Dr Paul: welcome back. We're now two of Per Flay. And we are talking about something about what are we talking about? ⁓
Dr Wafaa: Well, I think we're continuing to talk about self-care ⁓ this season, season one. I don't know how many episodes we're going to do for the time being, ⁓ So we'll take it from ⁓ where you were ⁓ walking your dog time. Did you go ⁓ take a walk your dog?
Dr Paul: Absolutely. It was a nice sunny day. And I think the dog enjoyed it. And I think actually today's conversation is about the diet. And the point being that afterwards, I was rather hungry. And obviously, I had to eat something. And I think diet is a very interesting topic and a very important one. Because most people aren't really sure what they should be eating. And in my consultation, I often have a bit of a chat about what to eat, when to eat, how to eat. And it's very, very nuanced. We talked about the word nuanced last time. And it's difficult because there's so many diets out there. There's always sort of dieting regimes, there's all this thing about nutrition. And I think the problem within journal practices as GPs, we're not necessarily trained in nutritional diet. And it's very difficult to I guess, evidence based or let alone evidence informed advice on nutrition and diet, partly because there's just so much out there. Wafia today, we're quite lucky because Wafia is a functional doctor and she'll have her own take about diet. ⁓ But yes, we'll use this episode to focus on what I see in my day to day when we talk about diet and nutrition and then we'll see what Wafia says. So over to you.
Dr Wafaa: ⁓ I'm ⁓ Yes, it's interesting and I'm so happy and proud and I wish like all the GPs and all the doctors actually take a pause ⁓ and ⁓ ask their patients what they Because most probably ⁓ most of the doctors do the A1C, which is in the blood test, reflects to your blood sugar level in the past few months ⁓ and ⁓ most of them are But we're going to talk about blood tests later on in another episode. when it comes to nutrition, people are in a very conflicting, like, you know, the trendy. So this so plant based. This is trendy. And look at this guy is building his muscle with a plant based diet. I don't know how. And then another one going on pescatarian and then ketogenic diet and then vegetarian and then vegan. then it's. actually mind blowing, but at the end of the day, what I do tell my patients, and I'm not a nutritional therapist, let's just have, let me have to be clear. I'm a functional medicine doctor, clinical oncologist, as you know, but from my experience with Patricia Daly, who was the best nutrition therapist I've ever seen in my life, and from what I have learned from functional medicine, and to wrap that with my experience as a clinical doctor, I like to listen to the patient. about his habits about eating and then I tell them about insulin resistance. So no matter what you eat, you have to think about insulin resistance and I like when you said Paul what they eat, when they eat and how they eat it. Did I say that correctly?
Dr Paul: Yes, bolasses.
Dr Wafaa: So the thing is that when you spike your blood sugar, it actually increases insulin. So insulin spikes are extremely important because when you are eating all the time, you spike your insulin. And when you spike your insulin, you spike your cortisol. And when you spike your cortisol, you are in a fake stress mode. So you might not be stressed, but your body is in high cortisol level and will imitate stress for you. And I don't, maybe I need to go to a nutritional therapy education, but People who are stressed, they binge on high carbs and they feel like the subtle or like a few minutes or maybe 30 minutes of satisfaction and then they binge on more. This is food addiction. We'll talk about it on another episode. don't know how many episodes we're going to make. However, what I would really love is for people to think what are they eating in the morning? What are they eating in the...
Dr Paul: you
Dr Wafaa: for lunch what are they eating for dinner provided that that person is not on a strict diet and he's eating three meals per day so first you have to start eating you have to focus that your food is mainly protein and then good fats and some carbs not the other way around because like ⁓ i pass like when you are walking with your dog or without your dog and you're passing by ⁓ all of the shops, Preta Manger, Nero, Starbucks, all of these things along the way, what will you get quickly? A sandwich, a pastry, croissant, a muffin, skinny muffin, as they say, because it's skinny and it will not make you fat, but it will spike your blood sugar. And then when you go to the salad section, you will find pasta salad, which is fine, by the way, if it has tuna in it or a good protein. So you have to understand that when you eat, it is a bio-individual thing. Like I get very high sugar spikes. I wore the CGM and I know that you are experiencing it now, Paul, so I need to... So the CGM is the continuous glucose monitoring. And you put it in your arm. You don't have to be diabetic to wear it. It's very, very nice to actually experiment if you are...
