On this Q&A plant-based doctors answer questions and discuss the most effective ways to optimize your immunity.
Questions Answered
- (02:33) – Immune system and immunity
- (09:05) – The gut microbiome
- (13:54) – So what is an antioxidant?
- (15:03) – Important vitamins and micronutrients
- (18:03) – Lifestyle factors that help with our immunity
- (21:29) – Any advice on how to incorporate greens when you have gut issues?
- (26:42) – Do you recommend DHA EPA supplements?
- (30:01) – Any advice digesting rice as I get constipated after I eat rice?
- (33:59) – I've been diagnosed with hypothyroidism and have been found conflicting information about what would improve this condition naturally. What would this panel recommend?
- (38:23) – What specific blood tests do you recommend annually for maybe someone on a whole food, plant-based diet?
- (43:04) – Have you ever seen anyone with zero ferritin level?
- (43:42) – Do you treat low ferritin?
- (46:38) – On fasting and thyroid disease. Have you seen any improvements after they maybe spent some time at True North?
- (49:01) – Can people water fast if they're taking levothyroxine or thyroid?
- (49:37) – Any tips dealing with traveler's constipation?
- (53:57) – Do you have any advice on how to time meals when you occasionally work seven overnight shifts in a row?
Complete Transcript
Dr. Chris Miller
(00:04)
We'll talk about…Yeah. Whenever you think it's my turn to go, I'll be ready.
Dr. Laurie Marbas
(00:08)
Okie dokie, here we go-
Dr. Chris Miller
(00:09)
Oh I'm going to move this.
Dr. Laurie Marbas
(00:10)
Okay. Here are our attendees. Hi Penny! And Jenny. Someone's on the phone with us. Excellent. And we'll be waiting also for Dr. Klaper and for Julieanna to join us. Okay. Looks like I need to send them the link real quick. Thanks guys. Where are you all from? Share with us. Hold on I got to see here. Invite…
Dr. Chris Miller
(00:44)
Hi Kims! Happy Thursday to you! Yay! I love Thursdays, it's so fun for everyone to get together.
Dr. Laurie Marbas
(00:54)
Chris, do you see on your end the share? I don't see where my participant… Oh, here we go. I find it. Invite. Geez, Louise, that was weird. All right, so let's get Dr. Klaper on here.
Dr. Chris Miller
(01:06)
Clara! Welcome. Hello, hello. And there's Trudy! Yay! Love it. We have to do one of these in person so we can meet everybody in person.
Dr. Laurie Marbas
(01:19)
Oh! Caribbean! Nice!
Dr. Chris Miller
(01:22)
Oh yeah, there is some Caribbean… Nice.
Dr. Laurie Marbas
(01:26)
All right, I'm going to start sharing this to Facebook as we get everyone else to join. There's Julieanna. Looking for… All right. Share on… Thanks everyone for being patient as I get all the other stuff here squared away. There's Dr. Klaper. All right, so everyone else is joining up here. We're about to go live on Facebook as well.
Dr. Chris Miller
(02:03)
Dr. Klaper, yay!
Dr. Laurie Marbas
(02:03)
And just to let you know that we do also record these events. Just so you're aware. All right, now we're going to go live.
Dr. Chris Miller
(02:17)
There's everybody. Hi, guys!
Dr. Michael Klaper
(02:18)
Hey! Hi everybody!
Dr. Chris Miller
(02:21)
Hey guys! We're just waiting for the Facebook to go live here. And then we can get started. Here we go!
Dr. Chris Miller
(02:33)
All right, so welcome everybody! Today we're going to talk about the immune system and immunity. And I think Dr. Klaper, you want to start first with, especially your particular topic, that you want to share with us?
Dr. Michael Klaper
(02:47)
Sure. When you think about it, no matter how you look at our human body, it's stunningly amazingly complex and wonderful and magical. And there's so many affirmations of that. One of which is that we live in a sea of microbes and they're in the air, in the water and they're on us and in us. We're saturated with these viruses, bacteria, et cetera. And yet, we go through our lives without… Well, occasional episodes, but by and large, free of infection. The fact that you cut yourself and the skin closes up and heals and usually doesn't get infected, that an oral surgeon or dentist can open up a big flap in your mouth, part your gums, work in your mouth as saliva sloshes all over and you close it up and the next day it's pretty much healed and we don't get infection, that you can do septic surgery at all is remarkable.
Dr. Michael Klaper
(03:48)
How do we heal infections all the time? Why aren't we running with all these sores and abscesses? Well, we've got this amazing human body, all its many inherent miracles in our immune system that keeps us free of destruction by these microbes. And the scientists, we roughly divided the immune system into two major categories. Again the body is the body, but there's this we call innate immunity and the acquired immunity.
Dr. Michael Klaper
(04:24)
The innate immunity is something that is active 24 hours 7 days a week, immediately available in our body and it's those defenses that your body has that keeps those germs out or kills them right away when they get in. [inaudible 00:04:42] we talked about.
Dr. Michael Klaper
(04:43)
Well your skin, in general, very effective barrier. And the skin not only by its physical nature, but by the skin oils that are from oil glands on the skin, they have an antibacterial activity to them. Your tears have enzymes in them that destroy bacteria. Your saliva has enzymes. There are antibodies in our secretions, in our nasal mucus, our [inaudible 00:05:13] mucus that recognize bacteria and lock them up and keep them from invading. It's really remarkable. And the very act of coughing is part of your innate immune system to keep those germs out.
Dr. Michael Klaper
(05:32)
And these mechanisms work against all bacteria. Doesn't matter if it's staphylococcus or streptococcus, clostridium. If they invade your skin, you're immediately going to marshal this response. Your white blood cells come in to eat up the germs and inflammatory substances show up. And this happens no matter what the invader is. That's your innate immunity. Whew. Long answer.
Dr. Michael Klaper
(05:59)
Your acquired immunity comes from a couple of specialized immune cells. Your T-cells, your B-cells, they live in your lymph nodes and your spleen, your liver. And those are directed specifically against specific germs and this is how vaccinations and immunities and [inaudible 00:06:17] viral infections work. Where that innate immune system is immediately available, the acquired immunity, that takes 4, 5 days at least, after you've been exposed to the microbe, to come up with antibodies specifically tailored to that particular microbe. And it's an amazing system. And of course, it allows us to function in this constant rain of viruses that we're exposed to. We quickly make antibodies against them to neutralize them. Nature is really looking after us, our body really looks after us.
