The Doctor’s Kitchen. Dr Rupy Aujla

It’s true that some research has shown benefits for urinary-tract disorders⁴⁷ and irritable bowel,⁴⁸ but the study of which bugs can potentially impact a condition is still very much in its infancy.^49,50

      For now, I encourage experimenting with different ingredients like traditionally prepared kimchi, sauerkrauts and probiotic yoghurts that are full of different strains of bacteria that may have benefits.^51,52,53 Look for unpasteurised varieties usually found in the fridge section of supermarkets. Experiment by folding them through salads or simply adding them to the side of a dish as a garnish. They can complement the simplest of dishes and add another dimension of flavour.

      I see the popularity of foods to help our microbiome as a return to traditional methods of eating …

      • Polyphenol-rich foods like cacao, dark green leafy vegetables, beetroot and green tea are richly coloured and intensely flavoured ingredients that bring a host of benefits to your body.⁵⁴ Polyphenols are chemicals we find in plants of which there are literally thousands. Some of them have been shown to improve the gut lining, encourage growth of microbe patterns that are beneficial as well as have other advantages to general health. My recipes are designed to incorporate as many different polyphenol-rich foods as possible.

      • Spice your food. Turmeric, cumin, sumac, cinnamon and caraway are just some of the ingredients that improve the aroma and taste of foods, but spices in general are another source of polyphenols. We’ll talk more about them in the Medicinal Spices section (see here), but for now consider that the inclusion of these fabulous ingredients could potentially have positive effects on your gut bugs by reducing inflammation.⁵⁵

      • A varied diet is key. Your microbes thrive on new, interesting foods, which is why eating seasonally, for example, may encourage you to change things up throughout the year. We want to make sure your microbes are not bored with having the same meals and studies suggest they tend to favour diversity!^56,57 There appears to be an improvement in the range of gut bacteria populations when a variety of foods are consumed, so here’s yet another reason to try out some gorgeous, colourful recipes and mix things up.

      • Raw foods. I’m not a raw foodist, nor do I advocate a completely raw diet. And, contrary to popular belief, cooking doesn’t destroy all the micronutrients in foods. Sometimes, cooking can actually increase the availability of phytochemicals,⁵⁸ like in the case of tomatoes⁵⁹ and broccoli.⁶⁰ But, having some raw foods in your diet like celery, kohlrabi or radicchio is great for the bugs. It makes another argument for not overcooking your vegetables and keeping a little more texture to your food, too. Nobody likes overcooked sprouts!

      When it comes to a holistic approach of how to look after our microbiomes there are some other suggestions outside of our diets that I encourage patients to think about as well.

      • Avoid antibiotics. Your doctor is trained to recognise and prescribe these when there is a clear need for them, but far too often we see them used inappropriately.⁶¹ Antibiotic medications indiscriminately remove large proportions of bacteria including the beneficial types that are good for us,⁶² so I always encourage a reserved attitude to using and requesting them. You are more likely to convince your doctor to hand them over inappropriately by pressuring them, than if you trust their pragmatic and informed decision.

      The Royal Colleges of medicine and editors of medical journals are very aware of the growing problem of antibiotic resistance.⁶³ The huge impact on our gut microbe population^64–67 is another reason why the medical community is trying very hard to reduce antibiotic use. Our microbiome is integral to health and antibiotics have far-reaching implications that we are just beginning to realise the magnitude of. So, for now, trust your doctor’s opinion and keep in mind that while you’re on antibiotics it’s even more important to follow my suggestions to keep your microbiome as nurtured as possible.

      • Refined carbohydrates, sugars and sweeteners all have a number of links with poor health outcomes. Their effect on your microbiome is an addition to the growing list. I would exercise caution for any ‘diet’ versions of popular drinks and any foods with synthetic sweeteners as they can adversely affect your microbes.⁶⁸ I still use a little sugar in recipes as an ingredient to heighten flavour and taste because it’s not a bad thing when used sparingly. But there are clear disadvantages to consuming it in excess, and indulgence will affect your microbiome population for the worse.⁶⁹

      • Exercise, laughter and mindfulness are not what you’d typically expect on a conventionally trained doctor’s prescription pad, but it’s definitely on mine! As well as the wealth of positive effects on mental health and wellbeing, daily meditation and exercise may also have a positive impact on the microbiome.⁷⁰ You don’t need to wear fluorescent leggings and stare blankly into the abyss. Mindfulness is any action that quietens your inner thoughts and allows active mental rest. Try a guided meditation app, breathing exercises or simply gardening as a way of releasing inner tension and letting the mind relax.

      The science examining our microbiome is accelerating at an incredible pace. I’m sure we will learn more in the coming years about how to nurture this inner population that is inseparable from our wellbeing. I truly believe that future approaches to medicine will involve a significant appreciation for ‘gut health’. My recipes will show you how to keep your gut bugs happy, which will ultimately have a wealth of good effects for you.

      I’ve written more about these lifestyle changes on my website: www.thedoctorskitchen.com

      Fibre champions

      We need a greater awareness of where we can get fibre into our diets, and these are some of my absolute favourite fibre-rich ingredients. The official recommendation is at least 30g of fibre per day, but I see that amount as the bare minimum.

      Food is information

      Our culinary journey through food in medicine could not be complete without visiting the topic of how food and lifestyle affect the very foundations of our existence.

      Genes, made up of DNA, are what we inherit from our parents. They are the molecular code for characteristics such as how we look, the likelihood that we will get a chronic disease and even our behavioural traits. They also regulate intricate processes in the body, such as how we deal with inflammation and remove cancer cells. Vitamins and minerals, as well as things such as sleep quality and stress, can all impact the factors that alter the expression of our genes for better, or worse, health.

      What has this got to do with food? Everything.

      Micronutrition and the timing of when we eat as can alter our gene expression.^71,72 Our food is constantly communicating with our DNA.

      This area of research is adding yet another layer of complexity to the scientific study of why and how what we eat affects our health. There is a wealth of information available on this subject far beyond the remit of this cookbook! If you are interested, I have extra information on my website, www.thedoctorskitchen.com, including links to reading materials on subjects such as nutrigenomics, nutrigenetics and epigenetics.

      Despite its complexity, I included this section because I want you to appreciate the incredible effect food has on our longevity. I want to share some insight into the fascinating studies that have framed my understanding of how food has positive effects on our bodies.^73,74 It explains why I try to weave certain ingredients into my dishes that tick the boxes for both flavour and function. By including these delicious ingredients in our diet we can potentially affect our genetic functioning for the better.⁷⁵ Today, we can start this colourful and enjoyable journey toward good health.

      I hope this motivates and inspires you to look at adapting your diet