Season Four Finale

A season finale. . . with special guests! Edward Phillips, MD, and Juna Gjata, creators of the podcast Food, We Need to Talk, join us to comment on common themes between the two series, and suggest what should be next in your food & health podcast listening line up.

The  first season of Food, We Need to Talk is available online. Two episodes cited specifically in this conversation were: This Is Your Brain on Cheesecake and Disordered Eating and Eating Disorders. We also talked about what makes a "fad" diet and common characteristics of popular diets that don't support sustainable healthy eating strategies, covered in Doomed If You Diet, Doomed If You Don't. The problems with the good food / bad food mindset are explored in Good Food, Bad Food and also What the Heck Should We Eat?

In this first season they do not go deep into diets tailored for treating or managing specific health conditions. But what will happen in the next season? We'll have to tune in March 21st to find out. . . 

The podcast mentioned when I steal Steven Levitt's interview structure is People I Mostly Admire from Freakonomics Radio, which also has a health care podcast in its portfolio, Freakonomics, MD (Steve interviews the host on this 2021 episode).   

You were promised links to microbiome-focused podcast episodes. There are a lot. It is literally a category of podcast unto itself.  A few options that are clear about both the interesting questions before us & the limits of the current science:

• BBC Good Food Health Podcast - Dr. Megan Rossi
• Stuff You Should Know - Your Gut Is Also a Brain
• What Went Wrong at uBiome Part 1 and Part 2 - The Journal (also a cautionary tale in what fraudulent medical billing looks like) 

Find easy links to this season's episodes in order here. And an extended playlist here.

This season of Policy in Plainer English is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) as part of an award totaling $189,892.00 with 0 percentage financed with non governmental sources. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by HRSA, HHS or the U.S. Government.

This podcast is part of the Food Access in Health Care program at Bi-State Primary Care Association.

Transcript

00:00

Welcome to the Policy in Plainer English podcast, I’m your host Helen Labun and this is our season finale episode.

Now, we do our final episode in a more conversational format . . . and this time is no different. What is different is that I’m bringing in guests from outside of my own organization, which means no cheating by handing them talking points for their side of the conversation. 

To manage this, I’m stealing a trick from one of my favorite amateur interviewers -- the economist Steve Levitt. He likes to have editorial asides with the audience explaining what he’s trying to do in the interview section ahead. And if there were ever a podcast episode to try out the techniques of other podcasters, it’s this one because my guests are the hosts of the Food, We Need to Talk Podcast. Juna Gjata and Dr. Edward Philips, who is usually introduced with the words ‘everyone calls him Eddie.’ I’ve heard that at conferences and symposia and research presentations. . . even when I asked him before we started recording what I should use he said “everyone calls me Eddie” – which, I’ll note, isn’t precisely the same as “I prefer to be called Eddie.” I may be overly suspicious since I’m married to someone who screens calls by whether the caller refers to him as Larry. 

These guests are the perfect pair to test something that I’ve been self-conscious about, which is that on my podcast, I have guests introduce themselves – something you’re never supposed to do, according to the people who write ‘how to podcast’ guides. Here’s the thing. If you’re using a podcast, which isn’t live and has lots of editing to make everyone sound the best, then it’s a great way to get people who don’t normally engage with the media share their perspectives. It also means that when you ask for a bio, you sometimes get a half page dense with professional citations, and sometimes get an email with the directions “just say whatever you want.” When you let people introduce themselves, it all kind of evens out naturally. So let’s see what happens here. 

01:59

PHILLIPS: I'm Dr. Edward Phillips. I'm an assistant professor of physical medicine, re rehabilitation at Harvard medical school. And I've been working at the VA Boston healthcare system for the past six years as the whole health medical director.

GJATA: Wow. Eddie, that's a really fancy title. I'm jealous. I'm Juna Gjata. I am not a professor, but I did go to Harvard a very long time ago. And I host the podcast as my full-time job. And I post a lot on TikTok and Instagram and YouTube.

LABUN: And I am Helen Labun and looking at my 20th college reunion coming up this year, I would say that Juna did not go to Harvard really long ago.