Dr. Michael Klaper
(06:55)
Why did I go into such detail? Because every one of those amazing, mysterious, stunning, intelligent mechanisms that our body has requires good nutrition. They require enough proteins and vitamins and minerals and they need freedom from interfering substances, alcohol and too much sugar, et cetera. And we're all experienced clinicians. I know Dr. Miller and Dr. Marbas, we've all worked in emergency rooms in big city hospitals and you see the poor Skid Row alcoholics come in and they've just been living on cheap wine and candy bars. And you could see it in their tissues. You see it in their infections. You see it in how poorly their wounds heal. They just don't have that tissue strength, that immunity, that vigor to their immunity. And it's a gross example, but it's an inescapable demonstration of how what we eat, how the health of our bodies is absolutely determinant of how healthy our immune system is. And we want to keep that immune system strong, especially these days.
Dr. Michael Klaper
(08:11)
So it's going to come back to the beauty about that whole food, plant-based diet. It nourishes your immune system and gives your T-cells and B-cells and everything what they need so they can get out doing their jobs. You try and live on energy drinks and granola bars and there's no life in that food. And pretty soon, gee, you notice the sore isn't healing under your armpit your you got this mouth lesion that isn't going away. And people become very worried their immune system isn't up to snuff. So eat those fresh fruits and veggies and all the things you're going to hear this next hour.
Dr. Michael Klaper
(08:49)
But you've got this immune system taking care of you, take care of it too. It's really important and it's always watching what you eat there. So feed it well.
Dr. Laurie Marbas
(09:00)
Excellent. Yeah, I like it. It takes care of you if you take care of it and it's always watching. That is true.
Dr. Laurie Marbas
(09:05)
So Chris, you want to go next? because I think you were speaking about the gut microbiome. That's where we come into really close contact with what we're eating.
Dr. Chris Miller
(09:14)
Yeah you can transition beautifully from Dr. Klaper's presentation. So now that we understand the two components of the immune system and that our skin, our barrier, our mucus are all part of the immune system, the interesting question is, the immune system has such an important job as he pointed out. It's always watching. I call it our guardian angel. And it knows when something's foreign, when it can potentially hurt us, and it wants to get rid of that. It also recognizes when cells are growing out of balance and starting to go rogue and that's potential cancer cells. It recognizes that and gets rid of those. And it also causes inflammation to heal as Dr. Klaper was discussing. But as it overdoes it, it can start attacking itself and reach autoimmunity. So, it's a very fine balance.
Dr. Chris Miller
(10:03)
The question is, how does it get to be so intelligent? How could it possibly know? Isn't it fascinating what the immune system is capable of doing? We have learned so much recently in what the immune system can do and how it learns this and it goes through a very, very strict training process.
Dr. Chris Miller
(10:23)
Think of it like training for the military. It's there to protect us. It's our military. And it has to be trained specifically to know who's foreign and who is self and which tissue is self. And what can get interesting is these viruses, they're foreign, so it recognizes that's foreign.
Dr. Chris Miller
(10:41)
But those viruses are tricky. They can go into the cells and then all the body sees is a normal cell. And so it still has receptors on it that our immune system can recognize and still get rid of it. And if cells that are ourself are going rogue, it can get rid of those. So how is it learning this?
Dr. Chris Miller
(11:00)
This is what comes down to our microbiome, now we know. The microbiome is in our gut, most of it's in the colon but it covers our whole gut from our nose, our mouth, our pharynx, esophagus, stomach, all the way down. But the majority of the good microbacteria that we always think of are in our colon doing all the good stuff. And these bacteria are always in contact with our immune cells. Think of it as the gut microbiome and then there's a mucus layer, and then just one layer thick of the gut lining. And that's it. Right underneath that is 70% of our immune system. And it's there on purpose to protect us because it's our military. And our gut [inaudible 00:11:43] from our mouth to our anus is our largest surface being exposed. And so it's there and it's constantly in communication.
Dr. Chris Miller
(11:51)
Our microbiome, all those 39 trillion bacteria and viruses and parasites and everything that's in there already living on us, and it's in constant communication with our immune system. And so the immune system develops needing this microbiome there, and it needs it to develop tolerance of who's self and who's foreign. And they've done experiments in that. Animals that don't have a microbiome, that are A, no germs at all, they're sterile because it's designed in a lab, that they don't have immune systems. They can't fend for themselves anymore and do any of the important functions.
Dr. Chris Miller
(12:25)
So we need this and we need it to be sensitized. And so we need a healthy microbiome. It's doing its job to protect us. It's helping to build the antibodies, it's helping to build tolerance, it's helping your immune system.
Dr. Chris Miller
(12:36)
And so that's where it comes to from the time that we are prenatal in our moms or even in our grandmas to all the way throughout our lives. And as Dr. Klaper was starting to say, and we're going to be talking about this, it's the food that is one of the most important things to feed that microbiome so that it can do its job. And you want a diverse microbiome and you want it to be robust in the healthy, life-promoting type of bacteria for the most part. And so you're going to get that by eating fiber-rich foods and avoiding toxins to it. So [hide 00:13:09] lots of animal products, artificial flavors, colorings, all of that and taking in lots and lots of good fiber and diversity and all the good stuff that we're going to be talking about that we always talk about because we love to talk about it. It's so vital for that immune system and we're now understanding how it's just the coolest thing ever.
Dr. Chris Miller
(13:28)
So that's my overview of how it is getting sensitized.
Dr. Laurie Marbas
(13:33)
Christine, that's awesome because that really just segue ways in to now let's talk about the micronutrients
Dr. Laurie Marbas
(13:39)
I'm not going to be talking about your fat and proteins. I'm talking more about your vitamins and minerals and things that are really important to include in your everyday diet. I'm going to give you just a little overview of a few of them and what they do in the immune system. But first of all, you'll hear a lot of talk about antioxidants.
Dr. Laurie Marbas
(13:54)
So what is an antioxidant? These are compounds that inhibit the oxidation, and oxidation is a chemical reaction that produces free radicals. So you can think of free radicals as literally, I think of a band, some type of band that's going around and causing all sorts of trouble and basically, they're free and they're radicals. They can do and cause damage to your DNA, they can cause damage to other parts of the cell itself, in the infrastructure of the cell.
Dr. Laurie Marbas
(14:25)
So the antioxidants halt that process of the free radicals causing cellular damage. So that's just to give you an idea of what I'm talking about.
Dr. Laurie Marbas
(14:35)
And then sometimes we also hear, especially recently, hear what's cytokines. So what is a cytokine? These are small proteins that are released by cells and they have a very specific reaction, so when you have two cells that are communicating, they determine how those cells communicate and so that's kind of where the cytokines are. Think of them as cellular messengers.
Dr. Laurie Marbas
(14:57)
So if you hear me talk about that, it'll give you some base of what are antioxidants and what is a cytokine.
