Webinar Replay

Lifestyle Medicine Doctors Q&A | Fasting, Menopause, Sleeping habits



Our Plant Based Telehealth doctors answer questions regarding intermittent fasting, menopause, and healthy sleep habits, and late-night snacking.

Questions Answered

  • (00:03) – Any advice for hot flashes?
  • (03:24) – What are the optimal levels of vitamin B, D, homocysteine, and A1C?
  • (11:05) – I'm looking forward to menopause, is this foolish?
  • (13:17) – Any suggestions for what appears to be an eczema, psoriasis?
  • (16:14) – What are your thoughts on intermittent fasting with a plant-based diet?
  • (21:44) – What is endothelial function? And why is it so important?
  • (24:00) – Why don't you use oil?
  • (28:49) – How do you respond to conflicting information on the most important plant-based foods?
  • (32:23) – What helps with falling asleep and staying asleep? Any thought on late night eating?

Complete Transcript

Dr. Laurie Marbas

(00:03)
Any advice for hot flashes? Having one about every 20 to 30 minutes, interrupted sleep, following a whole food, plant based diet. Oh, I'm so sorry. Dr. Elisabeth, Kim, whoever wants to do that.

Dr. Elisabeth Fontaine

(00:16)
Yeah, every one of us can talk, Niki, I haven't had the chance-

Dr. Kim Scheuer

(00:21)
I can.

Dr. Elisabeth Fontaine

(00:22)
Oh my gosh, you guys are a little early. But I do see the typical… I mean, I guess Laurie asked me because I'm a gynecologist as well, and certainly have encountered a lot of women with the problem that you have. So first of all, 50% of women, after about three, four years, will not have hot flashes. So some women are lucky. Some won't even have it, but some will be exactly like you, I'm going to say you because I can't remember the name that Laurie said, very, very symptomatic. And certainly, we can help quite a bit with trying to figure out what are the element that triggers.

Dr. Elisabeth Fontaine

(01:01)
So if you're on a plant food base, definitely decrease inflammation quite a bit, trying to do some exercise. And reducing some of the agent that are triggering, some women it's a little bit of alcohol, doesn't need much, spice, different things, coffee. You got to keep an eye on the things that trigger. So you start with that, once you've used all this and there's absolutely nothing else. I am not opposed on hormones, personally. That's a little bigger discussion and that's something we can definitely discuss in appointment or another time. Because it's a little bit bigger for discussion.

Dr. Laurie Marbas

(01:39)
Oh, absolutely. Anybody else have any of thoughts, suggestions?

Dr. Kim Scheuer

(01:45)
I've had a lot of patients really decrease their symptoms significantly with increasing their soy. And I saw what's the therapeutic amount of temperature, edamame, or tofu. I am not sure what the therapeutic amount is. I have some every day and enjoy it. Anybody else know?

Dr. Laurie Marbas

(02:04)
I think one to two servings a day of whatever it is that you're consuming is what I've been reading about that. And so honestly, I haven't had any really serious symptoms, on occasion I'll have a weird, maybe a little warmer. But is it that or is it something else? But that seems right. But I also do soy daily. But also, soy is good for your bone health, which is even more important after menopause. So there's so many good things that come from soy products.

Dr. Chris Miller

(02:29)
And for your heart health, it even lowers cholesterol, the soy products do.

Dr. Niki Davis

(02:32)
And it decreases risk for breast cancer too.

Dr. Elisabeth Fontaine

(02:36)
Absolutely. Soy is good, don't get me wrong. But for the women that are severely symptomatic, you have to take such a large amount, a lot more than the typical amount that we're suggesting here because it's just overwhelming. And there will be always, in anything we do, some that are in the outside category. So it's a little bit harder for these women.

Dr. Laurie Marbas

(03:00)
Yeah, absolutely. And I've had women that even whole food, plant based, like you said, are very severely suffering. They're just, they can't sleep, their mood, everything. And we put them on hormones for a limited time and they do great. So like you said, that's a discussion per individual, but medication's not the evil thing here. At least we have some options to provide some relief because I mean, these poor ladies are suffering. It's just not a nice time sometimes. So very good. Let's see here, Jennifer would like to know the following thoughts on optimal levels. She said, oh vitamin B, D, homocysteine, and A1C. What are your thoughts on, I'm assuming, blood levels, where you would think that should be? Anybody who'd like to answer that?

Dr. Chris Miller

(03:52)
I can help with some of that.

Dr. Laurie Marbas

(03:53)
Okay.

Dr. Chris Miller

(03:54)
I can tell you some of what I go by anyway, although I know there's some differences within all of us. But B12 levels, because we know that plant based eaters don't really get B12 since it's in the ground and it's from animals eating dirt type things. And we wash our vegetables, so we tend to not get the B12 anymore. So I tend to push it to be a little bit higher on the scale. So closer, like 600 to 700, 800, 900 sort of that region and everyone is different, how much they need. People ask me, “How much should I be taking?”

