Transcript: You Can Add 10 Years to Your Life by Changing Your Diet! - Dr Federica Amati on Midlife Nutrition

INTRODUCTION

Dr Federica Amati: The majority of us are going to die from diet-related chronic diseases. Now, having a poor diet is the biggest risk factor for an early death. And that's quite a big statement. That's quite a big deal.

There is this cognitive overload. People are just like, "I don't know where to look or what to do anymore, so I'm just going to disengage." People are left really vulnerable to what we know is a poor food environment. There's very loud food marketing. There's this push for convenience. I think it's a very modern problem that convenience is king.

If you've had a pretty rubbish diet - so quite a lot of highly processed foods, highly refined carbohydrates, red and processed meats, low fibre and low variety of plants - and you suddenly switch it up, you can gain a decade, a decade of your life. That's a huge amount.

Paul Sutton: Dr Federica Amati is a hugely respected nutritionist with a PhD in medical science and the author of the book, Every Body Should Know This. The book has gained rave reviews for the way it approaches nutrition and diet from a life-stage perspective, outlining how our body's requirements change as we age.

From a public health perspective, Federica makes the role of nutrition in disease extremely clear. She takes an incredibly pragmatic and refreshing view of food, dismissing specific diets and complicated nutritional plans for down-to-earth advice around what we should eat and why.

So how do our nutritional needs change in our 40s and 50s, and what should we really be eating to ensure that we live a long and, more importantly, healthy life?

<THEME MUSIC>

PS: I'm Paul Sutton, and this is Middle Man, the show for midlife men and the people who love them.

EPISODE

PS: Thank you for making time to join me today. I really do appreciate it. Now, I read your book Every Body Should Know This a while back, and I was really impressed by the fact that, even though you're from a medical scientist background, the information in that book is really accessible. It's very simple to understand. It doesn't, you know, it doesn't seek to overwhelm someone who's reading it. And you've also got the life-stage aspect on it, which was really useful. Why did you set about writing that book in the first place?

FA: I set about writing it because I realised that working in nutrition science and medical science and also working in communication—so science communications—life-course nutrition was never really spoken about.

But it's a very, I wouldn't say common, but it's certainly how I teach medical students about nutrition. Because when you are trying to help people understand what the best course of action is, or what the best recommendations are, it's important to understand what life point people are at because nutrition needs do change throughout the life course, and there are specific needs at specific points in time.

For me, it's kind of obvious that we should all know this, hence the book. But I realised that no one else had done it in this way for popular writing, for popular books, and it seemed like the more I spoke about it with my patients, who I see one-on-one in clinic, and also just when I talk about nutrition all day long, people resonated with this idea of, like, "Well, yeah, of course, that makes sense, but we've never heard it that way." So that's why I wrote it, to be honest.

Books are a really good way to put forward a very long-form idea or concept in a complete way. It's tricky to explain life-course nutrition in just one podcast episode or in one news article or even on social media. So for me, writing that book was the best way that I could help to communicate the science and the reason why it's important to understand life-course health, to be honest, and how life-course nutrition is such an important tool.

You can have life-course approaches with lots of things—exercise and mental health—and it's just being aware of that flux and being aware that, as we grow older, we evolve, and with that evolution comes different needs. It's funny, you know, often when I talk about this, I say the fact that your needs have changed is good because it means you're still alive. And it's true, right? Otherwise, if we were stationary—you’re never stationary, you're never still in life. That only happens when you die.

So it's important to understand that, and it also helps us be much more forgiving to ourselves and much more accepting of change. I think often, especially from midlife onwards, people struggle with change. They struggle with the fact that they can't eat the same foods or do the same amount of exercise or drink the same amount of alcohol or only sleep five hours and feel fine.

That's a reflection of the fact that we've changed and we've aged, and, you know, we're still alive. So let's embrace that. Let's understand it, and then, hopefully, I've given some of the tools to help us flourish through that change instead of resist it and try to deny it and sort of try to shoehorn old lifestyle behaviours into our new lives, which normally doesn't work when people try to do that.

PS: I mean, nutrition, obviously—it’s an obvious statement to say that nutrition is important, right? It’s not rocket science. But why is it so important? Because, I mean, this links to everything else, obviously. Yeah, can you summarise that?

