Episode Transcript
[00:00:06] Speaker A: Hi, and welcome to Aging in America. I am your host, Beana Coleman with parent projects. I am very excited to have this conversation with you all today. Very important conversation for anybody at any age, really. But of course, you know, into the aging market. We are talking to Doctor Shad Marvasti, and I really hope I pronounced your name right. So I would love to welcome him to the show. And we're going to talk about food is medicine.
[00:00:34] Speaker B: Thank you very much.
[00:00:36] Speaker A: So really, just to jump off, can you tell us a little bit about food is medicine? Because I think everyone wants to hear about it.
[00:00:44] Speaker B: Sure. Well, food is. Medicine is an ancient concept. You may have heard of the quote from hippocrates, let food be thy medicine. Medicine be thy food. This is really something that's been around for thousands of years and across the globe, many cultures, indigenous traditions as well. You may even have your own home folk remedies related to food. Food is what brings us together. That's what connects us. It nourishes us. It gives us life. And really, food as medicine is a concept that is now finally coming back to the center of the stage in terms of healthcare, most of medicine, and healthcare, as you know, focuses on medication, surgery and procedures with very little emphasis to prevention or even looking at lifestyle or things like exercise or nutrition. But really, that's changing because when we look at the landscape of healthcare and the diseases of our time, diet is actually the number one risk factor for preventable disease and death around the world. That's above smoking, above your weight, above your blood pressure, above your cholesterol level, above your sugar level. If you're diabetic, what you eat affects all of those things, and it's the number one risk factor.
And so that's something that we really need to all know about.
[00:02:12] Speaker A: Speaking as a sandwich generation caregiver, also a momentous. So being part of that sandwich generation caregiver, that is so scary. I think about what my kids eat, and I think about what maybe I should throw away when I get home. And it's very, very scary. So I'm so glad you brought that to our attention. I watched the video, your video that's on your website, and you said something in there, and please correct me if I'm wrong, but it was that 19 hours out of all of med school is focused on nutrition.
[00:02:43] Speaker B: That's right. On average, medical schools only teach about 19 hours, not credit hours, but 19 literal hours across all four years of medical school. That's all we get in terms of nutrition.
[00:02:55] Speaker A: And to your point of what you said about disease and everything, it's such a shame because I feel like, yes, of course, medicines matter, surgeries matter. Yes, we know that. But if you could do something such as diet to help prevent this stuff in the short term and long term, why not learn more? Why not have this as, I don't know, in your back pocket as a tool?
[00:03:19] Speaker B: Absolutely. Especially when you think about, I mean, medications are life saving, so can surgeries be as well? Right. But they don't come without side effects. Right. Medications, actually, some estimates have adverse reactions to medications as high as the fourth leading cause of death. So you really want to see, is there another option outside of medication as surgery, something that we can do in addition to that, to minimize the more aggressive kind of interventions that are done in medicine. And when you look at food as medicine, it's a great opportunity where you can actually use food to prevent, treat, and even reverse some of the diet sensitive chronic diseases of our time without any of those side effects. And actually, a lot of what we do in the field that I'm in, which is integrative medicine, where we take a whole person approach to care, we really use food as medicine as a cornerstone of that. And so we actually do a fair amount of de prescribing where we take people off of medication as they make diet and lifestyle changes, and they no longer need the medication because the food and the lifestyle and all the components of their life align. Very similarly to how my colleague at honor health, doctor Pankow, I think, spoke with you a few weeks ago about blue zones. All of these things connect together. And as you develop this kind of model of health and these patterns in your life, you don't need as much medications or surgery either, because your body is healing itself and you're doing everything to get your body into the right place in your mind as well.
[00:04:56] Speaker A: So incredible, first of all. But second of all, can you kind of just go into, so people understand, like, what is the food you recommend then? Because I think when I'm listening, I'm like, I want this, but where do I start?
[00:05:11] Speaker B: So the first step is to recognize that the standard american diet is sad. Okay, so that's an acronym for you. Standard american diet is sad and sad because over 70% of the calories that we consume are actually processed foods. Okay? So about its standard macro diet is about 12% plant based, you know, and about 70% it's going to be processed food, which is even including half of that plant based, and the rest is animal products. And so really needs to be the other way around, where 80% plus needs to be whole food, plant based.
