Updated 1st May 2024

Foods for every stage of life, with Federica Amati

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In today's episode of the ZOE Science & Nutrition podcast, we hear from Dr. Federica Amati, nutrition lead at Imperial College London and ZOE’s head nutritionist. The conversation explores an often-ignored topic that Federica is deeply passionate about: life-course nutrition.

Life-course nutrition is also the focus of her latest book, Every Body Should Know This — The Science of Eating for a Lifetime of Health, which will be released on April 25th.

So, what is life-course nutrition? In brief, it’s about understanding the power of food to support your health at every stage of your life.

We all know that our bodies are very different now than they were 10 years ago. And 10 years from now, they‘ll be different again. But we rarely consider shifting our diets to work with these changes.

Many of us settle into dietary patterns when we’re young and, despite significant changes to our bodies, we continue in the same patterns for the rest of our days.

Instead, Federica explains that “Each life stage provides unique opportunities to improve our health and happiness.”

We recognize that a newborn has different dietary needs from a 10-year-old, but few people appreciate our changing needs as we move from child to teen, from young adult to middle age, and then into older age.

In this episode, Federica shares fascinating insights on a whistle-stop tour of each life stage and its nutritional requirements.

We start the journey in the first 1,000 days of life — the “golden window” of opportunity. This phase begins on the day of conception and ends on the baby’s second birthday. 

Of course, the mother’s diet is vital for the baby’s future health. Perhaps more surprisingly, Federica explains, the father’s contribution is just as important. For instance, dad’s nutritional status at conception plays a role in the development of the placenta — it takes two to tango, after all.

Federica also upends long-held myths. For instance, she explains that eating allergenic foods like peanuts during pregnancy will reduce the baby’s risk of developing an allergy, contrary to popular belief. 

As she guides us through life’s stages, Federica teaches us how to support children’s bodies and brains as they hit growth spurts. She also explains why a good diet can offer teens protection from mental health conditions and why young adults don’t need to eat meat if they want to build muscle.

In our 20s and 30s, it’s relatively easy to build muscle, and our cognitive skills are sharp. Although old age seems distant at this point, it’s important to stay active and eat well if we want long, healthy lives.

Although heart disease doesn’t generally occur for a couple more decades, the groundwork starts in our 20s and 30s. So, Federica recommends a plant-based diet with lots of polyphenol-rich foods, which protect against blood vessel damage.

As the conversation turns to midlife, Federica describes recent evidence that switching from a standard Western diet to a “longevity diet pattern” at 40 can add around 10 healthy years to your life. 

Finally, she guides us through the twilight years, where our nutritional needs shift once more. In this stage, we need to adjust to reduced appetite, poorer nutrient absorption, and a less flexible metabolism.

Importantly, though, it’s never too late to make a change. Federica says switching from a typical Western diet to a healthy diet at 70 can add another 6 or so healthy years to your life.

This fascinating journey is meant to inspire and empower. “Don’t worry about what you haven’t done, look to the future,” she says. “Embrace the change, be aware of it, and instead of fighting it, harness the power of food to support your health.”

Show notes

Did you know that even at the age of 70, with the right nutrition, you could potentially extend your life by 6 years?

In today’s episode, we learn why it's never too late to change our diets for the better. Dr. Federica Amati, ZOE’s head nutritionist, dives into the unique nutrition needs at every life stage.

From the golden windows of opportunity that can transform your health, to practical food recommendations for adolescence, young adulthood, and beyond, Dr. Amati gives insights to enhance your well-being, no matter your age.

Dr. Federica Amati is a researcher at King’s College London and a registered nutritionist. She’s also a lecturer and nutrition topic lead at the Imperial College School of Medicine. Federica empowers people with accessible, practical knowledge to make informed choices about diet and lifestyle and improve health based on unique needs and preferences — at every stage of life.

Follow Dr. Amati on Instagram.

If you want to uncover the right foods for your body, head to zoe.com/podcast, and get 10% off your personalized nutrition program.

Follow ZOE on Instagram.

Want ZOE Science & Nutrition’s top 10 tips for healthier living? Download our FREE guide.

Is there a nutrition topic you’d like us to explore? Email us at podcast@joinzoe.com, and we’ll do our best to cover it. 

Episode transcripts are available here.

ZOE Science & Nutrition

Join us on a journey of scientific discovery.

[00:00:00] Jonathan Wolf: Welcome to ZOE Science & Nutrition, where world-leading scientists explain how their research can improve your health.

Today, we learn about the new science of life course nutrition. The idea that to improve our health, we should change how we eat at each stage of life. 

When I find a meal I like, I tend to stick to it. If it gives me energy and makes me feel good, I'll eat it regularly. Many of us find a particular way of eating and then stick with it for life. But according to the emerging field of life course nutrition, each stage of life has its own distinct set of nutritional needs that should inform the way we eat. 

Our guest today is Dr. Federica Amati. Federica is a researcher at King's College London, a registered nutritionist, and head nutritionist here at ZOE. Federica's new book, Every Body Should Know This, is the essential nutrition and lifestyle guide across the lifespan. In this episode, she explains how we can tailor our diets to each life stage in order to optimize long-term health.

Federica, thank you for joining me. 

[00:01:18] Dr. Federica Amati: Thank you for having me. I'm so excited. 

[00:01:20] Jonathan Wolf: Well, so am I. And congratulations on your new book, which I love, and I know is going to sort of form the basis for our conversation today. 

[00:01:28] Dr. Federica Amati: Yes. Thank you so much. 

[00:01:29] Jonathan Wolf: All right. Well, Federica, this shouldn't be a shock to you, but we have a tradition here at ZOE, where we always start with a quick-fire round of questions.

Are you ready to go? 

[00:01:38] Dr. Federica Amati: I think so. Let's go. 

[00:01:39] Jonathan Wolf: All right. Does each life stage have its own unique requirements that can affect our health? 

[00:01:46] Dr. Federica Amati: Yes. 

[00:01:47] Jonathan Wolf: Does diet make a bigger health impact at some ages than at others? 

[00:01:51] Dr. Federica Amati: Absolutely. 

[00:01:52] Jonathan Wolf: Could the right dietary change add 10 years to your life? 

[00:01:56] Dr. Federica Amati: Yes. 

[00:01:57] Jonathan Wolf: Do you believe there is a safe way to drink coffee during pregnancy?

[00:02:01] Dr. Federica Amati: Possibly. 

[00:02:03] Jonathan Wolf: Alright, and then Federica, what's the most surprising thing that you learned writing your book, Everybody Should Know This?

[00:02:10] Dr. Federica Amati: For me, it was just weaving together the story of life course nutrition, touching on all the major windows of opportunity, and how that could all form this really beautiful story.

And we'll go into this, Jonathan, but there's some really key windows of opportunity that are well-recognized in scientific literature, and then there's others that are often overlooked and don't get as much love as they should. 

[00:02:31] Jonathan Wolf: I know I think about adopting a certain way of eating, a diet, for really long stretches of time. And, in fact, basically, if I find something that I like, I'm just going to keep eating that sort of for the rest of my life. 

And I think most people sort of end up finding a way of what they eat sort of in their twenties, and they basically just keep doing this for the rest of their life.

[00:02:52] Dr. Federica Amati: That's absolutely right, yeah. 

[00:02:53] Jonathan Wolf: And I've become sort of much more aware of this as I've had children of my own and then doing ZOE. I've seen the huge difference as I think about food with my 16-year-old, because when he was younger I wasn't thinking about nutrition at all, and then with my 4 year old I'm so conscious about it, but at the same time feel that I'm not doing a very good job of feeding them the right food for when they are.

So I think talking about this and, and, you know, you focus a lot on these different windows of opportunity, starting with these windows of opportunity in childhood. I'd love to get into that, hopefully without making me feel even guiltier at the end of this podcast than I feel at the beginning.

[00:03:32] Dr. Federica Amati: Yeah, definitely. So that's a really important point. I don't want anyone to feel bad. So the idea of this book is to deliver the information and then make the best of it. Now, obviously, I have young children too, and I'm past the first golden window of opportunity with them too. 

