Notes

00:08
[Applause]
00:15
I was just 24 years old when I saw a
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patient die in front of me for the first
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time I was working as a junior doctor in
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a busy any department a 60 year old lady
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came in having had a cardiac arrest
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missed likely results of a heart attack
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the ambulance crew had started
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resuscitation at the scene and we
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continued delivering drugs manual
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compressions exactly how it all been
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trained but despite our best efforts we
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ended up calling her death and I
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remember leaving that recess bay feeling
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so frustrated this wasn't what I'd been
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led to believe medicine was about I
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wanted to save lives not struggle in
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vain and succumb to losing patients and
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when they went home that night I
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refreshed my memory on how many heart
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attacks there are in the UK every year
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it was slightly less than but now it's
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over a hundred thousand one every five
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minutes and thirty thousand cardiac
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arrests occur in the same way this poor
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lady presented out of hospital
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with less than a 1 in 10 chance that
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they'll survive so the reality was from
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the moment the ambulance crew brought
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her into the department there wasn't
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much we could do at that point we were
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reacting to disease that had been
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untreated undiagnosed and started long
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ago the first presentation of which was
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her collapsing to the floor with a heart
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attack but today I have 15 minutes to
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save your life or more specifically I
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have 15 minutes to help prevent the
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deaths of roughly 50% of the adults in
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this audience today who will succumb to
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preventable lifestyle related illnesses
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like heart disease stroke and
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complications of metabolic
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these lifestyle related illnesses that
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caused millions of deaths worldwide and
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in this country
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my name is rupee I'm a NHS doctor and
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the medicine I'm prescribing today is
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food but as more people understand the
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power of our diets to help prevent and
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in some cases treat ill health the
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logical question becomes doctor what
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should I be eating and if you've looked
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at the headlines or scroll through
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social media
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you will notice meat eaters fighting
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with vegans paleo fighting with the
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Diabetes Association a war of attrition
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between multiple sides with the losers
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being the millions of people just trying
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to figure out how best to look after
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themselves today I'm going to help you
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with a different approach because it
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seems strange to me that you can have
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some people who decide to eat a
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plant-based diet and improve their heart
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disease markers others who choose paleo
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and improve their bowel symptoms while
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some swear by low carbohydrate and come
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off diabetes medications if these diets
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are so wildly different how can they
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achieve such similar and frankly
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remarkable outcomes and the reason why
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is because a lot of the underlying
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principles are the same
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let's take a visual approach so I've
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taken the liberty of excluding diets
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that restrict yourself to just eating
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cucumbers or just pure meat luckily
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they're not that popular and they lack
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an evidence base but when we look at
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popular diets that have credible studies
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paleo low carbohydrate Mediterranean -
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whole food plant-based and we map out
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where the similarities lie you will
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notice an abundance of overlapping
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themes and it's this exercise that
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reveals the principles behind a lot of
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them naturally as you would imagine all
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of them remove excess junk food
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processed foods excess sugar as well as
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balancing for energy control I think we
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can all reason with that
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but what do they include largely plants
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fiber quality fats and lots of colors
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what do these do well when you eat
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largely plants you're ensuring a
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selection of micronutrients vitamins
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minerals but also phytochemicals the
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thousands of chemicals that we find
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locked in roots leaves and grains we
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used to think that the benefits of
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plants were just because of antioxidants
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but it is far more complicated than that
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these chemicals can help regenerate our
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human cells help signaling between them
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as well as changing their function fiber
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from whole grains beans legumes can
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contain hundreds of different types of
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fibers and these feed your microbiota
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this incredible population of microbes
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that nurture your health by releasing
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nutrients they digest food for you they
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balance inflammation they they balance
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excess sugar and feeding this population
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with these sorts of foods is critical to
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maintaining them that's essential for
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your brain health the precursors to
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hormones that cursory or bloodstream
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quality fats that you find in nuts and
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seeds are incredible for benefiting your
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health and contain a myriad of different
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fatty acids and colors food has the
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ability to interact at the very core of
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our existence our DNA and alongside
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other lifestyle factors like stress and
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sleep food has the potential to switch
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genes on and others off this is the
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exciting field of nutria genetics the
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power of your food to change the
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expression of your genes to promote
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health and we know for the majority of
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us it is a diet that consists largely of
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plants and lots of colors
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many bodies including the World Health
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Organization recognized that eating a
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prudent diet consistent with these
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features lowers the risk of chronic
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kidney disease autoimmune conditions
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inflammatory bowel disease cancer
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depression and many more beyond just
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obesity and disease your plate contains
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a wealth of information that interacts
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with your very inner ecosystem in the
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most powerful way and the confusion that
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surrounds dietary conflict it's actually
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creating an apathy toward motivation and
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behavior change we initially assumed as
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conflicting dietary methods are actually
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at the cereal and complementary in many
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ways I want to make it clear here that
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food is not a panacea it's not a
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cure-all or a replacement for the many
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drugs and services that I prescribe as
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an NHS doctor daily but it is a huge
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component of well-being and it's this
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conflict that is creating an issue I
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would also love to stand here and
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explain to you what you should be eating
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and expect you to just do it in the same