And, you know, not this processed food. And the problem with processed food, or what I like to call Franken food like substances, it's not really food, okay? So the first thing is to realize that these franken foods are not real foods, right? We've been taught that pop tarts are a food, but they're not really a food. We've taught that certain breakfast cereals, those are foods, right? Or, you know, versions of pizza that are frozen or other kind of things, products, right? When you look at the ingredient list has all these different chemicals and preservatives, these manufactured oils to increase the shelf life. These are not food. These are industrialized waste products that are connected to flavors, which basically get us to crave the flavors that are high in calories but very low to no nutrients. It's not real food. So the first step is, is to recognize the difference between real food and franken food. And once you do that, that's the first step is to start to realize, and the way you do that, real food mostly comes out of the ground. And then if it's an animal based product, it's going to be an animal that eats stuff that comes out of the ground, right? And it's not overly treated or overly processed. So the ingredients are something that your great grandmother should be able to understand and you should be able to pronounce and be able to actually link it to a real food. And that way, you know, it's a real food.
[00:07:15] Speaker A: I love this term, franken food. I just. I'm so clever, I'm going to use it at home. Like I said, I have the kids and I just keep running through my head, like, what they had for breakfast. And I don't want to say pop tarts might have been on the menu. So I love hearing that.
So on a personal level, I actually have started trying to eat a more anti inflammatory diethouse. And what I've noticed is it is, like you said, more of these plant based things than I ever realized. And I guess the concern that I find is, where do you find all these items? And I think that's probably the biggest hindrance to some people. Right? Like, I buy these beans on Amazon that are crunchy, but can everyone get these beans? Are there other sources of them?
[00:07:59] Speaker B: Absolutely. So I think that your grocery store actually has a lot of this, and so do farmers markets. Okay? And so one general rule is to look at the periphery of your grocery store and not in the middle right. Because in the middle is where all the packaged stuff is, the frozen stuff. Now, frozen vegetables are just as good as fresh vegetables. So that's one thing you can realize, and that's great because a vegetable is a vegetable. Now, in terms of deciding what to buy, organic or not, in terms of the impact of pesticide concentration, you want to look at something called the clean 15 and the dirty dozen. Okay, so clean 15, dirty dozen. This is from the environmental working group where they've actually looked at pesticide concentrations. And in general, the fruits and vegetables that have a very thin skin, like grapes or leafy greens or berries, you need to get organic because they absorb the pesticides otherwise. Right. Versus things like pineapple, which has that really thick skin. Right. It's hard to even get out the fruit part in the middle. You're going to be okay if you don't get an organic version of that. So that's one way to kind of decide what to buy organic when. That's one of the questions a lot of patients ask me. And I have it on one of my main handouts at honor health integrated medicine, where I see patients. The other thing is that actually even canned beans, okay, that don't have other ingredients. Right. That may just have a little bit of salt, not too much. Right. But are basically just in the can. You can warm them up. You can actually make a really delicious dish that one of our chefs with the culinary medicine program, one of the other things that I do is actually, I work to redesign medical education to include nutrition and include lifestyle medicine, whole person care to address the social, behavioral, and lifestyle determinants of health. And so I founded the culinary medicine program at the University of Arizona, College of Medicine, Phoenix. And so we work with chefs, we work with farmers, we work with agriculture, we work with nutritionists, and we bring in the combination of the arts of cooking with the science of nutrition and medicine. And we do these demonstrations, in fact, part of the Blue Zones project that we have with honor Health in Scottsdale. We're doing cooking demonstrations multiple times a year. We have one coming up this weekend with one of our chefs and the Scottsdale farmers market. I bring this up because also you can actually get really healthy meals for not that expensive. One meal that one of our chefs, chef Sasha, put together is something called cowboy caviar, which is basically a combination of different canned beans, some canned corn, then you cut up some fresh onions and tomatoes, add high quality extra virgin olive oil, some avocado, some vinegar, and maybe some pepper. A little bit of a kick if you'd like. And that's a complete meal with healthy fat. The vinegar helps to lower blood sugar. The healthy fat of olive oil is anti inflammatory.
