ENCORE: Dr Megan Rossi, the Gut Health Doctor

Louise Minchin and BBC Triathlon presenter Annie Emmerson talk to Dr Megan Rossi,  founder of The Gut Health Doctor,  considered one of the most influential gut health specialists internationally. 

A Registered Dietitian and Nutritionist with an award-winning PhD in gut health,  Megan set up The Gut Health Clinic in London, where she leads a team of gut-specialist dietitians. 
Her debut book, Eat Yourself Healthy (UK, Aus & Europe) and Love Your Gut (US & Canada), was first published in September 2019 as an easy-to-digest guide to gut health and beyond, immediately becoming an Amazon and The Sunday Times best seller. 
 
The conversation offers great advice and a much deeper understanding around gut health and why its so important to look after your gut at any age.

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Transcript

Louise Minchin: 0:04
Hi everybody, welcome to our next episode of the Her Spirit Podcast, with me, louise Minchin and lovely Annie Emerson, who've just returned, haven't you? You've been travelling for work. How lovely. Annie Emmerson: 0:15
Oh, it was brilliant. It was a whirlwind, though quite literally it was a lot of flying Santander, various flights to Madrid as well, connections driving, 400km. It was fun. Yeah, it was a little lead role commentary job and I was working with a really great South African girl, so we had a lot of fun. We had a brilliant night on Saturday night tapas, wine, everything and then up at half past five in the morning and home back in time for Sunday lunch. Louise Minchin: 0:41
No, I'm really glad I'm giving our next guest today, that you've mentioned tapas and wine, because I suppose she's got her point of view on that We've been trying to get. I love this podcast because there's lots of people we've got our eyes on aren't there and that we've tried to get hold of for a while, and our guests I've definitely tried to get hold of for a while. We've not been able to get hold of her for the last seven months because she was very busy. She was off having a baby, so very many congratulations on that. Let's do the introductions and there's so much for you everybody in this podcast, which is going to be all about all sorts of things. It's all about your tummy, I think that's the easiest way of saying it. We're going to have masses of advice, masses of different questions. I know from you as well. I'm absolutely intrigued to be able to share this guest with you. I mean, it's the wonderful Dr Megan Rossi, who is also known as the Gut Health Doctor, and I've got beside me in my left hand here, annie, her book which, as you can see, is heavily used. Can you see all the post-it notes? And, megan, it's lovely. Thank you so much for coming on our podcast. Absolutely great to see you. Let's go through it. Before we started, I was like I'm drinking chamomile tea today. I think that might be heavily influenced by you, megan. What are you drinking? And thanks very much for coming on the podcast. Megan Rossi: 1:52
I'm actually. It's an absolute pleasure to be here, but I'm just having plain boring water guys. Hydration all the way Annie has stepped it up. Annie Emmerson: 2:00
Annie tell us I've taken it to new levels. I really have nothing to do with the wine I drank over the weekend or over Sunday lunch. Yesterday I'm having ginger, meducah, honey and lemon and hot water because I had a bit of a cold body. I feel a bit sorry for myself for about four weeks. It's just like I get one every year and last about four weeks, and then it goes, and then I find for the rest of the year. So I've just started that last week and I've continued on with my new drinking. That's normally after three coffees first thing in the morning though, but we will talk to Megan about, because coffee and red wine are my things and I don't know if they're good or bad. Megan Rossi: 2:33
You'll be very happy to know with my answer, although you know there is some disclosures there which I'm sure we'll get into. But I think after all that travelling as well, we know that it certainly is important to really nourish your gut, because when you're travelling a lot, your gut really goes through a world wind in terms of the sleep, changing the different cuisines that you're having. So you need to certainly nourish it post a trip, for sure. Louise Minchin: 2:58
Okay so let's take back. We'll take you back a bit. So you are called the Gut Health Doctor and I know, annie, you love knowing where people come from and we've got a little clue, I think, megan, already from your accent. So just tell us where you were born in Australia, absolutely so I was actually born on a farm. Megan Rossi: 3:18
I'm a country girl at heart, no idea, definitely didn't plan to move to London, but in terms of Gut Health it would certainly inherit my upbringing playing in the dirt, eating fresh fruit and veg, etc. But actually my first conscious encounter with the gut wasn't a very positive one. It was in my final year studying nutrition and dietetics and I actually lost my grandma to bowel cancer. So you know my first memory of the gut was a really negative one. It put her through the surgery, the chemo and obviously taking her life. So I hated the gut so much. But then I started working as a dietitian and a nutritionist, both in the hospital setting, with all different types of conditions whether people had different cancers, kidney disease but also I was very fortunate to be the nutritionist for the Australian Olympic Secretive Swimming Team. And what I found so striking is no matter where all these people came from, whether they were in the hospital setting or elite athletes they're all coming to be complaining of the gut. And it was really at that point. I was like gosh, what is it about this organ that's haunting me? And that was 2010, so it was just kind of on the cusp of where new research was coming out about the gut and I thought, you know what I owe it to my patients and, of course, my grandma, to find out more about the gut. And that's when I decided to embark on a PhD, really trying to understand whether we nourish the gut through the right nutrition, whether that can improve the health of not just the gut but other organs like our kidneys and our you know, mental health, etc. And that changed everything for me in terms of the gut. You know it was like oh right, the gut is hugely powerful. If you look after it, it will look after you. If you don't neglect, it then actually bends. That's when it becomes kind of, you know, a bit of an angry gut and there's a lot of ramifications of that. Annie Emmerson: 5:03
I mean it is so interesting and I don't really know where to start. I'm probably one of those fortunate people that you know can kind of pretty much eat and do whatever and I'm always fine. I have loads of friends who have all sorts of issues and I kind of sometimes find it quite hard to you know, understand, being someone that kind of has cruised through life, and nothing really seems to irritate my gut. But I think what I'm really interested in to talk about is, as you talk, we just said there about the other organs and how we can protect them. So maybe you know my gut is totally fine, but what I'm putting in it isn't great. It's fine for the gut but maybe it's not right for the other organs. I mean, that's a kind of big question to fire at you. Megan Rossi: 5:46
That is such an important point because I think historically people thought, look, if I don't have gut symptoms, I must have great gut health. But actually we're now appreciating gut health is so much more than gut symptoms. In fact, if we think about what gut health is, it's the functioning of our 9 meter digestive tract, the tube that delivers food from entry all the way to exit. And that 9 meters is so important for absolutely everyone for three key reasons. The first one is you know the good old saying you are what you eat. It's not that correct. It's more, you are what you digest, because no matter how healthy the, you know the food you put into your body is, if you don't have a good gut lining, you can't extract that food from your gut, which is like this long tube, and get it actually into your blood to start feeding things like your skin and your hair and your other organs. So really to make the most out of your food, you need to have good gut health. So for digestion, the second one, which is, I think, quite important Annie, you touched on about immune health. We know that 70% of our immune system actually lives along that 9 meter digestive tract. Oh, wow, yeah. So we certainly see people who have really good gut health also have strong immune systems. So maybe you know, because you're getting just one cold a year, but we certainly, I think, could really work on your gut health and what I certainly see in clinic is that can improve your immune health and may actually reduce that risk of the common cold Can. Louise Minchin: 7:07
