Webinar Replay

Lifestyle Medicine Doctors Answer Your Questions | Night cramps, Asthma, Folic acid



On this Q&A plant-based doctors answer questions about supplements to help with night cramps, foods that help with Asthma, and folic acid supplements.

Questions Answered

  • (00:35) – Could you share what you guys are doing for Halloween and kind of to get through this time when there's a lot of candy and sweets around?
  • (05:50) – My daughter, age seven, was recently on three rounds of antibiotics. And her nutritionist has advised us to keep her away from sugar while she's on this five week protocol. Would it be okay to give her a few pieces of Halloween per day?
  • (12:27) – What are the best foods for asthma, COPD?
  • (17:14) – I'm currently following Dr. Klaper's leaky gut protocol myself with the supplements for six to 12 weeks. Is it good to repeat this periodically for maintenance? Is there an abbreviated protocol that might be beneficial?
  • (22:21) – Is there a supplement that would help with night leg cramps?
  • (25:28) – How do you find a cardiologist that promotes plant-based eating?
  • (28:51) – How early should someone start taking folic acid supplements before becoming pregnant? Is getting folate through diet alone sufficient?
  • (32:22) – Any other specific reasons why the fat issue is so different for folks trying to heal autoimmune disease?
  • (34:47) – I am in menopause and gaining weight. I'm only 43 and want to know what can I do?

Complete Transcript

Dr. Chris Miller

(00:00)
I actually wanted to start today off by talking about Halloween and what everyone is thinking. And if you guys could post for us in the chat box, or if you're on Facebook. I guess, let me get my Facebook Live up here so I can see everybody on Facebook. If you could post for us, if you have challenges or what you're doing for Halloween, or with all the candy that's coming around, with all the sweets. With holidays and parties and things coming up, it's starting to get a little bit hard.

Dr. Chris Miller

(00:35)
And if people are on our plans, trying to heal and recover and doing great, we don't want to be sabotaged. So I'm curious what people are thinking, if anyone is struggling or having any concerns. And then I'll share what I'm going to do. And I'm curious, Elisabeth or Niki, when you're done messaging, if you could share what you guys are doing for Halloween and kind of to get through this time when there's a lot of candy and sweets around.

Dr. Elisabeth Fontaine

(01:02)
Well, I don't mind to start. But usually, you know, when I had kids, it was a little bit different. But usually I go to a friend's house and we definitely put some costume, very appropriate. It's never the same every year. My husband used to make amazing costume.

Dr. Elisabeth Fontaine

(01:20)
But we made the effort, because people don't know in the environment here, we started something that was called Rise Vermont. So it's community collaborative to help the kids and the whole community for a better lifestyle. So we make an effort to choose what we're going to offer the kids.

Dr. Elisabeth Fontaine

(01:40)
And the thing is that the street that this person is, there's tons of kids that come. But it's more like people making the effort of putting the accent of the way that they put the costume. And we really are out there with the kids and playing.

Dr. Elisabeth Fontaine

(01:57)
The things that we give is usually not candy. We usually try to give something that could be useful for art. Pencil, they have the Rise Vermont on it, or things like that, to encourage. So I don't know how much they like it, considering that they probably open the bag after and they say, Okay, there's no candy. But it's a slow change. And I think that what the kids, especially for that, what the kids are looking for is to have crazy people like us that kind of play with them and show them that we can have fun. And you know that it's, so I'm not talking about food that I'm eating, but more for the kids. That was my input. So I don't know about you guys.

Dr. Chris Miller

(02:37)
For me this year, I'm excited about Halloween because I am giving out glow sticks. And we have a lot of kids in our neighborhood and they're so cute and they're little and we know them and our neighbors' friends. And so we bought little glow sticks, because I didn't want to give out candy. So I'm excited about that. And Clara wrote here, thank you, she wrote, few parties with COVID. So that's true. Hopefully that is true. And people won't be gathering too much. But I know my neighborhood, we definitely have trick-or-treaters. Yeah. So no candy from us.

Dr. Niki Davis

(03:10)
Well, I wish that I could bring my son to your house to go get some glow sticks. That would be fun. You're a little too far away. But we also, you know, we don't do candy either. So we give out little toys and pencils, and things like that. And I have to say, we get kids that are excited about it because it's something different. And we do a lot of different things they can choose from. And so far, I mean, we have even little tiny things that… The little bubbles where you can blow bubbles. And so lots of different things to choose from. And, yeah, we've had kids loving it. So that's what we like to do.

Dr. Elisabeth Fontaine

(03:49)
Yeah. This year, I think I'm going to be traveling and it's going to be a little bit warmer. So I won't be at the place to do costume, but I'll be biking. So I was thinking about putting some sort of a crazy thing on me, like a spider in my head. And maybe I should carry thing for the kids. It might be interesting.