Dr. Chris Miller

(04:27)
And so I usually start people with about 500 to 1,000 micrograms and then usually do a test at some point and see where they are, kind of see where their base is and how much they've had in them previously and how well they're absorbing it. And it kind of matters, all that, so that's B12. Homocystine, I just want it in the normal range. I typically want it under 10, even a little bit lower if possible. But that's definitely a genetic thing too. So some people have real clean diets and it's a little bit higher. So we might use B vitamins to try to help get that down. The methylated B folate, which is B9, methylated B6, and methylated B12 to help with that out a little bit.

Dr. Chris Miller

(05:09)
But it kind of varies, it's not that exact number, but I usually want it definitely in the normal range and even a little bit lower if possible for that. Vitamin D, there's some controversy over. I typically push for at least over 50. I know that some people are going even higher, but I'm usually around 50. If they're at least 40, I feel good about it. And if we're trying to do something more with autoimmune or something, we might push it a little higher. It depends though too, because some people don't absorb it real well. So I kind of watch that. I know some of the other doctors do that a little bit differently, so they can get their answers as well. And there was one more and I don't remember what the last one was that you asked about.

Dr. Laurie Marbas

(05:48)
A1C.

Dr. Chris Miller

(05:48)
A1C, so that's typically under 5.6, 5.6 or less for not having diabetes or when it gets to 5.7, then it's prediabetes first. But we want to push it, kind of keep an eye on that, where it is. But it depends again, where you are, if you have diabetes type two and we're making progress. So it's hard to give one exact number, but definitely for the A1C, that's an important number. We want it 5.6 or less. So hopefully that's helpful.

Dr. Laurie Marbas

(06:21)
Anybody else like to chime in? All right. And I just had a thought on the vitamin D. So there's different measures and parameters when you're measuring it on your blood. So the 30 is a good number to aim for and nanomoles per milliliter, which converts to 75. And so when you do the different conversions, some other things. So depending on what studies and what you're looking at, 30 of those when you're looking at for optimal bone health, and that's coming back on most of your labs, like through Quest and LabCorp. So 30 is the number, but if you hear someone speaking of 70 or above, sometimes ask them, “Well, what is the measurement in the units?”

Dr. Laurie Marbas

(07:02)
Because that will make a difference. So just to keep that in mind. And the home assisting, less than 10, again, you have the less stroke risk and there's like you said, multiple factors there too. But I like the B12 also between 600 and a little bit up higher because that's when I see the methylmalonic acid is not elevated and the homocysteine tends to be a little bit more likely to be under 10. So that's just, again, anecdotal. But it seems to be playing out fairly often. So just throw that in there as well. Okay, someone asked what is pectin? Is fruit pectin in jams bad and should it be avoided? Anybody a pectin expert here? That's actually a really interesting question.

Dr. Chris Miller

(07:44)
Pectin in general is a fiber. So it's in apples and things, so it's actually really good for you. So pectin shouldn't be avoided. But as a preservative or using it for something else, I'm not entirely sure once it's… I'm not sure at that point.

Dr. Laurie Marbas

(07:58)
Yeah. And I'll say I'm not either. But I do see it in a lot of the more whole food, without the added sugar even stuff, so I'm not sure. That's a good question though. It's rare that you'll stump all of us, but that one, maybe you got us. Let's see here, Suzanne asked, when transitioning to a whole food, plant based diet. I keep being told to go low and slow with beans. Is there a specific plan on how to do this? Do I do one tablespoon of beans a day or increase the two tablespoons after a week? How do I make sure I'm getting enough iron while building up? I try to avoid supplements as I can get very constipated easily. So who would like to take on the bean question? We get a lot of that.

Dr. Niki Davis

(08:41)
So I would say that with beans, start out with, I guess it really depends on if you're eating beans already, how much you're getting. So maybe try to figure out how much per day you're already getting and then just increase it by a little bit. So maybe increase it by a fourth of a cup and see how you feel. And I always love to tell people to keep a food diary. So if you're looking at wanting to try to figure out how you're doing with the increases in the amounts of beans that you're getting. Just write down, “Felt a little bit more bloated today,” or however you're feeling. And then you can knock it back down maybe to an eighth of a cup and see how you're feeling.

Dr. Niki Davis

(09:21)
And again, keep that diary. And just increasing it slowly as you go. And there are products that you can take in the beginning, if you're adding more beans or you're eating more whole foods. And so you're producing more of the gases and the things like that through your gut biome, that love to eat the fiber and all of that. But just making sure that you can try like… I know that there's a vegan form of The Beano, I don't remember what it's called. But there is like a Beano type supplement that you can take that helps with that gas that comes off of the beans. And then as far as iron, that's something that you're going to find in a lot of different vegetables. And so don't think of it as that you need the beans in order to get that. So just making sure that you're getting a varied vegetable diet, plant based diet.

Dr. Laurie Marbas

(10:15)
Perfect.

Dr. Kim Scheuer

(10:16)
Adding citrus to like a salad will help absorb the iron and things.

Dr. Laurie Marbas

(10:21)
Yeah, vitamin C.

Dr. Niki Davis

(10:21)
Yeah, the vitamin C.

Dr. Kim Scheuer

(10:23)
Yeah, little pieces of orange on your salad might help or a little bit of mango. It tastes good and it helps you absorb it.

