In this week's webinar, Dr. Miller and Dr. Marbas answer questions all about the immune system.
Questions Answered
- (02:18) – The importance of a balanced immune system
- (04:47) – Stress and the immune system
- (16:52) – What causes IBS, or irritable bowel syndrome?
- (20:48) – How is our gut related to our mind and body?
- (23:42) – Discussing the importance of sleep.
- (36:22) – What do you think about Tofu?
- (37:52) – Describing a specific WFPB nutrition plan to help “step things up”?
- (43:36) – Discussing acceptance and forgiveness as a mindset to reduce stress.
- (47:03) – What are the more inflammatory foods to avoid at first in healing the gut?
- (53:07) – Using good health food to crowd out less healthy stuff
- (54:42) – Is melatonin helpful for getting a good night sleep?
- (58:01) – How often should vitamin levels be checked?
Complete Transcript
Dr. Laurie Marbas
(00:06)
I'm Dr. Laurie Marbas, co-founder of Plant Based TeleHealth. In today's webinar, we actually spoke about everything relating to the immune system. We spoke about how to keep the immune system in balance. So, let's say that you were actually exposed to an illness, you are going to have a better chance to recover. And then also about how to keep the immune system from overreacting, which could lead to things like autoimmune disease.
Dr. Laurie Marbas
(00:28)
You can join us for our free live Q and As with the Plant Based doctors every Sunday at 2:00 PM, Mountain Standard Time or 4:00 PM, Eastern Standard Time. To find out how to register, check out plantbasedtelehealth.com or you can check us out on Facebook at Plant Based TeleHealth.
Narrator
(00:44)
We are making plant-based lifestyle medicine available to everyone who desires it. With telemedicine, we are removing barriers that prevent many people from accessing this type of care. Lifestyle medicine promotes healthy behaviors, and when adopted, individuals can expect improvement, and in many cases, reversal of chronic disease.
Dr. Chris Miller
(01:03)
Happy Easter. Thanks for joining us today. Today, we're going to talk about, we started an immune system health series last week, and we've been talking about it amongst ourselves because it's so in the news right now. And it's so very important that we protect our immune system. And there's been a lot of questions from patients and friends and myths, and a lot about, “Should we be boosting it? Should we be suppressing it? Is it safe to do a plant-based diet right now? What should we be telling people?”
Dr. Chris Miller
(01:32)
And so we wanted to do a few things today. We wanted to talk about an overview of the immune system, what it means to have immune system health and whether we should be focusing on boosting it, or suppressing it, or what our goals should be with this. And then we want to introduce a healthy immunity challenge.
Dr. Chris Miller
(01:49)
And I like to call it a healthy immunity challenge because the goal is not just to do one or two things to the immune system, but to create balance, to create an overall healthy immune system. And that is what we'd like to offer you after we talk today a little bit and tell you how that's going to work.
Dr. Laurie Marbas
(02:06)
Fantastic. So, if there's any questions, go ahead and we'll start that big… So Chris, let's start with, can you tell me a little bit about what that means to have an immune system that's in balance versus boosting the immune system?
Dr. Chris Miller
(02:18)
Yeah, thank you. So, the immune system is so, so, so important and now more than ever, right? And it's certainly getting a lot of attention, rightfully so, but the immune system has several functions and they're opposite ends of the spectrum. So, on one end, which is what we're talking about so much right now with coronavirus is that it protects us. Our immune system is our army. I call it my guardian angel. It's there 24 hours, seven days a week, when I'm sleeping, when I'm playing, when I'm goofing off, when I'm working, no matter what I'm doing, my immune system is there protecting me.
Dr. Chris Miller
(02:53)
You want it to be functioning optimal. So, this is what people are talking about boosting. Let's boost the immune system so it functions optimally. But ideally if you boost it too much, then it becomes hyperactive and then it can turn into an autoimmune disease or chronic inflammation and never really quiet down or what they're saying, the cytokine storm, where you're getting so many antibodies, you're getting this immune response, you're getting these chemicals being released, and blood vessels are dilating, and inflammation is happening out of control. So, those are all things that are too much immune system.
Dr. Chris Miller
(03:25)
On the other hand, you don't want it to be underactive because then it's also out of balance. And if it's underactive, it's not going to be there to protect you against these viruses, these bacteria, these parasites. It's not going to detect them. It's not going to protect you against abnormal cells as they age and they get senescent, they're no longer functioning and your body needs to get rid of them. Or they go rogue, which is cancer and your body needs to get rid of it.
Dr. Chris Miller
(03:46)
So, you really want your immune system in balance. You want it optimally functioning, you want it precise, you want it well-trained like soldiers that are good at what they do. Just the right amount. They're out there, boom, they do their job and then they quiet down. And interestingly, which is what I think is so fascinating is that there's a lot we can do to affect how good our immune system works directly. We can directly influence our immune system, which is what the challenge is going to be all about.
Dr. Laurie Marbas
(04:14)
Perfect. And so, an example of that in my own life was, so, I was pregnant with number two, Jonathan, who's going to be 24 this month. And I was healthy. I had no health issues. I wasn't overweight. I felt fine at pregnancy. There was, I feel, a little complications in the beginning, but those were anything to do with an immune system or something, but after I had him, Jonathan was actually born with testing that showed he was hypothyroid. And then I was diagnosed hyperthyroid about three, four months later.
Dr. Laurie Marbas
(04:47)
So, Jonathan was retested two weeks later and the hypothyroidism had resolved itself, but he went on to develop pretty significant learning disability and dyslexia. He's done great. I mean, he just graduated college. But now I've been dealing with that all the time. So, that stressor right? Chris, your immune system needs to be in balance so it can handle stress even though a stress of pregnancy, a stress of an illness, a lot of type I diabetics will become ill with the type I diabetes after a cold or flu. So, do you have any other thoughts on stressors and how we can help prepare for that?
Dr. Chris Miller
(05:22)
Mm-hmm (affirmative). So, that's a really good example is the stressors. And certainly there's a lot right now. We're worried, right? Economically. We're worried about our health, our loved ones, we're worried about all of our workers, essential workers out there right now. There's a lot of worry going on.
Dr. Chris Miller
(05:39)
And there's a humongous mind, gut connection. And in addition to that, there's the mind all of our thoughts are turned into what's released from our glands in the back of our brain, which goes off to our adrenal glands, which release, there's over a hundred stress hormones. And those stress hormones are going to elevate inflammation as well and keep this propagating, keep everything continued and so it doesn't quiet down.
Dr. Chris Miller
(06:06)
So, our thoughts very, very significantly, or is a stressor to both our gut lining, which is a direct part of our immune system, which we'll talk about at some point, and as well as to our overall inflammation. And we now have so many good studies that show that people who are worried and report stress subjectively have significantly increased inflammatory markers, so their immune system is potentially overworking versus people who have a sense of calm. They may have the same problems in this world, but they're proceeding it differently. And so, your perception of that stress, which calms it all down and leads to very different reaction to our stress hormones in our bodies and how our immune system is going to react to it.
Dr. Chris Miller
(06:50)
So, that's just one great example of how we can control our immune system. Hence, when we talk about the challenge, you're going to see activities like meditation, or coloring books, or getting outdoors and being mindful, feeling the wind and breathe in the air, or yoga, right? Everybody gets to choose what helps them relax. But that's what we're aiming to do is to keep our immune system and the stressors in check and in balance.
Dr. Laurie Marbas
(07:17)
Yeah, I think that's also very important to understand that mind, body connection, because during that pregnancy also, we were also preparing to move from Texas to Ohio because my husband was active duty Air Force, and I was supposed to be due to deliver during the time of moving. So, that was very worrisome. And so that all of those stresses the mind, body, but there's a practice called noting that's really nice too.
Dr. Laurie Marbas
(07:43)
Like you had mentioned meditation, some coloring books, but you're just becoming aware of your surroundings. So, if you think about your senses, right? So your sight, smells, hearing, touch, taste. So, if we're walking down the street, for example, and we're worried, and we're just ruminating on things that are stressful, but instead step outside of your mind and start thinking about your different senses. So, let's say you hear a dog barking, “Oh, that's my hearing. I hear a dog barking. Oh, I see a bird flying. So I'm using my senses.”