Dr Paul: You
Dr Wafaa: driving during traffic if your blood sugar will spike, if you're yelling at someone and your blood sugar will spike, which foods that you eat will spike your blood sugar the most and how long will it stay? So I think that ⁓ everyone is different from the other, but I think that ⁓ low carb is the best, whether it was low carb pescatarian, low carb ketogenic, low carb whatever. It's all because of the blood sugar. The blood sugar, and there is a lot of data, and I actually present those data in the conferences. There are two main things, two main papers I want to talk about. 1973, they actually put sugar in a petri dish, and they found out that when you add sugar, your immune system gets paralyzed for five hours. Five hours. paralysis of the phagocytic activity of your white blood counts. So if someone sneezes in your face, you will get infected. That's like, I'm joking. The other thing, it's 2019 paper, very meticulous paper about the molecular cascading in your cell to your nucleus that hyperglycemia, which is high blood sugar in your blood, causes tumor initiation. progression, metastasis and new vessel formation, which is metastasis as well, angiogenesis, and ends up in chemotherapy resistance or cancer resisting treatment. So it is very dangerous. The hyperglycemia that we are being exposed to, everything is filled with sugar all around you.
Dr Paul: I think for the listeners, can guess that Wafey is the expert in this, and she's really taking a deep dive. I'm going to just draw it one step back first, ⁓ in so much as ⁓ one. think what's really important is, yes, ⁓ what she says is ⁓ spot And I think it's important to understand that some of the science here. ⁓ Moving back to general practice ⁓ a split second. ⁓ When we talk about the what and when and how, sometimes I will talk about the what might be the superfoods like kale, broccoli, spinach, parsley, ginger, turmeric, these sorts of things. But also we need to understand that the gut microbiome is an ecosystem within an ecosystem and it's a moving target. And so it's really important to figure out what works best for you. And of course, knowing what is knowledge means that you can really go and take a deep dive in terms of optimizing things. I think in terms of the general understanding of it, ⁓ I think it's also useful to know what things can you gamify in terms of the dietary side of things. So there's the what, okay, it might be that sometimes some people find that broccoli is really good. So we know that it's got sulforaphane and intervinoicology side of things really good. However, it might make your IBS irritable bowel syndrome worse for some. And then maybe other foods that work for you, but not for your friend or your partner. So it's really important to have a bit of a trial and error or what I like to call trial and improvement to figure out where, yeah, what works best for you. When you eat, it is a matter of course. So we know that I think when you eat, it takes something like four to six hours, I think, I there's some studies to then say how long it takes to digest it from the stomach and then for it to go down further. And of course, if you're eating it very late, well, you're in that phase where you want to go to bed. you're in that rest and recover phase. But if there's still food stuck in that stomach and you're trying to digest it, well, a lot of that blood is going to have to be redirected to digest it. And we all know from our basic, perhaps, biology GCSE, you've got the hydrochloric acid and you've got the proteic enzymes trying to turn away at it. Well, no wonder you may be suffering from reflux, that heartburn sensation, because you've timed it. Hit late for that eating so that that digestion process can be facilitated. How you eat also matters. Being mindful of how you eat. But you can also, I mean, sometimes the conversation I have with patients who, let's say, I wanted to lose weight, we can even trick our minds. So for So if you've got a plate this big, and we've got a fine amount of food of this size, versus a smaller plate with the same amount of food, we know we get fuller. even on that smaller plate similarly even colorings, I think evolution, we've sort of, over time decided that dark colored purple stuff, blue stuff is potentially poisonous. Although we know it's very good. We can actually dampen down our satiety and appetite by being gamifying and coloring everything blue. Hopefully not the one that's artifical but something that's actually natural in color, right? And so there's ways in which, like even the size of the cutlery, if you've got smaller knives and forks or chopsticks or whatever you use, right, chopsticks are a difficult, but it just means that you slow down the pace at which you eat. And it's so easy then say, okay, we'll chew your food. We all know that, but these are things that you can nudge to get yourself to perhaps slow down the speed at which you eat, because we all know our stomachs are a bit of a dumb organ. So by the time that we've actually eaten stuff and we feel full, we're actually overeating And there's a fantastic saying in Japan called Hara Hachibu, or Hara Hachibun me, which means eat to 80%. Because it's all to do with the hormones. And I'm sure we'll put it on the website about cholecystokinin and gastrin and other hormone side. But it's just that we want to make sure that the stomach doesn't get over distended by the time that you actually feel full. and it's being intentional and mindful of how you eat that then enables us to get the right nutrition, but also the right amount of calories. But also we need to now figure out which food groups to eat and not to eat. And of course, we all know that it's important not to eat. That the things that are ultra processed, the E numbers, the artificial flavours, the preservatives, all that, that's a given, right? But it's also important that maybe hidden stuff like hidden salt. In terms of the sugar side of things, you want to make sure that the order is good. So, Wafi, you mentioned about and you revealed the fact that I've got what we call a freestyle leap. For the first time, like I said in the previous episode, I'm a firm advocate of see one, do one, teach one. And my nurse said, I've got a free freestyle leap. And I said, can I try it? So I've actually literally got the circle stuff here that's monitoring my sugar levels in real time. And I've just been playing around with it as me as the experiment of seeing How far can I spike up my sugar by eating lots of sweet stuff versus, for instance, the timings, right? So as Wafai mentioned in terms of the sequence, some aspects of sequence of what you eat, I've noticed that if I've eaten a good decent meal with a of vegetables and then I have my dessert, that sugar spike is less so. And sugar spikes are not great because we know that that links to... inflammation and insulin resistance, and we could take a deeper dive of the science at a later episode. But it's sometimes useful to know that, okay, it's not all about knowing the metrics, but sometimes it's really useful to know how you operate, and then what you can do to navigate it in a way that it works for you. Just wondering, what are your thoughts with all this and me being a bit proactive for myself, Maffei?
