The PBTH doctors discuss brain health, gut health, and hypothyroidism.
Questions Answered
- (00:15) – Intro
- (06:07) – Mood Disorders
- (08:27) – What can I do to improve my brain health besides just eating whole food plant-based?
- (11:46) – The APOE gene
- (14:53) – Do you recommend omega-3 supplementation if you are also consuming flax seed on a daily basis?
- (17:05) – Are these recommendations relevant for Lewy body dementia as well?
- (18:44) – Are any of you in Michigan for an office visit?
- (19:11) – For diabetes and cholesterol, is it better to focus on added sugar or total carbs?
- (25:01) – Should I avoid soy products with hypothyroidism or any other foods?
- (29:09) – Is coconut milk not recommended?
- (29:32) – Should I be getting regular blood tests to check levels?
- (31:33) – Is there a cholesterol resource on your website openly available?
- (33:01) – Can ground flax seed raise blood sugars?
- (34:37) – What factors determine when a patient begins insulin?
- (39:43) – How do you encourage friends and family to start a whole food plant-based diet?
Complete Transcript
Dr. Laurie Marbas
(00:03)
… with this. And today I think we want to just focus in on brain health. Who would like to get started? And then we can start… Well, as the questions ramp up we'll go from there.
Dr. Chris Miller
(00:15)
Well, I can get started a little bit on brain health. I'll start with the basic, just basic stuff for brain health and then you guys can jump in and give a little more details with it. But so clearly this is all about Plant Based TeleHealth, so we're going to talk about the importance of food. So diet-wise for brain health, plant-based diet is number one, right? So cutting out all those pro-inflammatory foods, the animal products, the dairy products. And when I say whole food plant-based, emphasis on the whole food, so that means unprocessed food. So if you eat unprocessed plant foods, so from your legumes, your whole grains, your fresh vegetables, your fresh fruits, and nuts and seeds, that is going to be your winning combination.
Dr. Chris Miller
(01:01)
I always emphasize plenty of fresh leafy greens and vegetables, plenty of omega threes for your brain health, and that includes your flax seeds, your chia seeds, your hemp seeds. Your leafy greens, your walnuts are going to be high in omega threes for brain health. And we talk a lot about the different vitamins, the B vitamins. Vitamin E is antioxidant for the brain. Well, you get those from your plants. You don't have to memorize all the different nutrients, and that's the sweet thing about a plant-based diet. If you eat your colors of the rainbow, you know, orange, sweet potatoes are really high in those B vitamins, your leafy greens are really high in those B vitamins. Vitamin E is found in nuts and seeds, especially sunflower seed are especially high in vitamin E, but it's a fat-soluble antioxidant so it protects your brain from any chemical oxidation or overoxidation that's going on. So you're getting that from your nuts and seeds.
Dr. Chris Miller
(01:54)
So when you follow the diverse plant-based whole food diet that we're recommending, you're going to get these nutrients without having to focus on, “Am I getting enough?” And of course we check nutrients when you work with us, so we make sure you're getting enough, that you're not deficient in the necessary nutrients. And so that's what I recommend as a first step as far as diet. Of course, diet is not the only thing but I'm going to leave you guys to start jumping in on some of the other stuff that's super important for brain health, but that's the introduction part.
Dr. Laurie Marbas
(02:24)
Thank you, Chris. Anyone else want to jump in?
Dr. Kim Scheuer
(02:27)
Sure. I love what you said, and I love what you said about the brain health. And in fact, gut health is so connected with brain health. So working on your microbiome and eating all of the things that Dr. Miller mentioned is so, so very important. Also, as she mentioned, there's other things. There's getting outdoors, there's moving more, getting sunlight. So sunlight will help. Getting stress reduction, sleep is so important. Those are all very, very important things. And [inaudible 00:02:58] lots of information, as Dr. Miller mentioned about inflammation and inflammation in the brain which causes depression and anxiety and things like that, so taking those things down, avoiding toxins that can make your brain worse like alcohol. You don't want to dull your brain. You don't want to dull other things. So those are some of the things that I was thinking of when we talk about brain health.
Dr. Laurie Marbas
(03:25)
I think Dr. Scheuer, your froze for a second. You're back? Can you hear us okay?
Dr. Kim Scheuer
(03:34)
I'm back. But let's see what Dr. Davis has to say.
Dr. Niki Davis
(03:40)
Yeah. So when I think about brain health, I think about… It's hard for us, I think, as lifestyle medicine doctors to really focus on specific areas of the body because we know that the entire body is connected, the entire body is benefited from a whole food plant-based diet. But to connect that, to give you an idea what's going on in your brain sometimes like when people are diagnosed with something like dementia, you have to think back at why is this happening? Why did this start in the first place? And we know that at a young age now, we are starting to see fatty streaks in even kids' aortic arteries. That is leading to plaque formation and something we call atherosclerosis, hardening of the arteries. That is also something that is not only in the big arteries in our body, but also into the smaller, smaller, smaller arteries down into the capillaries.
Dr. Niki Davis
(04:43)
And guess what? Your brain also has arteries and vessels in it, and that also can be affected by atherosclerosis. And when you have that hardening of the arteries, you have the plaque formation, you have a hard time getting blood to the places it needs to go in your entire body, but also in your brain. So all the same things that can help with artery health, atherosclerosis is the same stuff that's going to help your brain. And that's where if you know about the prevent and reverse heart disease with a whole food plant-based diet, a low fat diet, that's also going to help brain health.
