Speaker 1: Welcome back to another bonus episode of Until It's Fixed. I'm Kelly Chamberlain.
Speaker 2: And I'm Dr. Kenny Poole.
Speaker 1: As we cover ways to make healthcare work better for everyone, these bonus episodes will draw connections between the topic we recently discussed and our daily lives.
Speaker 2: We'll talk about one thing you and I can do today related to that topic, to take charge of our health and wellbeing.
Speaker 2: Last week's episode was a good one, and we covered [00:00:30] how multi-layered and complex healthcare disparities are. Mm-hmm. And how many things really influence the health of individuals, like where we're born, where we live, where we work, where we play, how we live, how we work, how we play. Mm-hmm. [affirmative], for example, black people have higher rates of long-term health conditions like diabetes, asthma, cardiovascular disease, which oftentimes related to again, these multitude of factors like [00:01:00] exercise, stress, anxiety, diet, lifestyle, and how we make progress is definitely something that's complex. Yes. But it goes back to the idea that healthcare is certainly local.
Speaker 1: I love what you're saying because I think about community health all the time, and it's the individual plus like the more macro, so the micro level plus the macro level of health. And then I think about our societal cultural conversations around what health and wellbeing is. That's not always rooted in medical [00:01:30] advice or guidance. And so even thinking about with diet for example, like there's so many different things that are influencing how we think about what's healthy. And there's so many different kinds of diets that are being promoted to us, whether it's keto or a blood type. And ultimately I think that can make it very confusing to try to understand what we're meant to be doing. And really, I think oftentimes it's much more straightforward than we make it, which is just eating whole foods, fruits and vegetables, you know, making conscious decisions about [00:02:00] what it is that we're putting inside of our body, while also recognizing that within a communal space at this macro level, access to fresh fruits and vegetables is not always as easy for some people as it is for others.
Speaker 2: Yeah, I'm, I'm glad you brought up diet because so often when people talk about healthy living, the first thing that comes to mind is activity and exercise. And that's huge. And that's what we talked about last week and had a wonderful discussion around. But when you think about, you know, bang for your buck [00:02:30] really having a direct effect on your health, you have to think about nutrition. One of the things I used to mention with patients, I would tell people, you know, if we went outside and put on tennis shoes and ran up and down the block for a half hour, we may burn, you know, 250 calories if you will. But if you get a 20 ounce bottle of soda, right? Mm-hmm. [affirmative], that's 240 calories, sir, somewhere around that, right? And so eliminating [00:03:00] that one bottle of soda does the same thing as, you know, running at a pretty brisk pace for a half hour. So diet is huge and I'm glad we have the opportunity to speak with Dr. Ed McDonald, who is a gastroenterologist. He's a food blogger, he's a trained chef, and he's the head of clinical nutrition at the University of Chicago. And he'll be sharing his suggestion of one thing that we can lean on for today to get better, and that's taking control of our nutrition.
Speaker 3: So Dr. Pool, thanks [00:03:30] for the introduction. I really appreciate the opportunity to come on the show and discuss nutrition. This is something I'm very passionate about. It's actually one of the reasons why I'm also a trained chef. So after we finished medical school, cause Dr Pool and I went to medical school together, I actually went to culinary school after residency primarily because I knew from my experience growing up here in Chicago and also treating patients as a resident, that nutrition is one of the most important determinants of our overall health. And that's something that not only corresponds for my own experience, but it's backed up by the literature. [00:04:00] There's actually a pretty solid article in jama, uh, journal of American Medical Association that showed of all the risk factors, including 17 risk factors for early death, food was the number one risk factor. Okay? So food was more powerful determinant of dying early than smoking cigarettes, than not exercising, then not wearing seat belts, et cetera.
Speaker 3: So it's really related to multiple different aspects of our health. So in terms of one tip that I would recommend that all your listeners [00:04:30] and people in general start to really take advantage of and place in their life would be eating more fruits and vegetables. Hmm. Does that mean everyone has to become vegans and everyone has to be on plant-based diet? I'm not exactly saying that even though those diets do have their health benefits, but I do think the human body in general needs more fruits and vegetables than what the average person is consuming. Definitely what the average American is consuming. So if you look at data from nhanes, one of the large population studies that we have, only about 9.3% of [00:05:00] people are actually meeting guidelines for, uh, vegetable intake, which is extremely low. And it doesn't matter your race, ethnicity, income, majority of Americans are just not getting enough fruits and vegetables. And the guidelines really recommend that people are doing about a cup and a half to two cups of vegetables per day, which is not a whole lot. Okay. When you think about a cup, we're talking about a handful of vegetables. Okay? Mm-hmm. So a handful of broccoli is more or less close to a cup. So really just get a couple handfuls in and you're good for the most part. Mm-hmm.
Speaker 2: [00:05:30] That's great advice. It is. Dr. McDonald, could you share suggestions for those who feel that their local grocery stores or their local stores don't have quality fruits and vegetables?