Dr Wafaa: This is fantastic and we should all eat with chopsticks so we can actually eat slowly. Because if we eat with chopsticks, actually we will eat slowly and we will eat mindfully. Unless you're eating, of course, sushi and you're stuffing a big piece of sushi in your mind and you're just very eager to finish it so that you can eat the next. However, like eating mindfully because when you eat slowly, you say, number one, you will chew better. So you will make your
Dr Paul: Slowly.
Dr Wafaa: the rest of your digestive system more at calm and you will improve the post-absorptive state. So the nutrients can actually reach better to your system and you will get benefit from what you are eating. Talking about one of the best groups for eating, but I wanted to mention something because you talked about eating the veggies and then the dessert and your sugar spike. There has been a scientific paper comparing between vegetables, meat and rice and which when you eat first spike the sugar the most so when you eat the rice first then the veggie and the meat this is your highest spike of blood sugar but when you eat the meat and the veggies then the rice at the end then you have the lowest spike in your sugar and because of know like a middle eastern and we have a lot of sweets and treats etc I don't tell my children or my friends not to eat the sweets. I tell them, but I told them like in summer, why don't you eat a slice of watermelon before indulging into your sweets? Because you will change the tongue, you know, the perception of tongue to sweets. When you eat a watermelon, when you eat a kiwi, when you eat strawberries, I don't think that you will need to eat the desserts afterwards. But anyways, it's a, you know, a process that you have to go through. You cannot change your eating habits all at once. But anyways, from a functional medicine integrative oncologist point of view, broccoli, as you mentioned, is fantastic. It modulates the inflammation in your body. And I actually teach people how to make your food more functional. So you never eat the cabbage or the broccoli or the kale raw. You have to steam them. And then you stir fry them with olive oil, you add some garlic and you add some Himalayan salt, pepper, freshly grounded pepper, and then maybe some curry, has ⁓ curcumin in it, it has coriander, it has all of these nutritious ⁓ herbs that actually trigger or act on modifying your genetic expression in your body. For instance, like my mom, may she rest in peace, she used to, whenever I had a stomach pain, she used to actually ⁓ boil for me caraway seeds and cumin and anise seeds and fennel seeds. And then she would give me that. And this is the best medicine ever. We have to go back to our roots, to our ancestors, how people used to treat themselves without needing the medicine. It's let food be thy medicine and medicine be thy food. So it's the food groups that you should eat, you should concentrate on them. And then you should consider how to make them more impactful for your body and enjoy it because healthy food, it tastes really good when you cook it the right way. Like I passed by the supermarket, I found out some, you know how I'm fond of noodles, Paul, but then I can't eat noodles because they have gluten. And then we're gonna talk about gluten in a separate episode.
Dr Paul: you
Dr Wafaa: then I found buckwheat noodles. So I got the buckwheat noodles and I made them stir-fry with some shrimps, soy sauce, of course you have to check a good soy sauce source, and some rice vinegar, and some sesame, and some chopped vegetable stir-fry. It was fantastic and it doesn't take a lot of time. So you have to prepare yourself. Like last week it was very busy for me for numerous reasons. So, but today I decided to, well, if you are busy, you're gonna eat crap unless you prepared for it. So I did yesterday, I did some flaxseed crackers. I smashed some avocados in a jar and I made guacamole with garlic, salt, pepper, cumin and lemon so that it doesn't go black. And then I made a pesto sauce. So whenever I am hungry, I have my cheese. good cheese, have my pesto, have my guacamole, and I have my flaxseed crackers. You know that flaxseeds actually modulate the TP53 gene, which is a gene for longevity with the search one, and it actually makes your, it protects your cells from developing cancer. And I'm sorry that I keep bringing back cancer, but this is my specialty. What do you think about those little small tips? Because we're not gonna like discuss, we're not gonna...