And then you get your protein, you get your fiber from the beansen and the fresh vegetables. Avocado also has healthy fat. And people who are on a budget or even people who are on the supplemental Nutrition Assistance program, like the food Stamp program, which is referred to, you can actually go to farmers market. Pretty much most every farmers market now is participating in the double up food bucks program, which means that for every dollar that you have from snap, that becomes $2. When you go to a farmers market and want to buy fresh produce with that snap food stamp funding that you have. So you can actually two for one at most every farmer, farmers market around the country with those benefits, and you can get fresh produce, which is really, you know, one of the best things to have every day.
[00:11:34] Speaker A: Do you? That's, that is worth it in itself for that, that tidbit. Do you know how we're getting the word out about that? That's incredible. I feel like that could be life changing to some people.
[00:11:44] Speaker B: We try as much as possible. In fact, my medical students and I, we do a monthly demonstration of the downtown Phoenix farmers market and we talk about it. We highlight the local vendors and the farms. We're going to be doing that this weekend at the Scottsdale Farmers market with the Blue Zones project. So we try to get the word out as much as possible and hopefully this podcast can also do that as well. But, you know, people don't realize that some of these things are actually more accessible than you think.
[00:12:11] Speaker A: And I actually agree with you. I think people are scared. They don't think they can get their hands on the healthy food. So I totally agree with you on that. It's really funny you talked about cowboy caviar because that's what I grew up eating as like a poolside dip. You're not going to love this, but on the bottom, my mom with a cream cheese, so we'd make it like a dip. But the way that you made it, I'm like, oh, that is, that sounds really good. I love that.
[00:12:36] Speaker B: Should try it. Doesn't take that long either, to prep it.
[00:12:38] Speaker A: No, it's so easy. I agree with you on that one. All right, so you've given us great information. Can you just tell us how you got into this? Because it is so niche. I love this.
[00:12:48] Speaker B: So this has been a passion of mine growing up. My mom was a nutritionist and my family kind of comes from a traditional persian background. And we actually, Iran or Persia and India and China were all part of the old Silk road, where a lot of these traditional medicines and folk remedies and food medicine systems of practice were actually developed, and they're still passed on to this day. So we actually had a lot of these remedies I grew up with, like, where we had, like, hot and cold natured of foods and how you need to balance your foods. And so this was always kind of the rubric that I kind of grew up in. And as I got older and got into college, I looked at kind of the philosophy of medicine. I started out of looking at history of science and history of medicine, and I asked myself, why do we have such a thing as alternative medicine? Why is it just not medicine? Right? And why are we not focusing more on health and prevention? I started reading books by doctor Andrew Weil, which he talks a lot about integrative medicine. And I ended up going to medical school in Tucson to actually work with him. He's been a long time mentor of mine since medical school. And so I really became passionate about transforming medical education and healthcare in a way that we focus on using food as medicine, lifestyle as medicine, and really taking a whole person approach to care. And I think very excited now that medicine is starting to move in that direction. Insurance is starting to reimburse for food as medicine.
Health systems like honor health are actually developing programs around whole person care with integrative and lifestyle medicine. And we actually, at Honor Health, we just launched in collaboration with Desert Mission, which is our food bank. We just launched our first produce prescription program at my clinic, which is basically where you bring fresh produce to the clinic. And patients basically are getting that as a prescription. And they're part of a group visit where we have our dietitian, we talk about nutrition, their health condition, and they answer questions, and then we give them a cooking demonstration, and we give them, like, some samples, and we give them recipes of the food, and they use that produce, and they have access to that produce to help to treat their, their medical conditions, basically. So it's called a pharmacy with an.
[00:15:07] Speaker A: F. I cannot even tell you how exciting this is. How would someone here locally get involved in that? And then do you know if there's any nationwide comparable?
