In this Q&A the plant-based doctors answer questions and discuss how diet influences menopause.
Questions Answered
- (00:03) – Introducing Dr. Elisabeth Fontaine
- (01:28) – Introducing Dr. Jeffrey Pierce
- (03:28) – How menopause happens and hormones
- (16:43) – I had a total hysterectomy at 42. How do I know if I'm in menopause?
- (19:28) – I'm as active as I was before menopause. Why can't I eat as much as before?
- (22:51) – Osteoporosis and bone health
- (28:09) – I had a partial hysterectomy at 55. I have noticed dryer skin and nails Any advice for these issues?
- (31:30) – I heard soy is not good for you because it's so refined. What are your thoughts?
- (37:40) – Can menopause cause fat loss around the hips and buttock area?
- (42:24) – After a few meals without meat, I have low energy and I need to eat meat to get back to higher levels of energy. What am I doing wrong?”
- (48:28) – Is our menstrual health history indicative of how menopause will be for us?
- (50:57) – Will soy help my anxiety, or will it affect my hormone replacement therapy dosage?
- (56:00) – What can we do if you live in an area without a variety of foods?
- (01:01:15) – What would you say to beginners struggling to give up junk food?
Complete Transcript
Dr. Elisabeth Fontaine
(00:03)
So, I'm Dr. Elisabeth Fontaine, I'm originally from Quebec City, but I've been practicing in Vermont, OB-GYN for 27 years. And actually, what brought me to the Plant Based was actually my patients. This is how it happened. Women that were getting older and menopause, interest, taking all sorts of different supplements to try to help them due to studies that were a little bit concerning at some time that we certainly discuss regarding hormones. So, I got interested to all this and say, people that know me will know that I'm significantly interested in the health of people with exercise and nutrition. So, I joined at the time the anti-aging and then I realized that it was going from lots of mitigation to lots of supplements. And I said, “Well, yeah.” Not that I'm against it, but it was a little bit difficult for me.
Dr. Elisabeth Fontaine
(00:58)
And then I realized that there was lifestyle medicine. So I started going to their conference and this is how I learned the importance of the nutrition in plant, food based. So, it's a little short story, but this is what brought me for the importance and obviously being a GYN was kind of fascinated how much I could help people, not only with their chronic diseases with menopause. So this is what we're going to discuss today. So, I'll let you go, Jeff. I was quick.
Dr. Jeffrey Pierce
(01:28)
Thank you very much, Elisabeth. So yeah, I'm Jeff Pierce. I'm from Texas and I live in California, live in practice mostly in California here. And I'm a family doctor. I was trained in the typical model of sort of like mostly disease care. The people bring these diseases to you, and this is how you sort of treat them. And when I stumbled upon this whole practice, this whole new specialty of lifestyle medicine and learning more about how… No, we can look at this and approach this in a totally different way, let's really focus on health, let's really focus on diet and other lifestyle modalities to keep someone healthy. And if they do have conditions, we can reverse them, some of them and treat them with diet and exercise. My mind was blown. And so, what started from, “Okay. Yeah, sure. We can do this with diabetes and maybe some high blood pressure, heart disease.” It's expanded to see that many conditions from autoimmune conditions to some cancers and stuff like that can all be approached in this manner.
Dr. Jeffrey Pierce
(02:39)
So, love to talk about menopause, which is not a disease, but a stage of life and to talk about how diet and lifestyles can play a role.
Dr. Laurie Marbas
(02:51)
I think this is a fabulous topic because I just turned 50 last year and entering into this premenopausal, weird state of life. And I can't wait to absorb what you guys are going to share with us. So, how should we start? What have you guys planned to teach us today? And everyone who's watching, please feel free to post questions on the Plant Based TeleHealth Facebook page, or here in our webinar. I'll be watching for those. And I will share those with our amazing doctors as we go along.
Dr. Elisabeth Fontaine
(03:21)
Great. So, maybe-
Dr. Jeffrey Pierce
(03:23)
That sound good. Yeah.
Dr. Elisabeth Fontaine
(03:23)
… I thought… Yeah, that's great. And anxious to be able to help you, Laurie.
Dr. Laurie Marbas
(03:27)
Please.
Dr. Elisabeth Fontaine
(03:28)
I thought that it might be good to give a little bit of information regarding how menopause happen and the hormones, because people will say, “Okay we, as a physician may know these things,” but a lot of people may not know. So, basically in itself, the hormones that are very important that decrease dramatically at menopause, they come from the ovaries. And when we are born, the ovaries are producing what we call follicle. And these follicle, their numbers are kind of predetermined almost for each one of us. And at puberty, we have a little gland in our brain that kind of stimulate the ovaries to produce and help to choose a dominant follicle, which would allow us to get pregnant or obviously having [inaudible 00:04:20].
Dr. Elisabeth Fontaine
(04:20)
And that just is an amazing kind of play around all our life until we reach menopause where suddenly that these ovaries' follicle are not there as much. And then suddenly we have this significant drop of hormones, mainly estrogen, progesterone, but the one we're going to focus today, maybe the estrogen, and this is where this thing happen, where you start having significant symptoms. And that's what we want to review today. I can go a little bit more, but Jeff, what do you think? You want add a little something to what I just said, and then I can kind of mention the symptoms and what seems to be bothersome.
Dr. Jeffrey Pierce
(05:07)
No, I see the fact that it does tend to happen about age 51 in the United States and around the world. So good timing, Laurie. We appreciate you being safety for us today.
Dr. Laurie Marbas
(05:20)
Yeah, I'm happy to accommodate.
Dr. Jeffrey Pierce
(05:25)
And I think, let's see, menopause defined as the cessation of periods for a 12-month period and then the perimenopausal or this transitional time where the periods start to become irregular and the symptoms start to appear and it be interesting to talk about what are the most bothersome symptoms, how those are reported in the United States versus other parts of the world and what we can do about it.
Dr. Elisabeth Fontaine
(05:55)
Yeah. And I know that, and thank you for telling a little bit more about the menopause, perimenopause, because also thank you about what you're talking about, it'll be very important to kind of look at the distinction between what's happening in the rest of the world. And what's happening here, where we have more of a standard American diet. So, when suddenly around perimenopause, menopause, the follicle does not produce as much of the estrogen. And then suddenly we start having symptoms. Symptoms vary, but in the United States, 75% of women will have these symptoms. And probably the worst one is what we classify as hot flashes or hot flashes. Everybody say it a little bit different, but they could be quite bothersome. And then, like you say, you have for a lot of us cessation of the period, but a lot of women are with irregular period, heavy period and then nothing, and then difficulty sleeping, anxiety.
Dr. Elisabeth Fontaine
(07:03)
There's multiple symptoms that are coming during that time. Depression, and probably one in the long term, you're going to end up having some sort of a progression with hot flashes, eventually it's symptoms around what we call the urogenital. So, becoming dry and it's a little bit more difficult to have sexual intercourse. And then you also have the impact on the bone because the estrogen are very important. So we end up having bone that are weak, we call that osteoporosis and that can increase the risk of their fracture. So those are all important things that we need to remember when we discuss the nutrition, which we will most likely jump in. I'll see what my friend Jeff, which I'm always amazed to see that a man is interested with menopause, such an amazing partner here.
