Here is the full transcript of Dr Rupy Aujla’s talk titled “The Role of Food In Health” at TEDxBristol conference.
In this talk, Dr. Rupy Aujla emphasizes the critical role of nutrition in medicine, a topic often overlooked in medical education. He highlights the emotional and cultural significance of food, lamenting the lack of nutritional training in medical schools and the general education system.
Dr. Aujla discusses his initiative to integrate culinary medicine into the curriculum of UK medical schools, combining cooking with professional chefs, dietitian-led nutrition lectures, and practical applications in NHS settings. He stresses the importance of understanding food beyond its basic nutritional components, advocating for a proactive approach to health through dietary choices.
Dr. Aujla proposes the radical idea of integrating community kitchens into GP surgeries and prioritizing nutritional research. He concludes by offering simple, practical dietary advice, urging the addition of nutritious elements to every meal to combat lifestyle-related illnesses and promote overall health.
Listen to the audio version here:
TRANSCRIPT:
The Beginning of a Medical Journey
I was just 24 years old when I saw a patient die in front of me for the first time. I was working as a junior doctor in a busy A&E department. A 60-year-old lady came in having had a cardiac arrest, most likely a result of a heart attack. The ambulance crew had started resuscitation at the scene, and we continued delivering drugs, manual compressions, exactly how we’d all been trained.
But despite our best efforts, we ended up calling her death. And I remember leaving that resusc space feeling so frustrated. This wasn’t what I’d been led to believe medicine was about. I wanted to save lives, not struggle in vain and succumb to losing patients.
And when I went home that night, I refreshed my memory on how many heart attacks there are in the UK every year. It was slightly less then, but now it’s over 100,000. One every five minutes. And 30,000 cardiac arrests occur in the same way this poor lady presented.
Facing the Harsh Realities
Out of hospital. With less than a one in ten chance that they’ll survive. The reality was from the moment the ambulance crew brought her into the department, there wasn’t much we could do. At that point, we were reacting to disease that had been untreated, undiagnosed, and started long ago.
The first presentation of which was her collapsing to the floor with a heart attack. But today, I have 15 minutes to save your life. Or more specifically, I have 15 minutes to help prevent the deaths of roughly 50% of the adults in this audience today, who will succumb to preventable lifestyle-related illnesses. Like heart disease, stroke, and complications of metabolic disease. Lifestyle-related illnesses that cause millions of deaths worldwide and in this country.
The Power of Diet in Medicine
My name is Rupy. I’m an NHS doctor. And the medicine I’m prescribing today is food. But as more people understand the power of our diets to help prevent and in some cases treat ill health, the logical question becomes, “Doctor, what should I be eating?” And if you’ve looked at the headlines or scrolled through social media, you will notice meat eaters fighting with vegans, Paleo fighting with the Diabetes Association, a war of attrition between multiple sides. With the losers being the millions of people just trying to figure out how best to look after themselves.
Today, I’m going to help you with a different approach. Because it seems strange to me that you can have some people who decide to eat a plant-based diet and improve their heart disease markers. Others who choose Paleo and improve their bowel symptoms. While some swear by low carbohydrate and come off diabetes medications.
If these diets are so wildly different, how can they achieve such similar and frankly remarkable outcomes? And the reason why is because a lot of the underlying principles are the same. Let’s take a visual approach. So I’ve taken the liberty of excluding diets that restrict yourself to just eating cucumbers or just pure meat.
The Common Ground of Popular Diets
Luckily, they’re not that popular and they lack an evidence base. But when we look at popular diets that have credible studies, Paleo, low carbohydrate, Mediterranean, DASH, whole food, plant-based, and we map out where the similarities lie, you will notice an abundance of overlapping themes.
And it’s this exercise that reveals the principles behind a lot of them. Naturally, as you would imagine, all of them remove excess junk food, processed foods, excess sugar, as well as balancing for energy control. I think we can all reason with that. But what do they include? Largely plants, fiber, quality fats, and lots of colors.
What do these do? When you eat largely plants, you’re ensuring a selection of micronutrients, vitamins, minerals, but also phytochemicals. The thousands of chemicals that we find locked in roots, leaves, and grains. We used to think that the benefits of plants were just because of antioxidants, but it is far more complicated than that. These chemicals can help regenerate our human cells, help signaling between them, as well as changing their function. Fiber from whole grains, beans, legumes, can contain hundreds of different types of fibers.
The Impact of Diet on Health
And these feed your microbiota, this incredible population of microbes that nurture your health by releasing nutrients. They digest food for you. They balance inflammation. They balance excess sugar. And feeding this population with these sorts of foods is critical to maintaining them.
Fats, essential for your brain health, the precursors to hormones that course through your bloodstream. Quality fats that you find in nuts and seeds are incredible for benefiting your health and contain a myriad of different fatty acids and colors. Food has the ability to interact with the very core of our existence, our DNA.
And alongside other lifestyle factors like stress and sleep, food has the potential to switch genes on and others off. This is the exciting field of nutrigenetics, the power of your food to change the expression of your genes to promote health.
And we know, for the majority of us, it is a diet that consists largely of plants and lots of colors.
The Power of Informed Dietary Choices
Many bodies, including the World Health Organization, recognize that eating a prudent diet consistent with these features lowers the risk of chronic kidney disease, autoimmune conditions, inflammatory bowel disease, cancer, depression, and many more. Beyond just obesity and disease, your plate contains a wealth of information that interacts with your very inner ecosystem in the most powerful way.