02:35

LABUN: Look at how quickly they got me to reveal my age, those are two podcast interview pros. 

The combination of a doctor with a long career in whole person care, partnered with a recent college graduate, is a key dynamic for their podcast Food, We Need to Talk, which began at WBUR in Boston and has since been picked up for distribution by PRX. Unlike this podcast, which is grant funded to create educational content on specific topics, their podcast is a scientifically-informed reflection on our relationship with food – that also needs to gain traction with a popular audience. Balanced coverage of basic science in food and diet has not always won the clickbait wars against promos for the latest miracle berry. Remember our interview with the chef-educator who said the registered dietitian gave a sensible health diet plan, then she came in with her culinary skills to make that diet sexy? Think of this as the podcast equivalent. It seems right, then, to begin with the origin story of their podcast before delving into some of the topics they’ve covered. 

03:39

GJATA: I will go ahead and start with this Eddie, and then I'm gonna let you come in when you come into the story. Okay. So basically Helen, the way the podcast started was when I was in college, I would say I got very, very into fad dieting and kind of like fad exercise programs. And I would never really describe myself as overweight in the clinical sense, but I was always trying to lose weight. So I was always trying to be like 10 to 15 pounds lighter than I actually was. And it led to a lot of very detrimental behaviors. I would say it's a lot of like very low calorie eating, like counting on my calories, blah, blah, blah, a lot of over exercising and whatnot. And around senior year of college, I got really into lifting weights, which introduced me to the whole evidence based fitness community on social media and in podcast circles and stuff like that.

And that was really my first introduction into the fact that a lot of these topics like nutrition and exercise that I always saw as kind of not making sense because, you know, one thing would tell me to do this. Another thing would tell me to do the opposite. It was always so confusing. A lot of it was actually not really debated in the scientific community. Like of course there are aspects that we might argue about, but a lot of it really isn't that complicated. And it's just very, very misrepresented in media. Usually, because people have a financial incentive to sell some sort of diet program or some sort of exercise program or something like that. 

And so I kind of became obsessed with fitness senior year of college onward. The gym was my entire life. It was all I thought about. It was all I talked about. I was really annoying to be around, but I was just really, really excited because it was the first time in my life I had actually liked to exercise and been really excited to care about my body. Not just always trying to be thinner. 

And so about a year and a half after I graduated college, I always thought I wanted to be a pianist. And so I was preparing my grad school auditions and it had just come to the point where I realized I did not want to do piano because I didn't to be alone all day. And so I sent an email to a health editor at w R and just asked her if I could come in and ask her about her job and like, just find out more about what she did. And I brought a paper and one line on the paper was like, you guys should have a health podcast. And in our conversation, she was just like, “wow, you seem really passionate about this, would you like to write a blog for us?” And I was like “a blog? It's not 2005. I wanna host a podcast”. And that was kind of how it started. So she said, “okay, send me an outline and send me any experience in audio you have”, which was none. And so I wrote the outline and that's kind of, the rest is history. And then I'll let Eddie take over on how he got involved.

06:21

PHILLIPS: So the producer at WBUR, Carrie Goldberg, was the then CommonHealth reporter, or she ran the CommonHealth blog. I knew her from a prior podcast that we did together called the magic pill. And when Carrie and I did that podcast that actually won an Edward R Murrow award for excellence in innovation. And when she met Juna it was Carrie's judgment that, well, maybe this would come across better with sort of two voices rather than one. So I was invited in to meet Juna, quickly, from my perspective. I'm a physician who is devoting more and more, pretty much all of my time now to not just taking care of disease, but promoting health, through improved health behaviors -- parenthetically, nothing they actually teach in medical school -- that's why we're trying to change that. So I see the podcast as this wonderful way, instead of talking to 10, a dozen or a thousand patients a year, we can reach tens or hundreds of thousands of people.