Dr. Laurie Marbas
(08:15)
So, just noting the different senses, like what's going on with my eyes, my smell? I smell cherry blossoms, or I take a deep breath and it's refreshing. Those are things to do as you're doing something to pull yourself out of whatever the trap is of the worry or the stressors that you might be in at the moment. Because sometimes it's really hard to shut off the brain.
Dr. Laurie Marbas
(08:35)
So, the other thing would be like a body scan that you can do. What are my feet doing? How do I feel right now on my knees? And all those different things. So just some ideas there. For people who aren't used to meditating, I am not a very good meditator. I'm just not. I tried multiple times. Prayer works for me fairly well, but even then, it's stressful to think long. I can't do this for more than 5 to 10 minutes.
Dr. Laurie Marbas
(09:00)
So, for those who are like me and struggle with that. So, guys feel free to open up the questions. If you have any questions, please type them in the Q and A box. And so, Chris, what other activities have you seen your patients use to really help decrease stress, which will also help balance our immune system?
Dr. Chris Miller
(09:19)
So, those are great examples, Laurie, what you described to me, and you're such a good example too, because you're not someone who can sit quiet and calm your brain. And that's a very common thing with a lot of people, right? The monkey mind, it keeps going. And so, it takes some practice to get to that meditation where you just feel comfortable sitting quietly. But people can start with guided visualizations, which you listen to, there's all sorts of good apps now, you can download stuff on the computer. That's what I have done in the past.
Dr. Chris Miller
(09:50)
And it takes you into a nice, happy field and you're taking your deep breaths. And it puts you in a nice state of mind and you don't have to be thinking it, you're just listening to what the tape says. And for those 10 minutes, you're doing what you're also saying when you're noting things outside is you're becoming mindful. You're only aware of this present moment right now. You're very focused on the present. The right now. You're non-judgmental is how it's originally defined by Jon Kabat-Zinn.
Dr. Chris Miller
(10:16)
So, being mindful in the moment. And so, when you're doing those things like your body scan or you're noting, or having people listen to the guided visualization, you're relaxing. You're not thinking of all these stressful thoughts that are ruminating in your mind and your stress hormones, your levels can start coming down and your immune system can start bringing it back into balance into a normal instead of being in this hyperactive state.
Dr. Chris Miller
(10:41)
So, I do a lot of that to start with, with people that are having monkey mind and not enjoying the meditation. And then exactly what you described is those are mindful tricks. And I know you do a lot of work with mindfulness. So, those mindful tricks, just going outside and noticing things. What do you see? What do you smell? What do you feel? The air on your face, look at the clouds, whether it's good or bad, it's non-judgmental. You're just there looking at it in a curious way. Like, “Oh, wow, isn't that curious? I feel the breeze on my cheeks. Oh, wow, isn't that curious? It's snowing out and it's April.
Dr. Chris Miller
(11:12)
So you're being mindful. So that also has been shown to lower those stress hormones and bring your immune system back in balance. And then a big one that we do is things like music therapy. So, music can totally put people in the zone and calm down the immune system.
Dr. Chris Miller
(11:27)
And it's, they looked at all different kinds of music. And while things like Beethoven and certain things have done really well, but it's also what people like. So whatever someone likes is going to work for them. So there's no one right answer. If you don't like classical music, that's not going to relax your stress hormones and bring you back into a normal zone. So you do what you like.
Dr. Chris Miller
(11:46)
And then there's things like creativity, that's a big one. As we get busier, busy and stressed out and we have these full lives, we forget about the things that bring us joy in our creativity. So people who love to paint, or play the guitar, or write poems, or all these things puts us in that zone. Right? And really anything that puts you in that zone, that flow, that moment where you're really focused brings back your stress hormones. It's going to bring you back to being mindful, lower your stress hormones.
Dr. Chris Miller
(12:16)
So, I have patients do three things and there's just so many things you can do. Breath work. We work on breathing in slow. Then there's so many different types of breath work, but you breathe in… The idea for whichever you end up choosing is to breathe in long and slow and out long and slow, and in long and slow and out long and slow.
Dr. Chris Miller
(12:34)
And if you do it with gratitude while you're breathing in and you're having gratitude, this is HeartMath techniques that they train you, and you can see your heart rate variability improving. You can see your body, your sympathetic and parasympathetic nervous systems coming back into balance. That's the fight and flight and the rest and restore. And it brings them back into balance when we're doing these slow deep breaths and we're remembering gratitude.
Dr. Chris Miller
(12:59)
So, we work on things like that. We do things like gratitude journal, three to five things every day that you're grateful for that day and why you're grateful for it, writing it down makes it more real, so we work on that. And things like you said, prayer is a real good one for people who pray, but there's all different ones.
Dr. Chris Miller
(13:16)
So, if you don't meditate well, you don't have to meditate. We don't want this to be a stressful thing. We just want to learn quiet time. We just want to learn ways to get you in the zone to help decrease the stress. So there's different techniques you can use. And so, I have everyone try to do three a day, which doesn't have to take long at all. If you do the breath work, that's a minute. If you're mindful, you can go outside or go in a room in your house and be mindful for a few minutes throughout the day. It doesn't have to take long or be a major commitment, but resetting yourself to the day is key. So it's really, really an important tool.
Dr. Laurie Marbas
(13:50)
Those are fantastic, Chris. So, just a couple of things to understand is when you were mentioning perception, so someone can have the same identical circumstances and go through the same difficult time, but it's their perception of it. One can see it as an opportunity, doors are opening, even though we're going through the struggle. For example, right now, the COVID-19, many people see it as, of course, it's stressful financially and thing, but other times people are thinking, “Wow, this is actually forcing me to slow down. It's forcing me to connect with family and do these amazing things that we would not have otherwise done and really see the importance of certain things in life.” Right? So, that visualization sometimes just… Because it's snowing outside now. And so, I can't go outside necessarily. I mean, I could, but it wouldn't be very enjoyable, but I can visualize somewhere that I love to be, and that also can be it.
Dr. Laurie Marbas
(14:43)
But a really easy, that breathe in and out is using your hand, I think it came from somewhere in England. I can't remember the exact, but Dr. Judd Brewer taught me this, but you just breathe in and out, in and out, and like this. And you go through your hand back and forth. And that really helps. And I've used four, seven, eight breathing as well with patients. And someone who had high blood pressure, literally we did one set of four, seven, eight breathing, well, it's three sets and her blood pressure dropped 20 points systematically that top number after breathing.
Dr. Laurie Marbas
(15:16)
So, you're breeding in, you're stimulating hormones and calming down and slowing down your heart rate. So those are just some helpful tips-
Dr. Chris Miller
(15:25)
Laurie, do you want to tell them what the four, seven, eight breathing is?
Dr. Laurie Marbas
(15:26)
Yeah, sure. So, four, seven, eight breathing, what was, Dr. Weil? Yeah. And he's the one that came up with this. That's where I read. I've been using it with patients for many years. And so, basically you breathe in over four seconds. You hold your breath for seven. Seven. And you breathe out over eight. And you repeat that four times. Why four, seven, eight? I'd have to dive in to see why Dr. Weil chose that, but any of those techniques of breathing are going to be helpful.
Dr. Laurie Marbas
(15:56)
But you do that four times. And it is very relaxing, especially because you're focusing on the breathing, you're not focusing… I find it funny that you call it monkey mind is like a Marbas monkey mind because I have a lot of that going on. I have a lot of things going, “Oh, oh.” The shiny object. What's next? So it's four, breathe in over four, hold for seven, breathe out over eight, repeat four times.
Dr. Chris Miller
(16:20)
good studies on that when you breathe in and then you breathe out twice as long. So that's, you're breathing in for four and out for eight, it stretches your diaphragm, which triggers your vagus nerve. And for autoimmune people, some of your doctors probably know more about this than I do, but they're doing vagus nerve implants for rheumatoid arthritis, severe cases. And to try to trigger the sympathetic nervous system to slow down to lower the inflammation by just doing those breath works; breathing out for twice as long. So that's why it is such a powerful tool.
Dr. Laurie Marbas
(16:52)
Absolutely. So we've got some questions here. Let's see what you think. And like I said to Dr. Carney and to Dr. Krant, if you guys want to join us, let me know and I'll make you a panelist. All right. So Andrea, uh, I need to email you Andrea, by the way back. I apologize for that. Would you please comment on IBS or irritable bowel syndrome and known causes, risk factors and/or contributors. Alto IBS can also be inflammatory bowel disease or IBD, but some practitioners say IBS is very much a mentally-induced, stress-induced condition. Others say that it's not true, that it is a veritable physiologic condition. I'd love to better understand IBS if that's within the parameters of the discussion. Thanks. Don't know if IBS is autoimmune-related.