Dr. Laurie Marbas

(10:30)
Absolutely. And the other thing is, why are you low in iron? So is it an absorption issue? Is it a loss issue? Are you not making your blood cells? And is it truly low if you're anemic? Is it because of low iron or is it something else? There's different types of anemia, so that is where us plant-based doctors can be helpful and order labs.

Dr. Laurie Marbas

(10:49)
And all these lovely ladies are open for appointments, including Dr. Jeff Pierce and Dr. Klaper at plant-basedhealth.com just a little pitch there for us. But absolutely, so that would be the other question is what's the cause? And then of course the food to help with it. So very good. All right, so here's another question. Someone asked, looking forward to menopause, is this foolish? Am I missing enjoying something in my 40s? I want to put this behind me. Anybody have thoughts on that?

Dr. Kim Scheuer

(11:17)
I was so excited when I hit menopause. It was great. It was just awesome, so I'm with you. I didn't miss anything, but just make sure you're eating healthfully, you're doing weightlifting exercises because you don't want to get osteopenia or osteoporosis that you're getting out and getting all the micronutrients you can be in. But I was so psyched. It was great. And the more plant based I ate, the more soy I ate, I had less symptoms. So I was actually looking forward to it, to see how it would be, so I could talk to my patients about it. But it was easy and I don't miss anything in my 40s. So it was great, enjoy. Let your body do this.

Dr. Laurie Marbas

(11:55)
And I'm honestly looking forward to the day that it just not surprised anymore. It's like, “Oh, you skipped a month and oh, there it is again.” Yeah, well, that's such a pain.

Dr. Elisabeth Fontaine

(12:05)
Yeah, but to complete on that. There's definitely the symptomatology, the hot flashing and all that, we discussed those things. We've got to be careful that there's many other symptoms that women will come with. And the dryness, especially with sexual intercourse, it's not necessarily going to be replaced by the plant food base and you may have to discuss other and mean. And unfortunately, it's a subject that is really discussed, they're shy to ask the question. So you really have an open mind, to say it's amazing to be on the plant food base. It helps quite a bit, but there's other things that we may need to discuss. So let's just be open as much as possible to facilitate these discussion.

Dr. Laurie Marbas

(12:48)
Oh, I agree 100%, sexual health is so very important, it is. And it's funny a lot of patients who are like, “Well, I'm kind of embarrassed to say this, but…” But then that turns into a really fruitful conversation for them, so don't be afraid to ask those questions because that's what we're here for and it's confidential. And it's just really important that you have all those concerning questions because that will bother you and we're here to help. And so it's really important to feel free and comfortable asking those questions.

Dr. Laurie Marbas

(13:17)
So another question, I'm going to pull over here, Chloe asked an interesting question. Where'd she go, Chloe Stein, who's amazing. You guys to take out Chloe's Clean Cuisine, if you're looking for some yummy recipes, by the way. Chloe asked, is there any suggestion for what appears to be an eczema, psoriasis outbreak on my husband's face. He had a history of this on his hands, but it went away after two years of gluten-free, plant based eating. This red, scaly outbreak on the face was unexpected and he can't seem to get it under control. So any thoughts on just your rashes in general, plant based diet, was doing well and then maybe resurgence, any ideas there?

Dr. Chris Miller

(13:56)
Hi, Chloe, first of all, thank you for that question. I would look for a trigger. So when it can be a contact thing, if he's been exposed to a new soap, a new anything. I don't know, a detergent, something, new clothing. So if there's a contact to it, number one. Number two, I would ask how his gut health is. So has he had a little bit of more gassy and bloating than he normally does? Is he not digesting food as well? A little bit of loose stools or is it totally stone cold, wonderful normal? Because I always go to the gut for the connection between the gut. If it's not a contact thing or something direct topical, then I go to the gut is my next go-to. And so I would really pay attention to that.

Dr. Chris Miller

(14:40)
What he's eating, if he's eating a ton of fruit, because it's summer, sometimes that can do it. If he's eating late at night, because you guys are going out now for the first time in forever. So things like that I would pay attention to as well. Definitely make sure his gut health is good. And the third thing that comes to mind, just offhand, without knowing him or anything about his history, is stress in his life? Because that can be a trigger too. So if he's undergoing some stress right now or there's something going on with work, or life, or whatever, that definitely can be a trigger. So sometimes these things that seem so innocuous, that set us off. And sometimes it's a combination of all this. Eating a little bit differently, maybe having a little alcohol. Who knows what's in the mix? But anything like this can throw it out of the balance. And so you'll want to try to tease that out and see if you can get that back in balance.

Dr. Laurie Marbas

(15:31)
Very good, thank you.

Dr. Niki Davis

(15:31)
Yeah, and going on the stress, I think, the mental stress, but then also physical stress. So I worked as an intern at the TrueNorth Health Center, where they do fasting. And we would notice that when the body was under stress because it was being fasted and then refed, that some people would break out in a rash. So just thinking of that too, if you're making some big dietary changes, sometimes just that is enough stress in your body to cause you to have some outbreaks that you normally wouldn't have.

Dr. Laurie Marbas

(16:02)
Absolutely. I think we underestimate what stress does to our body. What it does to your blood sugars, your blood pressure, your everything. It's just so very interesting.

Dr. Chris Miller

(16:12)
It is, it's very powerful.