Dr Paul: Absolutely.
Dr Wafaa: I'm going to make a cooking workshop on the podcast now.
Dr Paul: ⁓ absolutely. I think in the closing minute or two, I think one other aspect is, is sometimes you need to figure out what works for you. And I can give you a good example here. I know that I various fruits that I like. And Kiwi, for instance, I know you mentioned this earlier, hadn't featured very high up on the list of fruits that I like. But I know over the course of time that for me, Kiwis make me feel better the next day. So my regime at the end of the day is to have some probiotic yogurt drink and then actually have a kiwi at the end of the day and then go to bed. Okay, it's probably not so good for the stomach, but I know for me it works. So I think for the listeners perspective, it's important to figure out, it's not just about what food you like. I mean, it's like, we're not talking about indulgence and the dopamine kick of having the extra bar of chocolate. It's actually saying what really makes me feel good in myself internally. And it might be like, freestyle leave, it gives you the metrics, right? So I know that the timing matters and what I eat and what next. But it might be that you think, think, I had just yesterday, I remember, I had a situation where I actually lead into chat GBT and saying, I'm a bit hungry, is it better for me to have something sweet, or something salty? And it turned out the results saying, depends. Of course, if you've got cardiovascular risks of heart and strokes and hypertension, high blood pressure, sorry, then of course, you don't want to have too many salty stuff. But if it's of the two, like being for like, then it's probably better to go for the salty than the sugar within reason, of course. But even that knowledge is quite interesting, because I've had to look it up. So was thinking to myself, how would it respond to this? And it's only because I've got this that I actually asked that question intentionally. And I think for the listeners, I think it's important to as you start getting an awareness of what works best for you. not also withstanding the actual science behind it. And of course, nutrition diet is an evolving field, as we all know. I think it's quite nice for you to then do a bit of trial and error, a of trial improvement to figure out what foods can you then eat that makes you feel better.
Dr Wafaa: Yes, this is very good because I keep telling my patients you have to experiment with foods. So after you eat that food, are you getting bloated? Are you getting an ⁓ energy crash? You feel fatigued? Do feel sleepy? Do you have headaches? So all of these things can be an indication if that food is good for you or this combination of food or that time when you ate that food is not good for you. And actually ⁓ referring to this, because we are on a podcast, so some of the listeners will know. that this is a CGM, a ⁓ continuous glucose monitoring. actually wearing two of those actually changed the way I looked at food. And sometimes when you go into a gathering or an outing and a lot of people like offer you some stuff, what you can do in a very polite way, ⁓ this is fantastic, but thank you very much. I do not need it right now. And when you say out loud, I do not need it right now. you're actually apologizing in a very decent way to the person in front of you that you cannot take that food. And at the same time, you are rewiring your brain in a neuro-linguistic way, telling to your brain that you do not need this right now. So this is actually the tools that I use when I'm in front of a big pie of maybe strawberry or a big delicious meal, and I can't take it right now because I just had my lunch, for instance. So yeah, I think that I hope our listeners know that this is not a cooking workshop. However, I would like to experiment with every food that they eat. If it makes them crash, if it makes them more energetic, then they put it at the top of their list. They would try as much as they can. I know that the temptations are everywhere, but they should try as much as they can to not take that. ⁓ Mars or Twix or Galaxy bar from the supermarket on their way out and take some nuts instead. Get some cheese from the fridge. There are a lot of healthy options, especially what I have seen in the UK. It has evolved here in Egypt as well, but you have to go to a specialized supermarket for that. Or you just do it yourself and take it in a bag while you are walking your dog.
Dr Paul: Excellent. So on that note, Wafaa, what are you going to do until our next episode?
Dr Wafaa: Hmm, yes, I'm gonna maintain my habit of doing healthy things at home so I don't actually crave and take that bag of chips that my son has brought yesterday. When you have the alternatives, you will feel good about yourself.
Dr Paul: Excellent. Well on that note listeners, I hope you guys can also have a bit of a thought think about what you might be able to do from the nutrition and the diet side of things but until then we will see you next time. All the best. Bye for now.
Dr Wafaa: Well. What about you, Paul? Paul, what about What are you going to do until the next episode?
Dr Paul: Good question. mean, the advantage is that I know my sugar levels in real time at the moment. So it's perhaps making sure that if there is that craving to want to have that biscuit or something sweet, is to perhaps think twice about it and go for another option. Or even for that matter, if it's late in the evening, just say, nah, not gonna eat it. I'm sure my brain will be sad initially, but the next morning, I'm sure my body will thank me for my choices.
Dr Wafaa: Absolutely. It takes like willpower. But if you tell your brain, do not need it, it will be happier.
