#228: Dr. Laurie Marbas Answers Your Pressing Plant-Based Health Questions
Dr. Laurie Marbas, plant-based physician
Plant-based physician, Dr. Laurie Marbas, joins Rip LIVE to answer your health questions!
Dr. Marbas is a renowned board-certified Lifestyle and Family Medicine physician. She is licensed to practice in all 50 states and Washington, D.C.
Questions and highlights from this Q&A include:
Is it bad to combine berries with bananas?
Should we wait to shower for optimum vitamin D absorption?
Is there anything that can help with COPD?
Is vital wheat gluten (used to make seitan) too processed?
How can I get more protein and collagen after surgery?
What are your thoughts on plant sterols to get cholesterol down?
Can you address hair loss on a transition to whole food, plant-based?
Recommendations for osteoporosis?
Thoughts on coffee and green tea?
Is it best to take B-12 with or without food?
Does intermittent fasting with whole-food plant-based eating help with weight loss?
Do all sugars affect your body in the same way? (stevia, maple syrup, etc.)
Is a plant-based diet making my legs hurt?
What is the best way to get rid of visceral fat?
With the weather starting to change, what dishes are you looking forward to?
Thoughts on supplementing EPA and DHA?
Any thoughts on what can help with tinnitus?
Does roasting sweet potatoes affect their nutrition?
What are the benefits of wearing continuous glucose monitors (if you’re not diabetic)?
About Laurie Marbas, MD
Partner with Dr. Laurie Marbas, a renowned board-certified Lifestyle and Family Medicine physician. She is licensed to practice in all 50 states and Washington, D.C. She embodies professional versatility and expertise. Dr. Marbas is committed to delivering personalized, top-notch healthcare solutions tailored to your unique needs. Embrace this unique opportunity to work with her and experience the remarkable difference she can bring to your health and wellness journey.
Episode Resources
Watch the Full Episode on YouTube
Dr. Laurie Marbas Website - Discover all of her health and medical services - https://www.drmarbas.com/
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Episode Transcription via AI Transcription Service
Happy Holidays! Happy Holidays!
We cannot wait to bring you some spectacular episodes of the PLANTSTRONG podcast in the new year with even more PLANTSTRONG education and inspiration on some of the most requested topics starting January 4th.
Before today's show, I would love love to invite you to join us at one of our PLANTSTRONG retreats in 2024.
[0:40] You've heard me talk about these. You can spend a week with us in Black Mountain this spring or Sedona this fall, and whichever you choose, each event is an opportunity to reset, recharge, and relax while we do all the cooking.
Enjoy endless buffets of whole plant-based fare, daily exercise, exercise, lectures on the leading science, and nightly entertainment while connecting with new friends from around the country.
We say that this is a once-in-a-lifetime experience that you won't soon forget, but we also have quite a few people who have come every year as an annual celebration of what a plant-based lifestyle has done for them.
So whether it's your first or your fourth time, we hope to see you at one of our epic events this year.
[1:33] Simply visit the show notes or go to planstrong.com and click on events today.
Now, while we're putting those together and taking a little break to spend time with our loved ones, enjoy this Q&A session with Dr.
Laurie Marbas that we did live a few months ago.
And just so you know, we go live just about every Friday on Facebook Facebook, and YouTube for even more fun and educational content to help all of you on your journeys.
Visit the show notes for all the links to follow us on your favorite social platforms.
Now, please welcome Dr. Laurie Marbas as she answers your pressing PLANTSTRONG questions.
Introduction and Temperature Check
[2:20] We are back. Another Friday. Back by popular demand, we have Dr.
Laurie Marbas. She's going to be doing a wonderful Q&A session with us.
So get out your questions and throw them into the chat room.
But before you do that, let us know where you are listening from today and what the temperature is where you are.
Today in Austin, I want you all to know that it is right now 84 degrees, Laurie, and we have not seen a day below 90 in a long, long time.
So this is very monumental for us.
Wow. It's 84 here in Mission Viejo, California, and it's very unusual to be this hot.
So there you go. Well, we got Beth tuning in from Tulsa and it's 67 in Tulsa right now. How about that?
[3:19] So did you say you're in Mission Viejo right now?
Yeah, California. That's where I live. Yeah, yeah, yeah. Yeah.
You know, Mission Viejo is notorious for being a huge swimming power.
Like they've had the mission. Yeah.
Really down the street. There's the pools and everything. It's amazing facilities.
Absolutely. Yeah. They have produced more Olympians from that that club team, the Mission Viejo Natadors, than wow, than just about anybody.
That's impressive. Yeah. Very, very cool.
All right. Right. So everybody, everybody, we've got limited time here with Dr.
Laurie. So I'd love to utilize her as much as we can with your burning questions that you have.
I'll get the kind of the ball rolling here, Laurie, if you don't mind.
Yes, sir. So I've seen a lot of noise lately about some reason it's bad to combine bananas with berries.
[4:23] And I'm wondering if you've seen this, heard of it, and if there's any kind of validity to, you know, why it would be wrong to combine a banana with some berries.
Yeah, it's interesting. I first heard this from a patient, I don't know, about a month or so ago.
I guess there was a small study indicating that there's an enzyme from bananas, PPO or something that will keep berries from, you know, you can't absorb the nutrients as well from the berries. So it's best to separate them.
Again, it was a really small study. It kind of glanced it over and I wasn't impressed enough to remove my banana from my very concoction because it makes me quite happy to eat those two things together.