Dr. Laurie Marbas
(05:17)
Those are excellent points. It goes back to, I don't know, as a family practice physician, back then you order CAT scans and you see age appropriate brain atrophy, shrinking of the brain. And it makes me think, “Well, I wonder if we had CT scans of people who ate healthy their whole life if they didn't have that age appropriate brain atrophy that Americans are suffering.” Seems to be an epidemic of shrinking brains. But speaking about the brain health and Alzheimer's, and memory is really key, but sleep of course is really important. But what's interesting, there's a book called Psychobiotic Revolution and it talks to you about a third of depression and anxiety actually might be caused from the inflammation of our nutrition. So it's really interesting.
Dr. Laurie Marbas
(06:07)
I certainly had patients that had mood disorders or other things like schizophrenia that do much better on a plant-based diet. Their severity of the symptoms improved and many times you can get them off medications or reduce medication. So that's really interesting too, is looking at the mood, because I know you guys probably have stories of patients whose moods dramatically improved and then there's a ripple effect. Any thoughts on depression or anxiety and things related to that?
Dr. Chris Miller
(06:36)
Absolutely, Laurie. That's a really good point, is that our mood plays a significant role. And something along those same lines, when I think of mood and I think of depression, I actually think of inflammation because there's a component of inflammation that worsens depression. Inflammation is known to be a trigger of Alzheimer's and worsening dementia as well. So the connection that I see it as if I try to break it down and understand in my mind, it's twofold. One is the inflammation connection between brain health and depression. And two is the microbiome, because that leads to both mood disorder and like depression as well as dementia as type thing. So it's important that we work on all of that.
Dr. Chris Miller
(07:23)
And for inflammation, the anti-inflammatory diet, anti-inflammatory lifestyle, which is sleep and so much active relaxation techniques and exercise, moving your body, circulating, removing toxins by moving your body, drinking plenty of fluids. So living this lifestyle, connecting with people so you feel the feel-good hormones kick in, and that helps you with the mood as well. And it's very intricately related, so that's a wonderful point.
Dr. Laurie Marbas
(07:53)
Absolutely. Because you know the brain is only three pounds, literally. It's a three pound organ but it uses 20% of your glucose every single day. So it's a very active, hungry little thing. And that sleep is… I always tell people, if I can focus in on two things; first thing, food and sleep, and then it's like giving you a gift. It's like a whole new awakening. And remember, at night when you're sleeping, getting that deep restful sleep, that's when the janitorial crew comes in, right? They're cleaning up all your metabolic waste and making you ready for the next day. So that's really key.
Dr. Laurie Marbas
(08:27)
I just want to mention to you real quick, questions, guys. Please feel free to ask questions. If you're on the Plant Based TeleHealth Facebook page, please put them there. If you're in the webinar, please feel free to put those in the Q&A box, and absolutely. But is there any specific foods that you guys are aware of that you like to recommend for patients if they're worried about maybe their parents had dementia and they're worried that, “Hey, I don't want to do this. What can I do besides just eating whole food plant-based?” Is there some specifics that you guys like to recommend or activities?
Dr. Kim Scheuer
(08:59)
I learned this from Dr. Miller and that's blueberries. I love the berries because they are so full of antioxidants that will help and actually have been [inaudible 00:09:11] and help with memory. And, and so yes, thank you, Dr. Miller.
Dr. Laurie Marbas
(09:18)
Who doesn't love blueberries?
Dr. Chris Miller
(09:19)
I love blueberries, yeah. By the way, you didn't really laugh at the pun that you just said so I have to point that out again. Did you guys all catch what Laurie said? She's like, “If you give someone plant-based diet and sleep, it's like a whole new awakening.”
Dr. Laurie Marbas
(09:33)
I pride, but nobody… obviously, I fail at standup comedy, even here.
Dr. Chris Miller
(09:40)
I was cracking up. So I hope people caught it from… I had to go back and point that out.
Dr. Laurie Marbas
(09:45)
I guess I should point out. I was like, “No pun intended,” well, pun intended. Obviously I better stick this doctor thing. The comedy thing's not working out so well.
Dr. Chris Miller
(09:58)
[inaudible 00:09:58] for brain health though, another thing that I would point out, I don't have a specific food besides blueberries and a clean whole food plant-based diet that has plenty of fresh fruits and vegetables in addition to cook so you're getting a diverse amount of all your nutrients. But in addition to that, something else that's been proven to be really important is a sense of purpose. And that's why sometimes when people retire, it's so hard because they lose that sense of purpose. So I think it's really interesting that we can redefine ourselves at any age, at any moment. Like if your kids are grown up and out of the house so now your new sense of purpose, you have time for yourself. Maybe you have more time for creativeness. Maybe you have more time to connect with others, to volunteer. There's so many way is we can redefine ourselves and build a purpose.
