AL Andrew Leigh
MN Manny Noakes
MN We once did some interesting maths in Australia, the weight gain over a decade and what that meant in excess kilojoules and how many people that could feed, and it turned out to be several million people for a year.
AL My name’s Andrew Leigh, and welcome to The Good Life, a politics-free podcast about living a happy, healthy, and ethical life. In this podcast, we seek out wise men and woman who have lessons to teach us about living life to the full, with humour, pleasure, meaning and love. We’ll chat with musicians and athletes, CEOs and carers, about making the most of this one precious life.
If you like this podcast, please take a moment to tell your friends or rate us on Apple Podcasts. Now, sit back and enjoy the conversation. Two thirds of Australian adults and a quarter of children are overweight or obese. Half of us don’t do enough exercise, nine in ten of us don’t eat enough vegetables,
AL In 2005 the CSIRO published the Total Wellbeing Diet what they said was a scientifically proven diet for Australians. Their diet book has since sold more than a million copies knocking Harry Potter off the bestseller list and winning the World Food Media Award. But the diet was not without its knockers, including a critical editorial in the journal Nature. Still, it’s fair to say that it’s Australia’s most popular diet today.
The principal author behind the Total Wellbeing Diet was Dr Manny Noakes, Senior Principal Research Scientist in the CSIROs Nutrition and Health Program, with 200 papers to her name and an H index of 44, just trust me that’s impressive. Manny has three CSIRO Medals and serves on numerous expert government committees. We’re here to talk about eating well, a critical aspect of a good life. Manny, welcome to the podcast.
MN It’s a pleasure.
AL What was your relationship with food as a child?
MN Very passionate I have to say. In fact, perhaps too passionate. I was somewhat of a chubby child. In fact, by the time I was 11 I do recall weighing 11 stone. So, I think I probably used food for comfort quite a bit. But also coming from a Mediterranean background, Italian, food was really quite central to my life and still remain so.
AL When did that change?
MN It hasn’t changed, food is still central to my life.
AL Yes, okay. But you're very svelte now.
MN Yes, certainly. Well, I wouldn’t say svelte. But look I think I always had an interest in food and health as I grew older. And probably my teenage years I was much more concerned about body image issues and probably in my early 20s started to seriously tackle weight.
And I do recall back then, and I can mention it on air, but the old Weight Watchers program was one that I thought was an excellent program and one that is actually not so different to the Total Wellbeing Diet as it was then. It was a high protein eating plan, it was quite nutritionally balanced, it was very prescriptive, so you knew exactly what you were doing.
And there are a lot of elements of that that really helped me to really cope with eating less and eating better at the same time. And so that really was an important turning point for me but also it meant that I became very interested in nutrition and health. I did a Bachelor of Science at Adelaide Uni, and I then went on to do nutrition and dietetics a few years later.
AL So, was it your own relationship with food that drew you into research or was it something about the scientific exploration that most attracted you?
MN I think it was both. I always really enjoyed biology at school and understanding how things work in the body and so I think it was a combination of both the culinary aspects and the scientific aspects. And sometimes people say, oh look, doesn’t it take away the enjoyment of food looking at it from a nutritional end and I would say exactly not.
Because it just gives you another dimension from which you can enjoy food, not only from the culinary dimension but also from that nutritional dimension as well.
AL So let’s talk about your most famous diet. I've got a little sort of simple rundown as to what a day on the Total Wellbeing Diet might be like. 40g of high fibre cereal, 250ml of low-fat milk, two slices of wholegrain bread, two pieces of fruit. For lunch 100 grams of lean chicken, fish, or eggs. For dinner 200 grams of lean beef or lamb, two and a half cups of vegetables, 200 grams of low-fat yoghurt, three teaspoons of rapeseed oil and each week two glasses of wine.
That makes it a high protein, moderate carb, low-fat kind of diet. So, I'm wondering if you can talk us through each of those aspects of the diet. Starting with protein, what role does protein play in healthy eating?
MN First of all I’d like to say that the Total Wellbeing Diet is really based around whole foods because that’s how we eat food and food is more than just the macro nutrients that it contains. However, what we do know from both our research and international literature is that protein is a component that really has not just an impact on body composition and muscle mass but also has really important effects on appetite regulation.
