TRANSCRIPT: The Midlife Shift #6: Geraldine Georgeou

Watch or listen to the episode here.

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[00:00:00] [Intro] Welcome to The Midlife Shift — juicy conversations to help you thrive after 50. Everybody wants to live better, wants to look better, wants to stay younger. If we’re hard talking about the future, there’s nothing better you can do than to make sure that you’ve got some more luck and stand the whole, “Oh no, I’ve got no regrets. Really. Have you lived a life?” Join us as we shake things up and talk about the things that matter — and maybe a few things that don’t.

[00:01:05] Alex Brooks: When nutrition science meets sanity, we need to talk to an accredited practicing dietitian. We’ve got Geraldine Georgeou with us — 30 years’ experience as an APD. She’s the author of The Healthy Skin Diet, and you work regularly with doctors and medical specialists to treat conditions and disease through diet and nutrition. Welcome. But I want to know: if health is real wealth, Geraldine, what do we need to invest in food and diet?

Geraldine Georgeou: Well, I think we get so busy — and look, firstly, thanks for having me, Alex. Gosh, I don’t know how long it’s been, a couple of years?

Alex Brooks: A couple years.

Geraldine Georgeou: And yeah, I think we do definitely have to invest in our nutrition now. Whole foods, we talk about it, but we’re so busy, we’re time poor, but we need to spend time on ourselves.

Alex Brooks: Yeah, but we hear a lot about whole foods. What does that really mean?

Geraldine Georgeou: Yeah, I think we think about unprocessed foods, okay? And think about how we grew up — just think about how we were fed by our mums.

Alex Brooks: Well, I quite liked my Tic Toc biscuits, and Monte Carlo’s which I don’t think are whole foods. I probably would have thought they were when I was five, but…

Geraldine Georgeou: They would have been a treat, right?

Alex Brooks: That’s right.

[00:01:46] Geraldine Georgeou: I think we need to understand where our macronutrients are coming from. Fueling our car — we’ve got to learn to drive our car, help the driver drive the car, so fuel it well.

Alex Brooks: Macronutrients that you’re talking about — carbs, protein, those kinds of things. Can you explain what they really mean in, like, everyday language when we’re at the supermarket?

Geraldine Georgeou: 100%. So I think people, firstly, have become very carb-phobic —

Alex Brooks: Yeah, totally —

Geraldine Georgeou: But we need that as fuel. So low GI carbs, wholegrain breads, cereals, you know, the humble potato. The potato’s got good resistant starch, it’s gonna feed our bodies, it’s gonna feed our gut. Making sure we’ve got a good source of low GI carbs, lean proteins. There’s a wealth of proteins out there, so we’re talking about animal proteins – lean red meats, chicken, fish, of course, and omega-3s. But then also you’ve also got tofus, which is rich in estrogen – estrogen-effective foods. Making sure we’re getting a good source of protein at every meal. And then good fats. I always tell my patients: have you got a protein, a carb and a good fat at each meal?

[00:02:49] Alex Brooks: All right, okay. And good fats — let’s talk about what that looks like, right?

Geraldine Georgeou: Well, my Greek husband will say olive oil all the way.

Alex Brooks:Extra virgin olive oil is what we've done in our past podcast and Australia actually has some of the best extra virgin olive oil in the world.

Geraldine Georgeou: So true. And we’ve got a really good standard. But we also need to make sure we've got other fats like avocado for example, plant fats, nuts are good sources of fat not just a small amount of protein, but making sure we've got that incorporated throughout the day.

Alex Brooks: And I remember interviewing chef Kylie Kwong years ago, and she was like: “Don’t cut out fat in your diet, because all the flavor is in the fat.”

Geraldine Georgeou: Well, it’s true. And I think too, it's how we prepare it. So if we can also not overheat it when we're cooking, because we don't want to turn that fat into a bad fat. So monounsaturated fats, I can go on. Polyunsaturated fats, gosh, you'll have me here for days.

[00:03:46] Alex Brooks: What is a monounsaturated fat versus a polyunsaturated fat?

Geraldine Georgeou: Yeah, so monos are like the olive oils, the polys are more like the vegetable oils.

Alex Brooks: Like a sunflower oil, or what's another type of polyunsaturated fat?

Geraldine Georgeou: Yeah, you'll find them in all sources, including nuts, for example. Seeds. So we're talking about flax seeds, linseed, all those sort of seeds will have those sources of both poly and mono unsaturated fats.

Alex Brooks: Okay, see, there's just so many terms. If we think about our superannuation as high risk, medium risk, low risk, and your risk appetite helps determine your return on your financial investment, what foods would you say are high risk versus medium risk versus low risk, once we're sort of over 50 and start thinking about these things?

Geraldine Georgeou: Yeah, I think high risk foods, if we think that way, those are high sugar obviously and high saturated fat foods. I think a lot of people think a whole food means that if I'm having full cream milk or butter that's safe but it still has saturated fats that can really example fixture heart health. So if we think about low risk foods we're talking about whole grains making sure we've got good sources of lean proteins, low saturated fat meats, make sure we're getting enough fiber. So that will improve and reduce our risk.