FA: I think I can. If we look at the epidemiological shift—so why is nutrition so important right now? I mean, arguably, it’s always been important, but right now it’s critically important because we’ve got to a point in time in humanity where, luckily, we’re not dying off so much from diseases that we catch because we haven’t washed our hands. We’re not dying off so much from diseases that we can prevent with vaccines. We’re not dying off so much from diseases that result from a bacterial infection against antibiotics.

So we’re now at a place where modern medicine and hygiene practices mean we live longer, and the missing piece now is our nutrition. Unfortunately, as our hygiene and medicine have evolved, our food environment has actually got worse. The majority of us are going to die from diet-related chronic diseases now.

Having a poor diet is the biggest risk factor for an early death. And that's quite a big statement. That’s quite a big deal. Even up to 30 years ago, smoking was still killing more people. More people were smoking, and a lot of early deaths were due to smoking. Thankfully, that has started to change, but it’s left us wide open to notice the fact that diet-related diseases are what’s killing most of us.

So it’s a really urgent time for nutrition to take centre stage because we need to really tackle what’s essentially a public health crisis when it comes to nutrition.

PS: And I know in the book, you talked about how diet could help prevent—I think it was 80% of chronic diseases. I mean, that’s astounding, isn’t it, really?

FA: It is. But 80% of early deaths are caused by four main lifestyle factors—modifiable lifestyle factors, right? The four things that kill us off the most are heart disease, cancers, metabolic diseases like type 2 diabetes, and upper respiratory tract infections—so lung infections or chronic lung conditions.

Now, those four chronic conditions that we die of most commonly—80% of those cases are preventable. There’s always going to be the 20% where it’s genetic predisposition or an exposure that you can’t control, but 80% of them are chronic exposures to changeable factors.

It is shocking when you hear it, but it makes sense when you think about what is causing these diseases, right? For example, type 2 diabetes or obesity—so metabolic dysfunction, metabolic diseases like type 2 diabetes and obesity—were vanishingly rare at the beginning of the 1900s, right? They just weren’t a thing. Now, they are the majority. They’re the main drivers of ill health, and it’s a direct reflection of our environment.

Our genes haven’t changed that quickly. Our life expectancy hasn’t changed so dramatically that it’s all age-related. It’s actually to do with the exposure that our diet brings. So it sounds shocking, but when you think about it, you’re like, “Yeah, that kind of makes sense. I can see how that’s happened.”

The four modifiable lifestyle factors that can help to prevent these are diet, movement, not smoking and reducing alcohol.

Diet is the most powerful. Having a healthy diet, and we’ll get into this, I’m sure, but having a healthy diet is not rocket science. We know what constitutes a healthy diet. We have plenty of data—both epidemiological and randomised controlled trials. We have lots of data to tell us what that is.

Movement is another critical thing that’s changed is that we’re very sedentary nowadays compared to how we used to live, and that has a direct impact on our health, including, of course, our metabolic health. The less we use our bodies, the less our muscles maintain themselves, and so our metabolic function really changes and edges towards dysfunction.

Smoking is not as big an issue as it used to be, but still, 14% of adults in the UK smoke. That’s one in ten people, right? So it’s worth saying, “Please don’t smoke.” It will very likely kill you earlier than you would otherwise die.

Alcohol, especially here in the UK, drives a lot of ill health, mental health issues, disease, and early death. It’s worth saying again that there is no real benefit to drinking alcohol in terms of anything. There is no J curve—it’s not true that one glass a day is better than no glasses. That’s been debunked.

It’s part of society, part of what we do—I drink occasionally—but it’s important to understand that it should be very occasional because it doesn’t hold any benefit otherwise.

Those four lifestyle factors are the key drivers we should be paying attention to. When I say, “What you eat, how you move, not drinking too much, and not smoking,” it’s not exactly new information. But those are the four things, and when we speak to most people, they don’t do all four. Often, it’s like, “Well, maybe I’m really good at going to the gym, but I actually drink too much on the weekends.”

If you get those four squared off, you’re doing really well, and then you can look to optimise.

So this is one of those reasons why I tend to be quite sceptical about new supplements or the latest trends of, like, IV drips or whatever. You’re looking at something that probably has no benefit, potentially some harm with some of them, and if there is any benefit, it’s such a marginal benefit compared to what you achieve with those four behaviours.