Dr. Jeffrey Pierce
(08:03)
Well, I can't bring quite the personal depth of understanding to it that the other half of the world can, but yes, it's a fascinating and important topic of course to be able to discuss with my patients about. No, I think all that sounds great. And to sort of review the myriad of ways that someone can present the conditions that someone can bring to the office and be sharing with you about, and some women sort of breeze through it and don't have too much difficulty with it. And some women, I think I've seen that up to 9% of women can still have symptoms like hot flashes at age 70. And so, some people have a long course of this that's very distressing and everything in-between. And we're here to talk about how there are various ways from diet to supplements, medications, to exercise, et cetera, that you can have some control over these findings.
Dr. Elisabeth Fontaine
(09:16)
Yeah. And in itself, we may not spend too much time today, but we could on hormones replacement therapy. That certainly have been, especially me when I started my practice many years ago, every woman, when I was in Canada in my residency, every woman that would reach menopause was on hormone. So we certainly can keep that. Because if you say, if the estrogen drop and you replace them, it's definitely what works the best. But let's put that on the side and let's chit-chat more about what… First of all, I was saying earlier that you have the chance to be in different countries. So, let's review that.
Dr. Elisabeth Fontaine
(09:59)
I just said that in United States, 75% of women will be symptomatic of some of what I mentioned earlier, what we think is potentially that they being more symptomatic due to their diet, at least some of that. In itself, they consume a lot more meat, four times more fat, don't have as much fiber and therefore I'm going to use my he a little bit, but if you have more estrogen level due to your diet, it seems that women that eat less fiber and have more fat due to the standard American diet, then you get to this level as opposed to there. And when you get to menopause and nothing is happening no more, that's drop from the estrogen level is what makes women having a lot more hot flashes. So, that being said, I'd like to know a little bit more about what's happening in other countries.
Dr. Jeffrey Pierce
(11:02)
Yep. Yeah. I think it really pays for many reasons to be sort of a citizen of the world here to look at health and disease, not just through the eyes of a North American, but to look across the world. And it's always so telling like why is it that in this country we have high rates of colon cancer, but in Africa and parts of rural Africa, they have very low rates of colon cancer. And what is it, what's the difference in-between? And so an example of this based on what we're talking about today is Margaret Lock out of McGill University, I believe in Canada did a study. She was sort of one of the researchers that's quoted most on this, where she was looking at Japanese women in their reported rates of hot flashes and was depending on what study, we're looking at 20% or less and so much lower than the 75% to 80% of reported hot flashes that you see in North America and in many countries in Europe.
Dr. Jeffrey Pierce
(12:11)
And the same was true in other parts of Asia, with China having rates in teens of hot flashes and Indonesia. But not just in Asia reporting lower rates, also study looking at women in the Yucatan in Mexico also have lower rates. And so without doing a rigorous head-to-head study where they grouped one people and another group of people and followed them for 10 years, but looking at these populations and trying to make following theories in assumptions, the diet, like you mentioned tended to be much lower in fat in these areas with lower reports of the hot flashes. So, lower in fat, higher in fiber, higher in soy products, the women tend to have lower body mass indices, so lower weight for their height.
Dr. Jeffrey Pierce
(13:05)
And so, based on some of these observations, the idea that if we can mimic this, if we can work on weight loss, we can work on adding fiber and healthy foods to our diet, if we can add more soy products for their estrogen modulating effects, it seems like there's probably going to be some benefits for that. And of course there's many more studies that did look at this on a smaller level as well.
Dr. Elisabeth Fontaine
(13:30)
Yeah. These studies, but when you think about it, the amount of studies related to nutrition and menopause is lacking compared to many other studies that are made. It's about any other health-related disease for any reasons, and I don't want to say that women that push a little bit aside, but again, maybe because the menopause is considered being a natural element that happened during a life, but there's so much symptoms and so many problem that could be related to that. Now, you were mentioning about the different diet. One of the thing that women think in United States is compared to any other, like in Asia, China is they focus dramatically on the soy. They're probably eating a lot more soy and that's what I need to take. They don't realize that, okay, soy is a component, yes, there is probably phytoestrogen a little bit, and you need to eat a lot of soy in order to replace the estrogen.
Dr. Elisabeth Fontaine
(14:36)
So, they don't necessarily take time to understand that the whole diet is important, is being able to capture and reduce the amount of fat and increase the amount of fibers. So everything that we have in our typical American diet, the meat, the chicken, the fish, the milk, the cheese, eggs, all these components are substantially increasing the amount of fat. And unfortunately the weight compared to the diet of the different part of the world that do not experience as much symptomatology like having more corn, fiber, beans, legumes, nuts, and sufficient amount of protein, which is unfortunately, one of the dramatic anxiety raised into this country that I'm not going to have enough protein if I don't eat a plant food-based diet.
Dr. Elisabeth Fontaine
(15:39)
So, that's very important to be able to mention that, especially for the bones, it's very important though that brings us actually, maybe to other subject for the bones or even the weight, which is something that is so important for all individual, but women and women that reach menopause in my practice was always really a substantial impact and wanted to know what is it that I can do in order for me and not gaining any weight and changing that shape, where you have a tendency to gain a little bit more in the abdomen. Want to add something about that poor Jeff, you have to think about all these women that are coming and concerned about their weight gain.
Dr. Jeffrey Pierce
(16:29)
Sure. No, I have to talk about it and Laurie I didn't know if you're getting questions also feel free to pipe in, but I'll comment a little bit on the weight to she as well.
Dr. Elisabeth Fontaine
(16:43)
Or ask us anything, yeah because you're part of the audience.
Dr. Laurie Marbas
(16:43)
Oh, I am part of the audience. And so, which is… There's two questions. One will be one that I get a lot from patients, but this other one is from Michelle who ask, “I had a total hysterectomy at 42 when I was still having periods. How do I know if I'm in menopause and I still have my ovaries?” I think that's a very basic question. And then I have a question regarding the weight.
Dr. Elisabeth Fontaine
(17:05)
Yeah. Yeah. So, usually even of course, it's easier to know when you stop your period when you still have the uterus, but if you had a hysterectomy and they kept the ovaries, that you're still going to have the symptomatology and you're going to start having those hot flashes and these changes like most women. And one of the thing that could be done by your physician is to measure what we call the FSH, which will be significantly elevated. This comes from the brain, sending the message to the ovary, “Please, please produce estrogen.” But we don't necessarily have to do these tests. In itself, Michelle, if you come to my office and you start telling me how much you're having hot flashes and how you feel, I have a pretty good idea that you're going through your menopause.
Dr. Laurie Marbas
(17:57)
Very good. And then, like you said-
Dr. Jeffrey Pierce
(17:58)
And for someone who… Oh.
Dr. Laurie Marbas
(18:00)
Go ahead, Jeff, sorry.
Dr. Jeffrey Pierce
(18:02)
Sorry. I'll just say, and if for someone who has hysterectomy and your [inaudible 00:18:04] at that point [inaudible 00:18:07].
Dr. Laurie Marbas
(18:07)
Oops, you froze. So, [crosstalk 00:18:15].
Dr. Elisabeth Fontaine
(18:16)
I can answer that because I have a good idea what he's going to say.
Dr. Laurie Marbas
(18:18)
Yeah, exactly.