Dr. Laurie Marbas
(15:03)
Let's talk about what are those important vitamins and micronutrients. So that'd be vitamin A, that actually helps maintain the mucosal cells in your respiratory tract, like what Dr. Klaper was talking about. You have vitamin C, that's an antioxidant. It's really important for pathogens to be killed by your immune cells. Vitamin D regulates immune cell activity so you know it will control what's being produced and what's not. Vitamin E is a fat-soluble antioxidant. There's A, D, E and K. Those are your fat-soluble vitamins. And what they do is they protect the cell membranes from free radicals. Your own cell within itself, even just from the process of your breathing, your cells actually making energy creates free radicals. So it's really important that we have those even on a daily basis outside of our immune function.
Dr. Laurie Marbas
(15:54)
Then there's B6, that regulates inflammation. It helps antibody production. You have B12, which we know we should supplement as plant-based eaters, we should have a nice, regular regimen for supplementation. I would not rely just on fortified foods alone, but I would definitely make sure that you're taking in the supplement. It has roles of what we call natural killer cell functions and that's just a more of a broad immune reaction.
Dr. Laurie Marbas
(16:23)
You have folate, that's where all those greens come in. They also work with natural killer cells. They also want to make sure that you mount a sufficient antibody response. So those are important. Iron, beyond you hear about anemia, but it's also important for cytokine regulation. So those little messenger cells, and you hear about these cytokine storms. So iron is an important part of that. It also helps your white blood cells kill bacteria.
Dr. Laurie Marbas
(16:50)
There's selenium. So selenium, you probably heard from Brazil nuts. It seems to be one important… And you don't want to take too much of those. You can actually be toxic in selenium. But it's also important part, in science, that regulate antioxidant activity.
Dr. Laurie Marbas
(17:07)
You have zinc. Pumpkin seeds are a great source. I add pumpkin seeds to my diet every morning on my oatmeal. But it's an antioxidant, it regulates cellular grown and immune cell differentiation. So you have your immune cells and then they have to differentiate into the different types. That's part of that. And then copper is a free radical scavenger. And it also has what we call anti-microbial properties, meaning that it can help you kill bacteria, viruses, things like that. The important thing to understand is if you take in zinc supplements, a lot of people are taking in zinc supplements right now, it can actually decrease your copper absorption. So it's really important that you don't take too much of that. The body's daily threshold is about 40 milligrams of the zinc daily. So just to keep that in mind when you're… People are like, “I'm just going to take in some multivitamin, I'm going to take in all these supplements to try and boost my immune system.” Don't do that. Try to get mostly from your food, B12, possibly vitamin D, and that's where you need to be focused on.
Dr. Laurie Marbas
(18:03)
Now Julieanna was going to speak about lifestyle factors that help with our immunity was well.
Julieanna Hever
(18:09)
Wonderful information, all of you. I want to just add to that conversation that one of the most extraordinary things about plants, in general, are they are unique because they're the only things that have phytonutrients. Plant nutrients. I put phytonutrients and fiber in the same category as the most health-promoting nutrients that we really do need to be thoughtful of, most importantly.
Julieanna Hever
(18:32)
And what's interesting, if you think about the plants and this concept called xenohormesis, if you think about it, what doesn't kill you makes you stronger. And plants are out in the world and dealing with weather and pests and prey and it has to stand up for itself and be strong and protect itself. And so it develops all of these phytonutrients that are… You can see they're evident in the color, in the pigmentation, the way they function, all of that. And the beautiful thing is that we get those same benefits when we consume them. So I always suggest eating a wide variety of plant foods, obviously and especially the eat the rainbow every day because you're getting all the different types of phytonutrients. And you can identify them by the color. So that's a whole interesting talk.
Julieanna Hever
(19:15)
If you think about it, if anyone's ever broken a bone, you break down the bone, it's broken and it has to build back stronger and thicker. Just like when you're weight training or exercising and you get these microscopic tears in your muscle fibers and then it builds back thicker and stronger. That's hypertrophy.
Julieanna Hever
(19:29)
What happens with all of that, is that if you eat more plants, simply said, you are getting a wide variety of these nutrients that are very protective against the environment.
Julieanna Hever
(19:40)
Besides food, food is first and foremost, 100%. It's all about the food. However, there are other things that are really important in your daily lifestyle that can contribute to ultimately a strong immune system.
Julieanna Hever
(19:53)
First of that would be exercise. And that's because your lymphatic system parallels your circulatory system, but it doesn't have a pump, it doesn't have a heart. So how do you get that lymph pumping through your system to detoxify and take out toxins and get rid of stuff? With muscle contractions. So you want to move your body, you want to get some circulation going so that all of that bad stuff goes out and all of the beautiful nourishment that you're taking in goes into your cells. There's just a million reasons why exercise is so good.
Julieanna Hever
(20:20)
It also helps contribute to stress reduction because, well, it's exercise. You get all those wonderful feel-good hormones that are released when you do so and so many other things. Stress reduction is really important and that's why these are all so interrelated. You want to have as many ways of managing your stress as possible. I'm speaking to myself as well because we all fall into that trap, but exercise is a wonderful way to reduce stress and getting adequate sleep. Exercise helps with getting enough sleep. It's just this wonderful, beautiful synergistic effects of eating plants, moving more, resting and managing your stress as much as you can.
Dr. Laurie Marbas
(20:59)
Fantastic. We have a few questions. If you guys have any additional questions, please, if you're in our webinar, type them in the Q&A box. And if you are watching this on Facebook, we would appreciate you sharing us talking and we want to spread the word to as many people and help as many people as we can. So we do appreciate that. If you are on a different link and you want to submit a question, please go to the Plant Based Telehealth Facebook page and you'll see the live video there and you can submit there. I'm only monitoring the one on our page, so I do appreciate that guys.
Dr. Laurie Marbas
(21:29)
And so, we do have a few questions here. Kelly asks, “Any advice on how to incorporate greens that we know are so important when we have gut issues. I am having gut issues leftover from antibiotic steroid use from an illness a few years ago. But every single time I eat greens, it empties into the toilet 100% undigested. Anything I can do to help train my gut to tolerate the greens?” Who would like to take that?
Dr. Chris Miller
(21:54)
I can take that. So, yeah that's a concern. It starts with repairing our guts, actually, so if you're not absorbing it, then that's irritating you and you have to re-train your gut and re-build up the appropriate microbiome.
Dr. Chris Miller
(22:09)
So if you're not tolerating the raw and it's causing loose stools then we take out the raw or cut it way back and do a little bit more cooked. By cooking it, it's already pre-digested a little bit. You can also blend it. Some people, if it's still so bad, even with cooked, that's not enough so they blend it. And sometimes we even do juices. Take out the fiber and you still get the nutrients that we're looking for while you're doing the cooked.