Dr. Niki Davis

(04:11)
Yeah.

Dr. Elisabeth Fontaine

(04:12)
[inaudible 00:04:12] some ideas. I don't know how much I want to carry on my back, but something nice, like multiple little crazy thing, not food. Or whatever, even if it was good food, it's always, need to be very careful about what we bring and what we offer. Because we've seen so many crazy things.

Dr. Elisabeth Fontaine

(04:28)
But it certainly can be a fun event. You don't want to make it like, yeah, there we go, we're not there… So now the kids have a chance. So I can see also people are really decorating. I mean last year, I don't know this year how it's going to be. But last year was phenomenal, to see the color, the pumpkin and the road just lights up. And that was very important for people to feel that something was going on. So that's great.

Dr. Niki Davis

(04:59)
So we did some pumpkin carving this week and we roasted up some pumpkin seeds. Do you guys ever do that? They're so good.

Dr. Chris Miller

(05:08)
Oh yeah, for sure. How did you roast them?

Dr. Niki Davis

(05:11)
So I just did them, actually I used my air fryer. And I just kind of guessed at the time, and the temperature, and they worked out perfectly. And I put a little bit of paprika on them. I was kind of looking up to see what kind of spices to put on them. And the one that I saw was the pumpkin pie spice, which I thought, I don't know if that sounds very good. So I just did a little paprika and it was excellent.

Dr. Chris Miller

(05:37)
Awesome. Awesome. That sounds delicious. Well, we're getting some questions here. And some few more people saying, “Hi,” I'm looking at Facebook Live now. So we made at work this week. Krishna says, “Hi.” Hi.

Dr. Chris Miller

(05:50)
And we got a question here from Kristen, hi Kristen. She says, Hello. My daughter, age seven, was recently on three rounds of antibiotics. And her gut is pretty messed up. She's on a couple supplements to help. And her nutritionist has advised us to keep her away from sugar while she's on this five week protocol. And of course, to minimize ongoing. With Halloween it's so tough. Would it be okay to give her a few pieces of Halloween per day? Day, it says. Halloween candy, I think she means. Or would it be okay to have one small piece a day for a few days? Any way to moderate at all? What do you guys think?

Dr. Niki Davis

(06:28)
Well, I would say in trying to get the good gut flora to kind of replenish… Because I think some people don't understand that an antibiotic literally… I mean, certain antibiotics work better for certain bacteria, but they still kill off some of the good bacteria. And that's the issue with an antibiotic, is it does get rid of the antibiotic that is causing the issue, but it can kill off the good bacteria too.

Dr. Niki Davis

(06:59)
And so making sure that you are eating a really healthy diet, that feeds those types of good bacteria to help them flourish. So lots of fiber. I mean, you've got bacteria that just live on fiber and all of the good whole plant foods. So, in my mind, as long as you're trying to do a really good healthy whole plant food diet to help that kind of come about, a little bit of candy here and there isn't going to hurt things in my thought. That's just my thought. As long as most of the time, 99% of the time, you're doing those whole plant foods to kind of help feed those good bacteria.

Dr. Elisabeth Fontaine

(07:38)
I love it. Dr. K is coming in at the bottom, it says to Niki Davis.

Dr. Niki Davis

(07:44)
Oh it does. That's so funny.

Dr. Elisabeth Fontaine

(07:47)
Yeah. That's okay. He probably used your link, but that's okay.

Dr. Chris Miller

(07:52)
We all shared links this time to get on. So I would agree with Niki about the antibiotics. And the goal is to just do your best, is what I always recommend to people. And so she's seven and candy is everywhere, and it's so hard. So you as a parent have to just sort of decide, maybe it's worth that one little piece of treat.

Dr. Chris Miller

(08:15)
I always try to do healthy treats. So maybe you can make oatmeal cookies, with things that don't have sugar in them. Some of these wonderful plant-based recipes out there. So she has treats that she can have that don't have sugar in them. So you can keep her on track. But, again, I understand we're just doing the best we can. And again, she is seven, and so that's really difficult, given Halloween. So, yeah, that's a really good question.

Dr. Elisabeth Fontaine

(08:40)
What do you think, Dr. K, about Halloween and how do you do this? We discussed that…

Dr. Chris Miller

(08:48)
Yeah. We're trying to figure out for seven year olds and young kids, what's the best way to help them through Halloween.

Dr. Michael Klaper

(08:55)
What did you like to have in the bag when you were seven years old?

Dr. Elisabeth Fontaine

(08:59)
Lots of candy. No, I wonder if the company has, did they come yet with plant-based candy? They come with all of these food that are kind of fast food vegan. But in this, for the occasion to have something that could look like candy for the kids. It's not perfect, but it's an idea.