[00:05:00] Alex Brooks: Okay, okay, and fiber, we'll get onto that discussion. Now, since I started with Citro, I’ve learned a lot about diets. There’s the DASH diet for blood pressure, the Mediterranean diet, or a whole food diet seems to be the most well-researched because it's so flexible and it's based on exactly what you're talking about, which is whole foods that don't come in a packet, wide variety of colors and meals so that you get lots of different nutrients. And now there's intermittent fasting or time -restricted eating as well. So there's so many, we think we're moving away from diet culture 'cause we don't do grapefruit diets anymore, but now we have all these other things. What's your view on these different diets and eating styles?

[00:05:50] Geraldine Georgeou: I think it's really important one thing. I think we forget about what we like to eat.

Alex Brooks:I don't, I never forget what I like to eat.

Geraldine Georgeou: And I always say to patients, it's good to follow a theory, but do they know you? And where are you and your health needs? So for example, we're talking about this group of 50 year olds and above, and I am part of that team. I think it's important to look at what's your health requirement? So are we looking after your bone health? Are we looking after your skin health? Your gut health? Are we looking after your cardiovascular health? And are we getting those nutrients in your eating plan?

Alex Brooks: Yeah, okay.

[00:06:28] Geraldine Georgeou: So I think for a lot of patients I'm seeing where they're doing this food restriction, they're delaying their meal times, or maybe intermittent fasting, are we getting what you need for your nutrients? Like I mentioned, your macro, your micro, and your grains and your fibres, are we getting that in your day?

Alex Brooks: And so let's have a, let's chat about what that means. If you are only eating two meals a day like I try to do, what should I be having in a meal?

Geraldine Georgeou: Yeah, so I would say, well, firstly, when you do decide to eat, you need to actually have 30 grams of fiber a day. So that's going to be a big task if you're having two meals. So I'll be refining what you're doing with your food. I'll be looking at the amount of balance of protein and carb you're having at that meal time. So you're still managing to have that low GL to help that stable glucose release through your day. Because if you're not having that balance, your risk of then running out of glucose, having even hypoglycemia, which is a low glucose, you might find you'll get really tired. Sorry, Alex.

Alex Brooks: I've been tired for years, Geraldine.

Geraldine Georgeou: So I would say that it's really just important that you have someone look at, are you meeting, it might sound really simple. Like, are you getting your five serves of vegetables, two serves of fruit?

Alex Brooks: I definitely try to do that.

Geraldine Georgeou: Are we getting the balanced protein? And how does that marry up against your health? Like, when was your last blood test? And are we supporting your body's needs? So that's what I know. And so, you know, obviously, again, Mediterranean, there's a lot of research around that. Like we're talking about extra virgin olive oil, making sure we've got good fibres, lean fats, lots of omega -3s and fish. So I would say whatever framework you're looking at, are we getting the key nutrients that you need.

Alex Brooks: Yeah, and I guess we all love discovering a super food like extra virgin olive oil. You know, people are hailing it as like a miracle when really we've had it for centuries. Which is kind of funny. But is there such a thing as a super food or really is it about everything we eat in combination?

[00:08:40] Geraldine Georgeou: Yeah, I think, firstly, yes, what we eat in combination matters, But, I think because I've been working a lot in gut health, believe it or not the super food, and you might think I'll say the same thing a lot of times, is are we getting enough fiber? Because we've got to keep our people, the people in the village, so our commensal species, which will go on to a gut health, are we nourishing from within? Because we're now realising the gut axes and the impact of our gut, and this is what we're called metabolites, that actually then sends off conditions. You can have your hemi -sae skin again, but also gut brain axes, all these things. Are we just the results of a puppet?

[00:09:24] Alex Brooks: Because our gut and the research here has been incredible over the last 10 to 20 years. Our gut is our second brain. Totally. And our digestive system is how we fue. our body and our brain. Now, maybe in really simple terms, can you explain how that impacts our brain health, skin health? And I think there's even oral microbiomes. They're like, our body is alive with these little bacteria. And what we eat affects the bacteria.

Geraldine Georgeou: Yeah, so I think what I've been finding lately, again, back to the carb phobia, people are starving our gut microbiome. So the two things, the two things that are really important is the diversity of your gut microbiome and the quantity and have we got enough numbers or we've got enough species. Now if you think of those species, depending on their ratio or how they are living in your gut, they will help protect your gut microbiome or your gut environment to reduce, and I'm going off now, you don't.

Alex Brooks: That's okay, no, no, no, because I think it's just hard for people to understand that there are literally millions of different cultures living inside our body. And that's what the microbiome is, it's the interaction of all these different bacteria that have good health effects.

Geraldine Georgeou: That's right.

[00:10:47] Alex Brooks: And Dyspiosis is the scientific term, but that just means your bacteria aren't having a funky time, right?

Geraldine Georgeou: Well, they're having a little war in there. I mean, actually in my book I wrote, "What is in Las Vegas doesn't always stay in Las Vegas."

Alex Brooks: So give me an example of what gut dyspiosis, which is what people like you and medical doctors would call it. What does that really mean to everyday people?