Dr. Elisabeth Fontaine
(18:19)
I'm assuming that Michelle had her ovaries, but it is possible, we try to be conservative at 42. We wouldn't remove ovaries, but for all the reason, it's possible, cancer or… So, if the ovaries are removed at 42, you go in surgical menopause, which is actually sometimes goes faster than into the natural menopause. So the day after the surgery suddenly there is nothing, no follicle to respond and you start having those significant hot flashes, even more important to be extremely careful to eat the proper diet to make sure that you maintain healthy bones and feeling good. And obviously at such a young age, you could be somebody that would benefit if the ovaries were removed to discuss hormone placement therapy with your physician. We lost you for a minute, Jeff.
Dr. Jeffrey Pierce
(19:15)
Yeah. Sorry about that. I don't know what happened. Can you hear me okay now.
Dr. Elisabeth Fontaine
(19:18)
It's the andropause suddenly…
Dr. Jeffrey Pierce
(19:24)
All right. And, Laurie, you had a follow-up question.
Dr. Laurie Marbas
(19:28)
Yes. I had a question. So a lot of times what I'm seeing with my women and maybe it seems to be, again, these are anecdotal observations, but it seems to be recurring over two decades of my own practice is we hit women at this premenopause, menopausal stage. And there is a change in like you had mentioned earlier, fat distribution and weight gain. And of course, if you read the studies, they're like hormones are nothing to do with it. But even in my own life, I'm super active, but I can't eat as much as I did 10 years ago. So there's definitely something and I'm as active or more active than I was before. So I don't think this is a matter of activity level and it's certainly not the diet, the diet's about the same. Any thoughts or suggestions on that interesting observation.
Dr. Elisabeth Fontaine
(20:13)
Yeah. It's a complex. You wanted to say something Jeff, before I add anything?
Dr. Jeffrey Pierce
(20:17)
Oh, I would say that's a tough one, right? And so, if for someone who is not yet following the same super healthy lifestyle that you are, for example, Laurie, then there's sort of the low-hanging fruit of, “Yes, let's go to a plant-based diet and it's rich in nutrients, but it's low end calories and you'll see weight loss and let's work in some exercise to help with the total sort of healthy gains that you'll be getting from the system.” I think it's a trickier question coming from you, Laurie particularly, [crosstalk 00:20:49]?
Dr. Elisabeth Fontaine
(20:51)
I will try to give a little bit of my input into this. So, one thing happen with age. We have what we call our resting metabolic rate, which I study actually before my medicine. So we were comparing the impact of exercise on identical twins and non-identical twins. So, I trained these twins for 20 weeks for God's sake, but in women or any individual with time and in the resting metabolic rate, which is responsible of your resting energy expenditure during the day is going from there to slowly coming down with the menopause… With age, I shouldn't say menopause. It's not only hormones, but it comes down. And therefore, if you do not adapt what you're eating, you don't need to have too much difference. If the resting goes and you eat the same thing, you're going to gain.
Dr. Elisabeth Fontaine
(21:51)
So it is important to be careful with that. We all assume, “I'm eating the same.” You probably hear that. And Laurie, patient tell you, “I haven't eating anything. I'm eating the same. As a matter of fact, I eat less,” but they eat the wrong calories. So, that's one thing. The second thing I tell women, I say, “Listen with age, I'm a good example, you lose muscle mass and we have this terrible tendency to want to do aerobic exercise.” You have to switch to do some more muscle, weight training exercise. We don't have as much testosterone as the guy. So we have a tendency to lose that muscle mass and that muscle is where the energy is coming. So, all the energy that comes into your body, the glucose, if you don't have much muscle, it has to go somewhere it's stored in the fat. If you do the exercise, build muscle, you have a better chance that the proper calories will go in the muscle. So.
Dr. Laurie Marbas
(22:50)
Perfect.
Dr. Jeffrey Pierce
(22:51)
Mm-hmm (affirmative). That's really interesting. I think that ties in well to what I think you're about to launch into was the osteoporosis was the bone health. And maybe I'll just mention a word on that and we can expand on it. I think if you watch commercials, osteoporosis is a deficiency of pharmaceuticals or you're not getting enough fancy, expensive pills, and that's why your bones are ill or you're not getting enough calcium supplements and that's why your bones aren't healthy and that's not true. Bone health is a very complicated topic and is multifactorial on how to maintain a healthy set of bones. But the way I think about it, and I think several of us in the sort of lifestyle medicine who take a lifestyle medicine approach think about it is so eating a healthy diet to make sure you're getting the various minerals and micronutrients that you need to be building and rebuilding your bone.
Dr. Jeffrey Pierce
(23:55)
And with that, as a background, you have to use it or lose it sort of an attitude when it comes to bone health. And so, doing exercise, particularly weight-bearing exercise puts a stress on the bones, which gives a signal for them to grow and to maintain their strength. And so, you get plenty of calcium and vitamin D from eating vegetables, beans, and greens for calcium and getting some sunshine or if you're in Quebec City during January, maybe supplementing with some vitamin D supplements, but you're getting that. So you're getting enough minerals through diet, but then you have to be doing weight-bearing exercise on top of that and not smoking because of the increased risk of fracture associated with smoking, not drinking too much alcohol, not eating too many sort of calcium thieves, such as meat and dairy, which can affect how the calcium mineralization is going in our bones, et cetera.
Dr. Elisabeth Fontaine
(25:00)
Oh, well said. I think I'm going to hire you to [crosstalk 00:25:04] everything. And then I'm going to see a little thing at the end just to see if I can put the cream on the top. This is amazing. Now, one other thing I'd say for people that may not be as used to definitely the importance, especially in women of prevention, that means doing the exercise. But one of the things that we have for a message here is that in order have enough calcium, you got to take milk. And this is something we've been used to. It's part of our… It's ingrained in us. This is our value as it was always transmitted that way for us. And then when you look at the research and you're a little bit more open, you realize that it's not, especially when you do studies, when you do study of population that are not taking milk for calcium that are simply eating the real whole food diet, they have bones that are stronger than us that are supposedly drinking milk, which we're not going to discuss the other impact of milk.
Dr. Elisabeth Fontaine
(26:02)
But for calcium wise, it's not where the best calcium is coming. The example is that animals have amazing bones and they're not drinking milk, they're eating plant-based diet. They probably not as much as… Probably a lot more than us, but they certainly succeed to maintain their bones. So, that's important to remember the impact of a good diet that may not be related to amount of how much milk you are drinking. That's something else. But you know what, I think I have kind of a brain fog that may be related to menopause. It will come to me. I promise it's going to come back. By the way, I was going to tell Laurie, I said, “If you are around menopause, you certainly don't have the same look as beauty of women that I see in menopause and therefore one plus for the fact that you're eating a proper diet that allow you to maintain these amazing traits.”
Dr. Jeffrey Pierce
(27:08)
Good thing for you. It's not the makeup artist?
Dr. Laurie Marbas
(27:09)
Yeah, no, in the last… Yeah, no, there's no makeup artist, but the 12 months just maybe it's TMI for some people, but yeah, I would say in the last 12 months, I've skipped half of my period. So, it's like the weirdest thing is like, “Yeah, here it comes.” But I'm doing great. I have no other symptoms other than-
Dr. Jeffrey Pierce
(27:25)
Oh, wow!
Dr. Laurie Marbas
(27:26)
… [crosstalk 00:27:26] come or it doesn't. So.
Dr. Elisabeth Fontaine
(27:29)
Oh yeah, one more thing before you made your… That's my fog is coming back. For the vitamin D. So, in order for us to absorb well the calcium, we need vitamin D, which is more like of a hormone and the vitamin D, the best form we can get is from the sun. But obviously now we protect our skin with everything so that we don't have any sun burn, but an exposure of about 10 minutes a day of the vitamin D coming from the sun would be a lot better than absorption of any supplement that you want to take. So, obviously if you never go out, it's different, but the vitamin D for absorption of calcium is very important.