Dr. Chris Miller
(22:33)
And then as it improves, and it will, it will always improve, but you have to slowly re-build that tolerance back. And then you start to add back in more and more raw a little bit at a time. Because your goal is to eat a large raw salad every day or have lots of raw and all these colorful fruits and vegetables that Julieanna was talking about for the phytonutrients. So, you just slowly bring it back in, but you do want to eat those greens. Your goal is to work them in, take a little break from them. Give it some time.
Dr. Laurie Marbas
(23:00)
Absolutely. Dr. Klaper?
Dr. Michael Klaper
(23:02)
Yes, I agree with Dr. Miller. It helps, if you're that sensitive, to kind of Trojan horse the greens in where you're eating the easily digestible with well cooked rice. You can just blend in or just have a small amount of greens with each mouthful. A little bit, just have a small portion, but the main carrier food is the quinoa or the rice that you're eating. And then slowly increase the proportion of the greens inside the starchy vehicle there. And often, you just sneak it right through without causing problems.
Dr. Michael Klaper
(23:40)
One thing that Julieanna mentioned that just really resonated with me as far as the phytonutrients and how the plants interact with their environment. It's so true where, we're talking about eat your greens and phytonutrients are good for you, but I'm sitting here in South Florida and on a day [inaudible 00:24:03] sometime. It's two in the afternoon here, almost three, and the sun is fierce. It is painful to stand outside. You can't stand out for more than 4, 5 minutes. [inaudible 00:24:15], you could feel your skin starting to burn. And yet I'm looking at these green plants outside. We have banana plants and green… And they're just standing out in the sun, hour after hour after hour. And this ultraviolet radiation that would just oxidize all the proteins and delicate molecules in my skin, these plants are just so rich in antioxidants, they don't oxidize. And so, man, you want to take that stuff into your body that gives you such protection against oxidation which is, the name of the game, is where aging really starts. So eat your greens. They know something that you want.
Dr. Laurie Marbas
(24:59)
Julieanna? Any advice on how to get more greens into the diets and suggestions?
Julieanna Hever
(25:04)
I always want everyone to get more greens into the diet. I love the suggestion of steaming lightly. Steaming makes it easier to absorb.
Julieanna Hever
(25:10)
Something that wasn't really mentioned exactly, but it sounds so obvious, but so many people forget to do this. Chew really well. Chew, chew, chew, chew, chew. Really get the food in there and taste it and put your fork down. Take small bites and really enjoy it.
Julieanna Hever
(25:26)
I guess this might be one of those cases where I would say, “Okay, have a green smoothie or a blended salad. This has come up every single week. Just because it's already in a pre-digested and easier for you to absorb. But again, sticking with it, staying the course.
Julieanna Hever
(25:39)
I put everything on a bed of greens. I talk about that and saying that for years. Whatever I'm going to eat, I'll put on either a salad or cooked greens. If I'm making pasta, I make sure there's greens in there. There always has to be green, otherwise it doesn't feel like a whole meal or a real meal. But again, it takes getting used to and re-acclimating, and it's this win-win process because it will get easier and you'll be consistent and the microbiome will start to shift. You'll wind up feeling you'll just feel better and better and better. Stay the course and do what it takes. Get them in!
Dr. Laurie Marbas
(26:11)
Excellent.
Dr. Chris Miller
(26:11)
If you need help with that, we can help you too.
Dr. Laurie Marbas
(26:14)
Yes, absolutely.
Dr. Chris Miller
(26:15)
Because sometimes it's a little bit more healing of the gut to get it fully where you can tolerate these foods.
Dr. Laurie Marbas
(26:20)
Yeah and especially if that's been going for a couple of years, you worry about micronutrient absorption and things there, so that certainly might be worth at least one or two visits with us. Again, guys, we're at plantbasedtelehealth.com, you can see myself, Dr. Miller, Dr. Klaper and we're super excited to work with you at any point. And we're in 40 states, so we're pushing on the last 10.
Dr. Laurie Marbas
(26:42)
We do have this question come up fairly often. Do you recommend DHA EPA supplements? I'll just say what I think about that. I think there's certainly a need to supplement with B12. Measure, and then check, if you need vitamin D. We encourage you to do ground flaxseed and walnuts and chia seeds, those type of things that will help you get those shorter fatty chain omega acids, oh my goodness. But the important thing here is that, sometimes you may be or not absorption. Again, measure. So before you start just taking a lot of supplements, speak to someone and… Measure, test, don't guess as Dr. [inaudible 00:27:19] always mentions. Again, we just want you to be careful with supplementation, but does anyone else have any other thoughts or suggestions on the DHA EPA?
Julieanna Hever
(27:30)
I recommend supplementing. I have all my clients supplement. I supplement. Vegans just have lower levels of EPA and DHA in our bodies. We could eat double the ALA from flaxseeds, chia seeds, hemp seeds, walnuts, soy foods, stuff like that, but we're not necessarily converting, as the evidence shows. Now, does that matter? We don't necessarily know for sure because we have a decreased risk for cardiovascular disease and probably Alzheimer's as well, certain things that are linked to those nutrients. I have my clients supplement with a microalgae formula and it just goes with part of the whole group of notable nutrients that need to be considered on a plant-based diet.
Dr. Laurie Marbas
(28:09)
Absolutely.
Julieanna Hever
(28:10)
[inaudible 00:28:10] insurance policy, yeah.
Dr. Laurie Marbas
(28:11)
Yeah and I think there's some really interesting science behind vegans having lower amounts as well for their short-chain versus long-chain. It's just something to keep in mind and speak to someone about as well.
Dr. Chris Miller
(28:23)
Also, actually, I have a point on that. I also supplement with it. And the DHA, it can turn off in some people if they're not able to convert it enough. Some people can't, some people can, and if you don't really know, it can lead to brain delay, I guess, or aging faster, dementia or some the neurodegenerative diseases. So that's the DHA.
Dr. Chris Miller
(28:46)
But interestingly, the EPA is very anti-inflammatory. Studies for inflammation, at higher doses, it can be anti-inflammatory for that purpose. But it does suppress your immune system. So there is a pro and con with that too. So it's ideal if you can take that little extra DHA to protect your brain, and then get your EPA and DHA, the rest of it from your flax or chia seeds. But a little bit extra, I have used it as a supplement sometimes for people with either anxiety or autoimmune issues as they're tapering off prednisone because it's also an immunosuppressant. At a little bit higher doses, it's an immunosuppressant.