So it's not about being like, Oh no, I didn't do that. It's more about, okay, really good to know. And that might help someone else that you have in your life and you love. And then look at the future windows because each life stage has really unique opportunities to make a big difference to our life and our quality of life and our relationship with food. It's really important that we have a good relationship with food. 

So the very first window is what we call the golden window of opportunity, and it's called the first 1000 days. And it's the one that has the most research on it, right? There's a whole body of research called DOHAD, which is Developmental Origins of Health and Disease, and all these great terms. And it really talks about how important nutrition is from the day of conception till the second birthday, which is roughly 1000 days. 

Now in that time frame, so much happens because literally our entire bodies are built in our mother's womb. Every organ, every structure, every blood vessel. You know, when babies are born, nearly all of the cells that will make them into adults are there.

So that's why it's such a structurally crucial time. and nutrition is what provides the building blocks to have the best possible blueprint and the best possible foundations. So it's a bit like, we think about building a house. Those first two years are, make the difference on how that house is built, what materials have you used? Does it have strong foundations? 

[00:05:09] Jonathan Wolf: And so Federica, the first window of opportunity is actually before you're born. It's really the mother's. It's nutrition you're talking about then because it's while she is pregnant I guess that is actually the starting point. 

[00:05:21] Dr. Federica Amati: It is. And actually, Jonathan, when we look at this, the three months prior to conception, so 90 days before you are conceived, the mother's and the father's diet and lifestyle have a huge impact on the quality of the egg and the sperm.

[00:05:35] Jonathan Wolf: So let's talk about that for a minute because there's many variations obviously in how children are conceived. But for everybody who's been trying for a really long time and has been making sure they're doing everything they can to conceive successfully, there are all the people like, oh, it'll probably never happen, and they're really surprised that they've just had a baby.

And they're like, oh, I should probably stop drinking and start eating better. And now you're saying you not only need to improve your diet at the point of conception, you're now saying three months is enough. And for the father as well, which I've never heard before. 

[00:06:04] Dr. Federica Amati: Yes, so this is a really crucial point, and I talk about this in the book a lot. It takes two to tango. The father's responsibility, the father's contribution to the baby's health is just as important as the mother's. 

So we know that paternal health has a massive impact on the child's health. And it actually has a massive impact on the success of the pregnancy. So lots of factors, including how the placenta forms. The placenta is the organ that our body builds to house the baby. That's actually really impacted by sperm. 

So both paternal and maternal health and diet, pre-conception, have a big impact. But that's not to stress people out. I think what it means is, we have to be aware that if we are trying to conceive, or even if we're not, but we're not taking precautions, it's a good idea to have a healthy lifestyle.

So for example, if you are not necessarily trying to conceive, but then if you did fall pregnant, you would choose to have the baby, then you're really considered in that bracket of people who are potentially going to conceive. Now if that's you, then it's worth investing some time in thinking about looking after your health.

[00:07:14] Jonathan Wolf: I had no idea that anything that I ate would have any impact on the quality of my sperm. Is that real science? 

[00:07:25] Dr. Federica Amati: Oh yeah, it's very real science, Jonathan. So we know that men who are micronutrient deficient, specific nutrients have been pulled out like zinc, for example. 

Zinc is really crucial for the right functioning of your sperm, making sure that it not only forms properly but also is able to swim. So sperm, if they're not well-nourished A, they can be malformed, so they actually don't look like sperm. B, they can actually not have a very good engine behind them so they don't get very far. And C, you can have much lower sperm count, which means that the amount of sperm that are available to actually go and find the egg and allow conception to happen are much reduced. 

[00:08:01] Jonathan Wolf: And Federica, I know we're not normally big believers in sort of individual micronutrients versus the right overall diet. In this case, is it literally just eat some zinc and you're fine?  

[00:08:13] Dr. Federica Amati: You're completely right, Jonathan. It's just the science has been done to try and identify which nutrients are most important. But there's lots more research outside of individual micronutrients that shows specific dietary patterns are what make the difference. 

So you won't be surprised if you read the book, you'll know that the Mediterranean diet has so much research behind it. And it also has so much research to support good fertility for men and women. And it's no surprise because it's so nutrient-dense, there's such a variety of foods. It's all about finding as many different plants that are seasonal, local to you. And these foods, with a little bit of shellfish, a little bit of oily fish, are what are thought to be the best foods to support fertility for both men and women.

There is slight differences in which micronutrients are thought to be more important for the mother or the father, but actually it's the overall dietary pattern that supports having an abundance of these micronutrients anyway. So we don't want to focus on just taking the zinc tablet, no.

[00:09:10] Jonathan Wolf: Amazing. So you've described how diet is really important for conception for both mother and father. And then I just want to take you through the rest of this sort of a thousand-day starting window before we go on to the second window. 

And we started strong by jumping straight into life course nutrition, but I guess maybe to step back just for a second, this is this idea that, what? What exactly does it mean? 

[00:09:33] Dr. Federica Amati: This is the idea that we need to be aware that our bodies change throughout our lives. We are not static beings, we evolve every year. We become someone new in terms of physiology and metabolism. A lot of the people I've worked with one-on-one, Jonathan, come to me and they say, I've always eaten this way, it's always served me. And now suddenly it doesn't. 

And what I would love for people to embrace and to understand is that we're supposed to change, and changing is part of the privilege of aging. So if we're lucky enough to live a long life, then we should expect that our bodies and our physiology and our needs change with that.

So that's really the core message of the book is to embrace that change, be aware of it, and instead of fighting it, let's learn what the best changes are that we can make to support our evolution into older age. And this is something that I teach medical students in my role as a lecturer, but I realized that outside of lecturing and, you know, outside of academic conferences, no one talks about life course nutrition.

[00:10:36] Jonathan Wolf: And I think most of us assume that there's one right way of eating that we should have. And to be honest, when you speak to a lot of scientists, even on this podcast, a lot of them had this quite generic advice. So this is, I suspect, surprising to most people.

[00:10:52] Dr. Federica Amati: You're right. I think it's actually fairly novel as a concept to bring to a wider audience. It's really something that in nutrition research and nutrition education we talk about, especially if like me, you are interested in maternal and child health, it impacts all of us, right? 

So it's something that I'm hoping that we'll just bring an extra layer of understanding and an extra layer of compassion because if we understand that we're supposed to change, we'll be a lot kinder to ourselves. 

[00:11:17] Jonathan Wolf: I love that Federica. So you tell me a little bit about after conception. I assume that the father's diet now becomes a lot less important.

[00:11:25] Dr. Federica Amati: Yes. Apart from if the father has a terrible diet and he's living with the mother, then it can influence her. So we want everybody to be on board here. 

[00:11:34] Jonathan Wolf: Tell me about what we understand about the mother's diet through pregnancy, and I know having been through this, and I know you've been through this, that this is a really tough time for a mother.

There's a lot of pressure associated with this, as there is over the next few years. Are you about to heap more weight on that? More pressure on anybody thinking about this for themselves or other loved ones? 

[00:11:55] Dr. Federica Amati: No, no, definitely not about pressure. It's just more about understanding. I think that we just touched on the importance of pre-conception and part of the importance of that and why we advise women trying to conceive to for example, take folate or folic acid before they even conceive, is because the first triments for a lot of women is really tricky. 

The first trimester is the first 3 months of pregnancy, the first 12 weeks, and it's typically A, when women find out they're pregnant, and sometimes some women don't find out they're pregnant until they're about six weeks in, which is basically halfway through. 

And it's also when a lot of women will suffer with nausea. Morning sickness is such a wrong term because it lasts all day, and for some women that can be quite serious. So HG [hyperemesis gravidarum] is a condition where you literally can't keep water down. It's really quite severe, hospitalizations are usually required.

But for the majority of women, it's just this low-level nausea. But it can really make eating a diversity of food difficult. I never forget that I tried to eat a sweet corn avocado fritter when I was pregnant because I knew it would be nutritious and good for me and I had to run out of the restaurant. So bad. 

So this pressure in the first trimester, it's really a crucial time because it's when the placenta is forming. It's when the egg and the sperm suddenly multiply into essentially what starts to look like a proper baby by the end of the 12 weeks. 