[5:07] So, but there is maybe I would say a signal that there might be something to consider. I don't necessarily think you have to make, huge changes at the moment. It's kind of like, yeah, let's see what the evidence shows. But I wasn't convinced it was a very small study.
Yeah. Well, I can tell you, I usually have two bananas on my cereal with berries, with kiwi.
Anybody that's been following me on Instagram knows that I have at least three different fruits on my cereal and sometimes four or five with with different nuts and seeds.
And, um, I, I, I, I find it absolutely.
It's it, to me, it almost sounds like, you know, well, there's, there's lignans or there's lectins in those beans and, oh boy, that's a bad thing.
And, uh, you know, the reality is something else.
Yeah, absolutely. And I've literally have had bananas and berries almost every single day for the last 12 years.
I don't know. I've been pretty good, so there's that.
Yeah. You look like you're holding up all right, for sure. I'm holding up pretty good. And you too. All right.
[6:18] I'm going to go in and start pulling up some of these questions here.
Question about showering after sun exposure for vitamin D absorption
[6:21] So this is from We Celebrate Eating Plants.
Wants to know, should we wait to shower after sunshine for optimal vitamin D?
Do you understand exactly what that question is, what they mean yeah so there was some like concern like the the you're in the sunshine and the vitamin d is being changed right um in your skin and should you wait because you wash it off i haven't seen any evidence that you need to do that i personally out in the sun will shower because i you know you're sweating gross so you know it's completely up to you and your hygienic preferences I don't think you need to worry so much.
The majority of the people that I've seen anyway, may require small amounts of vitamin D supplementation just to keep it above, even if they live in Florida.
And if you're living in Florida and outside, I'm not sure people want to be around you.
Yeah yeah but it really is i think um again it gets to that it's such a minute concern people get really deep in the weeds and i'm just like i'm ignoring kind of the bigger things in lifestyle that they should be complementing with you know being out in the sun like good sleep eating hopefully so we get zeroed in on one small thing but no i i don't think you need to do so much But again, I haven't dove into the research on that particular topic, but I will make a note of it.
[7:45] Vitamin D and showering. Yeah, I mean, it's an interesting question and something that may deserve a little more attention.
Absolutely. Is there anything that can help with COPD?
Yeah, absolutely. So when you think about COPD, so this is an issue typically reserved for those who have a history of smoking or current smokers, they may require oxygen.
But when you switch to a whole food plant based diet, I've seen some really interesting things happen with COPD, including like their pulmonary functions, like there's pulmonary function tests you can do, you know, how much can a person breathe in?
How rapidly can they breathe out their lung capacity, the inflammation decreases, which is dramatic in a whole food plant based based diet, which will help alleviate, you know, the need for medications and your breathing capacity, you may see improve along with the fact that you can also do more exercise, which also help with all of that.
So all of it comes together, but I think it honestly starts one stopping what may have caused it, which would be the smoking.
And then two, uh, doing your best to eat a healthy whole food plant based diet for sure.
Sounds, sounds, sounds like a good protocol right there. there.
Question about vital wheat gluten and its healthiness
[8:56] This is from Ellen wants to know, can you talk about vital wheat gluten?
It seems like an item that's too processed to be healthy.
Yeah, I guess. I mean, I certainly wouldn't go out looking for, you know, like, and it definitely depends if what you're making, what you're doing.
[9:14] I don't know much as far as like, is it too processed to be healthy?
I think anything you have to look at in the whole.
So I would, again, let's move to the whole food versus removing moving something because if we start isolating, for example, a whole soybean is fantastic, but we start bringing out the soy protein isolate, that's an issue, right?
So then it starts acting more like animal protein. It can cause more issues.
So where are you talking in the context? Is this in a processed food?
Are you adding it to a recipe to do a certain function? So I guess it really depends on the context and how much you're taking in.
Yeah. Yeah. I would imagine like when I think of vital wheat gluten, I think of usually like seitan, right?
Which is which is a great kind of, you know, meat substitute.
It's what, 70 percent protein. Yes, it's it's processed.
[10:05] But I think if you're going to have that like like we probably have it once every two weeks in a stir fry.
I think it can be. Yeah, I think I think it can be fine. you're not overdoing it and um, Yeah. Yeah. The only thing you need to be concerned about is if you have celiac disease or some gluten sensitivity issues.
Some individuals, I'd say 10 to 15 percent of those with Hashimoto's or hypothyroid issues may want to be very careful about their gluten intake as well.
So but again, it's not all people who have Hashimoto's, a smaller percentage. Yeah. Yeah.
I'm just kind of pulling them up here as they're coming in. would love to ask how to get more protein collagen in my diet, especially after my recent surgery.
Importance of Protein in Healing and Collagen Supplementation
[10:56] You have any thoughts on that one? Yeah. So, you know, it's, it's an interesting discussion because after surgery, you do need more protein in order to heal, right?
Cause those, your body is reconstructing all the things that were damaged in that process.
And so again, it can gets back to really focusing in on tofu and beans and whole grains and eating Eating those foods that have higher percentage of protein and that's in seeds as well, right?
So it's, again, another source of great protein, healthy fats.
But the collagen, your body will take the precursors that you're consuming, vitamin C and some other things, and make the collagen.
[11:31] So I would be less concerned about consuming some type of collagen supplement, which a lot of people will recommend because it's broken down in the digestive system anyway. way.
But again, making sure you're eating adequate calories to sustain a healthy weight.
And if you want to focus in on some higher protein foods, I don't think that's a bad idea.
It seems like collagen is like trending in a major way right now. Oh, for sure.