Dr. Chris Miller
(10:40)
Even if you don't have a lot of time or a lot of energy or a lot of money, you can still find some way that gives you a reason to wake up in the morning and that go-to that, “The world needs me. I got to get up and do this.” And hopefully it's something you're excited about, but that sense of purpose is really important. So if you don't feel like you have that right now, because there are moments in my life where I'm like, “I don't know if I have the right purpose or if I'm doing enough for this world,” or whatever. And I always try to recreate myself and come up with some new way that you can really feel like you're contributing so you're excited to get up in the morning. So that's been shown to be important.
Dr. Niki Davis
(11:12)
I was going to say that reminds me of the blue zones. Because if you're familiar with the blue zones, that is one of the things that they've found in people who live long lives, long, healthy lives, that they do have that sense of purpose. They have that thing that they wake up for, whether it's a career or just their grandchildren, they're just excited to spend time with their grandchildren that day. It can be something really simple, but it is important to have that thing, that joie de vivre that you want to have every day.
Dr. Laurie Marbas
(11:46)
Yep. Makes complete sense. Absolutely. So we have a few other questions. Someone's asking about the APOE gene and of course that increased risk of dementia. Any thoughts or suggestions about what people could do? Is it just more focused on the lifestyle interventions? If someone wants to explain what that is, that's super helpful.
Dr. Chris Miller
(12:13)
So I can take that one. APOE is a gene, it's a genetic marker. People who have APOE genes are more likely to have heart disease and to have, or atherosclerosis, I should say, and to have dementia, I guess Alzheimer's, but definitely dementia. And so if you have… You get two genes, one from your mom, one from your dad. And so if you have two genes, you're APOE44, and then you're at the highest risk. And I don't remember the amount actually. I always have to look that up, but it's a pretty high risk of Alzheimer's and heart disease, but it's not a hundred percent. It's absolutely not a hundred percent. And so that's the good part about it. And if you have one gene, if you're APOE4, you could also be an APOE3 or an APOE2. So if you have a four and three or four and two, you're a little bit lower risk, and depends on which one of those that you have, but you still are at increased risk compared to the normal population which have no apple APOE4s. They might be two, three.
Dr. Chris Miller
(13:13)
And so, one is it tells your risk. And so if you know you're at higher risk, then you really want to be really stricter about your lifestyle modifications, your whole food plant-based diet, you're getting enough sleep, exercise, you know, the stuff that we're talking about, you really want to. And it has been shown to be helpful. So there are people who have of two APOE4S who are aging well with good memory, and so we can't blame that a hundred percent on our dementia. Yes, it puts you at higher risk though, so you really do want to crack down on that.
Dr. Chris Miller
(13:46)
And the second thing that it does is it lets you know a little bit how well you metabolize fat. It has a little bit to do with how you pull cholesterol out and how you metabolize fat. I'm sorry. I'm choking on my… Excuse me, everybody. So if you have two APOE4s, you tend to not metabolize fat as well and so you want to eat a lower fat diet and you really want to avoid alcohol. It's even worse for those people with APOE4 genes. If you have a two or a three, you can have a little bit more fat, a little bit more nuts and seeds, a little more avocado in your… And we see that.
Dr. Chris Miller
(14:20)
We see that in some patients, and some of you might be my patients and we've seen this together, but you put someone on a low fat, whole food plant-based diet and the cholesterol actually gets worse. Those people metabolize fat a little bit differently and they need to be on a higher fat at diet. So then we put them on a little bit higher fat and actually the cholesterol improves. So that's a smaller percentage. The APOE44 people are about 25%. So I hope that answers your question. If you do have it, yes, you can do something about it. You just really need to crack down and be really good with your lifestyle changes.
Dr. Laurie Marbas
(14:53)
Absolutely. Next question. I'm just going to stick with the brain health for a minute and then we'll get to some of these others. Someone did mention, did you recommend omega-3 supplementation if consuming flax seed on a daily basis? Any thoughts or suggestions there?
Dr. Niki Davis
(15:14)
I can take that. So I recommend to people to get at least one to two tablespoons of ground flax seed every day because that'll give you your daily recommended value of the omega threes. And you really don't have to worry about much more than that. Now, having said that, omega-3s are also very plentiful in leafy greens. And so if you're somebody who's maybe looking at weight loss, you might want to try to increase the amount of leafy greens in your diet because you're going to get less calories. It's a lot more calorie dilute to eat leafy greens, and you're going to get some omegas from that. But really, just one table spoon of ground flax a day will get you what you need for omegas without the need of supplementation. And we do have the ability to check your omega levels at labs, so we can do that too if you're one of our patients.
Dr. Laurie Marbas
(16:00)
Absolutely. I do like checking.
Dr. Kim Scheuer
(16:02)
I'm sorry that my internet seems to be a little bit off, but that's one of the things I would [inaudible 00:16:14] APOE positive, is check those levels, because in your case, maybe you would [inaudible 00:16:19]. So that's one of the things that I would do there.
Dr. Laurie Marbas
(16:25)
Dr. Scheuer, could you say that again?
Dr. Kim Scheuer
(16:25)
And as, I think it was doctor… I'm so sorry, my connection seems bad. I apologize. Can you hear me?
Dr. Laurie Marbas
(16:33)
Mm-hmm (affirmative). We just missed that last part of what you said.