Dr. Laurie Marbas

(16:14)
Absolutely. So there's some really good questions here. Here's another good one. Anna, intermittent fasting and a plant-based diet, thoughts, durations of fasting hours or days.

Dr. Elisabeth Fontaine

(16:24)
I think in itself, I try, when I talk to my patient to say naturally speaking, I say intermittent fasting because it's a new wave and it's a very hot topic. But if you ask the people to say you have dinner, not too late, at 6:00 and you don't eat until let's say 7:00, you're doing intermittent fasting. So I don't tell them that because they want to hear it, “So we're going to do inter intermittent fasting. I'm just going to have you eat at 7 o'clock at night and you're not going to eat until 7:00 in the morning. In itself what we do is we're only removing the junk food, potentially, that they eat at night. I'm not talking with somebody who is eating plant food base. But you remove that eating at night, which unfortunately, is often a bad trigger. So it's a simple way to look at it. But then you don't have to say, “Okay, which recipe am I going to use? It's going to be 24 hours, it's going to be a week. It's going to be…” So that's my little input on that.

Dr. Laurie Marbas

(17:25)
Absolutely.

Dr. Niki Davis

(17:27)
Yeah, I'm a big fan of intermittent fasting. I think some people could say, “Well, this is a fad. Is this really something that we should be doing?” But if you really look back and you consider that it didn't always used to be that we had well lit, warm homes, that we stayed up late, watching TV. It used to be that when the sun went down, we tucked away and stayed in for the night. We weren't out foraging for food. So to me, it makes sense that you have an extended period of time of not eating, that you're not going to be looking for something at 2 o'clock in the morning to eat. It just wouldn't be safe. So I think it is something that just is natural for us to have that nice big break from food.

Dr. Niki Davis

(18:15)
It allows your body to reset, to get rid of toxins, to just relax and not be so focused on digesting food constantly. So it's a really nice way to give your body a break. And so I think that having an earlyish dinner, 6 or 7 o'clock. And then just holding off on eating until the next morning, whether that's 7 or 8 o'clock in the morning, that's intermittent fasting. And I think really, it just cuts down on that extra snacking that you don't need. A lot of this snack late at night to help us stay awake. It's actually something that if you're sitting and watching TV and your body's starting to get tired, eating a little bit helps keep you awake. So naturally, if your body is saying, “I'm ready to go to sleep,” it's not the time to be snacking. So I think that's really what it cuts out, is some of that extra snacking that you just don't need to do late at night.

Dr. Laurie Marbas

(19:10)
Absolutely.

Dr. Chris Miller

(19:11)
That's huge too, Niki. I love that. That's something that I think is overlooked because we read about all the data on it. The data's pretty strong that the not eating period helps heal your body, it lowers inflammatory markers. It helps lower cholesterol, and blood pressure, and blood sugars, and all these good things that can happen when you have these periods of not eating. But one thing that I noticed and it's so true in so many of my patients and in myself, I like to eat at nighttime.

Dr. Chris Miller

(19:36)
I mean, I used to, and so by saying, I don't eat after this certain hour, has really helped taken that away. And it helps my patients too, I know. And so it's been huge. And so maybe that alone is how it's helping us, I don't know, so that's a good point. I think sometimes we forget to point that out. But if that's something that you're going home and you find yourself eating late at night, then set a time where you're not going to eat past and watch what it does. It's pretty cool how it just shuts off that urge.

Dr. Niki Davis

(20:05)
Well, and it tends to be mindless eating at that time too. So during the day, it's lunchtime, you're starting to get hungry, “Okay, what am I going to eat? Well, I'm going to take this great whole plant food that's prepared in my fridge and heat it up and eat that.” But at night, you've already had dinner, you're not necessarily hungry and you're just eating to just keep yourself busy really. And it tastes good, but it's not-

Dr. Chris Miller

(20:33)
Or it's binge eating or emotional eating, right?

Dr. Niki Davis

(20:35)
Yeah, oh, absolutely.

Dr. Chris Miller

(20:36)
That's when we're doing all of that. And I know some of you out there must be relating with this, because I've definitely been there. And so you can't control that late night eating, that's when you're creating your sweets. And you were so good all day and now you're going to ruin it. And so setting that time has been so significant for me and for many of my patients. So yeah, that's a great-

Dr. Niki Davis

(20:55)
There are some good apps out there too. I think the one I use, I think it's called Zero, if I remember right. But basically, you just can put in okay, this is the amount of time that I want and you tell it, “Okay, I'm starting my fast right now.” So you have dinner, you start your fast. And it's funny how just having that set on your phone, it's like, “Okay. Well, now I can't because I told the phone that I'm not going to eat.”

Dr. Chris Miller

(21:19)
That's awesome.

Dr. Niki Davis

(21:20)
You don't want to go back and change it and say, “Okay, fine, I ate. So I'm going to start it now at 8:00 PM instead.” So I think that that really helps to have that running in the background to help keep you motivated to stay in that window.

Dr. Chris Miller

(21:35)
That's awesome.

Dr. Laurie Marbas

(21:36)
Excellent. Well, well done. And someone else says they love using the Zero fasting app, so-

Dr. Niki Davis

(21:43)
Okay, I got it. Right, woohoo.