Dr. Chris Miller
(29:27)
You want to be careful though. You don't want to be on that for a long time because, again, it's suppressing your immune system and it is changing your microbiome a little bit. So that's something that I use intermittently with people as medicinally while they're maybe tapering off medications to make the transition easier. But I don't recommend being on it, specially not a high dose, for a long time. And it also causes your blood to thin, so if you're getting surgery you'll bleed a little bit more. You want to make sure you stop that before surgery. All in all, it's better to do that little supplementation and try to get it from food as much as possible.
Dr. Laurie Marbas
(30:01)
Any other suggestions on that? All right. We have another one also on “Any advice digesting rice as I get constipated after I eat rice?” All right.
Dr. Laurie Marbas
(30:13)
How about this, we talk about the constipation. Because some people move to this whole food, plant-based diet and they actually have the opposite effect and I've actually used some of Dr. Klaper's suggestions with the prunes and the water and it's actually worked very nicely, but… Anyone like to discuss that?
Dr. Chris Miller
(30:29)
Are you talking about the constipation or the rice?
Dr. Laurie Marbas
(30:31)
The constipation or the rice, either one.
Dr. Michael Klaper
(30:35)
Yeah, a truly whole food, plant-based diet, in a healthy person, doesn't have diabetes or some neurologic disease, it's virtually impossible to become constipated. You're eating large amounts of fiber, you're walking around drinking water, your intestinal tract has no choice but to push things along and eventually, pretty much on a daily basis.
Dr. Michael Klaper
(31:10)
I think we're looking at two separate phenomena. One is, the feeling of fullness that people have frequently on a whole food, plant-based diet, which is normal and to be expected. We are telling you to eat pounds of fiber every day. We're telling you to eat big salads and hearty vegetable soups, big plates of whole grains and beans and fruit. It's a lot of fiber and that fiber weighs something. A whole day of eating like that, the oatmeal for breakfast and the salad for lunch and the soups and the et cetera. At the end of the day, man, you've got your three pounds of fiber working its way through your intestinal tract and people feel that it weighs something. Shows up on the scale, freaks people out. “I'm getting fat.” No you're not. That's just the food and the fiber and the water moving through your intestine, it's not part of you. “But, well I feel this…” and if they don't have a bowel movement every day, “Oh, I'm constipated.” No you're not.
Dr. Michael Klaper
(32:09)
What frequently happens is that the colon will fill up with fecal mass and you have a very effective bowel movement and you empty out the colon. In many people, it takes a day or two for that colon to fill back up again now from the food that you're eating. But the person, “Oh, I haven't had a bowel movement today, and I feel all full down here. Must be constipated. I need an enema. I need… This isn't working for me.” Well, the truth is, it's just the rhythm of a large, high-fiber diet moving its way through your intestinal tract. Some days you may have two or three bowel movements, some day you won't have one. But by and large, as long as you're passing these soft, easy to pass stools on a regular basis, relax.
Dr. Michael Klaper
(32:55)
We're biological creatures, not mechanical devices. It's not a matter of, “Oh, I have gone 12 hours and 14 minutes without a bowel movement, I must be constipated.” No you're not. Just keep eating the healthy food and walking and drink your water and your colon will know what to do. Now, if you got neurologic issues, got MS or something, that's another issue.
Dr. Michael Klaper
(33:19)
So, when we throw this word around, “constipation.” The definition of constipation is having bowel movements less than three times a week and when you do pass those stools they are hard, balls of stool that are difficult to push out. That's constipation. Unless you fall into that category, don't saddle yourself with bad definition or something wrong with you. And realize, again, when you have a bowel movement, it takes time for the next one to come along. So people scare themselves unnecessarily [inaudible 00:33:51]. Don't scare yourself unnecessarily. Most people won't, can't get constipated on the kind of diet we're talking about here.
Dr. Laurie Marbas
(33:59)
Absolutely, that's great. Chris there was a really interesting question I think you'd be great to answer. Mike asked, “I switched from a SAD–” it just cracks me up, Standard American Diet, SAD diet. “To a whole food, plant-based diet in February and my labs have improved immensely,” Awesome! “And I've been diagnosed with hypothyroidism and have been found conflicting information about what would improve this condition naturally. What would this panel recommend?”
Dr. Laurie Marbas
(34:25)
And I'll just say mine actually improved as well. Not completely off medication, but certainly, after 15 years after diagnosis, but on a whole food, plant-based diet. Chris and I taught a really in-depth class on thyroid health. Do you want to suggest anything?
Dr. Chris Miller
(34:39)
Sure. Good job going whole food, plant-based. That's number one, the most important thing. Everything we talked about, feeding that microbiome, all the fiber, all the food that have fiber all, all the nutrients, micronutrients. If you're eating those colors of rainbows in and those greens, that's number one, hands down, the most important thing you could be doing for yourself, for your thyroid.
Dr. Chris Miller
(35:00)
And then there's other things that we pay a little extra attention to. Make sure iodine level is okay. If you're whole food, plant-based or you're not buying things salted, then we do usually recommend either a supplement of iodine, making sure you have the appropriate amount of iodine, which usually it's about 150 micrograms. So whether you get it from sea vegetables or you have a source, but to make sure that that's okay because too much iodine and too low can cause hypothyroidism. You want to make sure of that.
Dr. Chris Miller
(35:29)
And then other nutrients really important to that thyroid are selenium, it needs a little bit of selenium, which you can get through diet or taking a little extra supplement. And then zinc is really important for thyroid hormone to be made. Again, that's [inaudible 00:35:44] through diet and Dr. Marbas certainly went through some of the sources of zinc such as pumpkin seeds and whole grains and legumes, things like that, and other seeds and nuts as well. You can get it through diet or you can take a little extra supplement.
Dr. Chris Miller
(35:56)
It needs iron. You don't want to take extra iron, but you just want to make sure you're not deficient it, so just eating your diverse plant-based diet usually get plenty of iron from that. So it needs that as well.
Dr. Chris Miller
(36:07)
And it needs the amino acids. Eating plenty of healthy plant-based diet. Getting your beans in, maybe tofu or tempeh, things like that. You have whole grains and your plants as well. So all of that, you're going to build a health that's going to help you with the nutrients that your body needs to build that thyroid healthfully.
Dr. Chris Miller
(36:29)
Soy and cruciferous vegetables are good for it, so please make sure you're enjoying those. Lots of greens, as we talked about, as long as your iodine level's okay, you can be eating them. Don't usually recommend juicing or overblending too many crucifers, but you definitely can and should need them. So eat your cruciferous vegetables. And also your soy products. As long as your iodine's okay, it's extremely beneficial. There's so much online about how it interferes and if you look at the data, it does not pan out that people are [inaudible 00:37:05] when they're eating it. For a healthy thyroid, it's okay to eat that as well. And certain other micronutrients are okay.