Dr. Chris Miller
(17:35)
Wow. That's a good question packed in with a lot of good stuff there. So, I'll let any physician help answer after I give my answer because there's a lot of good stuff in that. Thank you for that question. So, IBS, we're going to go with irritable bowel syndrome, which in general is not inflammatory bowel disease. So, it's not auto-immune, and usually people who are diagnosed with that often have had a workup already meaning and things are coming back negative.
Dr. Chris Miller
(18:00)
So they're negative for Crohn's disease or ulcer colitis or sclerosis of the gut, other autoimmune issues. And it's more like a functional thing. But interestingly, IBS is a tough one to talk about because I see it as a wastebasket term. It means that we don't really know what's going on. And there's lots of different causes to IBS.
Dr. Chris Miller
(18:22)
So, one person's IBS is going to look very different from the next person, from the next person, from the next person. And we can have 10 people all with different reasons for their IBS. Again, this catch term that means it's more of a functional thing. So, I always think it's a good thing in one sense because we don't yet have pathologic findings. People will get scoped and they don't see necessarily anything. Sometimes they might see a little information, but in general, it's not like the full blown where there's actual pathology.
Dr. Chris Miller
(18:49)
So, there's a lot of factors that can contribute to it. So, what does that mean? So, some of the factors that can contribute to that we look for in it is, one is what's called dysbiosis. So that means the bacteria, the microbiome, those 39 trillion that we have most of them in our gut supposed to be in our lower colon, they can be out of balance and they can out of balance in several different ways.
Dr. Chris Miller
(19:11)
One, they're just out of balance. So, we have a balance of these protective and less protective, more pathogenic bacteria. And so, if it gets out of balance, these pathogenic ones start overtaking it, that can destroy the whole part of the lining and then the epithelia of those cells or the gut. So that will bring it out of balance and lead to IBS-type symptoms.
Dr. Chris Miller
(19:30)
Or you could have the bacteria that's supposed to be in your lower colon. So what happens if people take proton pump inhibitors, or their gut isn't functioning as well, or they don't eat enough fiber, or they take other medications, or several other reasons, but those bacteria migrate up to the small intestine. And so they cause gas and bloating there and discomfort, sometimes nausea, things like that and a fullness. And that is also considered IBS, but for a little bit different cause, and that is what we call SIBO, small intestinal bacteria overgrowth.
Dr. Chris Miller
(20:03)
Those bacteria that are supposed to in the colon protecting us and taking care of us are now up in the small intestine fermenting high fiber foods and causing excess gas and bloating. So, that's another cause for IBS. Another cause for IBS is things like leaky gut, and that is the gut lining itself gets damage. And that's often secondary to the microbiome getting damaged. But the gut lining becomes damaged and it's only one cell layer thick.
Dr. Chris Miller
(20:28)
And so, what happens when you get this leaky gut is you start getting bigger proteins and peptides or proteins that haven't fully broken down into their amino acids migrating across the bacteria. The microbiome can migrate across, toxins can migrate across, and that can cause irritation and inflammation.
Dr. Chris Miller
(20:48)
But there is a big component. And those are just some of the examples of the more common ones that I see. But your question about the mind body part of it is, is it related to that? And it absolutely is. And all of our gut is related to mind body. And so, our thoughts, there's the vagus nerve that we're talking about. The vagus nerve has many branches and it's going to our heart. It's going to our lungs. It's going to all of our intestines and it's going right back up. They are in so much communication back and forth all the time with our thoughts.
Dr. Chris Miller
(21:19)
And so, there's so much evidence now that we don't want to eat when we're stressed out. This was a thing with me, I'm an emergency room doctor, and I know Dr. Carney you are too, but you work in the ER and you're wolfing down your food and then you're going out to your next patient. And so, I'm stressed out, I'm in a busy shift, I'm wolfing down my food. And so my thoughts, my stressful thoughts are going to my gut right there.
Dr. Chris Miller
(21:41)
I was talking about the sympathetic and parasympathetic. Sympathetic is that fight and flight, go, go, go, go, go. When you're in sympathetic mode, as we often are, it shuts down the gut. It slows digestion. So, our gut is no longer digesting. It's not metabolizing nutrients. It's not absorbing nutrients. It's not doing what it's supposed to do. And that can lead to gas, and bloating, and discomfort, and bad digestion overall, all these problems, as well as dysbiosis and the gut microbiome being out of balance.
Dr. Chris Miller
(22:07)
And so, we want to slow it down, slow down those stressful thoughts, eat slowly, eat mindfully, chew our food real well and send a message to our gut that we're in parasympathetic. We're chill. Life is good. And the gut kicks in, it's going to digest now, it's going to absorb nutrients. It's going to do its job. It's going to help us feel healthy.
Dr. Chris Miller
(22:29)
So, when people have IBS as well as auto-immune, as well as any inflammatory, our thoughts absolutely are affecting it. And so, we'll see that we get poor digestion, worsening of symptoms. And some people live with this chronic high stress and that is their major trigger. And so, when I work with my IBS patients, and Laurie and the other doctors out there probably do something similar, but we talk about food and nutrition, but we always approach our thoughts and our stress and how we manage it. But I do that for my autoimmune too. It's not unique to IBS, but it's such an important component. I find you can't heal one without dealing with the whole picture.
Dr. Laurie Marbas
(23:07)
No, I think you summed it up nicely and hit some really major points. But the other thing is they call it the second brain for a reason. So, there's a lot of interconnections nervous system attacking the gut, so there's more nervous system attachments and speaking in highways than actually leaving your spinal cord, that's going to the gut.
Dr. Laurie Marbas
(23:26)
So it's really important. So if you think about it, when you ever had that gut intuition or that butterflies in your stomach, I mean, there's things going on here that we don't understand. So they're talking to each other. So really, really very well said. And I think that hopefully that'll answer your question.
Dr. Laurie Marbas
(23:42)
Beyond, you have to look for, of course removing dairy and offending foods, but we're talking to people are plant-based. So Dr. Krant had a question. Can you talk about sleep? Chris, this is one of your favorite things, and it's direct, at least speaking about, effects on immune balance and also what is ideal amount of, and type of sleep and sleep tips we might not already know.
Dr. Chris Miller
(24:03)
Good questions, Jessica. Thank you. So, sleep is something I talk about a lot and I really work on myself because I'm not a good sleeper. And I think, again, as a med student, an emergency room doctor, I'm used to being up all night and just go, go, go. And I'm still working on a good sleep hygiene to get regular sleep.
Dr. Chris Miller
(24:21)
Our sleep directly affects all these things as well. So, we used to say, like when I was a med student, we would say, “I'll sleep when I'm dead.” Meaning there's so much to do right now. I don't need to sleep. But now we know that if you don't sleep as much, you'll die sooner.
Dr. Chris Miller
(24:35)
So, as far as what we're talking about now with the immune system and just overall health, when we're sleeping, that's when we're getting the rest and repair, we're pushing out toxins in our body. We're repairing our cells. We're fixing broken DNA. We're getting rid of toxins. Like I said, we're cleaning house at nighttime.
Dr. Chris Miller
(24:51)
A couple of things, one, if we're not getting the sleep that we need, we don't have time to do that repair of our cells, we don't have time to clean house. For example, if we eat late at night, now we know there's good science not to eat within at least three hours before you go to bed because you don't want to use your energy when you're sleeping, I don't want my body digesting food. Energy is going into digestion. I want my body repairing me and healing me and fixing those broken DNAs and getting rid of all that waste. And so, I purposely am going to sleep on an empty stomach, not in a stressful mood to help get the repair.
Dr. Chris Miller
(25:28)
Other things that happen when we sleep, again, talking to stress is cortisol levels fall. And that's a real important one. And so, like for me, when I was go, go, go awake all night, I'm living in high cortisol and that's extremely dangerous. You want to get your melatonin to kick in, which is going to override all your other hormones and calm everything down. You want to reduce your cortisol. You want to reduce your insulin, right? You're not eating so glucagon can kick in. And basically our hormones are falling into balance or general inflammation is decreasing.