Dr Wafaa: Well, I think we're continuing to talk about self-care ⁓ this season, season one. I don't know how many episodes we're going to do for the time being, ⁓ So we'll take it from ⁓ where you were ⁓ walking your dog time. Did you go ⁓ take a walk your dog?
Dr Paul: Absolutely. It was a nice sunny day. And I think the dog enjoyed it. And I think actually today's conversation is about the diet. And the point being that afterwards, I was rather hungry. And obviously, I had to eat something. And I think diet is a very interesting topic and a very important one. Because most people aren't really sure what they should be eating. And in my consultation, I often have a bit of a chat about what to eat, when to eat, how to eat. And it's very, very nuanced. We talked about the word nuanced last time. And it's difficult because there's so many diets out there. There's always sort of dieting regimes, there's all this thing about nutrition. And I think the problem within journal practices as GPs, we're not necessarily trained in nutritional diet. And it's very difficult to I guess, evidence based or let alone evidence informed advice on nutrition and diet, partly because there's just so much out there. Wafia today, we're quite lucky because Wafia is a functional doctor and she'll have her own take about diet. ⁓ But yes, we'll use this episode to focus on what I see in my day to day when we talk about diet and nutrition and then we'll see what Wafia says. So over to you.
Dr Wafaa: ⁓ I'm ⁓ Yes, it's interesting and I'm so happy and proud and I wish like all the GPs and all the doctors actually take a pause ⁓ and ⁓ ask their patients what they Because most probably ⁓ most of the doctors do the A1C, which is in the blood test, reflects to your blood sugar level in the past few months ⁓ and ⁓ most of them are But we're going to talk about blood tests later on in another episode. when it comes to nutrition, people are in a very conflicting, like, you know, the trendy. So this so plant based. This is trendy. And look at this guy is building his muscle with a plant based diet. I don't know how. And then another one going on pescatarian and then ketogenic diet and then vegetarian and then vegan. then it's. actually mind blowing, but at the end of the day, what I do tell my patients, and I'm not a nutritional therapist, let's just have, let me have to be clear. I'm a functional medicine doctor, clinical oncologist, as you know, but from my experience with Patricia Daly, who was the best nutrition therapist I've ever seen in my life, and from what I have learned from functional medicine, and to wrap that with my experience as a clinical doctor, I like to listen to the patient. about his habits about eating and then I tell them about insulin resistance. So no matter what you eat, you have to think about insulin resistance and I like when you said Paul what they eat, when they eat and how they eat it. Did I say that correctly?
Dr Paul: Yes, bolasses.
Dr Wafaa: So the thing is that when you spike your blood sugar, it actually increases insulin. So insulin spikes are extremely important because when you are eating all the time, you spike your insulin. And when you spike your insulin, you spike your cortisol. And when you spike your cortisol, you are in a fake stress mode. So you might not be stressed, but your body is in high cortisol level and will imitate stress for you. And I don't, maybe I need to go to a nutritional therapy education, but People who are stressed, they binge on high carbs and they feel like the subtle or like a few minutes or maybe 30 minutes of satisfaction and then they binge on more. This is food addiction. We'll talk about it on another episode. don't know how many episodes we're going to make. However, what I would really love is for people to think what are they eating in the morning? What are they eating in the...
Dr Paul: you
Dr Wafaa: for lunch what are they eating for dinner provided that that person is not on a strict diet and he's eating three meals per day so first you have to start eating you have to focus that your food is mainly protein and then good fats and some carbs not the other way around because like ⁓ i pass like when you are walking with your dog or without your dog and you're passing by ⁓ all of the shops, Preta Manger, Nero, Starbucks, all of these things along the way, what will you get quickly? A sandwich, a pastry, croissant, a muffin, skinny muffin, as they say, because it's skinny and it will not make you fat, but it will spike your blood sugar. And then when you go to the salad section, you will find pasta salad, which is fine, by the way, if it has tuna in it or a good protein. So you have to understand that when you eat, it is a bio-individual thing. Like I get very high sugar spikes. I wore the CGM and I know that you are experiencing it now, Paul, so I need to... So the CGM is the continuous glucose monitoring. And you put it in your arm. You don't have to be diabetic to wear it. It's very, very nice to actually experiment if you are...