Dr. Kim Scheuer
(16:38)
So I was saying that if you are APOE positive, that then I would absolutely get your omegas checked because you might benefit from supplementation. And then also as Dr. [inaudible 00:16:53] I think was the one [inaudible 00:16:54], the genes are [inaudible 00:16:55], is your lifestyle that pulls a trigger. So be as healthy as possible and take down the [inaudible 00:17:03] keep yourself as healthy as possible, either way.
Dr. Laurie Marbas
(17:05)
Got you. Perfect. Other questions. Let's see here. Are these recommendations relevant for Lewy body dementia as well? So the thing to remember is that the whole idea here is prevention of Alzheimer's. You'd need to really look into the more specific details of the research. I'm not familiar with the research showing that as far as reversal, once that occurs, it's where it is. It's halting the progression. So if you're at risk, that's the whole point here, is to do the prevention. So I think that's at least my understanding when you look at the long term. Are you guys familiar with other research or anything like that specifically? No? Okay. And some of the other questions. So I think that goes along with someone's asking, “If we have cognitive decline, can changing to a whole plant-based diet still help?” I think so, because of inflammation, right? In the [inaudible 00:18:14]-
Dr. Chris Miller
(18:14)
It can always help. Any time, yes, no matter what stage you are, you can arrest it at that stage and not progress. There's always a chance something's going to reverse, even if it's just a little bit. And we're always amazed when you reverse inflammation, when you take out that oxidative stress, when you flood your body with all those nutrients and all the healing, good lifestyle stuff we're talking about, yes. So no matter what stage you are in, hopefully you'll get to see some benefit, or at least not worsening.
Dr. Laurie Marbas
(18:44)
Excellent. So, a good question here. “Are any of you in Michigan for an office visit?” Yes, we have docs in all 50 state. So please check out plantbasedtelehealth.com. Click up on the top, there's a “find a doctor” tab, and then just drop down to your state, Michigan, and magically appears your doctors who are available to see you. And so, yes, please feel free to see some of these incredible physicians we have available here.
Dr. Laurie Marbas
(19:11)
So let's bump to some of the non brain health questions that we're getting. Let's see here. “For diabetes and cholesterol, is it better to focus on added sugar or total carbs? And how many should we aim per meal per day?” I think that's a really interesting question because I think diabetics are educated, “Must count, must count the carbs, must do this.” So you guys want to walk in through that a little bit with them? I think that's super helpful. Dr. Davis?
Dr. Niki Davis
(19:44)
Yeah. So I don't really like talking about counting carbohydrates for diabetics, I'm going to be honest. I really focus on making sure that they're eating the right foods and focusing on getting their blood sugars to improve. Once you're eating the right kinds of foods, you're not worrying about portion control, you're not worrying about calories, you're not worrying about number of carbs. You're really focused on just as long as you're eating the right food, you eat when you're hungry and you stop when you're full. And that's how I talk to my patients about it, is really looking at eating the right kinds of foods. And time and time again I see people improving their blood sugar numbers, getting off medications just by doing that.
Dr. Laurie Marbas
(20:31)
So that's a type 2. Yeah, I would clarify, yeah.
Dr. Niki Davis
(20:34)
Oh sorry, are we talking about type 1?
Dr. Laurie Marbas
(20:36)
Yeah, no, I would say type 2, for sure.
Dr. Niki Davis
(20:37)
Yes, type 2.
Dr. Laurie Marbas
(20:37)
I would just want to throw that out there because that's not 90, 91% of Americans have type 2.
Dr. Niki Davis
(20:43)
Absolutely.
Dr. Laurie Marbas
(20:44)
But for type 1, obviously if you're making insulin decisions on it, you're going to… Well, even still. Sometimes they don't, but the carb counting I'd say just in that helps, but still eating this way, there's no need to limit yourself, you just use the insulin that you need. And you'll find that your, what we call insulin to car ratio goes amazing. You can do one unit to like 25, 30 carbs, which is incredible insulin sensitivity. And so, but yeah, it's so right, right, you don't need to worry. There may be a point in the beginning where we might focus on lower glycemic foods because you're just moving into plant-based diet and the insulin resistance is maybe driving up sugars, that may be where we be a little bit more intensive on food choices, but it's not going to be amount of carbs. It's going to be just getting on starchy versus starchy. Again, each person's [inaudible 00:21:39], but yeah, absolutely right. Doctor, it was very good. [ Crosstalk 00:21:44]-
Dr. Chris Miller
(21:43)
You don't need to worry about counting sugar because hopefully you're not eating too much sugar.
Dr. Laurie Marbas
(21:48)
Yeah, exactly, exactly. And when we talk about added sugar, people are like, “Well, the sugar in fruit.” No, no, no. When we talk about added sugar, we're talking about processed added sugars, the white sugar or even, I would still consider-
Dr. Chris Miller
(22:01)
Maple syrup.
Dr. Laurie Marbas
(22:01)
Yeah, exactly. Any of these things, condiments, the syrups, all the different things you hear people using, honey, whatever that may be. Now, that's simple sugars. Are they better than others? Well, that's questionable, but maybe yeah. Honey definitely has seen some properties that are helpful, but it is a matter of just eating healthy plain anti-inflammatory decreasing insulin resistance and you'll see some amazing stuff. What about cholesterol? Any suggest for cholesterol? Because she also mentioned cholesterol. Any specific foods that you like to suggest?