They're putting it in food. People are taking it in supplemental form.
And is there anything to that? Not that I've seen.
A lot of the quote unquote, so if you're strictly plant-based or vegan, Again, you're already what you're getting in these vegan collagen supplements are the precursors. Right.
So, again, what you can get from whole foods. So save your money off these supplements that are probably not going to be showing any benefit.
But, you know, people worry about wrinkles and different things, skin integrity with the collagen components.
[12:30] So not that I've seen any evidence to it.
Got it. This is just a nice comment from Lori Williams saying, and this is in reference to you and I both have bananas with berries.
Right. And how we you know, I've been doing it for a good you know, you said 12 years. I've been doing it almost 35 years and we both look great.
So thank you, Lori. Thank you. I like your name, too.
[12:53] Exactly. So this is from Penny Drugsma.
What a great last name. name. Penny Drugsma, Dr. Marbus, what are your thoughts on using plant sterol capsules to help lower cholesterol?
[13:05] Yeah, it's really interesting. So the plant sterols, you know, when I first discovered them a few years ago, especially with patients who are really struggling to get their cholesterol down, I thought it would might be a good idea.
But if you dig into the research, and this is more animal based research, by the way, what we found is that the, you know, the plant sterols keep your body from reabsorbing your body's cholesterol that's being recycled, So it basically inhibits that absorption. So you will see a decrease in numbers.
However, the sterols, the plant sterols and the cholesterol are very similar in, think of it as a shape, right?
So you're taking a key and fitting it into a lock or a receptor, you know, excuse me, some molecules fitting into its receptor.
So what's happening here is that people take up the plant sterols instead, and they can actually incorporate it into like atherosclerotic plaque.
So it can actually, you can still have an acceleration of atherosclerotic plaque, even though your numbers are lower.
So you might be a little bit deceived in that sense. So I personally do not recommend them just based on the current evidence that we have.
And there's probably some genetic propensity to who can do that and who can't.
But if you want to consume foods that are high in plant sterols, I think that's a safe way to go, like sunflower seeds or sesame seeds, something like that would be fine.
[14:23] Wonderful information. Thank you. I'm going to go a little bit farther down and then I'm going to start coming back up on the list with questions.
So Nikki wants to know, can you address hair loss during a transition period to whole food plant based?
Hair Loss during Transition to Whole Food Plant-Based Diet
[14:36] I'm guessing there might be a might be some minor hormonal shuffling going on.
Yeah. So I've seen this a few different times and I definitely would like to address it because I think hair loss, especially for women, can be quite disconcerting.
So when you transition or have any type of stress, be it good stress, you will sometimes see when you're having a lower calorie diet that might be part of it.
[15:02] For example, I had when I first started implementing a whole food plant based diet with patients, I neglected to say eat all four categories.
I said, just go eat plants. And they went straight to the produce aisle and left out the beans. grains, whole grains.
But these were things that I had to learn, you know, 12 years ago when transitioning and practicing because I didn't really have good places for you to go learn.
So there's that piece, right? And sometimes this will happen, you know, your hair goes through these phases of growth.
And majority of the time you have about 80 to 90% of your hair is in active growth phase, and then the other is in a dormant phase.
And when you have this transition or stress in the body, you may see, you know, down to 40% growth phase and 60% dormant. And then there's a hair loss.
And what you'll see is over three to six months that hair growth should return.
It's kind of like after pregnancy, you'll get a rapid amount of luscious mean hair, and then you have the baby and it all falls out.
So maybe it's the stress of releasing the baby, but maybe just parenthood.
But the other thing that should be very mindful of is our iron stores.
So if your Your ferritin is less than 50. So ferritin is the protein that holds onto iron and stores it away.
[16:16] If it's less than 50, there's been really good evidence of making one.
You can you can increase your iron rich foods, but sometimes women are low.
And I speak to women because of most of my patients in the ones I see this happen with.
Or if you're a runner, long distance runner, sometimes you'll see a lower iron scores.
But if your ferritin is less than 50 and if we can, you know, if they're having heavy periods or something else, or maybe they're not eating well or whatever the multitude of reasons might be.
If we actually do some supplementation for a period of time, get that ferritin over 50, the hair loss in 100% of cases will typically stop.
[16:53] And that's also goes with, and these are people who are not anemic.
So you could also have that occur with people with restless leg.
Typically you want to get ferritin around 75 or above and then fatigue for women who have this, just like, I'm just fatigued, but everything looks normal.
Your thyroid's normal. You're not anemic, but your ferritin's below 50.
Sometimes that will improve. So just some things to think about with hair loss.
[17:17] Nice. This is from, wait, let me, somehow I lost that one. Here we go.
Recommendations for Osteoporosis Prevention and Treatment
[17:24] Yeah, from Nan. What are your recommendations for someone with osteoporosis?
I hear negative things about medications like Fosomax.
Can I get enough calcium through my diet and build bones with a daily walk of at least two miles?
So osteoporosis is a complicated matter. First of all, we should be having this discussion with parents and their children because we really need to be banking on our bone stores, you know, in childhood, because by age 30, that's when we start actually losing our bone mass.
But absolutely resistance training is key, right?
At least three times a week, you know, doing lifting, moving heavy things, walking can be a part of that, but I would still push towards more resistance training, like compound movements, progressive strength training, progressive overload, where you're, you know, lifting and pushing and pulling and doing different things, kind of like go watch a MS listen for a day, right?
[18:17] So those are the type of things you need to do. Now, as far as osteoporosis prevention, that's a big thing.