Dr. Chris Miller
(26:00)
Our memories are being made, the first half we're making memories, and the second half we're… actually look at that, I can't remember how that is, but I think it's the second half you're solidifying memories and the second half you're stabilizing emotions.
Dr. Chris Miller
(26:13)
So, if you don't sleep, if you don't get into the four stages of sleep, that can be a problem. And so we hear all this about sleep now, and there's just so much more about sleep, which is fascinating to me. It also affects our microbiome. So, we're circadian beings and even our microbiome is circadian. There's different ones that are more active at nighttime from the ones that are more active at daytime, the gut shuts down at night. We're not meant to digest food at night, so it's not peristalsing as well, it's not absorbing nutrients. It's quiet, it's sleeping, it's repairing itself. That one cell layer of the epithelium has to repair and that's happening at night.
Dr. Chris Miller
(26:44)
So, you really don't want food sitting in your stomach, in your gut all night so that it doesn't have to worry about digesting it and all that food just sitting there. But the microbiome itself is not meant to be detoxifying at nighttime or digesting food, it's meant to be doing other things. Other bacteria become more prominent at night. And that's why we have these very diverse, very variable microbiomes so that different ones have different roles. And so we know that to be true now too.
Dr. Chris Miller
(27:15)
So there's really good studies now that as far as the immune system goes, that if you get less than six hours of sleep a night, that you you are, I think it was four times more likely to get a common cold. And so, your immune system is definitely enhanced, it's more precise, it's doing its job correctly, it's in balance when we get at least six hours of sleep. And so here we are this crazy virus running around. And if any of us get exposed to it, hopefully we're getting more than six hours of sleep at night so that at least we have a good chance that our immune systems are going to be doing what they're supposed to do optimally.
Dr. Chris Miller
(27:51)
And they know that from taking med students and they injected flu virus into their nose and they watched how much they slept. And they were able to see who got it and not. As far as tips to sleep better, this is a tough one. I work on this a lot with myself and my patients, but sleep hygiene, I start with sleep hygiene. And what that means is creating a sleep routine, what you do at night. You want to set your body to rest and repair and get it into landing mode like it's going to go to sleep.
Dr. Chris Miller
(28:24)
And I think of it like an airplane flying. This is you all day, you're awake. You're not going to just, boom, be asleep. You don't turn off your computer. Okay, goodnight. That's not how your body works. You've got to give it time to unwind, relax and then you go to sleep. And so, that's where the last hour, depending on the person, but at least usually about an hour. For me now it's even a little more, maybe an hour and a half. But I turn off my computer. I'm not on emails. I'm not taking important calls. I'm not having big conversations about politics or the coronavirus or any of this at nighttime because that's too much stress on me at night and I won't be able to sleep. So, all of that, it's quiet time.
Dr. Chris Miller
(28:59)
So what am I doing? I'm reading a book, or a magazine, or journaling, writing my gratitude, doing some gentle stretches, things that I want to do. It's my personal time. I feel like we earn it. We get that little time at night. So, I have that. And then having a routine. So, you brush your teeth, you get everything ready so your body starts knowing, “Okay, you're brushing your teeth. This must be a sign that…” It's the same routine every day. It's getting ready to go to bed. Lights down at night. So bright light, blue light actually wakes you up. It suppresses your melatonin and you want your melatonin to be high.
Dr. Chris Miller
(29:30)
So, red light actually does not do that. So you can have red light. So, I have some red nightlights and red lamps at nighttime, or I just turn the lights real low so I'm not in any bright. And that supposed to be, supposedly we do better if we follow the natural lighting. So, when it's light out and dark out, but our seasons are so crazy that I don't do that. So, obviously I use my lights.
Dr. Chris Miller
(29:52)
So, you turn down the lights at night, you want to ideally be on track where you go to bed around the same time every night and wake up the same time every morning. And if you're tired, you don't sleep in longer, you go to bed earlier. You want to always do waking up the same time every day on your own without an alarm because your body isn't telling you what you want. So you want to get into this rhythm.
Dr. Chris Miller
(30:11)
Again, we're circadian beings. The more of a rhythm we can get into, the more our bodies are going to be happy with that. And then things like avoiding caffeine during the day, some people are so sensitive, even a cup of tea in the morning, they're not going to fall into that deep sleep because they're halfway from… It depends how fast they metabolize caffeine. But some people who are slow metabolizers may still have that little bit and they don't fall in that deep sleep.
Dr. Chris Miller
(30:33)
Whereas other people are fine. They can drink tea and coffee throughout the day and they can sleep just fine. So, that's something we experiment with people. Alcohol. It turns out to be more of a stimulant about three to five hours after you drink it. So, people who drink alcohol we'll play with that for them. So, there's sleep hygiene, then there's other tricks to it too, but that's the basic overall. And then from there there's cognitive behavioral therapy.
Dr. Chris Miller
(30:56)
So we get anxious when we can't sleep. So, things like getting up and journaling at night, having gratitude and not turning the lights on, doing that body scan that Laurie talked about can be very helpful. Those types of things can help too. And there's counselors and different things because the anxiety sometimes can be a big deal, but always I start with sleep hygiene because there's so much to it.
Dr. Laurie Marbas
(31:19)
That's fantastic. So, the sleep hygiene is really important. So, I used to think, one, that I was just a light sleeper. I wasn't necessarily tired through the day, but when I switched my diet actually to a plant-based diet eight years ago, I started sleeping much more and less wakening up so much. So that's a really interesting thing you said, it's almost like the bad food, I wasn't eating horribly, but the other food was not, it's almost like a caffeine similar. It wasn't getting the restful sleep that I thought I was actually achieving.
Dr. Laurie Marbas
(31:48)
So, the other thing is, I interviewed Dotsie Bausch, who was in the Game Changers. I interviewed her Friday. And she has a documentary you guys should watch. It's really interesting. And it's called Personal Gold: An Underdog Story. And I was watching in preparation for her interview.
Dr. Laurie Marbas
(32:07)
And I tell you, these guys, went in 2012 Olympics and they won the silver and they were true underdogs. I can't even describe in a short period of time how amazing this is. But what they did was they actually had one coach, their husbands were volunteers, and they were bike mechanics. They didn't have a support system. They went to Spain to travel and to actually train together because the Olympics were in London. And it was interesting.
Dr. Laurie Marbas
(32:35)
So they reached out to their network and really were asking for volunteers. And so they found people who were specialists in sleep and looking at biohacking in the sense of looking at all their outputs. And so they were learning all sorts of things. And a couple of things with sleep that came out that was really interesting, it was a cooler temperature.
Dr. Laurie Marbas
(32:52)
When they got into a cooler temperature, some of them even had circulating water and the mattresses and the air conditioning. It was really interesting. Just a couple of degrees lower, people were getting deeper sleep, which allowed them to be more rested, more restorative sleep, which allows them to have greater output when they were training the next day.
Dr. Laurie Marbas
(33:12)
And when they did that, I mean, it was really, you should see this huge output change and they were cutting time. So when you're on tracks, the track's cycling, they're banking at 44 degrees. I mean, I'd be probably scared just to walk on that track much less ride a bike at 40 miles per hour. But they were doing that. And so, they were cutting seconds and more seconds, which was really, really interesting.
Dr. Laurie Marbas
(33:36)
Some other things there that was, so you're not only going to see more energy, but it really does show as an output, but they were watching people and how quickly they got into that deeper sleep. It was just really fascinating. I would encourage you guys to watch it. It's was truly…
Dr. Chris Miller
(33:51)
There's another study, Laurie. It's not about a super athlete like her and she is amazing. So, I can't wait to watch her documentary. It was about people who had insomnia. And again, I'm not insomnia, but I'm not a good sleeper. And so, they took all of these people who said that they had insomnia and were not good sleepers. They couldn't get their sleep under control. And they took them camping for a weekend or maybe like five days. But they took them camping. And so they had no cell phones. They had no lights except for a fire that they made and they lived the camping life. Right?
Dr. Chris Miller
(34:23)
So they were making their own food and socializing and going to bed when it was dark. Maybe reading a little to a flashlight or something, singing some music together, whatever. The camping things. Active during the day. And it showed that all of them a hundred percent, by the end of this time that they were there were sleeping well and now their problems had gone away.