Dr. Michael Klaper

(09:26)
Mm-hmm (affirmative). I just sit on my porch and play the grumpy old man and say, Get off my lawn. And, Get away from here. Bah humbug. And [inaudible 00:09:44] used to hate it when they used to put an apple in your bag there, or an orange. That never was a big hit there.

Dr. Michael Klaper

(09:52)
I like your idea of the oatmeal cookies. At morning, I'll probably go to a Whole Food somewhere and see if there's anything semi sweets or chocolate or whatever, that's got minimal sugar in it. For one night, it's not important to the kids. Strange custom, all the way around.

Dr. Michael Klaper

(10:10)
It's very interesting the way the holidays, whatever Christmas was, as far as the positivity and love and all that, that seems to be diminishing and Halloween, this night of horror and terror and scaring people and fear and monsters, it's become the Christmas decorating time. And some of the displays around here are just jaw dropping. And some of the front lawns, there are cemeteries and all those flying creatures and skeletons.

Dr. Michael Klaper

(10:50)
It's commentary, I guess, upon the times we're in, of course. Like the movies that are being made now. And so how do you put as much positivity into it as you can? You know, there are still little kid, there's still six year old fairy princesses out there, you know, and you really want to cheer them on. You want to make them feel safe and seen. And in on the joke, you know, on the celebration of it.

Dr. Michael Klaper

(11:20)
And I don't know if they like semi sweet chocolate, but that's probably what they're going to get. I suspect. I'll buy something vegan to throw in the bag. I'll go to Whole Foods and let you know if I see anything interesting. Trader Joe's may have something, let me go over there, check it out. Let me know if any of you find anything good that's only semi-toxic.

Dr. Elisabeth Fontaine

(11:42)
Semi-toxic.

Dr. Chris Miller

(11:46)
Oh yeah. It's a tough one. So we have some more questions here. First of all, Denise Rose is saying she's wishing Dr. Marbas a very happy birthday. So Dr. Marbas is not here today, but it is…

Dr. Michael Klaper

(11:57)
Oh, really?

Dr. Elisabeth Fontaine

(11:57)
Is it today?

Dr. Michael Klaper

(11:57)
Today? She's 21. Finally made it. She can drink legally now.

Dr. Chris Miller

(12:06)
So Laurie, we're sending you some birthday wishes and hoping you're having a wonderful time right now.

Dr. Michael Klaper

(12:12)
Absolutely.

Dr. Elisabeth Fontaine

(12:12)
Are we singing? Are we supposed to sing happy birthday? Do you think she's listening?

Dr. Chris Miller

(12:17)
We'll sing when she's back.

Dr. Michael Klaper

(12:18)
Okay.

Dr. Elisabeth Fontaine

(12:19)
I'll do it in French for her.

Dr. Michael Klaper

(12:20)
Good.

Dr. Niki Davis

(12:20)
There you go.

Dr. Michael Klaper

(12:20)
You don't want to hear me sing.

Dr. Niki Davis

(12:23)
Oh I know that one, I think. In French.

Dr. Chris Miller

(12:27)
Leslie here is saying, What are the best foods for asthma, COPD?

Dr. Elisabeth Fontaine

(12:34)
You know, it's interesting. I'm going to let Dr. K… It seems that for me, whatever chronic disease that we're talking about, the best diet is the whole plant food diet. So to me it would be like being too specific on one thing. I kind of have a vision of a holism. Who is the physician, not the physician, the PhD that always talk about holism at [inaudible 00:13:01]. He wrote the China Study. So I say it a little bit like that, and think that if you really make an effort to go toward the best you can, toward a variety of whole plant food base, I think you got it. But maybe Niki and Dr. K has more specific or even Chris, answer.

Dr. Michael Klaper

(13:24)
Well, just some common sense advice from the respiratory clinic there. That when you're dealing with people with chronic obstructive pulmonary disease, they have diseases both, [inaudible 00:13:37] both in their bronchial tubes, carrying air to the air sacs. And in the air sacs themselves they're all dilated, blown out.

Dr. Michael Klaper

(13:45)
And so anything that produces irritation or swelling or more mucus, if from the lining of the bronchial tubes is not the owner of the [inaudible 00:13:58], to say the least. So the classics, of course. If there's any dairy in your diet, read the labels, whatever. But yank dairy out, that's kind of notorious for it. And I would probably, as pain in the posterior as it is, to go gluten free for 90 days, or three, four months. I would really get the gluten out. No matter what the blood tests show, the only way to really tell is yank it out for a few months and see how you do.