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way I can prescribe a pill to a patient
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and ask them to take it three times a
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day but it's not I remember around seven
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years ago when I started introducing
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diet into my consultations I had a 45
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year old man come into my clinic his
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blood work showed that he was on the
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verge of type - but diabetes and we had
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a conversation about how diet and
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lifestyle can prevent the progression to
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type - he wasn't keen on changing much
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about his diet that was full of
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convenience foods but I said look let's
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just start slow let's just start with
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one meal and he said well I have frosted
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Wheaties for breakfast I don't really
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like that maybe that I said great do you
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like oats he said I don't mind porridge
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fantastic here's a recipe make some oats
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put some sunflower seeds on it add some
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frozen berries there
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a cheap try that for a couple of weeks
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come back and let me know how you get on
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I wrote down the ingredients for him he
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got up to leave and I thought to myself
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wow roofie I think you've really changed
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this guy's life and then as he left
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through the door he turned back to me
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and he said just one more thing doctor
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how do you make oats nutrition isn't
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simple for a number of other reasons
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food is an emotive subject it's how we
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celebrate it's part of our culture our
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history nutritional medicine isn't being
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talked about by us in medicine because
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most of the doctors here in this room
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we're not taught about the importance of
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food at medical school our children are
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not educated and how to grow or cook as
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part of their schooling which is why I
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have patients that can't make the
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simplest of dishes like oats and access
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to healthy foods depends on where you
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live the promotion of unhealthy options
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target the most vulnerable and whilst I
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can't pretend to help with every aspect
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of this complicated food environment I
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can provide you with some insight into
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some hope there is a movement starting
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in the UK and it is starting right here
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in Bristol because your local medical
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school is one of the first in the
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country to start teaching future doctors
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not only the foundations of nutrition
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but also how to cook in 2018 I brought
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together a group of nutrition experts
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and doctors passionate about reforming
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nutrition education and UK medical
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schools we ran the UK's first culinary
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medicine course and intense four weeks
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of culinary activities with a
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professional chef nutrition lectures
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with a registered dietician and teaching
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on how to apply this information within
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the constraints of an NHS clinic
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appointment by a GP this unique
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collaborative teaching method took
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students through the
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Packt of nutrition or mental health on
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our guts on our environment and beyond
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we ran the cooking courses in an NHS GP
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surgery right here in Bristol with his
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own fit for purpose community kitchen we
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even had students run their own health
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promotion clinics go into families homes
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and helping them stop their cupboards
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with nutritious affordable ingredients
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and arranged by one of your incredible
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local GPs
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we even had medical students cooking for
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the homeless talking to them listening
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providing a medicine and its purest
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sense this is a career-defining
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experience that all health professionals
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should have it starts a conversation a
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real perspective into the grandeur of
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food beyond just whether something is a
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carbohydrate or full of vitamins all
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health professionals have a role in
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nurturing a culture that appreciates the
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power of food this is how we reverse the
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tidal wave of lifestyle related
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illnesses that threatened to completely
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expend all NHS resources unless we get
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to the root cause of what is causing
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illness in the first place and many died
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many many studies point or diet as the
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contributing factor today we need to ask
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ourselves if we dare to think as
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radically as we have done in the past
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this is not radical this is the norm in
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almost 50% of American medical schools
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but we will make that the norm here in
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the UK as more medical schools wake up
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to the need for nutrition training in
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medicine but if we are serious about
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building the healthiest population
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possible where chronic disease is a
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rarity type 2 diabetes is uncommon heart
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disease affects the minority of people
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if we are serious about giving everybody
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access the
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best possible protection from disease
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then we need to start reforming our food
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systems and our food environment making
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food as medicine not a cute or quirky
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concept but the norm elevating
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nutritional medicine into a recognizable
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mainstream concept in the pursuit of a
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proactive healthier population
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affiliating or GP surgeries up and down
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the country with community kitchens and
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investing far much more research into
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nutrition I've talked a bit about how
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food can prevent disease I've talked to
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you a bit about how complicated this
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food environment is in our little way of
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mitigating that and I want to end this
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talk in the same way I end my clinical
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consultations with some simple tangible
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advice as I promised I'd help you
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prevent disease just one more every time
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you look at a plate of food or you sit
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down to eat just ask yourself can you
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add just one more can you eat just one
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more colorful vegetable portion or nuts
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or seeds or fruit at every mealtime just
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one more if you're having a curry can
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you add some spinach to it if you're
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eating an omelet can you serve it with
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some green beans and even if you're
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enjoying a delicious Cornish pasty can
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you serve that with a side of butternut
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squash mash it's these collections of
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small additions to our diet slack every
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day every week every year that have the
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potential for much larger downstream
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effects the opportunity of having the
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biggest impact on your health is
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actually in your hands it's not with a
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blockbuster drug it's not with a new
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pioneering surgical technique it is with
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the simplest solution is how we feed
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ourselves and I'm hopeful we can
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generate a food focus approach to health
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in our communities instead of reacting
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to disease in our emergency departments
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thank you
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[Applause]