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Dr. Sarah Berry is an associate professor at King’s College London and has run more than 30 human nutrition studies. Most notably, she’s the lead nutritional scientist for PREDICT — the world’s largest in-depth nutritional research at the science and nutrition company Zoe.
Dr. Sarah Berry unlocks the mysteries of how women's bodies respond to food during the menopausal transition in this eye-opening conversation about nutrition, hormones, and health. As lead scientist for PREDICT, the world's largest in-depth nutritional research at Zoe, Dr. Berry shares groundbreaking findings about the dramatic metabolic shifts occurring during perimenopause and beyond.
Ever wonder why your body suddenly stores fat differently or why your blood sugar feels unstable? Dr. Berry explains the science behind these changes, revealing how dropping estrogen levels create a "roller coaster" affecting everything from cardiovascular health to sleep quality. The research is clear: premenopausal women typically have better cholesterol, blood pressure, and insulin sensitivity than men of the same age—until perimenopause disrupts these protective factors.
What's particularly fascinating is how differently each woman responds to food during this transition. Dr. Berry's research reveals up to 20-fold differences between individuals, challenging the one-size-fits-all approach to menopausal nutrition. Rather than restrictive diets, she suggests practical strategies that work with your biology: time-restricted eating (finishing dinner before 7pm), maintaining consistent sleep patterns, and simply slowing down your eating rate by 20% can reduce calorie intake by 15% without conscious effort.
Most encouraging is the finding that women who improved their diets experienced a 35% reduction in menopause symptoms—regardless of whether they were taking hormone replacement therapy. This suggests that focusing on diverse, plant-rich foods with plenty of fiber can complement medical approaches or provide an alternative for women who cannot or choose not to take HRT.
Whether you're approaching perimenopause, in the midst of the transition, or supporting someone who is, this conversation offers evidence-based hope that small, sustainable changes to how and when you eat can significantly impact how you feel
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Episode Transcript
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Sandy Kruse (00:02):
Hi everyone, it's me, Sandy Kruse of Sandy K
Nutrition, health and LifestyleQueen.
For years now, I've beenbringing to you conversations
about wellness from incredibleguests from all over the world.
Discover a fresh take onhealthy living for midlife and
(00:26):
beyond, one that embracesbalance and reason without
letting only science dictateevery aspect of our wellness.
Join me and my guests as weexplore ways that we can age
gracefully, with in-depthconversations about the thyroid,
(00:49):
about hormones and otheralternative wellness options for
you and your family.
True wellness nurtures ahealthy body, mind, spirit and
soul, and we cover all of theseessential aspects to help you
live a balanced, joyful life.
(01:10):
Be sure to follow my show, rateit, review it and share it.
Always.
Remember my friends balancedliving works.
Remember my friends, balancedliving works.
Hi everyone, welcome to Sandy KNutrition, health and Lifestyle
(01:31):
Queen.
Today with me I have a specialguest.
Her name is Dr Sarah Berry andshe is an associate professor at
King's College, london, uk, andhas run more than 30 human
clinical sorry, human nutritionstudies.
Most notably, she's the leadnutritional scientist for
(01:52):
PREDICT, the world's largestin-depth nutritional research at
the science and nutritioncompany ZOE.
I hope I pronounced it right,it is ZOE right, I did.
Dr. Sarah Berry (02:03):
It is Zoe.
I hope I pronounced it right itis Zoe right, I did, it is.
Sandy Kruse (02:13):
And today we're going to be breaking down the
very complex connections betweenlifestyle, hormones and health,
and how diet can lessen theeffects of menopause on women's
bodies.
And I think this is a veryimportant conversation because
myself, as a holisticnutritionist, I hear all the
time about people who will doeverything else in the world but
(02:35):
change their diet when theyhave an issue, and I don't think
there is a better person tohave this discussion with than
Dr Sarah Berry.
So, with that, welcome, thankyou.
Dr. Sarah Berry (02:50):
Thank you for having me on.
I'm excited to dive into it andalso dive into why it's so
difficult to change your diet.
Sandy Kruse (02:59):
Yeah, I think this is going to be a great topic
because, I mean, the sciencesays that diet matters and we
can use food as medicine, andthis is so important, especially
for women who are just kind ofentering into these stages and
seeing these changes in theirbodies, you know, right around
(03:20):
perimenopause.
So I have to ask you if youcould just let us know your
background and why such aninterest in this field.
Dr. Sarah Berry (03:28):
Yeah, so I'm a nutritional scientist by
training.
I did my PhD many years ago atKing's College London, a
university here that has one ofthe world's leading nutrition
departments, and I started offresearching the impact that food
structure has on our health,and particularly in relation to
cardiovascular disease, and howthe different fats that we eat
(03:52):
and the structure of food, howit impacts what we call our
postprandial responses, so ourshort-term responses to food, so
those kind of metabolites thatchange two to four hours after
eating food metabolites thatchange two to four hours after
eating food.
And I started to notice thatactually people's responses were
so, so different.
There was like a 20 folddifference between how one
(04:12):
person would respond versusanother person, and so I had the
privilege to get involved witha what was a startup seven years
ago and now is a company calledZoe Science and Nutrition
Company, and now is a companycalled Zoe Science and Nutrition
Company, who have really beenat the forefront of developments
in personalized nutrition basedon this idea that we all
respond so differently to food.
(04:34):
And through Zoe we're runningthis huge program of research
that you mentioned, the Predictprogram research, which is
collecting data in hundreds ofthousands of people and looking
at how we differ between people,how we differ day to day and
how we metabolize food, and howwe differ depending on multiple
factors, and one of thosefactors we were starting to see
(04:54):
a couple of years ago that wasactually having quite an impact
on how we metabolize food, onour health factors as well
related to, like blood pressure,lipids, inflammation was the
menopause, and so that's how Ikind of dived last few years
into menopause research and,more recently, also looking at
menopause symptoms.
(05:14):
So looking at the relationshipbetween both diet and menopausal
health, and by this mean I meanall the unfavorable health
changes that happen peri andpost menopausally, but also diet
and menopause symptoms, whichis what many people talk about
when we think about menopause.
So that's how I've ended upwhere I have.
So menopause for me is arelatively new area, but I have
(05:35):
spent 25 years looking at therelationship between diet and
all of the kind of factors thatactually are relevant in
menopause kind of factors thatactually are relevant in
menopause.
Sandy Kruse (05:47):
I'm going to say one thing that really stuck out
that you just said is thebio-individuality aspect and how
certain foods will affect youdifferently than it will affect
me, and I think that this is keyhere.
Because think that this is keyhere?
(06:10):
Because, excuse me, I noticedin this area of health and
wellness we get a lot of adviceand it gets very complex,
especially for women who areexperiencing these changes in
their bodies.
And even though I'm a holisticnutritionist, that doesn't mean
that I'm not going to havechallenges.
But when we hear advice, that'spretty blatant advice you must
(06:30):
do this, you must do this, youmust eat this, you must have
this, you must take this.
It gets very daunting for a lotof women, especially because
we're already dealing with thesechanges.
So I love that there's thatwhole bio-individual aspect to
(06:51):
what you do, sarah.
It's amazing.
So I guess we could start about, because you have such vast
experience in this, what do wesee around menopause?
That maybe makes this wholefood aspect a little more
complex.
Dr. Sarah Berry (07:13):
So I think we need to step back and think well
what is menopause?
And I know many of yourlisteners might know this, but
there might be many listenersthat don't know this.
There might be some menlistening who have women in
their lives that are goingthrough this.
So if we can just pause for amoment and think about what
menopause is, then I think itputs into context why food might
be relevant and why we havesuch wide-reaching health
(07:34):
effects related to menopause.
So menopause, very simply put,is the point in time one year
after your last menstrual cycle.
So it's the point in time ayear since you had your last
period or last menstruationbleed.
Now you don't go to bed onenight premenopausal and wake up
hey presto, I'm postmenopausal,that's it, it's all over.
(07:57):
No, it doesn't work like that.
There's an entire menopausetransition period, and this
menopause transition periodstarts when your oestrogen
levels start to decline and, inthe definition that we use as
scientists, it ends 10 yearsafter your last menstrual cycle.
Now the perimenopausal phase isthe phase that your oestrogen
(08:21):
starts to decline up until whenyou have that last period, or
the year after your last period.
This can last anything from twoyears to eight years, depending
on individuals.
Again, we're all so different.
But what's really important tonotice in this perimenopausal
phase what happens is not thisbeautiful slow decline in
oestrogen that your body adjuststo day by day.
(08:44):
No, it's a roller coaster.
It's this phase of hormonalchaos where you've got these
peaks and troughs and movingaround in oestrogen, and that's
why the perimenopausal phase isso challenging.
Postmenopausally it's morestable, but your body's still
adjusting to this change inoestrogen.
And the reason that we knowthat perimenopausal and
(09:06):
postmenopausal women have amultitude of issues is because
oestrogen receptors are all overour body.
Oestrogen receptors aren't justdown there, related to our
reproduction or our ovaries.
We have oestrogen receptors inour brain, in our muscles, in
our bones, in our heart,everywhere, and so as we lose
estrogen, we aren't gettingthese estrogen receptors
(09:28):
stimulated and therefore they'renot doing the job that they are
there to do, and this is why wehave such far reaching issues
or symptoms.
We have health related issuesthat we talk about a lot less, I
think, or not as much as weshould relate to menopause.
So we know, for example, fromour own research and other
published research, thatpremenopausally, women are doing
(09:51):
quite well in terms of health.
So by this I mean at any givenage compared to a similar age
man, and I'm talking about theaverage here.
Women on averagepremenopausally have lower blood
pressure, have bettercholesterol, have better insulin
sensitivity, have less visceraladiposity, so less fat around
the belly, have lowercardiovascular disease risk.
(10:13):
What happens is when they meetthe perimenopausal transition
phase, suddenly these start togo up and suddenly their risk,
these intermediary risk factorsassociated cardiovascular
disease, their blood pressure,their cholesterol, the insulin
resistance, the inflammation,the visceral adiposity, suddenly
goes up to the level of men andin some cases in our own
(10:36):
research, for example with bloodpressure we see it even
overtakes men.
So firstly you have thesehealth effects related to
menopause, which we know dietcan have a really fundamental
role in helping negate.
And then you have the symptoms.
This is what I think many peoplethink about when they think of
menopause.
You have these really impactfulsymptoms.
(10:57):
Again, they vary from one personto the other and by symptoms I
mean everything from theneurological symptoms so the
memory loss, the brain fog, theanxiety, the mood swings, the
depression, the low mood tophysical symptoms so achy bones,
achy shoulders, poor skin, poorhair, etc.
Such as, you know, the poorsleep, for example, and you know
(11:29):
, sexual symptoms as well lossof libido, vaginal dryness, etc.
So we also have these farreaching symptoms and the reason
is, again, is because we haveestrogen receptors all over our
body.
We've not got estrogen bindingto them.
They're not doing what theyshould be doing and so suddenly
we're hit with these awfulsymptoms, and this is one of.
We've been looking at both ofthese in our ZOE predict
research.
We've been looking at thehealth aspects.
(11:52):
We've been looking at how theydiffer from people, how diet
might help, and then we've alsobeen looking at symptoms, how
prevalent they are, howimpactful they are in people's
quality of life and where dietmight fit in with these, and
also where other hormonal kindof therapies fit in as well.
Sandy Kruse (12:08):
Has the research that you guys have done at Zoe
explained the whys?
Like I know, you can't speakabout prescriptions or anything,
(12:31):
but you see a lot of women are.
I guess it's suggested to themby their primary care physician
to go on a statin because theircholesterol shoots up.
So why does that happen, otherthan?
Is there another reason otherthan the fact that you know, we
just don't have the estrogenanymore?
Dr. Sarah Berry (12:54):
So that's a really interesting question,
because what's very difficultwith menopause research is to
disentangle natural parts ofaging versus what's due to
estrogen.
Specifically, menopause is anage-related event, and so how do
you disentangle?
Well, this is just becauseyou're getting older.
So we know, for example, in men, as they get older, their
(13:17):
cholesterol tends to go up.
In women, your cholesterol tendsto go up.
What's due to the menopauseversus what's due to age.
Now we do suddenly see like aninflection point, so to say,
where cholesterol might steadilyincrease and suddenly at the
menopause phase it suddenly goesup.
We know that there are someunderlying mechanisms for this.
We also know that for themajority of people, if they then
(13:41):
start taking hormonereplacement therapy and see this
for in our research, forexample, then your blood
cholesterol levels go back down.
So again, building that picturethat it's not just age-related,
that there is a direct effectof oestrogen, and this is for
multiple reasons.
So one of the reasons is thatwe know that your body
(14:03):
composition changes duringmenopause, so estrogen changes
where we deposit fat.
So in a kind of very simple,using very simple terminology,
we know that estrogen kind ofdirects fat to our hips and our
bottom.
So women have this pear shape.
When you start to lose estrogen, you lose that kind of
(14:24):
protected direction of fat to anarea that we know is quite safe
to have fat and what happens isis therefore you start to
deposit fat around your abdomen,around your belly, so you
increase what we call visceraladiposity, which is basically
tummy fat, and we know this isreally metabolically active.