Dr. Chris Miller
(34:43)
And so, I think about myself when I can't sleep. I'm like, it's because I'm not… And I left the camp, so I think if I were camping, I wouldn't be on my cell phone. I wouldn't be working online and stressed out and thinking, “What time is my alarm set for?” And all these things. That shows us how dramatic, how we live, affects how we sleep and then how we feel overall. So, I think about that all the time. And so, we need to be like campers.
Dr. Laurie Marbas
(35:09)
Absolutely. I think that's a beautiful sentiment to getting out in nature, right? So, we need to be active outside, because I know when I exercise, I obviously sleep better that night because my body's like, “It's time to go to sleep,” so I can rest and do this again in the morning. So, I think, just even an evening walk with your family, plus the sun's coming down, your pineal gland in the brain's going, “Oh, sun's going down. I need to get in preparation for sleep.” And so, that's just some other things to consider.
Dr. Chris Miller
(35:40)
See, that's a really good one, Laurie. People who don't exercise don't sleep as well. So, your body's designed to exercise and use up the energy that it has in your muscles. And then it sleeps to recover as part of recovery, so that is another good one for people to get outdoors and to get moving every day.
Dr. Laurie Marbas
(35:57)
Cool. And Kip said, “Dr. Miller, the camping reference was mentioned in their circadian code by Dr. Satchin Panda, which I found to be excellent.”
Dr. Chris Miller
(36:07)
I read that book too, Kip and I love it. There's so many really interesting tips in there that how much of a circadian rhythm our bodies are. It's so interesting. So, yeah-
Dr. Laurie Marbas
(36:17)
Cool. I'm going to get that then.
Dr. Chris Miller
(36:19)
Yeah.
Dr. Laurie Marbas
(36:19)
I love this.
Dr. Chris Miller
(36:20)
It's book.
Dr. Laurie Marbas
(36:22)
You should see I have literally a huge stacked up library. Okay. I just want to get to the next few questions. So Angela, she did post a question then she said not to answer, but Angela, I'm going to go ahead and answer it because I think a lot of people have that question. I hope you don't mind. She says, what's your opinion on tofu? I eat about two blocks a week, probably too much as it's not a whole food. But actually it is a whole food. I would consider it a whole food. Maybe it's a tad processed, but honestly that's a fine amount to eat. Three to five servings a day of a soy product would be okay. Unless Chris you have anything else to add to that, but that should-
Dr. Chris Miller
(36:56)
Agree. It's a really good food. There's so many benefits that we know now. The only people I say not to is people with messed up guts. So my autoimmune patients, myself included back in the day. But it can be a food sensitivity. So, if it bothers you and it causes problems directly after you eat it, then you want to hold off for a little while until your gut gets healthier. But no, it's a wonderful food otherwise.
Dr. Laurie Marbas
(37:18)
Absolutely. And as I'll be 50 this year, if you are hedging those perimenopausal symptoms as women go through these changes because of those phytoestrogens, which decrease risk for breast cancer and things like that, it can also help with those menopausal symptoms. So guys, I eat tofu every day or tofu and soy products. So, I'm just saying, you got-
Dr. Chris Miller
(37:37)
I love tofu.
Dr. Laurie Marbas
(37:39)
Actually, I just made some marinade to put us on some tofu today and stir fried vegetables.
Dr. Chris Miller
(37:45)
Anthony, I feel like you need a new tofu recipe for us.
Dr. Laurie Marbas
(37:52)
Oh, okay. And then Angela also says, “I'm looking for a specific nutrition plan. I'm already plant-based and wants to take it further. Mitochondria hormones, anti-aging, reduce inflammation, optimal health. I have done hours upon hours of research, but I cannot find these answers. So, Chris, do you want to speak to maybe what you would consider an optimal plant-based diet? And I can chime in on some other things too.
Dr. Chris Miller
(38:17)
Yeah. Angela those are great questions. You and I sound like we'd be good friends because I myself read that stuff all the time to you. I feel like I can't get enough of it as well. And that's great. You're totally right. So the mitochondria, the powerhouse is inside of our cells, and there's data now that we can increase how well they function as well as the number of them in the cells.
Dr. Chris Miller
(38:36)
And so, that's something we're thinking of. And now this chronic fatigue or the fatigue that we feel a lot of people feel that certainly autoimmune people feel as well. It's not due to their adrenals fatiguing, but it's due to the mitochondria not functioning optimally. And so, eating and living to optimize your mitochondria is actually really important and a big thing that suppresses mitochondrial health.
Dr. Chris Miller
(38:59)
So your mitochondria are putting out energy, that's their job. But if you're in a stressful mode, and stress can be lots of things, it can be poor nutrition, your body's under stress from not having the nutrients. It can mean your thoughts. You are worried about everything going on, how you're perceiving what's going on right now. That's stress. It can mean being in an improper environment, being too cold to hot all the time. It can mean not getting proper sleep. That's going to be stress on your body.
Dr. Chris Miller
(39:21)
So, whatever stressful environment that you have, your mitochondria are no longer going to be put our energy the way they're supposed to. They're going to guard themselves. They're going to shelter down just like we're all doing right now, right? We're all in defense mode as well. We're under stressed or we're in defense mode. So our mitochondria do the same thing and they don't put out the energy.
Dr. Chris Miller
(39:37)
So our goal, if we want to work on mitochondrial health is to help them put up more energy. And so that is done through diet. So the anti-inflammatory diet, which I do have some tips on that that we'll talk about, but it's not all that different from whole foods diet, but it's just a little bit. But it's also really dealing with how we perceive stress, or stress management, getting exercise, getting the sleep. The lifestyle things, they're so crucial because they're so crucial, they play a role everywhere.
Dr. Chris Miller
(40:03)
Getting sunlight, actually the sunlight and the red light penetrates into the mitochondria and re-stimulate them, making sure we're not nutrient-deficient in anything. The B vitamins, the minerals, these are essential and the mitochondria need them, but we get that from our diet. So, again, the good whole food plant-based diet.
Dr. Chris Miller
(40:24)
But something else that makes them quiet down and not work well is inflammation. So, those of us walking around with chronic inflammation are not going to have the energy or mitochondria are not going to be as healthy. And so it's combined, your questions on anti-aging and inflammation and mitochondria, they're all very related. So, as we deal with an antiinflammatory healing diet, as we heal our guts and get the microbiome in balance and heal the gut lining, as we're dealing with our stress and we're going to get quality sleep, all of this is reducing inflammation, which is helping our mitochondria so it's part of that health as well. Which is also anti-aging because we're now functioning optimally.
Dr. Chris Miller
(41:01)
So, they all play in together. So, when I work with someone and help them with a plan, I start with a general anti-inflammatory healing plan, which is whole food plant-based diet. But I do look at it because I, myself had so many food sensitivities and triggers and a lot of stress and I couldn't eat whole food plant-based.
Dr. Chris Miller
(41:23)
So, so many of them made my inflammation worse, at least initially. And so, individualizing it to removing potential triggers at the beginning, foods that can be more inflammatory, really hitting the anti-inflammatory foods a little bit harder at the beginning. And watching how a person progresses. And while we're working on the whole lifestyle factors at the same time. So, each person might look a little bit different at the beginning depending on where we're coming from.
Dr. Laurie Marbas
(41:50)
No, I think those are all really good. You're exactly right. So, I would say what do you mean by take it a little bit further? Of course even a whole food plant-based diet is going to increase the length of your telomeres. So telomeres are, think about your shoes. So, if you have some shoestrings and there's these little plastic caps at the end of them, they are there to protect your shoe strings, right?
Dr. Laurie Marbas
(42:14)
So when they pop off or they're topped off after wear, your shoestrings will fray. And so, what happens if we eat a whole food plant-based diet? We're finding is that the telomeres actually are on the caps, the end of our DNA, which is our genes. And they actually can get longer and they last longer, and that is your aging. So when those pop off or they're worn down on your DNA, the DNA can actually begin to die and the cell dies.