I just ask you because you know you explain it really well in the book as well and I'll talk about. It's called eat yourself healthy but you explain it really well about, because I think it's kind of sort of new it's not new science, but it's new to kind of talking about it. I think how important the gut can make. You know, and you indicated there to everything else. We've got a question from Jane. Why is gut health so important for our overall health? Explain the links, because you already call it an organ and you know, if I'd had to write down what were the organs of the body, I wouldn't have written gut down. Megan Rossi: 7:38
Yeah, no, it's really. You know, it is actually quite a new phenomenon and, like we said, in terms of the importance of the gut, yes, it's digestion, yes, the immune function we've known about them for quite some time. It's this third element which is really this landmark scientific discovery that's essentially changing what it means to be human, and that is comes down to the fact that we contain trillions of bacteria along that nine meter digestive tract, and the scientific name, which you may have heard, is called our gut microbiota or a gut microbiome. Essentially, that's just a fancy name that reflects these trillions of bacteria that live inside that nine meter digestive tract. That's actually, you know, like I said, doing so much for our body in terms of it produces hormones and vitamins and communicates to other parts of the body, like our brain and our kidneys, and helps regulate things like our appetite. Louise Minchin: 8:30
So it's this gut microbiome that is really, I guess, what's brought the fame to this concept of gut health and then what I've been really intrigued by and you sort of gave a little hint of it there is this connection between your gut and your brain which, again, you know, I never thought there was a connection. But we talk about your gut feeling, don't we? Megan Rossi: 8:51
Exactly. Again, I think for many, you know, over a hundred years we've known that the gut and brain are connected. You know, if you have think of the English language in terms of all the metaphors that we use, you know I've got a gut feeling someone gives me the poops, I can't stomach someone's behavior. So we've always connected the emotions, you know, with gut function. But again, it's this new kind of understanding of this, of the bacteria and having a role in that two-way communication. And you know, for people who love a bit of a science, there's really these three ways that we think that the gut bacteria and the brain communicate because they're very different parts of the body. So I understand why people go oh, is this just like hippie-dippy stuff? And historically I thought that until you know, the science really unfolded. And the three ways is one's kind of like a mobile phone where the bacteria zip these messages up by this nerve called the vagus nerve to the brain. That's one. The second one is a good old postal service sort of system where the bacteria actually produce chemicals based on what we feed them. Those chemicals get into our blood. Some of them can then pass that blood brain barrier, so send messages up via our blood system. And the third one is by the immune system, kind of like an alarm system. So because the immune system most of it lives in the gut with the bacteria, if the bacteria you know trigger the immune system, that then sends these inflammation markers throughout the body and again, that's another way the brain sort of is alerted by the gut bacteria. So it's those three ways that they're kind of communicating. Annie Emmerson: 10:19
This is honestly an incredible lesson. It really is on that point talking about the gut, so I looked to your latest Instagram post. I'll read it how do you know if your gut is healthy? And you say expensive poop tests are not the answer. So how do we know if our guts are healthy? Is there a way of finding out other than perhaps just general health and how you might feel on a day-to-day basis? Megan Rossi: 10:45
Yeah, and it is. It's such a great question and one which, sadly, there is no single assessment at the moment to determine whether you've got a healthy gut. Which is why I wrote that post, because a lot of people I see in clinic, you know, have spent loads of money on these really expensive you know gut bacteria tests which we certainly. I work as a research fellow at King's so we do collect people's poop samples in the research world to understand what's going on. But the commercial tests just aren't valid yet. They're kind of they're hearing from the scientific world that you know this is an exciting area so they're trying to jump on the bandwagon but it's very much too early. But you know, if you've got loads of money, why not do it? But the information you get from these tests aren't going to, isn't going to change my clinical recommendations at the moment. So instead, when I was writing my first book, I thought, gosh, how can I give people a bit of an insight to where the gut health currently stands? So I created that gut health assessment which you would have read out in the post. So essentially it helps people score their gut health from a scale of zero to 20. And by asking them very simple questions, just 10 questions, things like are you getting gut symptoms? But also, are you on medications, how stressed are you, how often are you getting sick, are you on a restrictive diet, et cetera. And you know, we can add the assessment to the show notes here so everyone can complete it and get a bit of an understanding of where their gut health currently stands, which then helps people identify where their gut health journey can take off from, because everyone's on very different, you know pathways. Some people, like you said, are having no gut issues, but actually their immune health is at risk or they're not sleeping right, so that's kind of where they need to target. Other people actually really comes down to the gut symptoms, and around 20% of people are suffering with ongoing gut symptoms, whether it's things like bloating, constipation, et cetera. And there is, you know, so much research around evidence-based strategies that can help them. You don't have to suffer in silence, and I think that's a really important message to get out there. Louise Minchin: 12:43
Okay, so we've got so many questions here. One, I mean there's so many different issues with gut, aren't there? There could be, I don't know. I mean we're going to talk about poo in this podcast. I should have said that earlier, aren't we? I mean we are, aren't we? There's constipation, there's diarrhea, there's IBS. There's so many different issues that many of our listeners will be suffering from. So, before we come to kind of the solutions because you're absolutely brilliant on what we can do to help ourselves and what we can eat, you know how do we even approach that. You know, if somebody's I've mentioned just three things that could be happening what is your kind of like when you see someone, what are your first thoughts? Megan Rossi: 13:20
So I get people to complete a bit of a gut health assessment questionnaire in terms of symptoms. So if they're having gut symptoms, I get them to fill this out Again. Those who have the book can access the assessment, but it looks at things like you know. Are you passing excess winds? Is that bothering you? Are you, do you have reflux? Do you have heartburn? How often you're opening a bowels? What do your bowels look like and go through? All the sorts of kind of gut symptoms people can experience and I get them to scale it and if they're having those symptoms at least once a week and it's quite burdensome, then it alerts me that that is where we need to start with their gut health. We need to look at really getting on top of those gut symptoms before we focus on other elements. Louise Minchin: 14:01