So, so much structural change happens in that time. But crucially, the placenta doesn't attach to the baby until about week 10. So we're not exchanging nutrients via the blood in this time. So, actually, what impacts the nutrient status of the yolk sac that forms in the very early weeks, and before we attach the placenta and how the placenta forms, is what nutritional status the mother was in before she was pregnant. 

And also what she then eats in those first 12 weeks does actually translate into amino acids and hormones that are secreted through the endometrium. So the endometrium is the lining of the womb. And these glands that are there, and some quite researched science found that they sort of release nutrients into the space to reach the developing embryo. 

[00:14:10] Jonathan Wolf: Because of this, I want to make sure I'm following this, because at this point, I always think about about this thing with the little cord that goes into their belly button. 

And that's through the placentas you're describing, but you're saying that isn't there in the first few weeks. They're just sort of sitting in this swimming pool of fluid and they just sort of clean in whatever is out there before the placenta is there. 

[00:14:31] Dr. Federica Amati: So the yoke sac, which literally provides nutrition, like an egg. Yeah. Is based on the paternal and maternal nutrients that… 

[00:14:41] Jonathan Wolf: I hadn't realized that I started off really like a chicken. Okay. I'm learning a lot here today Federica. 

[00:14:46] Dr. Federica Amati: Then the placenta is also forming, so we're building a whole new organ. I find this mind-blowing. This brand new organ is built to house a life, right? So there's a lot of quite a high nutrient requirement. There's a lot of protein being used, a lot of other nutrients that are…

[00:15:00] Jonathan Wolf: And so what does this mean for the mother? Because you described both on the one hand they're quite nauseous, so it's quite hard to eat anything. What do we know about what a mother should be thinking about eating at this point? 

[00:15:12] Dr. Federica Amati: So in this window if you're well nourished, if you've been well nourished beforehand, then just eat what you can and really try to focus on whole foods. The most important thing is to try not to resort to ultra-processed foods that are very low in nutrients. So they're really lacking in nutrients. 

Find an eating window that works for you. So there's usually a spot of time and it differs from mother to mother. Find a spot of time that you feel a little bit less nauseous. Often that can be a mid-morning for a lot of women or even if it is late at night, just take the window and then make that the most nourishing meal you possibly can.

Stay really well hydrated and have fruits, cold foods are really helpful. So having frozen fruits. Also this is one of the times in life where smoothies can play a really important role because they can be nutrient-dense, served ice cold they're basically flavorless and you can actually get quite a lot of that really good stuff in a small amount of time when you're not nauseuos.

So there's a few things. you know, to do. If you weren't particularly well nourished before pregnancy, then you might need a bit more support. And it's worth working with someone who works in the space of pregnancy nutrition just to make sure you're hitting all of your requirements. Anemia being one of the most dangerous things.

[00:16:27] Jonathan Wolf: Thank you, Federica. And then what about as you go through to the next six months of pregnancy, does anything change? 

[00:16:33] Dr. Federica Amati: Yeah, so in the second and third trimester, there's massive growth. So there's usually an increase in energy requirement just because A, your own maternal tissues are growing. So there's new tissues in the breasts and you're expanding essentially with the baby.

You're also starting to store more fat for breastfeeding. So mothers start storing fat in their hips and thighs, which is like this easy-to-release fat which is then used in breast milk, and interestingly that fat also stores vitamin D and other fat-soluble vitamins that then go into breast milk.

So you will be hungrier and I think it's really important during pregnancy to eat more food. But eat more food is crucial. So more whole foods. So making sure we're getting plenty of vegetables and fruits, nuts and seeds. Don't shy away from allergens unless you're allergic yourself. 

Allergens are foods that can cause allergies later in life, so peanuts, soy, milk,  dairy, also gluten, sesame, there's actually depending on which list you look at, there's between 7 and 11. Fish and shellfish, these are the kind of main ones. The more exposure a baby has in the womb, eggs, the less likely they are to then develop that allergy later in life. 

[00:17:46] Jonathan Wolf: I have a friend whose daughter was born with a huge peanut allergy and ended up going through a whole set of trials that actually were at King's College London.

And so I was shocked to discover that basically, scientists have sort of reversed their understanding of this, where before pregnant women were being told to avoid all of these different foods and now apparently the feedback was, well, you know, you become allergic to peanuts because you're not exposed to peanut.

If you're exposed to peanut all the time, you wouldn't get this allergy. And is this why you're saying actually go out there and eat all of these different things that are potentially things people are allergic to? 

[00:18:22] Dr. Federica Amati: They're also really nutritious foods, right? So eggs are wonderful, peanuts are wonderful, almonds are great, all these foods that are allergens, seafood, shellfish.

But yeah, we now know that we have to train the immune system to know that these are not the enemy. Because an allergy is really an overreaction by the immune system to a protein found in these foods that is actually not harmful. So exactly right, the dogma used to be…

 [00:18:44] Jonathan Wolf: You're sort of teaching your baby already, even before it's left the womb, that this stuff is safe.

[00:18:49] Dr. Federica Amati: Yeah. 

[00:18:49] Jonathan Wolf: And so already giving it like this gift of being able to eat these foods without being allergic to them. 

[00:18:53] Dr. Federica Amati: Exactly. And it becomes even more crucial after birth, because then we're training the baby's microbiome, but we'll get to that. 

In pregnancy, apart from the allergen I think it's also important to remember the baby can taste the amniotic fluid. So if you're eating broccoli and kale and garlic and these kind of more adult tastes, bitter tastes rather, the baby will be more used to them, much more likely to accept broccoli during weaning, if they've been exposed to broccoli in the womb. 

[00:19:19] Jonathan Wolf: So is that why some pregnant women suddenly have these crazy cravings for some really weird tastes that they don't normally, they're just trying to teach their child to enjoy, whatever it is, is that…?

[00:19:30] Dr. Federica Amati: Well cravings is interesting. Some cravings have really solid science to say that they basically signal a problem. So eating soil is a really bizarre one, and that's actually usually a signal of low iron, for example. So nonfood item cravings usually signal some sort of deficiency.

But weird food combinations are just apparently a quirk. I think it's partly to do with the change in our smell and our taste. Which means that we find different combinations really appealing. 

So, with my second pregnancy, I was obsessed with salt and vinegar, which is not my thing. And so, I had to find creative ways of not just eating salt and vinegar crisps.

And so, you know, chickpea, roasted chickpeas with salt and vinegar, roasted seaweed with salt and vinegar. You know, it depends. 

[00:20:15] Jonathan Wolf: And how are you with the salt and vinegar now? 

[00:20:17] Dr. Federica Amati: I mean, just not that bothered. 

[00:20:19] Jonathan Wolf: So I know a lot of people are saying, our listeners will will be like describe the full life stage, I haven't got any small children, I want to make sure that Federica gets there. Can we move on to maybe the key life stages after the baby is born?

[00:20:33] Dr. Federica Amati: Yeah, so, you're right, Jonathan. The first thousand days is crucial and there's lots to talk about. Then there's this really important stage for children around the age of seven where they have another growth spurt. 

So another opportunity for us to provide them with lots of nutrients and work on their physical resilience. So really climbing, playing, running, all these really physical exertions that help to start to shape the body composition that we want to see for long-term health. 

And then the one that's really overlooked is teenagers. So teenagers have a really critical time period where, again, they have another growth spurt, and then they have the beginning of their puberty, which is transformative in both boys and girls, slightly different ages. And they also have this really critical period where their brain structures change. And there's this change in the synaptic map of the brain. 

Synapses are where the neurons meet and talk to each other in the brain. And in teenagers, their diet supporting this change is so important. And with girls, because they start their periods at this time, this is when we really have to start thinking about iron-rich foods and making sure that our young teenagers are getting enough iron in their diet to compensate for this new blood loss that they will have roughly every 28 days.

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[00:21:45] Jonathan Wolf: And Federica, just to make sure I've got this, you're saying rather than thinking about this sort of very consistent experience with our children between being born and, you know, being grown up, that there are these particular windows. 