We know it's unhealthy fat.
We know it's more linked withinflammation, with
(14:45):
cardiovascular disease, withtype 2 diabetes, with higher
blood cholesterol, bloodpressure et cetera.
Because it's so metabolicallyactive, menopausal women have
five times more likelihood ofhaving visceral adiposity than
if they're premenopausal.
So firstly, you've got kind ofindirect effects going on
because of oestrogen's impact onother areas, so, for example,
(15:08):
increasing adiposity.
We also know that oestrogenimpacts many enzymes involved in
how we metabolize fat, how weproduce fat in the liver, how we
remove fat from the circulation.
We also know it's involved inprocesses related to how we
process glucose as well in theblood, so from the carbohydrates
(15:30):
in the meal, because it's it'shas an impact on insulin, for
example.
It has an impact on theseenzymes, lipases, involved in
how we process fat.
So we know that these again areall mechanisms that are
important in also some of theunderlying pathways related to
(15:51):
recordings.
I feel it really gives more ofan authentic.
Sandy Kruse (16:08):
Take on all of my recordings and, as a woman who's
almost 55 and menopausalexactly what you're talking
about, and I know I'm an N ofone but I see exactly that when
my estrogen is not optimized, Iget that central belly fat.
(16:31):
And this isn't to insultmenopausal women at all.
I'm not saying that.
I'm just saying that you canalmost visually see that center
of a woman get larger and it'slike their bum and their hips
(16:52):
disappear, you know.
And so a lot of women are like,oh my God, I don't know what's
going on.
I'm getting this belly fat andfor me personally, again N of
one.
I know it's all about thatoptimization for estrogen, but
I'm on bioidentical hormones andthat might not be the choice
(17:14):
for every woman.
So this is where we go.
Okay, well, how can I optimizemy body composition?
Using food and using lifestyle?
Dr. Sarah Berry (17:28):
Lifestyle matters too, and movement too,
and movement, yeah, and I thinkit's challenging and I don't
want to.
I'm reluctantly, rather I'mreluctantly saying this, that
it's challenging, it's tough,but I think we have to be
realistic in these conversations.
You know, I would love a bellylike Jennifer Lopez.
(17:49):
I would love, you know, to looklike Halle Berry.
The reality is I don't.
I'm 47.
I'm starting to get a bit of abelly around my tummy.
I've not put weight on and Iknow it's because I'm in that
perimenopausal transition.
But we have to be realisticabout what we can do about it.
And I think that I'm not justsaying we accept it, that this
(18:10):
is just inevitable, but we haveto accept it's going to be
harder to maintain the bodyshape we had before if we're
peri and post-menopausal.
And this is because, as well asthat direct effect that I
talked about on estrogen andwhere it directs the fat, you've
got so much else that's goingon, which is where what you've
said lifestyle also comes intoit.
(18:31):
Diet comes it.
So, for example, most peri andpost-menopausal women and we see
that 85 percent in our cohortsay that they're not sleeping
well, that they have sleepdisturbances.
So 85 percent of perimenopausalwomen are having sleep
disturbances.
Now.
Sleep impacts so much.
Sleep impacts our desire to dophysical activity.
(18:52):
Sleep impacts our mood.
Sleep impacts our stress level.
Sleep impacts the dietarychoices that we make.
If we've had a bad night's sleep, the reward centers in our
brain are heightened and they'llbe saying hey, sandy, I know
you were going to have this nice, healthy breakfast, but, damn
it, you've not slept very well.
Go and have a quick fix.
You're fighting against that.
What we also know from our ownresearch, from our Zoe Predicts
(19:14):
studies, is if you've had a poornight's sleep, you also have a
difference in your metabolismimmediately the next day.
So we gave people identicalmeals across a number of
different days to have forbreakfast.
These are high carb, high fatmeals and what we found is on
the days that people had a poornight's sleep, when they had
that high carbohydrate meal forbreakfast, they had a higher
(19:37):
postprandial glucose response,and by this I mean circulating
levels of blood sugar afterhaving that meal.
They had a higher responsecompared to days when they had a
good night's sleep.
So you've got women who arehaving all of these things being
thrown at them the lack ofestrogen directing fat to their
belly, the poor night's sleep,the higher glycemic responses,
(19:59):
the craving for different kindsof food, the low mood, the less
desire to do physical activity,et cetera, et cetera.
It's kind of creating thisperfect storm.
And, yes, we can try and fightagainst the perfect storm, but I
think we have to recognize thatit's going to be harder.
(20:19):
And do we want to fight againstthe perfect storm?
Do we just accept?
You know what my body shape ischanging?
But what I will do is make surethat I'm eating as healthy as I
can, but I will accept that mybody shape is going to change.
It's a personal choice.
Sandy Kruse (20:44):
And I love that you said that about the sleep,
because I think this is key Ifwomen can really kind of have
that as your foundation andutilize the tools that are
available to you, because I dofeel that we need more tools in
order to sleep well.
(21:12):
I mean, if you're a mom, it kindof starts when you have babies
and then you end up havingteenagers and then you end up
having menopause and it's tough.
But I think if we put ourselvesfirst and we do whatever it is,
whether it is working with yourphysician and I know for me I
began using bioidenticalprogesterone, starting off with
the cream and this isn't whatthis discussion is about, but
(21:35):
for me it immediately helped meto optimize my sleep.
That's where it kind of beganin my 40s, because I recognized
that nothing else was workingand I needed to do what I could
for my sleep.
Now, the other thing I do findinteresting is I'm sure you've
(21:59):
looked at this and I wonder ifZoe has in the Predict, research
has looked at this Just interms of you know, our blue
light and how that might affectour circadian rhythm, which can
in turn affect our hormones.
I don't know if Zoe has donethat.
Any research there.
Dr. Sarah Berry (22:20):
No, we haven't done research specifically
related to blue light.
We have done lots of researchlooking at how time of day
impacts our responses to food,how time of day impacts our
post-prandial responses, likeour glycemic responses, how
factors like meal ordering,time-restricted eating.
So we've done lots of workaround that and I think what
(22:41):
this work shows to us is thatthere's lots of tools to our
toolbox.
So it goes back to somethingyou were saying earlier.
That, again, know, I was sayingearlier how tough it is and I
think that we can try to changeour diet.
It's hard, but we can also tryand change other factors related
(23:02):
to how we eat, and this iswhere I think the whole
circadian biology is fascinating.
So, whilst I don't know how theblue light and circadian
biology fits in specificallywith hormonal levels, what we do
know is if you're eating lateat night.
So, for example, in our cohortwe see that 30 percent of people
are snacking after nine atnight.
(23:22):
That's huge.
We know that if you're eatingafter eight or nine at night,
you're at higher risk ofmetabolic disease.
You're at higher risk of higherinflammation, higher blood
pressure, higher inflammation,higher blood pressure, higher
cardiovascular disease, etcetera.
And again, becausepostmenopausally you're already
at higher risk of that.
These are the kinds of thingsthat we could be quite mindful
about.
Even if we're not totallychanging our diet or making big
(23:44):
changes to our diet, why don'twe change how we're eating the
food?
So why don't we stop eatinglate at night if we can try and
shift the last meal of our day alittle bit earlier and then
change other factors related tohow we try and give our body a
kind of fast period?
So try and make sure we'rehaving 12 hours, ideally 14
(24:07):
hours, where we're not eatinganything.
And we run this study called theBig If Study, the Big
Intermittent Fasting Study,where we asked people at a
population level just tryreducing the time window in
which you eat your food.
You don't need to go crazy.
All the studies out there usethese crazy eating windows of
only eating four hours or sixhours.
That might work for some people.
(24:28):
Certainly wouldn't work for me.
So we just said you know, maybehave your last meal of the day
at seven o'clock.
That means you can have yourfirst meal of the day at nine
o'clock the next morning.
So you're eating in a 10 hourwindow.
This improved people's moodimproved, their energy levels
improved their hunger levels,improved their weight, and we
saw this worked really well aswell in peri and postmenopausal
(24:51):
women.
And we did this in 150,000people in and we told them to
carry on the normal way you liveyour lives, carry on that noisy
way you live your life, don'tchange anything else.
And we saw an improvement.
And I think where we saw thebiggest improvement was actually
those that were doing what wecall early time-restricted
eating, so those that weremaking sure they finished a bit
(25:11):
earlier, so with, for example,having their last meal at least
before seven in the evening, andwe saw a benefit across
everyone.
But the fact that we saw aneven greater benefit in some of
the parent postmenopausal women,I think is really promising.
And then another area that kindof fits into this again it's I
have to caveat, it's not relatedto the blue screen, but it fits
into this whole idea of thecircadian biology that we're
(25:34):
talking about is that also, weknow that consistency in sleep
is really important, consistencyin the time you go to bed.
So we did some reallyinteresting research that we
published a couple of years agoon what we call social jet lag.
I don have you ever heard ofsocial jet lag?
No, no, so it's a relativelynew term and what it basically
(25:57):
means is inconsistency in whenyou're going to bed, in your
sleep pattern.
So, for example, people who arebeing sensible in the week,
coming home, going to bed at 10o'clock every night on a weekday
because they're getting up forwork and then at the weekend
they're going out, partying,going crazy, going to sleep in
two in the morning.
Or it might be the other wayaround.
(26:18):
You might be like me, who worksincredibly late every evening
because I get so excited by allthe signs.
Then at the weekend it's likecatch up time and I'm going to
bed early.
But it's that inconsistency andwe call this social jet lag,
where you're changing your sleeppattern, not because you're on
a plane, but because of how youmight be living your life
socially.
And what we see is, if you havesocial jet lag, we see that that
(26:40):
impacts different areas relatedto health as well.
We see it impacts some of thedietary choices you make, and we
see that it also impacts yourmicrobiome composition in a way
that we know is unfavorable andmay lead to other unfavorable
health effects.
And so I think this isfascinating.
And the reason it's fascinatingis because I think, as
nutrition scientists, we'vealways thought it's all about
(27:00):
what you eat.
Change your diet, reduce this,reduce that, cut out this.
Well, firstly, I think, asnutrition scientists, we should
say this is what you should addin to make it healthier.
But secondly, we've got all ofthese other tools we can fiddle
with.
We can stop eating late atnight.
We can try and you know eat ina more consistent way.
We can do things like slow downthe pace in which we eat our
(27:22):
food.
You know, there's amazingresearch showing that if you can
just reduce how fast you eatyour food by as little as 20%,
you can, without even thinkingabout it, reduce the amount of
energy, so the amount ofcalories you're consuming, by
15%.
So, instead of having yourbreakfast in 10 minutes, have it
in 12 minutes, because, withoutrealizing it, the evidence
(27:44):
shows that, on average, you'llactually eat 15% less calories.
So there's all these differenttools that menopausal women can
bring in to help them on theirjourney.
Sandy Kruse (27:53):
That's one I've never heard, sarah, I love that.
Dr. Sarah Berry (27:59):
So eating rate is fascinating.
And I tell you why the rate'sfascinating.
Firstly, because there'srandomized controlled trials now
showing if you just tell peopleto slow down their eating rate,
you can see significant weightloss so doing it in a controlled
environment.
So there's randomizedcontrolled trials where they
randomly allocate, you know,overweight individuals to either
(28:23):
eating at their normal rate, oreating fast, or eating slowly.
Those that are told to eatslowly and eat slowly lose more
weight than those who are toldto eat at their normal rate.
We also know it affects therate at which we metabolize food
.
It affects our hunger feedbacksignals.
And what's really interestingabout this as well is that we
know it's one of the mechanismswhy these heavily processed or
(28:45):
ultra processed foods, as wecall them, are bad for us.
We eat ultra processed foods onaverage 50% more quickly than
unprocessed, nutritionallymatched foods.
Sandy Kruse (28:58):
So I think that's very fascinating, like I've
always been taught to eat slowlybecause you will be.
It's just like what you saidabout the hunger signals you
will feel satiated much sooner,but I find that really
fascinating.
And here's something you weretalking a lot about the eating
(29:21):
window and the fasting.
So I think you're going to findthis interesting.
Back in 2022, this was the yearthat I first experienced I was
52.
My cycle was really off.
I think I had only five periodsthat year.
Well, I was listening to and Ilike to call it the maniverse
(29:41):
the advice of all the giant, youknow, voices in the wellness
space, and it was all aboutfasting, and so I'm like they
say to do this.
So I'm going to do this, and Iwas doing intermittent fasting
with only an eight-hour windowwhere I could eat, and so I
(30:02):
would stop eating whatever 6.30at night or so, and then I
wouldn't eat until 11 o'clock orso 11, 1130 the next morning.
I had a very small window.
So during that time that I wasactually experiencing a lot of
perimenopausal symptoms, myHbA1c went up to 6.1.
(30:25):
So I was essentially insulinresistant at that point.
And so this speaks to exactlywhat you're saying about how
everyone's different and youhave to be really cognizant of
whatever advice you're taking inaround menopause that it's
(30:46):
really applicable to you.