Dr. Kim Scheuer
(22:35)
For cholesterol, I tend to like to use as much high fiber foods as possible. You want to eat that will help you not lose weight if you don't want to lose weigh [inaudible 00:22:48]. If you need to lose weight, but getting high fiber foods will help pull out some of the cholesterol in your body. There's also [inaudible 00:22:55] we have a whole cholesterol [inaudible 00:22:58] at Plant Based TeleHealth and all of our physicians are very aware of it. So even if you're eating extremely healthy, if you're eating fully whole food plant-based and still have a little cholesterol because your body is just like that, then we can help you out with that. But don't put anything in your body that causes more cholesterol either. So be careful on any no animal products, no dairy, and just increase the fiber. That will help a lot.
Dr. Laurie Marbas
(23:28)
That was good.
Dr. Chris Miller
(23:29)
And I would say also along those same lines is what Kim just said is no oil. So that will raise it so fast. And be careful with the excess nuts and seeds. While we all advocate for them because they're super healthy, I've seen people go plant-based and eat a ton of nuts and seeds and the cholesterol actually can go up with that. So you want to keep it to a reasonable amount, quarter cup, half a cup, something depending on your height, your size and how much you exercise. But, and it also depends on how you, we talked about this today, your APOE status. Even if we don't check it, we can tell with how your cholesterol responds to the diet and so then we can adapt your diet. So that's one thing, is the nuts and seeds.
Dr. Chris Miller
(24:10)
And then the other thing is recent studies, or at least recent to me have shown that soy is beneficial. So I add that a little bit to my patients. And it's lucky because I happen to love tofu, but so if you're eating one to two servings of soy, that's been shown now to lower both triglycerides and LDL, which is so interesting. I find that interesting. I don't know if you guys have other specific foods that you use but-
Dr. Kim Scheuer
(24:34)
Avoid the coconut. Avoid coconut oil and coconut-
Dr. Laurie Marbas
(24:42)
[inaudible 00:24:42].
Dr. Kim Scheuer
(24:42)
… and Whole coconut.
Dr. Laurie Marbas
(24:45)
Coconut milk, yeah. So yeah, you're right on, I would echo Chris, I love soy tofu, soy milk, the edamame, the whole soybean. There's so many benefits to breast cancer reduction, cholesterol, bone health-
Dr. Chris Miller
(25:00)
Heart health, yeah.
Dr. Laurie Marbas
(25:01)
… menopausal, such and so. So again, two servings a day would be highly recommended, which is depending on what you're eating, half a cup would be the edamame, half a cup with the whole soybean. And then which leads us to the segue to the question, “Should I avoid soy products with hypothyroidism or any other foods?” Any thoughts or suggestions there?
Dr. Chris Miller
(25:22)
Why don't you take that one for us, Dr. Marbas?
Dr. Laurie Marbas
(25:22)
Yes. [ Crosstalk 0 0:00:25:27] my thyroid is a mess. No, honestly, it was. So I was just… For those of you, many of you already know this, but I was diagnosed 25 years ago with hypothyroidism at the birth of my second child. And what was interesting, I was on medicine for 15 years, went plant-based 10 years ago, my medicine needs dropped dramatically. Like my TSH dropped to zero and it was always in like two and a half before that. I was like, “what's going on? Because nothing's changed other than my diet.” And sure enough, that was the catalyst for the improvement, because now I've stopped this autoimmune inflammatory process that was attacking my thyroid. And even this last year, as I think I've mentioned a few times, is that I've had to drop my dose again. So I don't know what's going on now, but I have never avoid tofu and never avoid the soy. Research is showing that you're okay to consume it.
Dr. Laurie Marbas
(26:25)
So yeah, you can eat your soy and enjoy the benefits because there's so many good things that come with the soy, but I just want you to be aware of that. So enjoy these plant foods. Don't worry about it. If anything, it's going to help the situation, not hinder. And then we had one other question, which I have a thought on but I wanted to get you guys' thought too. Sharon asked, “I'm hypothyroid, whole food plant-based, no oil now. Having trouble with freezing cold at night, especially hands get cold too but not as bad as feet. I exercise daily, eat green leafies daily, some nuts, some avocado, lentils. Last blood test a year ago showed no anemia. Worried about peripheral artery disease. Any suggestions?” Any thoughts on really strict plant-based eaters and thyroid? That's my thought anyway.
Dr. Laurie Marbas
(27:15)
I think it's an iodine. I'd just make sure your iodine is correct, its level is good so that you have enough iodine in your system to produce thyroid hormones. So there may be some issue there. Another thing is, even though it shows that you're not anemic, check your ferritin level. Make sure your ferritin is up there. Maybe increase your iron-rich foods. So there's a few things there that that might be helpful. But again, come see one of us and we'll be happy to direct that. But any other thoughts on the cold that comes with the hypothyroid? Because I know for me, there are certain times I have to pay attention to what I'm eating or I'll get those cold symptoms too, but-
Dr. Chris Miller
(27:54)
And I would say, I would add to that also that Raynaud's can be something. So maybe you have a little bit of that going on. So what Raynaud's is is it's a phenomenon where you get basal spasm in your fingers and toes, in your extremities. And so they might get really cold and they might turn blue in extreme cases. And then when they reperfuse, they turn white first and then they turn… Or they turn white when you're cold, sorry. And then when you reperfuse them they start warming up, they turn blue and then they get really warm when the blood is fully going back there. So you might have a component of that. And that is common in people with autoimmune type stuff just in general. So if you have hypothyroid, you may have a component of some vasospasming in your toes and fingers.