And the second thing you're saying, which I think is probably the biggest surprise, I think many of us worry most when our children are very small, and also as our children become more independent, particularly three or so, and they start to have a lot of opinions about their food, many of us are just like, okay, you know what, I sort of give up a lot. You get this compromise between what they're pushing for and what you feel that you want to do. And then you sort of, you know, I'm certainly struck that you tend to spend a tiny amount of time thinking about what your 10-year-old is eating compared to the thought you're putting into when they were, you know, 12 months old.

And I feel that I've discussed this quite a lot, this seems quite common. But you're actually saying, firstly, that it continues to matter. But also that particularly there's sort of this window around seven, which I'd never heard of. And again, when you're becoming a teenager, which makes sense. But again, I don't think there's a particular focus on diet around being a teenager. 

[00:22:58] Dr. Federica Amati: No, there isn't. And we're doing a huge disservice to our teenagers and our young kids. I mean, when we look at the diet of young children and teenagers, it's the worst in the country. 

They have the highest consumption of ultra-processed foods when we look at calorie intake. So about up to 72% of calories. What that means is that the most of the diet that is, you know, produced in children and teenagers comes from ultra-processed foods. 

[00:23:19] Jonathan Wolf: 72% of their diet comes from ultra-processed foods. 

[00:23:22] Dr. Federica Amati: Yes, so what I've seen actually in my clinic is parents coming to me and saying, my child is really not liking food. You know, I made her lasagna. I made her shepherd's pie, I made her broccoli, she's not eating it. 

I go Okay, well, tell me about the weaning journey and often times, these children have gone from formula feeding straight into pouches. And so formula feeding tastes the same at every feed. Exactly the same and the pouches are, you don't see anything with the pouches. They're just squeezy pouches, and they're quite bland, and you don't actually have to touch or taste texture. There's no texture or difference. 

And then some people almost exclusively wean children on these maybe with some of their finger snacks that you see. And then when they're a bit older and they start going to nursery or socializing or eating at the table, they suddenly, of course, they don't want to eat broccoli. They've never seen it before. It's not something they've been exposed to. 

Exposure is key with children. So even if it may feel frustrating to keep offering lots of vegetables and whole fruits and, you know, fish and them just not eating it, there's very good science to show that repeated exposure is much more likely to result in acceptance.

So, sitting at the table with your children, letting them share your food, letting them touch it, taste it, spit it out, that's all part of the process. But if we don't engage our children in eating habits with us, they won't be able to learn because they, children literally learn how to eat from us. And then later, if we haven't had a massive impact on that, they will learn from their peers.

And we have, again, good data to show that peer pressure in teenagers can really impact eating behaviours. So, if a teenager hasn't got a massive food culture from their home, they may well be impacted by their peers to eat you know, fast foods or to eat snack foods. 

I mean, as I said, they have, teenagers have some of the highest consumption of ultra-processed foods. It's easy to find, it's cheap, and they can buy it from corner stores or supermarkets on the way into school. 

[00:25:16] Jonathan Wolf: And does it matter, Federica? 

[00:25:18] Dr. Federica Amati: It does. So, there's a few issues with it. First of all, as I said, the brain development at this age is really critical. It's a critical phase. They're also under exam pressure and academic pressure. So actually, we're asking a lot in terms of cognitive need at this age together with the changes in the brain. 

If we don't fuel that properly, if we don't give children the right food, they won't be able to concentrate well, they won't perform as well as they could in exams, and they'll find school much harder. So it's really important. 

Now, aside from the brain side, the brain function, we also have to remember there's another rapid growth phase. So they grow taller and that rapid growth phase requires more tissues to be built, and their body composition changes again. So what we're feeding our children at this age impacts that.

What body are they growing into? That depends on the nutrition they receive. Of course being active is important, but nutrition is the first pillar. So, If we're not feeding our teenagers properly, we run into the risk of them not being able to perform well in terms of their cognitive skills. But we also run into the problem of their actual growth being affected.

And, you know, mental health is a really big issue for young people and we know that having a diet that doesn't support mental health can result in a high risk of anxiety or depression. And when these diagnoses are made earlier in life, so there's a stat I put in the book, it's about 75% of diagnoses for mental health conditions are made by the age of 24.

[00:26:46] Jonathan Wolf: And a lot of people would be surprised that what a teenager eats would have anything to do with that, given everything we read about the pressures from their peers and mobile phones and all the rest of it. 

[00:26:55] Dr. Federica Amati: Of course it is a complex picture so I completely agree that social media and phones and advertising all play a part. But if you have a solid foundation with your nutrition, you just have a better chance of being able to deal with the stress and your body will be able to adapt better.

And also, the other thing that I really want to mention here is we talked about, you know, how can we be ready for conception? Well in teenagehood when all these changes happen and we suddenly have a more adult body and if you are female, you have periods. If you have good nutrition then, you're much less likely to become anemic later. You're much less likely to suffer with these nutrient deficiencies because if you are eating 72 % of your calories from ultra-processed foods, you will be lacking nutrients. There is, they are not enough nutrients in there. 

[00:27:41] Jonathan Wolf: Now, as you're talking about this, I'm thinking about my 16-year-old, who basically feels that he doesn't get anything like enough meat at my house. 

He's sort of convinced, because, you know, he's been growing a lot, he wants to grow even taller, and he's convinced that he needs to eat lots of meat because it's got lots of protein, and if he doesn't get that, that's the thing that's really going to deprive him of his health. 

And he's very skeptical that all of this plants and whole food, which is, you know, we eat a very much a ZOE diet, sort of driven actually by, pretty much by what ZOE's recommending to us each, each week. If I make him listen to this, what are you going to tell him? 

[00:28:20] Dr. Federica Amati: Well, so what I will say is that you don't need to eat lots of meat to grow well. In fact, you can get more protein and all the amino acids you need, all 20, including all the nine essential amino acids are found in all plants. 

And there are some plants that are higher in protein, so lentils are amazing, edamame beans are a wonderful source of protein, great to snack on as well. You can get lots from whole grains and beans. There's lots of variety, nuts and seeds. 

Having a little bit of meat in the diet, absolutely fine, but you really don't need a lot because meat is so nutrient-dense and it is so easily easy, easy to absorb the protein's, very easy to absorb. If you have it every, maybe once a week or maybe it's every 10 days, that's plenty.

What I will say is actually in this phase, it's more important to have oily fish in the diet, and oily fish also contains great protein, which is really easy to absorb. 

So no, we don't need to be eating chicken fillets at every meal. I mean, I've worked with people who literally add chicken fillets and salmon fillets to breakfast, lunch and dinner to hit ridiculous protein targets. And actually, the evidence tells us that if you want good long-term health, you need to be eating high-quality plant-based protein and reduce your animal protein intake. 

[00:29:32] Jonathan Wolf: I think it's lovely to hear. And I do have one positive story on this because, you know, I think I've talked on the podcast before about how our diet at home really changed after my wife Justine did ZOE and got her results and got really convinced and started to say well, I want to eat all of this every dinner. So then suddenly we shifted our dinner to being a really good one, driven by what was sort of overlapping between the guidance for Justine and myself. 

And as a result, my son started to have to eat this same dinner, because we eat together. And I would say for the first, six to nine months, there was a lot of complaining about it. I think once it's just become, well, this is what I eat at home, and I've got used to this for more than a year, he's just got used to it, and he now eats a huge variety of plants that he definitely would not have eaten a couple of years ago.

And that does not mean that his diet is perfect by any means. He's definitely still eating lots of ultra-processed food as soon as he leaves the house.  But I feel really good about the fact that he's eating a much better diet at home, and also I hope that it's sort of laying the foundations for when he's an adult, thinking like this is the food that I should be eating, and I understand that the pizza and the burger, which he loves, is like a treat rather than just the completely standard food.

And in that sense, to be honest is hopefully going away with a much better diet than I, you know, ever had not growing up with an Italian family like you, Federica. 

[00:31:05] Dr. Federica Amati: But so what you just touched on, so you've done the exposure with your child. It has worked and he now has a much more varied diet. Now, also, we have to remember for children and for teenagers, they have much more metabolic flexibility than we do.