Dr. Laurie Marbas
(28:09)
And speaking of vitamin D, because it is a fat-soluble vitamin, so women who are overweight or obese will have much lower levels available. So, again, it's an important thing that these amazing doctors we can do on plant-based health is actually measurement and speak to you about your specific points. And actually, do you guys have… You want me to go into another question or do you have something else you'd like to talk about? I have three more questions for you guys coming. They're really good ones. Marlene asked, “I'm 59 and had a partial hysterectomy at 55. I have definitely noticed dryer skin, less elasticity, and even my nails have more ridges and are drier. Any help for these issues?” And this is a very common problem.
Dr. Elisabeth Fontaine
(28:46)
So, that's a good example of some of the other symptoms or fact that happen. The skin is affected and the skin has a lot of estrogen. I mean, the whole body is estrogen receptor, and we all react differently. For some women it's going to be more with the hot flashes, but some other could be like, Marlene is having some dry skin. So, again, I'm not sure exactly where you are into your progression into a plant food-based diet, but if you are able to be on a whole plant-based diet, you can potentially see a reversing of these elements. And again, obviously, it's never bad to discuss with your physician, see if there's any indication for any hormone and therapy, but for the skin, I would certainly start by having a good diet and obviously using proper cream.
Dr. Jeffrey Pierce
(29:51)
Yep. It makes me think of Dr. Rajani Katta, who is a dermatologist who used to be at Baylor, where I went to medical school in Houston and she has a plant-based dermatology practice. She wrote a book called, Glow, and I'm sure you could search Rajani Katta, it's K-A-T-T-A. And she has a website full of really good information about things that a healthy plant-based diet will bring to healthy skin and nails. There's some more information there.
Dr. Laurie Marbas
(30:24)
Cool.
Dr. Elisabeth Fontaine
(30:24)
That's so interesting. It gives you this relationship of realizing how many specialist physician that are going into whole plant food base and can have like this autoimmune disease and the weight and the skin and cardiovascular disease. It's amazing. You see that coming all over it. The impact is… I mean, while we're talking, there's that food revolution diet happening webinar, and you have all these amazing people like Dr. Crager that talked to us last time, but all physician experience that are talking about the importance and how much it had made a difference into their patient normally in menopause, but certainly menopause for us today is the important topic. You have other questions, Laurie. I see your-
Dr. Laurie Marbas
(31:17)
Yeah.
Dr. Elisabeth Fontaine
(31:18)
… [crosstalk 00:31:18] shining.
Dr. Laurie Marbas
(31:19)
Yeah, absolutely. And by the way, the one that asked that question, Marlene said, “I am 100% percent plant-based and thank you for that information. I will look it up. Thanks.”
Dr. Jeffrey Pierce
(31:29)
Okay. Awesome.
Dr. Laurie Marbas
(31:30)
And here's another question from Sharon. She says, “I'm currently on hormone replacement therapy, mainly for anxiety that developed at menopause. I was on birth control to regulate periods. It kept them very regular and a cold turkey that put me abruptly into menopause. Not a period from that point. It totally threw me for a loop and anxiety went crazy. Ironically, no hot flashes, weight gain or night sweats, sleeping is fine with melatonin. I eat plant-based for the most part with occasional fish or free-range organic chicken, because I'm dropping too much weight. I eat a healthy fat, nuts, flax, avocado, BMI, 17.7.” Wow. “I'm underactive thyroid on NP Thyroid. I do exercise along with weight training. Not sure what to do from here. I heard soy is not good for you because it's so refined. What are your thoughts?” That's a great question.
Dr. Elisabeth Fontaine
(32:21)
Soy is too refined. I think that this [inaudible 00:32:25], but not that I want to specifically go into this. Well, yeah, that is kind of fascinating. I think that the big thing here is this weight for some women like her and me trying to maintain a good weight and you got to be able to increase substantially your intake and in the plant food-based, amazingly we don't really have to calculate how much calorie, because in itself, it's almost hard to keep up. So she definitely needs to increase substantially the amount of what she's eating in the plant food-based. Now, you also have to realize that, and we didn't discuss it specifically, but some women will be symptomatic, whatever they do. And the hormones may be beneficial for them. If she was on birth control pill, very well-controlled, I'm always amazed when you think about it, how physician we do, it's okay to be on birth control pill, but when you get menopause, you can't take it anymore because the WHI, which is the Woman Health Initiative that was done 20 years ago, that probably women still know.
Dr. Elisabeth Fontaine
(33:34)
And they don't know the name of the study, but they know that you shouldn't be using hormone. And again, that study, just to be clear, was reviewed many, many times to show that their result were not… First of all, the study was not done with the proper population, older women, obese people, diabetes. So there's higher risk, but for Sharon, I think that for her, if the anxiety and she's doing well on hormones, I personally as a gynecologist, I would have a tendency to continue that. But for your BMI, I think we need to have somebody that maybe work with you as maybe a trainer, exercise to try to help you to get a little bit of weight.
Dr. Jeffrey Pierce
(34:23)
Yeah. That's real interesting. And just with Sharon's example, there's so many things to talk about. We could have an hour long Facebook Live just on the many really interesting points that she brings up. I will say a point about soy just because there is a lot of talk about soy as well and hearing that, “Oh, it's not good for us and maybe it causes breast cancer and men that grow breasts.” And there's all sorts of crazy stuff that you can see or different sorts of claims on the internet that you can see. From what I know, from what I've learned from the research studies that most of us look at in the lifestyle medicine field soy is a good thing. And Sharon mentions the risk of very processed soy, maybe not being the greatest for you and so I think yes, go for as unprocessed or as minimally processed soy as you can.
Dr. Jeffrey Pierce
(35:23)
And so edamame, which is just the young soybeans that you would eat at a sushi restaurant classically, we have a bag of it in our freezer, and you can either get it in the pod or out of the pod, and you just pop it in the microwave or on the stove top, and you've got beans for all the fiber benefits of it, but then also the phytoestrogens, which act in a way that are so beneficial to the body that on many levels, one on the level of menopause that we're talking about. In some women, they really do in studies show that they can reduce symptoms of hot flashes, for example, and then also listening to leaders in the field for like breast health and breast cancer, like Dr. Kristi Funk in Southern California who has her book, Breasts and Owner's Manual talking just the other day on this Food Revolution Network about how it acts on a different receptor than the mammalian estrogens, that it actually acts to turn down the effect of estrogen on things like risk for breast cancer.
Dr. Jeffrey Pierce
(36:32)
And so that women who are eating more soy have less breast cancer. And so, eating soybeans, eating tofu, eating tempeh, eating miso soup, these are either unprocessed or minimally processed versions of soy that are good for us on many levels. And so, I'm a strong component of soy and I think some people's concerns about soy are based off of things that we talked about based off of mouse studies decades ago that have been replaced by human studies that show the benefit.
Dr. Laurie Marbas
(37:06)
Absolutely. And I would just add one other thing outside of that she just mentioned was her being on NP Thyroid. So this is a combination of T4, T3. You may be overdosed. And the reason I don't use the Armour Thyroid, NP Thyroid, one, they're very difficult, their ratios are inaccurate when you look at the physiologic needs from a T4 to T3 ratio in the body. So, you may just be actually being overdosed. And there are course obviously people who are very thin and struggle to gain weight, but that may be adding to that, kind of exacerbating that issue that you're noticing.