So after that I actually Ibecame a certified metabolic
balance coach and I actually didmy own program.
I changed the method in which Iate, changed how I ate.
So I went back to three meals aday, but I still had a fast of
(31:11):
you know, between 12 and 14hours overnight.
I started to eat with proteinfirst.
So the order I don't know whatyou think about this and I'd
love to hear your opinion or ifthere's research I would start
eating my meals with proteinfirst and at least a couple
bites of protein before I ateanything else.
(31:34):
I didn't go keto or low carb oranything like that, but I had
really high value I like to callit high value carbohydrates,
much more on my plate.
Not that I ate a ton of breadanyway and I lost a ton of
percentage.
I'm going to say I'm not goingto give the exact percentage of
body anyway and I lost a ton ofpercentage.
(31:55):
I'm going to say I'm not goingto give the exact percentage of
body fat and I lowered myvisceral fat during that time to
be within a healthy range.
So my question to you is doesthe food order because you hear
a lot of different opinions onthis matter, on how you're going
(32:19):
to eat your meal Like, if youstart with protein, does that
matter?
Does that help with beingalmost like a buffer for
whatever else is comingafterwards?
Like, what are your thoughts onthis?
Because there are a lot of bignames who talk about eating
veggies first and then, like Iwould love to hear your take on
this, because there are a lot ofbig names who talk about eating
veggies first and then.
You know, like I'm, I wouldlove to hear your take on this.
Dr. Sarah Berry (32:39):
So I think there's two different aspects to
this that we need to thinkabout.
There's what I call mealordering, so the order in which
you eat your meals over the day,and then there's food ordering
the meal in which you eat yoursorry, the order in which you
eat your food within order, inwhich you eat your food within a
meal.
So we've done some research atzoe looking at meal ordering,
where we randomly allocated in aclinical trial, people to
(33:03):
different breakfasts, these kindof high carbohydrate breakfasts
, um, and it was in a crossoverdesign.
So over a period of a couple ofweeks every day they would have
a different type of breakfast,but everyone had all of those
breakfasts.
But then at lunch they were allgiven exactly the same meal.
So they had differentbreakfasts over the 14 days but
they had exactly the same lunchon every single one of those 14
(33:26):
days.
And what we saw was that whatpeople were having for breakfast
was partly shaping theirpost-translucent glucose
response, so their post-transferglucose response, so this
post-meal sugar response to whatthey were having at lunch.
So there were certainbreakfasts that were causing
people to have a higher bloodglucose response to their lunch
compared to other breakfasts,even though the lunch was the
(33:47):
same.
Now I don't know if you'veheard of the post-meal sugar
response.
I don't know if you've heard ofit was moderate.
How that would impact over many, many years.
Probably it wouldn't impactthings that much.
And this is where I think weneed to be very, very cautious.
We need to be really cautiousabout how we're eating our food
and the impact it has in termsof the size effect.
(34:08):
So let's now step whilethinking about that.
Let's think about the foodordering which is what you're
talking about.
So, yes, meal ordering has animpact.
There isn't loads of researcharound the order in which we eat
different foods or differentnutrients within the food and
how it impacts our health, howit impacts our metabolic
(34:29):
responses.
There's lots of anecdotalevidence and from very
well-known people saying this ishow I've done it and this is
what's worked for me.
That works for you great.
If that's how you want to eatyour food, great.
I think what the evidence doesshow is that, yes, if you have
protein and particular types ofprotein as a preload, so
particular types of protein thatwe know increase insulin.
(34:51):
So whey protein, for example,that we know increases the
secretion of insulin and youhave that as a preload, and
there's quite a few studies thathave done this, where it's
given like as a preload, maybe30 minutes before a meal or 15
minutes before a meal.
What that means is that you'vegot an insulin response so that
when you're then eating thecarbohydrates, the insulin's
already circulating the blood.
(35:11):
Hey presto, it can quickly thendispose of that glucose.
So it's lowering yourpostprandial glucose response.
What we also know is thatadding fiber, any type of
protein and any type of fat to ameal, that delays your gastric
emptying, so it delays the rateat which your stomach empties.
So you will have glucoseappearing, appearing sorry
(35:34):
glucose appearing in your bloodat a slower rate, and at a rate
that then can be removed, so tosay, more quickly by the insulin
.
So it's slowing down the rate.
Now, whether, therefore, youshould sit in a restaurant or
sit at your dinner table and say, well, here's a lovely meal,
there's some potatoes, there'ssome fish, there's some fish,
(35:55):
there's some vegetables.
I'm going to eat that fish, I'mgoing to wait five minutes,
because that's my protein bit,then I'm going to eat the
vegetables or potatoes, orwhether, according to other
people, I'm going to eat thefiber rich vegetables first and
then I'm going to eat the others.
Yes, I believe, based on whatevidence there is, it is going
to reduce your postprandialglucose response.
(36:17):
I believe, though, it's onlyhas a relatively small impact,
and I think what we have toremember is what impact is
eating that way had on you, foryour pleasure of food?
Because what worries me so muchin the wellness world and the
diet world is that we are oftenrecommending or making changes
(36:41):
that actually have a reallysmall size effect just because a
scientific study has showedit's significant.
Does that really mean it'sgoing to, over a long period of
time, actually have that much ofan impact?
And also the variability in howthese different bits of advice
(37:05):
impact someone is huge.
So someone on social media whodoes the fiber first, for
example, or the protein firstyeah, it might reduce their
post-vendor glycemic response by50%, but actually, on average,
it's probably not going to dothat, and probably for many
people it will have almostminimal effect.
So I'm a great believer in foodbeing about joy, about being
about pleasure, about beingabout our social connections,
(37:27):
our culture, and so personally,I would never change the order
in which I eat my food unless Iliked eating a particular bit of
food first.
My kids sit down.
They eat their vegetables last,but that's because they don't
like vegetables and I tell themthey have to eat that at the end
.
That's just the way that theynaturally eat.
(37:48):
When I eat my food, I just eatit in a random order.
I don't even think about theorder in which I eat it.
My food, I just eat it in arandom order.
I don't even think about theorder in which I eat it.
But despite the evidence to showthat, yes, it might impact it,
I think it's going to have sucha small impact compared to other
things that I do, compared tothe fact that I should have done
that run that day, which Inever do, the fact that I didn't
(38:08):
go to bed at that time, thefact that I still had that glass
of wine that I told myself Iwouldn't have.
They're going to have a hugeimpact and I should focus my
efforts on those.
I don't think I should focus myefforts personally on some of
these micro things.
However, having said that, formany people, it's micro habits
that are easy for them to do,sustainable for them to do and
(38:30):
therefore, in combination, ifthey do many of them, it might
improve their health.
So I'm very much sitting on thefence on that, but that's
because of my own personal viewof how I think we need to be
careful in optimization that wedon't just have fun.
Have fun in life, have fun withfood.
It's a pleasure.
Sandy Kruse (38:53):
Yeah, you're talking to a girl who lost her
thyroid at 41 and has done everysingle diet under the sun since
then.
So you know, I think there's alot and that's a totally
different conversation.
But in this world of food andwellness there's a lot of what I
call orthorexia, and I'm thefirst one to admit that I have
(39:18):
had a lot of challenges aroundfood because I kept trying and
you also mentioned that I kepttrying to chase this
pre-thyroidectomy body that Ihad before.
It's kind of like thesemenopausal women chasing their
(39:38):
pre-menopausal bodies and it'slike you know that whole thing
about food and pleasure.
I come from a family where foodis celebratory, but I also come
from a family where you neverleave anything on your plate.
You see what I'm saying.
So you know like I come fromparents who were farmers old
(40:01):
farmers in Croatia where foodwas scarce and you know there's
scarcity in there.
So there's a lot of topicssurrounding that.
But I do agree with you thatfood, you know it can be
pleasurable and I think a lot ofwomen around menopause have
(40:22):
this fear around food and so youknow, I know that you would
know even about cortisol and howthat can affect that weight
gain, and if you're alwaysstressed around what am I going
to eat, what can I eat?
And if it stresses you out toeat food in a specific order,
well then is it giving you thatbenefit anyway.
Dr. Sarah Berry (40:45):
No, and I don't believe so.
You know, I often finish all myacademic talks by saying if a
food or meal is too healthy tobe enjoyed, it's just not
healthy at all, and I think wereally need to remember that
when we're thinking about thechoices that we make.
But I think it's hard, becauseI think we all want to eat the
(41:06):
best, to maintain how we mighthave been or what we might have
been able to get away with 10,20 years ago.
When we become pre andpost-menopausal, it's tough.
Sandy Kruse (41:19):
It is, it is.
It's just like back in theolden days where you would sit
in front of the TV and get yourpopcorn and watch a movie.
You know, you never had tothink about it and every once in
a blue moon.
My husband and I will stillhave those nights because I'm
really trying just to be morepresent and, as you know, I was
(41:42):
in Europe for 10 days.
I didn't look at what order Iwas eating my food, I wasn't
careful.
I'm like I am going to be sopresent in this experience.
But it's not about gorging.
That's not what this was about.
It was about just being presentand enjoying the food that I
was trying from differentcultures.
(42:02):
So I do have to ask you moreabout this insulin sensitivity
we kind of touched oncholesterol insulin sensitivity.
We kind of touched oncholesterol yep.
So is it because our estrogenlowers that?
We lose that sensitivity and webecome more insulin resistant,
(42:25):
it like.
Why does this happen?
Is it specifically estrogenrelated?
Dr. Sarah Berry (42:30):
so, again, I think it's multifactorial.
Um, and I know as nutritionscientists we say this about
most things, but it is becausethat's the reality.
So, just like cholesterol, Ithink we've got the same thing
going on.
So, for example, you've gotthat increased visceral
adiposity.
We know that that certainlyimpacts our insulin sensitivity.
(42:51):
You've got the effect thatestrogen has on insulin, for
example, on insulin release aswell.
And then what we've seen in ourresearch and this was published
about two years ago, it's verynovel research is we saw that
people had, yes, very differentinsulin sensitivity depending on
whether they were peri orpremenopausal.
(43:13):
But what we saw was there was adifference in their
postprandial glucose response.
So we saw that postmenopausalwomen and I think I mentioned
this earlier had a higherpostprandial glucose response,
so a higher blood sugar responseafter having carbohydrates in
their food, compared to if theywere premenopausal.
And what was interesting isthat we were able to look.
(43:33):
Was this due to oestrogen, dowe think, or was it just
naturally part of aging?
So, firstly, we looked at do westill see this when we adjust
for lots of other factors, likeBMI, like the background, diet,
like age, et cetera, et ceteraand we saw that it was still
there, that, even when we adjustfor these other factors, you
still saw this difference inthis post-meal glucose response.
(43:57):
But it's very difficult to everfully adjust for age, and so
what we did is, because we hadsuch a big group of women that
we had been studying, weactually took what we call an
age-matched cohort, so we took asubgroup of individuals and we
matched them for age so that wecould remove this confounder of
age, the confounder of the factthat menopause is an age-related
(44:17):
event, and what we found isthere was still a significant
difference in postprandialglycemic responses, so these
post-meal sugar responses,depending on whether you're a
pre-peri or post-menopausal,with the peri and
post-menopausal having higherresponses, even in an
age-matched cohort, whichsuggests that, yes, it is a
(44:38):
direct effect of oestrogen,related to insulin or related to
the metabolism of glucose.
And this is after we adjustedfor factors like BMI as well.
I don't know the exactmechanism, it's not something
that we've looked into at thekind of molecular level, but I
know that there's other peoplethat have been looking into this
(44:59):
.
Sandy Kruse (45:00):
Just curious with that research that you did was
sleep in there, because that'sthe other factor, right, just
like what you were saying.
We all know that if we don'tsleep well, we tend to eat
poorly the next day.
We tend to crave those, thosecarbohydrates that aren't really
(45:21):
good for us.
So was that accounted for otherthan just age?
Dr. Sarah Berry (45:28):
that's a very good question and I cannot
remember.
Sandy Kruse (45:31):
I'm just curious because then it would be age pre
post-menopausal sleep.
Do you get what I mean?
It would kind of have all thosecomponents.
Would be interesting to see.
Yes.
Dr. Sarah Berry (45:45):
I can't remember if we adjusted for
sleep.
We adjusted for lots ofdifferent variables, like how
healthy the background diet was,like BMI, and we did see a
difference, obviously, in sleepquality between the pre and
post-menopausal.
So yeah, it would beinteresting to see how our
results play out if we adjustfor sleep and then if we don't
(46:06):
take the sleep into account.
Sandy Kruse (46:07):
Yeah, yeah it would be interesting.
Dr. Sarah Berry (46:08):
You might have done that.
Sandy Kruse (46:09):
I can't remember everything that we've published
that I can't remember everythingthat we've published.
Okay, so let's move on tosymptoms, because symptoms are
big and I know that there areplenty of herbals and things
like that that women can take tohelp with symptoms.
What about food?