So it means that they're much more able to, if we give them a burger, which is high and easy to access sugars in the bun and high and easy to access fats, their body is younger, they're much more able to deal with that quickly and swiftly. 

So what I want to make sure people don't take away from this is actually children should have a variety of other fun foods, let's call them, you know, as long as they have a good foundation for most of their meals. Of course, children will then want to try and have some ice cream after dinner, or they might want to have some cake at their friend's birthday. All of those are completely normal parts of life. And even every day, they will be exposed to sweets and all sorts of biscuits and gingerbread men, you know, name it.

That's not so much of an issue for children if they have that real foundation of good food at home and they're getting enough micronutrients and nutrients and all the building blocks in with their food. 

[00:32:10] Jonathan Wolf: It's all right to have some of this, but you're saying providing it's not like their diet all the time. It's more like there is a sort of underlying healthy…

[00:32:18] Dr. Federica Amati: I'll give you an example. So people always ask me like, oh, you must have no sweets at home. I'm like, no, I definitely do have sweets. And my children love candy kittens. I mean, they are perfect for children. And my youngest loves crisps, she's just like her dad.

[00:32:32] Jonathan Wolf:  Potato chips for our American listeners. 

[00:32:34] Dr. Federica Amati: Potato chips for our American listeners, exactly. So they are at home, but they are brought out in a bowl to share once we've all had a lovely lunch together. And it's on top of. It's after we've had lots of nourishing food.

So it's just important not to default to these fun foods as the primary source of their nourishment. That's the problem. That's the real key. 

[00:32:55] Jonathan Wolf: I'd love to switch to the next life stage. So you've, you've managed to survive childhood. There are probably not many listeners to this who are actually in childhood. Now you're into adulthood. Is that it? Are all the golden windows of opportunity closed? 

[00:33:11] Dr. Federica Amati: No, no, there aren't. So, the golden window is just the first, but there are windows of opportunity in adulthood where we can really make a difference to our future health. 

So in our mid-twenties to mid-thirties, we are in this really amazing space of what I call maximum power. Where it's easy to build muscle, our metabolism is still relatively flexible, our cognitive skills have been sharpened because most of us have chosen some sort of career path and we know what we love to do.

And so there's a space where actually we could take this time and build the kind of body we want to take into the future. I think about this as, okay, if you're, say you're in your late 20s or early 30s or even mid-30s and you have a vision of who you want to be when you're 85. So maybe you're somebody who when you're 85 you want to be walking up and down the high street, doing your shopping and carrying your groceries home.

To get to that when you're you have to be really quite active in your 30s. So Being physically active, maintaining your strength, and making sure that you're feeding yourself with the foods that support long-term health is the best way that we can ensure that in later years, we have this spriteliness about us.

This is also the age where cardiovascular disease, which is still the number one killer, in across the globe. This is where some of the heart disease, stroke, heart attacks, clots in your, anywhere really, to be honest, throughout your blood vessels. This is where some of these risk factors, some of these red flags will start to form.

You won't necessarily see them in blood work, although some do. So, already around 30, some people will start to have elevated cholesterol levels. They'll start to see signs that their diet is not serving their body well. It is not doing a good job in maintaining everything as it should be. And that really, that's when we really need to think about, what do we need to do to maintain health for the long term and heart health is the first red flag. 

[00:35:07] Jonathan Wolf: And so what does that mean in terms of sort of nutritional needs now that might be different from other times? 

[00:35:12] Dr. Federica Amati: So there's a few things. I think in our 30s, it's again, really refocusing our attention on a plant-based diet with plenty of polyphenols, which are these colorful chemicals that we find in plants that we know are really protective against the damage that can be done to our blood vessels.

It's also thinking about reducing some of the habits that are really harmful. So reducing alcohol consumption. If you don't drink alcohol, great. If you do drink alcohol, make it really occasional. Maybe two, three times a week, one glass of red wine. It shouldn't be part of our daily lives. And at this age, it's when often drinking does ramp up and it becomes a normal part of our lives and it really shouldn't.

I'll say this because it's obvious, but it needs to be said, but stop smoking. Smoking cigarettes is the quickest way to take lots of years off of your life. So if you're looking for that longevity hack, stop buying supplements, and actually just stop smoking. 

[00:36:08] Jonathan Wolf: And why do you say stop buying supplements? 

[00:36:09] Dr. Federica Amati: Well, I think there's quite a lot of supplements out there at the moment that are aimed at longevity, and the science is shaky best.

If not, just actually one of the supplements that's really popular at the moment could actually be harmful and people are taking it long-term. Not enough studies, it's not at all regulated. So it's NAD+. You may have heard of it. And actually it's quite a worrying trend to see that people will take this pill hoping that it will somehow rejuvenate their mitochondria.

[00:36:37] Jonathan Wolf: And you're worried that people taking this might actually be harming their health. 

[00:36:40] Dr. Federica Amati: Yeah, so there's some early data to suggest that actually it could increase the risk of things like pancreatic cancer. So it's another conversation for another time, but we know a lot more. 

[00:36:51] Jonathan Wolf: But you're saying that most supplements that are out there, you think people should stop taking.

[00:36:55] Dr. Federica Amati: Yeah, it’s quite unregulated. There are exceptions. So folic acid in pregnancy, we mentioned earlier and a really simple multivitamin in older, older life after 70 could actually be helpful. But most of these super supplements that are trying to do super things are unregulated. And we have such better data to show that changing your diet can add years to your life, and reducing your alcohol and stopping smoking can add years to your life, that we should really be focusing on the things we have super strong data on.

And it might not be as easy to package up and sell on sexy shelves, but essentially, good diet, no smoking, reduced alcohol, and physical movement are the four pillars to make sure that we live a longer and healthier life. 

[00:37:39] Jonathan Wolf: And I know one thing you're really interested in is the gut microbiome, Federica.

Does that change when we reach adulthood? 

[00:37:46] Dr. Federica Amati: So there's a massive flux in the first years. So our microbiome is seeded by how we're born. So the very first bacteria that colonize the gut come from either being born vaginally or from whatever you come into contact with when you're born through caesarean section, which is usually skin microbes.

And then from there, how you're fed. So breastfeeding or formula. And then how you're weaned, so the first foods you meet, whether you live in the countryside, do you have pets at home, all these things contribute. Quite flexible at the beginning of life, but then by the time you're about three, which is pretty young, your microbial signature is pretty fixed.

But what's really interesting is that in adulthood, even though obviously you can't change the early life exposures that you had or antibiotic treatments you've had to take. You can actually change your gut microbial species, you can fluctuate the sort of good bacteria that we know are associated with better health by making dietary choices that help to support that.

So I love this analogy, which is Tim Spector's analogy of the gut garden, and this idea that we can change the soil in the garden, we can better its health, we can plant some new seeds and really help to diversify into this beautiful English garden, by the foods we eat, adding some fermented foods and really looking after our gut microbiome.

Because it is such an important part of our health, especially when we look at the immune system and the gut-brain axis are the two that are really clear. So we talked about allergies and we talked about the fact that the gut microbiome helps to train our immune system in childhood to know what is and isn't the enemy. 

And then later in life, the gut microbiome is hugely influential for our mental health. It's hugely influential with how often we get sick and how we recover, but also our low-level chronic inflammation. So we're talking about mid 30s, 40s, this low level chronic inflammation can have a massive impact on our risk of heart disease.

Because if we have inflammation that is sort of always at this low level, especially if you then also have high stress, so your cortisol levels are up. That is how the damage to our blood vessels takes place. And it's also something that puts us at higher risk of metabolic disease later in life, like type 2 diabetes or obesity.

[00:40:03] Jonathan Wolf: And I think one of the things that I was really worried about was, I knew my microbiome was not very good when I first met Tim and heard him talk about, Tim Spector, talk about this sort of seven years ago when we were starting ZOE. And I was, I think very worried that actually I was sort of stuck with it.

Now, you're overseeing more than a hundred thousand people who've become ZOE members now. What are you seeing in terms of real-life ability of people to improve their microbiome by sort of changing what they eat following this experiment? 