07:23

GJATA:  And I'd say our relationship on the podcast is very much like . . .well, the way me and Eddie are on the podcast is the way we are in real life. And I think a really good way to describe it is like Eddie is my American dad. So, I'm very Albanian. I have very Albanian parents. And, like, when me and Eddie were recording the podcast, we just had to spend a lot of time together and he would always give me rides to and from the studio. And so on our car rides, especially, he would just be like, “can I give you some life advice about this thing?”, you know, blah, blah, blah, blah, blah. And I was like, sure. And so after a while, I was like, oh my God, Eddie's like my American dad, you know, we spend so much time together and we're constantly learning from each other. And I think that's what people love about the podcast is the dynamic between the two of us and also the two very different perspectives we bring to these topics that affect us all. But I think depending on how old you are, and even like what gender you identify as, and stuff like that, these things can really impact you differently. And I, we bring two really different perspectives to topics that are really important to a lot of people.

08:24

LABUN: And, and I'm alone as a podcast host with no one to give me advice. So, a couple of things that you mentioned that I think play well to the two different perspectives. When we think about our relationship with food and setting goals for food, you know, this description kind reminds me of me in high school, except for, I didn't have the advantage -- or the disadvantage -- of Google and the internet, right? I was in the gym every day, trying to make my biceps as big as possible, mostly because at that time I was hyper focused on being the best open weight, female wrestler in America. 

GJATA: I love it. Right. 

LABUNL And that, and that was my goal. And if I would've had a way to accommodate fad diets to reach that goal, I am a hundred percent sure the fad diets would've been all there. Now, in my social group, as we enter our forties and fifties, it's a lot more talk of anti-inflammatory diets and energy diets and diets for hormones, which I don't even understand, but I'm wondering, and maybe this is partially more for Eddie, just from talking to patients often, about how specific, when you talk to folks, are they getting about their goals for diet? Do we have this image that the goal is always just to be thinner than you are right now, which is when we hear a lot about in popular culture or is it more refined? Like I want a diet that can help me achieve X, Y, and Z health goals.

09:48

PHILLIPS: So, the approach that I've learned to take over the last few years, and this is a constant evolution of practice, and this comes from the work at the VA, is to actually step back and ask a much broader question, which is, you know, dieting is a thing that you could do, but let's not talk about that until we figure out what your health goals are, what your purpose on this planet is, what you want your health and, you know, sort of what activities you're, you're trying to do. And then let's figure, is there a modification to how you're eating that makes sense. So I kind of go right for the “why.”

Dieting is remarkably fad driven. Back when I was growing up they were talking about the Scarsdale diet and counting your calories. And then, and then weight Watchers said, “oh, don't count calories, count points”, which were just calories summarized into points. And now we talk and then we started talking about macros, and then a big thing now is talking about types of food to avoid. So fill in the blank, you know, you're gluten free, dairy free, GMO free. You're defining what you're not eating sometimes much more than what you are eating.

LABUN: To the discussion of finding your “why”, I think a common theme in these is the idea that somebody else is setting your goal for you, whether it's through marketing a diet or something else. And something that was discussed on your podcast was the idea of engineering hyper palatable foods. I would say, this is the same sentiment as the fad diet, except for kind of the opposite, right? What we might call junk foods. But now they're hyper-palatable foods that are engineered to eat a lot of and consume a lot of calories, but still with that same theme of somebody else setting your food goals on your behalf, through the food environment. Let's talk a bit about those hyper palatable foods.

11:43
 LABUN:  Editor Helen is stepping in here to set up the next bit for those who haven’t listened to Juna and Eddie’s podcast. 

First, obviously we’re going to link Food We Need to Talk from our show notes at PlainerEnglish.org, and the bit we’re about to get into is largely from the episode This Is Your Brain on Cheesecake. Yes, they write catchier titles than I do. 

One topic explored across the Food We Need To Talk episodes is the psychology of our relationship with food and the different factors that influence how we think about ourselves in relation to our diet, much like we were just discussing. Another topic is the neuroscience of how our brains respond to food as a stimulus. We’ve addressed that in a non-neuroscience way on this podcast, looking at how different professions approach the question of making a food more or less appealing – in our case towards the goal of helping turn the diet we intend to follow -- or, depending on circumstances, *need* to follow --- into a diet we’ll also enjoy. Their podcast got deeper into the science and also into the darker side of that quest to make foods appealing, the foods that we loosely refer to as, quote, addictive, or junk food, or as we said, hyper-palatable. Which is where we’re now heading in the conversation. 