Dr. Sarah Berry (46:31):
So we've just recently completed a huge study
this is in 70 000 women, wherewe ask them questions about
their symptoms and we ask themwhat symptoms they had and we
ask them to grade them on ascale of zero to five into how
much they impact their qualityof life.
From this we generated a scoreusing something that we call our
meno scale calculator, and thisis a calculator that's
available for anyone.
And what this calculator does itgenerates a score using
(46:51):
something that we call ourMenoscale calculator, and this
is a calculator that's availablefor anyone.
And what this calculator doesit generates a score out of a
hundred.
So you've got and this is basedon what we know from published
research and our own research ofthe 20 most common symptoms.
Now I know that there's 50 ormore known symptoms, but you
know we have to stop somewherein research.
(47:13):
So we selected the 20 mostprevalent symptoms and then we
asked people, on a scale of zeroto five, how much of an impact
does having a quality of life,and you return a score out of
100.
This meno scale is availablefor anyone to complete.
It uses modern language,because lots of the other
menopause symptom questionnairesuse old-fashioned language like
how excitable are you, whichpersonally makes me want to
(47:37):
throttle the person thatgenerated that.
They're typically generated 50years ago, by men as well, who
have no idea of what these womenwere going through.
So we're using modern language,accessible language, it's free
for anyone to go on.
You can go to zoecom, uhforward slash meno scale and
anyone can fill it out.
(47:58):
If you fill it out, then youget returned a score.
You get told how you comparedto someone your similar age on
hrt or not on hrt, what your topsymptoms are and how they
compare.
So we've got all of this data.
We've got people's meno, sotheir average score related to
the impact that the symptomshave on them.
And then we've also got forthese 20 different symptoms and
(48:22):
what we see first is thatsymptoms are really prevalent.
We see that the kind ofsymptoms that we used to think
were the main symptoms, like hotflushes, are actually the least
prevalent.
The most common symptoms arethe things like the sleep
disturbances, the brain fog, theanxiety, the low libido, the
weight gain, the slowedmetabolism, low mood,
irritability, etc.
What we see as well in thiscohort of 70,000 people is that
(48:46):
people have more symptoms astheir BMI goes up.
So people living with obesityhave an increased risk or an
increased chance of havingsymptoms and having them more
severely as their body weightgoes up.
Now, this is a problem because,if we go back to what we were
talking about 15 minutes ago,it's really difficult to
(49:08):
maintain your body weight andyou're going through the
menopause.
This becomes really problematic.
What we also see on a morepositive note, is that people
have a reduced likelihood ofhaving symptoms if they have a
healthy diet.
If they have an overall healthydiet and I don't mean by this
you know very specific foods,but I mean overall if their
(49:30):
dietary pattern is more healthy,they have a reduction in
symptoms.
Now, this data was collected atone point in time.
It's what we callcross-sectional data.
So what we did is we thenlooked at does the symptoms that
people are experiencing changeif they go from an unhealthy
diet to a healthy diet?
And what we see is, if wefollow people up over a period
(49:52):
of time, as people change froman unhealthy diet to a healthy
diet and these are peoplefollowing our ZOE program, which
is this personalized nutritionprogram we see that they
experience a reduction of around35% in their menopause symptoms
.
Now, that's huge.
Now, this isn't a randomizedclinical trial.
There isn't a control arm, soobviously we have to be slightly
(50:14):
cautious with how we interpretthis in terms of the causality.
But what we are seeing is, inthose who follow our ZOE program
, who improve their diet,there's a 35% reduction in
symptoms.
We know from other publishedresearch people following a
Mediterranean diet alsoexperience a reduction symptoms,
so it's not that we're juststicking out.
(50:35):
What's interesting as well iswe looked at these individuals
according to whether they wereon hormone therapy or not on
hormone therapy.
Those that were on hormonetherapy obviously have a lower
starting point in terms of theirsymptom burden, but what we see
is they still benefit fromimproving their diet.
They still get a 35% reductionin symptoms.
(51:02):
And I think this is reallyreally important that HRT alone
is not the only answer.
You can use diet with orwithout HRT to have a
significant impact on yoursymptoms.
Now, this is going to varyperson to person and I know we
talked about this earlier in ourdiscussion.
Some people will respond reallywell, some people will respond
less well, and it's aboutfinding what works for you, and
this is what I love about ourMenos scale that we've generated
.
People can use that to trackhow their symptoms change.
(51:23):
So if they're starting on HRT,if that's their choice, they can
see.
Well, let's track each week howmy symptoms are changing.
Is it working?
If they're embarking on a dietor a lifestyle change, they can
use the Menoscale again to tryto see.
Does this work for me?
Does it improve my symptoms ina slightly more objective way
than necessarily kind of tryingto remember, or do I feel a bit
(51:44):
better this week?
Sandy Kruse (51:46):
Oh, I love that.
Now people who are listeningare probably going to say well,
what is a healthy diet?
I know you mentionedMediterranean.
I typically follow aMediterranean diet.
I would say, for the most partI am a big personally.
(52:07):
This is me now.
I believe in the 80-20 rule, Ibelieve in a balanced diet, but
for the most part whole, realfoods.
So what is classified as ahealthy diet?
Dr. Sarah Berry (52:26):
So a healthy diet means different things for
different people, and I think ahealthy diet also varies
depending on where you are rightnow.
So for the average American,average British person, who
consumes 50 to 60% of theirenergy from ultra processed food
, a healthy diet might just bereducing that ultra processed
food by 10%, just increasing anextra few vegetables, et cetera.
(52:50):
So I do think we need to bearthat in mind.
But when I talk about a healthydiet, and when I talk about a
healthy diet in relation tothese results, it's a diet that
is very high in fiber.
It's a diet that's high inplant-based whole foods, like
you mentioned.
So these could be fruits,vegetables, pulses, for example,
(53:10):
whole grain.
It's a diet that is low inthese heavily processed,
unhealthy foods, so low inrefined carbohydrates ie, white
bread, white rice, for example.
Low in ultra-processed meats.
So you know your salamis, yourhams, those sorts of things.
(53:31):
It's a diet that's diversesalamis, your hams, those sorts
of things.
It's a diet that's diverse andthis is really important because
we know on average, a foodcontains about 72 000 different
chemicals.
We want to get a diversity ofchemicals and so we often talk
about having 30 different plantsa week to get that diversity
doesn't have to be 30, butmaking sure you're eating a
(53:53):
diverse uh, you know array ofdifferent fruits, different
vegetables, differentplant-based foods, and trying to
eat the rainbow.
So food, uh, plant-based foods,often pigmented, like red
peppers, beetroots, these sortsof things.
The pigments can come frompolyphenols, come from these
magical bioactives that we knowimprove health.
So making sure you're alsogetting a diversity of colors in
(54:16):
your diet.
And then there's some evidenceas well, when it comes
specifically to menopause, thatsoy isoflavones might improve
your health.
Now, this isn't specific advicethat we give in our ZOE program
, what I've just mentionedbefore.
That is advice that we givethat we see improves people's
health.
But I do think it's worthmentioning, related to diet,
(54:38):
that I'm very, very skepticalabout different supplements.
There's a term we use in the UKcalled menowashing.
Stick the word, you know theterm menow in front of it and
you can charge 10 times as much.
There's so many supplements outthere that are being sold to
women at very expensive pricesto say this will cure your
menopause, this will solve yourmenopause symptoms.
(55:00):
There's really, reallyinconsistent evidence.
Now what I would say is, if itworks for you, great, because
again, it's going back to that.
We all respond differently.
If you find a supplement thatworks for you, I think that's
fantastic.
Respond differently.
If you find a supplement thatworks for you, I think that's
fantastic.
But what we do know is that theonly supplement that I believe
(55:21):
there's sufficient evidence toshow that it works is soy
isoflavones, and these are akind of phytoestrogen and these
are a chemical that mimic theestrogen molecular structure and
they bind to our estrogenreceptors.
So we know that countries wheresoy isoflavones are consumed
regularly to a high amount likeChina, japan they have lower
menopause symptom burden.
(55:41):
We know that if you supplementpeople at a certain level with
soy isoflavones, then they willhave, on average, an improvement
in symptoms if it's a certainlevel.
But we know that there's hugevariability.
And we know there's hugevariability because what we also
know is that your gutmicrobiome impacts how you
metabolize soy isoflavones.
(56:02):
So some people have a gutmicrobiome such that they get a
huge benefit from soyisoflavones and other people
have a gut microbiome such thatthey might only get a small
benefit.
So it takes us back to thatpoint earlier of again.
You might see a huge benefitfrom taking soy isoflavones.
Sandy Kruse (56:20):
You might recommend that to your friend and they
might say oh, it's just notdoing hardly anything that's
because we always want sodifferently and for a whole
array of different reasons okay,um, I know, okay, I know that
we're coming close to the end ofthe recording, but I can't not
ask you about this topic andmaybe you'll answer this, maybe
(56:47):
you won't, but what are the topthree issues women need to
consider at menopause and howcan we really use?
We touched on so many differentthings.
I just want something thatsomeone can take away from this
(57:09):
podcast and say, okay, I'm goingto stop here.
I want to address these topthree issues and we can eat the
way that we've been talkingabout.
Go check out Zoe, which I wouldlike you to summarize what
that's about as well.
But what are top three issuesLike?
Is it heart health?
Is it brain health?
(57:29):
Like what are the top threemenopausal issues that women
just need to think about?
Dr. Sarah Berry (57:35):
Really difficult.
I think we need to be mindfulof our heart health, because our
cardiovascular disease riskgoes up.
I think we need to be mindfulof our bone health, because we
know that estrogen impacts ourbone health.
And I think we need to bemindful of our brain health as
well, because of how it impactsour cognition, but also how our
(57:57):
brain ages due to changes inestrogen.
And I think what's common toall of those three issues are
the four pillars of health, andI know that many know these are
important.
But I think it's reallystepping back and thinking about
these four pillars of healthand can you change any of them?
(58:18):
Physical activity,weight-bearing exercises, in
particular for bone health.
Physical activity for hearthealth.
Physical activity for brainhealth, reducing stress it's
hard.
Perimenopause and postmenopauseis a time where women
experience much stress.
Often they're still got teenagekids, they're still working
full-time, they might be caringfor elderly parents.
(58:39):
It's hard to minimize stress,but being mindful of the stress,
I think, is important.
The third pillar of health issleep, which we've touched on.
Anything that we can do forgood sleep hygiene to help our
sleep in any way that we can isgoing to help.
And then the fourth one is dietthat we've talked about, and
those four pillars of healthwill impact all of those issues
(59:02):
our brain health, our hearthealth and our bone health.
Sandy Kruse (59:06):
I love that.
Now tell us a little bit aboutZoe a little bit about Zoe.
Dr. Sarah Berry (59:19):
So Zoe is a science and nutrition company
and Zoe is building on sevenyears of amazing science that
we've been doing and thehundreds of years before that
that scientists all over theworld have been doing in
nutrition science to enablepeople to make the smartest food
choices for them.
So it started out on the basisof investigating how much
variability there is betweenindividuals in how they respond
(59:39):
to food and seeing that there'sa huge difference in how one
person responds compared toanother person.
And then we've been conductinglots and lots of trials looking
at, well, what explains thisvariability?
Why does someone respond likethat versus someone respond a
different way?
And can we use vast amounts ofdata to predict how people
(01:00:00):
respond to deliver the bestadvice?
And so we deliver advice that'spersonalized to an individual's
biology.
So we look at people's biology,so we look at their microbiome.
We look at their blood health,so we look at various chemicals
circulating in their blood.
We look at people's biology, sowe look at their microbiome.
We look at their blood health,so we look at various chemicals
circulating in their blood.
We look at their glucoseresponses, etc.
We ask people about theirhealth history and so many other
(01:00:21):
factors.
We look at how people live theirlives.
We look at how people make thedietary choices they make, why
they make the dietary choicesthey make, what their
preferences are, and peopleundergo a two-week test period
where we test lots of differentthings.
So they're wearing differentwearable devices, they're
monitoring their glucose, theirblood fats, their microbiome and
(01:00:42):
then, using this years andyears of science and these
hundreds of thousands of datapoints that we've collected, we
feed back to people afterthey've done this two-week test
phase how they should eat bestfor them.
That fits in with the way theylive their lives.
So it's an app-based productafter they've done the test
phase and enables people to lookfor every food whether that's
(01:01:03):
the best food for them.
It enables people to monitorthe food they're having.
It enables people to tracktheir progress, to see whether
they're having a healthy dietfor them as an individual and
overall, and people can sign upto do this for 12 weeks or six
months or 12 months, and it'sfollowing.
This ZOE program that peoplehave signed up for is where we
see these big improvements inmenopause symptoms.
(01:01:26):
We've also published arandomized controlled trial in
Nature Medicine a few months agowhere we compared health
outcomes cardiovascular healthoutcomes on those who were
following the ZOE program versusthose following standard US
dietary recommendations, and wefound that those following the
ZOE program had significantimprovements in cardiovascular
(01:01:47):
related health outcomes, as wellas body composition so well
weight and waist circumference.
Sandy Kruse (01:01:53):
And it's available in the US.