Dr. Michael Klaper

(14:22)
And then third, if your COP suddenly gets worse and there isn't an obvious cause, you didn't go for a bike ride behind a bus or something. Or if you weren't sitting in the room with a smoker. If you're suddenly starting to wheezing and cough, et cetera, it's a valid question to ask, What did I eat yesterday? Because there is a good chance something in yesterday's food stream has been absorbed in your bloodstream, flowing through your bronchial membranes, et cetera, maybe setting off some type of internal irritation if you will.

Dr. Michael Klaper

(14:57)
So if there's any [inaudible 00:14:59], then we open up that jar of pickles. I've seen sulfides, nitrates, make it worse. So if there's any question, think about what you ate yesterday. Eliminate any possible culprits there, and see if it gets better. And then maybe a week or two later, have that food again. And if you get all tight and wheezy, well, that's all you need to know. There's something in there you're reacting to. That's all you need to know. Don't eat that food there. But yeah, make sure the dairy and the wheat is out for a good long time.

Dr. Chris Miller

(15:33)
And I would agree, completely agree with that. And COPD is very difficult because you can get these exacerbations and not necessarily know why. Or if you get a little infection or something. But I also really emphasize, so we're all whole food plant-based, we're assuming that with this, because we're Plant Based TeleHealth. But really make sure you're not getting any dairy products in, like even an accidental exposure. That will really trigger off your lungs.

Dr. Chris Miller

(15:57)
And I find in some asthmatics that sugar can be a major trigger as well. So even if you're eating plant-based, but you are getting a little sugar in, even like natural sugars like maple syrup or… I would really try to keep that out. And sometimes even grinding oats into oat flour and then baking with it, even that is too much for some asthmatics.

Dr. Chris Miller

(16:19)
So you really want to emphasize the whole foods and make sure you're eating plenty of raw green leafy vegetables and cruciferous vegetables. Those phytonutrients, especially when they're raw, they're really anti-inflammatory. And a lot of asthma and COPD is airway spasm and inflammatory component to it. And so you can improve that part of it, at least, with the raw green leafy vegetables, colorful berries, things like that. So really emphasize that.

Dr. Chris Miller

(16:45)
So it's got to be a whole food plant based diet that's done well, not just a plant based diet. So if you're not working with someone, maybe someone can help you or maybe you already know that. But hopefully that will help it be a little bit better as well.

Dr. Chris Miller

(17:01)
And here Kip is sharing with us, for treats I plan to make some of these. He shared some Monkey and Me Kitchen Adventures. So there's a link here. If people want to take a look at that, I haven't seen it yet. Thank you Kip.

Dr. Chris Miller

(17:14)
And I have another question here. Let me pull this up on Facebook Live. This one's for Dr. Klaper. It says, where did it go? Oh, here. Kristen says, Thank you. I'm currently following Dr. Klaper's leaky gut protocol myself with the supplements for six to 12 weeks. Is it good to repeat this periodically for maintenance? Is there an abbreviated protocol that might be beneficial?

Dr. Michael Klaper

(17:40)
Is this someone with autoimmune disease or IBD, or why are they doing this? Do they say why they're doing this?

Dr. Chris Miller

(17:47)
Kristen, if you can respond why you're doing this. She says she's just following your leaky gut protocol, but she doesn't say why here yet.

Dr. Michael Klaper

(17:55)
Leaky gut protocol. Should she repeat that? Only if she has signs of leaky gut. If her joints start getting… So whatever it was that, whatever symptoms she had that was tied in to that diagnosis, they reappear. Absolutely. If you get the skin rash back, you start wheezing or you get the migraines back, whatever.

Dr. Michael Klaper

(18:17)
But also again, what have I been eating or drinking? I mean, leaky gut is not a natural state. That's the sign of an injured membrane from either direct chemical assault from all the things we're eating and drinking, or from the microbes that get spawned from what we're eating and drinking. And so be honest with yourself. If you've been eating out in restaurants for 10 days, been traveling or whatever. Or if you've increase your alcohol intake or processed food. And plus these symptoms come back. Yeah. There's probably all the evidence you need. Probably wouldn't be a bad idea to repeat, clean up the diet, get on the [inaudible 00:19:00] and the glutamine for a while. And might want to take a probiotic, controversial if that does much.

Dr. Michael Klaper

(19:07)
But yeah, if you think, especially if you've been there once before and you got diagnosed, you know what it feels like. Yeah. If you feel like it's coming back, jump back on the protocol and do it as often as you need to. Few weeks of really clean eating can't hurt. So yes, I would definitely do that.

Dr. Elisabeth Fontaine

(19:24)
Okay. Would you mind sharing with us at large, what you suggest for your protocol?