MN And you might say, well, a lot of people eat when they're not hungry and that's true. But if you are trying to lose weight you will get hungry and therefore having enough protein is really important to be able to cope with saying no at times when it can be a little bit more challenging.
AL Do you have a favourite source of protein yourself?
MN I like all protein sources. I like dairy protein sources, ricotta is one of my favourite foods. But I like meat, I like chicken, I like fish. It’s really how they're prepared and what they're prepared with that really makes the difference.
AL And there's been a lot of focus recently and I know CSIRO has done some work on this and the environmental impact of eating a lot of animal protein. Are you encouraging people increasingly to look at eggs or at fish rather than, what is it, feathers and fins rather than fur?
MN Look I think that’s a really complex question. At the moment we’ve just published a very comprehensive review on diet and the environment in the literature around that. A lot of the literature is based around greenhouse gasses which is only one dimension of environmental impact, it’s not the only dimension important though it is.
MN And when we’ve looked at the environmental impact of different dietary patterns what we see is perhaps the two most critical elements of what we could do to help the environment is to avoid food waste. And food waste is twofold, one, overconsuming food is food waste and then the food that we actually throw away is also food waste.
And both of those things are a major contributor to environmental impact. And we can focus a lot on trying to shift the dial from one thing to another but if we’re trying to achieve better health as well as environmental impact changes then we need to look at the bigger picture. And basically, eating less and eating a healthier diet will actually help to lower the impact from the food that we use.
And we believe that that’s a much more palatable message for people, they’ll understand that more than trying to work out how many food miles which may or may not have anything to do with environmental impact or avoiding certain foods etc. So not wasting food is critically important and both at the level of the consumer but also post-farmgate as well
And eating just enough to meet your needs and enjoying that food, so it’s all about quality of food not quantity. And I think that part of our obesity challenge is really the fact that we have focused a lot on upsizing and quantity. I think that is shifting, I think we see some really good signals that people are focusing much more on smaller amounts, smaller portion sizes. And that's starting to become more popular and more mainstream and that's a really good direction for things to be going.
AL Yes, I lived in the United States for four years and I remember traveling through Texas, sometimes being struck by the fact that one regular meal seemed like it would contain enough food for an entire family to eat for dinner in many parts of the world.
MN We once did some interesting maths in Australia, the weight gain over a decade and what that meant in excess kilojoules and how many people that could feed, and it turned out to be several million people for a year. So, in other words, the excess that we consume, although can’t directly go towards feeding people, but we hear a lot about population growth, and we’ve got to grow more food. I think we probably need to look at how we can make that food go further.
AL That’s a nice way of putting it. So then looking at carbohydrates, many of my friends will say when they need to lose weight the simplest rule of thumb is cut out carbs. Atkins and Paleo are essentially designed around this idea of just lose the carbs. But the Total Wellbeing Diet has moderate carbohydrates in it. Why is that?
MN Well, carbohydrate foods are really important for gut health. We now understand that the gut has a microbiome that we need to feed and carbohydrates that are less well digested will help to increase the number of healthy bacteria in the gut. So, it’s very good for digestion. But also, carbohydrate foods contain certain nutrients like thiamine and other components.
MN That said, the CSIRO and I also and my colleagues have been involved in studying low carbohydrate diets, that’s one of my areas of interest from way back. And my good colleague Dr Grant Brinkworth has launched a low-carb diet into the marketplace. And this is a particular low-carb diet that’s very well balanced. And so, it is possible to have a healthy diet that’s lower in carbohydrate provided you choose that carbohydrate carefully.
It generally needs to be low in glycaemic response and also high in wholegrain. So, once again, quality carbohydrates are important, it’s not no carbohydrates. But we’ve tended to think in our fatphobic phase that carbohydrates are all great and are innocuous and that’s absolutely not the case.
And so we now understand that healthy fats are fine. But excessive amounts of refined carbohydrate, be it in the form of sugar which is one form of refined carbohydrate or be it in the form of refined white bread and biscuits and cakes, are just as damaging as what we thought animal fats were in the past.
AL And as you say, before the low-carb fad came the low-fat fad. But the Total Wellbeing Diet doesn’t ban fats, but it does suggest minimising fat intake. Why is that?
MN It’s not so much minimising it, it’s just that you’ve got to keep the kilojoules under control. And so, if you have a lot more protein and you’ve got some carbohydrate foods not only from grains but also from fruit, you then have to balance the kilojoules. And there will be fats coming from those protein foods and there's a minimum of three teaspoons a day of fats and oils.