It is Okay.
So what is the website?
Just zoecom.
Dr. Sarah Berry (01:02:01):
Go to zoecom and you can find out about the
science we're doing.
You can find out about thecommercial product that we offer
.
You can find out also about ourmena scale and all of our other
research that we've got goingon.
Sandy Kruse (01:02:15):
That's amazing, and I know that they're on
Instagram, as are you as well,dr Sarah Barry, so I will have
all this information in the shownotes and I just want to thank
you so much for the wonderfulconversation.
Dr. Sarah Berry (01:02:29):
Our pleasure.
It's been lovely chatting toyou.
It's just been like sittinghaving a chat over a cup of
coffee.
I don't have my cup of coffeewith me.
Sandy Kruse (01:02:37):
Not at this time, right, not at this time?
Dr. Sarah Berry (01:02:42):
Yes, not at this time.
It's half five here in the.
Sandy Kruse (01:02:43):
UK.
I hope you enjoyed this episode.
Be sure to share it withsomeone you know might benefit.
Share it with someone you knowmight benefit, and always
remember when you rate, review,subscribe, you help to support
my content and help me to keepgoing and bringing these
(01:03:05):
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Join me next week for a newtopic, new guest, new exciting
conversations to help you liveyour best life.
Hi everyone, it's me, Sandy Kruse of Sandy K
Nutrition, health and LifestyleQueen.
For years now, I've beenbringing to you conversations
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(00:26):
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(01:10):
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Hi everyone, welcome to Sandy KNutrition, health and Lifestyle
(01:31):
Queen.
Today with me I have a specialguest.
Her name is Dr Sarah Berry andshe is an associate professor at
King's College, london, uk, andhas run more than 30 human
clinical sorry, human nutritionstudies.
Most notably, she's the leadnutritional scientist for
(01:52):
PREDICT, the world's largestin-depth nutritional research at
the science and nutritioncompany ZOE.
I hope I pronounced it right,it is ZOE right, I did.
Dr. Sarah Berry (02:03):
It is Zoe.
I hope I pronounced it right itis Zoe right, I did, it is.
Sandy Kruse (02:13):
And today we're going to be breaking down the
very complex connections betweenlifestyle, hormones and health,
and how diet can lessen theeffects of menopause on women's
bodies.
And I think this is a veryimportant conversation because
myself, as a holisticnutritionist, I hear all the
time about people who will doeverything else in the world but
(02:35):
change their diet when theyhave an issue, and I don't think
there is a better person tohave this discussion with than
Dr Sarah Berry.
So, with that, welcome, thankyou.
Dr. Sarah Berry (02:50):
Thank you for having me on.
I'm excited to dive into it andalso dive into why it's so
difficult to change your diet.
Sandy Kruse (02:59):
Yeah, I think this is going to be a great topic
because, I mean, the sciencesays that diet matters and we
can use food as medicine, andthis is so important, especially
for women who are just kind ofentering into these stages and
seeing these changes in theirbodies, you know, right around
(03:20):
perimenopause.
So I have to ask you if youcould just let us know your
background and why such aninterest in this field.
Dr. Sarah Berry (03:28):
Yeah, so I'm a nutritional scientist by
training.
I did my PhD many years ago atKing's College London, a
university here that has one ofthe world's leading nutrition
departments, and I started offresearching the impact that food
structure has on our health,and particularly in relation to
cardiovascular disease, and howthe different fats that we eat
(03:52):
and the structure of food, howit impacts what we call our
postprandial responses, so ourshort-term responses to food, so
those kind of metabolites thatchange two to four hours after
eating food metabolites thatchange two to four hours after
eating food.
And I started to notice thatactually people's responses were
so, so different.
There was like a 20 folddifference between how one
(04:12):
person would respond versusanother person, and so I had the
privilege to get involved witha what was a startup seven years
ago and now is a company calledZoe Science and Nutrition
Company, and now is a companycalled Zoe Science and Nutrition
Company, who have really beenat the forefront of developments
in personalized nutrition basedon this idea that we all
respond so differently to food.
(04:34):
And through Zoe we're runningthis huge program of research
that you mentioned, the Predictprogram research, which is
collecting data in hundreds ofthousands of people and looking
at how we differ between people,how we differ day to day and
how we metabolize food, and howwe differ depending on multiple
factors, and one of thosefactors we were starting to see
(04:54):
a couple of years ago that wasactually having quite an impact
on how we metabolize food, onour health factors as well
related to, like blood pressure,lipids, inflammation was the
menopause, and so that's how Ikind of dived last few years
into menopause research and,more recently, also looking at
menopause symptoms.
(05:14):
So looking at the relationshipbetween both diet and menopausal
health, and by this mean I meanall the unfavorable health
changes that happen peri andpost menopausally, but also diet
and menopause symptoms, whichis what many people talk about
when we think about menopause.
So that's how I've ended upwhere I have.
So menopause for me is arelatively new area, but I have
(05:35):
spent 25 years looking at therelationship between diet and
all of the kind of factors thatactually are relevant in
menopause kind of factors thatactually are relevant in
menopause.
Sandy Kruse (05:47):
I'm going to say one thing that really stuck out
that you just said is thebio-individuality aspect and how
certain foods will affect youdifferently than it will affect
me, and I think that this is keyhere.
Because think that this is keyhere?
(06:10):
Because, excuse me, I noticedin this area of health and
wellness we get a lot of adviceand it gets very complex,
especially for women who areexperiencing these changes in
their bodies.
And even though I'm a holisticnutritionist, that doesn't mean
that I'm not going to havechallenges.
But when we hear advice, that'spretty blatant advice you must
(06:30):
do this, you must do this, youmust eat this, you must have
this, you must take this.
It gets very daunting for a lotof women, especially because
we're already dealing with thesechanges.
So I love that there's thatwhole bio-individual aspect to
(06:51):
what you do, sarah.
It's amazing.
So I guess we could start about, because you have such vast
experience in this, what do wesee around menopause?
That maybe makes this wholefood aspect a little more
complex.
Dr. Sarah Berry (07:13):
So I think we need to step back and think well
what is menopause?
And I know many of yourlisteners might know this, but
there might be many listenersthat don't know this.
There might be some menlistening who have women in
their lives that are goingthrough this.
So if we can just pause for amoment and think about what
menopause is, then I think itputs into context why food might
be relevant and why we havesuch wide-reaching health
(07:34):
effects related to menopause.
So menopause, very simply put,is the point in time one year
after your last menstrual cycle.
So it's the point in time ayear since you had your last
period or last menstruationbleed.
Now you don't go to bed onenight premenopausal and wake up
hey presto, I'm postmenopausal,that's it, it's all over.
(07:57):
No, it doesn't work like that.
There's an entire menopausetransition period, and this
menopause transition periodstarts when your oestrogen
levels start to decline and, inthe definition that we use as
scientists, it ends 10 yearsafter your last menstrual cycle.
Now the perimenopausal phase isthe phase that your oestrogen
(08:21):
starts to decline up until whenyou have that last period, or
the year after your last period.
This can last anything from twoyears to eight years, depending
on individuals.
Again, we're all so different.
But what's really important tonotice in this perimenopausal
phase what happens is not thisbeautiful slow decline in
oestrogen that your body adjuststo day by day.
(08:44):
No, it's a roller coaster.
It's this phase of hormonalchaos where you've got these
peaks and troughs and movingaround in oestrogen, and that's
why the perimenopausal phase isso challenging.
Postmenopausally it's morestable, but your body's still
adjusting to this change inoestrogen.
And the reason that we knowthat perimenopausal and
(09:06):
postmenopausal women have amultitude of issues is because
oestrogen receptors are all overour body.
Oestrogen receptors aren't justdown there, related to our
reproduction or our ovaries.
We have oestrogen receptors inour brain, in our muscles, in
our bones, in our heart,everywhere, and so as we lose
estrogen, we aren't gettingthese estrogen receptors
(09:28):
stimulated and therefore they'renot doing the job that they are
there to do, and this is why wehave such far reaching issues
or symptoms.
We have health related issuesthat we talk about a lot less, I
think, or not as much as weshould relate to menopause.
So we know, for example, fromour own research and other
published research, thatpremenopausally, women are doing
(09:51):
quite well in terms of health.
So by this I mean at any givenage compared to a similar age
man, and I'm talking about theaverage here.
Women on averagepremenopausally have lower blood
pressure, have bettercholesterol, have better insulin
sensitivity, have less visceraladiposity, so less fat around
the belly, have lowercardiovascular disease risk.
(10:13):
What happens is when they meetthe perimenopausal transition
phase, suddenly these start togo up and suddenly their risk,
these intermediary risk factorsassociated cardiovascular
disease, their blood pressure,their cholesterol, the insulin
resistance, the inflammation,the visceral adiposity, suddenly
goes up to the level of men andin some cases in our own
(10:36):
research, for example with bloodpressure we see it even
overtakes men.
So firstly you have thesehealth effects related to
menopause, which we know dietcan have a really fundamental
role in helping negate.
And then you have the symptoms.
This is what I think many peoplethink about when they think of
menopause.
You have these really impactfulsymptoms.
(10:57):
Again, they vary from one personto the other and by symptoms I
mean everything from theneurological symptoms so the
memory loss, the brain fog, theanxiety, the mood swings, the
depression, the low mood tophysical symptoms so achy bones,
achy shoulders, poor skin, poorhair, etc.
Such as, you know, the poorsleep, for example, and you know
(11:29):
, sexual symptoms as well lossof libido, vaginal dryness, etc.
So we also have these farreaching symptoms and the reason
is, again, is because we haveestrogen receptors all over our
body.
We've not got estrogen bindingto them.
They're not doing what theyshould be doing and so suddenly
we're hit with these awfulsymptoms, and this is one of.
We've been looking at both ofthese in our ZOE predict
research.
We've been looking at thehealth aspects.
(11:52):
We've been looking at how theydiffer from people, how diet
might help, and then we've alsobeen looking at symptoms, how
prevalent they are, howimpactful they are in people's
quality of life and where dietmight fit in with these, and
also where other hormonal kindof therapies fit in as well.
Sandy Kruse (12:08):
Has the research that you guys have done at Zoe
explained the whys?
Like I know, you can't speakabout prescriptions or anything,
(12:31):
but you see a lot of women are.
I guess it's suggested to themby their primary care physician
to go on a statin because theircholesterol shoots up.
So why does that happen, otherthan?
Is there another reason otherthan the fact that you know, we
just don't have the estrogenanymore?
Dr. Sarah Berry (12:54):
So that's a really interesting question,
because what's very difficultwith menopause research is to
disentangle natural parts ofaging versus what's due to
estrogen.
Specifically, menopause is anage-related event, and so how do
you disentangle?
Well, this is just becauseyou're getting older.
So we know, for example, in men, as they get older, their
(13:17):
cholesterol tends to go up.
In women, your cholesterol tendsto go up.
What's due to the menopauseversus what's due to age.
Now we do suddenly see like aninflection point, so to say,
where cholesterol might steadilyincrease and suddenly at the
menopause phase it suddenly goesup.
We know that there are someunderlying mechanisms for this.
We also know that for themajority of people, if they then
(13:41):
start taking hormonereplacement therapy and see this
for in our research, forexample, then your blood
cholesterol levels go back down.
So again, building that picturethat it's not just age-related,
that there is a direct effectof oestrogen, and this is for
multiple reasons.
So one of the reasons is thatwe know that your body
(14:03):
composition changes duringmenopause, so estrogen changes
where we deposit fat.
So in a kind of very simple,using very simple terminology,
we know that estrogen kind ofdirects fat to our hips and our
bottom.
So women have this pear shape.
When you start to lose estrogen, you lose that kind of
(14:24):
protected direction of fat to anarea that we know is quite safe
to have fat and what happens isis therefore you start to
deposit fat around your abdomen,around your belly, so you
increase what we call visceraladiposity, which is basically
tummy fat, and we know this isreally metabolically active.
We know it's unhealthy fat.
We know it's more linked withinflammation, with
(14:45):
cardiovascular disease, withtype 2 diabetes, with higher
blood cholesterol, bloodpressure et cetera.
Because it's so metabolicallyactive, menopausal women have
five times more likelihood ofhaving visceral adiposity than
if they're premenopausal.
So firstly, you've got kind ofindirect effects going on
because of oestrogen's impact onother areas, so, for example,
(15:08):
increasing adiposity.
We also know that oestrogenimpacts many enzymes involved in
how we metabolize fat, how weproduce fat in the liver, how we
remove fat from the circulation.
We also know it's involved inprocesses related to how we
process glucose as well in theblood, so from the carbohydrates
(15:30):
in the meal, because it's it'shas an impact on insulin, for
example.
It has an impact on theseenzymes, lipases, involved in
how we process fat.
So we know that these again areall mechanisms that are
important in also some of theunderlying pathways related to
(15:51):
recordings.
I feel it really gives more ofan authentic.
Sandy Kruse (16:08):
Take on all of my recordings and, as a woman who's
almost 55 and menopausalexactly what you're talking
about, and I know I'm an N ofone but I see exactly that when
my estrogen is not optimized, Iget that central belly fat.
