The Whole Health Cure Sharon Bergquist, MD

Why exactly should we avoid food additives, and how do they affect our health? In this episode, I am fortunate to be joined by Dawn Sherling, MD, to break down the differences between processed and ultra-processed foods, identify common additives to avoid, and discuss consequences of absorbing these substances through our diets.

Dawn’s latest book, "Eat Everything: How to Ditch Additives and Emulsifiers, Heal Your Body, and Reclaim the Joy of Food," delves into recent scientific findings surrounding the consumption of ultra-processed foods. As she explains, we eat almost 60% ultra-processed foods in the United States; in comparison, a country like Italy eats closer to 20%. Given the prevalence of additive-filled foods in American society, it is important to know potential harms and what to avoid. To build a framework for our understanding of processed and ultra-processed foods, Dawn refers to the NOVA food classification system.

As an example, Dawn explains that milk is a NOVA Category 2 culinary ingredient, or a “whole ingredient.” It can be combined with other whole ingredients, like salt and cultures, to produce cheese. The cheese falls into NOVA Category 3, which is a “processed food.” The final classification group is NOVA Category 4.

“The NOVA Category 4 are the ultra-processed foods, and those are things that are full of the additives and emulsifiers… to make [a product] thicker or to make it last longer.”

New research suggests that even though our bodies do not necessarily digest additives and emulsifiers, they are likely absorbed by the microbiome and contribute to diet-related diseases, inflammation, and mortality risk.

“Nature abhors a vacuum. If we're not using an additive for energy, for calories, for something, our microbiome probably will.”
Listen to the full episode for Dawn’s top five additives to avoid, tips on shopping for less processed food, and guide to spot ultra-processed foods when eating out.

Here are the details of our conversation:
[00:01:24] Dawn’s journey into researching additives and emulsifiers
[00:05:47] Differences between Italian and American food
[00:07:09] The NOVA food classification system
[00:09:41] Types of additives and how they are used by the microbiome
[00:12:05] The aggregate effect of consuming ultra-processed foods
[00:15:10] What is an emulsifier?
[00:18:07] Wider effects of ultra-processed foods
[00:21:36] Grocery shopping to avoid additives
[00:25:09] Dawn’s top five additives to avoid
[00:29:16] Artificial sweeteners and the Diet Coke studies
[00:31:09] Recognizing food when eating out
[00:33:35] Finding the joy in eating

This is part II of coverage on the topic of protein. In Episode 191, I spoke with Vesanto Melina, MS, RD, about the amount of protein we should be consuming and the best ways to obtain it. We covered a wide range of topics, from how protein is absorbed to how it is optimized for body functions, yet there are so many fascinating subjects left to discuss. In this episode, I am thrilled to joined by Vesanto’s co-authors, Brenda Davis, RD, and Cory Davis, to analyze the importance of protein quality and understand the global impacts of various protein sources.

Brenda, a registered dietitian and leader in plant-based nutrition, reveals that protein quality is often determined by the food’s PDCAAS (Protein Digestibility Corrected Amino Acid Score). This score assesses a food’s amino acid composition and how effectively those nutrients are absorbed into the body. While these metrics are undoubtedly important, they fail to tell a protein’s full story.

As Brenda describes, “the traditional definition of protein quality ignores some really important factors in terms of how our protein sources impact our health risk… if that protein source causes colorectal cancer or increases your risk of heart disease or diabetes, to me that impacts its quality in a pretty big way.”

The impact of protein quality on health and lifespan has been proven in countless studies around the world. In fact, a 2020 study showed that substituting just 60 daily calories of animal protein (the equivalent of one egg) for plant-based protein can reduce mortality by about 10%. Beyond this, not only can protein sources like soy, tempeh, and legumes make a dramatic difference for personal health, but they can have wider impacts on our planet. Cory, an accomplished agrologist and environmental scholar, makes an even greater case for plant-based protein.

Drawing on industrial data, Cory says, “industries like fracking… use 70 to 140 billion gallons of water a year, a massive amount. Agriculture then uses 2 quadrillion gallons of water per year.”

This excessive water usage, coupled with land use and pollution, has devastating effects on our environment through deforestation, emissions, and manure spills. It is estimated that if our society adopted plant-based diets, we could sequester 16 years’ worth of greenhouse gas emissions and gain a 66% chance of meeting the Paris Climate Accords.
Listen to the full episode to learn more about the health and environmental evidence promoting plant-based protein.