Make sure your vitamin Ds are above 30, making sure you are getting enough calcium, which you most honestly can, right?
If you go to something like MyFitnessPal or Cronometer and you track your food, you know, if you're hitting like a thousand milligrams per day, you're fine.
Now, some people may have had a history of fractures, right?
So if they have very fragile bones and you know, they've had spinal collapse, or they've had a hip fracture, or some fall with some other type of fracture.
[18:56] They may require medication.
And unfortunately, that's just where we're at.
Now, those individuals will probably require calcium supplementation, just because remember, the body's inhibiting the release of calcium for things like muscle contraction and things. So you would need that.
Now, outside of being on medications that inhibit the calcium being released.
I do not recommend calcium supplementation because calcium supplementation can increase atherosclerotic plaque.
It can cause, you know, what they think is happening is the calcium enters into the bloodstream.
It can cause some platelet aggregation or some clotting to occur.
So those are the things you need to be mindful of, but making sure your vitamin D, getting out in the sun, doing strength training, walking again, and you should should be able to get enough protein and calcium and all the good things that you need to have healthy bones but if you have osteoporosis and it's severe that's a different discussion and you need to know why why do you have osteoporosis right so there's lots of different reasons yeah and i would tell you too you know don't smoke don't know you don't want to uh too much salt is bad as well right and um yeah you could have hyperthyroidism you could have uh parathyroid issues.
I mean, there's so many issues that need to be investigated.
But yeah, just you need to know why so you can correct course.
Coffee vs Green Tea for Blood Pressure
[20:20] All right. Here's an interesting question from Meg. She's lost 50 pounds.
She's off blood pressure meds, I think.
I think her question is, she's having one cup of black coffee.
[20:34] It looks like a day. Her blood pressure is 125 over 77. Is green tea okay?
I'm whole food, plant-based, no oil, no alcohol.
I run or walk 10K a day. I have 30 pounds left to lose. Curious about your opinion. it.
Yeah. And I think one cup of coffee is fine per day and green tea if you enjoy that.
What's going to happen, you know, obviously the 125 over 77 is better, but it's not optimal, right?
We want to see it less than 120, even probably closer to like 115 on top and definitely under 80 on the bottom.
But congratulations, by the way, for losing 50 pounds. That is absolutely phenomenal.
But as you lose that additional weight, you should see your blood pressure start to the decline.
And then it would just include foods that also help with blood pressure, right? Potassium rich foods.
You want to, you could try hibiscus tea, ground flaxseed, all those things, dark green leafy vegetables, all those incredible foods that you can add into your diet will also help get that number a little bit lower.
But if you want a cup of coffee, again, I think it's okay.
There's actually some interesting things, health benefits to coffee.
I don't drink coffee. I just I just never liked the taste, but for those who do, I don't.
Yeah. I'm the same way. I've never, I've never been a drinker of coffee. Yeah. No, I do drink tea.
My black tea on a regular basis. Yeah. Good.
[21:55] Speaking of which, you know, we have some of the best teas on the planet.
I'll have to send you some.
Oh, please. Oh, I'm telling people all about you, you, your food all the time.
So you're definitely on my list of things to do. All right.
[22:10] Sharon wants to know, look at how you spell Sharon. Isn't that wild? S-H-A-R-Y-N. Cool.
Best to take B12 with or without food?
I don't think it really matters. Yeah. Yeah. Yeah. Well, that's what I was thinking.
Kelly wants to know, does intermittent fasting with plant-based eating help to lose weight?
Sure. Yeah. So let's think about what intermittent fasting is doing.
One, it's making you mindful of your food and how much you're taking.
So most of the time, it's because people are eating less food, right?
You're skipping a meal or you're condensing your food and you're not as hungry and you've We've set these rules of like, I'm not going to snack later in the evening when I'm watching intelligence.
So, yeah, it ends up being most of the time related to a caloric deficit, which is why you would lose weight.
But if you put someone on a whole food plant based diet and do intermittent fasting.
Yeah, absolutely. It's a very powerful combination.
Different Types of Sugar: Maple syrup, white sugar, and more
[23:05] Honey, do all sugars affected by the same way?
Maple syrup, white sugar, date sugar, coconut sugar, date syrup and the fakes stevia and erythritol. all?
Yeah. So it's, it's an interesting question. Um, now have I gone down to the rabbit holes of the sugar, you know, where it's coming from?
These are still simple sugars.
Um, I think there's probably healthier in the sense of where they're coming from, right?
Maybe the less processed, but sugar is still sugar at the end of the day and you'll see blood sugars rise.
Um, but, uh, yeah, so I would still just be very mindful of your sugar intake, regardless of where it's coming me from. I still use maple syrup.
Um, I don't, and sometimes date syrup, but again, these are just one-offs.
It's not like I'm having this every single day. It's in a recipe.
Um, and I think maple syrup is, you know, there's probably some compounds that have health benefits to them.
Like, um, honey is not vegan, but honey in general has some really interesting antiviral antibacterial properties.
Um, when I was taking my wilderness medicine, uh, courses, um, they talked about about having honey sticks available beyond the fact for diabetics, you might need it, but application to wounds.
So it's really fascinating in that sense. For sure. Um, Yeah, if I could add to that, you know, typically almost all of these are 50 calories in a tablespoon.
The Benefits of Date Sugar
[24:29] Hey, what's up there? Good doggy. For the most for the for the most part, you know, they all are empty calories.