Dr. Chris Miller
(28:39)
And for Raynaud's, really, the treatment besides a whole food plant-based diet, which can improve it a little bit actually in some people, but in addition to that is just keeping it really warm. So like I live in Colorado, I love to ski and be outdoors, so I just make sure I have good gloves on, good socks on my feet keeping me extra warm. You can buy those heater things, that sand that you shake and it activates, put them in your gloves, stuff like that. So that can be a component in addition to everything else we already talked about.
Dr. Laurie Marbas
(29:09)
That's perfect. Excellent. And then someone else asked, “Oh, coconut milk is not recommended?” I just want to throw this out here. One cup of coconut milk has 51 grams of saturated fat. So, no coconut milk is not recommended for specifically that reason, at least there. There's another good question here I think you guys would be great to answer. “Should I be getting regular blood tests to check levels? And how often would you recommend? Is it okay to ask my doctor for these as a preventive measure? She seems a bit reluctant to test when I'm not apparently suffering from anything. I'm 59. Thanks.” I think that's a great question as to how we can help people as well. Any thoughts [inaudible 00:29:53]-
Dr. Niki Davis
(29:52)
So when she says levels, is she just saying levels of anything?
Dr. Laurie Marbas
(29:56)
Yeah. Like what would someone who's this healthy should be looking at or at least once a year speaking to someone about?
Dr. Niki Davis
(30:03)
I mean, there are some things that we typically will look at. I mean, there's some very basic tests that I would say most doctors check yearly for people who are over a certain age. We'll want to check your electrolytes, your kidney function, maybe your liver function, want to look at your thyroid. That's something that like we were just talking about, it can be very common to have issues with your thyroid. If you're somebody who's been plant-based for a while, it's worth checking your B12 level. We've got a couple of other markers that are nice to look at too for B12, homocystine and mefanamic acid. So those would be a few.
Dr. Niki Davis
(30:43)
Vitamin D is always important to look at because so many people are deficient in vitamin D. Just making sure that your levels look good there. And then of course there are some other optional labs that we can do to check like some minerals; selenium, zinc, things like that. And we also can check your omega fat levels to see where you're at. And then overall, I would say most people would recommend that you check your cholesterol once a year as well to make sure that's looking good. Normal total cholesterol is usually under 200 and LDL under 100, but we like to shoot a little bit better than that. And so we will tell our patients that under 150 total is what we would like to see, and then an LDL under 80 is what we try to shoot for.
Dr. Laurie Marbas
(31:27)
Exactly. Absolutely. You guys good for a few more questions?
Dr. Chris Miller
(31:31)
Sure.
Dr. Laurie Marbas
(31:33)
All right. So let's see here. There's so many. We're getting a lot. [inaudible 00:31:42] question, “Is there a cholesterol resource on your website openly available?” No, we have these talks regularly. We do have some very specific things that we're working on that seem to be working for patients focusing in on a few different protocols for foods and timing and stuff. So again, that's available to our doctors and we would love to see you. So if you really want a good question and get you as an individual what you should be doing, I feel like that would be a… even one visit might make an enough of a difference for you. Because we really, we tried to price these visits as lean as we can. And then also, so for patients' affordability, we're working on the insurance thing. So I would definitely make an appointment. Any other thoughts?
Dr. Chris Miller
(32:27)
To answer that, Laurie, is that's a really good question. And it's important that you do work with someone because there's some variability. Like we talked about genetics already today. People handle that differently. So the protocol is written with some basic things but there's definitely some differences in people and how they react and we adjust it. And depending on other comorbidities, other illnesses that you might have will make a difference as well. So yeah, if you get a chance, if you can squeeze in a visit to any one of the doctors here, one of us. Maybe that would be helpful and then after you can take it from there.
Dr. Laurie Marbas
(33:01)
Absolutely. Let's see here. “Can ground flax seed raise blood sugars?” Any question?
Dr. Niki Davis
(33:13)
I mean, yes. There's carbohydrate in ground flax so you are going to have a rise in your blood sugar, but it's not going to go from 100 to 500. It's not going to raise it a lot. I mean, food is meant to raise your blood sugar if it has carbohydrate in it, and so that's a natural part of food. We just don't want… First of all, we have to look at insulin resistance, which is primarily looking at fat content in the diet, which is usually from animal foods or oils. And then looking at the possibility if you are someone who's struggling with type 2 diabetes, looking at the higher glycemic foods in the beginning might be a good idea. But yeah, grand flax, isn't going to be a problem if you're… I don't know if we're bringing up because of diabetes, but it's not an issue for blood sugar.