Before we start talking about peptide supplements and NAD+ infusions and all these trendy things that cost hundreds of pounds, if you haven’t got these four squared off, the incremental improvement from this fancy new thing is going to be tiny. That’s where the true magic happens—when you can get those four behaviours into your life.

PS: Yeah, and I think that was the thing that most came across from your book to me, because you hear so much about different diets. You know, "Oh, you should be on a Paleo diet or ketogenic diet." And then, like you said, you hear, "You should have a glass of red wine a day" or "You shouldn’t have a glass of red wine a day," or "You should do the 5:2 thing." There’s so much out there. For me personally, I find it swamps me. I can’t cut through that. I haven’t got the time or the will to research all this stuff.

But to hear someone say, "Actually, do you know what? It’s actually quite simple. You just need to eat well and do these other things, and you’re there"—it’s just refreshing, I suppose, to have someone say that.

FA: Yeah, it’s good to hear that. I think it’s not worth complicating things that don’t need to be complicated. And I completely hear you. There’s this cognitive overload. People are just like, "I don’t know where to look or what to do anymore, so I’m just going to disengage."

And that’s even worse because then people are left really vulnerable to what we know is a poor food environment. There’s very loud food marketing, very loud food advertising. There’s this push for convenience, which I find really fascinating. I think it’s a very modern problem that convenience is king.

Everything has to be quick, everything has to be delivered, everything has to... And it’s like, that’s not a demand we created as consumers. It’s a demand created for us by the industries that supply us with these things.

It’s really interesting because it’s created this false sense of, "Well, I don’t have time to eat. I don’t have time to cook myself a meal." And it’s like, hang on a minute—when did this become okay? When did it become acceptable for us to completely disengage with a behaviour that we have evolved over millennia to be our primary focus?

Until maybe the last 250 years, okay? Maybe a bit more than that. But seriously, if you think about pre-agricultural times, all we did all day was scavenge, forage, hunt, then prepare, share the food, and then talk about it and draw paintings in caves about how we got the food. Literally, that was our entire lives. That was our social lives.

And now you see adverts by companies saying things like, "Wasting time thinking about your lunch? Don’t. You can just drink it at your desk." Okay, we definitely did not evolve to do that.

I’m not suggesting we should all live like cavemen or that Paleo diets are right. I’m just saying, culturally, carving out time to actually prepare food and share it with someone—or even if it’s just sitting down and eating it by yourself, but with no distraction—is a core part of the human experience.

This culture of "no time, must rush, and convenience" has shaped us. Once you see it, you can’t unsee it. This idea that somehow we should be ashamed of how much brain space is taken up by thinking about what to eat next... It’s like, that’s normal.

Actually, it’s normal for us to think about, "What should we eat next? What should we have for dinner?" That’s normal human behaviour. What’s not normal is to just grab a bar and eat that instead of a meal.

PS: That must be quite, like you said, an eye-opener for you, having worked in this space, and now, like you said, seeing that and noticing it. You must see that everywhere, all the time.

FA: Honestly, yes. And there are some really beautiful experiments that have been done looking at behaviour regarding food advertising specifically, and how repeated food advertising across different channels—radio, out-of-home posters, social media, TV—has a stunning power to influence our choices subconsciously.

When you see the experiments, it’s like, wow. You can basically predict what people are going to choose in a restaurant. If they’ve been exposed to advertising across different touchpoints, even with 40 choices on a menu, they will go for the one they’ve seen advertised.

So, yes, once you start working in this space, a lot of what I do is just helping people reconnect with the fact that food is our friend. It’s not there to confuse or punish us.

To your point, people feel very confused. They feel out of touch and don’t have the time or inclination to figure out what’s true. Food has become something people don’t want to engage with. They’re like, "Oh God, someone just tell me what to eat or give it to me."

A lot of what I try to do is help people reconnect with food as something that’s a real pleasure. It’s something that directly, positively influences our health and helps us to connect socially. Food touches so many aspects of our lives that make things better if we just change our approach to it and realise that it’s there to help us. It’s there to be our friend and to encourage us to feel better and have a pleasurable experience when we eat.

So that’s actually one of the most important parts of my work—changing people’s mindset about food. Once they see food as an ally for health, it completely changes the way they think about it.

Especially for people who’ve grown up with a narrative around food that’s very punishing. For example: "Don’t eat that; you’ll get fat," or "You’re not hungry; you’re just thirsty—have a glass of water." There are so many of these, and they’re often perpetuated through families without even noticing.