Dr. Laurie Marbas

(21:44)
There you go, excellent. So this is a good question too. Karen asked, I hear a lot of experts and I read of several authors who refer to the endothelial function. What is this? And why is it so important? Thank you. We-

Dr. Kim Scheuer

(21:58)
So endothelial cells are cells that are lining your vessels and they're all over your body. And what they do is they function to help your cells vasodilate and move easily. And when you have damage to the endothelial cells, you can have not only problems with dilation, which could cause blood pressure issues and lots of other things, but you can also have cholesterol buildup behind it. And that's what causes problems in the heart.

Dr. Kim Scheuer

(22:26)
So endothelial function, you definitely want to protect that as much as possible. And so there's lots of things that damage endothelial cells and that's animal based diets. Oils tend to damage the endothelial function too, which is why we tend to not suggest people eat a lot of oil and to try and avoid oils of any kind because that can affect that. So that's why endothelial function is so important to your body, because it's all over.

Dr. Elisabeth Fontaine

(23:00)
But stress also have an impact on this. So it's all related, that lack of exercise and definitely all that. So it is very important.

Dr. Chris Miller

(23:12)
And in addition to that, which was awesome. So important to protect our blood vessel endothelium, but there's also endothelium in our whole body. So it's your stomach lining as well. And that's our whole stomach lining from mouth to anus is one cell layer thick, that's the endothelium. And that has the important job of letting food in and keeping out toxins and keeping out waste products and being selective in what comes and goes and letting electrolytes in and water has to come in at certain spots, but not other spots. And so it's pretty amazing. And so you also, just like Kim said, want to protect that endothelium with a good diet and stress and sleep and paying attention to all those good things because the endothelium everywhere is so fragile and you really want healthy endothelium in your whole body.

Dr. Laurie Marbas

(24:00)
Absolutely. There's some good questions, guys. I'm trying to get big ones. Here's another good one and it's a question we get a lot. I don't cook with oil, but so many people are so surprised and ask, “Oil is so healthy, why don't you use oil?” What is a good answer?

Dr. Niki Davis

(24:21)
So I would say, and this is keeping it really basic because if you don't want to go into too much detail, but it is processed, first of all. It is not a whole food. It's not even really a food it's completely stripped away from its parent plant to make this incredibly calorie dense material that should not be on your plate. All right, who else wants to say something about oil? I love talking about oil.

Dr. Laurie Marbas

(24:50)
It's liquid fat, it's liquid fat, literally liquid fat. You don't need it, it's-

Dr. Kim Scheuer

(24:58)
And it's high calorie, some people compare it exactly to white sugar. White sugar is again, stripped away. You can have sugar in an apple and that's healthy for you, but you strip away everything from it and it's this very similar to the white sugar. And so it's the most calorie dense food, it damages the endothelial function and it's highly processed. So no, you-

Dr. Laurie Marbas

(25:23)
And it's quickly absorbed and quickly stored. So just think of it that way. The body's like, “Hmm, where there's this packet of liquid fat, what could I do with it? Oh, I know I'm going to take it and absorb it very quickly and store it in my fat cells.” It doesn't even have to break down the food to get the fat from it, because you've already done it. You're literally just supplying the 120 calories per tablespoon of pure fat just for your fat cells to expand. So now, is olive oil better than lard? Of course, but let's not go there. Let's look at there's no need for oil in our diet, I promise, it's not a whole food, it's-

Dr. Niki Davis

(26:02)
And if there were a need for it, you would just eat the plant that it came from. If you're really worried about getting the nutrients from that olive, or from that corn or wherever you're getting the oil from, eat the original source, because that's where you're going to get all the fiber, the micronutrients, the other macronutrients. And it's not just the fat that's been stripped away, that really, is pretty much nutrient free. It doesn't give you anything besides just pure fat.

Dr. Chris Miller

(26:34)
And in addition to that, for the last thing, sorry, I have to chime in, for people reversing disease, the oil can sabotage some of your disease reversal. So people with diabetes, we're doing a low fat diet. So the oil might be the thing that keeps their blood sugar from falling and make blood sugar and the insulin go way too high. So we can see that. People with autoimmune diseases, the oil can cause the gut to leak some toxins called LPS, lipopolysaccharide over and cause joint pains and other symptoms that people with autoimmune diseases get.

Dr. Chris Miller

(27:06)
It can raise cholesterol. Some people are trying so hard to lower their cholesterol with this healthy plant-based diet. And then all of a sudden we realize they're having oil and we take that out and we see a significant decrease in that. So depending on what your goals are and where you are too, I always say to my patients, so it's something to keep in mind. If you're trying to get disease reversal, then we want to really go forward it and do it.

Dr. Laurie Marbas

(27:28)
Exactly, okay. And then if you guys, someone asks also, please tell the truth about coconut oil. So first of all, coconut oil is high in saturated fats, which is the fats that increase your risk for heart disease, and cancers, and your diabetes. It is an unhealthy… One, it's oil. But two, it's even one of the more unhealthy oils. So it is not healthy for you. So please don't consume it.

Dr. Niki Davis

(27:52)
It's 90% saturated.