But I will say, like, you know, the good thing I would say about date sugar, for example, is it's basically just pulverized dates.
And so you're at least getting, you know, all the fiber and and some nutrition as well there.
Yeah, I think if it's taken the whole fruit and putting a little water and blending it, that's fine.
That's a different story than pulling the sugar molecules out of it, for sure.
Yeah, but Connie, the thing is, most Americans are consuming 30 added teaspoons of sugar a day.
That's 150 plus pounds a year, and that's an issue.
Tissue so i think i think what laurie and i it's like we really you know if you can keep your added sugars to like two two added teaspoons a day i don't think it really matters what i wouldn't do the the fake stuff but it really shouldn't make a difference it's just america is overdosing and the fact of the matter is we've got it in your pasta sauce your yogurt you've got it in your your crackers.
I mean, you can't escape it. So you got to learn to read labels and buy packaged boxed and canned foods intelligently.
Yeah. Pasta sauces, ketchup, places you wouldn't know. Think about it. Exactly. Exactly.
[25:57] Here's a biggie. I had a sudden cardiac arrest on October 8th, 2017.
I have a defibrillator and have never had one problem until August 7th.
I woke up in my My legs hurt so bad that I could barely walk.
I easily walk seven miles a day without pain.
Only when I first wake up, my doctor said I need to stop my BPD.
I'm not sure what that is. And go dash.
Oh, oh, I know what that. Yeah. And go dash because it was my diet that caused the pain. I've been plant based since for 18 months.
I don't know. What do you think? No, no.
Seeking Second Opinion on Leg Pain
[26:34] Plant based diet is not going to suddenly cause your legs to hurt and barely walk. I would think back injury, either that or some arterial like issues there with some type of clotting issue.
Right. Because you have a history of atherosclerosis. Maybe there's, you know, remember, it doesn't just affect the heart arteries.
It could affect the arteries going down into the legs.
So I would absolutely please seek a secondary opinion because that is absolutely not true.
You need additional workup and if anything, imaging, blood tests and things like that. So please do not ignore that.
OK, thank you.
[27:16] Rhonda, best way to get rid of visceral fat. And will you help tell people what is visceral fat?
Yeah. So visceral fat is the fat that's going to kill you.
Because think of it, you know, it's different than the fat on someone's hips, right? So these are the individuals that you may see that have more of an apple shape.
And visceral fat means it's the fat in and around your organs, right?
If you think inside your gut and different things. So this is very inflammatory fat stores.
And so the best way to reduce your visceral fat is, again, eating a whole food plant based diet, having a moderate caloric deficit, exercise and doing all the things that we always tell you to do, things that we know we should do, but we don't always do as well.
But as you lose weight, the visceral fat should begin to dissipate as well.
And there's different testing you can do, like an in-body scan will tell you to some degree.
I don't know how much of accuracy or you can do like a DEXA scan specifically for body composition. And that can kind of give you an idea of your visceral fat as well.
[28:23] All right. Justin here wants to know, with the weather starting to change, what foods are you looking forward to this fall?
All oh uh what'd you say chili soups and chilies i i couldn't agree with you more like uh two nights ago we made a i should say my wife made it it was a pumpkin chickpea curry dish that we'd made over over rice brown rice and it was divine but definitely definitely stews chilies wonderful wonderful hearty soups.
Um, I love dipping a nice, a nice, uh, bread in those things or rolls.
Uh, the plant strong cornbread that's out. Oh my gosh. I love your cornbread.
I love your cornbread. Yeah.
Yeah. I actually, I had somebody yesterday that told me, They took, I think it was two of the chunky chipotle chilies, poured it into a saucepan, or not a saucepan, a dish.
Yeah, a dish. And then they did a package of the cornbread on top of that, and they had chili cornbread. Oh, nice.
That's a great idea. Because I have chili in my cupboard as well.
It was Carrie, actually, who's hiding, working in the shadows.
The Debate on Supplementing DHA EPA
[29:47] Let's see. Uh, all right. What's this? Um, what is your take on supplementing DHA EPA?
I've seen a lot of back and forth on this from the plant-based doctors.
Yeah. I mean, what do you think?
[29:59] I am, uh, you know, I debate my head. Yeah. I'm actually very torn.
So, cause when you do like an omega check or fatty acid check to levels, you know, many times you'll see someone, if they're not supplementing with like the omega-3s, a long chain algae, uh, or algal oil, um, you'll see that that they're low, but then there's evidence that maybe this is, you know, the DHA is actually stored in tissue.
So you can't accurately measure it. Of course, we're not going to go do some brain tissue biopsy.
And I've met some amazing people and they point out the research and I'm like, well, there's that too.
But, you know, if someone's not eating a lot of nuts and seeds, maybe they're not getting much ALA, you know, I feel torn.
So I think what I'd like to do is look at the person talk to them if they're having any history of heart disease or if they have inflammatory disease like some type of rheumatoid arthritis or autoimmune disease i give them a small amount i think it's 250 milligrams per day is one to maybe just you know i just like to maybe just get our levels okay until we have a little bit more evidence and a little bit better testing available um because it's really important for brain health heart health and i i just would We'd be concerned if we just base our decision on what we know right now on completely not supplementing.
I don't know. Well, and let me ask you this.
The potential harm of excessive amounts of EPA and DHA
[31:23] It seems like a smart idea as an insurance policy.
But in your opinion or in any research or any data, has it shown that having excessive amounts can do damage?