So it's important to kind of know yourself, know what is your normal Exactly. Megan Rossi: 14:06
So keep a seven day symptom diary If you are noticing something's not quite right, and that will then kind of give you a little bit more of a pattern around you know what is your normal and what might have it changed from. And then, if you are, you know, seeing a healthcare professional, always take that along and show them. Or if you just, you know, investigating on your own, you can head over to the Gut Health Doctor website and we've got all the resources there to assess what is normal. Great question so there is no one type of poop that is normal. You'll be happy to know. But essentially there is this scale we call it the Bristol Stool Form Chart and it goes from a scale of one, which is like a hard Malteser, all the way to seven, which is like liquid diarrhea. So what we see as normal is anywhere from a type three, four or five. Now if you're having these one or two is kind of the really hard ones. Ongoingly, that's towards the more constipation. Then it's worth getting on top of that. If you're more of a six or a seven, ongoingly, again that's more diarrhea. So there are strategies to help you with that. Now, that's just one thing to look at. So the consistency, but also the frequency, is another one to think about. And you're laughing so much, but this is the sort of thing, again, you don't need to share at the dinner table, but I think people need to, like you know, review their gut symptoms or you know their bowel movements, you know, every fortnight or so, because actually it gives you so much insightful information to where your health is. So, in terms of the frequency, what we see as again normal is going anywhere from up to three times a day to three times a week as a minimum. So there's quite a wide range there and that just shows everyone's slightly different. But if you're going less than three times a week or you're going more than three times a day, again that suggests there might be something worth investigating. So keeping an eye on that. Annie Emmerson: 16:08
Megan. Her spirit's obviously a lot about with a lot about everything, but particularly exercise and encouraging people to exercise more for health, not just physical but mental health too. So when we look at the gut does obviously what you put in the gut I would say, is the number one importance. But what about exercise? Does that improve gut health? Because certainly, if we're talking about pooing, if you exercise regularly you tend to poo quite regularly, so I'm guessing that's a pretty positive thing. Megan Rossi: 16:39
It absolutely is so independent of diet. So no matter what you eat, we know that exercise really can have an important impact on a gut bacteria and there's a number of different mechanisms hypothesized for why that is One, like you said, it helps with bowel movements and that essentially means that your bowels are moving more regularly and therefore the bacteria getting more fresh food put into them, because most of that gut bacteria, those truins bacteria, actually live along the final part of that nine meter digestive tract, so 1.5 meter at the end is where most of them live. So we want to make sure they're getting like a constant food supply. Essentially. The other one is that when we exercise we produce the lactate and that is thought to kind of be another fuel source for the gut bacteria as well as exercising often as outdoors, so we're getting exposed to kind of environmental microids that live in the grass and the dirt, which, again, I thought to be really beneficial to help diversify in the bacteria that's in our gut. Louise Minchin: 17:42
Okay, so the exercise is one thing you're really so much about what we eat, aren't you? And also that we can. It's a really optimistic message I think you have that we can actually change things, can't we? So where do we start with that? So for the. Megan Rossi: 17:57
You know, my general number one principle is around this plant-based diet diversity concept, and this comes from the research which shows people who eat at least 30 different types of plant-based foods in their diet each and every week have better gut health than those people who eat the same types of 10 plant-based foods on repeat. So it doesn't actually matter whether you are vegan, 100% plant-based, or an omnivore, someone who eats plants but also eats a meat. What the key concept is that's really linking with gut health, is a number of different types you're having. Now this certainly isn't about going oh gosh, I'm only having two types. I'm going to go from two types of plants a week all the way up to my 30. It's about kind of thinking about how many you're currently having, counting them up, how many different plants across the week, and then going, okay, I'm not quite at my 30, how about this week? I'll add an extra different type and then adding that in. So it's about thinking wherever you can to get different types of plants in your diet. So, instead of just getting the steam broccoli, get the steam stir-fry mix of veg. Instead of just your chickpeas, get the three bean mix. As many different types of plants essentially is what we see as key for the gut bacteria. Louise Minchin: 19:09
And plants count as all sorts of things, don't they? It's not just broccoli, but herbs, and also pulses and legumes, which I'm not very good at. Perfect. Megan Rossi: 19:18
You've read the book clearly, so I call them the super six. So, plants, there's six different types of plant food groups. You've got your whole grains, your nuts and seeds, your fruit, your veg, your legumes, so your beans and your pulses, and then your herbs and your spices, so each of them count to a different type of plant point. And a lot of people say who are on things like a keto diet where they cut out things like your whole grains and your legumes go. Hey, I'm getting all my plants from the vegetable group, so I'm completely fine and at the end of the day, it's always down to the individual, but it's important. I think people have the education, the understanding and the research is showing that each different type of plant food group actually delivers different types of plant chemicals. So actually, if we're cutting out the whole grain group or cutting out the legume group, actually you're missing out on some of the really important nutrients that feed really beneficial gut bacteria. So, louise, where we can, if we can, try and get some legumes in. They're super simple. So if you're having something like a bolognese for dinner, you take out a third of the mince and add a can of your lentils in there. If you're having some sort of chicken soup again. Just add a can of the lentils. They're super affordable, great source of plant protein, as well as fiber and prebiotics the food for the good bacteria. Annie Emmerson: 20:35
I love the way you're talking about stuff, because I think sometimes diet people will steer away or they'll fear that healthy food is too expensive for their weekly shopping budget and actually it's not as you just said then, and some people kind of go, oh, lentils, but there are actually so many things you can do with lentils, right, yeah? Megan Rossi: 20:57
No, both of those points, I think, are really important. There is actually a lot of research out there that shows moving towards a more plant-based diet actually is more affordable than eating a lot of the animal produce. It's just, I think, that people have in their heads if they're going plant-based, then they have to go to the really expensive grocers and they have to spend half their wage on buying the latest super veg or the latest super seed. And that's not the case. All of the foods that I talk about in my books certainly can come from your mainstream supermarket Things like quinoa and buckwheat. Actually, you get them in most local supermarkets at no extra cost. But hey, if you go to some of these more fancy health food stores, they will mark up the price. So it's just about being a little bit more savoury about where you're getting your sources from, as well as things like eating in the seasons. When you're at the shops, check out what's the cheapest fruit and buy that. And if there's loads of it, why don't you freeze some for the next season instead of trying to buy something like strawberries out of season and paying four times the amount? Louise Minchin: 22:06