Dr. Laurie Marbas
(37:40)
So, I would definitely have that looked at and consider reducing or going to either a T4, T3 combo synthetic that you can do, or just a T4 alone. But again, it just really depends. But another question, you guys open for another question. I got several here. Okay. They're coming in fast now guys. All right. So, Michelle asked, “Can menopause cause fat loss around the hips and buttock area? I feel I have disproportionately lost fat in this area in the past couple of years. And if so, what would you recommend for these type of things?”
Dr. Elisabeth Fontaine
(38:10)
She's concerned that she's losing fat?
Dr. Laurie Marbas
(38:12)
Yeah.
Dr. Elisabeth Fontaine
(38:13)
[crosstalk 00:38:13].
Dr. Laurie Marbas
(38:13)
I wish I had that issue, right?
Dr. Elisabeth Fontaine
(38:15)
Yeah. I was going to say… I said, “That's not something that I'm facing very often.” Have you seen that women's body tend to gain their fat around the hip and the butt, men tends to gain more toward their abdomen. And actually the interesting thing is when menopause comes, we tend to shift a little bit. It's certainly not significant as much as she may experience it, but obviously we tend to kind of shift a little bit toward the abdomen. So, the question was, how can she add a little bit more?
Dr. Laurie Marbas
(38:55)
I would say, maybe build up, go ahead.
Dr. Jeffrey Pierce
(38:56)
Build up. Yeah.
Dr. Laurie Marbas
(38:56)
Maybe she's feeling things are changing. The proportions of her body and curves are not where the curves used to be. Maybe that might be more of a thought there.
Dr. Jeffrey Pierce
(39:06)
I bet it's multifactorial. I would add on to some of what Elisabeth was saying with aging and as the curves tend to go for multiple reasons, right? We're losing the battle with gravity. Gravity will always win, unfortunately. So some of that, the sag, the loss of elasticity will affect curves. There is the sarcopenia or the muscle wasting that just comes with age and part of having curves in the hips and buttocks are related to muscle mass as well, right? And so, that's why we're doing squats to work on the curves in the weight room and stuff like that. So, I think a muscle building program, a weight lifting resistance training program, like Elisabeth was… Like you were mentioning earlier, could have a role in that. Anything else? What would you add to that?
Dr. Elisabeth Fontaine
(40:06)
No, I agree with the exercise component and it's so fascinating that again, I'd say that 90% of women that I see that one lose weight, it's all are oriented into aerobic exercise, which actually could potentially do these kind of change into mobilization of fat in different area. But the fact that you can do weight training or exercise like Pilates or yoga will allow to maintain this a little bit differently. So, don't put so much emphasis on the aerobic training, but try to make an effort to mix up a little bit. I think.
Dr. Laurie Marbas
(40:47)
Yeah. And I agree. And I think certainly if you're looking at body shaping and she also mentioned here at the end, she says, “I've lost 65 pounds,” which is phenomenal by the way. Congratulations.
Dr. Elisabeth Fontaine
(40:57)
Oh, there you go.
Dr. Laurie Marbas
(40:59)
She goes, “My butt's disappearing, but my waist is not.” Remember when you lose weight, you tend to lose it… People think, “Oh, I'm losing it for my limbs first and the last is here.” But actually you kind of generally lose weight all over the same, but remember your limbs are thinner. So you're going to notice that you'll notice breast get smaller a little faster than this last part seems to be… We're adding the most fats. It'll seem like we're not losing it there, but we actually are. So, it's not like spot, you can't do spot reductions unless you're doing some type of lipo. But what I would suggest is like things like glute bridges, squats, you can do, like stairs will be helpful, lunges. And if your knees hurt, do backwards lunges. There's different ways to build that booty up to get it up where you like… I had lots of talks about booties and ladies.
Dr. Elisabeth Fontaine
(41:42)
Maybe now, are we going to start by doing exercise and we're going to do booty up webinar?
Dr. Jeffrey Pierce
(41:50)
I'm sure we'll get more hits.
Dr. Elisabeth Fontaine
(41:57)
All right. Whatever works.
Dr. Jeffrey Pierce
(41:57)
Yeah. And think of all the intraabdominal fat that our listener has-
Dr. Laurie Marbas
(42:05)
Michelle.
Dr. Jeffrey Pierce
(42:06)
… lost. Michelle has lost, which is reducing the risk for the heart disease and the other metabolic conditions that she's not seeing so well because it's in and around her internal organs. And so much of that must have been lost with her 65-pound weight loss and how much good it's doing her overall health and longevity.
Dr. Laurie Marbas
(42:24)
And you do lose muscle with weight loss. It does come, you lose fat and muscle, but you can negate that with muscle training, some type of resistance training. Speaking of being active, we have another question here from Marie, “I'm a very active lady who's 62, and trying to switch to a plant-based diet.” Congratulations, the best choice for your health. “However, after a few meals without meat, I have low energy and I need to eat meat to get back to higher levels of energy. What am I doing wrong?” Oh, so many things there we could talk about. Go ahead.
Dr. Elisabeth Fontaine
(42:56)
Jeff, I'm going to let you answer that [inaudible 00:42:59].
Dr. Laurie Marbas
(42:57)
I understand.
Dr. Elisabeth Fontaine
(43:00)
[crosstalk 00:43:00] and I feel that there's a family component there.
Dr. Jeffrey Pierce
(43:03)
Exactly.
Dr. Laurie Marbas
(43:05)
All right, go ahead, Jeff.
Dr. Jeffrey Pierce
(43:08)
Well, I think with… So, I don't know the exact reason, but we can come at a couple of different angles and Laurie feel free to please to contribute as well. But for anything, there comes a transition process when you're making change. And for one, especially if you have been eating meat two or three times a day for the last 20, 30, 40, 50, 60 years, there will be a change in what you experience when you cut some of these things out. Sometimes, especially if you're cutting out things very quickly, both meat and sweets and processed foods, there's almost like a withdrawal as your body, which has become to depend on a certain level of sugars and caffeine and different amino acids, et cetera. I think your body's sort of like, “Hey, I've had this fuel forever and now things are changed.” And there is a transition process with that.
Dr. Jeffrey Pierce
(44:03)
I think overall, when you look at people who have made the switch, you hear, “Oh, I feel much more energy. I'm not getting tired in the middle of the day. I'm not dragging, I'm eating foods that… Because I've taken out these highly processed foods and animal foods, I've been replacing them with highly nutrient dense foods. And so I'm getting more energy from all of these antioxidants and healthy, easily digestible foods.” And so, I think eventually, this is going to change for you. That's my first thought on that. Laurie, what else were you thinking?
Dr. Laurie Marbas
(44:40)
Yeah. So, I know I've been working with plant-based as a… I've been a physician for 20 years, but I switched over plant-based and really focused on medicine for about nine years now, and my first year of working with patients, this was a very common question. And it was my own fault for… Well, I was ignorant of how to actually counsel someone when they're switching over, because I just said, “Eat plants.” I never suggested maybe certain things to focus on because I never looked at the energy content, right? So, there's some really important things to keep in mind when people switch over to a plant-based diet, they often just think of fruits and vegetables, which are wonderful, obviously healthy foods. We need to fill our life full of, but they are very low in calories. And so when you're noticing that you're super active and you're noticing this energy decline, you're not getting enough calories many times.