And what kind of damage does it do? like what are the side effects how's it harmful right yeah so if you isolate like for example epa right and there's prescription medications you can increase your risk for bleeding and different things like that so you do need to be careful and 250 milligrams of a epa dh is not going to be harmful for you um in that sense but uh yeah you can absolutely anything it's even water right it's dose dependence right the poison is in the dose so you drink a gallon of water in five minutes, you may have hyponatremia and die.
So, yeah. Mm hmm. Mm hmm. Uh, All right. Well, the jury's still out on the old DHA EPA, but...
I will tell you, I take a small amount every day, if that will help alleviate...
What do you take? How much do you take?
I have around 250 milligrams, 350 milligrams, somewhere in there.
And is it a DHA EPA capsule that you take, or what form do you take it in? It's a capsule. Okay.
[32:40] And people are funny, too, because they get so concerned about the fat and the oil.
They're like, vitamin D is coming in an oil capsule. That's too much oil.
No, you'll be all right. It's a fat-soluble vitamin. It's all right.
And the same thing for the omegas.
So we've had, this is our second question, so I'll bring it to you here on tinnitus.
Do you have any thoughts on what can help with tinnitus?
That's a tough one, right? And for people that don't know, tinnitus is that ringing, that obnoxious ringing in the ears.
And I can tell you when I was a firefighter, Laurie, and especially after some loud calls.
And actually, when I was young, after some loud rock concerts, you just have that ringing in the ears. It would last for a long time.
Yeah. And it's really obnoxious. Yeah.
So the tinnitus, I haven't seen too much in the sense of treatment that's been very successful. Honestly, it's a matter of.
[33:38] Learning to live with it and making it part of it.
So you just kind of get used to it. You don't hear it as much.
Maybe most people deal with it at night, like dealing with, they'll put like a white noise machine in or something that they kind of hides the sound.
Cause when I was in the military, there were, you know, I was in the air force.
So there's lots of people exposed to loud noises all the time.
And it's the number one, I would say one of the most common disability ratings that we get of folks who are leaving the military is tinnitus.
And it can be quite significant and loud and just annoying.
But I don't have any good evidence as to what can help with it dietary wise or otherwise.
And I'm so sorry. I wish I did. Yep. Yep. Well, thank you.
So, again, we celebrate eating plants wants to know if we roast deeply like sweet potatoes, does that detract from the nutrition as opposed to just roasting lightly? lightly.
I've never heard that before. I don't know the difference, I guess, because I would just say roast it until it's done where you can poke a fork through it and it's tender. So I don't know.
You still need to cook it till it's cooked. So then I would stop.
[34:49] Maybe slowly at a lower rate, maybe a lower temperature might be something you might want to consider, but like, I don't know.
What do you roast your head i'm sure well i i know that for example there's um when you do when you brown toast and other things like that um what's it called that you create i'm trying to remember the ags uh there's another word i was looking for um like burn toast it's um not the ags anyway it's escaping me it'll it'll but if that's what she's talking about i i totally fully understand where she's coming from, but, um.
[35:29] The um acrylamides acrylamides that's exactly it that's what i was thinking about acrylamide right when you take typically like carbohydrates and you burn them yep yep the acrylamides so yep yeah i mean you don't want to do it to like where the sugars are burnt yeah i guess the over roasting yeah i see what you're saying yeah like this this the caramelization of it yeah yes yes the caramelization oh yeah uh yes she put it in thank thank you see you answered exactly exactly yeah i would be careful of going too far of course and just cooking it to the pot that it's you know enjoyable and not yeah so crunchy so i have a question for you it seems like um these continuous glucose monitors are kind of popping up all over the place right I see them all over Instagram commercials for them and stuff.
And I see you're wearing one too right now.
[36:31] Is this something I personally am like, don't we have enough gadgets and things like tracking our steps and tracking our sleep and tracking our heart rate?
It's like, don't we know how to do all these things? And doesn't our body know how to do them? And I understand it's a, it's, it can be, and I'm going to, I'm cocky and I'm going to turn over to you.
And I understand that it can be a very, potentially very valuable tool for people.
I would think, especially that are like type, type one diabetic, type two diabetic, pre-diabetic.
[37:07] Um, and I, I'm sure that if I was to do use one for a week, I'd be like, Oh, isn't that interesting?
You know, my blood sugar got up to one 60 when I ate that, uh, whatever.
But so what are your thoughts on the continuous glucose monitor and what has been your experience?
I love I love CGMs. So let me just tell you in the in the context of where they're helpful.
Right. So you have a type one diabetic makes their lives so much easier because these poor folks, they are poking fingers at every meal, every snack exercise.
You know, they're looking like I'm not feeling well. Am I going to pass out because my blood sugar?
So this has absolutely been game changer for type one diabetics.
Right. These were these folks require insulin for the rest of their lives. is.
[37:49] So there's that piece. And the CGMs provide that 24-7 data.
So you can see what's happening in different times, you know, variabilities, what's going on in your sugars.
So type ones, and then you have your insulin dependent type two diabetics.
These are the folks that I would hope would, you know, be able to eat a whole food based diet and, you know, transition off of insulin or oral medications that would need to be very mindful of blood sugar fluctuations.
Situations um but um that's also very helpful when you're detri titrating down medications right so i know like i'm seeing consistently blood sugars hitting under 150 every morning like hey we need to start pulling back even more on the insulin um the other things that are happening is like there's a type one and a half diabetics right so these are people who develop like an autoimmune type diabetes later in life many times i will where i've seen these patients is they're eating a whole food plant-based diet, they're exercised, they're thin, they're doing everything appropriately, but their A1Cs are still elevated and they just don't understand what's going on.