Also, frozen food is much more affordable. Is it as good? Megan Rossi: 22:11
It really comes down to the type of food that you're selecting. Absolutely, we know that berries still, and things like a lot of our snap peas are actually some of them contain more nutrients because they're picked and frozen straight away versus coming all the way from another country and having to endure kind of the rough ride. So I think, where you can mix it up, I always have a pack of mixed berries and mixed veg of frozen form in my freezer, always for those days where actually you don't have time to go and get fresh stuff and it's just there so you can just add them in a stew or whatever you're having. But I think it's still important to try, you know, include fresh foods where you can, but definitely there is nothing wrong with frozen forms. Annie Emmerson: 23:00
So, megan, you have so much knowledge and if we look back over the years back in, I think it was around about 2009 where you got your first class honours degree in nutrition, and then you talked about being kings. I know that quite well. Actually, my twin sister has rheumatoid arthritis and she's under kings and works really well for her. But to be a king, you've got to be an absolute expert. So your knowledge is so wide and so immense and you're so aware of how important a healthy gut is. But do you ever slip up? Do you ever think to yourself, like, right, I'm going to have a big Mars bar or, saudi, I'm going to drink a bottle of wine, or anything like that? What are your vices? You know what? Megan Rossi: 23:41
I love this so much because, there again, this is a huge myth that we definitely need to bust. When it comes to good gut health. It's not being about perfect, it's not about cutting things out. What's really more important is about what you're adding in, and that's why I highlighted that study before that compared vegans versus people who ate animal products, and what they showed is actually eating some animal products. If you enjoy it, a little bit of red meat actually is not going to be harmful for the gut. It's more important that you're adding in loads of veg on top of that. So you look through the recipes in my books and you'll see that one of the recipes is my pre-budget chocolate bar, and what that includes is white chocolate, which you guys probably know has got zero benefit for gut bacteria. It's pretty much just sugar. But white chocolate is actually one of my favourite foods. So when I was doing my final year studying or doing my PhD, it was Easter and I thought, oh god, I just want to have white chocolate. But hey, that's a bit selfish of me, because I'm learning how incredible these gut bacteria are looking after my mental health, my heart health, all of that sort of stuff. I kind of need to treat them at Easter as well. So I thought, hey, why don't I combine both of them? So what I did is just got my white chocolate but added prebiotics, which is the food for the good bacteria from dried mangoes and pistachios. Some extra virgin olive oil in there added that all together with some dark chocolate, and what I've done is turned a food that was very selfish for my taste buds into a food that actually still I think, actually tastes even better but also treats my gut bacteria. So it's like combining both worlds. Louise Minchin: 25:16
Can you explain? Well, we'll come to the sugar word in a bit, but you mentioned, I think, prebiotics there, because we hear a lot of things, don't we, about prebiotics, probiotics. I don't even know what the difference is, and you know we sold them as kind of like, you know, buy them out of a packet, but you've just said that you can actually put them in with pistachios, so just take us through all of that. Yeah yeah. Megan Rossi: 25:35
So there's many P words out there people start to hear about. So prebiotic, p-r-e biotic is essentially the food for the good bacteria, so it's most of them are types of dietary fibers which are found in all our plant based food groups. So if you're getting a 30 different types of plants each week from your whole grains, your nuts, your seeds, your legumes, etc. You're going to be getting enough prebiotics in your diet to feed the gut bacteria. You don't need to take a prebiotic supplement. Now there are a few cases in my clinic where I would recommend a specific prebiotic supplement, but that's very rare. So the vast majority of people get them from your whole plant foods. The other word which is literally so similar only one letter difference is probiotics, but they're very different things. So probiotic is the actual good microorganism, so the good bacteria, but actually some probiotics are types of yeast as well. So probiotics is a live microbes. And the thing about probiotics, you know, one of the questions I get asked is should I take a probiotic capsule? Should I take a supplement? The reason I am a bit hesitant about this one is because it's a very confused area. So one minute the media will be saying they're waste of money. The next minute the media will be saying actually everyone should take one? And the answer is very much in between. So the research has shown that each different type of bacteria does different things. So if you an example if you have iron deficiency, you're not going to go and take a vitamin D supplement and expect your iron deficiency to improve, are you? Because they're very different things. The same goes with probiotic. Each bacteria is going to do different things. So in my first book Eat Yourself Healthy, you'll see there's actually this pre-probiotic prescription pad there where I got my colleagues from Kings to come up with the seven areas where there's really good scientific evidence to take a specific probiotic. We've listed out the exact bacteria you should take, the dose you should take it at and the duration you should take it at. Now that sounds super prescriptive, but that's the way we have to be with probiotics if we want their therapeutic benefit. But if you're generally healthy, you don't need to take a probiotic capsule. It's only for specific reasons. So, for example, if you have to go on antibiotics for whatever reason, there's a good type, a specific type you should be taking. There's also actually some good evidence around a specific type to prevent the common cold any. So around a cold season actually it might be worth you taking that type. So it's about being very specific. Now, if we get into another, there's another word called postbiotic, and this is just another thing to be aware of because a lot of supplement companies are starting to push these words out. A postbiotic essentially is the chemicals the bacteria are producing. So remember I said before the ways the bacteria talk to our brain. One is via the postal service where the bacteria produce chemicals. So when they produce these chemicals the commercial world is thinking, hey, let's not even worry about the bacteria, let's just give people the chemicals the bacteria are producing, and surely that will have the same benefit. But sadly it's not as simple as that at the moment because actually for them to have the benefit they have to get undigested towards the end of our intestine, so that's to go through all the acidic environment of the gut which actually denatures it. So postbiotics is a fascinating area but again, not quite ready for translation in the commercial world yet. Annie Emmerson: 29:01
Another subject we talk about a lot on this podcast is the menopause, so I'm interested to know your opinion on would you make any changes? Are there things that women can do around about that time perimenopause, etc. That's that can help them? Louise Minchin: 29:18