MN And what we’ve done with our Total Wellbeing Diet online is people can personalise that a little bit more. So, if you're a bigger person you can lose weight on more kilojoules and that means that you’ll be able to have a little bit more fat. So, we shouldn’t avoid fat completely, some people use spray oils and are completely just into the no-fat phase, have totally skim milk.
I don’t think that’s necessary and there are important attributes of higher fat foods. For example, low-fat milk, rather than non-fat milk, has vitamin A whereas the non-fat doesn’t. And so once again it’s about healthy fats and reiterating the point that if we just focus on the macronutrients we’ll end up creating eating patterns that are really not always that healthy.
And we throw the baby out with the bathwater. So, again getting back to the Total Wellbeing Diet and even the low-carb diet is fully based around whole foods, getting that balance right. And that's something that I think we need to do more of in terms of promoting what good nutrition is about. It’s not just about looking at labels. If you're spending your life looking at labels then that’s a problem.
MN Because most of the time the foods in your shopping basket you don’t need to be worrying too much about that. If you’ve got a lot of vegetables, fruit, fresh lean protein foods, the labels are kind of the secondary aspect. You might want to choose the bread with the most amount of fibre or the lowest amount of salt.
But if that’s the only thing you look at you lose sight of the bigger picture that is that dietary balance that’s really important. And that’s why we’ve gone further with our work looking at how can people assess whether they're eating well or not? And so, we have an online survey called the CSIRO diet score which takes about 10 to 15 minutes to do.
And it doesn’t ask you questions about sodium or protein or carbohydrates. It asks you questions about what you ate yesterday or how much fruit do you eat each day and when you drink milk how much do you have. Those are the questions that we need to ask in terms of assessing whether that diet is balanced.
And you’ll get a score out of a 100 and on average Australians score a C, which is not that great. And so, there's lots of room for improvement no matter whether someone is overweight, obese, or normal weight, or underweight. The entire population could do with eating a healthier diet. And I think again that there are some positive shifts in that direction.
Even in the younger population albeit in an unusually quirky kind of way with turmeric lattés and kale smoothies and all those sorts of things. But it really signals a sense of really starting to prioritise nutrition and whole foods a lot more. And so, we might even complain about the Paleo diet but if you look at people eating the Paleo diet they're probably having a better diet than the average Australian diet.
MN So sometimes we have to be a bit pragmatic about things and not always downplay everything because healthier eating can come in many forms. They're not all perfect, but we have to accept that even a shift to whole foods albeit in an imperfect way tends to help shift that eating culture towards a generally higher priority for food and nutrition.
And if you come from the Mediterranean countries healthy eating is number one. How many Italian mammas would say, you know, what did you have for lunch today as the topic of conversation? It doesn’t happen in popular culture here but it’s starting to.
MN People take photos of what they’ve had, I do that ad nauseum whenever I travel. And that's cool, that’s fun, that’s great. And food is not just a commodity, not just something on the side, not just something that you don’t think about when you're walking down the street. It’s central not only to our survival but to who we are, and I find it an endlessly fascinating topic.
AL Yes I can vouch for your survey being very user friendly, taking only about ten minutes. I got a 71 and it told me that I needed to get rid of some of the additional items I was adding which I think is because I wasn’t complying with the two drinks a week implicit requirement.
MN Well, I think two drinks a week is only if you're in a weight loss phase. And the online program we’ve managed to extend that and shifted it to one indulgence a day. So, it could actually be one every day.
AL Sounds beautifully Catholic.
MN Yes, oh gosh and that’s so true too and there's so much guilt associated with that as well. But indulgence foods or discretionary foods as they're called are our biggest downfall. And we’ve got a really great report called the Diet Score Report that illustrates where all those indulgence foods come from. For men it’s mostly alcohol, for women it’s mostly confectionary chocolates.
But alcohol is definitely one that we overconsume. And once again if we really want to improve the quality of our diet eating less junk food is probably the most obvious, simplest way to do it. By that it means not cutting it out but again having smaller portions. Some of the companies are starting to make much smaller portion sizes of different chocolate bars.