Dr. Laurie Marbas
(45:29)
So, that's when I say, move the plate more towards your starchy vegetables, your beans, your potatoes, your squashes, those type of things. Actually, you're getting those good fats, like your nuts and your avocados because there's a calorie deficit occurring most likely, and that meat is more calorie dense. So that's when you add it back in, you feel a little bit more energy and you can go on about your way, but really build your plate around the starches and the beans, the legumes, the lentils, all these amazing foods, and then add in those fruits and veggies on top of it. And I think you're going to feel much better. At least that's been a very common thread especially in my first year. So, now I'm very cautious, especially with like my men or my women who are very active, that needs to be really a point made.
Dr. Laurie Marbas
(46:15)
For example, my 25-year-old Jonathan, he just turned 25 yesterday. He's [inaudible 00:46:21] eater. He can do 900 pull-ups in 90 minutes. His food intake is… It blows my mind. It's quite an amount of, I can't even tell you how much oatmeal. It's like this big bowl, is bigger than my head and that's just his breakfast. I can't keep up. But if you're active, that really needs to be something to think about. Your grains are another good source obviously. And so, just really think about making sure you're having some of the component of that with every meal. And if you're active, make sure that you're eating the right foods to fuel that activity so if like for example, I'm running later, I'll run my five miles, I'm training for a 50K. I make sure that I had a good substantial breakfast and that I'm fueled and hydrated so that I have the energy to sustain me during that activity. But any other thoughts, because I know many of us probably have run into this.
Dr. Elisabeth Fontaine
(47:11)
Yeah. I think just to maybe add little bit to what you're saying. So, the beginning, can't forget the fact that we've been addicted to a certain diet for quite some times and our mind is playing little trick to us. So, it's going to take a couple of weeks or more to adapt and start feeling like Jeff said and say, “Wow, I don't feel as much fatigue,” but at the beginning, you want to what we call auto medicated ourselves with what we know the best. If it's meat or if it's processed food or sugar or whatever, at the beginning, it's a little bit more challenging.
Dr. Elisabeth Fontaine
(47:47)
And the second thing is what Laurie said, it's amazing how much more we need to put in our plate. So if you go in the mind that you want to make a little sandwich with a little bit of meat, that was fine for us before. Now, suddenly you can put lots of vegetable and salad and legumes, and then having the same amount of calories. You need to do this. That makes a big difference. So, it's an adaptation and the majority of people come by doing plant food-based by not… There's not enough diversification in their diet, they just eat the same thing, kind of a salad with couple of legumes or fruit. It's not going to be sufficient.
Dr. Laurie Marbas
(48:28)
Right. Absolutely. And here's another question for you guys. Michelle asked, “Is our menstrual health history indicative of how menopause will be for us. I had endometriosis as a teen, fibroids and very heavy periods until my hysterectomy. Any thoughts or suggestions about that?”
Dr. Elisabeth Fontaine
(48:47)
Yeah. Usually, endometriosis and fibroids are estrogen dependent. So, they tend when you look at the population, well say that we see more fibroid in black population because we think they have a little bit more estrogen. So, in your story for yourself, you're obviously one of the good thing is once the hormones are not playing, the endometriosis will get better. You won't have as much pain. That's the good thing. So, it's a give and take into… it doesn't mean that you're going to have more hot flashes because of that, that to me, it doesn't have necessarily any correlation. But if we think that you potentially would've had more estrogen due to these different things, it is possible that you may be a little bit more symptomatic. I could be wrong, but you can think that way.
Dr. Jeffrey Pierce
(49:45)
Yeah.
Dr. Elisabeth Fontaine
(49:46)
Yeah.
Dr. Jeffrey Pierce
(49:47)
That's interesting. Yeah. I don't know of studies that look at populations of that, but I would imagine that that is true. I think it's a good time to plug a book that I enjoy a lot by Neal Barnard called, Your Body in Balance. And he mentions in the book a lot of the things that we're talking about, menopause being one of them, but also endometriosis and fibroids and how a lot of the same dietary and lifestyle changes can improve these other estrogen dependent conditions, PMS, heavy periods, et cetera. And so, we're taking a peek at, or listening to his lectures online and stuff.
Dr. Laurie Marbas
(50:32)
That's great. And I actually interviewed him as well on the Healthy Human Revolution podcast, all about his book. So I definitely took that was really… It was great. I learned a ton myself. And Carla's asking, “What was the author's name of the other book, Glow?” Jeff, is Dr. Katta?
Dr. Jeffrey Pierce
(50:49)
Yeah. Rajani Katta and Rajani is R-A-J-A-N-I and Katta is K-A-T-A, I believe. Yeah.
Dr. Laurie Marbas
(50:57)
Perfect. And here's another question. Sharon ask as a follow-up to… She had the HR treatment for the anxiety. She goes, “Will soy help her anxiety or will it affect her hormone replacement therapy dosage?”
Dr. Elisabeth Fontaine
(51:13)
No, I think that she would have to consume a very large amount in order to have an impact into her hormone replacement. It's not contraindicated. I think that people sometimes would concern, “Oh my gosh, I'm going to eat soy. I'm going to add substantial amount of estrogen and that could be a negative impact.” And I think Jeff mentioned that earlier, surprisingly estrogen is… I'm not talking about the synthetic estrogen, but the natural more estrogen is not contraindicated, actually is positive in helping into the health and the breast tissue as well. So, I don't think that this would have an impact on her hormone replacement therapy.
Dr. Jeffrey Pierce
(51:58)
Right. Sure. And there are some mental studies in the mental health for depression and anxiety in how different lifestyle modalities can help diet and exercise, meditation, of course. Would soy specifically as a specific food improve her anxiety? I don't know of studies that have looked at that as that particular of a thing, but I think in general, taking the sort of a holistic approach to the anxiety would be helpful. It's interesting that it seems like the main benefit you've gotten from the hormone replacement therapy is for the anxiety. And that wouldn't have been my first go-to if you had say, “Man, my anxiety has gotten worse as I've gone into menopause.” I would've thought, “Well, let's look at various sort of more typical ways to treat anxiety,” whether it's the lifestyle stuff we've mentioned or certain medications like the SSRI, antidepressant anti-anxiety medications, which can have some benefits for hot flashes as well.
Dr. Jeffrey Pierce
(53:06)
It seems to be working for you. And I think just keeping an eye on how along you're on the hormone replacement therapy and of course knowing your risk for cardiovascular disease and breast disease and all these other things that can be affected by long-term hormone use, while also thinking about additional ways to address your anxiety and these things [crosstalk 00:53:29].
Dr. Elisabeth Fontaine
(53:28)
Again, that's another can of worm you're just open. If you were to go to hormone, they could be a very long… I think that for her was that she was on birth control pill, which was substantially helping her anxiety. When the birth control pill was discontinued to enter menopause and suddenly for her, it was the anxiety. And I've seen that. And of course you have the general population that have the typical menopause symptoms, but for some women it's going to be anxiety or something and the PMS the same, you have so many different symptoms during the PMS, but for some women it's one and you are able to help them with controlling certain level of hormone. However, I do believe first that if you're able to help them by changing what they eat, you may not need to use the hormones. And that's the amazing component of whole plant food-based diet.