And can I just, while we're just about to do that, there's actually a specific question, danny, from Lisa. She says as I've aged, I've seen a massive difference in my gut. Does aging and menopause have an effect on our gut? Megan Rossi: 29:28
Really great question. So actually, we know that the bacteria are really important in estrogen regulation. So the bacteria actually help recycle the estrogen in our body. So they're very important for the balance of estrogen, and there has been a really fantastic study. It was close, it was in about 17,000 women going through the menopause and what they what they found is that those in the group who are having more plant based dietary fibers actually had a 19% reduction in hot flushes compared to those people who kind of just continued on the foods that they were having. So we certainly do know that nourishing the gut bacteria with plenty of those plant foods, because when they eat those plant foods, the foods contain fiber, which is a word we've all heard about. The reason, though, fiber is so important is because, essentially, it feeds the bacteria, so humans actually don't contain the enzymes needed to break down fiber, so fiber actually gets melabsorbed through most of our digestive tract, reaches the end where the bacteria are, and the bacteria have the enzymes to break it down. So fiber, essentially, is food for a gut bacteria, so feeding them. The fiber helped in this, and that research study reduce symptoms like hot flushes. So it is really, really important. Louise Minchin: 30:47
Jesse, who's her spirit of fuel coach, says I love Megan's book. She's very realistic, doesn't do fads and cutting everything out. What do you think about? You know, because people, lots of people, for lots of different reasons, do cut whole food groups out. And what is your kind of assessment of that? Megan Rossi: 31:04
Firstly, I want to say that I completely understand why, if you look on the internet, there is so many blogs out there saying that, hey, cut out your carbs, cut out, you know, your fats, you know, and you'll lose weight. You'll reach whatever goal you're after, and we certainly do see that. Yes, cutting out food groups, in the short term you will lose weight, but the sad thing about that is that as soon as you start to go back to eating including more of these foods which you will absolutely do, because your body is wired in a way that will prevent you from long term restricting foods and we think maybe your bacteria might even have a role in that, making you start to crave foods that you've cut out for too long. Once you start re-including them, actually people tend to gain not just the weight they lost, but actually plenty extra. So, if you know, weight is one of your key focuses and, to be honest, that's most of the reason I see in clinic of why people have cut out food groups. The science absolutely is showing that adding in more plant foods from all of those five categories really is what seems to be key to weight management and another reason for that, I guess mechanistically to help people, I guess, understand the science around. That is that these plant foods, like I said, when the bacteria eat the fiber, they produce these chemicals called short chain fatty acids. And these short chain fatty acids have a really important role in regulating your appetite. So they really can help not suppress your appetite but prevent you from always being hungry. So having plenty of these plant based foods in your diet will actually overall, reduce the amount of foods and the cravings that you tend to have. But the thing about that it's a kind of a slow and steady race versus. You know, cut the carbs out and drop five kilos in a week, which people might want to do on the short term, but the sad thing is they'll gain that plus plenty extra. It's about these long-term gains that we should be focusing on. Annie Emmerson: 33:07
Caffeine. What are your thoughts on caffeine? I can take or leave. It come the afternoon and I can sleep on it. I could have a coffee before bed and still sleep, but I normally like to have at least two or three in the morning, although, in fairness, I never really finished them anyway. I stopped half empty cups of coffee around the house. Louise Minchin: 33:31
But caffeine in small doses or in the right doses is good for you Just before you say that, before you answer that I love caffeine, but I know why could I do that? If I have a coffee after 12 in the day, I literally wouldn't be able to go to sleep at night. It has quite a big impact, doesn't it? Go on, tell us, Megan. Megan Rossi: 33:53
Yeah, look, there's a lot of individual variation between how people respond to caffeine and we think that actually comes down to our genetics In terms of the caffeine world and when I say caffeine we're not talking about just coffee. We know things like dark chocolate have caffeine in it. We know like cola drinks have got caffeine in it. Green tea has got quite a lot of caffeine in it. The thing about caffeine is it depends where you currently sit. If you're having gut symptoms, so things like diarrhea and a lot of bloating, actually we know that caffeine can exacerbate that and that's because it can change how your gut functions and how your gut moves and if you've got a sensitive gut, that effect is hyper exaggerated. Now we also know that if you're predisposed to a bit of anxiety, caffeine actually can increase your stress hormone cortisol. So we certainly see that people who are more anxious that they have caffeine, that can just exacerbate that. So in those two populations the gut symptoms or people with anxiety actually you need to be very cautious of the amount of caffeine you're having. Now, for people who don't have those issues, what we actually see in the clinical trials is that actually having things like coffee with caffeine in it actually can be beneficial for our gut bacteria in moderation, so up to three or so a week. And the reason for that is that it's not necessarily the caffeine having the benefit. It's the fact that the polyphenols, the plant chemicals in coffee, which is where the caffeine is from, is sought to have those benefits, so they feed the gut bacteria. So actually having a couple of coffees a day, you know, without if you don't have those symptoms, it's sought to be beneficial. Annie Emmerson: 35:36
I was like I thought you said three, I was going to get three a week. No, no, no, but two a day is cool. Okay, right, two days good. Louise Minchin: 35:46
Can I also ask? So that's good, annie. We can get a tick on the coffee, which is really great news because I absolutely love my one coffee a day. Honestly, I look forward to it. I can hardly do without it. Tracy, this is not just a behalf of Annie, but also Tracy and me as well. Alcohol what impact does that have? Megan Rossi: 36:05
Another great question. So you mentioned about the red wine, annie, you'll be happy to know that red wine is also loaded with these other plant chemicals, the polyphenols. However, there is an important point on the fine detail here. So if you're having more than about 120 mils of red wine, those anti-inflammatory benefits we think are linked to those polyphenols which feed the gut bacteria actually start to be more pro-inflammatory and that's because of the actual alcohol keeking in. So it's kind of the same with the coffee. It's not necessarily that it's a caffeine being good in small amounts, it's those plant chemicals, but you go over and then you start to get some of the negative effects. Louise Minchin: 36:48
Okay, so how much is in a glass size 175? Annie Emmerson: 36:52
is a standard. Look, I know it, it's terrible. 250 is what I think is ridiculous. Why do pubs? When did it start happening that you were selling large glasses of wine? Because someone could go to bed on two glasses of wine and go? Why do I have a hangover? It's because you've drank half a litre. So, but in very few places, lou, actually. You said 120, megan, but very few places actually sell like the 125, which is a small, small glass of wine. So it's 125, 175, 250. I know the quantity is way too well, but you know I've spent way too much time in the pub. Megan Rossi: 37:26