Geraldine Georgeou: So it just means that you, again, are we nourishing our gut? We're getting enough fibres. Are we actually reducing our saturated fats? Are we avoiding high processed foods? Those nutrients will then feed the species that live in there. So think of your neighbours, all right? If your species aren't in the right ratio, which is the biosis or dysbiosis, then you may then have a metabolic effect that will have impact on your health.

[00:11:49] Alex Brooks: And metabolic conditions are part of age -related disease right and decline very commonly they're all interlinked is what from what I understand. Can you explain a little bit about metabolic conditions because most of us just think that means fat or thin.

Geraldine Georgeou: You know, you’re sort of right actually I had a patient just yesterday that we diagnosed with insulin resistance yeah but this person was a personal trainer, super fit, and was horrified to think that he could have something that could be associated with someone that's normally obese or overweight.. Now, metabolic disease and how that evolves over time, yes, you mentioned with age, but it's also genetic.

Alex Brooks: Yeah, that's right.

[00:12:32] Geraldine Georgeou: And then it's impacted with how we're eating, how active we are, other things that we don't always think about – stress, sleep, and are we actually, you know, really nurturing and looking after our bodies. So if you have like gram-powered diabetes and you've got to aren't with a type stroke, for example, sadly, you'll find that, well, you need to understand where you are in your metabolic health journey. And this is why it's really important. Like we service our cars more than our bodies. You than our bodies. We need to look at our logbook. Have we got any hints that there are changes? When we're turning 50, for example, there are metabolic changes that we cannot control.

Alex Brooks: Like what?

[00:13:06] Geraldine Georgeou: So, for example, loss of estrogen. And that impact can then start having impact on your metabolism. Then the impact of the slowing of the metabolism, if you're not rectifying how you're eating and meeting your calorie need and again the balance then you might find you'll have this cascade effect and then all of a sudden you wake up one day, you get flagged by the GP and you go right you've got cholesterol coming, you've got signs of fatty liver. So these are impacts from involvement of lifestyle developing into a metabolic disease. So once again, it may not just show on the scales.

Alex Brooks: That's right.

Geraldine Georgeou: It may show that you've got a change of intra -abdominal fat. So what happens is when we're going into menopause, we can actually have a change of our body shape from being a pear.

Alex Brooks: Oh, I know that one.

[00:14:00] Geraldine Georgeou: Yeah, where's my booty gone?

Alex Brooks: Yeah.

Geraldine Georgeou: To then maybe increasing this intra -abdominal fat or abdominal fat. And that can change. And that can change.

[00:14:15] Alex Brooks: Belly fat is what the social media ads tell me it is. I know, we're seeing it all the time. I've got tons of it and those pictures are just horrific.

Geraldine Georgeou: No, not nice. So, and then you can change from 20 to 44 % of just the change of storage of fat just around that midriff area unknowingly. So you might think, oh, scars aren't really moving but it's changing within. And that's because of the hormone or changes in effects and the decline of our hormones at menopause. And then the impact of that, we start having changes the way we metabolised proteins, we have a change in the way we metabolise fats and a condition known as insulin resistance can start to evolve and then just the act of making more insulin can then start creating more storage of fat and then this octopus effect of cholesterol, fatty liver, lowering of your good cholesterol which is HDL so I can make it sound all grim and then from there you start showing a sign of a touch of sugar or diabetes. The issue with that is we don't need to wait for a train wreck.

Alex Brooks: Yeah, exactly.

Geraldine Georgeou: You know, we just need to start thinking, okay, my body is changing. My dietary needs are different.

Alex Brooks: That's right.

Geraldine Georgeou: So we need to look at, well, what is my calorie need? Do I need to revise this? Because my metabolism or the engine is slowing down.

Alex Brooks: And I mean, I've seen it written that we need less calories, but the reality is we also need more nutrition within less calories, which is kind of what makes it a bit of a explosion. Like, how do you work that out? And I think that's why the Mediterranean diet becomes the go-to framework, because that's just so much easier to think of, right? It's you just eat unpackaged foods. It's sort of the easy way to think.

[00:15:51] Geraldine Georgeou: Yeah. And I think what I'm seeing, and again, this could be a whole other topic, what tools we're using to help our patients. But I'm finding that protein, protein, protein. So we need to make sure we're getting enough protein in our diet because sarcopenia, which is loss of muscle, really evolves at this time. Resistance exercise is all so important, and I understand Michelle's been here so she's our expert but understanding that whole synergy of what am I doing, how am I moving my body and protein. Are we getting enough good protein throughout the day to meet our protein need? And then making sure we're factoring that in.

Alex Brooks: And what are some good ways to boost protein? So I know dietitians will talk a lot about lean meat, especially chicken, they love a bit of chicken breast, smoked salmon, you know all those sorts of meaty sources but a lot of people are trying to ease back on meat. How do you get enough protein if you do want to cut back on meat?

Geraldine Georgeou: Yeah it's tricky. I think what we really should be aiming for at least 30 plant foods even over a week. So one of those foods then will be tofu. I think tofu is very versatile.

Alex Brooks: And tempeh, right?