[00:15:19] Speaker B: I was trying to think of words nationwide. There is a national produce prescription collaborative. There's food is Medicine institute at Tufts. There's also a teaching kitchen collaborative. So there's a number of organizations around the country that are now moving this agenda forward locally. You can honor health, you can come establish care with us. Honor Health accepts a number of insurances, including Medicaid or access, which is what it's called in Arizona, Medicare and most private insurances. So a lot of this can be covered and we can kind of support your engagement with these programs and so, and also have like subsidized rates and things like that. So yeah, just come check us out on our health integrated medicine desert mission locally. And we'd happy to connect you with these resources, but there's a lot going on nationally right now, and the Centers for Medicare and Medicaid are starting to actually have feet, what they call 1115 waiver in certain states. Arizona is not one of them yet, but it really needs to be. And we're going to advocate for that. But basically allowing these produce prescription programs and also medically tailored meals program, which is another version of food, is medicine. So produce prescriptions is fresh produce. There's also grocery, medically tailored groceries and medically tailored meals. Medically tailored meals are like about ten meals a week. And these are usually for people who are elderly or people who have chronic disease, like kidney disease or heart failure or COPD. They're not otherwise able to take care of themselves and cook a healthy meal. And these programs have now been studied that if everybody who are eligible for them actually were getting them and we were reimbursing insurance, we'd literally be saving tens of billions of dollars in healthcare costs and preventing hundreds of thousands of emergency room visits and premature deaths just by giving these people with these really chronic, severe medical conditions medically tailored, healthy meals.
[00:17:23] Speaker A: This is a very large topic, obviously, but I do agree with you. I would say just from my own research, just being online on the Internet, you see more like food is medicine, eat more whole foods. If you were to work with a family who has aging parents, is there one diet of the hundreds I feel like, that you would recommend over another?
[00:17:44] Speaker B: I think one of the best diets that has the most research behind it is the mediterranean diet.
[00:17:48] Speaker A: You know what, I was wondering if you were going to say that. Okay.
[00:17:51] Speaker B: And there's one version of the mediterranean diet, which is called the mind diet, which has actually been studied for dementia, Alzheimer's and neurodegenerative conditions. And that's basically a combination of the mediterranean diethyde with the Dash diet, which actually is kind of lower in sodium. So basically what this diet looks like, no processed or franken foods, plenty of healthy fats, actually up to 35% to 40% of all your calories. Come from fat. And that fat is extra virgin olive oil and avocados, nuts, seeds, and wild seafood, okay? And it also includes plenty of leafy greens, vegetables, beans, and very little meat, okay? Mostly plant based, but very little meat as well.
And a lot of this healthy fats, because those are kind of what you really need for an aging brain, for an aging heart.
I'm in that sandwich generation as well. I'm dealing with my dad's own health conditions in this regard as well. And it's been very difficult for us and our family, and so we do the best we can. Right. Also, we have kids as well in school. And so it's always a push and pull. It's always a challenge to figure out what to prioritize. And you're not going to win every battle, but you want to do your best to try to bring as much as possible the real food forward for everybody.
[00:19:17] Speaker A: It's so funny because I always ask, and I know the answer. I just always ask. But if you were to avoid certain things, I'm assuming you're going to say refined sugar as probably one of the bigger ones to avoid. And I will tell you, and I've told you offstage, that my own father died of Lewy body dementia very young, and there was no question he had a horrible diet. I mean, I'm not joking when I say two to three candy bars a day, if not more.
And so looking back, I'm like, oh, I have to attribute a lot of this to the sugar he was in taking.
And so I think that's truly why in my own life, I started trying to eat a little more anti inflammatory because I saw, like, and I am sorry. You're going through your own family stuff. It's impactful, and it really makes you think about your future, your children's future, your aging loved one's future. So would you agree, would you say the refined sugar is one to stay away from?
[00:20:12] Speaker B: Absolutely. Yeah. When you say anti inflammatory, it's really, Doctor Weil has an anti inflammatory diet, and you can look that up. Doctor Weil's anti inflammatory diet. But it's very similar to the mediterranean diet. Okay. So not very different. You know, again, a lot of these phytonutrients from healthy plant fats, healthy wild seafood, nuts and seeds and. Yeah, the biggest problem with the standard american diet is definitely refined grains or excess sugar without fiber. Okay. So the problem is you don't need to avoid whole fruit and whole vegetables. You can eat as many berries as you want. You need to avoid a juice and any product that has sugar in it, you want to get your sugar from whole fruits. And when you eat that orange, for example, this is one of the thought experiments I give.
Let's say you're going to squeeze your own glass of orange juice, right? How many oranges does it usually take to squeeze a whole glass of orange juice?
[00:21:11] Speaker A: Five? Four?