Dr. Michael Klaper

(19:33)
Well, this was if… Again, especially if you've got, sent off a leaky gut test and intestinal permeability test, it came back positive, leaking all sorts of [inaudible 00:19:46] into the urine, et cetera, and it's obviously a leaky gut. I yank everything out, except either quinoa or brown rice, steam greens, steam yellow vegetables, non-citrus fruit. And I just hold them on that for two weeks, three weeks. And for whatever, and if you do a Google scholar lecture search on leaky gut, intestinal permeability and quercetin, Q-U-E-R-C-E-T-I-N, there are studies showing that it tightens up the tight junction between cells and can decrease leaky gut. So they get them on 500 of quercetin twice a day. Again, just for six weeks. It's not forever. They go through one big bottle of the stuff, that's usually enough.

Dr. Michael Klaper

(20:34)
And glutamine always helps the intestinal bacteria and intestinal lining cells. So I get them on glutamine 250 or 500 milligrams twice a day. That's it. And you know, probiotic used to definitely be important. Now the studies we're seeing, they don't do that much. They don't last that long. But if someone's, if we're trying to throw the kitchen sink at them, yeah I'll have them get a vegan probiotic, non-dairy probiotic. And I'll have them on that. And again it's just for like six weeks, this is not forever and ever. You [don't 00:21:08] have to be on quercetin and glutamine forever.

Dr. Michael Klaper

(21:13)
But the symptoms calm down, the joints stop hurting. The skin starts clearing up, et cetera, et cetera. Then we slowly add foods back, it's an elimination diet. You eliminate, put the foods back in every three days. I ask, what do you miss the most? Ooh, oatmeal. Great. They have a bowl of oatmeal tomorrow and wait 48 hours. See how your, fill in the blank, how your skin likes it, how your joints like it. Whatever the symptom was, make sure it doesn't get worse after you eat that.

Dr. Michael Klaper

(21:40)
And if not, then add a different food. Just keep track of it. So that's how you, the whole Cadillac version of the leaky gut repair. Could you do that over a week? Possibly. Maybe a brief little water fast and just some rice and steam veggies for a few days. That might be all your gut needs for a reset there. So everybody's different, but that's the basic skeleton of it.

Dr. Chris Miller

(22:07)
He says here, I had a few exposures to sugar and wheat and began bloating with almost every meal. I used the same protocol a few years ago and it worked wonders.

Dr. Michael Klaper

(22:21)
Oh, lovely. No extra charge.

Dr. Chris Miller

(22:21)
So here's another question. Nancy says, I'm whole food plant based. Is there a supplement that would help with night leg cramps? I'm taking magnesium, but it doesn't seem to help. Any suggestions?

Dr. Michael Klaper

(22:34)
Magnesium sure can help. There's usually an imbalance of calcium and magnesium in the muscle membrane there. And I get them and I use magnesium citrate. And I tell you a good dose of it, [inaudible 00:22:49] water, about right after dinner. And so it's in my bloodstream at bedtime. It doesn't do any good to take it first thing in the morning.

Dr. Michael Klaper

(22:58)
And it's an effervescent powder, and I put in one or two scoops of it and it fizzes up. And so it has got a good 500 milligram, about 350, 400 milligrams of magnesium in there. And I don't chugalug it down. I'll break it over the course of an hour or two. But before I go to bed, I'll have the whole 400 milligrams. But it works like a charm, for me at least. So if it's just a tablet that you're taking, you might not be dissolving it. It might not dissolve that well. You might not be absorbing it that well. Try one of the powder or liquid forms of magnesium.

Dr. Michael Klaper

(23:36)
And it should be, as I said, between the 300 to 500 milligram range. And if it's got a couple hundred milligrams of calcium in it, that's okay as well. And so try it in a more absorbable form. That's really kind of what's going on.

Dr. Michael Klaper

(23:51)
But if it's continually happening in one leg or whatever, make sure, talk to your doctor that there's nothing going on in your lumbar spine and that you don't need an MRI of your lumbar disc or anything like that. But if it's just classic night cramps, where you got to get up and walk around on a cold floor there, then yeah, try the magnesium at a high enough dose. It usually does the trick.

Dr. Niki Davis

(24:13)
Yeah. And I was going to say, the other thing, sometimes if you have restless legs at night, it can be a sign that you might have some anemia. And so talking to one of our doctors about getting tested for that, just to make sure that that isn't something that's causing it.

Dr. Chris Miller

(24:31)
And the other thing that can cause cramps, if it's one certain leg sometimes, is also stretching. If you have tight muscles. My husband goes bicycling and he gets night cramps every night only after bicycling. And he started stretching more and that significantly helped. And so if you're [inaudible 00:24:53] make sure that you're doing appropriate stretches and don't have tightness anywhere. And I would also add that dehydration can cause night cramps. Make sure that you're well hydrated, in addition to what everybody else has already shared. So these are just some thoughts to look into with that.