The other thing you need to know is that among people pushing back against that hyper-palatable engineered paradigm is the often-invoked Michael Pollan rule of Eat real food, not too much, mostly plants, and the Alice Waters example, which Michael Pollan often refers to, of a perfectly ripe piece of fruit – either a nectarine or a peach depending on who tells the story – being a satisfying and complete dessert.    

Okay. You’re all caught up. If I were Steve Levitt, I would clue you in that my goal in this next part of the interview is to induce my guests to draw connections between ideas presented in their podcast and the different angle that my own podcast took on similar issues. Mostly, though, I’m just thinking how glad I am that I chose people who seemed like the nicest hosts in all of podcasting for my practice run at this type of conversation. 

13:39

GJATA: When we use the word addiction. When we talk about foods, addiction is actually a very biological process that happens in the brain. And in terms of does food addiction in quotes look the same as like an addiction to cocaine or heroin's mother substance like that in it does not. It does not create the same dependency where you need the drug in order to, you know, overcome the withdrawal symptoms of not having it. But there is a lot of similarities in the sense of there's a dopamine response in your brain, particularly to hyper palatable foods that is, is very hard for people to resist. So when processed foods are being created, there is so much research going into every aspect of that food in order to make it very crave-able and not portion controllable. 

So, for example, putting salt, sugar, and fat together, those three things almost never come together in nature. Things that are salty are not usually also sweet and things that are fatty are also not usually sugary, right? Like, fat usually comes in animal products and sugar usually comes in fruits or maybe honey, and those things don't come together in nature. And they're all, independent of themselves, they're all very pleasurable tastes for almost all creatures. And then when you put them all three together, something that the human body has never had to encounter before. It's like this like overload of like, oh my God, this is so delicious. It's amazing. And of course, what are, are most hyper palatable foods full of? It's salt, sugar, and fat. And so when you have things that are being made to be so irresistible, it's very hard for people to eat a normal portion. And it's very hard for you to feel full on them because they're also extremely calorically dense.

So they have a lot of calories for a very small volume of food and they don't really fill up your stomach. So you're not going to get full on cookies the same way you would get full on a vegetable because there isn't as much water in the cookie that fills up your stomach with substance. So they're very easy to overeat. They're very high in calories. And beyond that, even the coloring, the packaging, the words used in the marketing, how crunchy it is, the mouth feel, the texture, all of these things are being researched constantly in order to pick the tastiest most appealing way to present these items for people to buy and eat. So is it addictive in the same way a drug might be? No. But does it cause people to, to engage in behaviors that we often see associated with addiction? Yes, because they will keep eating and overeating and engaging in behaviors that might not be good for their long term health. And they might know that, but they're not able to stop because it's kind of asking your biology to work against you.

PHILLIPS: When we talk about the parade of different diet diets that are out there now, and we can go from paleo to vegan to now there's even keto which is a crossover to, to elimination, diets and intermittent fasting. And no matter what you name, the one thing that they primarily all agree to is to avoid the foods that you describe,

GJATA: Right? Yeah.

16:53

LABUN: On the show, and not to put any blondie eaters on the spot here, but there was a very good description of one of these hyper palatable foods. And I'm wondering if we could have a quick recap of that description.

GJATA: Oh my God. Okay. Guys, my contribution to the obsession with hyper palatable foods. Okay. When I was little, we would go to Applebees a lot because there was an Applebees near my house and my family really didn't eat out that often. But when we did, we would often go to Applebee's. And the reason we always went is because there was a Blondie there, which I believe is still there, although they have slightly changed the recipe. They would come out with this skillet and it would be still sizzling from the oven. And it would have a Blondie, which is like a cake, on it. And then on top of the Blondie, there's toasted crunchy walnuts and there's cold ice cream. So you have like hot, super, super hot sizzling, but also cold ice cream, crunchy walnuts, and then a cream cheese maple kind of glaze that would be in a little boat next to it that you could pour over it. And that was me and my sister's favorite thing on the planet. It was so, so, so good.