Dr. Chris Miller
(37:11)
And then a big one that is often overlooked is stress. Stress plays a humongous role in the thyroid. If you look in two places of where thyroid is being made, from the thyroid gland to the peripheral conversion of T4 to T3, if you're stressed out, your body goes into stress mode and it won't make thyroid, it'll slow it down. Stress can be any form. From being the wrong temperature, from not eating. So if you're fasting, it turns the T3, the active thyroid hormone, goes into the inactive form to conserve calories because you're not eating. That happens if you're stressed out. You're going to get a slower metabolism because your thyroid is one of the things that's slowing down at that point. But any stress, worrying about things or just anything going on in our heads, any of that type of stress will lead to the thyroid slowing down, not functioning at its best.
Dr. Chris Miller
(38:05)
So a stress management program is so crucial to a healthy thyroid. That might include exercise and adequate sleep and deep breathing and getting outdoors and all the things that you can build into your day, really, really important in addition to the food. That's my quick nutshell of how to have a healthy thyroid.
Dr. Laurie Marbas
(38:23)
That was excellent. Any other specific thoughts? All right. And so, Vince, hey Vince, how are you? We know Vince. He's asking, “What specific blood tests do you recommend annually for maybe someone on a whole food, plant-based diet? For example cholesterol, B12, homocysteine, EPA, DHA, any others?” Do each of you have your own… what you like to do? Dr. Klaper?
Dr. Michael Klaper
(38:51)
You just mentioned major ones. I used to get them regularly. I haven't gotten them in many years. After a while, your body just is what it is. It's used to this food. I'm not going to change anything a whole lot. My cholesterol's 152 versus 154, et cetera, it's not going to change a whole lot. But yes, I would get a complete blood count, make sure there's no hidden anemia anywhere, comprehensive metabolic profile, checking your liver and kidney function. Might want to get a TSH just to see how your thyroid's doing. A lipid panel till you know that you don't need them anymore, that your cholesterol and your triglycerides are just normal and just for your curiosity. I would get a homocysteine to make sure that your B12 is adequate. When you don't have enough B12, homocysteine goes up. And inflammatory markers. I'd consider a high-sensitivity C-reactive protein, hs-CRP. And if that's negativo, best, less than one, you probably don't have any serious inflammation going on in your body. Those are the ones that come to mind. Vitamin D level would probably be prudent these days. That's about it [inaudible 00:40:09].
Dr. Laurie Marbas
(40:09)
Yeah, I think the only thing I'd add on B12 is methylmalonic acid. Just to take out the equation of folate concentration, but, yeah. Other than that, yeah.
Dr. Laurie Marbas
(40:23)
And this one actually is a good one too, Dr. Klaper, is, “I have regular bowel movements and I am whole food, plant-based diet, but when I fast at True North I had impacted bowels.” What is the reaction to the body when you're fasting? Especially for prolonged period of times at True North. What was your recommendations there?
Dr. Michael Klaper
(40:42)
Yeah. Most people don't have that problem on a water fast. We ask people before they come in to do a long water fast to just eat fruits and vegetables. Since they're whole food, plant-based diet, we just want plant material in their colon. And because most people had some… You don't come in with a totally empty colon or a totally empty digestive system. Some people have some fiber there.
Dr. Michael Klaper
(41:11)
But every once in a while, you get enough people who join [inaudible 00:41:16] long fast, some are going to come in with a really empty colon. Either they've taken some enemas beforehand and didn't tell us, or they eat mostly just a liquidy diet. But they come in with an empty GI tract. Well, then they don't eat fruit for two weeks or three weeks.
Dr. Michael Klaper
(41:32)
Now, the intestinal tract doesn't go to sleep there. It's secreting mucus, you're sloughing off cells from the intestinal tract that will then solidify, the [inaudible 00:41:45] in the gut will make the mucus congeal and you'll wind up with these hard pieces of stool that can be difficult to get out which is why we want people to come in with the rice and the veggies in their intestine. So that first bowel movement after the long fast is not a bowel movement from hell, which we see from time to time.
Dr. Michael Klaper
(42:13)
And so, if you're going into a fast, especially if you're already a plant-eater, don't do an enema before you come in. And the only ones we send out for colon cleanses are the meat and dairy folks who come in and couldn't resist stopping at McDonald's, the last supper on the way to the spa. They come in with a lot of hard stool that needs to be flushed out. But other than that, come in with some fiber in your intestinal tract and that usually doesn't happen. If people haven't had a bowel movement within 48 hours of ending the fast, then we give them prunes and that usually moves things along.
Dr. Laurie Marbas
(42:58)
Perfect.
Dr. Chris Miller
(42:58)
So interesting.
Dr. Laurie Marbas
(42:58)
Go ahead, Julieanna.
Julieanna Hever
(43:04)
I have a question for you guys. I'm just curious. You know how vegans tend to have lower ferritin levels? Have you ever seen anyone with zero ferritin level?
Dr. Chris Miller
(43:13)
No.
Dr. Laurie Marbas
(43:13)
Never.
Julieanna Hever
(43:17)
How would you treat it if you did? Just curious.
Dr. Chris Miller
(43:20)
[crosstalk 00:43:20] would re-test it.
Dr. Laurie Marbas
(43:20)
I'd re-test [crosstalk 00:43:21]
Dr. Michael Klaper
(43:21)
[inaudible 00:43:21] another test.
Dr. Laurie Marbas
(43:21)
Lab error!
Dr. Michael Klaper
(43:21)
Totally lab error.
Dr. Laurie Marbas
(43:21)
Lab error. That's the first thing you think, is lab error, for sure.
Dr. Michael Klaper
(43:29)
Yeah that's essentially what happened. But I've seen vegans with really low ferritin levels-
Dr. Chris Miller
(43:31)
In the single digits. Yeah.
Dr. Michael Klaper
(43:31)
I've seen them in the single digits and not sure quite what's behind that. What we're really looking at [crosstalk 00:43:42].
Julieanna Hever
(43:42)
Do you treat low ferritin ever? Would you ever treat it or you would just leave it be because it might be healthier because it's [crosstalk 00:43:50].
Dr. Michael Klaper
(43:50)
For the viewers, ferritin's a protein where it's the savings account for iron in your body. It's where the body stores iron. And it's mostly in your bone marrow, but there's ferritin in most tissues. And vegans run low ferritins. There's probably a good reason for it. But the only time I'd be really concerned is if it starts showing up in their blood count, they've got either iron-deficiency anemia or their red blood cells are getting small and there are just fewer around, then I would certainly treat. We can talk about a way to do that. And of course, you've got to make sure you're not looking at blood loss. That they don't have a polyp or an upper GI bleed and they're losing into the intestinal tract, that you're not looking at serious blood loss situation.
