem, but it's what you snack on and the timing that you snack that matters. I've done a clinical trial where I asked people just to change their typical US snacks to almond, so that they were changing 20% to 25% of their energy from typical US snacks to having almond nuts. We said, “Don't change anything else. Keep everything else the same.”
[00:55:49] After six weeks, this resulted in a predicted 30% reduction in cardiovascular disease risk based on the reduction that we saw in LDL cholesterol, so our bad cholesterol, and based on also the improvement we saw in blood vessel function. So, that's 30% improvement just from changing snacks. So, I would really advocate for people to do what's most simple for them and focus on stuff simple single dietary strategies. Getting your breakfast right, I think is really important. Again, that accounts for about 20% of our energy. If we can get our breakfast right and our snacks right, I think we're really setting ourselves up for success.
[00:56:29] Our data also shows that if you can get your breakfast right, if you can make sure you're starting off, so that you're on a good start to the day in terms of not having this roller coaster in glucose. So, choosing a breakfast that causes you to have a nice sustained elevation in glucose that's not dipping below baseline, that we know from our own research then sets you up to a really good start that you're not then over consuming calories the rest of the day impacts your alertness, your energy and so forth in a really favorable way.
[00:57:01] And then, the other bit of advice I would give to people, is as well as thinking about your diet in those meal centric ways. So, thinking about your snacks, thinking about your breakfast, getting those right, is thinking about how we eat, which takes us back to what we said about time restricted eating. Think about whether there's something about your dietary habits and about how you're eating that you can change that still enables you to enjoy food. So, is it that you can just try and finish your meals at 07:00 in the evening rather than 09:00 in the evening? Could you reduce the speed at which you eat your food?
[00:57:35] We know from published research now and also some of our own research, the importance of how fast you eat your food. So, we know that if you can just slow down the rate at which you're eating your food by about 20%, so this is eating your breakfast, let's say 12 minutes instead of 10 minutes, that subconsciously you will reduce your calorie intake on average by about 15%. And so, again, this is a small strategy. Just saying, “I'm just going to slow down how fast I eat my food.” This is obviously not for everyone. This is for people that may be worrying about their energy intake, but also, we know that it impacts other factors related to metabolism. I think it's being mindful about the importance of how we eat. So, the time of the day that we eat our food, the eating window, the speed that we eat our food as well.
[00:58:24] I think one last point I would make that I think is really relevant to peri and postmenopausal women, is the interaction that sleep has with how we process food and our dietary choices. I think this is really, really important. We know from our data that 85% of women in the peri and postmenopausal phase of their life have sleep disturbances. We know that if you have a disturbed night's sleep, if you're a short sleeper, we know that it impacts areas in your brain related to hunger, so that you're more hungry the next day, it impacts areas in your brain related to your reward circuit. So, it means that it drives you subconsciously to seek out a quick fix. So, those refined carbohydrates, those sugary breakfasts, basically those unhealthy breakfasts.
[00:59:12] We also know from our own research that if you've had a problem poor night's sleep and you have a carbohydrate rich meal, you have a higher glucose response, so a higher blood sugar response after that meal compared to if you've had a good night's sleep. So, you could have, let's say, a bagel one day when you've had a good night's sleep and have an okay blood sugar response. The next day, if you've had a poor night's sleep, it will be higher and then you're more likely to have a dip that then sets you off on that roller coaster.
[00:59:40] And so, I think one thing for peri and post-menopausal women to be aware of, is that sleep doesn't just impact the fact that we might not feel like doing physical activity. We might be grumpy. We might have less alertness. It impacts our food cues, our hunger cues, and it impacts how we metabolize the food. And so, it's about being sympathetic to that, but it's also about saying to yourself, “Okay, it's going to be even harder. I've had a really bad night's sleep last night. My brain is going to be tricking me into making the wrong choices. Wd when I make those wrong choices, it's going to be metabolically even worse for me.”
[01:00:15] And so, it's almost like pausing in the morning, I think and saying, “Okay, I really need to try hard to get off on the right start, choose the right breakfast, high protein, high healthy fats, high fiber breakfast to get me started, so that I can also almost reverse the impact that sleep is having on all of these choices.”
Cynthia Thurlow: [01:00:37] Well, I love all those simple swaps and the emphasis on small sustainable strategies that we can do throughout our lifetime.
[01:00:44] Please let listeners know how to connect with you. Obviously, I love ZOE Nutrition Podcast. How to connect with you outside of the podcast, learn more about your research, or if anyone listening wants to fund a seed oil study looking at cold press versus refined seed oils, we're all for it.
Dr. Sarah Berry: [01:01:01] Lovely. Thank you. Yeah. So, like you say, we've got a great podcast that ZOE Science and Nutrition Podcast, where we talk about all sorts of topics that we've talked about today in a lot more depth. I'm also on Instagram, which is @drsarahberry, and I always post on my latest research as well up there.
Cynthia Thurlow: [01:01:18] Thank you again, Dr. Berry. It's been a pleasure.
Dr. Sarah Berry: [01:01:20] Pleasure. Thank you for having me.
Cynthia Thurlow: [01:01:23] If you love this podcast episode, please leave a rating and review, subscribe and tell a friend.