Some consumers feel a bit taken aback by that as in that they feel that they're being jibbed because they’ve having to pay the same amount. And that may be a fair response, but my perspective is smaller serving sizes are good because the more and the bigger the serve size the more you will eat. And serve size is a big factor in what drives overconsumption.
AL And as you say these are issues that humanity has been thinking about for many millennia. I was struck looking over the CSIRO Diet by the similarities to Plato’s diet recommendations. He’s a big fan of moderation obviously, he says that people should eat cereals, legumes, fruit, milk, honey and fish but not too much of any of those things. How about your diet? How well does your diet match the Total Wellbeing Diet?
MN Before I say that, who would have thought that we were plagiarising Plato. But look I'm pretty fastidious with diet. I always make sure I have a reasonable breakfast. Lunch is problematic because it means preplanning. But my evening meal is usually maxing out on vegetables which has great mirth for my husband who I've been trying to encourage to eat more vegetables as well.
Last night we had whiting coted in polenta fried in olive oil, lightly pan fried, and a massive salad and a fruit salad for dessert. So, I think we were doing pretty well on that day. And I didn’t have my Sauvignon Blanc because I wasn’t feeling that well, but I would normally have a glass or two of Sauvignon Blanc along with that which is one of my personal favourites.
MN And my indulgences, I love things like gelati which is perhaps one of my favourite foods.
AL Very nice. There's been a bit of a debate particularly in the US literature over this question as to whether dieting is simply calories in and calories out or whether there's something particularly problematic about sugar in particular and the whole sugar is evil push. How should regular consumers who are trying to live a good life think about this? Should they still be counting calories, or have we moved away from that?
MN I think ultimately calories will count. You can’t discount calories. There are different strategies for reducing calories and decades ago reducing fat was the strategy. You cut out fat and somehow calories were reduced. Until there was a proliferation of low-fat foods that were higher in calories and then all of a sudden that strategy fell apart.
And I think we’re going to go down the same pathway with just thinking that it’s all about just sugar reduction. We just cut out sugar, we can eat everything else as much as we like and then somehow everything will be fine. I don’t know whether you’ve ever seen some of the no sugar recipes full of all kinds of other incredibly high calorie things.
Including coconut fat, not that there's anything wrong with that but you know it is energy dense and if you're trying to lose weight that’s not going to help you at all. So, I'm a bit disappointed by the sugar hysteria because it suggests that we haven’t learnt from our lessons of the past with fat. And if you look at the foods we overconsume it’s not just sugar.
MN Sure, some of the foods contain sugar, soft drinks, cakes, biscuits, but they contain other things too. And a packet of potato chips doesn’t contain sugar but it’s a contributor to excess kilojoule intake. Excessive alcohol consumption doesn’t contain sugar. And sure, initially you cut out sugar, you will perturb your eating pattern, you probably will eat less.
But as time goes on you’ll start to find things without sugar that you can eat as much as you like, and your weight will go back up again. So, I'm not a big fan of the witch-hunt for one thing that will be the panacea to curing obesity. That said, there is some interesting research on the addictive nature of some foods, entirely controversial, there’ll be some scientists that will completely disagree with it and other scientists who completely support it.
But there are scales where you can assess whether you have a food addictive like personality. And on that point, the CSIRO Diet Types asks questions about what characteristics you have as a person. And there is one diet type that we call the Craver, and that type of individual finds it harder to say no and finds it harder to avoid food cues when they're presented.
So, the strategy for that kind of person is not necessarily to have a little bit of something because that triggers more consumption, it’s to not have it at all. If you're a different diet type, for example a Socialiser, then having a more diverse palate of foods but in more controlled amounts can work much better.
MN And again, craving isn’t just for sugar even though some people do say they have a sweet tooth. Some of our research has shown that some people have a salty palate. But we don’t see large differences between a sweet palate and a salty palate in terms of overweight and obesity.
Suggesting that it’s not just as simple as that one thing of sugar driving consumption. What is interesting though is how the popular media can create incredibly compelling stories about this and how that can really sway people’s behaviour. And I think it’s something that we need to learn as scientists that we tend to always look at research on lots of people, hundreds of people, and look at the averages.
But we forget about the fact that the anecdote, the N equals 1, can be so much more powerful. And sometimes you have to, not so much in the scientific literature but when you're communicating, sometimes the anecdote, the success story, can be a far more powerful way of communicating a message than a randomised controlled trial.