(16:31):
And this isn't to insultmenopausal women at all.
I'm not saying that.
I'm just saying that you canalmost visually see that center
of a woman get larger and it'slike their bum and their hips
(16:52):
disappear, you know.
And so a lot of women are like,oh my God, I don't know what's
going on.
I'm getting this belly fat andfor me personally, again N of
one.
I know it's all about thatoptimization for estrogen, but
I'm on bioidentical hormones andthat might not be the choice
(17:14):
for every woman.
So this is where we go.
Okay, well, how can I optimizemy body composition?
Using food and using lifestyle?
Dr. Sarah Berry (17:28):
Lifestyle matters too, and movement too,
and movement, yeah, and I thinkit's challenging and I don't
want to.
I'm reluctantly, rather I'mreluctantly saying this, that
it's challenging, it's tough,but I think we have to be
realistic in these conversations.
You know, I would love a bellylike Jennifer Lopez.
(17:49):
I would love, you know, to looklike Halle Berry.
The reality is I don't.
I'm 47.
I'm starting to get a bit of abelly around my tummy.
I've not put weight on and Iknow it's because I'm in that
perimenopausal transition.
But we have to be realisticabout what we can do about it.
And I think that I'm not justsaying we accept it, that this
(18:10):
is just inevitable, but we haveto accept it's going to be
harder to maintain the bodyshape we had before if we're
peri and post-menopausal.
And this is because, as well asthat direct effect that I
talked about on estrogen andwhere it directs the fat, you've
got so much else that's goingon, which is where what you've
said lifestyle also comes intoit.
(18:31):
Diet comes it.
So, for example, most peri andpost-menopausal women and we see
that 85 percent in our cohortsay that they're not sleeping
well, that they have sleepdisturbances.
So 85 percent of perimenopausalwomen are having sleep
disturbances.
Now.
Sleep impacts so much.
Sleep impacts our desire to dophysical activity.
(18:52):
Sleep impacts our mood.
Sleep impacts our stress level.
Sleep impacts the dietarychoices that we make.
If we've had a bad night's sleep, the reward centers in our
brain are heightened and they'llbe saying hey, sandy, I know
you were going to have this nice, healthy breakfast, but, damn
it, you've not slept very well.
Go and have a quick fix.
You're fighting against that.
What we also know from our ownresearch, from our Zoe Predicts
(19:14):
studies, is if you've had a poornight's sleep, you also have a
difference in your metabolismimmediately the next day.
So we gave people identicalmeals across a number of
different days to have forbreakfast.
These are high carb, high fatmeals and what we found is on
the days that people had a poornight's sleep, when they had
that high carbohydrate meal forbreakfast, they had a higher
(19:37):
postprandial glucose response,and by this I mean circulating
levels of blood sugar afterhaving that meal.
They had a higher responsecompared to days when they had a
good night's sleep.
So you've got women who arehaving all of these things being
thrown at them the lack ofestrogen directing fat to their
belly, the poor night's sleep,the higher glycemic responses,
(19:59):
the craving for different kindsof food, the low mood, the less
desire to do physical activity,et cetera, et cetera.
It's kind of creating thisperfect storm.
And, yes, we can try and fightagainst the perfect storm, but I
think we have to recognize thatit's going to be harder.
(20:19):
And do we want to fight againstthe perfect storm?
Do we just accept?
You know what my body shape ischanging?
But what I will do is make surethat I'm eating as healthy as I
can, but I will accept that mybody shape is going to change.
It's a personal choice.
Sandy Kruse (20:44):
And I love that you said that about the sleep,
because I think this is key Ifwomen can really kind of have
that as your foundation andutilize the tools that are
available to you, because I dofeel that we need more tools in
order to sleep well.
(21:12):
I mean, if you're a mom, it kindof starts when you have babies
and then you end up havingteenagers and then you end up
having menopause and it's tough.
But I think if we put ourselvesfirst and we do whatever it is,
whether it is working with yourphysician and I know for me I
began using bioidenticalprogesterone, starting off with
the cream and this isn't whatthis discussion is about, but
(21:35):
for me it immediately helped meto optimize my sleep.
That's where it kind of beganin my 40s, because I recognized
that nothing else was workingand I needed to do what I could
for my sleep.
Now, the other thing I do findinteresting is I'm sure you've
(21:59):
looked at this and I wonder ifZoe has in the Predict, research
has looked at this Just interms of you know, our blue
light and how that might affectour circadian rhythm, which can
in turn affect our hormones.
I don't know if Zoe has donethat.
Any research there.
Dr. Sarah Berry (22:20):
No, we haven't done research specifically
related to blue light.
We have done lots of researchlooking at how time of day
impacts our responses to food,how time of day impacts our
post-prandial responses, likeour glycemic responses, how
factors like meal ordering,time-restricted eating.
So we've done lots of workaround that and I think what
(22:41):
this work shows to us is thatthere's lots of tools to our
toolbox.
So it goes back to somethingyou were saying earlier.
That, again, know, I was sayingearlier how tough it is and I
think that we can try to changeour diet.
It's hard, but we can also tryand change other factors related
(23:02):
to how we eat, and this iswhere I think the whole
circadian biology is fascinating.
So, whilst I don't know how theblue light and circadian
biology fits in specificallywith hormonal levels, what we do
know is if you're eating lateat night.
So, for example, in our cohortwe see that 30 percent of people
are snacking after nine atnight.
(23:22):
That's huge.
We know that if you're eatingafter eight or nine at night,
you're at higher risk ofmetabolic disease.
You're at higher risk of higherinflammation, higher blood
pressure, higher inflammation,higher blood pressure, higher
cardiovascular disease, etcetera.
And again, becausepostmenopausally you're already
at higher risk of that.
These are the kinds of thingsthat we could be quite mindful
about.
Even if we're not totallychanging our diet or making big
(23:44):
changes to our diet, why don'twe change how we're eating the
food?
So why don't we stop eatinglate at night if we can try and
shift the last meal of our day alittle bit earlier and then
change other factors related tohow we try and give our body a
kind of fast period?
So try and make sure we'rehaving 12 hours, ideally 14
(24:07):
hours, where we're not eatinganything.
And we run this study called theBig If Study, the Big
Intermittent Fasting Study,where we asked people at a
population level just tryreducing the time window in
which you eat your food.
You don't need to go crazy.
All the studies out there usethese crazy eating windows of
only eating four hours or sixhours.
That might work for some people.
(24:28):
Certainly wouldn't work for me.
So we just said you know, maybehave your last meal of the day
at seven o'clock.
That means you can have yourfirst meal of the day at nine
o'clock the next morning.
So you're eating in a 10 hourwindow.
This improved people's moodimproved, their energy levels
improved their hunger levels,improved their weight, and we
saw this worked really well aswell in peri and postmenopausal
(24:51):
women.
And we did this in 150,000people in and we told them to
carry on the normal way you liveyour lives, carry on that noisy
way you live your life, don'tchange anything else.
And we saw an improvement.
And I think where we saw thebiggest improvement was actually
those that were doing what wecall early time-restricted
eating, so those that weremaking sure they finished a bit
(25:11):
earlier, so with, for example,having their last meal at least
before seven in the evening, andwe saw a benefit across
everyone.
But the fact that we saw aneven greater benefit in some of
the parent postmenopausal women,I think is really promising.
And then another area that kindof fits into this again it's I
have to caveat, it's not relatedto the blue screen, but it fits
into this whole idea of thecircadian biology that we're
(25:34):
talking about is that also, weknow that consistency in sleep
is really important, consistencyin the time you go to bed.
So we did some reallyinteresting research that we
published a couple of years agoon what we call social jet lag.
I don have you ever heard ofsocial jet lag?
No, no, so it's a relativelynew term and what it basically
(25:57):
means is inconsistency in whenyou're going to bed, in your
sleep pattern.
So, for example, people who arebeing sensible in the week,
coming home, going to bed at 10o'clock every night on a weekday
because they're getting up forwork and then at the weekend
they're going out, partying,going crazy, going to sleep in
two in the morning.
Or it might be the other wayaround.
(26:18):
You might be like me, who worksincredibly late every evening
because I get so excited by allthe signs.
Then at the weekend it's likecatch up time and I'm going to
bed early.
But it's that inconsistency andwe call this social jet lag,
where you're changing your sleeppattern, not because you're on
a plane, but because of how youmight be living your life
socially.
And what we see is, if you havesocial jet lag, we see that that
(26:40):
impacts different areas relatedto health as well.
We see it impacts some of thedietary choices you make, and we
see that it also impacts yourmicrobiome composition in a way
that we know is unfavorable andmay lead to other unfavorable
health effects.
And so I think this isfascinating.
And the reason it's fascinatingis because I think, as
nutrition scientists, we'vealways thought it's all about
(27:00):
what you eat.
Change your diet, reduce this,reduce that, cut out this.
Well, firstly, I think, asnutrition scientists, we should
say this is what you should addin to make it healthier.
But secondly, we've got all ofthese other tools we can fiddle
with.
We can stop eating late atnight.
We can try and you know eat ina more consistent way.
We can do things like slow downthe pace in which we eat our
(27:22):
food.
You know, there's amazingresearch showing that if you can
just reduce how fast you eatyour food by as little as 20%,
you can, without even thinkingabout it, reduce the amount of
energy, so the amount ofcalories you're consuming, by
15%.
So, instead of having yourbreakfast in 10 minutes, have it
in 12 minutes, because, withoutrealizing it, the evidence
(27:44):
shows that, on average, you'llactually eat 15% less calories.
So there's all these differenttools that menopausal women can
bring in to help them on theirjourney.
Sandy Kruse (27:53):
That's one I've never heard, sarah, I love that.
Dr. Sarah Berry (27:59):
So eating rate is fascinating.
And I tell you why the rate'sfascinating.
Firstly, because there'srandomized controlled trials now
showing if you just tell peopleto slow down their eating rate,
you can see significant weightloss so doing it in a controlled
environment.
So there's randomizedcontrolled trials where they
randomly allocate, you know,overweight individuals to either
(28:23):
eating at their normal rate, oreating fast, or eating slowly.
Those that are told to eatslowly and eat slowly lose more
weight than those who are toldto eat at their normal rate.
We also know it affects therate at which we metabolize food
.
It affects our hunger feedbacksignals.
And what's really interestingabout this as well is that we
know it's one of the mechanismswhy these heavily processed or
(28:45):
ultra processed foods, as wecall them, are bad for us.
We eat ultra processed foods onaverage 50% more quickly than
unprocessed, nutritionallymatched foods.
Sandy Kruse (28:58):
So I think that's very fascinating, like I've
always been taught to eat slowlybecause you will be.
It's just like what you saidabout the hunger signals you
will feel satiated much sooner,but I find that really
fascinating.
And here's something you weretalking a lot about the eating
(29:21):
window and the fasting.
So I think you're going to findthis interesting.
Back in 2022, this was the yearthat I first experienced I was
52.
My cycle was really off.
I think I had only five periodsthat year.
Well, I was listening to and Ilike to call it the maniverse
(29:41):
the advice of all the giant, youknow, voices in the wellness
space, and it was all aboutfasting, and so I'm like they
say to do this.
So I'm going to do this, and Iwas doing intermittent fasting
with only an eight-hour windowwhere I could eat, and so I
(30:02):
would stop eating whatever 6.30at night or so, and then I
wouldn't eat until 11 o'clock orso 11, 1130 the next morning.
I had a very small window.
So during that time that I wasactually experiencing a lot of
perimenopausal symptoms, myHbA1c went up to 6.1.
(30:25):
So I was essentially insulinresistant at that point.
And so this speaks to exactlywhat you're saying about how
everyone's different and youhave to be really cognizant of
whatever advice you're taking inaround menopause that it's
(30:46):
really applicable to you.
So after that I actually Ibecame a certified metabolic
balance coach and I actually didmy own program.
I changed the method in which Iate, changed how I ate.
So I went back to three meals aday, but I still had a fast of
(31:11):
you know, between 12 and 14hours overnight.
I started to eat with proteinfirst.
So the order I don't know whatyou think about this and I'd
love to hear your opinion or ifthere's research I would start
eating my meals with proteinfirst and at least a couple
bites of protein before I ateanything else.
(31:34):
I didn't go keto or low carb oranything like that, but I had
really high value I like to callit high value carbohydrates,
much more on my plate.
Not that I ate a ton of breadanyway and I lost a ton of
percentage.
I'm going to say I'm not goingto give the exact percentage of
body anyway and I lost a ton ofpercentage.
(31:55):
I'm going to say I'm not goingto give the exact percentage of
body fat and I lowered myvisceral fat during that time to
be within a healthy range.
So my question to you is doesthe food order because you hear
a lot of different opinions onthis matter, on how you're going
(32:19):
to eat your meal Like, if youstart with protein, does that
matter?
Does that help with beingalmost like a buffer for
whatever else is comingafterwards?
Like, what are your thoughts onthis?