Dr. Michael Klaper

(25:07)
A very gentle calf stretch is helpful. And if I weren't naked from the waist down I would show you how to do it, but I don't have anything on, so…

Dr. Elisabeth Fontaine

(25:18)
Thank you for sharing.

Dr. Chris Miller

(25:28)
We're getting close to time, but I think we have time for a few more questions if you guys are okay. Let's see. I have a question here. How do you find a cardiologist that promotes plant-based eating and doesn't just push pills. Kim is asking us.

Dr. Niki Davis

(25:41)
There are a couple of sites. So the Physicians Committee for Responsible Medicine, they have a find a doctor area on their website. And then there's also a website, plant-based doctors.com, I think. Plant-based doctors.com. Those are both really good places where you can search by specialty and by location.

Dr. Elisabeth Fontaine

(26:05)
That's good. I was not even aware, but you know, the president of the American College of Lifestyle Medicine is a cardiologist, plant-based. So I don't know if she can, you know, do consultation online, that I don't know. I think she's based in Florida. I can't remember her name exactly, but maybe you guys remember.

Dr. Niki Davis

(26:24)
And I know that Dr. Marbas has had someone on our webinars in the past that was a plant-based cardiologist as well. So I know they're… And I don't remember her name, but they do exist.

Dr. Chris Miller

(26:39)
They definitely do exist. And if you work with one of the doctors here too, we can also help make referrals for you as well. If you need to see someone for a one time thing. So don't give up on that. If you're having a hard time finding someone, we can help you find someone and someone who works in your state too, or does telemedicine for you. Depending on where you are.

Dr. Michael Klaper

(26:58)
Do you know what state that person is in?

Dr. Chris Miller

(27:00)
I didn't see it yet. If you can post…

Dr. Michael Klaper

(27:04)
It's getting to be more and more plant-based cardiologists. I'm getting to meet. I just met Brian [inaudible 00:27:10] from Nashville, I just met Jami Dulaney down in Florida. There's going to be more and more of them, it's wonderful. Steve, somebody, in Denver.

Dr. Chris Miller

(27:18)
Oh, Kim says she's in Florida.

Dr. Michael Klaper

(27:20)
In Florida. On the west side, she should look out, check out Dr. Jami Dulaney, D-U-L-A-N-E-Y. And she's in the Tampa area there, and it would be worth going to see.

Dr. Chris Miller

(27:29)
Dr. Monica Aggarwal is out there too.

Dr. Michael Klaper

(27:33)
Yes. Monica's up in Gainesville, right. That's in the central part of the state. So yes, there's a couple down here. Oh. And Dr. [inaudible 00:27:44] Reddy is over in Tampa. And he's my kind of cardiologist. He had a patient with angina, he was telling me, and he walks in and he pulls, and he reaches in his pocket. Pulls out a angioplasty catheter, it's what he does, he's an interventional cardiologist. And he pulls out the angioplasty catheter. And he reaches in and he pulls out a baby carrot. He says, Take your choice. You could get a plant based diet or meet me in the cath lab. And they usually choose the carrot. And he gets great results. Lovely man. Check him out. Dr. R-E-D-D-Y at VA hospital in Tampa. And he's involved in ACLM, you probably know him. But yeah, there's three plant-based cardiologists in Florida.

Dr. Chris Miller

(28:36)
Yes. You're in a good state there, Kim. You have big choices. Any other questions here? I saw one to me, but I don't see it anymore. So I'm sorry. I don't know where that question went. Let's see.

Dr. Chris Miller

(28:51)
And then Alexander here, here's one for Elisabeth. How early should someone start taking folic acid supplements before becoming pregnant? Is getting folate through diet alone sufficient?

Dr. Elisabeth Fontaine

(29:03)
You know, if you don't use any contraception, you should put the folic acid. Because you know, you never know when you're going to conceive. So as a prevention, it should be always there and present. It's always hard to know, as far as the second part. We don't know exactly what you eat. So as, I think that when you're in a state of not knowing and you're trying to get pregnant, the supplement is good too, yeah. And you can find some vegan supplement as well. So I think it's a good idea to be careful, and not… Even if we replace it in our food chain everywhere, I'd still be careful. Because you know, just to have this sufficient amount.

Dr. Michael Klaper

(29:43)
Whenever I check the folate levels on my vegan plant eater folk, it's usually off the chart. And they usually have plenty of folate. They could sell it on the street. And they, and so as long as you're eating those big helpings of grains, kale, [inaudible 00:30:04] for your arteries and everything else, you're probably already, you're probably pretty covered for folate. Dr. Fontaine I'm curious, do you make any distinction, or have any concerns, regarding folic acid versus folate in any supplement? Do you make any distinction between the two?

