Food As Medicine Episode 3 With Dr. Dexter Shurney

[00:00:00] In the previous episode,

[00:00:02] Well you know it's an overused cliche but you have to make the right choice the easy choice.

[00:00:07] And food is no different. In fact, food may be even more in that line of thinking that

[00:00:15] if the food doesn't taste good, the food isn't accessible and easy and convenient

[00:00:21] then it's going to really be hard to change those behaviors that we're trying to change.

[00:00:31] We're going to be talking about conversation about innovative and evidence-based behavior change strategies

[00:00:35] designed to increase well-being.

[00:00:37] Tune in to listen to thought leaders, industry experts and innovative scientists discuss hot button topics

[00:00:43] surrounding specific behaviors, design and communication strategies.

[00:00:47] Host Dr. Kerry Evers takes you on a journey to change the discussion,

[00:00:51] change perspectives and ultimately help you change behavior for your clients,

[00:00:55] populations and perhaps even yourself.

[00:00:59] Welcome back to the Behavior Change Architect podcast and our series on food as medicine

[00:01:04] which is being sponsored by the Blue Zones Well-Being Institute.

[00:01:09] And this is our third episode in this series and we are thrilled to have Dr. Dexter Schurney back with us today

[00:01:15] to talk about a variety of things in this topic and kind of pull everything together for us.

[00:01:21] Up until this point, we've been talking about food as medicine and how that impacts us in so many ways.

[00:01:27] It isn't just about nutrition. This affects our social experiences.

[00:01:32] It affects how we're feeling, our mental and emotional health.

[00:01:36] And we've been talking mostly about research and statistics and some of the science behind this

[00:01:42] but that can be different than our everyday lives and for many of our listeners,

[00:01:46] this is something that impacts them.

[00:01:48] It impacts the populations that they're serving,

[00:01:51] the individuals that they're working with in a clinical type situation.

[00:01:55] So Dr. Schurney, thank you so much for being back with us today first of all.

[00:01:59] Well, thank you for having me back. It's a pleasure.

[00:02:02] So I wanted to start off with just what do you think are the biggest challenges

[00:02:07] for people trying to address their food choices?

[00:02:11] We may know what's right or what is the best science

[00:02:15] but why do you think it's so challenging for so many of us?

[00:02:18] Yeah, that's a good question and I think it's a good place to start

[00:02:22] because if we can understand what the challenges are, what the barriers are,

[00:02:26] well then we can start to think through what are the right solutions

[00:02:29] to break down those barriers and make it easier for people

[00:02:33] to actually do the things that they're trying to do.

[00:02:36] What you said is that people know about the science.

[00:02:39] I think you're right. If you ask any parent, if their child came to them

[00:02:43] and said, I want to eat cake and ice cream three times a day,

[00:02:46] most parents would say no. That's not healthy.

[00:02:48] So I think we all get it that we should do better.

[00:02:51] It's just a matter of what are those obstacles.

[00:02:53] And so I think it depends on the individual, it depends on the family,

[00:02:57] it depends on where you live.

[00:02:59] But there are probably some large buckets of obstacles or potential barriers

[00:03:05] that we should keep in mind and I would say that the first is taste.

[00:03:09] I think there's a myth or a thought that healthy food doesn't taste very good

[00:03:17] and people just haven't had the experiences or the opportunity to try different things

[00:03:23] that can actually be very healthy and also be awesome in terms of how they taste.

[00:03:29] And so I think that's the first thing is that people have to get over the thought

[00:03:32] that if it's healthy, it must not taste good.

[00:03:35] We say food is medicine, so it probably tastes like a medicine,

[00:03:39] which isn't a good thing.

[00:03:41] So we have to get over that.

[00:03:43] I think the other thing is affordability.

[00:03:45] Oftentimes it is true that things that are healthier perhaps cost more,

[00:03:51] but it's not always the case.

[00:03:53] So again, there's a bit of a mythology out there that we might want to educate people around too

[00:03:59] that there are ways to eat healthy that don't cost an arm and a leg so to speak.

[00:04:04] And then the other thing is having to do with convenience.