Dr. Laurie Marbas

(27:54)
Oh my goodness.

Dr. Chris Miller

(27:56)
But honestly, I like it on my skin. It has helped a lot. I'm serious, my hands were getting so dry and you can see I've been putting it on, the coconut oil, and they feel so much so better.

Dr. Laurie Marbas

(28:05)
Nice.

Dr. Niki Davis

(28:05)
So you don't have to throw it out. You just use it on your skin instead.

Dr. Laurie Marbas

(28:08)
Well, the other thing too, would be interesting to see though, be careful, and I think Chris and I, you and I have talked about this even, is that the absorption through the skin. So that would be something to monitor.

Dr. Chris Miller

(28:17)
Yeah, I have monitored my own cholesterol, because it is high in saturated fat, right? So you worry about if your cholesterol levels are going to change. And my own are good right now, they haven't changed, as I do my little bit of oil, so I continue. But right, it is something to pay attention to. The reason that came up is I had seen one small study where people were commenting that maybe it was raising their cholesterol. So I didn't want to give up my coconut oil yet, so I retested mine and it was okay, so-

Dr. Laurie Marbas

(28:43)
Perfect. So I know we're at a half hour mark, do you guys have 15 more minutes in you? Yes?

Dr. Chris Miller

(28:49)
Sure.

Dr. Laurie Marbas

(28:49)
Okay, all right. There's so many good questions today. This is a good one. Jennifer asked, how do you answer and assist someone who has read in the conflicting information, do not eat the most important plant-based foods, such as lectins, beans, soy, gluten, greens, fruit, which is pretty much everything we eat? Astounding how these high nutrient dense foods get such a red flag by many, who would like to take that one on?

Dr. Kim Scheuer

(29:11)
I personally love sending people to nutritionfacts.org, because he goes and shows the studies and he talks about each one of those controversial things. Everything can be manipulated. So I say, follow the money and go to nutritionfacts.org. And then that really helps. I look at where the science is and tell them where the science is.

Dr. Laurie Marbas

(29:38)
Absolutely. And then you got to look at who is speaking, right? So you have the doctor, I won't give him the benefit of saying his name, who talks about the lectins and how they're so bad for you. He writes this book, he's a cardiologist, but then you go look on his website and he's selling supplements that are lectin blocking. And I'm like, “This makes no sense.”

Dr. Laurie Marbas

(30:00)
So basically, he's making money for sending forth a myth that this is an unhealthy thing. So let's be very suspicious about those things. That's the great thing about Dr. Greger and nutritionfacts.org, because he does speak the truth. It's an unbiased truth. He's not getting paid by anyone. He literally just puts it out there. He's been it for many, many years and he is a great resource. And he has quotes where he gets today. You go back and look at the primary resource if you'd like. So again, that's a great resource, but anybody else have any ideas, thoughts?

Dr. Chris Miller

(30:36)
In addition to what you guys said, those are great ideas, I also look at long term studies. And so all around the world, people who eat beans are living the longest, right? Look at the Balloon Zone Study. And there's so much more, Mediterranean diet. They're eating lots of tomatoes and lots of beans, and these people are thriving on these diets and living to 100 years old and not getting disease. So how can we all of a sudden say that they're so bad, take them out or you're going to die. So there are people with certain sensitivities at certain time in their life.

Dr. Chris Miller

(31:03)
So there may be a time where beans do bother you and even autoimmune people, if you're having a leaky gut and you're having issues, it can cause worse joint pains for a short time. That just tells me that you need to fix your gut and get it to a healthier level and heal it up and then be able to add beans back in as it improves. It doesn't mean don't ever have them because you want to have them, so you become part of these longevity studies and live long and age well too because since it has all those benefits. So if you look at long term studies, in addition to what people are saying, short term, sure, you can eat them. But long term, then we start to understand that, okay, maybe these can't be that bad because people are eating them for years and years and years and thriving on them.

Dr. Laurie Marbas

(31:45)
Mm-hmm (affirmative), absolutely. And this is common sense, guys. It's common sense. So anyway, we seem to have lost the ability to have critical thinking skills in our society. But let's just go back and just think about it and sit down and think about it. It's like we just react, we don't sit and take the time to actually think. I mean, Einstein used to do thinking experiments. That's kind of what we need to go back to.

Dr. Laurie Marbas

(32:07)
Let's just do some thinking processing here, so yes. And then some people you can't convince, because they're going to believe what they want to believe and you just save your argument for another day, another person. So let's move into night, there's some good questions about evening stuff. One, what helps with falling asleep and staying asleep? And any thoughts there. And then the other question is about late night eating and any ideas there. And then we'll be done. But go ahead, any thoughts on helping someone fall asleep?

Dr. Niki Davis

(32:38)
Well, so first of all, you've got to have a good environment. So making sure that you are in a somewhat cold, dark room. And when I say dark, it's not just about turning off the lights, you've got to not only prepare ahead of time, which means turning off screens and any artificial light for a couple of hours before you're planning to go to bed. But also looking around your room because there are now, on your light switch, you've got little lights that pop up and that are there all the time. Your alarm clock, all over the place you're going to see little lights here and there. And so you got to cover those up because those are going to affect you. So really preparing your environment that way, as far as light goes, sound.