Because there are a lot of bignames who talk about eating
veggies first and then, like Iwould love to hear your take on
this, because there are a lot ofbig names who talk about eating
veggies first and then.
You know, like I'm, I wouldlove to hear your take on this.
Dr. Sarah Berry (32:39):
So I think there's two different aspects to
this that we need to thinkabout.
There's what I call mealordering, so the order in which
you eat your meals over the day,and then there's food ordering
the meal in which you eat yoursorry, the order in which you
eat your food within order, inwhich you eat your food within a
meal.
So we've done some research atzoe looking at meal ordering,
where we randomly allocated in aclinical trial, people to
(33:03):
different breakfasts, these kindof high carbohydrate breakfasts
, um, and it was in a crossoverdesign.
So over a period of a couple ofweeks every day they would have
a different type of breakfast,but everyone had all of those
breakfasts.
But then at lunch they were allgiven exactly the same meal.
So they had differentbreakfasts over the 14 days but
they had exactly the same lunchon every single one of those 14
(33:26):
days.
And what we saw was that whatpeople were having for breakfast
was partly shaping theirpost-translucent glucose
response, so their post-transferglucose response, so this
post-meal sugar response to whatthey were having at lunch.
So there were certainbreakfasts that were causing
people to have a higher bloodglucose response to their lunch
compared to other breakfasts,even though the lunch was the
(33:47):
same.
Now I don't know if you'veheard of the post-meal sugar
response.
I don't know if you've heard ofit was moderate.
How that would impact over many, many years.
Probably it wouldn't impactthings that much.
And this is where I think weneed to be very, very cautious.
We need to be really cautiousabout how we're eating our food
and the impact it has in termsof the size effect.
(34:08):
So let's now step whilethinking about that.
Let's think about the foodordering which is what you're
talking about.
So, yes, meal ordering has animpact.
There isn't loads of researcharound the order in which we eat
different foods or differentnutrients within the food and
how it impacts our health, howit impacts our metabolic
(34:29):
responses.
There's lots of anecdotalevidence and from very
well-known people saying this ishow I've done it and this is
what's worked for me.
That works for you great.
If that's how you want to eatyour food, great.
I think what the evidence doesshow is that, yes, if you have
protein and particular types ofprotein as a preload, so
particular types of protein thatwe know increase insulin.
(34:51):
So whey protein, for example,that we know increases the
secretion of insulin and youhave that as a preload, and
there's quite a few studies thathave done this, where it's
given like as a preload, maybe30 minutes before a meal or 15
minutes before a meal.
What that means is that you'vegot an insulin response so that
when you're then eating thecarbohydrates, the insulin's
already circulating the blood.
(35:11):
Hey presto, it can quickly thendispose of that glucose.
So it's lowering yourpostprandial glucose response.
What we also know is thatadding fiber, any type of
protein and any type of fat to ameal, that delays your gastric
emptying, so it delays the rateat which your stomach empties.
So you will have glucoseappearing, appearing sorry
(35:34):
glucose appearing in your bloodat a slower rate, and at a rate
that then can be removed, so tosay, more quickly by the insulin
.
So it's slowing down the rate.
Now, whether, therefore, youshould sit in a restaurant or
sit at your dinner table and say, well, here's a lovely meal,
there's some potatoes, there'ssome fish, there's some fish,
(35:55):
there's some vegetables.
I'm going to eat that fish, I'mgoing to wait five minutes,
because that's my protein bit,then I'm going to eat the
vegetables or potatoes, orwhether, according to other
people, I'm going to eat thefiber rich vegetables first and
then I'm going to eat the others.
Yes, I believe, based on whatevidence there is, it is going
to reduce your postprandialglucose response.
(36:17):
I believe, though, it's onlyhas a relatively small impact,
and I think what we have toremember is what impact is
eating that way had on you, foryour pleasure of food?
Because what worries me so muchin the wellness world and the
diet world is that we are oftenrecommending or making changes
(36:41):
that actually have a reallysmall size effect just because a
scientific study has showedit's significant.
Does that really mean it'sgoing to, over a long period of
time, actually have that much ofan impact?
And also the variability in howthese different bits of advice
(37:05):
impact someone is huge.
So someone on social media whodoes the fiber first, for
example, or the protein firstyeah, it might reduce their
post-vendor glycemic response by50%, but actually, on average,
it's probably not going to dothat, and probably for many
people it will have almostminimal effect.
So I'm a great believer in foodbeing about joy, about being
about pleasure, about beingabout our social connections,
(37:27):
our culture, and so personally,I would never change the order
in which I eat my food unless Iliked eating a particular bit of
food first.
My kids sit down.
They eat their vegetables last,but that's because they don't
like vegetables and I tell themthey have to eat that at the end
.
That's just the way that theynaturally eat.
(37:48):
When I eat my food, I just eatit in a random order.
I don't even think about theorder in which I eat it.
My food, I just eat it in arandom order.
I don't even think about theorder in which I eat it.
But despite the evidence to showthat, yes, it might impact it,
I think it's going to have sucha small impact compared to other
things that I do, compared tothe fact that I should have done
that run that day, which Inever do, the fact that I didn't
(38:08):
go to bed at that time, thefact that I still had that glass
of wine that I told myself Iwouldn't have.
They're going to have a hugeimpact and I should focus my
efforts on those.
I don't think I should focus myefforts personally on some of
these micro things.
However, having said that, formany people, it's micro habits
that are easy for them to do,sustainable for them to do and
(38:30):
therefore, in combination, ifthey do many of them, it might
improve their health.
So I'm very much sitting on thefence on that, but that's
because of my own personal viewof how I think we need to be
careful in optimization that wedon't just have fun.
Have fun in life, have fun withfood.
It's a pleasure.
Sandy Kruse (38:53):
Yeah, you're talking to a girl who lost her
thyroid at 41 and has done everysingle diet under the sun since
then.
So you know, I think there's alot and that's a totally
different conversation.
But in this world of food andwellness there's a lot of what I
call orthorexia, and I'm thefirst one to admit that I have
(39:18):
had a lot of challenges aroundfood because I kept trying and
you also mentioned that I kepttrying to chase this
pre-thyroidectomy body that Ihad before.
It's kind of like thesemenopausal women chasing their
(39:38):
pre-menopausal bodies and it'slike you know that whole thing
about food and pleasure.
I come from a family where foodis celebratory, but I also come
from a family where you neverleave anything on your plate.
You see what I'm saying.
So you know like I come fromparents who were farmers old
(40:01):
farmers in Croatia where foodwas scarce and you know there's
scarcity in there.
So there's a lot of topicssurrounding that.
But I do agree with you thatfood, you know it can be
pleasurable and I think a lot ofwomen around menopause have
(40:22):
this fear around food and so youknow, I know that you would
know even about cortisol and howthat can affect that weight
gain, and if you're alwaysstressed around what am I going
to eat, what can I eat?
And if it stresses you out toeat food in a specific order,
well then is it giving you thatbenefit anyway.
Dr. Sarah Berry (40:45):
No, and I don't believe so.
You know, I often finish all myacademic talks by saying if a
food or meal is too healthy tobe enjoyed, it's just not
healthy at all, and I think wereally need to remember that
when we're thinking about thechoices that we make.
But I think it's hard, becauseI think we all want to eat the
(41:06):
best, to maintain how we mighthave been or what we might have
been able to get away with 10,20 years ago.
When we become pre andpost-menopausal, it's tough.
Sandy Kruse (41:19):
It is, it is.
It's just like back in theolden days where you would sit
in front of the TV and get yourpopcorn and watch a movie.
You know, you never had tothink about it and every once in
a blue moon.
My husband and I will stillhave those nights because I'm
really trying just to be morepresent and, as you know, I was
(41:42):
in Europe for 10 days.
I didn't look at what order Iwas eating my food, I wasn't
careful.
I'm like I am going to be sopresent in this experience.
But it's not about gorging.
That's not what this was about.
It was about just being presentand enjoying the food that I
was trying from differentcultures.
(42:02):
So I do have to ask you moreabout this insulin sensitivity
we kind of touched oncholesterol insulin sensitivity.
We kind of touched oncholesterol yep.
So is it because our estrogenlowers that?
We lose that sensitivity and webecome more insulin resistant,
(42:25):
it like.
Why does this happen?
Is it specifically estrogenrelated?
Dr. Sarah Berry (42:30):
so, again, I think it's multifactorial.
Um, and I know as nutritionscientists we say this about
most things, but it is becausethat's the reality.
So, just like cholesterol, Ithink we've got the same thing
going on.
So, for example, you've gotthat increased visceral
adiposity.
We know that that certainlyimpacts our insulin sensitivity.
(42:51):
You've got the effect thatestrogen has on insulin, for
example, on insulin release aswell.
And then what we've seen in ourresearch and this was published
about two years ago, it's verynovel research is we saw that
people had, yes, very differentinsulin sensitivity depending on
whether they were peri orpremenopausal.
(43:13):
But what we saw was there was adifference in their
postprandial glucose response.
So we saw that postmenopausalwomen and I think I mentioned
this earlier had a higherpostprandial glucose response,
so a higher blood sugar responseafter having carbohydrates in
their food, compared to if theywere premenopausal.
And what was interesting isthat we were able to look.
(43:33):
Was this due to oestrogen, dowe think, or was it just
naturally part of aging?
So, firstly, we looked at do westill see this when we adjust
for lots of other factors, likeBMI, like the background, diet,
like age, et cetera, et ceteraand we saw that it was still
there, that, even when we adjustfor these other factors, you
still saw this difference inthis post-meal glucose response.
(43:57):
But it's very difficult to everfully adjust for age, and so
what we did is, because we hadsuch a big group of women that
we had been studying, weactually took what we call an
age-matched cohort, so we took asubgroup of individuals and we
matched them for age so that wecould remove this confounder of
age, the confounder of the factthat menopause is an age-related
(44:17):
event, and what we found isthere was still a significant
difference in postprandialglycemic responses, so these
post-meal sugar responses,depending on whether you're a
pre-peri or post-menopausal,with the peri and
post-menopausal having higherresponses, even in an
age-matched cohort, whichsuggests that, yes, it is a
(44:38):
direct effect of oestrogen,related to insulin or related to
the metabolism of glucose.
And this is after we adjustedfor factors like BMI as well.
I don't know the exactmechanism, it's not something
that we've looked into at thekind of molecular level, but I
know that there's other peoplethat have been looking into this
(44:59):
.
Sandy Kruse (45:00):
Just curious with that research that you did was
sleep in there, because that'sthe other factor, right, just
like what you were saying.
We all know that if we don'tsleep well, we tend to eat
poorly the next day.
We tend to crave those, thosecarbohydrates that aren't really
(45:21):
good for us.
So was that accounted for otherthan just age?
Dr. Sarah Berry (45:28):
that's a very good question and I cannot
remember.
Sandy Kruse (45:31):
I'm just curious because then it would be age pre
post-menopausal sleep.
Do you get what I mean?
It would kind of have all thosecomponents.
Would be interesting to see.
Yes.
Dr. Sarah Berry (45:45):
I can't remember if we adjusted for
sleep.
We adjusted for lots ofdifferent variables, like how
healthy the background diet was,like BMI, and we did see a
difference, obviously, in sleepquality between the pre and
post-menopausal.
So yeah, it would beinteresting to see how our
results play out if we adjustfor sleep and then if we don't
(46:06):
take the sleep into account.
Sandy Kruse (46:07):
Yeah, yeah it would be interesting.
Dr. Sarah Berry (46:08):
You might have done that.
Sandy Kruse (46:09):
I can't remember everything that we've published
that I can't remember everythingthat we've published.
Okay, so let's move on tosymptoms, because symptoms are
big and I know that there areplenty of herbals and things
like that that women can take tohelp with symptoms.
What about food?
Dr. Sarah Berry (46:31):
So we've just recently completed a huge study
this is in 70 000 women, wherewe ask them questions about
their symptoms and we ask themwhat symptoms they had and we
ask them to grade them on ascale of zero to five into how
much they impact their qualityof life.
From this we generated a scoreusing something that we call our
meno scale calculator, and thisis a calculator that's
available for anyone.
And what this calculator does itgenerates a score using
(46:51):
something that we call ourMenoscale calculator, and this
is a calculator that's availablefor anyone.
And what this calculator doesit generates a score out of a
hundred.
So you've got and this is basedon what we know from published
research and our own research ofthe 20 most common symptoms.
Now I know that there's 50 ormore known symptoms, but you
know we have to stop somewherein research.
(47:13):
So we selected the 20 mostprevalent symptoms and then we
asked people, on a scale of zeroto five, how much of an impact
does having a quality of life,and you return a score out of
100.
This meno scale is availablefor anyone to complete.
It uses modern language,because lots of the other
menopause symptom questionnairesuse old-fashioned language like
how excitable are you, whichpersonally makes me want to
(47:37):
throttle the person thatgenerated that.
They're typically generated 50years ago, by men as well, who
have no idea of what these womenwere going through.
So we're using modern language,accessible language, it's free
for anyone to go on.
You can go to zoecom, uhforward slash meno scale and
anyone can fill it out.