[00:04:10] Obviously fast food, it's called fast food for a reason.

[00:04:14] You drive up, you get it and go.

[00:04:16] And for the most part, it's probably fairly inexpensive compared to some other things.

[00:04:23] So there's that convenience and there's that time element that I think can also be an obstacle,

[00:04:28] but there are ways to get around that as well.

[00:04:31] For instance, people can learn how to prepare staples of a meal

[00:04:35] that can last them beyond more than one meal.

[00:04:38] So it's not as if they have to spend hours over a hot stove every time they want to eat,

[00:04:44] but they can pull things out and microwave it and things like that.

[00:04:47] It takes a little planning, but it can be done.

[00:04:50] And it can also be done, those same techniques that make it convenient

[00:04:55] and take some of the time element away can also make it more affordable

[00:05:00] because you can buy things and purchase things in bulk.

[00:05:03] So, you know, those are some of the obstacles.

[00:05:05] And then I guess the last thing too is that perhaps people feel they don't have the skills

[00:05:11] if they do want to do more preparation of food at home.

[00:05:15] Unfortunately, a lot of our home ec classes and things that we used to have in yesteryear

[00:05:20] are no longer available to us.

[00:05:23] But those things can also be easily taught as well.

[00:05:30] And again, we have microwaves and things these days, rice cookers,

[00:05:34] Instapots, crockpots, things that make this a lot easier than a lot of people imagine.

[00:05:42] So those are, I would say, Kerry, those are some of the things that act as barriers

[00:05:47] and make it difficult for people.

[00:05:49] But again, with the proper focus, we can eliminate a lot of that.

[00:05:54] It's interesting when you were just talking about food is medicine

[00:05:57] and we think about medicine as tasting bad.

[00:06:00] The only thing I could think of is the song, A Spoon Full of Sugar,

[00:06:04] Helps the Medicine Go Down.

[00:06:06] And how if we're trying to avoid sugar, that's not exactly what we want to be telling our kids

[00:06:10] that, you know, food is medicine, you need to add the sugar in there.

[00:06:15] So a question in terms of that.

[00:06:20] So many of our listeners are individuals who are developing programs

[00:06:24] are trying to help others, you know, with their food choices,

[00:06:28] with having smarter options for themselves.

[00:06:32] How do you think employers and health plans can help individuals with this challenge,

[00:06:38] addressing the four different areas you just spoke of?

[00:06:42] Yeah, so I mean one, I think it's just more awareness and knowledge

[00:06:46] of why this is a good thing to do.

[00:06:48] I think a lot of people just look at food as calories and calories out.

[00:06:52] So all I have to do is worry about the calories and the carbohydrates

[00:06:55] and everything else sort of takes the care of itself and pop a vitamin and I'm good to go.

[00:07:00] And we know that that is not the case.

[00:07:04] And so I think there should be some effort on the part of employers and others

[00:07:10] to make the case that, you know, healthy nutrition diet is of importance.

[00:07:19] I think the other thing is that we do a lot of things because of our built environment.

[00:07:25] And so, you know, it's a cliche but it's true.

[00:07:29] You should make the right choice, the easy choice.

[00:07:32] And so employers if they have cafeterias, they should think about the food options

[00:07:38] that they have in those cafeterias that they think about the pricing of those options,

[00:07:43] you know, are the healthy foods, you know, more expensive?

[00:07:46] I mean, maybe we subsidize those in ways.

[00:07:49] Maybe, you know, we have fries but we use a convection or an air fryer

[00:07:55] which someone can be very good versus, you know, actually frying it in oil, things like that.

[00:08:01] And so there are ways that you can really make the built environment

[00:08:07] such that it's more sustainable and easy for people to do the right thing.

[00:08:12] So there are ways like that.

[00:08:14] I mean, certainly, you know, employers when they have meetings that extend over a lunch period,

[00:08:19] they can also, you know, try to have healthy options at those times as well.

[00:08:24] I was just going to mention, I know for a lot of small businesses,

[00:08:28] they don't offer foods, they don't have cafeterias.