Dr. Elisabeth Fontaine

(30:22)
Well, you know, no. And you may, educated me into this. I was not necessarily making the distinction for the people.

Dr. Michael Klaper

(30:32)
Dr. Joel Fuhrman had a big kerfuffle about this a couple years ago already, they are not the same. You want folate or methylfolate. Folic acid is, if you look at adverse effects, it showed up associated with everything from cancers to birth defects, et cetera, in some of these studies. So as it makes, you know, they are not interchangeable and not the same thing. You want folate, but all the more reason to eat your greens. And so you don't have to worry about it at all. But so I've been leaning and I've been noticing more and more prenatal vitamins have folate in them instead of folic acid. That's I think a good thing.

Dr. Elisabeth Fontaine

(31:11)
Good point. Thank you.

Dr. Chris Miller

(31:13)
Yeah, really good points there. Thank you.

Dr. Niki Davis

(31:17)
But I was going to say that there are some apps out there that you can put in your diet, what you eat and it will give you the breakdown of the nutrition. And so if it's something that you want to make sure that you're getting enough folate, you could always do that for a couple of weeks, just to make sure that your typical diet is getting plenty per day.

Dr. Chris Miller

(31:36)
That's great. And do you have any apps that you like to recommend, Niki?

Dr. Niki Davis

(31:39)
Yeah, the one that I use is Cronometer, so it's C-R-O-N-O, Cronometer. That seems to be a good one. And it's nice because I have a few patients that use that and they are able to export a summary so that I can see what their nutrition has looked like for the last month or week or whatever it is.

Dr. Elisabeth Fontaine

(32:05)
Well, for my defense, the majority of people when I was doing OB were not plant-based, and therefore we definitely needed to use a little bit of supplement. In the North American typical diet. A bit different here.

Dr. Chris Miller

(32:22)
And then I have a question here from Denise. She's an anniversary follower. I don't know what that means, but I think maybe you've been here for a while, so that's great. She says Dr. Miller, I watched your presentation with Clint [Paddison 00:32:34]. It was very interesting. So interesting to hear that both you and him could not do the omega three fats. Do you have any ideas on why it's so hard for some people, but not others, such as those that are successful with Dr. Goldner's protocol? Is there anything that can be said besides, Well, it's all personal, our bodies are different. Any other specific reasons why the fat issue is so different for folks trying to heal autoimmune?

Dr. Chris Miller

(32:54)
So for those people who didn't hear the talk, so I was talking to Clint Paddison, who's doing an autoimmune summit. And I was talking about when I was working, when I had really active lupus and was very sick, how I did not tolerate flax or chia seeds. Both of them gave me joint pains and I flared worse. So I was not able to eat either of them at that time.

Dr. Chris Miller

(33:18)
And I don't have an exact reason for you. But I know that means that my gut was such a mess. My microbiome was so out of balance. My gut was so leaky that I couldn't even tolerate these regular foods that are supposed to be so very anti-inflammatory. And there is some evidence that fat in general, cause LPS, lipopolysaccharide to leak across and activate your immune system. And it's like a toxin in your body. And so I think some of the fats, some people don't tolerate a high amount of fats initially for that reason. And my gut got leakier and I had worse joint pains. And so I ended up having to do supplements of algae oil because I was able to tolerate that. And then as I did more greens and improved in my gut microbiome and my gut wall got healthier. I was able to add the flax and chia seeds in. And now I'm able to eat them. So I have improved and we can heal from it.

Dr. Chris Miller

(34:11)
But if you're not tolerating the fats, we do need omega threes in us, if we're trying to reverse an autoimmune. I think we do. I think people are more successful. And so we try to find a way to sneak it in. If you're not tolerating certain ones, then is there something else we can try? We can try hemp seeds, you know, of course we're eating leafy greens. And so anything that we can do. So I don't have any science behind it. I just think, I just know about the LPS and the fats causing worsening leaky gut.

Dr. Chris Miller

(34:38)
So I don't know if anyone else has any thoughts on that. Why the people may not tolerate fats.

Dr. Chris Miller

(34:47)
Okay. And we'll take one last question here. And so let's see. Here's one more question. I have been on a plant-based diet and now I am in menopause and gaining weight. I'm only 43 and want to know what can I do? Do I want to take hormones? Who wants to tackle that? 43.

Dr. Elisabeth Fontaine

(35:10)
I don't mind taking that, but I have a train going by. You're not going to hear me. [inaudible 00:35:16] come back, I promise.