[00:40:36] Dr. Federica Amati: I love this question, because I think people do feel like, oh, I'm stuck with it now, that's it.

But we have to understand that the microbiome has layers, it's a whole universe in there. So whilst your cornerstone species, the ones that you'll find in your appendix, the ones that lie in the crevices of the gut, they'll be there for most of your life and they're fairly fixed. 

But the top layers of the gut microbiome, the ones that are flushed down the loo every time you go to the loo. They're the ones that we can really influence with our dietary changes. And what we've seen at ZOE is that there is real, massive change in the composition of the gut microbiome by following ZOE dietary advice for as little as 12 weeks. 

So we have to unpick the way that the microbiome is structured. The top layer of the microbiome has a massive impact because it still produces all these great chemicals for us. Short-chain fatty acids, vitamins, amino acids, it produces so much for us. 

And the things we eat every day, impact especially that top layer. So, just saying that, oh, well, it's fixed for life, it doesn't take into account the complexity of the structure of the microbiome and the fact that there are cornerstone species that are there for sort of for good. 

And then there are other species that fluctuate every single day. So, you know, there's that really great study, we call it the Singapore study, which just showed that within 48 hours, you can influence what gut microbial species are seen by just feeding people some curry spice mix. 

So, I think we've seen great data from ZOE members that they have really effectively shifted their gut microbiome composition. Some members have shifted it and they are so proud that their score is higher than Tim's. And there's this kind of competition. 

But yeah, of course, we've seen it and we've shown it in our randomized control trial and method that there is this real change in the gut microbiome by following specifically ZOE dietary advice that is really tailored to shift the microbiome composition to have more of these good bacteria that we know are associated with better health outcomes and reduced risk factors for the diseases that we all want to avoid.

[00:42:36] Jonathan Wolf: And Federica, you mentioned sort of 12 weeks. Does that mean that the job is sort of done in 12 weeks? So can you transform at this life stage? 

[00:42:45] Dr. Federica Amati: No, no, I think it's a really important question, but it, you know, just like a garden, you can't just plant it, make it look beautiful, and then just never water it again and never weed it, right?

You've got to keep feeding your gut. And feeding your gut the food that helps it is also the food that helps you. So it's all connected. We're all one thing, right? What's really compelling is that a gut-friendly diet or a diet that supports gut microbiome health is also a really healthy diet full stop.

And so we have to continue eating in this way to support that gut microbiome diversity and to make sure that our gut microbiome helps to keep us healthy alongside the rest of the impacts that our choices and food has on our bodies. 

[00:43:28] Jonathan Wolf: And Federica, one thing that really struck me in your book, you say that improving your diet at the age of 40 can add a decade to your life, which is astounding.

Unfortunately, I'm a little past 40 now, but can you tell me some more about that? 

[00:43:41] Dr. Federica Amati: Yes, it's a really great modeling study done by a professor called John Mathers, and it's based on a big database here in the U.K. called Biobank. And they basically looked at baseline dietary patterns in the U.K., which are not very good, Jonathan, unfortunately, we're not in a good place.

The general kind of baseline isn't great. What happens if you improve it to just the standard dietary guidelines? You add sort of six years to your life. Then what happens if you actually take that further and follow what they've called a longevity pattern Mediterranean-style diet? So basically add more fruits, more vegetables, more legumes, more nuts, more seeds.

And then it shoots up to adding 10 to 11 years to your life at age 40. 

[00:44:20] Jonathan Wolf: Amazing. 

[00:44:20] Dr. Federica Amati: But that study also looked at what happens if you do the same at age 70. So, 40 is not a magic number, right? You can add up to 11 years to your life at age 40, but you can add up to 6 years of your life, to your life at age 70.

[00:44:32] Jonathan Wolf: I just want to share that. You're saying you could be 70 years old, you're just eating the average diet in the U.K. or U.S. You can move to a really good diet and you can add how many more years? 

[00:44:44] Dr. Federica Amati: You could potentially add seven years to your life. And now, of course, this is a modeling study, but it conceptualizes and it shows us the impact which diet is likely to have.

[00:44:52] Jonathan Wolf: It's amazing. Now, we talk a lot on the show and within ZOE, actually, about the difference between years of life. and years of healthy life because I think many people listening to this will sort of be aware in a way that maybe they weren't when they were young that there's a huge difference and that many of us might be stuck with this awful thing of years, maybe even decades of very low-quality life because we've lost the health that gives us sort of the pleasure.

Is this just about years of life or does it actually add years of healthy life? 

[00:45:20] Dr. Federica Amati: It's really about healthy life Jonathan because what we also know is that the diseases that cause these chronic years of ill health are mostly diet-related diseases. 

So when we know that for some people over two decades of their lives will be spent in chronic ill health, and the main drivers for that are heart disease. So for example, having heart failure. There are also things like type 2 diabetes, and then also cognitive decline. 

Now all of those three things are hugely impacted and preventable with dietary change. So by changing to a much healthier dietary pattern, And knowing what works for us at each life stage, we can actually not only lengthen our life but prevent these main causes of chronic ill health.

[00:46:05] Jonathan Wolf: And Federica, I think you've talked quite a bit about the sort of general shape of healthy eating, you were talking about your 30s, and I'm guessing that's going a bit into your 40s.

What changes, if anything, as you get, you know, later into life? And I think maybe let's skip over menopause just because we're not going to have enough time and we should do something dedicated on that.

What about as we get sort of past that stage for both, you know, women and men? 

[00:46:35] Dr. Federica Amati: Yeah. So you're right that there is this window of opportunity. There is a window of opportunity in menopause because of the physiological metabolic changes. And with men, there is still this, what's called the andropause.

There is this change in testosterone levels and it is nowhere near as dramatic as menopause, but there is still a change. And for many men, it's a noticeable physiological change. So it's not to dismiss that. 

And as we look into sort of 55 to 65, there's this section of life which is sometimes referred to as sniper alley, which is not great, but you know, I call it twilight zone. 

But it is this sudden age bracket where we see an increased risk of death from disease. So, up until… 

[00:47:17] Jonathan Wolf: Specifically for men you're talking about?

[00:47:19] Dr. Federica Amati: Both men and women, but men is higher and up until this point… 

[00:47:22] Jonathan Wolf: And so that after menopause for most women.

[00:47:25] Dr. Federica Amati: Yes.

[00:47:25] Jonathan Wolf: And for men you're saying there is some changes, it's not the equivalent to menopause, but there are sort of hormonal changes in this period as well.

[00:47:30] Dr. Federica Amati: There are, but the risk for men doesn't come from the hormonal change, whereas the menopause actually does increase risk for women. 

For men, it's more of an accumulation of risk factors earlier in life and because men don't have oestrogen protecting them, that risk factor sort of accumulates more over, over that time frame.

And it's called Sniper Alley or Twilight Zone because this is when you suddenly start seeing that people you know or people that you hear about start dying from heart disease mostly. 

It's important to know this because what we talked about making those changes in your sort of 30s and 40s can actually really effectively prevent this increased risk window.

And we need to be aware that if we continue with dietary habits and other lifestyle habits that are not supporting our health, there is a very real chance that we'll suffer something in this time frame. And we need to support ourselves better to enter midlife. Because if you enter midlife really healthy, then your likelihood of actually continuing into your later years in good health is much higher.

If in midlife you suffer with, say, a heart disease, Or you have really high blood pressure, then it's just a harder change to then make to reverse that damage. 

[00:48:45] Jonathan Wolf: So Federica, is there anything specifically that you're talking about then as we go into later life that’s different about the dietary advice from what you've been talking about in these earlier stages?

[00:48:58] Dr. Federica Amati: Yes, there is. So as we get older, there's a few things that happen and it means that we become slightly less efficient at absorbing nutrients and also utilizing them. 

So this is really talking 65 plus, but also in this midlife period, it becomes really important to go back to these principles of having a high-nutrient diet, also making sure that we're not over-consuming energy-dense foods, because our metabolism and our lifestyles often don't allow for that.

So our metabolic flexibility, which is what we were talking about earlier, how our body clocks become a little bit less punchy. So when we're really young, you know, our incident increase in the morning is really marked. When you look at the 20-year-old, their incident in the morning goes right up, ready to have breakfast and make the most of it.