Dr. Laurie Marbas
(54:28)
Yeah. And I would agree. So there's some interesting research on inflammation and I've seen so many people's anxiety and depression improve with a whole food plant-based diet and there's inflammation that's occurring. And there is some suggestions and some studies show that about a third of depression and anxiety, maybe due to the foods that we're consuming. And so, you may see a significant improvement. And she was also a melatonin. So I would be careful with melatonin. Melatonin can actually suppress some other very important hormones. So, I would look at other ways of sleeping and dealing with anxiety outside of the melatonin. And there's things like yoga nidra, or some type of meditation practice will help with relaxation. There's an excellent book called Unwinding Anxiety, was written by a good friend of mine, Dr. Jud Brewer. He has an app as well called Unwinding Anxiety, which may be helpful with this mindfulness component.
Dr. Laurie Marbas
(55:19)
But obviously that abrupt cessation of hormones when she went from her birth control to suddenly in menopause was probably she was already maybe in some type of menopause and had this release. So anyway, it's a very complicated hormonal cascades and all sorts of things are going. But yeah, I think there's lots of ways I would start addressing the anxiety. Because at some point, like Jeff says, you want to balance that exposure versus the benefits and risk. And so the long-term exposure to hormone therapy is always a concern. Because again, this is a natural process and we just want to be careful with that. But yeah, I think that's right. And more questions. I got so many more. They're coming at me like this.
Dr. Elisabeth Fontaine
(55:59)
[crosstalk 00:55:59]. Yeah.
Dr. Laurie Marbas
(56:00)
You guys are. I don't know, it comes and goes. You guys are popular. So here's a… Carla asked, “What can we do if you live in an area without a variety of foods? Eating the same foods over and over can make you lose interest.”
Dr. Jeffrey Pierce
(56:16)
Sure. I can address some of that. Well, so living in an area without a variety of foods. So, there's the foods that you can get at your local store. And if your local store is a Seven Eleven or other convenience store, that can be very limiting, right? And there's been obviously pushes in these areas of “food deserts,” where there's trying to bring in mobile vans, doing mobile farmer's markets and bringing in more fresh fruits and vegetables and stuff like that to add to your diet, that's on one level. There's also the internet, which depending on how you're doing it can be either costly or about the same as if you were shopping at your local store. And Whole Foods is on Amazon and Whole Foods is not the least expensive place to get your food, but it has a whole lot of variety and they can ship it to your door.
Dr. Jeffrey Pierce
(57:29)
And so that's another, I think way to address that. And then the way that I like, but I know it doesn't work for everybody is… Laurie is smiling already because she knows what I'm about to say is that you can get a packet of seeds or some starts, and even if you just have a balcony or a porch, grow all sorts of things and some pots or like many of us out there who have a green patch of lawn that doesn't really do anything other than soak up the chemicals and herbicides that we pour on it, convert that to a place where you're growing tomatoes and peppers and everything else that you like to eat in that plot. So those no one-size-fits-all, none of this will work particularly well for everybody, but something out of those suggestions might help.
Dr. Elisabeth Fontaine
(58:24)
Yeah. I think they're good especially to… It all depends where you live. Obviously if she's limited, I don't know if it's Alaska where sometimes you have sun and then some period of the year you got nothing, so that could be complicated to the garden. But again, a lot of the legumes you can buy them in bulk and dry and then you can cook and mix all these different beans and mix the recipe with different vegetable. You can have things that you can put in your freezer, so it doesn't have to be all fresh. It'd be nice to say that it's always fresh. I don't have any problem with that, but sometimes you may just get a big bag of vegetable, edamame or different things that you can use to do your recipe if it's not feasible for you to have an amazing garden like Jeff has.
Dr. Jeffrey Pierce
(59:17)
It made me think of one.. Oh, sorry.
Dr. Laurie Marbas
(59:18)
Go ahead.
Dr. Jeffrey Pierce
(59:18)
One last thing I would put through that is sure is like… So, most of us have a small set of meals that we do on a frequent basis. And then how do we keep it interesting. And so, if you have your grain, if you think of a rice plus a vegetable plus a legume dish, that could be a Chinese dish. That could be a Thai dish, that could be a Mexican dish, that could be an Indian dish, that could be in some ways, an Italian way to prepare things. And so, so much it depends on spices that you can get sent in and how you prepare your foods. And you could use the same three basic ingredients and have be feeling like you're eating from a different part of the world every other day.
Dr. Laurie Marbas
(01:00:01)
Absolutely. There's so much gold that you guys just mentioned. And I would just like to maybe suggest some other things. If you live in a small indoor space, Hamama, H-A-M-A.com, they have these preseeded little coconut fiber mats, and all you have to do is you can get a little container and literally you add water and you add water and that's it. And two days later you have these amazing sprouts. You can cut them off. So that's another way to add some nutritious component, a little bit of variety.
Dr. Jeffrey Pierce
(01:00:30)
Yeah. Yeah.
Dr. Laurie Marbas
(01:00:31)
There's also things like Misfits Markets. They have like for $25, you can get enough fresh fruits and veggies that are organic, shipped to her door in most places in the United States. Again, this depends, I'm not sure which country she's living in. There may be other things, but also you can order in bulk on Amazon on nuts.com is another one. You can do grains. You can do your beans. So you can, like you said. And then as Dr. Scheuer is joining us as well and mentions change up your spices and Jeff [inaudible 01:01:00] the spices are really integral and make the same three ingredients taste very different. And then you can make your bowls. Like I know for us, like this morning, instead of just having steel cutouts, I put in half steel cutouts and half quinoa. And so you get a different variety there.
Dr. Laurie Marbas
(01:01:15)
So, even that, you can just change and maybe add different grains together, maybe make veggie patties, veggie burgers out of your quinoa and black beans instead of… The next time you're having a Mexican bowl. So, all these different things, just think outside the box and then freeze what you do have, and then you can eat those later for when you're looking for variety. But that's really solid. The other thing is we had a question kind of in this general places, how to get started? People say they're struggling to give up junk food. What would you say to your beginners?
Dr. Elisabeth Fontaine
(01:01:50)
It's interesting because you have two philosophy. You can say start progressively because when you switch completely, if you really… Let's give an example of our standard American diet. And then tomorrow we switch completely. Well, then you have to go shopping a little bit and buy element that you may need for cooking. So, one philosophy would be start by doing two meals during this week or two meals or that day you're going to focus and get your meal ready. So, as an example, Dr… What's his name again? Neal? Neal has this 21-day introducing, so that allow people to see the recipe and to do. So, that's very helpful. And actually, this is the way we started here in my family 10 years ago. We said, “Let's do this.” So we took the 21-day kickstart so that we knew exactly what to buy. We knew what to cook and there is an evolution on that that works very well. And then that the other one is, like I said, you go progressively. Change one day and then eventually you add it a little bit more each day.
Dr. Jeffrey Pierce
(01:03:15)
Yeah. Yeah. That's great advice. And I love that the 21-day program, which they have in Spanish as well on an app for both in English and Spanish. And then I like the idea of keeping it out of the house. And so some people, I think Laurie did this sorts, or maybe it was Chris Miller, gets everything in the house when they're switching over and it's just like, “We're taking it out and it's not going to be in the house anymore on day one to day two.” Other people say, “I'm just going to whittle it down and then not buy anymore.” But thankfully junk food does not like sprout up in the refrigerator. If it wasn't there last night, it's not going to be there in the morning when you open the door.