Dr. Niki Davis

(33:28)
Like I said, you want it to be a little bit chilly. That's natural that before, again, we had these lit, warm homes, it gets colder at night. And there's a reason that that feels good to us. One of the things that helps you fall asleep is when your extremities are warm. So your extremities need to warm up before you go to sleep. Because what happens naturally, is that as your extremities warm your core cools down a little bit while you sleep. And that is a natural state of sleeping. So you want to make sure that if your feet are really, really chilly, you're going to have a hard time falling asleep. So maybe using an extra blanket on your feet, wearing socks, using a heating pad, something like that can help start that process, so that your body feels like, okay, it's ready for me to start sleeping. There are a lot of other things, so I'll let somebody else, if there's anything else that anybody wanted to talk about as far as falling asleep.

Dr. Chris Miller

(34:23)
I have an honest question for everybody here and I'm going to ask it on behalf of everyone in the participants as well. But so we're not supposed to use any electronics for a couple of hours before bed, who really does that? I have tried so many times to read a book, or read a magazine, or do some stretching, but the reality is, I have work to do or I'm doing something online or I'm doing something fun on my computer. So I have blue blockers and things I try to do instead, dim the lights. But are you guys really doing that in order to help your sleep, staying off for a long time?

Dr. Kim Scheuer

(34:56)
What I do regarding that is yes, I agree, we have to work late. But I make a specific time, an amount of time where I'll just breathe. I'll do some breathing techniques to slow my brain down and stop that… movement that I have.

Dr. Chris Miller

(35:11)
So is that like 30 minutes? Like how much time? That's what I'm curious about because we always tell our patients to stay off for a certain time. But I don't do it for that long. So I'm curious what you guys actually are doing.

Dr. Laurie Marbas

(35:23)
On Tuesdays and Wednesday nights when I see patients, I get done and I shut the computer down and I go straight to bed. I don't have a problem with sleep, but I'm so mentally exhausted from… I'm like glued to the patient, trying to get to them. But other nights, I do try to, I like drawing and that's my thing. I'm usually doing a laundry or doing that last bit of something in the evenings for at least an hour and so-

Dr. Chris Miller

(35:49)
To take your mind off it, yeah.

Dr. Laurie Marbas

(35:51)
Or I go for a walk, take the dog out. And that evening, the light's a big, important thing. So that exposure to that morning light kind of sets you off with that circadian rhythm for the day. And they've noticed it even in people who are blind, so it's not necessarily a sight thing. So there's special cells in the back of your eyeball that are saying, “Wow, it's a morning time. That means I'm going to start changing some hormone patterns.” And in about 14 hours, those hormone patterns are going to change again to get ready to go to bed.

Dr. Laurie Marbas

(36:18)
And that's where we're talking about this light exposure in the house, it's artificial. So at night, start dimming your lights in your house even and make them a little bit lower because as you go for a walk and you see the evening sunset, that's what we see. And so in the house, they talk about keeping the overhead lights off and bringing down, turning on the lamps a little bit lower. So some really interesting research on that. There's a book called Why We Sleep and the name of the author just left me, but that's a really good book. And there's another one on circadian rhythms, but yeah, absolutely. But I'm not the best, but we do what we can, right?

Dr. Chris Miller

(36:54)
Absolutely. I have so many things for my sleep and those are who talk to me or my patients out there know that I pay a lot of attention to it because it's so, so, so important. And sometimes it's elusive for us. And so I try to relax and turn off my brain and I set a time. I don't check emails past like 6:00 or 7:00 PM because it makes me think too much and it ruins my whole night of sleep, I found. So I'm really strict about that. Don't exercise at night, don't eat at night. It keeps you awake. And if you stop eating later at night and then you do it one night, you'll find you won't be able to sleep. It's a big deal actually. So not eating late at night and not having stressful conversations, not watching politics, but I do need to unwind, and I am still sometimes near our computer, not doing work but unwinding. And that's where I feel like, “Oh my gosh, oh my gosh, I'm sabotaging myself.”

Dr. Chris Miller

(37:43)
But I've changed my lights to red lighting in the evening. And that's helped a lot too. And again, those blue blocking glasses can help a lot. Definitely, I don't exercise at night, that will keep me wide away because it wakes me up. So I try to exercise earlier in the day to wake myself up. And then by evening I'm like getting low and slow and quieting myself down. But yes, if you want sleep tips, I have all sorts of little things that I have done and I continue to try. After you do all the sleep hygiene and all these other little things that you can do, exercise definitely helps you sleep. If you don't exercise, you're not going to sleep. If you don't get outside in direct sunlight, it's going to inhibit, you're going to have more sleep. And I think I saw that in a lot of my patients during COVID when we were all locked inside, kind of scared to go out for a little while there, we weren't sleeping as well.

Dr. Chris Miller

(38:31)
And so we had to get more active and get outside as a group and help ourselves sleep better. There are some supplements that we can use. Definitely magnesium, something I like in the evening, can help a lot of people. Melatonin plus or minus, depends on the type of sleep reason. It can help some people fall asleep, especially if you're shifting time zones or you kind of get screwed up a little bit. Low dose melatonin is what I always use, 0.2 to two milligrams. So if you're using a higher dose, it's not been shown to be as effective anymore. And at that point, I don't think it's working, so low dose that. And then the breath work, like Kim was saying, is fabulous and all that. But yes, sleep is so important, so that was a great question. Whoever thought to ask that, thank you.