AL Which is of course deeply disappointing to the Randomistas among us.
MN I’m sorry.
AL I was struck by a fascinating study that the New York Times did when they went back to Biggest Loser contestants six years later and found that over half of them had roughly regained their pre-contest weight. And part of the challenge for them seemed to be that as their weight dropped their calory needs dropped a lot.
AL And so, the only ones who had kept the weight off were those who’d massively ramped up the exercise which meant carving out big chunks of time in their day to do a lot of walking in many cases. So, yes as you say, the anecdote was there about the effectiveness of Biggest Loser, but the facts long-term didn’t seem to bare it out.
MN I'm surprised that 50% of them were still not too bad which is actually a pretty good statistic because it’s often said that people after five years will regain all the weight. And that’s not necessarily true. In the US there's a registry of people who have successfully lost weight for many years and the researchers there have studied what their characteristics are about, you know, why they have been successful, and they have found certain things.
One of them is persisting with physical activity. And part of that is because it seems to have an impact on appetite control and obviously it gets you away from the food as well. The second thig is having a structured eating plan. You know, knowing ahead of time what you're going to do and planning ahead. Because often people who’ve been very overweight will often have some degree of predisposition and whether that predisposition is genetic or not.
MN It can be acquired, it could be epigenetic, but that drive is there, and it can be very strong. And so, they do have to spend a lot more of their cognitive effort keeping things in control and knowing what you're going to do means you don’t have to always think and make a choice.
And that’s part of the rationale for the kind of structure that we put into our eating pattern. In that if you plan ahead, if you know what you’re going to eat at least conceptually as well as actually sometimes, you don’t have to have that constant battle and struggle, will I or won’t I?
And so that structure is really important. The other thing that makes a difference is having life circumstances that are on your side. Sometimes things happen to people that can really upset the applecart and they are the triggers that tend to result in rebound. And learning how to deal with those kinds of setbacks in life and being resilient is a really important characteristic that some researchers are looking at now.
AL You were talking before about more addictive personalities not being able to have little bits of things. Are there particular rules you favour? I'm thinking, reputedly the Queen’s dieting advice is don’t eat pudding. Other people talk about skipping alcohol except on weekends. Others talk about the importance of not eating the bread roll.
One strategy I've heard has it that when you feel full you should accidently spill your glass onto your plate and so the rest of the food is spoiled so you're not tempted to pick at it. Do you have other sort of strategies that appeal to you for people who are in that more addictive mould?
MN I think it’s helpful for people who’ve devised their own strategies to some extent because they know themselves. The important thing is to have some rules and you need to work out what works but obviously an eating plan that is a healthy eating plan and following that. And certainly tracking, a lot of people say tracking is a good way to go and in the old days when we were doing research in our clinical unit we didn’t have the apps that we do today.
And things like MyFitnessPal and all of those kinds of things make it really easy. So that kind of mindfulness is really important. But also, things like not eating after 8 p.m. at night is a good one because there's some good sound scientific evidence why eating late at night is going to impact poorly on your appetite and on your metabolism.
So, understanding the fact that a kind of a rhythm to your eating pattern is important because there are biological rhythms that we have as well and eating at night-time is a particularly bad time to eat. The other of course is making sure that people have enough sleep because inadequate sleep also impacts on appetite, and you'll wake up often hungrier if not when you get up at sometime later during the day.
Probably for the alcohol lovers amongst us I’d say never have somebody top-up your glass and try to alternate alcoholic drinks with soda water or a low-calorie drink or just water.
AL You spoke about not eating after 8 which made me think of the issue around fasting. There’s some material I've been reading recently about the value of just extending the period between dinner and breakfast and pushing that out from 8 hours to 10, 12. Some people push it as high as 16, having a 16-hour period during in the day when they don’t eat. What do you think about that? Do you see much scientific backing for the idea that you should have a big gap during the day in which you give your digestive system a rest?
MN Certainly we've done some work in the fasting area as well and it’s a really interesting area and the number of publications in the fasting space are going up astronomically.
AL Growing fast.
MN Exactly. And look and there is very good evidence, in some ways I would bet that part of the value is that abstinence element and the fact that you’re not having food. Because for some people, particularly that addictive personality type which is probably lots of people, the more you eat the more you want to eat.