"Finish what’s on your plate."
"You can’t have that for dinner because it’s not dinner food."

There are so many cultural norms to untangle. But once you get there and realise you can just eat whole foods—the simplest approach is eating more whole foods you enjoy and can prepare without too much effort—it becomes straightforward.

It doesn’t have to be a lengthy process if that’s not your thing. It takes time to get there, but once you do, it’s easier. The real shift is the mindset: how we think about food. Is it something that’s there to trip you up? "Oh, I’ve fallen off the bandwagon. I’ve failed."

There’s so much negative language and thought around food. Untangling that is key. Then you can listen to your body, eat when you’re hungry, and not eat when you’re not hungry. It sounds obvious, but many people don’t do that.

People eat at a certain time because they think it’s "food time." Or they won’t eat when they’re hungry because they’re afraid of gaining weight, or they’re scared of something an influencer told them to avoid.

It’s an interesting process to help people work through that. But when it clicks, it’s awesome to see.

PS: I bet it is.

FA: It changes lives because they stop worrying about food and start enjoying it again. They see it as something that helps them, and it’s great. When they get to that point, my job is done.

PS: Do you find that, on the specific topic of midlife, you talked about beliefs and how someone might have spent the last 40 years, or whatever, with a certain set of beliefs around food—when to eat, what to eat. Do you find that it’s more difficult to unpick those beliefs with people who’ve reached a certain age?

FA: It’s a good question. It’s not an age thing, actually. It’s usually a motivation thing.

If someone is working on this for a specific outcome—whether it’s fertility, reducing the risk of heart disease, or because someone in their family has suffered from a disease and they’re trying to reduce their own risk—that motivation determines how difficult it is.

If someone’s just having a chat to find out more, they might be less motivated. They’ll be like, "Yeah, okay." But if they’re really trying to achieve something and they’re invested in that outcome, they quickly start to engage with, "How do I do this? How do I understand it?"

I’ve worked with men who don’t have time to cook—some don’t even have kitchens or fridges. They’re very career-oriented. When I say, "I’d like you to eat more at home," they’re like, "Okay, lady."

Younger men in their 30s often have elevated cholesterol and triglycerides, yet they’re slim and go to the gym. They think, "I look fine," but their diet is the problem. They’re eating out every meal and don’t have control over the quality of what they’re eating.

It’s tricky at first, but once they start engaging with it and see the benefits—not just in bloodwork but in how they feel—they often stick with it. They feel better, have more energy, and enjoy it.

It’s often the feedback they get from their own well-being that keeps them motivated. But initially, it can be tricky, especially with men in high-stress jobs. It’s really tough for them because they have so many other factors affecting their health.

Part of my job is helping them understand that having a healthy diet will improve their body’s resilience to other stresses. Once they realise that, they often engage more. But, as I said, it really depends on their circumstances and what outcome they’re working towards—that’s what determines their motivation.

PS: Okay, so again, on the topic of midlife, how do nutritional needs change as you get older? Because, going back to your book, you’ve split it into different life stages. Do you want to explain a bit about how, when you reach 45 or 50, for example, your body’s nutritional needs change?

FA: Yes. So when we get into our 40s, our metabolic flexibility starts to decline a bit.

When you’re younger—in your 20s and 30s, especially—your muscle mass is much easier to build and maintain. Muscle tissue is very metabolically active; it needs a lot of energy. Your basal metabolic rate—the energy you need just to stay alive—is higher.

This is when your metabolic flexibility is at its peak. Your body can efficiently process fats, carbohydrates, and proteins, and it can handle a high-fat, high-sugar meal relatively well, assuming you don’t have an existing metabolic disease.

But as you move into your late 30s and early 40s, maintaining that muscle mass becomes harder. From about 35 onwards, we start to lose muscle mass year by year, and this significantly impacts our metabolic flexibility.

For example, in your 20s, you might be able to eat a high-fat, high-carb meal like a kebab with rice and chips, and your body will process it without much issue. As you get older, that same meal can cause more postprandial inflammation—the inflammation that naturally occurs after a meal.

While some postprandial inflammation is normal, consistently eating inflammatory meals can lead to chronic inflammation, which is a key driver of many chronic diseases, including heart disease.