LABUN: What I like about that description --  and this is going to lead to me disagreeing with Michael Pollan, which I know is a very, very dangerous territory to wander into in the food world. What I like about that description of the Blondie is that it gets to a lot of things that I think we are intuitively tuning into with some of these foods that we really enjoy. The sizzle, the sound that gets us ready for it. The contrast of the hot and the cold, the contrast of the textures. It's not just about the sugar, salt, and fat, it's these other elements that can be transferred over to healthier options. I think that while it is possibly true, that we often hear from advocates for healthier eating that, you know, the perfectly ripe peach will taste just as good. Well, first off, I don't think I've ever actually had a perfect peach, but also those more manipulable -- is that even a word? Malleable? Adjustable? -- elements of a dish does give us a bit more control in moving from what we're used to, if we're used to eating in that engineered world. And we don't lose all the elements of that when we go towards a healthier diet.

19:13

PHILLIPS: If you talk to learn from a chef, they talk about not just serving food that tastes good, but engaging -- as you just summarized, Helen -- all of the senses. So there's how the food is plated, which is kind of the visual, and how it's finished, where you put dark on light and light on dark, you know, little, little Sesame seeds on something dark and, and, and, and just sort of the visual appeal. And then of course hearing the, the sound of it cooking. It doesn't have to be a Blondie. You could do that with other, you know, other, other foods. And then of course there's the smell. And then, and the last thing that you get to is even the taste, but there's even as, as Juna mentioned, the mouth feel, that's sort of a, another sensation. You can do that with a really nice plate of vegetables. And I wouldn't call that manipulation. I would just call that good cooking.

GJATA: Yeah, I totally agree. I, I think that's such a good point, Helen, that I think people think healthy food has to be very boring and yeah, there, if you compare a Blondie to a fruit, I don't think it's a fair comparison, especially if you're used to having a diet high and hyper palatable foods, we kind of talked about this, but there's that we interviewed the researchers who actually conducted this on mice, who if you give them hyper palatable food and they have it for a while, and then they go back to their regular diet, they will actually starve instead of eating their regular food, because they're used to hyper palatable food and they just don't like the way their old food tastes. So there is some changes that happen in your brain when that's the diet you're used to. And I think if you start to incorporate more healthy foods and you get used to it more, then yes, maybe you don't need to be as fancy with your cooking.

And you can really enjoy fruits for fruits and vegetables for vegetables. But when you're making the transition, then like giving yourself a reason to want these healthier foods is really, really important. So trying to make them have good mouth feel and differing textures and differing temperatures and really seasoning things. Like I think people don't season things enough and they don't venture out into new spices and new flavor regions. There's a lot you can do to make things taste better. And also to help you transition from more processed food to less processed food.

21:33

LABUN: Now, I introduced that question with the positive spin of what we can learn from these foods to help transition to a healthy diet. Obviously there's the other take on the alarming mouse study of starving rather than eating the healthy food. And this is one that I feel like I hear somewhat often in my world, of just feeling as if the deck is so incredibly stacked against healthy eating that the food environment that folks are in, the messages received, the fact that your brain does change its signals and what it craves and what it responds to that . . . that kind of adds up to a hopeless situation in terms of reversing some of the diet related health concerns that we see. How do we feel about the individual's ability to fight back against the food environment or, alternatively, I work in policy, right? One of our main premises is, well, what we're seeing today, isn't it has to be tomorrow, right? We could redirect some of where those excellent minds in food engineering go in the next round to something that, that does entice us down the healthy path.