Dr. Laurie Marbas
(42:39)
So that's actually increasing or fast-forwarding our aging. So, if we can slow down that process, that's the beauty of a whole food plant-based diet. And so, that's as far as the anti-aging. I would say if there are specific things that are bothersome to you individually that would be a great opportunity to work with Dr. Miller and myself and let us help you really tweak and get you on track. For example, I've worked with one patient of mine who was a professional triathlete, and she was really struggling with certain things. She wasn't plant-based, we got her plant-based, but then we had to tweak a little bit for her because of her training. And so each person can be a little different, their demands on their life, their time, there's previous sickness or things like that. Genetics also, there might be a little bit of things going on their. Food sensitivities. So, definitely would be something to reach out for us if you want to ask us.
Dr. Laurie Marbas
(43:36)
Let's see here. There was another question from Andrea. Another helpful thought is that life is all about change, just accepting that nothing is permanent and always susceptible to change as a way to transform our perception of change and to see it as a natural course of life. Exactly.
Dr. Chris Miller
(43:51)
That good, yeah.
Dr. Laurie Marbas
(43:52)
It may help us to let go of being attached to what was before and instead allow what is now to be, and to be okay. So, that's a big one. So, people who-
Dr. Chris Miller
(44:04)
It's good, I like that.
Dr. Laurie Marbas
(44:05)
Yes. I consider that, people who review and regret past decisions, my grandmother was the worst about that. I always said, I don't want to live regretting life. She would regret things she did as a teenager. I was like, “This is not a way to be living into your seventies. These are things we have to let go. They're done. And you ask yourself, what's the story that I'm telling myself, what's the benefit of me doing this?
Dr. Laurie Marbas
(44:31)
And just having this very gentle conversation with yourself and just asking some simple questions really helps you process through that. And of course, sometimes we need additional help, like as form of a therapist or a good friend who will hold true to what you're saying and be kind in their responses, but also give their honest feedback in a gentle way. So, that's where the community's really important and they can… because your memories also of an event may not actually be how it actually went down. And so that's really helpful too to always have the community and friends and speaking about what's happened. Just some additional thoughts there because-
Dr. Chris Miller
(45:09)
Andrea, I love that. And just to add onto what Laurie just said, that's a big thing with people with cancer and autoimmune diseases because it's a major stressor. It does keep your stress hormones elevated, it keeps your mind body thought disrupted. It's not as healthy as it should be. And just like what you're saying, ruminating like that and holding on and not living in the moment.
Dr. Chris Miller
(45:31)
And something I've been working on too, because forgiveness is about forgiving yourself as well and for some of the things that you did that maybe weren't the best choices you ever made. That's a really good point that you made. So, thank you for bringing that, but it's really important. I've worked with my patients at whole programs to help them with that, with others, with themselves. Whether we write letters and we explore much deeper and really, truly forgive to get that healing. So, that's a good one.
Dr. Laurie Marbas
(45:58)
Yeah. And forgiveness is a big one for me. I think because I came from a very difficult upbringing. And so, just because someone was brutal to you or you maybe had stress and trauma as a child, you may forgive, but it doesn't mean you have to integrate those people back in your life or that it doesn't mean that you're like, “Oh, things are hunky-dory and I just have to take it.”
Dr. Laurie Marbas
(46:24)
What it means is that you forgive the circumstances, that person, and you forgive them in the sense that I'm not going to allow this to harm me any longer. And when you do that, it took me into my forties to do that. It is such a release of stress that you're just like this, like you talk about being close all the time. It's like, “Huh. I've been released from my own mind to move on. And those people are not going to hold me captive anymore. I allow them to hold me captive.” So, those are just some things, and we could go into-
Dr. Chris Miller
(46:59)
I know. We should have a whole talk about that. That's some good stuff.
Dr. Laurie Marbas
(47:03)
Just the mind health and trust me, I've been through plenty of that. But it's just some thoughts there. So Jessica says, “What are the more inflammatory foods to avoid at first in healing the gut?”
Dr. Chris Miller
(47:15)
Good question, Jessica. Thank you. So, the inflammatory foods, one, this is one of the many reasons we go whole food plant-based, that we recommend that. So pro-inflammatory foods are foods like dairy products. Dairy is probably like number one for triggering the gut. It actually causes a local inflammation pretty much right after you have it. Even people who don't have gut issues and don't even notice it.
Dr. Chris Miller
(47:39)
It was interesting. They did a study in Italy and they found 85% of people had lactose intolerance of some sort or were getting information from the dairy, but they're all drinking their espressos with milk. So they were just living with it. People weren't even complaining of it. So, it's so pro-inflammatory. So all dairy and dairy products. And some people will have, “Oh, I just have a little bit of cream in my coffee,” but it really has to be all dairy. Even a little bit can still affect it. So that's one. Gluten tends to be very pro-inflammatory for people who have disrupted guts.
Dr. Chris Miller
(48:11)
So a healthy person, gluten is good. It's just a protein, it has benefits. And we know from studies that people who eat whole grains, all whole grains, including gluten containing ones, actually have less cardiovascular disease, less cancer, less diabetes, and age well. So, it's not gluten inherently that's that's bad. But once the gut is disrupted, as all of us with these weird conditions, autoimmune issues, and so many other things, once it's disrupted, then the gluten causes the tight junctions to separate a little bit. It releases some proteins and causes the leaky gut to get worse.
Dr. Chris Miller
(48:45)
So, I temporarily take it on in people. In many I do check if they have exo-celiac disease, and others we just remove it temporarily. And as people heal their guts and their inflammation quiets down and their situation, whatever, whether it's autoimmune or gut issues or something else headaches or acne or cardiovascular disease. But when that quiets down, they can try to reintroduce a little bit of gluten and see how they do. So, that's another one.
Dr. Chris Miller
(49:10)
Meat is very pro-inflammatory, all animal products, including eggs, including fish. And it's because, one of the reasons, there are several, but one of the reasons is there are arachidonic acid in it. Arachidonic acid is an Omega-6 fatty acid, which is pro-inflammatory. We're really ramping up the Omega three fatty acids, really emphasizing it. And so we really want to lower those Omega six fatty acids. So, those are taken out at the beginning.
Dr. Chris Miller
(49:33)
Processed foods. And this was a problem for me because I still like the little bit of healthy Cracker, or I would try to sneak in something and I always felt worse afterwards. So, it was like, my body was like, “No.” But the processing foods, there's a lot of reasons. Even if you buy the really healthy ones that don't have added chemicals and additives to it, but it's just in the over-cooking of it, the over-baking of it, that it no longer has nutrition in it. And it actually causes oxidative stress to break it down, digest it.
Dr. Chris Miller
(50:02)
So processed foods, but also processed foods are going to have the chemicals, and the additives, and the food colors, and all of that. And even things like aluminum, if you buy gluten-free plant-based vegan muffin, it might have aluminum in it, it might have other stabilizers in it, which are going to affect your microbiome directly and can worsen some of the inflammation. So, processed foods really got to go.
Dr. Chris Miller
(50:28)
So, luckily there's a ton of whole food plant-based foods that we can make easily, pre-make and have ready to go so we have plenty to eat without processed foods. Oils are another big one. Also very, very pro-inflammatory to the gut. So that's got to go at the beginning as well if we want to get healing. And what I find is people will take out one or two or three foods and say, “It didn't make a difference. I took out dairy or gluten and it didn't make a difference.” But if you're still eating oils and eating a lot of animal protein, you're still going to have the inflammation so you won't know.
Dr. Chris Miller
(50:54)
So you really want to take up those pro-inflammatory foods at the beginning, which is good because it fills you with the space to add all these colorful, wonderful fruits and veggies and whole grains and all this other good stuff that we're eating in a whole food plant-based diet and allow your gut to quiet down. And that might not be enough for people, but that's a starting place at least. And then we get into individual stuff and some more specific based on what's going on.
Dr. Laurie Marbas
(51:16)
Absolutely. And if you struggle, people sometimes they can get a tad overwhelmed when you say whole food plant-based diet. And they're like, “I can't do this.” Well, I personally did it overnight, but that's my personality. If you haven't figured that out yet, it's like, just get it done. Once and I'm done. So, for others though, you have to ease into it, right? So Chris, maybe some ideas would be doing breakfast first. And then what foods would you encourage people to eat for a breakfast and then maybe a breakfast, lunch, dinner. Any particular foods that you find if they're going to just ease into it, maybe they should focus on?