That really starts to flatten as we get older. 

[00:49:52] Jonathan Wolf: So your ability to cope with the cake or whatever is just much lower, is that what you're saying? 

[00:49:56] Dr. Federica Amati: Exactly, yeah. And so we have to be aware of that feed our bodies food that is a bit kinder to the metabolism, and also because our metabolism is changing, we are becoming less efficient at absorbing and putting nutrients in the right place at the right time.

So the biggest concern in people over sort of 70, 65-70 years, their appetite tends to be reduced, and actually this is when thirst, starts to be a little bit less efficient. So people worry in their 20s about making sure they get enough water, but really that's not an issue. We don't need to be carrying 20-liter jugs of water with us at that age. Our thirst response is really good when we're younger. We get thirsty, we drink. 

As we get older, that's less efficient, so the risk of dehydration starts creeping up. And what's really crucial here is that if you're in your 70s and you live alone, and perhaps you have a bit of arthritis on the hands, or perhaps you don't have all of your own teeth, it is much easier to eat very soft, easy to eat, easy to handle ultra-processed foods.

And ultra-processed foods aside from being low in nutrients, are also incredibly dry. It's one of the ways that they have such a long shelf life. So whereas it's great for us to get some water from our food, from fresh fruit, fresh vegetables, soups and stews, they're all quite naturally hydrating foods.

If when we're older we start reverting to cake bars and biscuits, mostly because they're just easy to eat, then we also lose the opportunity to hydrate through our food. 

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[00:51:24] Jonathan Wolf: And I'm guessing they're also just not good for you because they're not enough nutrients. But also the ultra-processed food itself is likely to be having negative impacts.

[00:51:31] Dr. Federica Amati: There is no positives to them. Yeah. So with older people, if they become malnourished, if they become dehydrated, it is a much worse picture. So it's a much more severe effect. 

So, you know, an elderly person who's dehydrated could easily fall over and fracture their hip, for example. That's something we really want to avoid.

So making sure that we nourish the older people in our lives, or if there's somebody listening to this and maybe they're 70 and they're approaching their 70s, I have clients who are in their 70s. Embracing nutrient dense foods, making these really delicious soups and stews with beans and lentils and whole grains and making the most of these foods that we know are brilliant at nourishing us. And they are naturally hydrating, and they naturally help with decreasing the risk of constipation, which is a huge problem later in life. Then we can really help someone's quality of life, and we can add extra life years.

[00:52:27] Jonathan Wolf: And is there anything, because I think a lot of people listening to this will be saying, Hey, I've already made a big shift to my diet, maybe they’re ZOE members, maybe they're not, but they've been listening to this podcast for a long time and they've been making a lot of changes. Is there anything around the diet itself that for the average person in, let's say, their 70s or 80s, listening to this is different from this average advice you were giving to somebody who was 40? 

[00:52:54] Dr. Federica Amati: Yeah, so it's really focusing on foods and on meals that are really complete because of this reduced appetite. So every meal opportunity needs to be really nutrient-dense. And that's why I talk about these stews and these soups and making things like lentil shepherd's pie. 

Because, A, you can batch cook and freeze in portions, so making it easier for the older person to have the meals ready to go. And B, they are nutrient-packed and they are also a little bit hydrating. Those two things are really important as we get older, and I think there has to be a bit more of a focus as well on fiber-rich, I mean fiber-rich foods are focused throughout our lives. 

But I can tell you that one of the things that I find really amazing is the difference that not being constipated can make to an older person, because older people tend to be less mobile, and less mobility or reduced mobility with ultra-processed food consumption, which is devoid of fiber, plus dehydration is the perfect storm for quite severe constipation. And it's not something you want to be dealing with for days on end. 

Looking after your gut and we have a natural aging of the gut as well. So it needs a bit more love and just really making sure that we provide opportunity for these very nourishing, hydrating foods that are high in fiber.

[00:54:23] Jonathan Wolf: And Federica, we had a lot of questions about that. Protein? Do you have any change in the advice around protein? 

[00:54:31] Dr. Federica Amati: So I think, as I mentioned, we're less efficient at absorbing protein, and typically we become more insulin resistant. And insulin is this hormone which is really important for the uptake of all nutrients into cells.

So if we become more insulin resistant, we also have more difficulty absorbing amino acids into tissues. Which is why there's a recommendation for more protein for older adults, because they're just a bit less good at absorbing it. 

Now, what I will say is this increase is minimal. So, we're talking about from 0.83 grams per kilogram of body weight, as recommended by all of the global public health authorities, it's maybe up to one gram per kilogram. 

And actually, working that out in your head is really hard, and I don't recommend anyone tries to track it. It's more about having that awareness piece, and it's kind of what I just said about really nutrient-dense meals.

So make sure that every meal opportunity for the older person in your life, if that's you, has a really good source of plant protein in it, or perhaps it's eggs every now and then, or perhaps it's oily fish, but really make every meal opportunity an opportunity to get some high-quality food, which will no doubt have the amino acids you need.

[00:55:43] Jonathan Wolf: So, it is real, you do need to increase your protein intake as you get older, because you're not absorbing as much, but it doesn't mean that you need to be paranoid about making sure that you're eating, sort of, red meat every day. 

[00:55:58] Dr. Federica Amati: No, no. I think what's really important, Jonathan, I think people often overlook the importance of, yes, we need to eat protein, but we also need to move, because actually, if you're trying to maintain muscle mass, or create new muscle tissue, the biggest driving factor for that is using your muscles. And giving them something to do. 

So, just eating the protein isn't going to help by itself. If you're eating enough food, if you're eating enough whole foods, nutrient-dense foods, you will be getting a variety of amino acids and enough protein. 

[00:56:29] Jonathan Wolf: I think that's brilliant advice. Before I wrap up, I think as head nutritionist at ZOE, I have to ask you about how becoming a ZOE member somehow fits into this story that you're talking about these life stages, given all the members that you see and that you talk to, and the way that you help advise what we're doing.

[00:56:50] Dr. Federica Amati: Yeah, that's a really good question. I love this because what's amazing about ZOE is that everybody has a nutritionist in their pocket that they can actually ask questions. 

But the product itself is also created to be like your everyday nutritionist. It's just so powerful to be able to help so many more people, and frankly, at a fraction of the price than if you had to pay to see me every day to actually help people give actionable advice on how to change their diet, which foods to include. And crucially, how to make these food changes, these smarter food choices, delicious, because the recipes that we've curated in the app are so great, they're so good, and it makes it easier to implement into everyday life.

[00:57:33] Jonathan Wolf: I think that's amazing. I'm lucky enough to be able to talk to you one on one and face-to-face. And I know we spend a lot of time talking about how do you figure out how to take sort of the complexities that you might have in an hour long one to one conversation with somebody and deliver all of this with the benefit of all this personalized insight from having done these tests and everything else.

I am once again really excited about the book. I recommend to everybody to take a look and I think hopefully you've got a sense through the story about thinking about is this relevant because there are children in your life, because you yourself maybe are still, you know, quite early into adulthood, you're maybe into later middle age myself. Or indeed, you know, getting into older age, whether it's for yourself or thinking about someone else you love. 

Although I have this conversation constantly about how I'm completely unable to convince my parents to make any change whatsoever in their diet. So don't be too frustrated if you can't ever get any loved one to do this.

The only way I've ever found this to work is when they've ultimately decided to do ZOE themselves. And my sister's just done it recently and suddenly it's like this light bulb comes on for her. So I've decided that you can't tell stuff to people they have to experience. 

[00:58:49] Dr. Federica Amati: It's so funny, Jonathan. My own mother is ZOE's biggest fan and she loves it. And she logs every day. She's like our star member. 

[00:58:56] Jonathan Wolf: I love it. And do you feel that there's lots of things she's now listened to that when you told her directly, she just completely ignored you? 

[00:59:02] Dr. Federica Amati: Yes, it's funny. So lots of the things I was advising her on, especially introducing more legumes into her life. She was like, yes, maybe, but then when it was structured in ZOE and she saw the feedback and she had these ideas, I mean, that woman eats legumes pretty much twice a day now. 