Dr. Michael Klaper
(44:45)
And in the runners we see it. We see these low ferritin levels as well. What I tell them to do, I have them a continuum for increasing iron, these folks do need to increase their iron, is to eat more greens, Popeye had it right there. You increase the iron absorption with citric acid, so I tell them if you've got some broccoli or asparagus in front of you, squeeze some lemon juice over it. If you're making a spinach salad, throw some mandarin orange slices in there. Get that citrus and greens combo going and then you'll absorb more iron into your bloodstream.
Dr. Michael Klaper
(45:19)
And after a few weeks of that, we'll re-check iron. If it's not budging, then I have them go to the Whole Foods store and get a bottle of [inaudible 00:45:28] and it's a thick dark syrup made from raisins and apricots and prunes. Iron containing dried fruits. Couple of teaspoons of [inaudible 00:45:41] has two milligrams of iron in it. A couple of teaspoons of that every day, go through a couple of bottles of that it usually corrects it. If that doesn't correct it, then you got a serious workup for blood loss.
Dr. Michael Klaper
(45:55)
But that lingering, low ferritins in vegans, I'm still looking for the holy grail on that one to understand [inaudible 00:46:03].
Dr. Laurie Marbas
(46:05)
That's fantastic. Let's see here. Got some other questions. So they're working on it. Okay.
Dr. Laurie Marbas
(46:13)
If we choose not to ask your question, we just want to keep these pretty general and broad. Some are asking some very specific questions regarding very specific things that aren't going to be really helpful for a lot of people and get into reading articles and stuff. Citing articles here, we just won't have time. We do appreciate the question, but just so you know that I'm being prudent with the questions because I want it to help as many people as possible.
Dr. Laurie Marbas
(46:38)
People are commenting here. Let's see here. Okay, someone else asked a question, Dr. Klaper, on fasting and thyroid disease. Have you seen any improvements after they maybe spent some time at True North?
Dr. Michael Klaper
(46:53)
I wish I could tell you yes, everybody's thyroid wakes up magically and starts doing push-ups and all those thyroid things. But indeed, the thyroid still sleeps [inaudible 00:47:07] there.
Dr. Michael Klaper
(47:11)
A lot of people have low thyroid function due to a condition called Hashimoto's thyroiditis. And this is an official autoimmune attack on the thyroid tissue. If you want to be impressed, there's few conditions in the body that show a big autoimmune reaction like Hashimoto's. You can Google “normal thyroid tissue under the microscope” and you'll see how quiet and sedate and organized it is. Then Google “Hashimoto's thyroiditis histology” or “tissue under the microscope” and you'll see it's swarming with lymphocytes. It is thick with it. It's like an ant colony. There's so much lymphocytic immune activity going on there. Something has breached the outer walls of the thyroid and it's now being seen as a foreign tissue. We don't understand why.
Dr. Michael Klaper
(48:06)
This inflammatory autoimmune fire burns in the thyroid for years sometimes. It usually subsides as the months and years go by, and then the question is, how much functioning tissue does a person have left? If they didn't lose much thyroid tissue, then they won't need thyroid replacement. That's why a series of TSHs and thyroid panels are important. But if you do those tests and the TSH is sky high and T3 and T4 are tiny, tiny, then that person's lost most of their thyroid tissue and they're going to need, in the long term, replacement.
Dr. Michael Klaper
(48:46)
I wish there was some way to magically resurrect, do a Lazarus on the thyroid tissue, but indeed I don't know how to do that. The tissue seems to be permanently gone.
Dr. Chris Miller
(49:01)
Can I ask you a question? Dr. Klaper, can people water fast if they're taking levothyroxine or thyroid-
Dr. Michael Klaper
(49:06)
Oh, yeah, absolutely. Very important question. By and large, on a water fast, you stop all medication. They become potentiated then you get all sorts of side effects. But there's certain medication people can't stop. Thyroid hormone being one of them. So for that we've understood, because it gets potentiated, we cut the dose in half. If you're on 50 micrograms of Synthroid, you drop to it down to 25 with a water fast. Absolutely cut those tablets in half, cut the dose half. Very perceptive.
Dr. Laurie Marbas
(49:37)
Excellent. All right. And we have someone also asking the question, “Any tips dealing with traveler's constipation?” So we're going across time zones, different foods, maybe they're dehydrated from flying, whatever. “My bowels just don't move when I'm away from home. Any suggestions?”
Dr. Chris Miller
(49:55)
That's so very common. You have no idea. So many people say that that happens. I do my usual bowel regimen. One thing is, are we drinking as much water when we're traveling? Sometimes we don't want to pee at the airport or, and then you're on the plane or something. So make sure you drink enough water.
Dr. Chris Miller
(50:12)
I find with constipation, if people aren't eating a lot of raw vegetables and fruits, that they will get a little more backed up. Even if they're eating the right fruits and beans. But the raw really is important. Can you eat an apple? Can you find a salad or pack a salad. Fine raw vegetables is helpful. And I always let my patients eat a little bit of flax or chia seeds as well. It lubricates the gut and if you drink enough water it helps it move it through. So eating doing those [inaudible 00:50:40] really, really important. Basic things as well as maintaining your whole food, plant-based diet, everything that we've already talked about.
Dr. Chris Miller
(50:49)
If it's [inaudible 00:50:51] sometimes I'll use a little extra magnesium for them to help stop [inaudible 00:50:55] get them moving. Especially at night time it can help people sleep and relax a little bit as well. So a little extra magnesium at night for people.
Dr. Chris Miller
(51:04)
And I also use dried fruit as a thank you and it's such a good thing. I love dried fruit when I'm traveling. I don't actually eat prunes, but finding dried fruit is also really high in fiber and that might help. And make sure when you eat dried fruits to drink extra water because it dries you out a little bit. Make sure you're covering that.
Dr. Chris Miller
(51:21)
I really think the raw is what we do differently when we're traveling. I've thought a lot about this. Why it happens to so many people. And it could be of course, circadian, that we're sleeping differently and everything's getting messed up. It could be that as well. I don't know if we're eating as much raw fruits and vegetables maybe. Those are my suggestions.
Dr. Michael Klaper
(51:40)
Ah, traveling. I remember traveling.
Dr. Laurie Marbas
(51:44)
Distant memory. Julieanna, you travel a lot too. Any thoughts or suggestions?
Julieanna Hever
(51:49)
Yes, I got my alert today. I'm supposed to leave for France tomorrow and I'm so sad we're going to have to wait until next year!