Dr. Chris Miller
(51:48)
It totally depends, if you ask me that, because I work with a lot of people with pretty severe autoimmune issues and pretty messed up guts, myself included. Whereas, even a whole food plant-based diet bothered me. But a relatively healthy person who's just easing into it, who just wants to improve gut health overall and overall health. And again, to back up a step more even, I think of it as three meals a day. It doesn't have to be breakfast. Okay, breakfast foods, lunch foods, dinner foods. It's three meals. You get three opportunities to eat.
Dr. Chris Miller
(52:18)
And so, your first meal can be a soup that you made, a plant-based whole food soup that you made over the weekend and you had some frozen and you heat it up for breakfast. I personally love to have a soup for breakfast in the morning now. It can be a salad. It can be leftover dinner from the night before, whatever whole food plant-based thing you had. It can be oatmeal. We love oatmeal with berries. It can be a fruit plate with some seeds on top of it, a nice treat in summertime when we can get fresh fruits. For sure.
Dr. Chris Miller
(52:42)
Yeah, so there's a lot of different things you can do for breakfast. HHI, your guys' website has a lot of recipes. Many of them I got from Anthony myself, personally. But you can get a lot of different things like that for breakfast. And it should be a good solid meal, I think. And then lunch is a good solid meal. And again, we're all different. Some people don't want to do so much for breakfast, so you can do it your own way. Lunch is your second meal, so another chance to get something in.
Dr. Chris Miller
(53:07)
So, you can start by just adding color in, start crowding out the other foods. Like if you maybe decide, “Okay, I'm just going to do dairy right now.” So you just take dairy out. And so now you're going to make recipes, you're going to try to substitute what could you do instead of where you added the dairy? So, you can start with one step at a time adding and trying new meals.
Dr. Chris Miller
(53:24)
Same thing with dinner, you try new meals, you learn to batch cook. You cook big amounts all at once so that you don't have to be cooking all the time. And you have it frozen, you have it ready to go, and you just start playing with these meals and you start crowding out one thing at a time. That seems to work for people, so I'll follow up with them in a couple of weeks. “Okay. I took dairy out.” “Awesome.”
Dr. Chris Miller
(53:41)
And they're like, “Chris, I ate brownies still, but I didn't put dairy in,” and I'm like, “Awesome. You did it then. That's great. What did you add in that was good?” “Oh, I added in more berries and the colors of the rainbow in every meal.” “Awesome. That's progress. We'll take it.”
Dr. Chris Miller
(53:53)
I don't care if they still had oil or meat for dinner. At this point that's not where we are. We're celebrating that victory. And then, “Okay, what are we going to tackle next? Okay, what are we going to tackle next?” And keep adding in the good stuff and crowding out the bad. And if you set a goal for yourself, as long as you get to that goal, it's okay how you get there.
Dr. Chris Miller
(54:10)
You do it like Laurie did overnight. I did it overnight too, but I was really sick. I felt like this was my only chance I had, but people do it all different ways. And I see success all different ways. The goal is to be sustainable. You don't want to go on a crash diet or crash plant-based diet where you do it for a month and then boom, you feel deprived and you go back to your old foods. You want to build new habits and make this sustainable, make this your life and make it who you are now. And, “This is just how I am. This is just what I eat.” So it's not even hard anymore. So, you can build a plan any way that you want.
Dr. Laurie Marbas
(54:42)
That's perfect. I think you definitely covered it, it's fabulous. Another question. What is your opinion on taking melatonin if you can't seem to slow down before bed?
Dr. Chris Miller
(54:54)
So, melatonin, it's not designed as a sleeping pill. It's a hormone, first of all, so you always want to be careful when you're messing with your hormones. But it's designed to help you let go of being awake, if that makes sense. And so, it's been proven to be beneficial with people with jet lag when you're changing time zones. That's where melatonin can be really helpful.
Dr. Chris Miller
(55:15)
And I find it is helpful for people who have a hard time letting go of being awake. But if you say that you can't let go of being awake, then I started saying, “Well, why not? What can we do to let go of being awake?” Because what we found from studies real melatonin that our body secrete lowers risk of breast cancer, lowers risk of other cancers. It's very incredibly beneficial, the real melatonin. And it's called the master hormone, because it keeps other hormones in check, other hormones that during the day are running rampant or instant levels or stress hormones. So many different hormones are going to ramp it during the day.
Dr. Chris Miller
(55:50)
And when the melatonin kicks in, it's like, “All right, guys, dudes, calm it down.” And so, we need real melatonin to do that. Fake melatonin, that supplement, doesn't necessarily have those same benefits. So, in that sense, it's not a good supplement at all. I mean, it's not a good substitute. You want the real deal. So, you really do want to work on things like sleep hygiene like we talked about. Quieting your mind down.
Dr. Chris Miller
(56:12)
If you're dealing with your kids, and you're putting them to bed, and you got work to do, at some point when the kids are in bed, you turn off the computer, your health is more important. You're not going to be able to do your work if you're not healthy. So, you really do want to work on quieting down overall.
Dr. Chris Miller
(56:25)
But that being said, I do use melatonin for some patients and watch how they do. I always start with a really low dose. Studies show that just 0.2 to 0.5 milligrams up to maybe two milligrams is what's beneficial. So, if you're not getting a result with more than that, that you really don't want to keep pushing it. People are getting 5 and 10 milligrams. And again, this is a hormone, so each hormone are intricately related to other hormones. So you want to be careful just taking high amounts.
Dr. Chris Miller
(56:49)
An added benefit of melatonin, which is really cool and it goes along with the circadian rhythm is it helps heal our guts. So, people with leaky gut and even people with heartburn, it coats and soothes and helps heal the gut. And I find that interesting. Again, melatonin is the master hormone. At nighttime is when it kicks in and it's helping your guts heal.
Dr. Chris Miller
(57:08)
And I said, one of the things that happens at night is we heal our gut. So the hormones been shown to be actually a little bit helpful for that too. So, if people aren't sleeping well, one, I would really work on sleep hygiene. You don't want to be on the melatonin all the time. It's not beneficial. You never want to be on something like that all the time.
Dr. Chris Miller
(57:25)
But you can try it temporarily here and there. If you're having a hard time with the stress, everything going on right now, really ramp up your sleep hygiene, your self-care. And if you want to play with a small amount of melatonin. And then if you're traveling or you have certain times it might be beneficial so then to use it a little bit.
Dr. Laurie Marbas
(57:42)
I couldn't agree more. I haven't found that melatonin is all that helpful for patients. So, you're just, again, taking something. And remember every supplement you have to consider that it's also almost a medication, right? Because you're taking your chain and you're putting an extra link in it. You're causing a chain to change. You're causing the system to tweak it a little bit.
Dr. Laurie Marbas
(58:01)
So sometimes that's important, which will be a nice segue to the next question. But other times it can cause a problem. So, just some thoughts there. So, Ella Honduras says, “How often should one get their vitamin levels checked? Should all plant-based people supplement certain vitamins or minerals?” So, I know Chris and I are very much on the same page on this. And absolutely, you should be taking at the minimal B12. You should probably be checked at least once a year.
Dr. Laurie Marbas
(58:32)
If you find that you're too high, you can back off the amount just a little bit, but anywhere from usually 350, depending on the age, 350 to 500 micrograms daily is going to be enough of B12. And most Americans, at least for those ones who live north of a certain latitude are going to be vitamin D deficient. And again, before I would supplement, I would say, certainly be checked. Especially if you're dealing with depression that also has an immune response. But supplement only vitamin D can be very helpful with that.
Dr. Laurie Marbas
(59:02)
So, those would be the two minimal ones I would say for sure. Chris, do you have any other thoughts on vitamin and minerals for certain. And I can go through the others that we might want to actually-
Dr. Chris Miller
(59:13)
Yeah, no, I agree with what you're saying. So those are the first two, and then there are others that, because we're all different that some people don't metabolize them as well, or take them up. And I'll let you explain what those are. And it would also be as far as when you check them. That depends on the person. If someone is healthy and has energy and is feeling great, I'm not necessarily going to check their nutrients all the time, every year, even. I will keep an eye on the D3 and I will keep an eye on the B12, but if I check it and they're feeling amazing and they're eating well, and I know they're doing well, they don't need to repeat it.
Dr. Chris Miller
(59:45)
But that being said, if people are having problems, so if they're fatigued or they're not thriving, they're saying their hair is brittle or breaking, or their skin's breaking, I might check omega-3 fatty acids. I might check a little deeper into, are they absorbing it? What are they eating? I look exactly at what they're eating, a food symptom plate diary. And then we might delve into checking them a little bit more.