Dr. Laurie Marbas
(33:58)
Yeah. I mean you can, when you wear [inaudible 00:34:02] glucose mark, I've worn these things and I've done everything possible to see… You name it, I've tested it. And yeah, when you start throwing in, like I have a smoothie every morning and it's packed full of greens and some fruit, it does nothing. It's like a 15-point bump up. I put my diabetics on those really a [inaudible 00:34:21] drink, their blood sugars do phenomenally well. Again, as long as you're drinking it slowly, it's crazy to me how this fiber-rich drink does nothing for the blood sugars. So yeah, your ground flax, you're fine. That's not going to be an issue.
Dr. Laurie Marbas
(34:37)
The one thing they did have [inaudible 00:34:39] question is, “What factors determine when a patient begin insulin?” Well, one thing is what type of diabetes you have and how high, right? So insulin and how quickly you are switching to maybe to a plant-based diet to control it if you're a type 2, there's some variability here. If you're a type one and a half, which is a later onset autoimmune, you may need a little bit of insulin, and it will depend on if you need bolus or long-acting. That's where the continuous glucose monitors are very, very helpful. And if you're someone who's walking around with blood sugars in the 300s, yes, you're going to probably need insulin for a short period of time to bring that down as we're moving you to a healthier diet. So think of it as a bridge. You're on the island of high blood sugars and you want to get to the island of low, so we're going to use insulin as a bridge and the diet to get there safely. It really will depend on the person and individual. But any other thoughts on the insulin use?
Dr. Laurie Marbas
(35:40)
Okay, we do have a few other questions. We do get this, and I'm seeing more of these. “I'm underweight at 98 pounds, five foot three so I eat grains for extra calories. Can you eat too much whole grains?” Any question or maybe discussion on how to gain weight on a plant-based diet for those who are really struggling?
Dr. Chris Miller
(36:07)
My thought on, “Can you eat too much whole grains,” that's an interesting question. I never really thought about it, but I would say in the short run, probably not if you're not reacting to it. I work with autoimmune people, some people may not tolerate it as well, but if that's not an issue for you and you're eating them in the short run, you can. I mean, somebody ate potatoes for a whole year and did fine. Seemed to do okay with that. So you can eat them for the short run. In the long run though, what I'd like to emphasize is the diversity of the diet. You get different nutrients from different foods. So you want to eat legumes for some of the benefits to your microbiome of the legumes and some of the extra amino acids maybe, and some of the minerals and your nuts and seeds, which if you're looking to gain weight, definitely want to be including those for all the minerals and vitamins and nutrients.
Dr. Chris Miller
(36:53)
And they are different. That's why we always talk about diversity so much, because each food is so different. So with your whole grains, if they're not bothering you, I would say, yeah, you can eat them all the time. But if you fill your plate with whole grains and maybe you're not eating your fresh vegetables, maybe you're not eating, because we only have so much room in our stomachs. So you want to get some of these colorful fruits and vegetables and all the other nutrients in. So I don't know. What do you guys think? I'm curious to hear.
Dr. Kim Scheuer
(37:20)
Well, I eat a lot of grains. I exercise a lot and I eat a lot of grains, but that happened over time after I lost weight and I felt that I needed more. But I agree with what Chris Miller says, is that I always have a bit of grains, a lot of green and some fruits and things like that. So it's a very diverse thing. If I feel like I need to gain more weight, I'll add a little bit more nuts and seeds in this. And again, this is where we individualize for people. You know, “Are you diabetic? Are you not? Do you have other things that we need to pay attention to?” And that's where we can help individualize your health improvement. And so can you eat too many grains? You can eat too many of anything if you only eat that at the expense of everything else. So, but I eat a lot of grains, but I also eat a lot of other things.
Dr. Laurie Marbas
(38:14)
Dr. Niki?
Dr. Niki Davis
(38:14)
Well, for gaining weight, I would say also just looking at maybe focusing on some of the higher fat plant foods, the whole plant foods, like you had mentioned, Dr. Scheuer, the nuts and seeds. And also looking at soy products. I mean, tofu is fairly high in fat. So soy products, avocado, no coconut, but those higher fat plant foods that are prepackaged and delicious. You're not needing to add extra fat that's been stripped away from something, so no added oils or vegan butters or anything like that. But in the whole food, you can add some of that to get a little bit of extra fat.
Dr. Laurie Marbas
(38:54)
Absolutely. And if you find that you're getting fuller too soon, sometimes I find that can be an issue and I struggle to eat enough food at one setting to make a difference, add in those snacks, but make those snacks a little bit higher in those calories. But just think of some ideas of ways, maybe the smoothie. You could add in some nuts and seeds to that. It's a little easier to drink the more calories and then trying to stuff it all in. So yeah, I think those are all really helpful things, but some people, just their metabolism is just through the roof and there's just nothing that you can do. Someone else can eat the same diet and gain weight as someone else is struggling. So there's, just again, that's the genetic gifts that we were dealt. I think one last question would be nice to end on is, “How do you encourage friends and family to start a whole food plant-based diet?” I think that's something we all are facing. So what do you think?
Dr. Kim Scheuer
(39:50)
[inaudible 00:39:50].
Dr. Niki Davis
(39:50)
I can start. Yeah, that's what I was going to say. No, it's okay. My favorite thing is being a role model. You don't need to preach it, you just show people that it's possible, you show them the benefits I have. I have one patient in particular that I've been working with and she said, “I started this to help myself, but now people are noticing it and they're asking me how I'm doing it and their blood pressure is improving and they're losing weight.” And I said, “Look at what you're doing, you're helping all these other people just by being a role model.” That's the easiest way.