And so, by having the rule, you're not eating for this amount of time, can certainly help to reset your appetite control mechanisms. What we don’t know about the fasting area is for whom does it work well and for whom doesn’t it work well. And it’s interesting you mentioned the fact that you don’t have a lot to eat for a certain period of time and that might be good thing if you're a Craver.
MN But what about the day that you can eat as much as you like? And so, some people will cope with that and won’t feel like eating that much and will just eat maybe a little bit more but not that much more. But then there's the other type that will actually go overboard and completely undo what benefit they may have achieved.
AL This is the sort of 5 and 2 approach?
MN Yes that’s right. On average that doesn’t happen, but the average isn’t the individual. And so, what we’re really interested in is for whom does it work well and for whom doesn’t it work well? Because ultimately we need to get to a point where, you know, there are a lot of different really good ways to lose weight.
The Total Wellbeing Diet is a good healthy way to lose weight. We also have our Impromy program which is a meal replacement program and the Flexi program which is a modified fasting program. All of those have been tested, they're all nutritionally balanced, they work well. But the question is, who do they work well for?
And there I think more interesting questions and that’s where I think the science is going now too. It’s not so much just looking at the average but looking at the diversity of response and trying to understand why that diversity is there and what are the reasons for that diversity.
MN Not just only for curiosity but for the purpose that you can then devise a personalised strategy for an individual. So, personalising is really where things are moving right now. And to some extent even at the level of the genetic makeup and the polymorphisms you might have that relate to appetite regulation, that relate to your propensity for obesity.
That relate to whether you're a better taster, whether you hate coriander, whether you're caffeine sensitive, all of those things are really fascinating aspects that we can learn about ourselves through some of these modern technologies.
AL And jumping on the 5 and 2, I have heard people say one of the things you can do during the 5-day period is if there's food you crave that you're not allowed to eat during that more calorie restricted period you can write them down and then make sure that you eat them on the two days. But I suppose that all turns on the extent to which your two days turn into a crazy eating binge compared to a sort of moderate increase in intake over that period.
MN Yes, I think it may work for some, but it might upset the applecart for others. There's some interesting distraction strategies in the literature. So, for example spraying certain scents can help to reduce that craving and that distraction of doing that. So, a lavender spray for example can help with just if you have that sensation as a distraction and it’s also a sensory distraction and that can help to allay some of that.
AL Pepper spray for example would distract the appetite for a while.
MN Absolutely. Interesting thought, but perhaps a little over the top.
AL What about longer fasts? Do you have a view on these multiday fasts that some people advocate?
MN I think if we look at what happens physiologically, the longer you fast, obviously you're not having protein, you start to use your own protein reserves, you lose muscle mass. And we’re really learning that muscle mass is critically important for health and wellbeing and particularly as you get older. It’s a hallmark of health and a hallmark, if you're muscle mass is low, of mortality.
So, people with the lowest muscle mass tend to have earlier deaths. Now, you might say it’s because it signals something else, and it does in a sense. If you’ve got really low muscle mass you’ll fall over more easily. It’s so bad on so many levels and that’s why ensuring that you're having enough protein particularly as you get older is important.
So, long fasts will decrease muscle mass very quickly and rapidly and even more quickly and rapidly if you're over 50. It’s fine if you're only doing it for a few days and that’s it just to get your head started and ready and motivated. But it wouldn’t necessarily be a strategy that I would recommend and particularly not for older people.
AL What about more straightforward strategies that you might use in a daily basis just to lower your appetite? I know you’ve mentioned before that you quite like ordering some extra steamed vegetables with a meal presumably as a way of bulking up a little bit. Can shakes and soups play a similar sort of role?
MN Soup certainly can play an important role before a meal. Obviously a vegetable soup is a good way of slowing down your eating, priming your digestive system and just filling you up that little bit. And similarly, vegetables with a meal will slow down your eating. It’s very depressing having a really tiny amount of food, having a lot of vegetables can make your meal more interesting but also will slow that meal down.
You're talking about meal replacements now I'm assuming. The issue if shakes are really intriguing because why they seem to work really well for some people is a number of things. First of all, you don’t have to think about what you're doing, that's what I'm having that’s it. I'm not having anything else, black, white. That works well.
The second thing about it is that it provides a kind of sensory deprivation in a good way. So, if you’re a person who craves things the use of a meal replacement will help to some extent to reduce those cravings. And we have shown that people on meal replacement programs, including the one that we’ve been involved in, weight loss will help to reduce those cravings.