[00:21:14] Speaker B: Peel each orange, chew every morsel with all that fibrous tissue that's there. And how many oranges before you start to feel full?
[00:21:22] Speaker A: Right? Yes.
[00:21:24] Speaker B: Right. So that's the fiber. So the fiber extends out. So every food in nature that has sugar in it also has a lot of fiber. Look at dates. If you paired up, it's all these fiber. So the fiber actually balance gram for gram. Fiber cancels out the sugar effect because it slows down the absorption of the sugar. So you don't get a big spike in blood sugar, which leads to a big spike in insulin, which is what leads to inflammation, development of fat, and also diabetes. And also, some are now calling Alzheimer's diabetes type three, because almost everybody who has a diagnosis of Alzheimer's has insulin resistance, and that comes from excessive sugar. Eating without the fiber, that comes from eating it in its naturally occurring state in a whole fruit instead of the juice, instead of the products that just are really, you think about a candy, you know, any foods, pastries, even ketchup now, right? Even bread, all of these things. And definitely candy bars. They're sugar delivery devices, just like a cigarette is a nicotine delivery device. Okay. They've done studies where they've looked at mris and looked at what areas light up when you eat certain things. They've done study where they've found given someone a bolus of cocaine, and then they had took a candy bar, and the same areas light up in the brain. So food industry knows this, right? And so it's an addictive thing. You're getting. You're craving it. You're not getting nutrients, though, right? When you get it in the real food, you're actually getting the nutrients. And so your body's satisfied with that. You're fuller sooner. You don't eat as much as, you know, overeat, right. And you're healthy. But with these other things, it ends, you know, sets up an endless cycle. So we have to educate ourselves and we have to empower each other, empower our loved ones to protect them so we don't get down this slippery slope.
[00:23:20] Speaker A: So a few things I know we got to wrap up here in a little bit, but a few things. And I want to talk about when you are talking, like we me talking to my aging parents. So anyone, what are some tips and tricks you would give? They're on the road. Maybe they didn't have time to pack strawberries for the day or whatever the case. Do you have any tips and tricks for people traveling like that?
[00:23:39] Speaker B: Yeah. So when you're traveling, if you have access to a grocery store, obviously, you know, trying to get some fresh, whole fruit and vegetables if you can, a lot of places now have those pre packaged vegetables and fruits that are already washed and already cut and ready to go. So getting some of that is one good strategy.
I think that, you know, making sure to stay hydrated when you travel is also important. Many things come down to lack of water, and whenever you get on a plane, you're going to get dehydrated as well. So I think that's also something important to keep in mind and also pack with you a variety of nuts and seeds. So, you know, take a little tupperware, whatever else you want to do. And I prefer raw, unsalted, obviously. So there's other nuts and seeds. They add oils and other things you don't need, but get a variety experiment. Sunflower seeds, you know, pumpkin seeds, tree nuts, walnuts, pecans, pistachios, almonds. Get a variety, see what you really like and mix it up. These, along with whole pieces of fruit are great snacks to have when you're traveling. So you can stay healthy on the go and you don't have to eat a lot of the other stuff that comes with it. And obviously avoiding liquid calories and, you know, a lot of soda and all that kind of stuff. Right? So, but if you eat the nuts and seeds and the whole fruits, you're going to be satiated, you're going to feel good, you're going to have the energy and stay active. Right. Also, that's another thing, too. Stretch, go for a walk. Use the gym at the hotel if you're traveling for work, you know, even just go walk around the block wherever you're staying. Right. Keep moving, stay hydrated and keep moving.
[00:25:15] Speaker A: And I like your tip about nuts because I assume that's probably one of the easier things to grab, maybe not from even from a grocery store, but also you're at a gas station. I mean, who hasn't seen pre packaged, you mentioned sunflower seeds or almonds or something at a grocery store. So that, that's a good one. Before we really do wrap up, do you have any methods that you've seen work for people to break their sugar addiction. Is it a thing people break?