Speaker 3: Yeah, it's a good question. So food deserts, that is a real situation. I'm on the south side of Chicago, a significant number of African-American neighborhoods in the city of Chicago, not only in Chicago, but other urban areas are considered [00:06:00] food deserts. So these are areas where the prevalence of healthy fresh food is just very low and a lot of people don't have access. And even when there are grocery stores, oftentimes those stores are very expensive and people can't afford the food that's actually in their neighborhood. So frozen vegetables are fine, okay? And frozen vegetables typically are cheaper than fresh vegetables, and in many ways, frozen vegetables may actually have more nutrients than some of the fresh vegetables. [00:06:30] Now, canned vegetables in recent years have fallen out of favor primarily cuz everyone's worried about sodium content and also BPA content. So BPA bisphenol a is a byproduct of plastic that may actually have some hormonal impact on the body, but in general, canned vegetables are cheap and can be healthy. So for folks who can't afford frozen vegetables and also can't afford fresh vegetables, definitely look for low sodium canned vegetables and [00:07:00] BPA free cans. Most canned vegetables are gonna stay relatively fresh for a good five years or so. So I think that's definitely a healthy option. I'd rather pursue that option than not eating vegetables at all.
Speaker 1: What advice do you have or what success have you seen from people you might work with who are able to kind of be sneaky about getting in their vegetables?
Speaker 3: My advice would be cook with vegetables. So before I went to culinary school, I would use a lot of seasonings and powders and, [00:07:30] you know, different dried herbs to kind of flavor my food. But when I went to culinary school, everybody was using, uh, vegetables to flavor whatever they were cooking. So we would start off with, uh, what's known as aromatics. And so if I was making a soup, I would cut up some onions, saute, onions, saute, celery, some carrots, maybe even some green peppers. And that in itself would be the foundation for the soup that I would cook or whatever dish, even if it was just a a meat dish, we'd throw it in there. I think we need to get back to using actual vegetables to flavor [00:08:00] our foods. As a gastroenterologist, i, I care a lot about the gut microbiome and there was a study that has demonstrated that when people consume at least 30 different types of vegetables throughout the week, that level, that rate of consumption is associated with higher amount of diversity or the highest amount of diversity in the gut bacteria. So if you can have a gut that supports a variety of different bacteria, that's really just a sign of your overall health.
Speaker 2: I'm a big salad eater that that's usually the basis of my lunch every day. [00:08:30] But I never counted how many vegetables I'm supposed to have. How do I make sure I get all 30 in
Speaker 3: When I think about 30 different vegetable products throughout the week or plant-based products throughout the week? That sounds intimidating, but it's not when you think about it, especially if you're using fresh vegetables to flavor your food. Okay, so those 30 different types of plant-based vegetables includes, you know, tame cilantro, parsley, and all these different herbs that we can be seasoned our food with. They also include garlic, [00:09:00] onions, all these fresh vegetables that have the opportunity to not only make food taste better, but also have the opportunity to improve our health.
Speaker 2: Can you speak a little bit about eating for heart health? Is there a vegetable hierarchy or are there specific things that people should be eating more of in order to help their cardiovascular health?
Speaker 3: That's a good question. And what I like about a healthy diet, it benefits the body in all aspects. So I don't think we need to say, well, eating this way [00:09:30] is gonna benefit the gut or eating this way is solely gonna benefit the heart. All these ways are mutually beneficial. Okay. So eating a diet rich in vegetables definitely can improve heart health. As a matter of fact, there's been a lot of different studies that have looked at plant-based diets as a tool to reverse heart disease. Mm-hmm. [affirmative], there's a well-established body of literature of using plant-based diets and cardiac rehab. But for people who are really trying to have a healthy heart, I think one of the strategies that's pretty well established [00:10:00] in the literature is decreasing consumption of sodium and also decreasing consumption of trans fats. So these are the fats that are typically in ultra processed foods and also decreasing consumption of red meat specifically. Uh, so red meat is rich and saturated fats, but red meat increases the risk of plaque and cholesterol building up in our arteries. So when we decrease not only our cholesterol consumption, but also decrease our consumption of red meat in general, that it has been associated with decreased rates [00:10:30] of heart disease and also high blood pressure and some of the other conditions that can be connected to heart disease.
Speaker 2: Well, yeah. Dr. McDonald, this has been outstanding. Thank you for your time and for your expertise,
Speaker 3: Dr. Pool. Thanks for having me on. I really appreciate it.
Speaker 2: I thought that his chips were great. I thought that they were simplistic enough for people to follow where, you know, as he said, you know, a handful or two of vegetables or fruits a day is what will get the job [00:11:00] done. And that's not a specific set of fruits and vegetables that you need to focus on. Some of them have benefits in some ways versus others, but no matter how you get it, whether it's frozen, whether it's fresh, as long as you are getting some, you're doing your job.
Speaker 1: So this was a great conversation on fruits and vegetables and next week we're gonna talk about who is primarily responsible for getting those into the refrigerator. And that has to do with caregiving and specifically how burnout, like we talked [00:11:30] about in episode one, impacts mental, physical, and emotional health. But as we are learning, women are 32% more likely to experience burnout than men. So we're gonna get deeper into that topic with a very special guest next week. Talk to you then.