And that's where we put a CGM on them. We're saying, oh, wow, this is what's going on.
You eat even just what other people eat and their blood sugars maybe hit 150, theirs are going to 250.
And then it comes back down because they're insulin. But they're not making quite enough insulin.
So these are individuals where we start learning how to dose with meals and-
[39:12] You know, does he need a little bit of insulin? So again, it depends on the person.
Do we check other tests like C-peptide or insulin antibodies?
So those are really very helpful. Then for the pre-diabetics, What's been really good about this is that it really shows that moderation kills.
[39:31] And so, you know, it's a great behavior change tool.
So when someone thought, oh, I can just have the vegan white rolls or, oh, I can have this, you know, that little bit of processed food or I can go out or I can do my alcohol or da da da da.
And what you'll see is these amazing trends. Right. Right. So I connect to someone's CGM.
I give them a code and they connect their app to me.
And then when we meet and we discuss it, we actually can talk about the patterns and, you know, they can keep notes in there. What are they eating? What's happening?
Understanding Blood Sugar Behavior and Insulin Resistance
[40:06] And it's been really interesting to see their behavior change, because when they scan their blood sugar, they're just like, oh, it's an objective data.
It's not me telling you not to eat this. Your body saying this is what I do when you eat these foods.
And the length of time right how long does it take you know we talk about insulin resistance and it's just really making people mindful of what's going on now for those outside of prediabetes or i feel i feel like there's a there's a group of individuals for example if i measure insulin resistance that'll show up on a lab test before prediabetes does and you might these might be the people who have fasting blood sugars in the 90s their a1c is like like 5.4 to 5.6, somewhere in there.
This is a beautiful time to kind of like the pre-diabetics to say, Hey, here's what's going on.
Let's talk about it. And maybe encourage someone to lose the weight to get them down, you know, a little bit lower.
So they understand they become more insulin sensitive and pay attention to the snacking because you ate lunch and now you're snacking an hour later, your blood sugars are staying elevated.
And so this is just a point discussion.
[41:16] For myself, I've never been pre-diabetic. I'm insulin sensitive.
I am just fascinated what's going on in a regular human body.
So can I ask you this? Yeah.
So what is, what have you seen your ranges fluctuate between? Yeah.
So it's fascinating because you also learn about stress, sleep, exercise, all of that and what's happening.
So my typical average is anywhere where between like 65 to 130, 140 when I'm a good whole food plant-based eater.
[41:51] Yeah. So it's about a 60, 70, 70 point range.
Yes. On average. And what you'll, what's really interesting is when I get up, it goes up a little bit just because I'm getting ready for the day.
When I shower, it'll go up when you exercise and what goes up and then when it trends down.
But what was interesting was I'm running, I have a group of folks that I, I work with and called the glucose mastermind, believe it or not.
And we do CGMs and we talk about these things. What was interesting is we're like, I'm going to experiment, guys, with I love London Fogs from from don't don't judge me on Starbucks.
Experimenting with Food Choices and Observing Glucose Responses
[42:28] And, you know, what was fascinating is like, I'm going to do a little experiment.
So what happens when I consume that?
Well, how much sugar shoots up right there? Sugar in it. But what if we pull out the vanilla pump and it's just the soy milk barely moves like 110?
So that's a great. ate again you can still enjoy some things like when you're traveling and make some small tweaks the other thing is i went to cafe gratitude it's a vegan uh restaurant you know like whole you know they're like organic non-gmo all these beautiful things i'm like you know i'm gonna try that cinnamon that's calling to me and just see what happens so i had that first and it's also like choice of foods how you compare them it was fascinating so i ate that and then i ate a wrap It had lots of veggies.
It had beans in it, some good stuff. So that would have been fine.
[43:17] Blood sugar shot to 191. I almost panicked. It was like, what in the world, Laurie? But it came down really quickly too.
What's quickly? What's quickly? Like how quickly? Within, probably within 15 to 20 minutes, it was under 140, you know, so it came down pretty quickly.
What do you think, what do you think got it to 191? Was it the wrap or was it the Cinnabon?
It was, it was the Cinnabon for sure.
[43:41] And the other piece of this I want to point out was stress um because i watched a movie on world war ii i had not eaten for three hours okay i love history so i started reading on the articles you know i've read so much i've been to all sorts of museums like it just fascinates me i went and for people that don't know you have a military background i do i do and um so yes that that's that's that's part of it and so anyway i again it's So we're talking three and a half, four hours. I go to bed.
I wake up in the middle of the night. I'd had a dream about what I had watched, which is not unusual.
I woke up the next morning and I looked at my data overnight.
My blood sugars were typically always, you know, 70 or so overnight, trended up to 120 at midnight and then it just precipitously dropped after I woke up.
I was like, this is stress. It was fascinating to me. So now I'm being more mindful of what am I doing to myself by watching stressful movies, reading stressful articles, listening to stuff I don't need to necessarily do.
Right. And so I found it fascinating because with higher blood sugar comes elevated cortisol, all sorts of things.
So anyway, that's for me has been an amazing experiment.
Using Continuous Glucose Monitoring as a Tool for Health
[45:05] But but it also helps people who like to snack and eat too much and are struggling to lose weight. And anyway, it's been fascinating.
[45:12] But as somebody, let's say, that isn't pre-diabetic, type 2 diabetic, any of those things, would you say that most people that are healthy have a range that's somewhere between, let's just say, 60 and 140, 150?