PHILLIPS: So recently I went out to a live medical conference -- real people, wearing masks -- called Healthy Kitchens, Healthy Lives, held every year at the Culinary Institute of America, sponsored with the Harvard Chan School of Public Health. And one of the most provocative moments of the entire conference was one of the teachers of Wesley Medical Ceter from Texas talked about the food environment that you mentioned. And think about neighborhoods, where you cannot get healthy food. And he described it as a food apartheid. And I thought, “oh, that's accurate”. That there were places that even if you were well-meaning and you wanted to get fresh fruits and vegetables, you can't find them within, in a, a, a distance that makes sense. And if you don't have. . .  thinking more in perhaps in a, an urban area, but if you don't have a car it's gonna be tough to, to get out.

So that's how dire it is. And, and that's what adds up to a measurable, incredibly impactful decrease in the life expectancy in certain neighborhoods. 

So that's the, the more dire part. On the other hand, I am continuously impressed – and this  is what I love about clinical care -- hearing stories of resilience from my patients who just simply say, like, “I have had enough” and they say “I just didn't wanna live like this anymore, and it wasn't that hard.” To start to evolve away that these addictive foods that we've talked about, when you start to cut back and stop eating them, they're less addictive and you can find apples and you can find, you know frozen vegetables, as a start. So, I'm always impressed by the efforts that allow people to learn, maybe not to be a chef, but enough to put dinner on the table at home. And they start to realize that it's actually cheaper and obviously more healthy. So, I'm not despondent about it. I think that we, we need to work at the policy level that will make it easier for everyone, but we also need to work at the individual level and, and at all interfaces.

24:55

GJATA: And I'll just say, we have an upcoming episode where we interviewed an expert in basically your body's biological response to dieting and how there's all these things that will happen to your body that make you more likely to regain weight and make weight, gain more desirable. They increase your appetite, it lowers your natural biological drive to move. There was all these things that, honestly, just made it sound hopeless. Like, why should anybody ever try to do anything? Because it just seems like your bodies were working against you every single turn. And even he said, at the end of the interview, that like people always interpret his research as really depressing and like, oh my God, there's no point. But he said, the amazing thing about humans is that we are not, we are not susceptible to just our biological drivers. We are always at the end of the day in control of our decisions.

And yes, we live in an environment right now where there's a lot of very unhealthy food and it's very easily accessible. And for some people even more so, like Eddie mentioned, I think that's a really, really important point that a lot of people just don't have the privilege of having easy access to healthy food. But even the people that do, it's like at the end of the day, it is a tougher environment to grow up in. But it just means that we have to rise even more to the challenge. And there have been other challenges in the past that we don't have now. And unfortunately, this is one of the ones of the 21st centuries, an abundance of unhealthy easy calories. And so at the end of the day, like, we're making our own decisions. We can try to be as informed as possible. And we're all trying to do our best. Nobody's going to do perfectly. But hopefully if you have at least the scientific basis, you can make better decisions.

26:36

LABUN: Taking some of this biological brain response science work down to an individual level, one thing I'm wondering if you can help me square up -- we talk also about intuitive eating, knowing your hunger signals, not labeling foods, good or bad, that approach to being at peace with food and diet, as opposed to a strict dieting. But how does that square the science? If you haven't been eating healthy food, you've been training your body to react to unhealthy food and all the disruptions to those signals. How do these two lines of thought fit together?

GJATA: That is something that I think I have struggled with the entire time we've been reporting, because on the one hand, I have a very Type A personality where if I learn something as bad for me, I'm like, okay, I'm never touching it again. And on the other hand, when you look at the research on restriction of making very strict rules about food for yourself, it's very, very bad. It does not lead to better health outcomes. It makes, it makes people very stressed. That increases anxiety. It increases propensity for eating disorders, and there's all these really bad effects associated with it. Right? So how do you square away these two things? I think there's a kind of medium ground in the sense that when we talk about ultra-palatable food, I think of that as very directly affecting your biology. But when we talk about intuitive eating, I think of that as very much affecting your psychology.