Dr. Jeffrey Pierce
(01:04:06)
And so, you just have to stop buying it is a big part of it, right? Because I know like if I open my cupboard and my body over millennia has been fine-tuned to be able to find this high calorie, high sugar, high salt foods, because they're so rare in nature to find them, right? And so, if they're now just in my cupboard, that's what I'm going to go to. And so, I don't keep deep-fried Oreos in my cupboard anymore. And if I'm feeling naughty, now I'm going to salted peanuts or something like that. And so, that's already a step above deep-fried Oreos. And so one is just not buying it. It's out of your house. If it's in your house, it's in your mouth as Dr. AJ says, as I've quoted before. And so that's one thing.
Dr. Jeffrey Pierce
(01:05:00)
And then crowded out with other things. And so if you have an easily accessible bowl of healthy foods on the counter and one on the table, and it's the first thing that you see when you open up your cupboard or your refrigerator, you'll go with that more likely than if you have to go all the way to the back, it's that extra, some extra steps to get to the food that's less healthy for you. Those are some [crosstalk 01:05:20].
Dr. Elisabeth Fontaine
(01:05:19)
But in itself, what you're saying, Jeff, which I really like is you have to be prepared. So you got to think about, “Okay, what am I going to do?” Let's say, if you work all week, you got to… Some people will use this Sunday to go buy, prepare so that instead of buying anything, that is the standard will cook their meal, that will be plant food-based and being ready. So, the first good thing is there and it's ready. They don't have to think and it's so easy for us when there's nothing ready just to use what we used to, just a quick thing that could be available, piece of cheese or.
Dr. Laurie Marbas
(01:06:02)
And then honestly, and as long as… You may even have stuff there, but even just prepping it one step closer so it's easier to consume. For example, this morning, my daughter was leaving. She had come to visit and we have all this fruits and stuff available. Again, nobody was eating. I was busy with other stuff, so usually I'm prepping it. So what happens is I cut some apples, I cut some pears, I cut up some oranges. I threw all the berries and some pineapple, made a fruit salad and suddenly it's all gone. So, it's just preparing that, but also your home has to be your safe space. And there's three things you got to keep in mind. If you want a behavior to occur, one you'll have motivation. So, if you have motivation, you feel better and eat, that's pretty straightforward, but it may go up and down.
Dr. Laurie Marbas
(01:06:43)
You need to make it easy. That's the ability. And you have to have a prompt. So that prompt could be hunger. That prompt could be visually seeing something. So if you want to make something hard or not want to do, if you don't want to eat the junk food, make it hard to do, get it out of the house, make it where it's more expensive. Make it where you have to go out and buy it at a far, far away place. Just something that you have to make it harder to do. So those are some things there to look into some elements, but your executive preparation is absolutely key. Also, on the healthyhumanrevolution.com website, I have a free seven-day course, walks you through everything you need to know about a plant-based diet, literally everything and even just that.
Dr. Laurie Marbas
(01:07:20)
And there's other things available to you all for free showing you how to spend time in the kitchen, how to shop on a budget, how to do this with kids? So, I went through and answered all those questions that I was getting over and over again. So, that's phenomenal. So, there's some other suggestions from some of our folks here. They're saying they using Forks Over Knives meal prep apps, which are great. Do you guys have any preference of ones that you like?
Dr. Jeffrey Pierce
(01:07:47)
I have Forks Over Knives has a good one. And I think the Engine 2 Diet has one. I think Rich Roll has one. I think if you don't have your own prep app, it's some sort of deficiency because it seems like there's so many out there, but those are some of the ones that I've heard of. How about you [crosstalk 01:08:09]?
Dr. Elisabeth Fontaine
(01:08:08)
And there's Aruba that culinary that offer a class so that you can learn how to cook. And it's not very expensive. I can't remember, but you do it online. You have all the lesson and they give you a lot of good recipe that you can… So at the same time, it's a good refreshing way to learn how to cook plant food-based.
Dr. Laurie Marbas
(01:08:37)
Absolutely. And I know we have other questions, but I promise to keep you guys an hour. We're going a little bit over, but there's a question about kids. I would say there's that book, Nourish is a good one. Was it Nourish by?
Dr. Jeffrey Pierce
(01:08:53)
Is it Reshma Shah and Brenda Davis?
Dr. Laurie Marbas
(01:09:00)
Brenda Davis. Yep. And then, like I said, on the Health Human Revolution site, literally I talked to you about every stage and age of what you should leave supplementation if necessary and what to do. There's a free superhero coloring book. Literally, [inaudible 01:09:10] out of… Literally, it's very extensive. And then some questions, just one quick question. I think that a lot of people may ask is about any sweeteners like monk fruit or stevia. What are your thoughts on that? And then we'll make that our last question.
Dr. Elisabeth Fontaine
(01:09:26)
Well, where I am is maple syrup.
Dr. Jeffrey Pierce
(01:09:31)
Yeah. [crosstalk 01:09:31].
Dr. Laurie Marbas
(01:09:31)
I'm a fan of maple syrup, myself or dates.
Dr. Jeffrey Pierce
(01:09:34)
Yeah. My wife cares for bees in our backyard and so we have a supply of honey that I will use sparingly and Dr. Klaper, who we're lucky to work with in our group, likes to say, “Just don't make sugar its own for food group. Make it something that you just add in small amounts.” And so, if you do put a small amount of maple syrup or dates syrup or whatever it is, it's a little something that adds a little bit more flavor to your food, but it's not a 98% sweet food.
Dr. Laurie Marbas
(01:10:16)
Perfect. Well, they're wonderful. And is there anything you'd like to say before we wrap up. We really appreciate your time everyone, and of course you can find these amazing doctors on plantbasedtelehealth.com, Dr. Elisabeth Fontaine, Dr. Jeffrey Pierce. Any final advice?
Dr. Elisabeth Fontaine
(01:10:32)
Well, the final advice is that the next time we have a webinar, we're going to start doing exercise [crosstalk 01:10:37].
Dr. Laurie Marbas
(01:10:37)
You're going to start with [crosstalk 01:10:41].
Dr. Elisabeth Fontaine
(01:10:43)
No, I just want to say it was a pleasure to, and we're going to continue working together as a team. So more than welcome to have people sending question and we can certainly answer if need to personally, but we'll be happy to see them online.
Dr. Laurie Marbas
(01:10:58)
Yeah, absolutely. Jeff.
Dr. Jeffrey Pierce
(01:11:01)
And my pleasure to join the conversation today. I thank everybody for their participation and their questions. Yeah.
Dr. Laurie Marbas
(01:11:07)
Absolutely. And thanks everyone for watching again. Again, you can find these amazing doctors and our other amazing doctors at plantbasedtelehealth.com and we are on all 50 states in DC. We also see international patients, click up on the information tab on the top of the website and it just explains everything, the costs and everything we can do. And we have some really cool things coming your way, and we're going to continue doing these as much possible every second Thursday of the month and fourth Thursday of the month. We also do free webinars. Many times we have special guests like last week was Dr. Michael Gregor. These are also on our website for replay, they're on our YouTube page and on the Facebook page. You can watch them at any time, but again, feel free and you can register for those webinars at plantbasedtelehealth.com. And so, thank you, Dr. Jeff and Dr. Elisabeth for sharing your wisdom. And we so appreciate your time and sharing your expertise with us today.
Dr. Elisabeth Fontaine
(01:12:01)
Thank you.
Dr. Jeffrey Pierce
(01:12:02)
Thank you.
Dr. Laurie Marbas
(01:12:02)
Everybody. You're right. Goodnight, everyone.