Geraldine Georgeou: Beautiful yeah. There's other proteins on the market like corn, Q -U -O -R -N mints, that's a mycoprotein from the mushroom family, give it that way. But I think, again, looking at the meals and the recipes that you use, and have you got enough protein combined into that meal?

[00:17:21] Alex Brooks: Yeah, it's really tough if you're trying to also get the five and two, you know, fruit and veggie in a day and the protein. In terms of carbs though, which totally we're all, we've all become carb phobic. I now buy those low carb potatoes because they actually taste really good. Especially when you put them in the air fryer. Yeah, they're quite delicious. But I'm just as much of a victim of that as everybody else. Whereas the potato actually has a lot of magnesium and potassium, like it's got a lot of good stuff in it. We don't eat it as much as we should. How do you get that diversity without, you know, turning into someone who's literally in the kitchen all day?

Geraldine Georgeou: Yeah, well, I think there's quick and easy ways to increase your example vegetable intake. I mean, like you mentioned, those 25 % less carb tight potatoes. But, you know, in reference to, you know, you may work, I did a shopping tour the other day, I did shopping tours with my patients.

Alex Brooks: Oh, do you?

Geraldine Georgeou: And so it's like funny, finding where's Wally, but, but we, um, it's going through the fresh section and you'll find there are even vegetables that are pre-packaged for you, which we know. So there's no, you know, trying those into meals, stir fries, you know, all those sort of things. But I think just, I don't know, I find that yes, meal prep could be good. Um, I always find if you try and make one meal, make sure it serves two. So you've got the meal that night and next next meal, next day at least. You know, don't be scared of a sandwich, a wrap, you know, soups, I mean, we're going into winter, so soup weather, fantastic way of getting those vegetables in, those root vegetables as you're mentioning.

Alex Brooks: Yep, exactly. And then in terms of sort of effectiveness of dietary approach to disease, given your interest in gut health, would you say that what's one of, I suppose there isn't one simple hack. I think that's what you're kind of saying. But in terms of some of the effective ways food and intake can treat diseases and conditions, what would you put on the hierarchy of, you know, consider this first to consider this least? So I'm talking about, you know, everyone's obsessed with eliminating gluten just like they are eliminating carbs, right? we want to increase the protein we eat, which is also tricky, but what sort of tips I guess are at the top versus lower down.

[00:19:44] Geraldine Georgeou: I think whatever theory diet youwant to follow, and you might sound very basic, but is it balanced? Like we need to make what meets a meal requirement. Like do we just eat yoghurt for breakfast or for a morning tea, or do we make sure that yoghurt's got a good source of protein, you're adding a carbohydrate in a form of a vegetable, and how can I add some extra fibre?

Alex Brooks: So how would you do that if you wanted to have yoghurt?

Geraldine Georgeou:Yeah, so very simple. I mean, I can talk about a recipe out of the book.

Alex Brooks: We'll make this good recipe today.

Geraldine Georgeou: But I would say to you, choose something that's in a controlled portion to start with, 'cause you might go a bit nuts with with the volume and then making sure, you know, have you got some seeds or nuts? Make sure that you keep those sort of things once you've opened the container in the fridge 'cause you don't want it to oxidize. You want to keep those nutrients and then making sure, you know, what's in season. I think we need to think about foods in season as well because if we don't, then what happens is then we're not getting the nicest serve there either. But I think balance is very important with whatever you do. And I plead with everybody to please keep your fibre intake going.

[00:20:51] Alex Brooks: And let's talk about things that have fibre in them, right? Because I do remember in the 1980s there was the F plan diet, which was this high fibre diet. And my mum was really into it at the time. And we were eating baked beans on potatoes. You know, it was very, very high fibre. But talk about what types of things that we don't think about when it comes to fibre.

Geraldine Georgeou: Well, I think you just mentioned one. I think legumes are a great way of increasing your fiber and they're very versatile and you can sneak them into things as well. So it doesn't have to be just a big lump of lentils, for example. But I think keeping your skins on fruits, I think making sure you've got seeds in that scattered through the the day, you know. We do know that even just adding one to two cups of vegetables to a meal, and some people even eat meals in order now. So for example, to eat the veggies first, then the protein, then the carb. So they all have merit. So I think again, I think I said this much earlier on, do you like what you're eating? And have a look at how you used to eat and look at how you can incorporate that throughout the day and don't be scared to add vegetables at breakfast.

[00:21:54] Alex Brooks: Well, like what? Like which ones?

Geraldine Georgeou: Well, let's make an omelet and let's add extra veggies that way.

Alex Brooks: Yeah, okay.

Geraldine Georgeou: And then having a nice whole grain salad or rye bread. Rye bread can really proliferate good microbiome in your gut.

[00:22:22] Alex Brooks: Yeah, and rye bread and sourdough is last longer as well than the packaged bread. So you can have them for ages without the food waste. 'Cause I think that's part of the disheartening thing is that you go to the supermarket thinking you're gonna buy healthy, you buy all this food and then you're just you know rinsing out the crisper a week later with rotting vegetables because you couldn't eat them all.