[00:25:40] Speaker B: Absolutely. Absolutely. I think, you know, in the same time that it takes for our taste buds to change over, which is about 28 days, that's about how long you need to kind of hold on to avoiding some of these franken foods that are kind of loaded with sugar. Now, what I usually like to do is I start to replace it, right? So if you have a sweet tooth, I like to get those folks into starting to eat whole fruits that they like, that are sweet. So you switch from candy bars or candy or other pastries or desserts or ice cream to basically eating these whole fruits and then also even doing some smoothies, but smoothies with unsweetened milks. Right. Of choice. Or water. And then also you can add avocado in there with some healthy fat that makes a nice texture for a smoothie. Gives you that smooth, creamy texture without, like, a banana. So it's not, you know, upping the sugar piece of it. But first step, I think, is just to start transitioning to real food. So still go with what you're craving, go with what you want, which is you want something sweet, but do like it with a whole food version. And then if you're kind of on the diabetes side or you're pre diabetic, like the 90 million people who are actually pre diabetic, only 60 million of them know that they're pre diabetic. So definitely get access to your primary care doctor and find out where you're at.
But also try to combine those with healthy fats and nuts and proteins. Like, so have a whole piece of fruit with a handful of nuts and seeds. The protein, the fat and the nuts and seeds with the fiber in the whole fruit, all of those lower the impact of the sugar, but you still get the flavor of that fruit so you don't get a big bump in your blood sugar when you combine those things together.
[00:27:25] Speaker A: That's awesome. I love the 28 days. Like, I can visualize it in my head. I was like, all right, get a counter and literally cross off the date. So I love that.
[00:27:33] Speaker B: Yeah. And what happens after the 28 days is if you go back and you actually try to bite, like a candy bar or something you had regularly, all you're going to taste is, like, pure sugar. Right. Or if you're trying to get rid of salt, right, pure salt. And it's going to be gross.
[00:27:47] Speaker A: It's going to be gross. I can see that completely. It's not going to be what you thought or what you thought you were craving?
[00:27:53] Speaker B: No.
[00:27:54] Speaker A: Anything that we did not touch on. This has been beyond helpful and so much wonderful information.
[00:28:00] Speaker B: No, this is great. Love talking with you about this. I think it's really important. And, you know, the other thing I'll just say is that it's never too late to make a change.
I think about a patient that I had recently, who's 72 years old, who's had type two diabetes for over 20 years, has been on insulin, multiple medications, never really able to get the diabetes under control, and came in to see us at integrative medicine and on our health, and we basically, she was very motivated to make changes. Right. And so we started on the program in terms of making these diet and lifestyle changes.
Within about three and a half months, we were able to cut out two of her medications. We were able to cut insulin by 30%. And more importantly than that, her blood sugar came down to, like, the pre diabetic level, which it had not done over the 20 years, that she didn't even come to the controlled level, but now she was in the pre diabetic level. Okay. And she's someone who really enjoys gardening. Okay. And so she gets, like, you know, would get cuts and bruises all the time. And as diabetic folks know, those cuts take forever to heal. And she was so excited that she said, I can't believe it. All of my cuts now are healing, like, within one or two days, and I have more energy than I've had in over 20 years. So someone like that, you might say, well, you're 72. Like, I don't know what else you can do. They just keep adding the insulin. You can. Even then, there's some of this that you can reverse and you can make an impact to have a better quality of life and really improve the progression of whatever medical condition you have. So food is, medicine can work at all areas in all spectrum, all parts of the age spectrum.
[00:29:47] Speaker A: Well, you touched on it. It really is that quality of life. I could not agree more with you that it's never too late to start. And look, I don't know her story, but let's say she has grandchildren. What a wonderful gift to give to her grandchildren that she's. She's healthy now. It's incredible.
[00:30:03] Speaker B: Absolutely.
[00:30:04] Speaker A: Well, thank you, doctor Shah. This was truly eye opening on so many different levels. So I appreciate that, and thank you for sharing your time, talents, and treasures with us.
[00:30:13] Speaker B: My pleasure. Thank you.
[00:30:19] Speaker C: Well, that's it for the team this week, and thanks for joining us. If you've enjoyed the content. Remember to subscribe and to share this episode on the app that you're using right now. Your reviews and your comments, they really help us expand our reach as well as our perspectives. So if you have time, also drop us a note. Let us know how we're doing for tips and tools to clarify your parent project, simplify communication with your stakeholders, and verify the professionals that you choose. You can find us on YouTube, follow us on Instagram and Facebook. Thanks again for trusting us until our next episode. Behold and beheld.
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