And the confusion that surrounds dietary conflict is actually creating an apathy toward motivation and behavior change. What we initially assume as conflicting dietary methods are actually adversarial and complementary in many ways. I want to make it clear here that food is not a panacea. It’s not a cure-all or a replacement for the many drugs and services that I prescribe as an NHS doctor daily, but it is a huge component of well-being.
And it’s this conflict that is creating an issue. I would also love to stand here and explain to you what you should be eating and expect you to just do it, in the same way I can prescribe a pill to a patient and ask them to take it three times a day. But it’s not.
Personalizing Diet for Individual Health
I remember around seven years ago when I started introducing diet into my consultations. I had a 45-year-old man come into my clinic. His blood work showed that he was on the verge of type 2 diabetes. And we had a conversation about how diet and lifestyle can prevent the progression to type 2. He wasn’t keen on changing much about his diet that was full of convenience foods.
But I said, “Look, let’s just start slow. Let’s just start with one meal.” And he said, “Well, I have Frosted Wheaties for breakfast. I don’t really like that. Maybe that.” I said, “Great. Do you like oats?” He said, “I don’t mind porridge.”
“Fantastic. Here’s a recipe. Make some oats. Put some sunflower seeds on it. Add some frozen berries. They’re very cheap. Try that for a couple of weeks. Come back and let me know how you get on.”
The Impact of Simple Nutritional Changes
I wrote down the ingredients for him. He got up to leave. And I thought to myself, “Wow. Rupy, I think you’ve really changed this guy’s life.” And then, as he left through the door, he turned back to me and he said, “Just one more thing, doctor. How do you make oats?” Nutrition isn’t simple for a number of other reasons. Food is an emotive subject.
It’s how we celebrate. It’s part of our culture, our history. Nutritional medicine isn’t being talked about by us in medicine because most of the doctors here in this room were not taught about the importance of food at medical school. Our children are not educated in how to grow or cook as part of their schooling, which is why I have patients that can’t make the simplest of dishes like oats.
And access to healthy foods depends on where you live. The promotion of unhealthy options targets the most vulnerable. And whilst I can’t pretend to help with every aspect of this complicated food environment, I can provide you with some insight and some hope. There is a movement starting in the UK.
The Rise of Culinary Medicine in Education
And it is starting right here in Bristol. Because your local medical school is one of the first in the country to start teaching future doctors not only the foundations of nutrition but also how to cook. In 2018, I brought together a group of nutrition experts and doctors passionate about reforming nutrition education in UK medical schools. We ran the UK’s first culinary medicine course, an intense four weeks of culinary activities with a professional chef, nutrition lectures with a registered dietitian, and teaching on how to apply this information within the constraints of an NHS clinic appointment by a GP.
This unique collaborative teaching method took students through the impact of nutrition on mental health, on our guts, on our environment, and beyond. We ran the cooking courses in an NHS GP surgery right here in Bristol with its own fit-for-purpose community kitchen. We even had students run their own health promotion clinics, going to families’ homes and helping them stock their cupboards with nutritious, affordable ingredients.
And, arranged by one of your incredible local GPs, we even had medical students cooking for the homeless. Talking to them. Listening. Providing a medicine in its purest sense. This is a career-defining experience that all health professionals should have.
It starts a conversation, a real perspective into the grandeur of food beyond just whether something is a carbohydrate or full of vitamins. All health professionals have a role in nurturing a culture that appreciates the power of food. This is how we reverse the tidal wave of lifestyle-related illnesses that threaten to completely expend all NHS resources unless we get to the root cause of what is causing illness in the first place. And many, many studies point toward diet as the contributing factor.
Today, we need to ask ourselves if we dare to think as radically as we have done in the past. This is not radical. This is the norm in almost 50% of American medical schools. But we will make that the norm here in the UK as more medical schools wake up to the need for nutrition training in medicine.
But if we are serious about building the healthiest population possible, where chronic disease is a rarity, type 2 diabetes is uncommon, heart disease affects the minority of people. If we are serious about giving everybody access to the best possible protection from disease, then we need to start reforming our food systems and our food environment. Making food as medicine not a cute or quirky concept, but the norm. Elevating nutritional medicine into a recognizable mainstream concept in the pursuit of a proactive, healthier population.
Practical Steps Towards Better Health
Affiliating all GP surgeries up and down the country with community kitchens and investing far more research into nutrition. I’ve talked a bit about how food can prevent disease. I’ve talked to you a bit about how complicated this food environment is and our little way of mitigating that. And I want to end this talk in the same way I end my clinical consultations, with some simple, tangible advice.
As I promised, I’d help you prevent disease. “Just one more.” Every time you look at a plate of food or you sit down to eat, just ask yourself, “Can you add just one more?” Can you eat just one more colorful vegetable, portion of nuts or seeds, or fruit at every meal time? “Just one more.” If you’re having a curry, can you add some spinach to it? If you’re eating an omelette, can you serve it with some green beans? And even if you’re enjoying a delicious Cornish pasty, can you serve that with a side of butternut squash mash?
It’s these collections of small additions to what our diets lack every day, every week, every year, that have the potential for much larger downstream effects. The opportunity of having the biggest impact on your health is actually in your hands. It’s not with a blockbuster drug. It’s not with a new pioneering surgical technique. It is with the simplest solution. It’s how we feed ourselves.
And I’m hopeful we can generate a food-focused approach to health in our communities, instead of reacting to disease in our emergency departments. Thank you.