Geraldine Georgeou: I think also too there's a lot more sort of pickled varieties as well so you've got the kimchi, all those fermented foods and all those can also help flourish good species including kefi so there's a lot more focus on that nurturing effect on our health.

Alex Brooks: So bringing a range of foods in to keep the diversity of bacteria flourishing.

Geraldine Georgeou: You got it.

[00:23:08] Alex Brooks: Now, in terms of skin and eating, now skin is actually bizarrely, one of our plays an important role in our immune system as well, right? Like it's an organ and probably our largest organ. But most of us just think about it in terms of visual.

Geraldine Georgeou: Yeah, true.

Alex Brooks: Visual effects. What do you need to do to eat well for your skin?

Geraldine Georgeou: Yeah, that's a big loaded question.

Alex Brooks: I know.

Geraldine Georgeou: I think it's really important to have antioxidants.

Alex Brooks: Okay, and what do you mean by antioxidants? I've heard the term, it's in a lot of my skincare as well. So how do you eat one?

Geraldine Georgeou: Yeah, so I think foods rich in vitamin C, that's an example.

Alex Brooks: So like oranges, limes, lemons.

Geraldine Georgeou: Exactly.

Alex Brooks: What else is rich in vitamin C? Berries?

[00:23:57] Geraldine Georgeou: Yeah, exactly. And I think to fresh, I mean, you can get dried fruits as well, but again, watch the portion. I think it's also important that, you know, fresh is best as well. I know that omega -3s are very important as well 'cause they're anti -inflammatory.

Alex Brooks: Can you talk about omega -3s? Because I think we all know that salmon has it and fish oil supplements have it, but what else has omega -3s in it?

Geraldine Georgeou: Yeah, so flaxseed, linseeds, so think about again what breads you're eating, are you getting a source of that? And then also to chia seeds, and they make a great chia pudding for example. So you know we can actually just shove a recipe like that, getting enough protein. I'm not against having a protein supplement. There's a lot of research with collagen, for example, that can have a real benefit. Verisol, which is a former collagen, can really help that dermis layer. So I think again, you know, whatever you're choosing, don't just choose one food group, put it together.

Alex Brooks: Okay. Yeah. Okay. And make your meals delicious. That's because that's the most important thing. Don't eat too much of it.

[00:25:03] Alex Brooks: There's also an issue with vitamin D. As people get older, it's really, really easy. Even younger people are deficient in vitamin D, but as you get older, apparently, it's more common that deficiency in vitamin D. How do we eat our way out of a deficiency in vitamin D?

Geraldine Georgeou: Very difficult.

Alex Brooks: 'Cause it's a tricky little nutrient that vitamin D, isn't it?

Geraldine Georgeou :Yeah, so vitamin D It's found in many protein foods and eggs, for example, but cod liver oil is another source or a great source of vitamin D.

Alex Brooks: It's not very delicious though, cod liver oil.

Geraldine Georgeou: Back in the day, they used to give you teaspoons of it.

Alex Brooks: I know.

[00:25:38] Geraldine Georgeou: So I usually, with most of my patients, obviously test vitamin D is important for bone health.

Alex Brooks: Yeah, that's right.

Geraldine Georgeou: And then some people take vitamin D with K to actually help the absorption of the vitamin D in the supplement. But once again, have a look where you're starting from. So if you're more, if you're less than 75 milli units per litre on your blood test, you would definitely need to have either just sun exposure, safe sun exposure with sunscreen of course. But I would also recommend just to keep an eye and look at seeing if you need also a vitamin D supplement.

Alex Brooks: Okay, because yeah, Kate Langbrook she does sun gazing every morning now.

Geraldine Georgeou: Oh wow.

Alex Brooks: A for her eyes and B because she likes looking at the sun and getting the sunlight. So yeah.

Geraldine Georgeou: Okay that's interesting.

Alex Brooks: Yeah I know, I was like, wow okay I didn't know about that. And our heart and cardiovascular health they're still very big killers and our diet can play a very big role there. Talk to me about eating for heart and cardiovascular health.

[00:26:43] Geraldine Georgeou: So with cardiovascular health, once again, it's important to see where you are with that health to start with. Is it just looking at your cholesterol? Do you need a calcium score to see if you've actually got calcification in your arteries? So then you'll know, is it just a dietary change together with exercise, or do I need to also seek medical help? So just know that where do you stand with your heart first?

Alex Brooks: And is that, is the most important test there, just a cholesterol test? Like, where would you start?

Geraldine Georgeou: Yeah, so usually, obviously, see a GP. Cholesterol tests will be somewhere to start. Look at your family history. If you had longstanding cholesterol, some people are fighting to not have medication. Again, maybe getting a calcium score, seeing cardiologists, having a stress test. So it's really important to know where you're starting from. So from a dietary change. You know, look at your saturated fats, look at your glucose metabolism. Is there any signs of diabetes? Because that will compound and even be the cause of cholesterol changes as well. And then interestingly, again, gut microbiome, there's a lot of research in different species that can actually help support reducing cholesterol uptake in your gut to then reduce the cholesterol in your bloodstream.

Alex Brooks: Exactly.