Dr Paul: You
Dr Wafaa: driving during traffic if your blood sugar will spike, if you're yelling at someone and your blood sugar will spike, which foods that you eat will spike your blood sugar the most and how long will it stay? So I think that ⁓ everyone is different from the other, but I think that ⁓ low carb is the best, whether it was low carb pescatarian, low carb ketogenic, low carb whatever. It's all because of the blood sugar. The blood sugar, and there is a lot of data, and I actually present those data in the conferences. There are two main things, two main papers I want to talk about. 1973, they actually put sugar in a petri dish, and they found out that when you add sugar, your immune system gets paralyzed for five hours. Five hours. paralysis of the phagocytic activity of your white blood counts. So if someone sneezes in your face, you will get infected. That's like, I'm joking. The other thing, it's 2019 paper, very meticulous paper about the molecular cascading in your cell to your nucleus that hyperglycemia, which is high blood sugar in your blood, causes tumor initiation. progression, metastasis and new vessel formation, which is metastasis as well, angiogenesis, and ends up in chemotherapy resistance or cancer resisting treatment. So it is very dangerous. The hyperglycemia that we are being exposed to, everything is filled with sugar all around you.
Dr Paul: I think for the listeners, can guess that Wafey is the expert in this, and she's really taking a deep dive. I'm going to just draw it one step back first, ⁓ in so much as ⁓ one. think what's really important is, yes, ⁓ what she says is ⁓ spot And I think it's important to understand that some of the science here. ⁓ Moving back to general practice ⁓ a split second. ⁓ When we talk about the what and when and how, sometimes I will talk about the what might be the superfoods like kale, broccoli, spinach, parsley, ginger, turmeric, these sorts of things. But also we need to understand that the gut microbiome is an ecosystem within an ecosystem and it's a moving target. And so it's really important to figure out what works best for you. And of course, knowing what is knowledge means that you can really go and take a deep dive in terms of optimizing things. I think in terms of the general understanding of it, ⁓ I think it's also useful to know what things can you gamify in terms of the dietary side of things. So there's the what, okay, it might be that sometimes some people find that broccoli is really good. So we know that it's got sulforaphane and intervinoicology side of things really good. However, it might make your IBS irritable bowel syndrome worse for some. And then maybe other foods that work for you, but not for your friend or your partner. So it's really important to have a bit of a trial and error or what I like to call trial and improvement to figure out where, yeah, what works best for you. When you eat, it is a matter of course. So we know that I think when you eat, it takes something like four to six hours, I think, I there's some studies to then say how long it takes to digest it from the stomach and then for it to go down further. And of course, if you're eating it very late, well, you're in that phase where you want to go to bed. you're in that rest and recover phase. But if there's still food stuck in that stomach and you're trying to digest it, well, a lot of that blood is going to have to be redirected to digest it. And we all know from our basic, perhaps, biology GCSE, you've got the hydrochloric acid and you've got the proteic enzymes trying to turn away at it. Well, no wonder you may be suffering from reflux, that heartburn sensation, because you've timed it. Hit late for that eating so that that digestion process can be facilitated. How you eat also matters. Being mindful of how you eat. But you can also, I mean, sometimes the conversation I have with patients who, let's say, I wanted to lose weight, we can even trick our minds. So for So if you've got a plate this big, and we've got a fine amount of food of this size, versus a smaller plate with the same amount of food, we know we get fuller. even on that smaller plate similarly even colorings, I think evolution, we've sort of, over time decided that dark colored purple stuff, blue stuff is potentially poisonous. Although we know it's very good. We can actually dampen down our satiety and appetite by being gamifying and coloring everything blue. Hopefully not the one that's artifical but something that's actually natural in color, right? And so there's ways in which, like even the size of the cutlery, if you've got smaller knives and forks or chopsticks or whatever you use, right, chopsticks are a difficult, but it just means that you slow down the pace at which you eat. And it's so easy then say, okay, we'll chew your food. We all know that, but these are things that you can nudge to get yourself to perhaps slow down the speed at which you eat, because we all know our stomachs are a bit of a dumb organ. So by the time that we've actually eaten stuff and we feel full, we're actually overeating And there's a fantastic saying in Japan called Hara Hachibu, or Hara Hachibun me, which means eat to 80%. Because it's all to do with the hormones. And I'm sure we'll put it on the website about cholecystokinin and gastrin and other hormone side. But it's just that we want to make sure that the stomach doesn't get over distended by the time that you actually feel full. and it's being intentional and mindful of how you eat that then enables us to get the right nutrition, but also the right amount of calories. But also we need to now figure out which food groups to eat and not to eat. And of course, we all know that it's important not to eat. That the things that are ultra processed, the E numbers, the artificial flavours, the preservatives, all that, that's a given, right? But it's also important that maybe hidden stuff like hidden salt. In terms of the sugar side of things, you want to make sure that the order is good. So, Wafi, you mentioned about and you revealed the fact that I've got what we call a freestyle leap. For the first time, like I said in the previous episode, I'm a firm advocate of see one, do one, teach one. And my nurse said, I've got a free freestyle leap. And I said, can I try it? So I've actually literally got the circle stuff here that's monitoring my sugar levels in real time. And I've just been playing around with it as me as the experiment of seeing How far can I spike up my sugar by eating lots of sweet stuff versus, for instance, the timings, right? So as Wafai mentioned in terms of the sequence, some aspects of sequence of what you eat, I've noticed that if I've eaten a good decent meal with a of vegetables and then I have my dessert, that sugar spike is less so. And sugar spikes are not great because we know that that links to... inflammation and insulin resistance, and we could take a deeper dive of the science at a later episode. But it's sometimes useful to know that, okay, it's not all about knowing the metrics, but sometimes it's really useful to know how you operate, and then what you can do to navigate it in a way that it works for you. Just wondering, what are your thoughts with all this and me being a bit proactive for myself, Maffei?