[00:59:16] Jonathan Wolf: That's hilarious. I think it's also because listening to your children is really hard, whereas this independent thing is much stronger.

Federica, let me try and summarize that and just correct me where I've got it wrong. 

So we started by just saying what is life course nutrition? And you said this is a really new thing coming through in science, talking about the idea that our bodies are changing all the way through our life. And so it isn't this one perfect answer all the time. Actually, that that is varying even before you think about how all of our bodies are individual. 

We started talking about the very beginning of birth and interesting. You said, well, actually it's three months. before birth even starts, sort of the nutrition matters. And shockingly, the father's nutrition is actually really important. So you know, the food that the father eats in the three months before the baby is conceived has a real impact on the sperm. 

And there's real scientific data that this impacts whether the pregnancy is successful in its health. And sure enough, eating a sort of Mediterranean diet, which is a sort of standardized ZOE-like diet without being personalized to you is sort of the key for both men and women. 

Then you said in the first 12 weeks, actually, nausea often makes it really hard to eat and the good news in a way is that the baby itself is not yet really hooked up in the placenta directly. But mainly don't stress too much, don't give yourself such a hard time. Figure out how to eat during the periods when the nausea is lower. 

And I think you had a few tips like frozen smoothies and things that might be able to help you to get better new nutrition. 

Then the next six months, suddenly there's this massive growth. And interestingly, I hadn't realized you're not only growing this baby, you're actually storing this food. Fat that is going to be in your breast milk and so it's actually really important to eat that food and all this healthy food because that's not only how you're feeding the baby right then, but if you are breastfeeding, then it's also what you can be feeding the baby for the next six months.

And critically, you said not only should you be eating lots of whole food, lots of vegetables and nuts and seeds. But also eating lots of things that you want to make sure your child is not allergic to, and you were like peanut and soy and milk and gluten and all these things people are worried about. Unless you're allergic, you should be eating them then, and also exposing your baby as soon as possible that they can have whole foods to avoid them getting this allergy. 

I love this idea. Babies are apparently tasting their amniotic fluid. So if you're eating broccoli and you're pregnant, then your baby's going to be eating this as well.

And then as they go through weaning, making sure you're exposing them to real food and that a lot of what we do now you're saying is like we sort of give them mush out of a packet and then why are we surprised that they don't want to eat any real food. 

Then I think with much more surprise to I think lots of people we talked about the fact there's, there's more windows. So there's one at seven that we really didn't talk about today, but then in teenagers, there's this big growth, but this is a critical time period, puberty for women, you know, girls going through puberty, there's a real change, for example, needing to get more iron. But that in general, children at this point are tending to eat this enormous level of ultra-processed food, just at the point that they're laying down all of this new stuff in their brain and everywhere.

So this is a really important age, even though, you know, if anyone is a parent like me going through this, it's a point where you also realize you have much less control over your children but it does matter and ideally you are able to continue to get them to eat food that's almost setting up what they will eat in later life.

But the good news is they're metabolically flexible. So in that sense they can get away with quite a lot of bad food . But you need to be setting these habits and getting the quality from the good food. So they can't just eat burgers. But you can be more relaxed than perhaps.

And you're saying your own kids get sweets in the house, you know? 

[01:03:09] Dr. Federica Amati: Yeah, of course. Yeah. And it's important not to demonize foods because they will become the ones they'll seek. 

[01:03:12] Jonathan Wolf: Yes. My wife talks a lot about this as well. Yeah. So I think it, obviously it's really important that you're not creating unhealthy food habits and relationships with food, which is another topic I think we should come back to. 

Then you talked about early adulthood and the interesting fact that in your 30s there's actually this opportunity maybe to really change a lot of habits. That this is the point when either your habits are going to become long-term harmful habits. You talk about alcohol, potentially this is the point when it starts to become much larger part of your life, or trying to make sure these are under control, you talk about alcohol, smoking you know, are you doing any exercise?

We also talked about the fact this is when you may be building like low-level, constant levels of inflammation. And so although you feel really healthy, you’re actually already starting to lay down this damage that's going to really hit you later. And so one of the reasons why you want to have this sort of plant-based diet with lots of polyphenols is that we know that sort of via the microbiome, this is protective of our blood vessels.

And you were saying even today, cardiovascular, heart health is our number one priority. One fear. 

And the good news is this is a point when you can really shift your microbiome. And you talked about the latest data you know, from ZOE, showing that in as little as 12 weeks, you can really see this measurable improvement in the number of good bacteria you have.

And you share this amazing new study that said that if you improve your diet at the age of 40, you can add a decade to your life. So that sounds really great. But amazingly, you can still add, I think it was six years even at the age of 70. 

And so coming to sort of the final period we talked about, you said you start to enter into sniper alley between 55 suddenly your risks are really increasing for both men and women. People that you know, will start dying mainly from heart disease. And it's not too late, but you need to really make changes if you want to avoid starting to be hit with something that's really going to take away this quality of life. 

And I think the key message is that, particularly as you're sort of above 65 to 70, your body is starting to get less efficient at absorbing nutrients and using nutrients. Often your appetite is also reducing, quite possibly the amount of activity you're doing is falling. And so you really need to make sure that your diet is really delivering for you. Because you're also saying you're metabolically much less flexible. 

You know, we see this in all the ZOE test results, right? In general, people's test results are worse. And so, that means you really need to think about your diet being very high in nutrients because you're going to probably have less food in total. 

And interestingly, you said, don't worry about water when you're younger and everybody's wandering around carrying these huge bottles of water. Worry about it when you're sort of 70 plus, when dehydration could become really serious. You know, that could be the thing that triggers the fall that breaks a hip. 

Fiber is even more important because constipation becomes a big issue, also tied into this. And that you don't want to over-consume this energy-dense food that doesn't have a lot of nutrients, which is your cakes and all these things as much.

And one real change, you said, is you do need to eat more protein than you did earlier because you're not absorbing it as well. But it's still not this vast fraction of your diet, but you do need to be eating those quality foods that are delivering it. 

[01:06:36] Dr. Federica Amati: Exactly. Jonathan, that was an amazing recap.

You're so good at these. 

[01:06:40] Jonathan Wolf: Well, I don't think it's as good as reading the book, which, as I've said, I think is fantastic. There were many parts that we just sort of touched over this time. 

It was really fun to have you on Federica. Thank you so much. Congratulations. Because I know secondhand how hard it is to write a book and I hope you're feeling really proud about it.

[01:07:00] Dr. Federica Amati: Thank you so much, Jonathan. It's been really fun. 

[01:07:02] Jonathan Wolf: Wonderful. Speak soon. 

I hope you enjoyed today's episode with Federica and feel you have taken something away that can help you or one of your loved ones improve their health, whatever their life stage. If you'd like more nutrition and health advice from our expert guests, the team has put together an incredible guide packed with actionable advice, which you can download for free by going to zoe.com/podcast

If you listen to the show regularly, you probably already believe that you can transform your health by changing what you eat. But now there is only so much you can learn from general advice on a weekly podcast. If you want to feel much better and live many more healthy years, you need something more.

And that's why each day, more than 100,000 members trust ZOE to help them make the smartest food choices, so they could feel better now and enjoy many more healthy years. Combining our world-leading science with your ZOE test results, ZOE is your guide and coach to sustainable improvements to your health.

So how does it work? ZOE membership starts with at-home testing to understand your unique body. Then ZOE's app is your health coach, using weekly check-ins and daily guidance to help you shift your food choices so as to steadily improve your health. I rely on ZOE's advice every day. And truly, it has transformed how I feel.

So to take the first step towards the possibility of more energy, less hunger, and more healthy years, take our quiz and get a free program to help identify changes to your food choices that you could make right now. Simply go to zoe.com/podcast, where as a podcast listener, you can also get 10% off.

As always, I'm your host, Jonathan Wolf. This episode of ZOE Science & Nutrition was produced by Julie Panero, Richard Willan, and Sam Durham. The ZOE Science & Nutrition podcast is not medical advice. It's for general informational purposes only.

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