Geraldine Georgeou: And then are we getting enough fiber and making sure it was fibre itself can also help with pulling, basically pulling cholesterol out of your system. So it's really important to have a look at all those things and working with a dietician in your doctor.

Alex Brooks: It really is. And the other really important consideration as we get older, or maybe it's just me and my knees, but knees and joint health and back problems, can eating an anti -inflammatory diet help with that sort of niggly little pain that we get as we get older?

[00:28:44] Geraldine Georgeou: Yeah, indeed. Like there's a lot of research, omega -3s, curcumin, watching your weight, understanding what you're eating, regulating your glucose, regulating your insulin. So if you've got elevated insulin, your glucose may look normal but you've got more insulin flooding around and the effect of making more insulin to move your glucose through your body can actually put an information on your joint itself. So some of the rheumatologists I work with, we actually run these tests to see have we got too much insulin circling, is there a medical approach together with dietary change, low GI, balanced protein, good fat and then do we need to give you some support nutrition to also help with reducing that joint inflammation.

Alex Brooks: And you told me about this new protocol that it costs a couple of hundred bucks. So there's definitely a fee involved. But talk to me about this gut health protocol and how that can work to manage age related conditions.

Geraldine Georgeou: It's like when I see my patients, I put them on a hoist.

Alex Brooks: You go under the hood, so to speak.

Geraldine Georgeou: So we can actually now see like a window into your gut health, looking at your commensal species, looking to see if there's any pathogens and understanding if we need to, you know, what fibres you need more of. Like there's a whole lot of food fibres, but there's also supplementation you might need to end up improving this, if we find this dysbiosis or imbalance of your gut microbiome. But if we have a pathogen, for example, so I've had some amazing experiences.

[00:30:10] Alex Brooks: So what do you mean by a pathogen? Describe what that is. That's usually like a bad bacteria or some kind, right?

Geraldine Georgeou: Or a parasite. So if people have been, who put your hand up, you've been to Bali?

Alex Brooks: Yeah.

Geraldine Georgeou: Okay, I'll give you my phone number later.

Alex Brooks: I got Salmonella in Bali as well.

Geraldine Georgeou: Yeah. I'm sorry to hear that.

Alex Brooks: That was a long time ago. I haven't been back since.

Geraldine Georgeou: But surprisingly there are actual, so if you think of them as incursions that can, E. coli, for example, can actually drive a condition, for example, underlying lupus.

Alex Brooks:Wow.

Geraldine Georgeou: So I have patients that come to me for the anti-inflammatory diet. But again, check there's nothing, they're driving inflammation. Let's not fuel that inflammation. So, if we can check and also understand you and then bring it together, we can then help reduce your inflammation.

[00:30:51] Alex Brooks: So, how would you test for, because obviously, you test for different types of gut bacteria in this test, but how do you test for pathogens and, you know, what does this report kind of look like when it comes back to you and how do you read it?

Geraldine Georgeou: Yeah. So, This company that I'm referring to though, you do take a stool specimen, but you might remember --

Alex Brooks: Poo, that's a poo specimen.

Geraldine Georgeou: That's it, and I sang it nicely. Don't want to put anyone off of their eating while they're listening to this. But you also, with the COVID where we do the swab, there's also a swab test off the stool, off the toilet paper. And that gets sent away. And they actually have different measures, so they can actually see the pathogens together with what's actually present and they can actually see the species through DNA so it's like the scene of the crime like CSI and we can actually look to see who's been has there been any DNA left behind.

[00:31:53] Alex Brooks:So it's like forensic poo examination to sort of eager health.

Geraldine Georgeou: Exactly, it's like forensic dietetics. But yeah but we have some wow factors so and interestingly I'm doing a lot of work with the center of digestive diseases and yeah so we've got some synergistic work with do we give you a fecal microbe transplant because –

Alex Brooks: That's a poo transplant, everybody.

Geraldine Georgeou: Yes that's right and you know some people definitely need that because they've got chronic illness, they've got not just RBS but inflammatory bowel and they've got what you call mucin degradation and intestinal permeability, which is then creating their whole disease process. But once again, it's like planting a plant. If you don't water it and feed it, then the FMT won't work itself either. So you need to work holistically in a multidisciplinary approach.

Alex Brooks: Yeah. So we did a story for Citro about poo transplants. And it's on the site. But yeah, it's fascinating that people can just have a little bit of healthy poo, transplanted, you don't have to eat it. But it doesn't enter your body in a nice way. It can totally change their lives, in some cases.

[00:33:16] Geraldine Georgeou: It can do it. And I think we're learning more and more as we are. So I think, again, it's very important to make sure we've got a good nutritional plan to support people through that process as well.

Alex Brooks: And I mean, gut health doesn't just affect digestive processes. We talked a little bit about brain health, but there's some fascinating research coming out of Australia, Australian unis down in Victoria about gut health and psychiatry, food and mood.

Geraldine Georgeou: Completely.

Alex Brooks: It's fascinating. Could you want to summarize that for people?