So, as we age, we need to be more mindful of this reduced metabolic flexibility. Feeding ourselves well and looking after our bodies becomes crucial because we won’t just "bounce back" the same way we did in our 20s.

We also need to be aware of changes in body composition. We’re more likely to gain fat mass and lose muscle mass as we age. Instead of just watching our weight, we should pay attention to body composition.

This means ensuring we’re doing active movement that signals to our bodies that our muscles need to stay. Movement becomes even more important than diet in this regard, because most of us already eat enough food to sustain our activity levels.

Our bodies are clever—if we move more, we’ll feel hungrier and naturally eat more. At that point, the quality of the food becomes key, as it provides the building blocks our bodies need.

Another factor to consider in midlife is the cumulative damage our bodies have experienced. From about age 15 onwards, our cardiovascular and respiratory systems begin to experience wear and tear.

This wear and tear depend on factors like whether you live in a polluted city, whether your parents smoked, or whether you were a sedentary child. All these factors contribute to your risk profile.

By the time you’re in your 40s and 50s, it’s important to think about preventing major events like a heart attack in your 50s or 60s. Heart disease is still the biggest killer worldwide, so being aware of your heart health—monitoring blood pressure, cholesterol, and triglyceride levels—is crucial.

The earlier you act to reverse trends like high cholesterol or blood pressure, the more likely you are to avoid medication and serious outcomes like heart attacks, strokes, or angina.

One of the challenges, especially here in the UK, is that we don’t have a strong culture of health screening. In many European countries, it’s normal to have an annual check-up, but here, we tend not to address issues until something happens.

This is particularly true for men. The NHS introduced free health checks where you can get your blood pressure checked and other basic screenings, but the uptake is low. Men often say, "I’m fine," and don’t go.

I’ve seen men referred to me by their GPs who say, "Oh, my cholesterol is a bit high, but that’s okay, isn’t it?" And I have to tell them, "No, not really."

There’s also a growing anti-medicine sentiment, which can be a barrier. While it’s good to debate newer treatments or public health initiatives, there are some well-established risk factors that we know we should address. For example, if your LDL cholesterol is high, your blood glucose is elevated, your triglycerides are up, and your blood pressure is climbing, these are clear red flags. Ignoring them isn’t wise, because the only person who will suffer is you.

In midlife, I would say the most important risk factors to monitor are cardiovascular ones—cholesterol, blood pressure, blood glucose, and triglycerides.

Unfortunately, another growing concern is the rise in colorectal cancer among people under 50. In countries like the UK, the US, and New Zealand, rates of colorectal cancer in younger adults are increasing.

So, it’s important to be aware of the red flags for colorectal cancer, like blood in your stool, new or persistent abdominal pain, changes in bowel habits, or unexplained weight loss. These are all significant warning signs that shouldn’t be ignored.

What’s encouraging, though, is that the dietary interventions that support heart health—like lowering blood cholesterol and blood pressure—also reduce the risk of colorectal cancer.

The single most impactful dietary change you can make to address all of these issues is to eat a high-fibre diet.

You’ve read my book, so you know how I feel about fibre—it’s massively overlooked. More than 9 out of 10 adults are fibre-deficient. The average UK adult consumes about 18 grams of fibre per day, which is the recommended amount for a four-year-old.

It’s clear we’re not doing well in this area. And yet fibre is so powerful—it lowers cholesterol, stabilises blood sugar, supports gut health, and reduces the risk of colorectal cancer.

With men, there’s this ongoing obsession with protein, particularly from animal sources like red meat. If you’re eating red meat every day, you’re directly increasing your risk of all these conditions we’ve discussed.

I always get pushback from the "carnivore diet" advocates, but the evidence is irrefutable. If just one person hears this and decides not to eat steak every day, then I’ve done my job.

Now, if you’re eating steak every day but also have a diet rich in vegetables, fruits, nuts, seeds, whole grains, beans, and leafy greens, that’s a different story. The problem is that eating too much of one thing often displaces other, more beneficial foods.

We know most people aren’t eating enough fibre, and when we look at dietary factors driving ill health, diets low in whole grains and fruits are some of the biggest contributors.

When I give talks, I often ask people what their favourite whole grain is. Depending on the audience, I might hear "brown rice" or "brown bread." But those aren’t whole grains.