But the thing is, if you are, you know, having alcohol, like you asked me before, do I ever kind of slip up? Yeah, absolutely. You know, when I go to I'm Australian where binge drink is by nature right, but you know I certainly have reduced the amount of binge drinking that I've done. But you know I still go out events and sometimes, you know, weddings. You're definitely going to be having a few too many, but the thing about that is you just need to, I guess, understand what's happened. So when you have, you know, large amounts of alcohol, what that does is makes your gut lining a little bit more leaky. So if we think of that nine meter digestive tract, it's kind of this kind of strong wall in there which only allows good things into your body. Now when you have too much alcohol, that wall gets a little bit more permeable, so things which normally wouldn't be allowed to get into your body and then into your blood actually can get through. So in the short term you get that slightly leaky gut. But you know, we also know that when we're stressed we get that slightly leaky gut and actually when we do, you know, really extreme exercise and again, in the short term we get a little bit of leaky gut. But hey, it's very short term and there's many things you can do to help. You know, kind of say sorry to your body for that. So things like having plenty of plant based foods prepared for when you get home that night or in the morning. You know if you're having a fry up, add some mixed beans in there, some roast tomatoes or some mushrooms, which is adding in some extra plants kind of to help, kind of reheal that gut lining from the damage that may have been done. Louise Minchin: 38:59
So when and when you get a lot I wish you could see everybody the way she explains this with her hands, because it's really helpful. So when you get so-called leaky gut, what you might let, I don't know a cold might come in or what sort of things might is that what might happen? Megan Rossi: 39:12
Yeah, so exactly right. So things that are a little bit inflammatory for the body. So some types of bacteria which might not be beneficial can actually start to get in, or some of the chemicals can actually get to the blood, which your blood's not really used to. Having that foreign product there sets your immune system off, which releases some of those inflammatory markers. Louise Minchin: 39:34
Just quickly on the alcohol front, because not everybody just drinks red wine, so with other, you know, presumably is red wine the best. And then, what do you think about other things? I don't know gin, vodka, whatever. Megan Rossi: 39:44
Yeah, look, so red wine has got the highest amount of those polyphenols in it Guinness, although, also has quite a lot of those polyphenols in it as well. The other types of alcohol they don't have as many types of plant chemicals in it, so they just have the alcohol. So I wouldn't say that they're beneficial to have, but they're not going to be completely detrimental. What I recommend if you are having a drink, if it's something like a white wine, why don't you split it with soda water? So actually you're still enjoying volume but actually you're having less of the alcohol? If you're having a gin, why don't you add it with some kombucha to get some of those fermentation benefits there? So just thinking about what you're adding things with is probably the best approach to drinking. Annie Emmerson: 40:33
Well, that's really interesting actually, isn't it? You know, like, have your little gym, but think about something nice and healthy to mix it with, which some people might kind of think really, but actually it kind of makes sense. Megan Rossi: 40:42
Yeah, I always add some frozen berries into mine when I'm having gin and soda, some frozen berries in there. So actually it's got the alcohol, but you've got those polyphenols in it to feed the bacteria. Louise Minchin: 40:52
You do great pictures of Instagram on the gins. I think you might have even inspired me to do that at some point. We mentioned a little bit earlier, didn't we? Sugar, so you know, so much is written about sugar and there is a lot of concern, and what are your kind of main thoughts on it? Megan Rossi: 41:07
Yeah, look, it's always for me coming back to the science. So we want to understand more about sugar. So the main sugar like table sugar is what people talk about, so sucrose. So the thing about sucrose table sugar is that when we eat it, actually it's digested very high up and nine meter digestive tract. So when you read online that sugar is a toxin for the gut bacteria, well actually you know, table sugar doesn't actually reach the bulk of bacteria because, remember, they live really far down. But we certainly do know that having loads of added sugar in your diet is not beneficial. But it's not because sugar is a toxin per se. It's more of because if you're loading up on sugar, that means you're probably also having a lot of processed foods which are really low in the dietary fiber and don't contain those beneficial chemicals or plant chemicals. So it's more of negative because it's what you're cutting out as a result of eating too much of the sugar. But if you're having small amounts of added sugar but loading up on the different types of whole plants, then actually sugar in your diet, according to the science, is completely fine. Louise Minchin: 42:11
Gosh, there's so much to take out of this, isn't there, annie? Annie, I want to talk to Megan, if we can, a little bit about your baby as well, because that's a whole nother journey you're on, isn't it? And presumably everything you've talked about is part of that journey as well, and there'll be lots of people listening who've got children, babies, all the rest of it, looking for what they should be doing. Megan Rossi: 42:32
Yeah, we know that actually, even preconception, mom's diet and also, interestingly, dad's diet six months out from conception, is thought to be really important for Bob's development. And we know that what mom's eating actually can start to influence what the baby will be more likely to accept once it's born. And remembering that the bacteria, or the baby's bacteria, most of that actually comes from the mom if delivered vaginally, and so that inoculation of all of those bacteria is really the initial kind of laying down the foundations for how the bacteria are training the baby's immune system, and that's why we see a lot of associations between babies that are born vaginally having a much lower risk of a range of different immune related conditions because they've been inoculated with mom's vaginal bacteria, which kind of then trains the baby's immune system of what things it should react to and what it shouldn't react to. Now I completely understand you know you can't control a lot of these things with C-sections and there's really interesting research looking at vaginal swabbing, where if and again, this is something that's not ready for translation, but certainly when I was having Archie I did take my own little kid in because I'm very much into the science where, if, for whatever reason, I had to have a C-section. I was going to get Archie inoculated with my vaginal microbiome. So the research is showing that actually wiping the swab in the mother's vaginal cavity and around the the but area and then, as soon as babies delivered by the C-section, wiping the baby again, that helps inoculate the baby and then is thought to help with the baby's development of their immune system. I mean, that is really incredible. Louise Minchin: 44:26
And is there? There's research being done into that? Yeah, vaginal seeding. Megan Rossi: 44:31