[00:34:01] Geraldine Georgeou: Well, it's a big task, but basically, again, what's happening within can actually affect your brain health and then there's a condition even like visceral hypersensitivity, where you might be sensing that you do have gut pain and you feel like you're not well. But what's actually happening is because of the dysbiosis, you're getting more gut brain messages that aren't really there. So you need to then again look at how you're going to nourish and understand what's actually happening. One of the jobs I work in or areas I work in is in gut motility. So in reference to what's happening from your esophagus stomach to small bowel and your large bowel.

Alex Brooks: So is that really just how quickly you poo?

Geraldine Georgeou: It can be and some people don't. So then we need to understand what stopped that mechanism. All the stomach doesn't release its contents which is called gastroparesis. So again, this whole how the gut is communicating with the brain and the messages to actually function can really impact people. And so yeah, so you need to then help hold their hand. There's a lot of work you may have heard about hypnosis and other areas in reference to managing the gut brain axes and understanding because It's like you have like, it's like you've had a sore foot and then you notice you've had a sore foot so you walked a different way. But what if the foot's healed but you still feel like you've got a sore foot? So it's that message that you're getting that is a mixed message and being able to turn that around.

[00:35:07] Alex Brooks:

• That's like my mixed message that tells me I always need chocolate, right? What's wrong with that?

Geraldine Georgeou: That could be a glycemic thing, but anyway. -

Alex Brooks: It actually really might be. So in terms of ultra-processed foods. We're starting to hear and read a lot about ultra -processed foods. What's an ultra-processed food versus a regular processed food?

Geraldine Georgeou: Yeah, so those foods that have been so processed, they're high in trans fats, they're high in sugar. They're pretty much turned into not the original food.

Alex Brooks: So they, are they, give me some examples of what they might be in the supermarket.

Geraldine Georgeou: So it could be something like an ultra processed food could be something like beef jerky or something that's got lots of salt added and flavors and it's not really a piece of meat anymore. If that makes sense.

Alex Brooks: So it's chemically altered?

[00:36:08] Geraldine Georgeou: It could be some of those artificially sweetened products that you're thinking, "Wow, it's got no calories," but it's so processed because it's had so many additives, flavors. I mean, a hint is look at the ingredients list. You know, how many ingredients have been put in there. So I think you need to ask, is this still really a food or is this being manufactured to think I'm having something that's free, free of calories, free of sugar, but what have we done to it to make it that in that space?

Alex Brooks: So often, I think what I'm hearing you say is that often we think it's a healthier choice because it might be low sugar or low fat or high protein but really it's ultra processed and in terms of our risk scale that we talked about would they be high risk foods?

Geraldine Georgeou: Yeah they will be because they're high salt they've got lots of chemicals added I think people get a false sense of fullness but they're not getting the nutrition. Another food that comes to mind is foods that are actually not very digestible.

Alex Brooks: Like what?

[00:51:40] Geraldine Georgeou: And then I do, I am known to have a protein powder for smoothie recipes.

Alex Brooks: Okay, so you like the smoothie?

Geraldine Georgeou: Yeah, and I may use a collagen protein, because again, it’s a protein with function, rather than just innate protein.

Alex Brooks: So you would treat that collagen protein like a whey protein or a plant-based protein, and you just replace it directly.

Geraldine Georgeou: Yeah, so I may do that. And sometimes I might have a malt tea, 'cause once again, are we always getting all our nutrition? But obviously monitor yourself, don't just start taking things without knowing if you need them.

[00:54:23] Alex Brooks: Yeah, I think that’s pretty key, right? And in terms of you’re tired, you’ve gotten home from work and you’ve got to cook a meal, what’s your quickest and easiest go-to meal?

Geraldine Georgeou: Yeah, I was thinking, hmm, again, you might think I say the same thing a hundred times, but I’m really time poor out with that omelet will be, like you said, look in the crisper. Um, it might be just making, I might have some protein of some kind. Like it doesn’t take long to just quickly heat up, you know, a piece of steak or some lamb cutlets or something like that. Um, and doing a little side of some, you know, asparagus or something like that. And if I don’t have a carb vegetable, then maybe I’ll finish with a piece of fruit.

Alex Brooks: Because sometimes too, as you may, and I’m sure everyone listening, they might notice this, that, you know, you’re hungry, a meal might have been five, six hours ago, and you get that sweet sort of feeling. So then you can have a piece of fruit after it, and maybe even a dollop of yogurt. Because once again, every time you have a carb, always chase it with a protein. So yeah, to keep that steady glucose response.

[00:55:30] Alex Brooks: So when I last worked with you, I discovered this Farmer’s Union vanilla yogurt. Oh my gosh, it’s just so delicious. It tastes like ice cream, but surely it can’t be good for me, can it?

Geraldine Georgeou: Well, it can be. It’s gonna have its natural probiotic benefit, but I think there’s also some protein-boosted Farmers’ Union yogurts out there as well, so yeah.

Alex Brooks: Yeah, I’ve seen a lot of those now. So you recommend the protein-boosted yogurts?

Geraldine Georgeou: Yes, I do, yeah. Especially if you’re over 50 ‘cause 30 grams of protein at every meal.

Alex Brooks: Yeah, it could be very hard.