(47:58):
If you fill it out, then youget returned a score.
You get told how you comparedto someone your similar age on
hrt or not on hrt, what your topsymptoms are and how they
compare.
So we've got all of this data.
We've got people's meno, sotheir average score related to
the impact that the symptomshave on them.
And then we've also got forthese 20 different symptoms and
(48:22):
what we see first is thatsymptoms are really prevalent.
We see that the kind ofsymptoms that we used to think
were the main symptoms, like hotflushes, are actually the least
prevalent.
The most common symptoms arethe things like the sleep
disturbances, the brain fog, theanxiety, the low libido, the
weight gain, the slowedmetabolism, low mood,
irritability, etc.
What we see as well in thiscohort of 70,000 people is that
(48:46):
people have more symptoms astheir BMI goes up.
So people living with obesityhave an increased risk or an
increased chance of havingsymptoms and having them more
severely as their body weightgoes up.
Now, this is a problem because,if we go back to what we were
talking about 15 minutes ago,it's really difficult to
(49:08):
maintain your body weight andyou're going through the
menopause.
This becomes really problematic.
What we also see on a morepositive note, is that people
have a reduced likelihood ofhaving symptoms if they have a
healthy diet.
If they have an overall healthydiet and I don't mean by this
you know very specific foods,but I mean overall if their
(49:30):
dietary pattern is more healthy,they have a reduction in
symptoms.
Now, this data was collected atone point in time.
It's what we callcross-sectional data.
So what we did is we thenlooked at does the symptoms that
people are experiencing changeif they go from an unhealthy
diet to a healthy diet?
And what we see is, if wefollow people up over a period
(49:52):
of time, as people change froman unhealthy diet to a healthy
diet and these are peoplefollowing our ZOE program, which
is this personalized nutritionprogram we see that they
experience a reduction of around35% in their menopause symptoms
.
Now, that's huge.
Now, this isn't a randomizedclinical trial.
There isn't a control arm, soobviously we have to be slightly
(50:14):
cautious with how we interpretthis in terms of the causality.
But what we are seeing is, inthose who follow our ZOE program
, who improve their diet,there's a 35% reduction in
symptoms.
We know from other publishedresearch people following a
Mediterranean diet alsoexperience a reduction symptoms,
so it's not that we're juststicking out.
(50:35):
What's interesting as well iswe looked at these individuals
according to whether they wereon hormone therapy or not on
hormone therapy.
Those that were on hormonetherapy obviously have a lower
starting point in terms of theirsymptom burden, but what we see
is they still benefit fromimproving their diet.
They still get a 35% reductionin symptoms.
(51:02):
And I think this is reallyreally important that HRT alone
is not the only answer.
You can use diet with orwithout HRT to have a
significant impact on yoursymptoms.
Now, this is going to varyperson to person and I know we
talked about this earlier in ourdiscussion.
Some people will respond reallywell, some people will respond
less well, and it's aboutfinding what works for you, and
this is what I love about ourMenos scale that we've generated
.
People can use that to trackhow their symptoms change.
(51:23):
So if they're starting on HRT,if that's their choice, they can
see.
Well, let's track each week howmy symptoms are changing.
Is it working?
If they're embarking on a dietor a lifestyle change, they can
use the Menoscale again to tryto see.
Does this work for me?
Does it improve my symptoms ina slightly more objective way
than necessarily kind of tryingto remember, or do I feel a bit
(51:44):
better this week?
Sandy Kruse (51:46):
Oh, I love that.
Now people who are listeningare probably going to say well,
what is a healthy diet?
I know you mentionedMediterranean.
I typically follow aMediterranean diet.
I would say, for the most partI am a big personally.
(52:07):
This is me now.
I believe in the 80-20 rule, Ibelieve in a balanced diet, but
for the most part whole, realfoods.
So what is classified as ahealthy diet?
Dr. Sarah Berry (52:26):
So a healthy diet means different things for
different people, and I think ahealthy diet also varies
depending on where you are rightnow.
So for the average American,average British person, who
consumes 50 to 60% of theirenergy from ultra processed food
, a healthy diet might just bereducing that ultra processed
food by 10%, just increasing anextra few vegetables, et cetera.
(52:50):
So I do think we need to bearthat in mind.
But when I talk about a healthydiet, and when I talk about a
healthy diet in relation tothese results, it's a diet that
is very high in fiber.
It's a diet that's high inplant-based whole foods, like
you mentioned.
So these could be fruits,vegetables, pulses, for example,
(53:10):
whole grain.
It's a diet that is low inthese heavily processed,
unhealthy foods, so low inrefined carbohydrates ie, white
bread, white rice, for example.
Low in ultra-processed meats.
So you know your salamis, yourhams, those sorts of things.
(53:31):
It's a diet that's diversesalamis, your hams, those sorts
of things.
It's a diet that's diverse andthis is really important because
we know on average, a foodcontains about 72 000 different
chemicals.
We want to get a diversity ofchemicals and so we often talk
about having 30 different plantsa week to get that diversity
doesn't have to be 30, butmaking sure you're eating a
(53:53):
diverse uh, you know array ofdifferent fruits, different
vegetables, differentplant-based foods, and trying to
eat the rainbow.
So food, uh, plant-based foods,often pigmented, like red
peppers, beetroots, these sortsof things.
The pigments can come frompolyphenols, come from these
magical bioactives that we knowimprove health.
So making sure you're alsogetting a diversity of colors in
(54:16):
your diet.
And then there's some evidenceas well, when it comes
specifically to menopause, thatsoy isoflavones might improve
your health.
Now, this isn't specific advicethat we give in our ZOE program
, what I've just mentionedbefore.
That is advice that we givethat we see improves people's
health.
But I do think it's worthmentioning, related to diet,
(54:38):
that I'm very, very skepticalabout different supplements.
There's a term we use in the UKcalled menowashing.
Stick the word, you know theterm menow in front of it and
you can charge 10 times as much.
There's so many supplements outthere that are being sold to
women at very expensive pricesto say this will cure your
menopause, this will solve yourmenopause symptoms.
(55:00):
There's really, reallyinconsistent evidence.
Now what I would say is, if itworks for you, great, because
again, it's going back to that.
We all respond differently.
If you find a supplement thatworks for you, I think that's
fantastic.
Respond differently.
If you find a supplement thatworks for you, I think that's
fantastic.
But what we do know is that theonly supplement that I believe
(55:21):
there's sufficient evidence toshow that it works is soy
isoflavones, and these are akind of phytoestrogen and these
are a chemical that mimic theestrogen molecular structure and
they bind to our estrogenreceptors.
So we know that countries wheresoy isoflavones are consumed
regularly to a high amount likeChina, japan they have lower
menopause symptom burden.
(55:41):
We know that if you supplementpeople at a certain level with
soy isoflavones, then they willhave, on average, an improvement
in symptoms if it's a certainlevel.
But we know that there's hugevariability.
And we know there's hugevariability because what we also
know is that your gutmicrobiome impacts how you
metabolize soy isoflavones.
(56:02):
So some people have a gutmicrobiome such that they get a
huge benefit from soyisoflavones and other people
have a gut microbiome such thatthey might only get a small
benefit.
So it takes us back to thatpoint earlier of again.
You might see a huge benefitfrom taking soy isoflavones.
Sandy Kruse (56:20):
You might recommend that to your friend and they
might say oh, it's just notdoing hardly anything that's
because we always want sodifferently and for a whole
array of different reasons okay,um, I know, okay, I know that
we're coming close to the end ofthe recording, but I can't not
ask you about this topic andmaybe you'll answer this, maybe
(56:47):
you won't, but what are the topthree issues women need to
consider at menopause and howcan we really use?
We touched on so many differentthings.
I just want something thatsomeone can take away from this
(57:09):
podcast and say, okay, I'm goingto stop here.
I want to address these topthree issues and we can eat the
way that we've been talkingabout.
Go check out Zoe, which I wouldlike you to summarize what
that's about as well.
But what are top three issuesLike?
Is it heart health?
Is it brain health?
(57:29):
Like what are the top threemenopausal issues that women
just need to think about?
Dr. Sarah Berry (57:35):
Really difficult.
I think we need to be mindfulof our heart health, because our
cardiovascular disease riskgoes up.
I think we need to be mindfulof our bone health, because we
know that estrogen impacts ourbone health.
And I think we need to bemindful of our brain health as
well, because of how it impactsour cognition, but also how our
(57:57):
brain ages due to changes inestrogen.
And I think what's common toall of those three issues are
the four pillars of health, andI know that many know these are
important.
But I think it's reallystepping back and thinking about
these four pillars of healthand can you change any of them?
(58:18):
Physical activity,weight-bearing exercises, in
particular for bone health.
Physical activity for hearthealth.
Physical activity for brainhealth, reducing stress it's
hard.
Perimenopause and postmenopauseis a time where women
experience much stress.
Often they're still got teenagekids, they're still working
full-time, they might be caringfor elderly parents.
(58:39):
It's hard to minimize stress,but being mindful of the stress,
I think, is important.
The third pillar of health issleep, which we've touched on.
Anything that we can do forgood sleep hygiene to help our
sleep in any way that we can isgoing to help.
And then the fourth one is dietthat we've talked about, and
those four pillars of healthwill impact all of those issues
(59:02):
our brain health, our hearthealth and our bone health.
Sandy Kruse (59:06):
I love that.
Now tell us a little bit aboutZoe a little bit about Zoe.
Dr. Sarah Berry (59:19):
So Zoe is a science and nutrition company
and Zoe is building on sevenyears of amazing science that
we've been doing and thehundreds of years before that
that scientists all over theworld have been doing in
nutrition science to enablepeople to make the smartest food
choices for them.
So it started out on the basisof investigating how much
variability there is betweenindividuals in how they respond
(59:39):
to food and seeing that there'sa huge difference in how one
person responds compared toanother person.
And then we've been conductinglots and lots of trials looking
at, well, what explains thisvariability?
Why does someone respond likethat versus someone respond a
different way?
And can we use vast amounts ofdata to predict how people
(01:00:00):
respond to deliver the bestadvice?
And so we deliver advice that'spersonalized to an individual's
biology.
So we look at people's biology,so we look at their microbiome.
We look at their blood health,so we look at various chemicals
circulating in their blood.
We look at people's biology, sowe look at their microbiome.
We look at their blood health,so we look at various chemicals
circulating in their blood.
We look at their glucoseresponses, etc.
We ask people about theirhealth history and so many other
(01:00:21):
factors.
We look at how people live theirlives.
We look at how people make thedietary choices they make, why
they make the dietary choicesthey make, what their
preferences are, and peopleundergo a two-week test period
where we test lots of differentthings.
So they're wearing differentwearable devices, they're
monitoring their glucose, theirblood fats, their microbiome and
(01:00:42):
then, using this years andyears of science and these
hundreds of thousands of datapoints that we've collected, we
feed back to people afterthey've done this two-week test
phase how they should eat bestfor them.
That fits in with the way theylive their lives.
So it's an app-based productafter they've done the test
phase and enables people to lookfor every food whether that's
(01:01:03):
the best food for them.
It enables people to monitorthe food they're having.
It enables people to tracktheir progress, to see whether
they're having a healthy dietfor them as an individual and
overall, and people can sign upto do this for 12 weeks or six
months or 12 months, and it'sfollowing.
This ZOE program that peoplehave signed up for is where we
see these big improvements inmenopause symptoms.
(01:01:26):
We've also published arandomized controlled trial in
Nature Medicine a few months agowhere we compared health
outcomes cardiovascular healthoutcomes on those who were
following the ZOE program versusthose following standard US
dietary recommendations, and wefound that those following the
ZOE program had significantimprovements in cardiovascular
(01:01:47):
related health outcomes, as wellas body composition so well
weight and waist circumference.
Sandy Kruse (01:01:53):
And it's available in the US.
It is Okay.
So what is the website?
Just zoecom.
Dr. Sarah Berry (01:02:01):
Go to zoecom and you can find out about the
science we're doing.
You can find out about thecommercial product that we offer
.
You can find out also about ourmena scale and all of our other
research that we've got goingon.
Sandy Kruse (01:02:15):
That's amazing, and I know that they're on
Instagram, as are you as well,dr Sarah Barry, so I will have
all this information in the shownotes and I just want to thank
you so much for the wonderfulconversation.
Dr. Sarah Berry (01:02:29):
Our pleasure.
It's been lovely chatting toyou.
It's just been like sittinghaving a chat over a cup of
coffee.
I don't have my cup of coffeewith me.
Sandy Kruse (01:02:37):
Not at this time, right, not at this time?
Dr. Sarah Berry (01:02:42):
Yes, not at this time.
It's half five here in the.
Sandy Kruse (01:02:43):
UK.
I hope you enjoyed this episode.
Be sure to share it withsomeone you know might benefit.
Share it with someone you knowmight benefit, and always
remember when you rate, review,subscribe, you help to support
my content and help me to keepgoing and bringing these
(01:03:05):
conversations to you each andevery week.
Join me next week for a newtopic, new guest, new exciting
conversations to help you liveyour best life.
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