Dr Wafaa: This is fantastic and we should all eat with chopsticks so we can actually eat slowly. Because if we eat with chopsticks, actually we will eat slowly and we will eat mindfully. Unless you're eating, of course, sushi and you're stuffing a big piece of sushi in your mind and you're just very eager to finish it so that you can eat the next. However, like eating mindfully because when you eat slowly, you say, number one, you will chew better. So you will make your
Dr Paul: Slowly.
Dr Wafaa: the rest of your digestive system more at calm and you will improve the post-absorptive state. So the nutrients can actually reach better to your system and you will get benefit from what you are eating. Talking about one of the best groups for eating, but I wanted to mention something because you talked about eating the veggies and then the dessert and your sugar spike. There has been a scientific paper comparing between vegetables, meat and rice and which when you eat first spike the sugar the most so when you eat the rice first then the veggie and the meat this is your highest spike of blood sugar but when you eat the meat and the veggies then the rice at the end then you have the lowest spike in your sugar and because of know like a middle eastern and we have a lot of sweets and treats etc I don't tell my children or my friends not to eat the sweets. I tell them, but I told them like in summer, why don't you eat a slice of watermelon before indulging into your sweets? Because you will change the tongue, you know, the perception of tongue to sweets. When you eat a watermelon, when you eat a kiwi, when you eat strawberries, I don't think that you will need to eat the desserts afterwards. But anyways, it's a, you know, a process that you have to go through. You cannot change your eating habits all at once. But anyways, from a functional medicine integrative oncologist point of view, broccoli, as you mentioned, is fantastic. It modulates the inflammation in your body. And I actually teach people how to make your food more functional. So you never eat the cabbage or the broccoli or the kale raw. You have to steam them. And then you stir fry them with olive oil, you add some garlic and you add some Himalayan salt, pepper, freshly grounded pepper, and then maybe some curry, has ⁓ curcumin in it, it has coriander, it has all of these nutritious ⁓ herbs that actually trigger or act on modifying your genetic expression in your body. For instance, like my mom, may she rest in peace, she used to, whenever I had a stomach pain, she used to actually ⁓ boil for me caraway seeds and cumin and anise seeds and fennel seeds. And then she would give me that. And this is the best medicine ever. We have to go back to our roots, to our ancestors, how people used to treat themselves without needing the medicine. It's let food be thy medicine and medicine be thy food. So it's the food groups that you should eat, you should concentrate on them. And then you should consider how to make them more impactful for your body and enjoy it because healthy food, it tastes really good when you cook it the right way. Like I passed by the supermarket, I found out some, you know how I'm fond of noodles, Paul, but then I can't eat noodles because they have gluten. And then we're gonna talk about gluten in a separate episode.
Dr Paul: you
Dr Wafaa: then I found buckwheat noodles. So I got the buckwheat noodles and I made them stir-fry with some shrimps, soy sauce, of course you have to check a good soy sauce source, and some rice vinegar, and some sesame, and some chopped vegetable stir-fry. It was fantastic and it doesn't take a lot of time. So you have to prepare yourself. Like last week it was very busy for me for numerous reasons. So, but today I decided to, well, if you are busy, you're gonna eat crap unless you prepared for it. So I did yesterday, I did some flaxseed crackers. I smashed some avocados in a jar and I made guacamole with garlic, salt, pepper, cumin and lemon so that it doesn't go black. And then I made a pesto sauce. So whenever I am hungry, I have my cheese. good cheese, have my pesto, have my guacamole, and I have my flaxseed crackers. You know that flaxseeds actually modulate the TP53 gene, which is a gene for longevity with the search one, and it actually makes your, it protects your cells from developing cancer. And I'm sorry that I keep bringing back cancer, but this is my specialty. What do you think about those little small tips? Because we're not gonna like discuss, we're not gonna...