Geraldine Georgeou: It’s quite hard to do. But she’s only eating two meals a day. I know, she’s shaming me.

[00:56:15] Alex Brooks: Not at all, not at all. Sorry, we’ll have to check later. It’s okay, I agree, it is really difficult. And what foods do you crave? Like, you talk about your dark chocolate ‘cause you’re a good dietitian.

Geraldine Georgeou: But I don’t know, I’m a bit more of a savory sort of person.

Alex Brooks: Yeah, okay.

Geraldine Georgeou: You know, and sometimes I think, oh, there’s nothing better than like a little cheeseboard, right? But then how do you eat something like that and not have all that saturated fat? So, you know, I love that figs are in season at the moment. And you can get like these little blue cheesy type things that are in small portions. So maybe having one of those on a little half fig, you know, sort of makes you sweet and savoury at the same time. But there’s nothing better than just even just having and making little charcuterie, you know, get some cut-out carrot, get some cucumber, just so you don’t go back for more. But again, you know, obviously it’s a little bit higher in saturated fat. But, you know, I think it’s also nice, there’s so many different types of dips out there and vegetable dips and there’s nothing better than just even getting a little plate together and pop some hummus and some crackers.

[00:58:01] Alex Brooks: And hummus is an exclusive topic in my circle of friends, because what’s the best hummus? Like we have found and we argue to the cows come home, one likes Yumis and another one likes the Aldi version of hummus. And I’m like, I’m suspecting they’re the same brand, right?

Geraldine Georgeou:Y eah, possibly. I just look at the, obviously the ingredients, less ingredients better.

Alex Brooks: Ah, okay. So you choose the least processed.

Geraldine Georgeou: Yes, eat. And I think also sometimes just making sure you don’t get, be careful of the huge pot. And try and put your portion out, because before you know it, you might eat the whole thing. And we all know what happens if you eat too many chickpeas in one go.So yeah, we may not have those conversations.

[00:58:40] Alex Brooks: Yeah. And in terms of healthy snacks— So I know most dietitians, they talk about balance in terms of the variety, five and two, but you will often talk about three meals a day with two snacks as well. Talk to me about those snack options.

Geraldine Georgeou: Yeah, so, well, like I described a minute ago, like cut up veggies with a dip, you know, vegetable dip, maybe a slice of reduced fat cheese, that could be a nice little combo with some whole grain crackers. There’s nothing wrong with having a piece of toast, grainy bread with a bit of peanut butter and a cup of tea, that green tea we were talking about before. You know, that could be a really good snack. It really depends on how hungry you are. I think sometimes people, you know, a high protein yogurt with some berries could be another little snack that you can have. There’s some really good nut protein bars out there that aren’t too high in sugar. Again, that missing protein that we need and still some carb but still controlled carb, low GI. So there’s lots to choose from. I think you just got to be, again, I’ll bang on about have we got a protein? Have we got a carb? Have we got a good fat at every meal? And don’t just have an apple because, for example, apples are great but put apple or peanut butter because at the end of the day you get that low GL, that low glycemic response. Because really having a snack, think of the way we eat is a pit stop with top up fuel, just like we’re going to drop into the petrol station to top up our car. A mini top up is still a top up of fuel. So is that fuel going to be a slow release fuel?

[01:00:20] Alex Brooks: Okay. And if I need to order Uber Eats and get takeaway food, what’s my best choice?

Geraldine Georgeou: Yeah, I would say for me, I choose something but I can get vegetables. So, for example, I’ve got a wonderful local Chinese that does gluten-free. ‘Cause I’m actually a celiac.

Alex Brooks: Oh, you’re a celiac.

Geraldine Georgeou: So is my Greek friend. She’s a celiac as well. That’s hardcore being a celiac.

Alex Brooks: Yeah, it’s been more than two decades. I know, I think it’s part of me now. But, and so very grateful there’s restaurants around me that make an effort. And I might just order, you know, a lamb or beef in black bean or Mongolian lamb, but I always add extra vegetables or I get another vegetable side dish and also add some tofu to that. And so then the rice portion will be small. And again, I’ve got a little protein, veggie combos, and then I’ve got that extra bit of carb. And order enough so I’ve got leftovers next day, of course.

[01:01:25] Alex Brooks: Yeah, I always do that too. But do you say what type of rice would you eat that with?

Geraldine Georgeou: Well, they won’t have, I usually recommend basmati, basmati whole grain or usual basmati rice. They won’t have that, but again, the portion’s about half a cup.

Alex Brooks: That’s so tiny, half a cup.

Geraldine Georgeou :That’s why we ask for extra vegetables.

Alex Brooks:Excellent. We’re going to draw this to a close. I will say I have cooked recipes from this Healthy Skin Diet book and they are really delicious.

Geraldine Georgeou: Oh, thank you.

Alex Brooks: They’re very yummy and the information in there is eye-opening and surprising. It’s not just your usual go-to stuff, so I really thank you for sharing your wisdom with us today. And you’ll find everything on the Midlife Shift. Be beautiful. Subscribe and follow and thank you again.

Geraldine Georgeou: Thank you so much.