MN So, I think that’s the other reason. The other is that you usually have them only for two meals a day, breakfast and lunch, as a partial meal replacement and then you have normal dinner. And so, breakfast and lunch are usually where we’re most time-poor. It’s really convenient and those meal replacements each contain 25% of the recommended daily intake of nutrients.
MN So, what we’ve found in our research is that if we look at people’s blood before and after a meal replacement their vitamin status improves after that meal replacement. So, there are significant advantages nutritionally of using them. Are they a long-term strategy?
You might say, no, we don’t advocate that. But the diabetes prevention programs in the US where they’ve used meal replacements have shown that in the early stages the people that had meal replacements on and off at different times over a ten-year period were the ones that were most successful in keeping weight off. So, they can be a useful strategy.
The question is, does it have to be a shake, or can it be just a preprepared meal that’s portion controlled? And again, our research has shown that there's no real difference if the calories are the same with a portion-controlled meal and having a shake. The shake tends to be cheaper and more convenient but a preprepared meal tends to work really well as well.
AL I'm interested too in food myths and reading one piece recently that was talking about three common food myths. And this is a New York Times piece again saying that salts, there's this perception that salt is a problem for the broad population. And it was arguing that while excessive salt can be an issue, average consumption is about 3mg a day which is about right.
Talking about the craze in the US now for gluten-free with 1% of the population being gluten intolerant and 20% of the population eating gluten-free. And this notion thirdly that the link between meat and cancer is large in magnitude and the author was arguing that, yes, the sign goes the way that you’d expect that more meat does increase cancer risk.
But the magnitude of the impact is so tiny as to not be worth worrying about in the scheme of things. I'm curious as to what you think about those myths and whether there's other food myths that you’ve come across.
MN So let me get started on the gluten-free. And gosh I've seen so many funny videos and we’ve got a little gluten-free Noddy book of our offices. We’ve done some work on food avoidance and it’s not just gluten, it’s also dairy free and various others. So, there's a significant proportion of the population that avoid these things.
Although the research is still in development, it’s really unclear why people have those gastrointestinal symptoms that they do, but it’s real. But whether gluten is the offending component is really hard to say because when you avoid gluten you're avoiding a whole lot of other things as well. Interestingly the typical nutritionist generally will say, well look, those people that avoid gluten they’re cutting out a food group but therefore they’ve got unhealthier diets.
MN In fact, our research shows from our diet score survey those people that were avoiders of something tended to have overall healthier diets. So, that sounds counter intuitive but then when you think about it, food avoiders are very mindful of what they're eating and therefore they tend to have a lot less junk food.
And so that’s where again you might say it’s not a good thing. But in fact, being a little bit more conscious of what you're eating even though you're avoiding something that may or may not be the offending product seems to have a better impact on your overall diet. And so again it’s part of the cultural shift that we’re seeing.
That there's an acceptance in restaurants now and hotels and pubs and clubs that people have diverse things that they don’t eat, and they now cater willingly for them. Whereas maybe a decade or more ago they were considered perhaps more of an undesirable, and so we’re just seeing that spectrum a little bit more.
On the issue of red meat and colorectal cancer I mean that’s been a vexed one as well. And yes there's a small slight increase in colorectal cancer from processed meat consumption, fresh red meat generally the evidence is really not there. And we’re not quite sure why it is for processed meats but perhaps it’s the nitrates, it’s hard to know.
MN But the difference between relative risk and absolute risk, the relative risk is about a 20% increase but for the average individual it’s really a very tiny impact. Again, if you think about all of the foods that impact on health and you put them together in an eating pattern there are a lot of things that we know that contribute to, there are protective foods and foods that are less so.
Again, it’s the total dietary pattern. So, there are other foods like fish consumption, dairy consumption, that are associated with lower colorectal cancer risks for example. So, again the total dietary pattern is more important than one particular food. If we look at meat consumption in Australia, on average we’re eating about the recommended amounts and we’re often assumed to be eating huge quantities.
If we had to reduce anything it would be the amount of processed meats. But in terms of the amount of fresh meat it’s probably not too far off the mark from the national dietary guidelines at the moment.
AL What about healthy eating for kids? Are there ways in which you think we can do a better job of talking with our kids about how to eat well?