[00:08:31] But I'm sure there's some things like you just said bring in healthier meals

[00:08:35] that smaller employers can do or maybe have fruits and vegetables available

[00:08:40] as snacks on the table or, you know, fill the vending machine with healthier choices.

[00:08:46] Things like that, that might be helpful for the small employers as well.

[00:08:50] That's exactly right.

[00:08:52] Actually, I was just on a call and we were talking about food as medicine

[00:08:55] in the area of hypertension.

[00:08:57] And one of the things we know, and there's really good research around this,

[00:09:00] is that hibiscus tea can actually lower blood pressure.

[00:09:04] And it's really a nice substitute for people that, you know, are addicted to soda with their meals.

[00:09:11] And so they don't want to oftentimes go to water, so you can substitute hibiscus tea.

[00:09:16] It's very flavorful.

[00:09:18] It's good and, you know, for people not wanting to drink water.

[00:09:21] It's a good substitute for that.

[00:09:25] But if you also have hypertension, it can help to lower the hypertension.

[00:09:30] And so you could have hibiscus tea, you know, in your clinic, in the waiting room or something

[00:09:37] and have a little note there that says, oh, by the way, if you have high blood pressure,

[00:09:41] this might actually be beneficial for you.

[00:09:43] Interesting. I never realized that.

[00:09:45] That's a great little tip for all of our listeners who might be dealing with some hypertension.

[00:09:50] So I know that during a recent conference in 2021 of the American Academy of Lifestyle Medicine,

[00:09:57] there was a Surgeon General Town Hall and it had several former Surgeon Generals participating

[00:10:04] and you were talking about addressing health disparities.

[00:10:08] Are there ways that food as medicine can help address health disparities?

[00:10:13] It really can. I mean, if we look at just what's happening right now with COVID,

[00:10:19] we know that people that are at greatest risk or people that are overweight

[00:10:26] or people that have one of these comorbid conditions that are related to diet and lifestyle.

[00:10:33] And so you look at the data and African Americans and some minorities have rates of COVID deaths

[00:10:42] that are much higher than the rest of the population.

[00:10:46] But if you look at the comorbid conditions and obesity that I just mentioned,

[00:10:52] those are related to lifestyle for the most part.

[00:10:55] And so that is a really aha moment, I think, for society to say, yes, this is a living example,

[00:11:03] a real example of how food and disparities are tied.

[00:11:09] There was also a study that came out of the University of Minnesota when COVID first was on the rise

[00:11:16] and it showed that people that had healthier lifestyles, regardless of your race,

[00:11:21] actually had the same levels of mortality related to COVID.

[00:11:26] In fact, the research showed that blacks actually did better than whites

[00:11:34] when you were able to actually adjust for some of these social determinants and lifestyle issues,

[00:11:41] which is pretty interesting.

[00:11:43] Well, and I bet a lot of people don't think about it that way.

[00:11:47] And mental health is also a very hot topic right now.

[00:11:51] We're all concerned about our mental health.

[00:11:54] Does food as medicine have a relationship to our mental and emotional health as well?

[00:11:59] It really does.

[00:12:00] I think a lot of people don't realize that some of our foods, foods that are high in L-tryptophan, for example,

[00:12:07] our body can take that and it converts it into serotonin as well as melatonin.

[00:12:13] And so serotonin is a drug that they often give to people that are suffering from depression.

[00:12:20] And so the food that we take in can actually be converted to that.

[00:12:25] And then of course the serotonin can also be converted to melatonin, which helps us get a good night's sleep.

[00:12:31] And so we know that there's relationship between a restful night and our mental health.

[00:12:40] Believe me, if any of us have had to stay up all night, our mental health is not so good the next day.

[00:12:47] And if that happens repeatedly, you can understand what the consequences might be.

[00:12:51] So it absolutely does.

[00:12:53] And foods that, you know, these whole foods that we've been talking about previously in this series are some of those foods that are high in that L-tryptophan.

[00:13:03] Can you say what some of the other ones are like specifically with depression?

[00:13:09] What some of those food components might be?

[00:13:11] Yeah, things like asparagus and onions.