Dr. Niki Davis

(35:19)
I know, I was going to say our OBGYN should be answering that. But I personally don't feel like starting hormones is the best idea right off the bat. You know, really looking at what your diet looks like. What are you taking in day to day? And look, is there anything that needs to be tweaked?

Dr. Niki Davis

(35:43)
The other things that I'll talk to people about who are having difficulty with weight loss is the possibility of adding in intermittent fasting as well. And I think that intermittent fasting makes a lot of sense. You know, back before we had homes that were well-lit, well-heated, we had to be careful about not being out too late at night, based on just predators and being cold and being caught out in the cold. So it doesn't really make sense that we should be snacking constantly all night long.

Dr. Niki Davis

(36:11)
So there should be a time when it gets about dusk, that we stop eating. And it gives your body that amount of time to really finish digesting and then have the time to go through the process of doing other things in your body, besides digesting food. And, you know, clearing out the toxins and really just giving your body a time to rest. Which is something that our bodies don't get a lot of time to do because we're constantly eating. We eat from the moment we go to bed and to the moment that we wake up.

Dr. Niki Davis

(36:43)
So that is one thing that sometimes is a nice tool for people who are having a difficult time, is just maybe giving yourself a little bit of a window, even if it's just 14 to 16 hours at night of just giving yourself a rest. And, you know, you can still have maybe a little bit of non-caffeinated tea, some water and things like that. But that might be something that you could use as a tool to kind of help you get back.

Dr. Niki Davis

(37:05)
You know, when you're having all these hormone changes, it is going to be a little bit more difficult. So just doing your best to be as clean with the whole food plant-based diet as you can, of course making sure you're not getting those extra oils that are highly processed and just so high in fat, 100% fat. And just looking at maybe shortening the window of time that you're taking in food too.

Dr. Elisabeth Fontaine

(37:28)
Well, I think you did a pretty good job, partner. So the train had gone by, you would've never been able to hear me. So if I hear well, what she said is she's whole plant based, but she's 43, in menopause and want to… So first of all, you know, it's an early menopause. You see, because the majority of women will hit menopause around 50, 52.

Dr. Elisabeth Fontaine

(37:52)
And I have to admit that the earlier you hit menopause, the more symptomatic usually you are. So I don't know if it's a natural menopause or surgical menopause. Let's say that, because usually there's a little bit of an evolution. And I totally agree. I have to admit that as a regular OB/GYN, I never knew that plant-based whole can make such a significant difference. And I've seen it, a huge change for symptoms.

Dr. Elisabeth Fontaine

(38:20)
However, unfortunately the variation of hormones sometimes will make it a little bit hard for the weight loss. And being able to be careful with, certainly the suggestion that Niki mentioned, but also do a good variation with the exercise and being able to vary from one week to another. Because your system is so used to the same kind of status quo.

Dr. Elisabeth Fontaine

(38:47)
You got to play with that a little bit. Like being able to, you know, obviously without injury, increase a little bit, your exercise in one week, rest the other week. Doing intermittent fasting, that might help. I am not totally opposed of hormone replacement therapy. I would say that I'm the one that probably knows the most and I'll be happy to discuss with somebody if they need to. But I think that what we've discussed prior to, is definitely my first line.

Dr. Michael Klaper

(39:18)
You heard some great advice from people who know. Only thing I could add is like with all plant-based diet weight loss programs, keep your belly full of vegetables. All fiber and water. So more soups, more salads, more steamed veggies. And don't eat any flour products, anything from a bakery, they're all fat and sugar. So no flour products, no oils, as Dr. Davis mentioned. And to do that, eat more salads. The salad is the main dish, like Dr. Fuhrman says. The laws of thermodynamics will work for you eventually. So eat more high fiber foods.

Dr. Chris Miller

(39:56)
Fantastic. Those are some great tips. All right, you guys, we're going to wrap up this conference. I just, I'm reading through a lot of what people have written. Thank you guys, everyone for your participation today. It was great. And lots of happy birthdays to Laurie. So, we're missing our Dr. Marbas. And so hopefully she's enjoying herself. We're thinking of her. Someone says Dr. Jami has a podcast too. That was…

Dr. Michael Klaper

(40:21)
Jami Dulaney. Yeah. Great.

Dr. Chris Miller

(40:25)
So, some good tips here for people who aren't seeing that. So thank you to everyone. Do you guys have anything you want to say as we leave?

Dr. Niki Davis

(40:34)
Thank you. That was fun.

Dr. Michael Klaper

(40:36)
Happy Halloween. Have a good time. Don't scare the kids too badly there.

Dr. Chris Miller

(40:43)
All right. Thanks, you guys. We'll see you all the second week of November. So take care, everyone.

*Recorded on 10.28.21

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