MN I don’t purport to be an expert on everything and very little of my research has been around eating habits for children. Although, I'm very familiar with the literature and some of my colleagues have children, dietitians in the team, and are absolutely passionate about this area. I think the important thing with kids is not to have a lot of food in the house that is tempting.
MN And to have rules around eating, not necessarily draconian rules but sensible rules about sitting down when you're eating. Rules around when you have discretionary foods. You don’t have to avoid them altogether but there's a time and place etc. And I think the other thing is that learning to like things requires habituation and we know that in children particularly with vegetable liking it changes a lot over the first few years.
But increasing exposure is really important so even if they eat a little bit of a vegetable they don’t like but do it on a regular basis eventually they’ll grow to like it. Someone was telling me the other day that they hated Brussel sprouts as a kid and now they love it. So, there’s always a light at the end of the tunnel.
AL Nibble your vegetables rather than eat all your vegetables.
MN Well, I think with kids don’t force but just try and encourage small amounts of things they may not like, and that way praise them for doing those things. But never use food generally as a reward, that’s probably not a good idea.
AL Manny what advice would you give to your teenage self?
MN Gosh, I think I struggled a lot in my teenage years, it wasn’t a really happy time. And so, I think I would say don’t worry, things are going to be great, and you wouldn’t believe what's going to happen to you in the future.
AL What's something you used to believe but no longer do?
MN Something I used to believe… Look, I probably as a very early stage nutritionist I was a fat phobic myself and clearly I think food and nutrition is far more complex than that. But I don’t know, that's a good question, I probably should reflect on that a little bit more.
AL When are you most happy?
MN I’m most happy when I'm eating at a table or when I'm preparing food.
AL What's the most important thing you do in your life to stay mentally and physically healthy?
MN Just dimensionally healthy I think. My family is really an important part of my life and being with them and sharing food with them is really important and my grandchildren now too. Physical I think is always a challenge for all of us that work in jobs that are often sedentary.
And so, I try to do what I can, but I try to do more purposeful activity. I have done the gym thing but now I think, well gosh, I could be doing housework and cleaning the windows and expending energy and doing something really productive at the same time. Why don’t I do that instead and that’s what I do.
AL I was going to ask you about guilty pleasures. You’ve already given us two in the Sauvignon Blanc and the gelati. Anything else?
MN No I think that covers it pretty well. Yes, roasted almond gelato at Shibo an excellent product.
AL What is your ethnic background by the way?
MN My background is Italian. So, I was born in Italy, in Tuscany actually, very nice place to go. And in fact, we go there probably every year or two and go back to where I was born. And it’s a wonderful experience to be in the country of your birth. And you don't ever really fully appreciate the fact that even though you’ve grown up somewhere where you were born has very deep significance.
And so much of the culture and the food connection is still there and I love that. I love the fact that they place so much importance on food and the taste of food and growing food and where it comes from and talking about it. And so, I can do that almost as a guilty pleasure really.
AL And your roasted almond gelato, there is one of my favourite spots to go and roam is a little gelateria just about a block away from the Parthenon which has the most extraordinary array of gelato flavours.
MN I'm sure I've been there but I can’t remember its name.
AL And finally, which person or experience has most shaped your view of living an ethical life?
MN Which personal experience.
AL Person or experience.
MN Gosh, look I think working at CSIRO has been an incredible experience for me in that we get money from the taxpayer to do research that’s going to make a difference to people, and I don’t ever forget that. I think it’s really great to love science but loving it just for the sake of science is a bit self-indulgent.
I kind of really like the fact that CSIRO is really about using that science to make a difference. And for that public benefit and that economic benefit is also a public benefit. And so, I think the role of the organisation in that arena is critically important and helping Australia to grow and to be successful as a country is really important.
So, I think that the people that I've worked with in CSIRO I think have got that strong sense of the ethics of what we’re doing and the importance of what we’re doing. And as an organisation, I'm really proud to have been with the organisation for so long and the opportunities that it's given me.
AL Manny Noakes, thank you very much for being a guest on The Good Life Podcast today.
MN It’s been fun thank you.
AL Thanks for listening to this week’s episode of The Good Life. We love getting feedback so please leave us a rating or a comment on Apple Podcasts formally known as iTunes. Next week I’ll be back with another inspiring guest to discuss living a happier, healthier and more ethical life.