Dr. Laurie Marbas

(39:11)
And a good thing on the melatonin, in adolescence, it can actually suppress certain puberty hormone release. So I would be very cautious about using it in children. So just to keep an eye on that. So the other question was, if you want to eat late at night and are trying not to, is it okay to chew gum, to keep from eating? I think that's a really interesting strategy. I hadn't thought about that. Any thoughts, ideas on avoidance of late night eating or chewing gum as substitute behavior?

Dr. Elisabeth Fontaine

(39:36)
I don't know. I guess a progression from not eating and chewing gum, I wouldn't say that it's a complete negative. It's not what I would necessarily recommend, but I say if it helps you to progress to non-eating eventually, that is okay. But it does stimulate quite a bit too when you to think about it, when you chew, everything keeps going, your stomach, salivary gland and everything. So you cannot imagine or think that, “Oh, I'm not going to put too many calories in my body. That should be okay.” It's not just the calories, the whole system will get into the, and that might become an issue. And just to joke a little bit about before, because I'm obstetrician and I probably didn't sleep enough all my life. Now, when it's time to go to bed, I fall asleep.

Dr. Chris Miller

(40:28)
Oh, it's awesome.

Dr. Elisabeth Fontaine

(40:29)
I'm catching up for all those years without sleep.

Dr. Laurie Marbas

(40:35)
All those babies.

Dr. Kim Scheuer

(40:36)
One of the things that does help me at night, and I wouldn't think that chewing gum would be the best because of some of the chemicals that they have in it, in the chewing gum. But I like a nice calming tea, like a chamomile or a sleepy time tea that might help, without any sugar or anything else in it. Just the warmth on my of hands maybe helps warm my body up a little bit and get me ready. And then just the calmingness of it does help.

Dr. Kim Scheuer

(41:08)
And especially if I'm hungry and thinking, “It's 8:00 and I know I should stop eating at 7:00, but I'm hungry. Let's try a big glass of, for me, hot water.” I'm weird, I like hot water or a calming tea. And that could be a problem for people who end up getting up in the middle of the night to pee. You don't want to have too much water in the middle of the night, but if that isn't your issue, because that'll wake you up and then you won't get back to sleep. If that's not a problem, that's something you can try.

Dr. Niki Davis

(41:40)
Well, I agree. Just having something to sip on, it's just giving you something to do, that's not starting the saliva process and keeping your body think, “Oh, food is coming. Food is coming.” But just having something like a water, ice water, sparkling water, something just to do, I think helps.

Dr. Laurie Marbas

(41:59)
Yeah, I think those are all excellent answers, all right. Well, we have spent 40 minutes. I'm so sorry for the questions we didn't get, I tried to get the broad questions as much as possible. But thank you guys for joining us. We'll be back in two weeks, same time, same place. And remember these great docs. Can you guys go through and tell us your names again?

Dr. Kim Scheuer

(42:21)
Dr. Kim Scheuer, I have licenses in 20 states. And I love seeing everyone. So I'd love to help take care of you.

Dr. Chris Miller

(42:30)
Hi, I'm Dr. Chris Miller again, and I am also licensed 20 states. But I am practicing out of Colorado and so happy to be back. And love to see you if you're interested in coming to see me.

Dr. Niki Davis

(42:43)
And I'm Dr. Niki Davis boarded in family medicine and lifestyle medicine. I am living in Salt Lake City, Utah, and I am licensed to see people in Utah, California, and Florida.

Dr. Laurie Marbas

(42:55)
And other states coming.

Dr. Niki Davis

(42:57)
Yes.

Dr. Laurie Marbas

(42:57)
Yay.

Dr. Elisabeth Fontaine

(42:58)
And I'm Dr. Elisabeth Fontaine, OB-GYN and lifestyle medicine and licensed in Vermont, Florida, Michigan, and New York.

Dr. Laurie Marbas

(43:12)
Yay, excellent. And we also have, Dr. Jeff Pierce, MD, he's in California and Texas. And Dr. Michael Klaper, who needs no introduction. He's in New York, Florida, Hawaii, and California. And I'm Dr. Laurie Marbas, I am in all the other states, actually every state. So again, there's some amazing docs here. We see international patients as well. You could see any of these amazing docs on plant-basedtelehealth.com. It talks about where the states are and what you need to do. And we are super excited and happy to see anybody. So thanks everyone for joining us.

Dr. Laurie Marbas

(43:46)
And these videos are recorded. They're put on our YouTube page, so please subscribe there. They're also left on the Facebook. So if you're on Facebook, you can have access to those. And they're also transcribed and eventually put on our website to hopefully, be there. And also, we're on Instagram. And again, like I said, we're on Facebook, so you can have access. And we do post other things as well on Instagram. So if you want to check that out, that's another helpful resource. So please come see us, refer people to us, share the word. And we're so thankful that you guys are here. So have a great weekend, everyone.

*Recorded on 6.10.21

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