And at any given time, you have biological drivers and psychological drivers motivating your hunger or your cognitive hunger or physical hunger. And so I think you have to reach this balance where if you want cake on your birthday, that’s totally fine. And you should allow yourself to have cake on your birthday because it's your birthday and that's what you want. But at the same time, maybe having cake in the house every day, readily available, is just setting yourself up for a losing battle or an uphill battle, because you know, that that cake has a very profound impact on your neurobiology. So I think there is a way to balance both of these things, but it is hard because, especially if you're the type of person that tees more towards extremes, then it's hard not to cut it all altogether and then end up making it even more desirable and end up having binges because you cut it out completely.

PHILLIPS: I'll, I'll answer a little bit of a different way. Know the field of medicine that I practice, physical medicine and rehabilitation, is all about adaptation. It's all about recovering from injuries. And we don't care whether you lost a leg or hit your head or a spinal cord injury, or sprained your ankle. We're gonna help you regain your function. And we do that through, at any age, you can get your muscle stronger and become more functional. So if you have a goal, you will get from Point A to Point B in the world of food, your body is endlessly adaptable. So yes, you may be eating a, what are we gonna call it, a hyper palatable or Standard American Diet – SAD - right now. But as you evolve, if you choose, you will actually favor different foods. If you haven't done a an episode on the microbiome, that's maybe where it's at.

30:01

Editor version of Helen cutting in again, because no, we haven’t done an episode on the microbiome, but we can link episodes other people have done at PlainerEnglish.org. Long and detailed and still-somewhat-mysterious scientific story short, your microbiome is a community of trillions of micro-organisms living inside of you, and most commonly it’s referring to bacteria in your gut. The composition of the microbiome changes due to a variety of factors and a big one is diet – including elements often under-represented in the typical American diet, like fiber as part of nutrient dense foods and a diverse range of ingredients.

in particular, fiber in your diet and the diversity of your diet. Your microbiome affects how you feel – in almost all senses of the word. It influences physical indicators of good health, how your body processes medicines, and also your feelings, including what foods you crave. The exact mechanisms remain in the research stage. But the key point for this conversation is the positive feedback loop our microbiome can create as our diet evolves. It could offer one antidote to the biological responses that reinforce unhealthy eating patterns– and Eddie’s use of the term ‘evolve’ is useful here because it reminds us that this is not all or nothing, an on- off switch of a healthy or unhealthy diet. The steps forward add up and it’s possible for them to build on each other at an increasing rate as reinforcing responses like those of the microbiome kick in. And, remember in previous episodes where we discussed how cultivating a flexible and expansive diet can help us in the future if we need to make modifications, building a resiliency for responding to changing health conditions? Well, our microbiome also appreciates that diversity in our diets, and it also has this positive effect on our future diet, so a flourishing microbiome might be another reason to practice some techniques for exploring new food horizons.   

31:51

LABUN: The microbiome is a good lead to one of my last questions, which is to say something a little bit nice about fad diets. One thing that I like about those diets, which I have never successfully, or even made a serious attempt at following to the letter, but the extreme diets tend to lead to very creative recipes. I love my paleo diet cookbook for condiment recipes, for example. I've learned a lot of new dishes and new ingredients that I never would've paid a attention to if they hadn't suddenly become fad popular associated with one of these diets.

GJATA: Yeah. I think that, like you said, fad diets actually do lead to a lot of the experimentation. Nutrition is so individual, like maybe some things are universal, like hyper processed foods are hard for us to portion control, but other than that, there really are no universal rules about: this diet is good for this person, therefore it's also good for another person. So I think it leads people to actually try out different things and see, like, what your body feels best on. If you're an endurance athlete, you're gonna be having a diet that's significantly higher in carbohydrates than somebody who leads a more sedentary lifestyle and is sitting all day, right? Because you really need those carbs for fuel. So trying out different things for your body is a great way to learn about your body, but also a great way to learn hacks for food.

And I get my info, personally, a lot from TikTok. I'm sorry. I know it's a very like young person, annoying thing to say, but they just have the craziest recipes. And I feel like especially vegetables and fruits right now are having such a resurgence because of things like cauliflower rice or cauliflower pizza crusts, or even the air fryer is like a revolutionary a device for everybody because any vegetable with olive oil and salt and an air fryer is delicious. So there's just a lot of things. I think, especially the internet and blogs, Instagram, TikTok, YouTube, all of these things, really democratize sharing new recipes and new hacks for food. And I love that. And especially because people eat so differently, you can always learn from other people and how they're eating. And I just think that makes food so much more fun.