Dr. Chris Miller
(01:00:05)
Or auto-immune people. We have to figure when we're starting out as an autoimmune or an IBS, if you're having gut issues or heartburn, you're not absorbing, you're not digesting and absorbing and assimilating the nutrients the way you're supposed to. So, at that point, you want to really enhance the nutrition you take in, and perhaps a little extra nutrients supplements at the beginning. And then we want to get your body corrected and into balance. And then you shouldn't need them as much, but we watch a lot is how you're feeling.
Dr. Laurie Marbas
(01:00:35)
Yeah. So I would say the things that I always talk to my patients about is, one, when you eat a whole food plant-based diet, a well varied, a variety of colors, a variety of the different types of groups, whole grains, your beans, your legumes, your vegetables, your fruits, and some nuts and seeds, for the majority, that's 99.9% of everything you need. Okay? So then we top it off with B12 and maybe some vitamin D.
Dr. Laurie Marbas
(01:00:57)
Again, like Chris said, some individually issues, some other issues might be iodine. We just need a tiny amount. If you don't like eating kelp and different things, or if you don't use iodized salt, you might actually become deficient. So that might be a very small thing to consider. Again, you don't want to overdo it because that can cause some problems with your thyroid health as well.
Dr. Laurie Marbas
(01:01:17)
Your DHA. These are talking about your Omega threes, your EPA. I have found a certain number of people that went on a whole food plant-based diet, I would say probably over the eight years I've been doing this, maybe 8 to 12, if I think back of all the different patients, will end up with joint discomfort. They're eating all appropriate, non-processed foods. I added ground flaxseed. They may have already been doing, but I also added the Omega threes and it went away.
Dr. Laurie Marbas
(01:01:45)
So, there are some things there to consider. Those are individualized. There's a very small amount of people that transition to food plant-based diet. Zinc is another one. That's why I eat pumpkin seeds every day. It's a great source of zinc. So look at those types of things. The things I mentioned here are, again, like I said, these might be the things that might be a little bit lower in a whole food plant-based diet is some people, especially if they don't like certain foods, selenium is another one. You can eat a couple of Brazil nuts a week and you're good there. Magnesium.
Dr. Chris Miller
(01:02:15)
Not a day. Not a day.
Dr. Laurie Marbas
(01:02:16)
Yeah, not a day, just a couple of weeks, because there's a lot of selenium in these Brazil nuts. K2. So, K2 is different from vitamin K. It's K2. It's very important for bone health. Oftentimes you can get a D3 K2 supplement. So if you have osteoporosis or something like that, it might be an additional thing to consider supplementing as well. So, Iodine, B3, selenium, zinc, magnesium. I think that's pretty much all the ones that I really focus on.
Dr. Laurie Marbas
(01:02:44)
I do like adding people to consider it, these are going to go to spices, however, would be turmeric and ginger, especially if you have migraines, that's very helpful. And then if you have a lot of inflammation, like you've got someone with arthritis or any type of rheumatoid arthritis, especially, those tend to work very well.
Dr. Laurie Marbas
(01:03:01)
And they're also very good for the gut, but I've had migraine patients who take the ginger. And I like mixing with the turmeric as well. It really helps calm down their migraines. So, just-
Dr. Chris Miller
(01:03:14)
With the whole food plant-based diet.
Dr. Laurie Marbas
(01:03:15)
With the whole food plant-based diet. Well, I will say a friend of mine who am transitioning over, she has headaches, but she also has really severe joint discomfort. And she said she would wake up all night because of this joint pain. And so, I talked to her about using, there's one particular one I like. You can get on Amazon. It's called turmeric complex. There's ginger, turmeric and black pepper in it. It's like 15 bucks. And I told her to take one twice a day, it'll help with some of the inflammation. And yes, black pepper can definitely, it 2000 fold increase your absorption of the turmeric.
Dr. Laurie Marbas
(01:03:52)
But with that, she said now her hands just quit hurting and she's able to sleep through the night. So now we're talking how pain also disrupts sleep, right? So now she's actually moving. She's sending me text pictures of all her food she's eating. She's like, “Okay, if that worked I'm really curious now what will happen.”
Dr. Laurie Marbas
(01:04:09)
And so that's really exciting to see someone, just one little tweak, have this amazing thing decrease pain, improve sleep, more energy. Now do you see where the cycle begins? And that's the beauty of switching to whole foods plant-based diet is you start the snowball, and it grows, and it grows, and it grows and it grows. And before you know it, your whole world has changed.
Dr. Laurie Marbas
(01:04:27)
And so, that's why we are so passionate about sharing this message. And Anthony and I and Chris and we're starting this Plant Based TeleHealth because we really want to bring that message to everybody. So, Kip, thank you for the reminder that adding black pepper does multiply the effect of the turmeric.
Dr. Chris Miller
(01:04:43)
Although, Kip, related to that, I do use turmeric just… I'm a whole food person. I always tell people like as much as I can get from food. So, I use turmeric root and I peel it. And there's a good study that shows people with kidney disease, actually lupus nephritis, but a quarter inch piece of turmeric before their meals actually decrease the amount of kidney inflammation that they had.
Dr. Chris Miller
(01:05:07)
So I read that study. So I started to follow that like, “Okay. Yeah, that's real science.” So, I did that quarter inch before meals and I definitely noticed a significant difference. And so, I tell my patients that, one, it's cheaper. We're not always buying supplements. And it also is important because the whole food has more benefits than just the turmeric supplement, the curcumin. And when we eat food especially if we have a damaged gut, it causes inflammation.
Dr. Chris Miller
(01:05:33)
There's always a little bit of inflammation with eating. So that's why fasting works so well, when we're not eating we feel better. So that little bit of turmeric right before a meal is actually helpful. And you don't need the black pepper if you're eating the turmeric with fat in your meal, if you have even just a touch of nuts and seeds or avocado, you don't need the black pepper with it. And if you don't have the black pepper or the turmeric, it helps locally with the inflammation in your gut. So there's other benefits to it. So you can play with that too.
Dr. Laurie Marbas
(01:06:01)
Yeah. For those who don't, that particular supplement is actually just a turmeric root ground up. For those who don't like the flavor of those kind of spicy foods. But yeah, you're exactly right. There are so many benefits to even the whole ginger. I love using ginger and you can actually, guys, keep it in the freezer and top out because you know you'll only use a little bit at a time because it's pretty strong. But the ginger is, it was an eighth of a teaspoon that was helping the migraine patients in the studies I was reading. So, amazing.
Dr. Chris Miller
(01:06:27)
Yeah, it's pretty cool. It's pretty amazing. The power of food. Gosh, that's crazy.
Dr. Laurie Marbas
(01:06:32)
Well, we want to thank everyone. We have no more open questions. And so, we're going to go ahead. It's been close to just a little over an hour and I want to say thank you to everyone for attending. And we hope to see you next week. And if you have any particular suggestions, we haven't decided on our topic yet, we'll be happy to take those or maybe we'll just do a free-for-all of recipes or whatever. But we're super helpful, Chris, for everything that you've been sharing with us and we want to thank you for that.
Dr. Chris Miller
(01:06:59)
Yeah, thank you. It's a pleasure. It's fun to have you guys here and participate with us. So, thank you for coming along and sharing with us too.
Dr. Laurie Marbas
(01:07:09)
This has been recorded. So these will actually be going up on our YouTube page and also the website. But you can check out, please subscribe to the Plant Based TeleHealth. We're just starting YouTube page and we're just doing and learning the editing process and what we want to do to make this really beneficial for people.
Dr. Laurie Marbas
(01:07:25)
So, please check us out. And like I said, if you need a whole food plant-based diet, Chris and I are covering at least 30 states. We have additional doctors joining us in the next few weeks and we can't wait to share who those are because it's very exciting. And I think you guys are going to really continue to enjoy these webinars because I sure know I am, so.
Dr. Chris Miller
(01:07:43)
Yeah, me too. Thank you.
Dr. Laurie Marbas
(01:07:45)
All right. And you guys have a great day.
Dr. Chris Miller
(01:07:49)
Thanks. Bye everybody.
Dr. Laurie Marbas
(01:07:50)
Bye-bye.
*Recorded on 4.12.20