Dr Paul: Absolutely.
Dr Wafaa: I'm going to make a cooking workshop on the podcast now.
Dr Paul: ⁓ absolutely. I think in the closing minute or two, I think one other aspect is, is sometimes you need to figure out what works for you. And I can give you a good example here. I know that I various fruits that I like. And Kiwi, for instance, I know you mentioned this earlier, hadn't featured very high up on the list of fruits that I like. But I know over the course of time that for me, Kiwis make me feel better the next day. So my regime at the end of the day is to have some probiotic yogurt drink and then actually have a kiwi at the end of the day and then go to bed. Okay, it's probably not so good for the stomach, but I know for me it works. So I think for the listeners perspective, it's important to figure out, it's not just about what food you like. I mean, it's like, we're not talking about indulgence and the dopamine kick of having the extra bar of chocolate. It's actually saying what really makes me feel good in myself internally. And it might be like, freestyle leave, it gives you the metrics, right? So I know that the timing matters and what I eat and what next. But it might be that you think, think, I had just yesterday, I remember, I had a situation where I actually lead into chat GBT and saying, I'm a bit hungry, is it better for me to have something sweet, or something salty? And it turned out the results saying, depends. Of course, if you've got cardiovascular risks of heart and strokes and hypertension, high blood pressure, sorry, then of course, you don't want to have too many salty stuff. But if it's of the two, like being for like, then it's probably better to go for the salty than the sugar within reason, of course. But even that knowledge is quite interesting, because I've had to look it up. So was thinking to myself, how would it respond to this? And it's only because I've got this that I actually asked that question intentionally. And I think for the listeners, I think it's important to as you start getting an awareness of what works best for you. not also withstanding the actual science behind it. And of course, nutrition diet is an evolving field, as we all know. I think it's quite nice for you to then do a bit of trial and error, a of trial improvement to figure out what foods can you then eat that makes you feel better.
Dr Wafaa: Yes, this is very good because I keep telling my patients you have to experiment with foods. So after you eat that food, are you getting bloated? Are you getting an ⁓ energy crash? You feel fatigued? Do feel sleepy? Do you have headaches? So all of these things can be an indication if that food is good for you or this combination of food or that time when you ate that food is not good for you. And actually ⁓ referring to this, because we are on a podcast, so some of the listeners will know. that this is a CGM, a ⁓ continuous glucose monitoring. actually wearing two of those actually changed the way I looked at food. And sometimes when you go into a gathering or an outing and a lot of people like offer you some stuff, what you can do in a very polite way, ⁓ this is fantastic, but thank you very much. I do not need it right now. And when you say out loud, I do not need it right now. you're actually apologizing in a very decent way to the person in front of you that you cannot take that food. And at the same time, you are rewiring your brain in a neuro-linguistic way, telling to your brain that you do not need this right now. So this is actually the tools that I use when I'm in front of a big pie of maybe strawberry or a big delicious meal, and I can't take it right now because I just had my lunch, for instance. So yeah, I think that I hope our listeners know that this is not a cooking workshop. However, I would like to experiment with every food that they eat. If it makes them crash, if it makes them more energetic, then they put it at the top of their list. They would try as much as they can. I know that the temptations are everywhere, but they should try as much as they can to not take that. ⁓ Mars or Twix or Galaxy bar from the supermarket on their way out and take some nuts instead. Get some cheese from the fridge. There are a lot of healthy options, especially what I have seen in the UK. It has evolved here in Egypt as well, but you have to go to a specialized supermarket for that. Or you just do it yourself and take it in a bag while you are walking your dog.
Dr Paul: Excellent. So on that note, Wafaa, what are you going to do until our next episode?
Dr Wafaa: Hmm, yes, I'm gonna maintain my habit of doing healthy things at home so I don't actually crave and take that bag of chips that my son has brought yesterday. When you have the alternatives, you will feel good about yourself.
Dr Paul: Excellent. Well on that note listeners, I hope you guys can also have a bit of a thought think about what you might be able to do from the nutrition and the diet side of things but until then we will see you next time. All the best. Bye for now.
Dr Wafaa: Well. What about you, Paul? Paul, what about What are you going to do until the next episode?
Dr Paul: Good question. mean, the advantage is that I know my sugar levels in real time at the moment. So it's perhaps making sure that if there is that craving to want to have that biscuit or something sweet, is to perhaps think twice about it and go for another option. Or even for that matter, if it's late in the evening, just say, nah, not gonna eat it. I'm sure my brain will be sad initially, but the next morning, I'm sure my body will thank me for my choices.
Dr Wafaa: Absolutely. It takes like willpower. But if you tell your brain, do not need it, it will be happier.