We’ve lost touch with what whole grains really are. Barley, buckwheat, spelt, quinoa—these are whole grains. They used to be staples in our diets but have largely been replaced by white rice and other refined grains.

PS: Again, is that a convenience thing? Do you think the industry has blitzed us with "you can have white rice instead of these things"?

FA: Yeah, you know, it’s a really good question. I think it’s partly because white rice is incredibly cheap and very versatile—it’s used in a lot of cuisines.

PS: Yeah, and it’s easy to know what to do with rice, isn’t it?

FA: Yes, but it’s the same thing you can do with barley, for example. The difference is that barley is nutritionally superior. White rice is just very different in terms of nutritional quality.

I think it’s also partly because the UK has, in many ways, lost its culinary culture. There isn’t really one unified culinary identity anymore. In some ways, that’s great because we have a lot of international influences. But in other ways, it’s left us with a lack of traditional staples.

For example, we grow whole grains here in the UK—oats and rye, for instance. Whole oats, not the jumbo rolled ones or porridge flakes, but actual whole oats. Most people don’t even know what they look like—they’re like little seeds. You can buy them, but they’re much harder to find in supermarkets compared to 10 years ago.

The good news is that I’ve started seeing spelt in those ready-to-cook microwave bags, which means people are beginning to embrace whole grains again. That’s a positive sign.

Often, people are scared of whole grains because they think they’re "carbs," and carbs are seen as something to fear. But it doesn’t work like that.

The key consideration with food isn’t just whether it’s a carbohydrate or a protein—it’s the quality of the food. Carbohydrates are not all created equal. There’s a big difference between eating an iced bun and eating spelt. Spelt is a high-quality carbohydrate.

The same principle applies to proteins. There’s a big difference between eating a slice of wafer-thin 60% pork ham and eating a grass-fed organic steak. Quality matters.

And when I say quality, I’m not talking about price. You can have high-quality, inexpensive foods, like tinned beans or broccoli. These are minimally processed and nutrient-dense.

Whole, unprocessed foods are the highest quality because they pack a variety of nutrients. That’s why I don’t like talking about "macros" (carbohydrates, proteins, fats). Most foods are a mix of these nutrients.

Take spelt, for example—it’s categorised as a carbohydrate, but it also contains healthy fats, protein, fibre, and starches. Few foods are purely one macronutrient, apart from things like butter or lard. The more whole and unprocessed the food, the more nutrition it brings to your plate.

PS: Okay, so you’ve talked about combining nutrition with movement. Is there a point where it’s almost too late to make a difference? For example, if someone has been eating a certain way for decades and they’re now 50, can changing their diet still have an impact?

FA: That’s a really good question. The answer is absolutely, yes.

There have been many intervention studies at different life stages, and one really nice modelling study, which I mention in the book, looked at what happens when people change their diet at age 40 versus age 70.

If you make significant dietary changes at 40, you can gain up to a decade of healthy life years. That’s massive!

Let’s say someone has been following a "Western diet" or "standard American diet"—highly processed foods, refined carbs, red and processed meats, low fibre, and minimal variety in plants. If they switch to a Mediterranean-inspired diet—rich in whole grains, vegetables, legumes, and healthy fats—they could gain up to 10 extra years of life.

And it’s not just about living longer; it’s about feeling better almost immediately. A poor diet over decades will leave you feeling pretty rubbish by 50. Making changes will improve energy levels, digestion, and overall well-being within days.

Often, people make dietary changes because they want to feel better now, not just to live longer. For example, addressing issues like constipation, diarrhoea, or irritable bowel syndrome can dramatically improve quality of life.

There’s also the gut-brain axis, which affects mood and mental health. A healthier diet can make a noticeable difference in how you feel emotionally and mentally.

One of my favourite trials involved people in their 80s living in a nursing home. They improved their diet, and within 12 weeks, their frailty scores transformed.

It’s never too late to start. There’s always a benefit, no matter your age.

PS: And like you said, it’s not just about longevity—it’s also about the quality of life during those years. You mentioned the Mediterranean diet earlier, which seems to have real staying power compared to other dietary trends. Why is it so good?

FA: The Mediterranean diet is the best-understood and most well-researched dietary pattern in the world. No other diet has such consistently positive scientific findings.

The beauty of it is that it wasn’t developed as a "diet" for a specific health outcome. It was discovered by observing populations who naturally ate that way and lived longer, healthier lives.