LABUN: Thank you so much for coming onto this podcast and, and talking to us about some of the themes that you explored in your own. Is there anything else you would like to add for the listeners on the topic of food, diet, and health or insights that you gained over of the course of creating Food We Need to Talk?

34:23

GJATA: Eddie, you go first, you got it. Eddie.

PHILLIPS: Before you decide to make any change to your health behaviors, whether you're gonna pick up exercise or change your diet, just stop for a moment and kind of question why you want to do that and ask yourself the why behind the why. If you go, like “I want to be so thin”, why do you want to do that? Well, because I don't think I look good, or I'm not, I'm not confident. Just sort of dig down a little bit, come up with a reason why it's even worth making a change. Once you find that, then whatever change you set out to do is actually going to be more achievable. I've got lovely examples of patients who, when I push them a little bit, they go, “I wanna be able to throw a ball with my grandson, but my knee hurts too much”. Like, they have a very strong “why”. Once they've established that, now they're willing, they're ready and they're able to maybe eat less hyper palatable food, understanding they'll lose weight, take the stress off their knee, do their exercises because what they hold most dear is their grandchild. So, I think that's sort of the general rule by which I try to care for my patients and by extension the people listening to our podcast. And I would say, in regards to food, don't let food be your enemy. You know, make, make, make peace with your food. And if that takes some experimentation, if that grace and that peace is somehow achieved by listening to Juna and I, then we've accomplished our goals.

GJATA: Eddie, that was so beautiful. The thing I'm going to say is that one of the most important lessons I learned through the podcast and just through my own experiences, but especially having to verbalize it through the podcast is making changes out of self-hatred, never actually leads to long term changes. So I did a lot of dieting and exercise changes and stuff that I would say, if somebody asked me, it was quote unquote for my health, but it was really because I didn't like my body. And like, I felt very unconfident and that always led to the most extreme behaviors and very detrimental behaviors, that I had to pay much bigger costs for down the line. Whereas if you really make changes out of self-love, then you are just set up so much better to make long lasting changes, because they're not gonna be extreme. They're not gonna make you suffer. They're not gonna make your life miserable. And at the end of the day, if you love the changes you're making, that's, what's gonna make them sustainable changes. So I would say approaching all the changes you make in your life out of self-love, instead of hatred was like the biggest lesson that I learned through the podcast and something I still, you know, practice to this day.

37:04

LABUN: If you want to hear Juna and Eddie’s episode that deals specifically with disordered eating, that too will be in the show notes. It offers some good framing on what to watch for and why. Much like the series as a whole helps define where scientific consensus lies on diets that do, or do not, support good health, and why. Which is a heartening perspective. Yes, there are signals right now that our country is in a diet-based health crisis. Which isn’t remotely heartening. But at the same time this isn’t like solving the problem of commercial scale fusion energy, the margin for error in diet is, for most people, quite wide by comparison. It accommodates a *lot* of variability. And, as this podcast series has explored, within that variability we have options for finding foods that suite our own personal tastes. Even if, sometimes, we need to make a change from what has been familiar. 

This brings us to the end of this season of Policy in Plainer English. But never fear, coming March 21st there’s something else to take its place in your podcast queue. 

38:07

GJATA: If you are interested in hearing me and Eddie, talk more about food, nutrition, metabolism, exercise, all these topics and more, you can find Food, We Need To Talk on any podcast platform distributed by PRS and we will be back on regular posting schedule every two weeks starting March 21st. We will see you all there.

LABUN: That's right. Get caught up on what you might have missed from this season of Policy in Plainer English. Then listen to the complete first season of Food, We Need To Talk. Then get ready for a new episode every two weeks in Food We Need to Talk, possibly forever.

PHILLIPS: That's the plan that, that, that's what the contract read.

LABUN: It's a lot of listening to look forward to.