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Michael Mosely: eat light, pedal fast -

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Robyn Williams: You'll remember Dr Michael Mosley with his 5:2 diet on The Science Show and SBS television, now repeated on BBC Knowledge. The point about Michael is he's a doctor, and so is his wife, so he knows the science and what your GP gets up to on the other hand. Could there be a gap?

Michael, we talked last time a few weeks ago about the diet. Are you still on the diet?

Michael Mosley: I am, I'm actually doing a sort of variant at the moment, what I would describe as 6:1, so I do it once a week these days because the research suggests that you can retain the benefits and also keep the weight off doing that. And there was a danger I was getting too skinny. I am now about 12 kilos lighter than I was when I started, and there comes a point where you have to choose between your face and your body.

Robyn Williams: So you're not being a recidivist?

Michael Mosley: I'm not at all, but I don't want to get super skinny because I think that's probably unhealthy as well.

Robyn Williams: What do you do on the one day?

Michael Mosley: I basically have scrambled eggs and a bit of ham for breakfast, and then I skip lunch, and then I have a big pile of vegetables and a bit of salmon or something like that in the evening.

Robyn Williams: How secure are you in the science of what you are doing, given the variety of information there is everywhere?

Michael Mosley: I am confident that intermittent fasting does bring benefits. It's particularly powerful and compelling when it comes to insulin sensitivity, and that was my motivation in the first place because I didn't get on this to lose weight I got into it because I was told by my doctor I was a diabetic, and my dad died of diabetes-related illnesses, so I wanted to do something about it. So I think that's quite compelling.

I think the evidence that going on and intermittent fasting regime might reduce your risk of dementia is enough to motivate me to do it, and it's certainly enough to motivate the people who study dementia to do it. But I think it's going to take 40 years and numerous trials before you have compelling evidence.

In the area of nutrition it is incredibly difficult to prove anything, just simply because you need huge numbers. So I would never claim that anything like this is even remotely proven. But I think there is a body of evidence that is building up.

Robyn Williams: On the other hand you could have taken a kind of relaxed point of view and said, well, my father was…was he 72 when he died?

Michael Mosley: He was 72, yes.

Robyn Williams: That's pretty good, and given the extra time you might have lived anyway, you could have coasted through, surely?

Michael Mosley: But I don't want to become diabetic because of all the complications. I look at the figures…I don't want to be impotent particularly, and I know my father, God rest him, was impotent towards the end. There are also various cancers associated, he had prostate cancer, I have an increased risk of that. When I had the test done before I got into this, my IGF-1 levels were very high, and those have all come down as well. So all the biomarkers have improved. In Britain we live a good long time, but the trouble is we live in ill health for the last 20 years. I don't particularly want to live until 90, but I do want to live in maximum health and I want to be happy, cheerful, getting around, I don't want to be popping 16 pills like the average European at the age of 65.

Robyn Williams: Do you know, there's a paradox, and it's represented by these programs that, well, to some extent that you do and I certainly do, where we have frontline medicine telling us all sorts of things about genomes, about proteins that can be given and different drugs and so on, and all this wonder stuff, and yet you look to the high street where the doctors are, and how many of the doctors actually know any of that or act upon it? And how can people like us actually get into the doctors? I know the last time I went I had to make three attempts at booking, and by the time I had four minutes consultation (or was it three and a half?) that was $75 plus $55 for the drugs. You know, the gap between the high-powered science and the everyday stuff that is happening in the street is colossal, is it not?

Michael Mosley: It is, absolutely, and there is a huge gap in knowledge as well because…I don't know what the average gap…it is probably about 10 years between what the scientists know, what the doctors and the nutritionists find out, and what the general public eventually get told, and by that time the science has probably moved on hugely. But the thing that encourages me is eventually it does get through. I think the only way you can really get to grips with it is by listening to wonderful programs like this one, buying wonderful books like mine, and you will find out what scientists really think now without having to have it mediated via the doctors. In this world of the internet where I think, after porn, health is the most searched-for thing, the most important thing is to go to places where you can actually trust information. There's an awful lot of nonsense out there.