Dr. Chris Miller
(40:24)
I like to lecture my friends and family. I'm just kidding.
Dr. Laurie Marbas
(40:28)
Well, actually, I have a bad habit. Anyway, go ahead.
Dr. Chris Miller
(40:35)
And no, I totally agree with that. And sometimes like giving them, if people express interest, so first you want to see if they're interested, but if they express interest, giving them resources and some of your favorite books or some of your favorite resources that are interesting or fun for them to look at. Group support stuff is always a great way. We all want to be social, we're creating it, and so getting them some way to be connected with other people is helpful. But that's only if they interested. If they're not interested, you don't want to push it on them because it leads to other problems. And in that case, you just want to lead by example, as the other two wonderful doctors have already pointed out.
Dr. Kim Scheuer
(41:08)
Well, I was sneaky once with my family members, and for my nephew who is not eating healthy and my brother I said, “For my birthday, would you give me an hour and a half so we could watch The Game Changers together?” So kind of sneaky in that one. It was my birthday present.
Dr. Niki Davis
(41:27)
Dr. Scheuer, I have to say that I did that same thing to my mom where I asked her for my birthday to read The China Study and it worked.
Dr. Kim Scheuer
(41:41)
Yeah, same.
Dr. Niki Davis
(41:41)
It worked.
Dr. Kim Scheuer
(41:41)
Maybe for my birthday I'll ask my family to eat plant-based.
Dr. Niki Davis
(41:43)
There you go.
Dr. Laurie Marbas
(41:45)
I just go straight to it. None of divisiveness going on here.
Dr. Niki Davis
(41:48)
That's awesome.
Dr. Laurie Marbas
(41:49)
Well, I mean, I have two theories. One, I have an MD after my name so I use it to my benefit. If I have someone who's pushing my buttons, I might pull out the lecture stool and say, “Sit down, we're going to have a talk.” Granted, I understand that's just more of my benefit than theirs. I get it. It barely works. But I will say this, what I have tended to do is educate, educate, educate. And then when someone asks you, “Why are you eating this way?” I'm like, “Well, there's all these amazing benefits and no negative side effects. Why are you eating the way you are?” I also can be a little bit more pokey and say, “If you say you love animals, why are you eating animals? If you say you care about the climate change and the environment, why are you eating this way?”
Dr. Laurie Marbas
(42:37)
So I try to point out and say, “Listen, you're not acting the way you're saying your identity is pointing. So there may be some friction there that you need to start thinking about.” And there's nothing wrong with that. Where if someone loves you in a kind way, point out to things how we can improve as humans. I think there's nothing wrong with that. My kids are very good at pointing out things, whether it's me cooking something or me saying something, like, “Mom, yes, we know the waitress did this, or whatever. You should be a little nicer.” I'm like, “You're right. Okay, fine.” [inaudible 00:43:09] are like, “Mom, why did you say that to one of the kids,” or, “Mom, you should be more patient,” or whatever.
Dr. Laurie Marbas
(43:16)
So I'm like, “All right, I'm a better human for you guys. That's good. That's good.” But again, so in a loving, however, you need to communicate with that person, I don't think there's anything wrong with that. Just, if you're a diabetic and you hear these stories that people are switching to plant-based diet and reversing it, why wouldn't you try that? Obviously what you've been doing is not working. So let's think about it. Let's just be logical here. So I don't know, I feel like all the warm fuzzies only go so far and then it just gets urgent. So, but that's how I see it. I see it as an urgent message. And you love someone, but again, you don't want to put risk in the relationship. There's a way of doing it. Humor or trying to be humorous can help. I'm not very good at it but I try. So, but anyway, but that's my lecture side. Anyway, go ahead, guys. Any other thoughts in closing? [ Crosstalk 00:00:44:05]-
Dr. Chris Miller
(44:04)
No, it was great to have everyone today. Thank you for all of those great questions. This was fun.
Dr. Laurie Marbas
(44:08)
Wow. We had a lot we didn't answer. And I do apologize, guys, that we didn't get those. We try to get to the ones that are… group them together and the ones that are more relevant to the conversation and that many people would be asking. So we do appreciate that. If you have a more specific question, again, please feel free to make it a doctor's appointment with one of these incredible physicians. There's nine, we're in all 50 states, in D.C. You would go to plantbasedteleealth.com, click on the “find a doctor”, click your state and then the docs will pop up, their bios and a link to schedule an appointment. We have phone numbers, we have an email. If you have any questions, we're happy to help in any way we can. Some of us are obviously more lovey dovey than others. That's all right, there's one of us for everyone. And so really, I try to be nice. I really am.
Dr. Laurie Marbas
(45:02)
But anyway, so there's that, guys, and I hope you guys have a wonderful day and weekend. Thank you, docs, for joining us and we love you guys too, because you make the world a better place and through your hard work. So, great. So everyone have a great day. We'll see you next time.
Dr. Kim Scheuer
(45:20)
Thank you, everyone. It was awesome.
Dr. Niki Davis
(45:21)
Thank you.
Dr. Chris Miller
(45:21)
Bye.
*Recorded on 1.27.22