[00:13:17] But what I will say also is that you want to eat a wide variety of those whole foods.

[00:13:24] And so I hate sometimes to start listing particular foods because the tendency is to say, oh, that's a superfood and I'm just going to eat that.

[00:13:35] And so while asparagus may be good for your serotonin levels, you also don't want to not eat some of the other foods that are good for other things.

[00:13:45] And so I always talk about you need to eat a wide variety of whole foods.

[00:13:51] And that's what people mean when they say a balanced diet, literally.

[00:13:55] And one of the ways that we talk about it is to eat the rainbow, right?

[00:13:58] Eat all of the colors that you can and more vibrant the color for the most part, the more or more rich the food is in terms of its antioxidant power and some of these nutrients that we've been talking about.

[00:14:13] And when I say that, I say try to eat seven colors, but that doesn't include fruit loops.

[00:14:19] Rainbow cupcakes or things like that.

[00:14:24] Or rainbow cupcakes or something like that.

[00:14:26] Yeah, so they have to be whole foods.

[00:14:28] They have to be natural foods.

[00:14:30] But for the most part, if we try to eat the rainbow seven colors a day, get into our diet, you're going to be fine, Carrie.

[00:14:38] And so I try not to stress the particular foods, but yeah.

[00:14:44] So as a clinician, if you have someone who just really has tried to make changes, they just feel like they can't do it for whatever reason.

[00:14:54] Are there some small changes that you would recommend to them that they could at least get started and maybe increase their motivation over time?

[00:15:03] I think so.

[00:15:04] There's a whole theory around behavior change and part of it is the researcher at a Stanford, BJ Fogg has done a lot of research in this.

[00:15:19] I want to give him credit and it has to do with taking baby steps and even in financial planning.

[00:15:28] You know, Dave Ramsey talks about baby steps as well.

[00:15:31] And I think for this particular topic, that's one way to approach it for someone that just hasn't really been able to jump in with both feet.

[00:15:41] So I can't do maybe I can't do everything perhaps, but what can I do and what would I like to do?

[00:15:47] And one of the ways to do that is to find foods that you really enjoy and then find the healthy ways to enjoy those same foods.

[00:15:56] So for example, I grew up eating mac and cheese.

[00:16:01] And it was one of those things that yeah, it's very good and guess what?

[00:16:07] I still eat mac and cheese, but I eat a much healthier version of macaroni and cheese than I did when I was growing up.

[00:16:15] And what that allows you to do is to still enjoy a lot of your favorites, but to do it in a different way.

[00:16:22] And so one of the things that's important for people to know is when we start talking about healthy food and food as medicine,

[00:16:28] it's not saying that you have to give up everything that you eat or like.

[00:16:33] But you can find healthier versions of it.

[00:16:36] It's not just what you take away, but it's also what you might be able to add.

[00:16:40] Another example of what you might be able to add is that and I don't know if I mentioned this in an earlier conversation that we had, Carrie,

[00:16:48] but when they serve people pancakes, we know what happens to their glucose.

[00:16:54] They get a glucose spike and then an insulin spike and it's not a good thing that we want to eat.

[00:17:01] But what we also know is that if we add blueberries like a couple of blueberries with the pancakes,

[00:17:07] so blueberry pancakes, but natural blueberries, not the syrup,

[00:17:13] we actually blunt the insulin spike by about a half, by about 50%.

[00:17:18] And so that's just an example of adding something to something we like, but we're actually getting a great benefit from adding those whole foods to it.

[00:17:29] So it's things like that that people can understand and appreciate and it just makes this so much easier to do.

[00:17:36] That's so interesting in it. You've mentioned moderation and you've mentioned in terms of the combination

[00:17:41] and making sure that you're having a wide variety of different foods.

[00:17:46] And one of the things I think a lot of consumers get frustrated with is the news that's always coming out about this new way to eat,

[00:17:56] this new finding and every day it feels like there's something new in terms of food and nutrition.

[00:18:02] And I know we've talked about how you want to stick with the science and kind of what we've always known.