Robyn Williams: Tell me, what do you tell your wife, who is a GP, about this gap, and whether she actually knows anything about what she is talking about?

Michael Mosley: We talk all the time and she is really, really helpful, and she loves the knowledge. She says she finds it very frustrating that patients come in from the diabetic clinic and they are still being told rubbish. She saw somebody the other day, diabetic, sugars all over the place, that's because he's eating white bread and lots of rice, and that's because that's the information he's been given by some diabetic website. And she is saying to him, 'You might as well just be ladling sugar into yourself.' Nobody has told him any better. And she finds that incredibly frustrating.

Robyn Williams: Do you know, from the University of Queensland, and I got the information about six weeks ago, the figure for how many Australians actually eat regularly fresh fruit and veg, it's 5.7% of the population. That is miniscule.

Michael Mosley: That is absolutely depressing as hell, I have to say, and I also understand it. One of the reasons that I got into intermittent fasting is we have not got used to being hungry. I think one of the things that happens when you're hungry is then you might actually reach for a vegetable. You might obviously reach for a pastry or a bar of chocolate, but if you can be persuaded to reach for a vegetable you'll discover vegetables are actually quite nice and that they will fill you up, and I think that's the real challenge for educationalists going forward; how do you get the message out there in a way that actually compels people to act as opposed to just closing off their ears?

Robyn Williams: Yes, we thought we knew about what is good food, but ten years ago, five years ago, we thought that a nice big glass of orange juice, fresh OJ was good for you, and you come along and tell us otherwise.

Michael Mosley: I mean, compared to some of the things you could consume I suspect it's not bad, but the trouble is…fibre is king, it's really about fibre, and the problem with orange juice and apple juice, that when you just drink it as a fluid you might as well be just having a big sugar hit. There is about 6 to 7 teaspoons if not tablespoons in some of these things, and that just sends your blood glucose levels crazy. And also we know that if you eat an apple it will fill you up. If you drink an apple juice it will have no impact whatsoever on the next meal you eat.

So what has happened is the kind of five-a-day campaign has been hijacked, of which apple juice, orange juice and smoothies is…I'm not a fan at all, but there are worse things, like tinned spaghetti hoops that will call themselves five-a-day but which are just packed full of rubbish. And that's the trouble is the health messages, immediately the food industry gets out there and they find a way to turn what is actually not a bad idea into a terrible idea.

How did our ancestors do things? Well, they had periods of feast and famine. When they exercised, did they really exercise…know what they did? They did a lot of walking, hunter gatherers do walking and they do it out in the sunshine. Sunshine is actually quite good for you, vitamin D is good for you.

Robyn Williams: And also to pedal quite a lot, because you demonstrate wonderfully in one of the films how you can pedal like crazy for two minutes or is it three minutes a week with intense effort, and that apparently does you, it clears out the glycogen, it really sets up the body and it doesn't give you a heart attack.

Michael Mosley: Absolutely, and that's really interesting, because again, hunter gatherers, when you observe them they do have short periods where they sprint, whether it is running away from something or it's trying to capture something, they do have these moments where they go for it, although most of the time they are not doing that. It's not long sustained running, it's short bursts. And this is what they call high-intensity training or HIT. Most athletes have been doing it for an awful long time, but it is now entering the mainstream.

And the idea is that possibly doing lots of low impact exercise is not the best way to go. The way you want to do it is increased general activity, get off your bottom every 20 minutes or so, walk those stairs, increase the amount of time you walk, but intersperse that with short bursts of really quite intense stuff. So I get on the bike, I pedal like crazy for 20 seconds, breather, 20 seconds, breather, 20 seconds, and that's it. And one of the programs, The Truth about Exercise, you see me do that, extremely sceptical, I have to say, that it would have any difference, but actually the changes were quite profound in just four weeks. This is early days, and again, rather like the intermittent fasting, we don't really know what the long-term impacts are, but certainly in terms of biomarkers it's very impressive.

Robyn Williams: And Michael Mosley's book is also impressive, it's called The Fast Diet, and his series continues on BBC Knowledge.