Dr. Sarah Berry
speaker
566 appearances
3 recordings
3 series
first heard Nov 2024
last heard 18 Dec
Dr. Sarah Berry’s voice in public audio — every appearance, attributed to the second.
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Appearances
I think the important thing is to say, try and just do something simple, because it's only by doing something simple that's easily implementable that you're going to actually have a long-term success.
effect because it's only that that you can sustain and so something that we've been doing quite a lot of research on in my work at King's College London is looking at snacking and we know that on average 20 to 25 percent of our energy comes from snacks so they are a simple single strategy that we can implement to improve our health and we recently conducted a study at King's where we
It was a randomized controlled trial. Half the people consumed typical UK, US snacks. Half the people were randomly allocated instead to consume almond nuts. What we found was those that, and nothing else changed. We said, do absolutely everything else, eat all your other meals the same, do the same physical activity, et cetera.
Just by changing the snacks that people were eating reduced their blood lipids, improved their insulin sensitivity, reduced all these other kind of unhealthy aspects related to their long-term health. And when we equate that to the long-term risk of cardiovascular disease, changing from typical US-UK snacks to nuts reduce the risk, the estimated risk of cardiovascular disease by 30%.
And I think that's really powerful. So yes, I agree with you. It's hard to make dietary change, but you know what you can do. Find a simple, single strategy that works for you. And that's just an example of one of the kind of things you could do.
Okay, yeah.
But we energy matched. So it was a proper controlled trial. So both groups had exact 20% of their energy, either from these pre-provided snacks to represent the typical US and UK snack, or 20% from almonds. And they were asked to eat them all. And so if they were starting to feel full, then they adjusted what they ate at their next meal, i.e. whatever their main meal or lunch was, for example.
But they had to eat all of these snacks. And we still saw that huge difference.
I think that many practitioners need to get better training in the metaphors in diet. You know, in the UK, our family physicians will have a matter of less than 10 hours of training in diet and nutrition. They have apparently, as I've heard, it might have changed recently. two to three hours on the menopause. So I think firstly, they need to be better trained in understanding the menopause.
I think that unless a woman is going through it, or is being very conscious in trying to teach themselves about it, then I don't think that it's easy to really understand what an individual experience is. So whether it's your physician or whether it's your husband, your partner, your friends, I think there needs to be a greater understanding of just how much it does impact women.
In terms of hormone replacement therapy, I'm not a medical doctor. I'm a research doctor. So it's really important I caveat that I can tell you what I believe based on the evidence that's out there. And I believe that the evidence for hormone replacement therapy, if delivered
transdermally, so using like the gel or patches, if given at least within 10 years or even five years of people becoming menopausal, but preferably starting at the first stages of perimenopause, that there are benefits in terms of symptoms. We know that. That's, I think, irrefutable. Everyone differs in terms of how effective the hormone replacement therapy is. Some people have huge benefits.
Some people don't have a huge benefit. but on average, people will benefit. What we see from our data, and I think there's a growing body of evidence around this, but it's not conclusive yet. What we see in our data is if individuals are taking HRT, they do have lower risk of these intermediary risk factors. They have
In our data, lower blood pressure, lower visceral adiposity, lower bad cholesterol, the LDL cholesterol, lower inflammation, better insulin sensitivity. These are all risk factors for chronic disease.
We cannot say conclusively yet whether taking HRT will reduce our risk of heart disease, type 2 diabetes, et cetera, because we haven't been studying it long enough in the way that it should be delivered. In the past, hormone replacement therapy was given orally as a tablet, which we know is metabolized very differently to how transdermally, so with the patches or the gel, it's metabolized.
We know if it's given orally, for many women, it might not have the same favorable effects in terms of these intermediary risk factors because of how it's metabolized by the liver. In the UK, I don't know what it's like in the US. HRT is given transdermally now. It's not given orally because we know that it can have an unfavorable effect if it's given orally.
And so based on what evidence there is for transdermal, so the application to the skin HRT, I would say that there are discussions that every practitioner should have with a perimenopausal or postmenopausal women.
as long as it's within 10 years of them becoming postmenopausal, about how it's going to improve their symptoms and about how it may impact some of these other cardiovascular risk factors. It's not licensed in the UK for prevention of cardiovascular disease. So I'm saying this with a note of caution and just telling you based on the results that we received.
have here i take hrt that's my personal choice it's benefited me there needs to be those conversations healthcare practitioners need to be really well educated in how menopause impacts not just symptoms but their disease risk and what can be done whether it is hormone replacement therapy or whether it's alternative therapies i think what we haven't touched on though drew
and which I think is really important, is the whole area of these other therapies that people try, supplements. In the UK, we use this term called menowashing. I don't know if you've heard of it before.
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