It started with Ancel Keys, who noticed that people in Mediterranean countries had lower rates of heart disease and lived vibrant, active lives well into old age. He identified the key components of their diet and lifestyle:

The Mediterranean diet focuses on whole, minimally processed foods. Leafy greens, fruits, vegetables, whole grains, and legumes form the foundation. Nuts, seeds, and extra virgin olive oil are also staples.

There’s an emphasis on small, oily fish like mackerel, sardines, and anchovies, which are rich in omega-3s. Shellfish is another key component.

Dairy is typically in the form of traditional cheeses or natural yoghurt, and red meat is consumed very sparingly—less than twice a week.

Sweets and processed foods are rare. Drinks include water, herbal teas, and sometimes red wine, though that’s optional.

The Mediterranean diet also incorporates lifestyle factors like regular physical activity and sharing meals socially. It’s not just about the food—it’s a way of life.

What I love about the Mediterranean diet is how accessible and practical it is. It’s not about strict rules or extreme restrictions; it’s about balance and variety.

The dietary pattern is built on real, whole foods that are simple to prepare and enjoyable to eat. Think about how meals are constructed: at least half the plate is made up of plants—leafy greens, vegetables, legumes, fruits, nuts, and seeds.

Then you add high-quality fats like extra virgin olive oil and a modest amount of protein from sources like fish, shellfish, or occasionally poultry. There’s room for fermented dairy like yoghurt or cheese, and red meat is eaten very sparingly.

The Mediterranean diet isn’t about eliminating food groups. Instead, it’s about prioritising nutrient-dense, minimally processed foods. It’s not unusual for sweets or sugary drinks to be almost completely absent from this diet.

What’s also crucial is the lifestyle component—eating meals socially, being physically active, and maintaining a sense of balance. These aspects are just as important as the food itself.

But, as I mentioned earlier, this way of eating is not how most people eat today. Many people consume processed or red meat several times a day, with few or no plant-based foods. For example, it’s common to see someone have a bacon sandwich for breakfast, a chicken salad for lunch, and steak for dinner—all in one day.

Compare that to the Mediterranean pattern, where meat is eaten only occasionally. This shift in thinking about meals and portions takes practice.

One strategy I often recommend is to change one meal at a time. Trying to overhaul your entire diet overnight can feel overwhelming, especially if you’ve grown up with a "food is fuel" mentality or a high-protein, low-plant diet.

Start with breakfast—it’s usually the easiest meal to control. Introduce more fruits, vegetables, or even legumes. Try a new bean or a whole grain you’ve never had before.

Snacks are another opportunity to make changes. Many people rely on protein bars or shakes, which are unnecessary and often highly processed. Swap them for a handful of nuts or seeds, fresh fruit, or something like boiled eggs with veggie sticks.

Even small changes can make a big difference. For example, a trial led by Professor Sarah Berry at ZOE showed that simply replacing snacks with almonds for two weeks reduced markers of heart disease.

It’s not about a massive life overhaul—it’s about making gradual, sustainable changes and noticing how they impact your energy, mood, and overall health.

And if you don’t know how to cook, I’d argue that learning to cook is one of the most important life skills you can invest in. We’re happy to pay for lessons in French or for personal trainers to teach us how to squat, but cooking is equally, if not more, vital.

For men, especially those who may not have been taught to cook or who have relied on others for meals, this is an opportunity to take control of your health and your life. It’s empowering to know how to prepare your own meals, and it’s a skill you can pass on to your children, nieces, nephews, or anyone else in your life.

Cooking doesn’t have to be fancy or complicated—it just has to work for you. And it’s one of the best investments you can make in your health and well-being.

OUTRO

PS: You can follow Fede and find out more about her work on Instagram, and you can buy Every Body Should Know This on Amazon.

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Next week, I'm talking to sleep physiologist Stephanie Romiszewksi about the role of sleep in midlife well-being. 

Stephanie Romiszewski: We blame sleep for everything. If I don’t sleep well, I’ll do badly in that meeting. As soon as we feel tired, we see it as a negative: ‘I can’t do this, that, or the other.’

But there are so many factors that affect how fatigued you feel, and they’re not all related to how long or how well you slept. Some of the things that make you feel the way you do in the morning actually have nothing to do with sleep at all

PS: See you then.