Julieanna Hever
(51:55)
I travel all the time. I personally deal with this every time and I travel all the time. And so it's brutal. And I've always struggled. By the way, I should say, back to what we were saying before, I do see clients that are on plant-based diets get constipation and rice is one of those major culprits. I would say to that person that asked about the rice, maybe switch out some other green or make sure it's wild rice or a different colored rice or quinoa.
Julieanna Hever
(52:19)
People have different reactions to different foods. I've seen this individual variability, so I would say just pick the foods that don't do it to you because it's so miserable, if you can control it. Or just eat it in small doses. But mind your body. A lot of people get constipated on salads. I worked with a lot of people going into the weight loss process and I'm coaching them every week. We talk about this all the time because when you're eating less and you're putting less through your GI tract, you're going to be less active. But rice is a very common constipator.
Julieanna Hever
(52:50)
Okay, and travel, oh my gosh. Yes, the magnesium is a good solution. It doesn't always work. I agree, Dr. Miller, that's exactly what I say. It's circadian. Especially I do a lot of international travel. Oh my goodness. And it takes a few days to adjust, but the best thing I've found, personally, and what I say to my clients, is water, water, water, water, water.
Julieanna Hever
(53:12)
A lot of people travel and they have this traveling, “Oh, I can eat whatever I want” or, “Oh I'm here this one time” and they're eating… You're definitely eating off plan most of the time and trying to get back to your plan, getting back to a schedule as best you can. It's impossible to have a perfect schedule when you travel. It's just not possible. You could do your best.
Julieanna Hever
(53:31)
And if you go and you're staying for a while, then you're going to acclimate. If you're traveling all over, it just makes it more complicated. It's worth it to travel, especially when we get to go do that again, so you just do your best. But lots of water and planning and trying to get into a routine as quickly as you can and if you can't then… It's worth it, you have to choose if it's worth it. It's very common.
Dr. Laurie Marbas
(53:57)
Yes, absolutely. There's another question here, speaking of sleep and travel. Dr. [Gregor 00:54:04] and others have discussed how important the timing of your food is. Do you have any advice on how to time meals when you occasionally work seven overnight shifts in a row? I'm sorry. Should I not eat while I am at work?
Dr. Laurie Marbas
(54:18)
That's a tough shift, I don't know if you're medical or not but that is really tough. I know when I worked nights when I was deployed to the Middle East, I was there for five months working nights. I didn't eat a whole lot during that time. I tend to eat at the end of my shifts. That was just my natural response to that. But do you guys have other suggestions when you have your shift workers?
Dr. Chris Miller
(54:41)
Yeah, I've researched the data quite a bit on this because I'm an emergency room doctor, so I've worked a lot of nights and my friend are all ER doctors. My husband has worked night shift for 30 years in the ER and he does the seven on, seven off [inaudible 00:54:56] shifts. He doesn't anymore. He switched to working days. But he had, for years. So we have talked and looked into this left and right.
Dr. Chris Miller
(55:02)
And you're totally right, whoever asked that question, that it's important to not eat too late at night. We're more insulin-resistant at night, [inaudible 00:55:11] the same food, our bodies shut down, our guts shut down. We're not meant to be digesting food at night. So it's really not good for us overall and it's one of the reasons that night shift workers have a little bit higher risk for cancers and heart disease and autoimmunity. But when they regulated their circadian rhythm, those risks actually went down. There's data on this.
Dr. Chris Miller
(55:31)
If you can control eating, and I know it's so hard, and I know. I worked them too and it's extremely difficult so I'm not going to say don't eat at night. For me it was next to impossible. I had to eat when I was working an ER shift at night. But I would try to eat until midnight and not past that. So I would eat my two meals at home during the daytime, [inaudible 00:55:51] still have normal time, and then a lighter meal in the evening. So it wouldn't be too much at night. But a lighter meal earlier on in my shift. As soon as it stopped being so crazy busy, so maybe like by eleven is when I would be able to eat a little something and then that would be it until the morning.
Dr. Chris Miller
(56:08)
And the data shows that that still is okay for your circadian rhythm. You can do time-restricted eating so keep it to like a 10-hour window that you're actually eating and that is really really important. Try to keep a little regularity to your meals, although of course it shifts when you're working your seven on versus when you're home for those seven. But trying to keep it and not eating too late at night and just sipping water or tea after that. But that data shows that those people ar able to decrease the risk and that's the best that I've come up with.
Dr. Laurie Marbas
(56:38)
Yeah, that sounds like a very reasonable and workable option. Julieanna, any suggestions on what those lighter meals might be? Or any thoughts there? Something to take to work with them? Healthy?
Julieanna Hever
(56:49)
I have so much to say about that. No. I'm going to pass. There's so much to say, it's like a whole conversation about what to eat and when to eat. It's hard, there's so much evidence about how difficult it is, like you said, Dr. Miller. It's really challenging and you just have to do your best. It's like traveling, you do your best and if it's lifelong, if you keep the routine, whatever it is, that's ideal, but I know that's not possible for everyone.
Dr. Laurie Marbas
(57:15)
Yeah, especially if you're doing any type of physical labor stuff. You may need to at something. And honestly, you just do your best, but this time-restricted eating might be an option. Especially if you're doing on and off.
Dr. Chris Miller
(57:28)
Huge.
Dr. Laurie Marbas
(57:29)
When I was working in the other side of the mountains, in Colorado, I was on call seven days in a row every single month for a hospital, so I worked days and nights. So it was all messed up, but I did still try to stick to as much as I could during the days, they early morning, later lunch and then not eat or snack even if I was up all night. But she says she's in the weather service. I thought that was interesting. Cool.
Dr. Chris Miller
(57:50)
That's cool. Yeah, I used to bring things like smoothies to work. I don't have time to eat a salad. Not in the ER, anyway. That was an ideal for me. So it depends on what breaks you had and when you could manage. But definitely a good, wholesome plant-based meal, I would say, that's not too heavy. [inaudible 00:58:08] extra grains, I didn't want to eat those late at night, but I would eat fruits and vegetables. Maybe a bean soup or something. Something I could eat easily at work.
Dr. Laurie Marbas
(58:18)
That's a good one. A good place to end it because I know Dr. Klaper has a meeting after this. Thanks everyone for watching and please share the Plant Based Telehealth platform with anyone you feel might need a plant-based doctor. That's plantbasedtelehealth.com and thanks for joining us! See ya.
Dr. Michael Klaper
(58:33)
Bye everybody!
Dr. Chris Miller
(58:34)
Take care of your immune system!
Dr. Michael Klaper
(58:36)
Indeed. Take care of you!
*Recorded on 9.3.20