And if it bebops in that range, like... Yeah, I think that's fine. Right.
My point is like, you don't, the goal shouldn't be to keep it at one 20, right. At all time. And you get obsessed with it like that.
Cause I know something about somebody that like they had some grapes and it shot up their, their, their glucose shot up 39 points.
And they were like, Oh my God, I can't have grapes anymore. And I'm like, really?
Come on now. Yeah. I mean, that's a normal response. And I think this is a great though discussion to have with people's Like this is a normal response to eating food that you require to be healthy. That's a normal, healthy response.
Your body's obviously going to take that food, digest it. You should see your blood sugar rise and then it should come on back down.
But where I do think it does help is because I'm seeing sick people, right?
Is these are individuals who are struggling to lose weight, stick to a healthy whole food plant based diet.
For me, it's a tool to utilize to help people. But yes, if someone is like myself, who's healthy, healthy, weight active, I don't need it other than I'm just I just like to geek out on the science and see what happens in healthy people.
[46:40] But there is a you know, if you hit if you look at the quote unquote suggested ranges, it's between 70 and 180.
So remember, these are for people who are typically diabetic.
Diabetic, but the kidneys, for example, when your blood sugar hits above 180 and above, it will start, you start peeing out glucose.
So if you want to even mark 180 as a healthy range, I think that's okay too.
Because it really depends on amount of muscle mass that you have, how active you are.
So you may have a healthier, maybe it's a little bit higher rate.
You're still going to be be okay.
[47:16] But it is a great tool and I wouldn't dismiss it for anyone who wants to know, but I think you need to be in context with the discussion with someone who understands the data and can go over that data with you. So you don't, I can't eat grapes.
That's an unhealthy response to seeing that data.
So you need to be able to learn and be reassured that you're okay.
Encouraging a Balanced Approach to Blood Sugar Management
[47:39] Yeah. And I think where Where my...
Hesitation and concern comes is with, with certain people that are advocating for people to really keep their, their glucose in a very, very tight range.
And because of that, wow, you really, you can't do fruit.
And if you do fruit, you have to do it with two handfuls of almonds to offset that, you know, that, that, that sugar load.
And it's like, no, this is, this is getting too, too, too, too ridiculous.
Yeah, no, I agree. I've actually had a few patients who were very healthy plant-based eaters, um, had a CGM from different companies and come in and speak to me.
It's like, how do I get my blood sugar even lower?
I'm like, I'm looking at their data because they showed me and I was like, you're fine.
[48:28] And just to reassure them and kind of pull them out of this unhealthy obsession that your blood sugar has to stay the lowest possible at all times.
[48:37] But yeah, so I think that's, that's, again, that's a discussion to have.
And people are going to hear things.
And if they need, you know, if someone wants to go through this understanding of why that I use as a tool, like to help people make better decisions.
So instead of the processed food, instead of having that snack or whatever, of, you know, candy bars, and they try to get an apple or banana or something.
So that learning for me is where where I'm making healthier choices, not removing the healthy foods because my blood sugar bumped a little bit.
It makes, yeah, that's, I agree with you a hundred percent.
Yeah. I mean, I think like, okay, when I get up, when I walk up stairs and do certain things, what happens? My heart rate goes up.
Right. I mean, it's not the same thing, but these are things that happen.
[49:25] But it is the same thing. Okay. I think it is because people think, oh, you know, lower heart rate's always better. Like, no, actually, there's a function for that. Right.
So like when you get up in the morning, your blood sugars will naturally turned up.
People are freaking out about this. That's like my blood sugar is over 100.
I'm like, let's look at the data and see what's exactly going on.
So, yeah, it went up because the cortisol is going up and it's getting your body ready for the day.
Guess what you need blood sugar and those big old muscles and to stand up and for your brain which uses 20 of your glucose every day by the way i mean here's this three little pound organ using a fifth of the glucose that's in your brain so if you are restricting your carbs your brain you know then you go to ketones and i mean that's a whole nother thing ketones and stuff but the main thing here is to understand that.
Trusting Your Body and Making Healthy Choices
[50:14] There is a range of healthy, but we live in a world that doesn't have just the healthy foods always available.
But if it'll help us as a tool to make different choices and to rest assured your body's doing what it knows what to do.
Your body knows what to do. If you feed it the right foods, it'll do what it needs to do.
There's no need to manage it.
But it is really interesting. All right.
[50:37] I need to wrap this up. I've got I've got another appointment in 10 minutes that I need to prepare for. But Laurie, if people are interested, are you taking clients, patients?
What's your status right now? Yeah, absolutely.
So I'm licensed in all 50 states and DC. You can find me at drmarbas.com.
Yeah, I'm happy to see anyone.
Fantastic. This has been great, Laurie. Thank you so much for diving in with us and shooting the kale. And I'll do some research on bananas and berries and vitamin D and showering. All right.
And the EPA and the DHA. That's always out there lingering. That's an ongoing continual discussion in my brain. So, yes.
Exactly. All right. Hey, give me a fist bump on the way out. Keep it PLANTSTRONG.
Stay Updated with PlantStrong events on Instagram
[51:33] Do you want to keep up to date with PLANTSTRONG events? events, then follow us on Instagram at @goplanstrong, or you can follow me at @ripesselstyn
The PLANTSTRONG podcast team includes Carrie Barrett, Laurie Kortowich, and Ami Mackey.
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As always, this and every episode is dedicated to my parents, Dr. Caldwell B. Esselstyn Jr.
And Anne Crile Esselstyn. Thanks so much for listening.