[00:18:08] What do you think the trends will be in the next decade in terms of food as medicine

[00:18:13] and what we're going to focus on and how we're going to help individuals?

[00:18:17] I think what we're going to see in the next, and it's already started,

[00:18:21] but what we'll see in the next decade is around the gut microbiome.

[00:18:27] And for those listening that may not have a really good handle on what that is,

[00:18:33] it's basically the bacteria and viruses and fungi that live within our GI tract.

[00:18:40] They're actually beneficial to our health.

[00:18:42] They help us to create certain kinds of nutrients that we need.

[00:18:48] It affects the way that we digest the food.

[00:18:50] And as that research comes out, as we're able to sequence the DNA, RNA of those entities that are living inside us

[00:19:01] that help us along this way, we're finding more and more that when they're healthy, we're healthy.

[00:19:07] And it's the symbiotic relationship that occurs.

[00:19:11] And so I think that's going to open up a lot of new information and it's very good.

[00:19:18] And we know that every aspect of our health really is derived from what's happening with our gut microbiome.

[00:19:27] It's not the only thing, but it's a huge piece of it that we really to this point have not understood.

[00:19:33] And so one of the things we're finding now is that what makes for a healthy gut?

[00:19:38] Well, it's whole foods and plant-based foods because if it's not a whole food,

[00:19:44] then it can actually harm that gut microbiome.

[00:19:47] So we're learning more about the mechanisms of this.

[00:19:51] And I think this is going to play a big role in showing some of the skeptics in terms of how food as medicine actually works.

[00:19:59] Now, having said that, you know the natural tendency as well.

[00:20:03] Let's just pop appeal with some probiotics or prebiotics and the same kind of mindset.

[00:20:10] But really we're going to come back to you and as we've talked about before, it's this pattern of eating that's really so helpful.

[00:20:17] And again, it's not about popping a vitamin or probiotic.

[00:20:21] Yeah. So we're going to have to close out and I hate to say that because I'd love to continue talking about this forever.

[00:20:28] But we're so lucky to have you as a leader in this field.

[00:20:32] And I was just wondering if you have any closing thoughts or anything you want to leave our audience with before we finish out this series?

[00:20:40] Well, thank you for having me. It's been a pleasure and this has been fun. I could go on forever as you know.

[00:20:46] I guess what I would leave our listeners with is food should be fun.

[00:20:52] And even though we know food can be a powerful healing effect, food has to be fun.

[00:21:00] We enjoy food. And so just because we're eating healthy doesn't mean that we can't go on enjoying the foods.

[00:21:09] And so that's one of the things I would say and also I would ask listeners to encourage their employers to give them more variety, more choices.

[00:21:23] Make sure it's good though for them to you know, half when they're at work or at the work site.

[00:21:30] And also just really you know, encourage even their local restaurants to do the same.

[00:21:37] It's the people that cause changes to occur and if enough of us are sort of pushing in the same direction we can actually get somewhere.

[00:21:45] But it should be fun. So that's I guess what I would like to leave them with.

[00:21:50] That's a great way to leave. And I just want to remind our listeners about a couple of resources that Dr.

[00:21:57] Sherney shared earlier in our broadcast nutrition facts.org, several books by Dr. Michael Greger How Not To Die and the How Not To Diet Cookbook,

[00:22:11] which is a new book by Dr. Greger. The True Health Initiative, which is an initiative shared by Dr. David Katz.

[00:22:19] And of course there's the American College of Lifestyle Medicine website at lifestylemedicine.org.

[00:22:26] And Dr. Sherney, this has been just a thrill to have you here and I want to thank you for leading this field and really taking us to

[00:22:34] new heights in terms of looking at food as medicine and how we can address health disparities with this area.

[00:22:41] And hopefully we'll be talking to you and your colleagues again in the future. Thank you so much.

[00:22:46] Thank you.

[00:22:47] And thank you to the Blue Zones Well-Being Institute for sponsoring this series, Food as Medicine.

[00:22:53] Be sure to check out our upcoming series by joining behaviorchangearchitect.com and sign up for the newsletter there. Thank you.

[00:23:16] Or follow us on your favorite podcast platform.