It's such an interesting area that is incredibly promising. So you know, if anyone is listening to this and is having a C-section, definitely worth talking to your healthcare team about, because there are some hospitals starting to consider doing it the hospital I was at and unfortunately didn't. And I asked them about it and they said you would have to do that yourself. So I took in my own little swabbing kit in preparation because the research is really quite promising. But you know it's not all doom and gloom. We certainly know that things like breastfeeding as also, if you can, really beneficial. It contains not only the prebiotics, so the food for the bacteria, but actually contains probiotics, contains the bacteria in the breast milk as well as all of these other types of chemicals which help really train, with the gut bacteria, the baby's immune system. So where you can, breastfeeding is really helpful. Again, I understand not everyone can breastfeed, so at that stage it's about things like when you start to wean above and I am going through the weaning stage and obviously the food is my whole world, so I'm loving it. But where you can, without getting too overwhelmed, trying to introduce as many different types of plants into the baby's diet really, again, is like feeding and nourishing baby's gut bacteria. Louise Minchin: 45:49
And if any of you have got little babies, do go and look at Megan's Instagram, because it's. I mean, I wish you know, I wish my mind are teenagers and not even teenagers anymore, but I wish that I'd been able to kind of get inspiration, because it really is incredibly helpful, annie oh no, I think that's amazing. Annie Emmerson: 46:04
I'm so glad there's so much here. That is absolutely brilliant. And you know, you go through life, don't you Like I'm generally touch wood. I feel really healthy. I still exercise a lot, even in my vast years past a century, half a century, a century, half a century last year. But I'm interested also to know what you think in terms of germs, because just like so, for example, using my daughter, who's 12, she's getting a bit better now. But she's getting a bit better now. But I always say she's slightly feral. You know you have to, literally if you're in a public, so you've got to wash your hands. You know she's never sick. That girl, I don't really know. I've never known her to be sick in I don't know. Yeah, not really, I just think she has. Even as a baby she wasn't. So is that just potluck or is it? Yes, go out there. And what do they say? Eat a peck of dust and all the rest of it. You know. Megan Rossi: 46:56
Yeah, so there is this concept called the hygiene hypothesis and that is where, you know, in our generation we're seeing a lot more high rates of allergies and autoimmune conditions and it's thought and hypothesized that actually maybe some of that was due to the fact that we were too clean with our kids. You know it was really pushed forward about the whole germ concept. You don't want germs, germs are bad, so spray and wipe everything. So the research is suggesting that actually that has had a negative impact on people's gut bacteria. In turn it's reduced the different types of gut bacteria and that's reduced the training of the immune system, which is thought to be really important, particularly in the first three years of life. So perhaps your daughter was onto something. Now I would say public toilets and things like that is really important when it's like in built up environments Louise's face, yeah, and you know going on public transport and stuff like that. But hey, if you live, you know, close to a forest or on the farm, then absolutely get the kids amongst the dirt. And we certainly are seeing from the science is that kids who grow up on farms have a much lower risk of different immune conditions as well as allergies, because we think again, they've been more exposed to different types of microorganisms which are then training their immune system as well as having a pet. So bubs who grow up with a furry pet again lower rates of a lot of these autoimmune conditions and allergies. Because if you think about, I've seen with my puppy, pistachio and Archie, you know, even if you try to keep them apart, the puppy is going to get a tongue in there at some stage, lick its toes and things. So there is a lot of microbes sharing down. We think that's quite beneficial, although you know, I think the first three months of life be very careful. Don't let the dog get too close to your bub because the baby's immune system is so vulnerable. But you know, slow and steady get them exposed. Louise Minchin: 48:55
I think what I love about you and, as I say, I follow you, obviously follow you in Instagram. I've got your book, etc. You sort of do this brilliantly fine line of you know really scientifically, academically, you know, researched, and all the rest information, as well as nailing Insta. I mean it's brilliant, is that? I mean that's really important because it means that your message is getting out. Megan Rossi: 49:21
Look, I had no ambitions at all about doing anything other than being an academic, so being in the research world. But you know, it was about a year of being in the UK working as a research fellow at Kings where I just I started to get a bit frustrated. I think that despite the amazing research that was coming out, not just from my group but all groups around the world, it just wasn't being translated. And you know, I was seeing, because I continue to also work as a dietitian, just keep my hand in clinical practice I was seeing people coming on the craziest diets, thinking they were doing their gut health good, when actually it was against what the science was saying. It was doing more harm than good. So I think it was really this injustice that made me go. Hey, I can't just stick in my you know research every time I need to go and do something. So, yeah, I set up the gut health doctor on social thought. Hey, if I could help you know a few hundred people you know nourish or understand I got a little bit more. I'd be, you know, doing some good. And yeah, through word of mouth it really has grown. And you've got your own product, yeah, so buying me is my little baby. And again the same reason. I know that education, information is just half the battle. Again, you know, I've got a husband who is a GP, has all the knowledge at his hand, but, hey, if you don't have convenience foods available, he's not going to look after his guy at all. So I've always knew that to have my you know big impact, I had to get into food industry. I had some opportunities with some of the real big guys and I thought, oh my God, this is amazing. This time I'm going to have my role, you know, in translating and getting people's gut health right. But sadly it was clear they just wanted me to brand slap. And I knew at that point that if I was ever going to get into food industry I had to do it my own terms. So I, by luck, met a guy who was ex-nest, so I had all of that knowledge and I said, hey, I would absolutely love to do this, but you have to trust me in developing the products and have to be in line with the science or I'm not doing it. And he said, yes. So Byami was born two years ago. Louise Minchin: 51:24
Actually, we just had our birthday yesterday and if you find the man, he's super scrummy. I had some of it today was basically just delicious cereal and you go. Because we're going to let Megan go in a minute and I've got a final question in a minute, you go first. I still got loads more, but we'll catch up with you Round two in time. Annie Emmerson: 51:41
I think that my final question to you and this is like you know, there's so much to talk about but if you had and I guess I think I probably know the answer but if you had one bit of advice to give to people and I guess we're talking generic, although of course no one gut is probably the same or one person is the same what is the one piece of advice that you would say if you can do nothing else for your gut, do this. What would it be? Megan Rossi: 52:06
