The Doctor’s Kitchen. Dr Rupy Aujla
work without my Tupperware brimming with cruciferous vegetables cooked in delicious spices and tasty fats. I began to realise the impact of stress on my heart, so I started meditating. I appreciated the importance of sleep, so I made sure (when I wasn’t on night shifts!) I was tucked up on time. More importantly, I never sacrificed my enjoyment for life. I wasn’t to be owned or dictated to by a condition. I wanted to take control of it … if I could.
My AF episodes reduced from one or two a week to zero.
On discussing my experiences with cardiologists, general physicians and lifestyle medicine practitioners it was hard to retrospectively pinpoint exactly what had happened to make the AF episodes stop. My increased vegetable intake likely replaced electrolytes and vitamins in my cells that were lacking. Eating cruciferous vegetables on a daily basis flooded my body with plant chemicals that we now understand have profound effects on DNA. I continued to drink alcohol on occasion, but I removed sugary drinks completely. My added dietary fibre is likely to have improved the functioning of my gut bacteria, which can lower inflammation via a variety of chemical pathways. I potentially attenuated the stress in my life triggered by poor sleep and a demanding job by increasing essential fatty acids in my food and practising mindfulness.
Rather than focusing on ridding myself of a condition, I had concentrated my efforts on providing my body with the best environment I could. I worked at being well in mind and body as much as possible. The complex interplay of food on our physiology, our DNA and even the microbes residing in our gut is a universe of science in itself. Without delving further into the analysis, what my experience reaffirmed for me was the immense power of lifestyle and the incredible ability of the body to ‘self heal’ if given the correct nutrition.
My family’s story, my personal story and those of the thousands of patients across the world who have managed to reverse and prevent disease using lifestyle medicine is my motivation for writing this book. This is my opportunity to share the information I’ve gleaned on my journey so far, and the journey I am still on.
Medical experience
My GP training was brilliant. I was experienced in multiple medical specialities, equipped to diagnose and skilled at providing emotional support. However, I was horribly inept at addressing the root cause of the biggest problems facing primary care across the globe: lifestyle-related illness, including diabetes, obesity and heart disease.
Beyond the ineffective recommendations of a low-fat, low-calorie diet we propose for weight loss and cholesterol control, there are no tailored diets for conditions. From my personal experience, I knew there was much more to food than just a collection of macronutrients and the simplistic view that we eat for energy purposes. I was ill equipped to give advice because nutrition training at medical school was lacklustre. So, to help myself and my patients, I decided to do the research.
I scoured journals, watched presentations, attended international nutrition conferences and began to unravel a magnitude of clinical evidence highlighting the impact of food on disease. I read thousands of papers, studies, editorials and books dedicated to nutritional medicine, and was shocked that medical schools cover this entire body of evidence in just a few uninspiring lectures.
I began to start my consultations by enquiring what patients would eat on a daily basis: how do you start your day? What time do you eat at night? Do you snack incessantly after meals? My clinics were more engaging and my patients loved the emphasis on nutrition. Convincing them that the key to longevity and good health was accessible using delicious recipes that I would tailor to their lifestyle, was motivational. I was able to inspire people to take control of their conditions through food in a way I hadn’t done before with just medications. I began to focus on promoting wellness habits, rather than just diagnosing disease.
My diabetic patients would improve their blood-sugar control, arthritic patients would lose weight and become more active and even those who had no significant change in their body composition felt better in themselves. Realising that I could combine my passion for recipe creating and flavour with a career dedicated to healing people was a revelation for me.
But, I couldn’t keep writing recipes for every patient in my consulting room. I was seeing over 40 patients a day, plus home visits, plus paperwork and prescriptions. It was just not sustainable. And that’s when the idea of ‘The Doctor’s Kitchen’ was born: a multi-platform resource inspiring patients to appreciate the beauty of food and the medicinal effects of eating well. A YouTube channel, Instagram account and blog where I could confidently direct patients to gain evidence-based information, lend my perspective on healthy eating and teach them how to cook their way to health.
An accumulation of poor dietary and lifestyle choices often leads patients to the emergency room and it’s partly my experience in A&E that’s brought me on this journey. It’s often a surprise to patients when their emergency doctor starts enquiring about their dietary habits, but acute care and chronic disease are related in many ways. Sometimes it’s a culmination of factors that results in tragedies like a heart attack, stroke or even a nasty skin infection that’s linked to poor diabetes control. Separating diet and lifestyle from acute medicine blinds us to the solution for our overburdened healthcare systems. I truly believe the answer lies in the quality of our community care where food plays a pivotal role. Practising good nutrition and lifestyle medicine means we can pre-empt disease rather than react to it in the emergency department.
Plates over pills
I want to make this clear so there is no doubt on this statement: food is medicine. It’s not my opinion, I’m not saying it because it’s fashionable and trendy, it’s quite frankly a fact.
We have a library of studies that demonstrate the effectiveness of nutritional interventions on lifestyle diseases that are society’s biggest killers. My job is to give you a flavour of the science and encourage you to value the importance of mealtimes. We need to understand that what we put into our bodies dictates how they function and deal with illness.
When I refer to food as ‘medicine’ I’m not talking about simply using ‘natural medications’ or food supplements instead of pharmaceuticals. I don’t advocate swapping your cholesterol-lowering drugs for a bag of nuts if you have abnormal biochemistry, for example. A traditional pharmaceutical model of healthcare where symptoms are treated individually is not the answer to our Western healthcare woes. It’s important that we don’t look at food like a ‘pill’. No magic bullet in the form of turmeric supplements, green tea shots or pomegranate juice exists, I’m afraid.
A complex interplay of diet, sleep, exercise and stress underlies the root cause of disease. This relationship between our environment and human biochemistry is alien to most conventionally trained doctors like myself, and we must redress the balance.1 The reason why I’m so nutrition focused and I believe in the power of ‘plates over pills’ is because it’s the easiest, most cost-effective and evidence-based method of preventing and reversing disease. The effect of a Mediterranean diet on cancer,2 diabetes3 and cardiovascular risk4,5 is a simple example of this statement in action. By improving patients’ diets we can drastically reduce the likelihood of all three common debilitating conditions to a far greater degree than any number of pills or surgical interventions.2,5
This is the direction in which medicine should be heading. Nutrition, along with other lifestyle factors, is where we need to concentrate our studies and resources. I’ve come across enough research and had enough personal experience in clinic with patients to judge that nutritional medicine is not a fringe concept. Dietary strategies are being trialled to reverse diabetes6,7 and even address the tricky and controversial subject of dementia.8 The added advantage of taking a nutritional approach to tackling