Honestly, it would get the plant diversity in. So for those who are looking at getting my new book, I have got this free plant points planner which I put on people. It's a magnet put on people's fridge and what they do is get you just to write down the different plants that you're going to have and it gives you that kind of insight of going hey, you know what? I always have broccoli, I need to get some bok choy in there or I need to have some beans in there. So it really helps you just focus on getting that diversity there. But I'm going to be cheeky and add a second point, in which is a really simple thing that I think we need to not overlook, and that is chewing your food. Well, because you know so many people I see in clinic who suffer particularly with digestive issues like bloating, I say to them look, go away for a week, try this one strategy and then, if it doesn't work, then come back to me and it literally is chewing. So most people chew their food less than 10 times and there's really good scientific research to show that if you're chewing your food at least 20 times, you really extract so much more of that good nutrition out of your food and because we not only have enzymes in our saliva which start to chemically break down the food, but also that chewing action. It's that dual effect, it's the physical breaking down but the enzymes in our saliva, which means that we need to chew our food a good amount of time to extract and really support our digestive system. Two diversity and chewing your food. Well, on my two top tips, I think you know what. Louise Minchin: 53:36
I don't need to ask my last question because I was going to ask you for three. Actually, you can give one more if you want. Megan Rossi: 53:40
Yeah, a third one I would say, again moving away from diet, because we all know about the diet elements and we've really spoken about that but is around this gut brain axis. There is really good scientific evidence, which I thought was hippie-dippy, but actually we've got the hardcore clinical trials that showing that doing something like five, 10 minutes of belly breathing or mindfulness each and every day really can help nourish those gut bacteria. Because if you're stressed up here it's going to stress out those gut bacteria. Whatever it is works for you, even if it's going for a walk in the forest or something like that. But belly breathing, we know, particularly is quite beneficial for relaxing that gut so you don't get all those tense nerves stimulating the gut bacteria. So belly breathing Belly breathing, so diaphragm breathing, so you know when you breathe. A lot of people breathe from their chest. Yeah, I do, I know I do. So you need to put your hands around your belly and really try to push that out like you're pretending to be pregnant, and that should be where actually you're doing your belly breathing from. So out you can do four in through your nose hold for four. Annie Emmerson: 54:52
Okay, hang on, where do I hold for four? I know so much stress, so push out through your belly and then breathe out, and then breathe in through your nose, annie, I'm going to send you to our mind section in the her spirit out, because there's so much around this. Louise Minchin: 55:10
We've got 21 days of calm. We've got 10 day meditation. We've got square breathing. I even know what square breathing is, but we can. It's all there, Annie. Annie Emmerson: 55:19
It's all there, I'm on it, I'm all over it. I just need to make time to go there. Megan Rossi: 55:23
But that's it Five minutes, guys, if you just set yourself that because I mean yeah, no one really has any more than five, 10 minutes each day to do something, but it is really powerful because the science has proved it. It's not just any total evidence. Louise Minchin: 55:38
Oh listen, you've been so great. I mean you've answered so many. I'm sure everybody listening there's so much that they can take away from this podcast. Megan, you're absolutely brilliant and good luck with your continued journey with the little baby, because I know that it's not always. It's lovely but it's not always the easiest. Megan Rossi: 55:54
Oh, I just can't wait till they're off to university. So I'm just looking at you with awe. Louise Minchin: 55:59
You know what you think it ends? Annie Emmerson: 56:01
never ends More stress, isn't it? Because when they're little, you can keep them in, you put them down, and they're there when you get back, because you can strap them into their chairs, put them in the cots. We can't do that with ours any longer, megan. We've got no control. Louise Minchin: 56:14
You always love them and they're always there and listen. It's absolutely wonderful to speak to you. Thank you very much indeed for your time, really great. Thank you, thank you, thank you. Thank you both, annie. I said in the podcast, didn't I, that we sort of like we go after people, don't we? That we want to get on the podcast, and sometimes it takes months, and it was so worthwhile talking to her, I think, wasn't it about lots of different things? I've taken masses out of her, out of what she said. I mean the last thing to chew, but I mean so many different things. It was just fascinating, wasn't it. Annie Emmerson: 56:45
I'm blown away. I absolutely loved chatting with Halleuse, so really well done for bringing her on board and it was so right, so worth the wait, and I think there's so much that people can take away from that. Louise Minchin: 56:59
But it's not bad news, is it? It's not bad news. Annie Emmerson: 57:02
It's not at all, and that's. I love the way she delivered it all and I think you know you don't have to. I wouldn't want any of our listeners to go oh my gosh, the enormity of like improving my gut health. I think there's lots of little things that you can take away from that and gradually build and of course you can have your glass of wine and your cream, egg or whatever. But there are really subtle, great ways that we can make changes to our gut health which can have humongous overall positive effects on general wellbeing. Louise Minchin: 57:29
It was. For me, it was those little things like buy the tin of mixed beans you know that, you know you're buying the beans anyway, or whatever it is the chickpeas. That, for me, was brilliant, right, okay. So what do we got to look forward to? We've got the her tour de her spirit, which is coming up soon, which is absolutely brilliant. I was part of it all last year. Everybody gets, I think it's running over five different months. We've got one different event a month Super fun. You can join either on Zoom, via the app, et cetera, through our lovely cyclist, who's one of your best friends, isn't she? Our lead cyclist, michelle, who's just fantastic at it. Annie, I will be joining in as much as I possibly can, and it's one of those nights where you know you're at home alone, but you feel like you're all together and having fun, even when it's really hard. So you've got to join us a bit more this year. Annie Emmerson: 58:18
I think I am. I think I am moving towards going to get a trainer. I don't have a trainer at home, which is absolutely rubbish, isn't it? Louise Minchin: 58:26
But I mean, since we've done this podcast, you have got a bike, I've got a bike. That's a good start, isn't it? Annie Emmerson: 58:32
It's a good start and I do get the benefit of cycling and not just being a runner as I move along in my fifties, because I think I tell you what girls out there listening, and men, because we know we have some men listeners. You know, it's great for the hammies, the hamstrings and the bum, the glutes cycling. You don't really use them that much unless you're a sprinter in running. So from a vanity point of view, cycling is great. It really is for the legs and bums. Louise Minchin: 58:58
I have been cheating on the winter swim challenge. I've been to warm water. Do you think that still counts? Does it still count, Mel, Sort of she says. Annie Emmerson: 59:09
If you read the small print it definitely, it is definitely okay. So I have just been told by my lovely, lovely friend, lisa Yeoman, who is a cold water swimmer, swims all the year round, gets up, she lives near the Thames. I mean, this is I don't get. She'll get up at six in the morning and go, got to go for a dip and just go and immerse herself. So she's given me the advice on the mittens that I need the four millimeter mittens and shoes because I just I have rain odds and I know that I'll suffer really badly. But it's in process. My cold is just about gone and I am getting in the cold water this week. You have my words. Louise Minchin: 59:44
I know so many people that are joining in on the winter challenge. Good luck to everybody. Keep noting down what you're doing. Keep going and we will get there. Thanks everybody for listening. Hopefully speak to you soon. Take care. Lots of love, annie. Lots of love, bye. 

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