Here are the details of our conversation:
[00:02:27] Writing Plant-Based Protein
[00:03:34] Cory’s interest in agriculture and the environment
[00:05:30] Protein quality and risk considerations
[00:07:44] The importance of protein for seniors
[00:11:10] Intentional protein consumption
[00:14:48] Transitioning into aging
[00:17:29] Identifying agriculture’s environmental impacts
[00:19:12] Tofu vs. steak vs. eggs?
[00:20:32] The cumulative environmental effect of animal-based protein
[00:23:20] Water use, manure spills, and emissions
[00:27:08] Reducing the risk of mortality in just one meal
[00:31:57] Protein to promote or demote health
[00:35:07] The role of supplementation?
[00:37:50] Plant-based meat substitutes
[00:42:06] Educating ourselves on the history of American agriculture
[00:44:58] Plants provide sufficient protein

Ozempic and Wegovy have garnered significant media attention as celebrity weight-loss medications and appetite suppressants. These drugs, classified as glucagon-like peptide-1 (GLP-1) receptor agonists, raise questions about safety, efficacy, and mechanistic functioning. To learn what’s truly behind these hot-topic headlines, I am joined by quadruple board-certified physician Jon Bonnet.

“Over 40% of adults over 20 are struggling with obesity. And almost three quarters of the country now are suffering from being overweight or having obesity.”

As Jon describes, obesity itself is a difficult disease to treat. Several factors, including underlying emotions, stressors, sleep, and additional medications, contribute to appetite control alone, so working toward a specific weight loss goal requires long-term physiological and behavioral change.

“Weight is not just a static thing you arrive at. It is a continuously changing balance and homeostatic proposition that moves over time.”

Jon discusses lifestyle-based weight loss strategies, like how to find and stick to a diet plan, what to expect when exercising for weight loss, and how to work toward adjusting your personal set point. He emphasizes that once these options have been exhausted, it may be appropriate to consider the role of medications.

“Medications are great, and they can be really good for certain people, but it's definitely not the first thing you want to do.”

GLP-1s are a class of drug initially intended as a diabetes medication. They increase the hormone insulin, which tells the body to store fat, and in the process were found to decrease the hormone glucagon, which tells the body to burn fat. Additionally, GLP-1s slow the rate at which food leaves the stomach, effectively decreasing appetite and thirst.

“For about a third of the people who take Semaglutide (the drug name for Ozempic and Wegovy), you're basically getting comparable results to having bariatric surgery… So that's really exciting to have a drug that is almost as good, or comparable to, having an irreversible surgical procedure.”

Join us as we dive into the side effects and costs of GLP-1 medications, what happens when the medication is discontinued, obesity theory, and the science of weight loss.

Here are the details of our conversation:
[00:02: 11] Jon’s background in lifestyle and obesity medicine
[00:04:34] The science of obesity and the set point “thermostat”
[00:10:49] Inputs in weight loss
[00:14:19] The exercise “lever”
[00:18:34] Battling the weight plateau
[00:20:38] Types of diets and how to choose them
[00:25:56] Building an exercise plan and how your body will respond to it
[00:30:54] The role of medication, why GLP-1s were developed, and how they work
[00:35:08] Side effects of GLP-1s
[00:40:42] Weight-loss drug brands and their efficacy
[00:45:28] Weight regain after medication
[00:52:04] “Fixing flowers” versus their environment

There is a one in eight chance of a woman in the United States developing breast cancer in the course of her lifetime. Given the prevalence of this disease, being aware of the lifestyle factors involved in treatment response can greatly improve post-diagnosis survivorship and quality of life.

To learn more about the importance of lifestyle for breast cancer patients, I am joined by Amy Comander, MD, who has specialized in breast oncology for over a decade. In this conversation, we focus largely on engaging the pillar of exercise toward breast cancer treatment and recovery processes.

“Where we do have good data in the oncology space is the important role of physical activity. So that's often something I ask all of my patients at that first visit, ‘What do you do for exercise?’”

Amy recommends about 150 minutes of moderate aerobic activity, which can include light movement like walking to the mailbox, each week. Understandably, this may be difficult for individuals who are undergoing physically taxing cancer treatments. When counseling her patients, Amy considers their individual condition and tailors their recovery plan to their needs.

“Those individuals who can remain physically active during treatment tolerate chemotherapy better… which then ultimately results in a better outcome. So physical activity during the treatment and beyond is so important.”

In fact, exercise’s role in cancer recovery has been found to be so critical that a new field, Exercise Oncology, is now emerging. Exercise Oncology is dedicated to studying metabolic and immune changes in cancer patients based on their physical activity.

“Our muscles release these myokines which potentially affect so many pathways… they may augment the immune system. There's so many fascinating mechanisms that are being uncovered.”

Listen to the full episode to learn more about this groundbreaking “new frontier” of cancer research.

Here are the details of our conversation:
[00:01:53] Amy’s work in breast oncology and survivorship
[00:02:50] Lifestyle medicine in oncology care
[00:03:53] Amy’s unique specialization and career journey
[00:06:05] Creating data-driven, credible resources for patients
[00:07:38] Using a diagnosis as a starting place for lifestyle change
[00:09:41] Nutrition data and exercise data
[00:10:35] Physical activity guidelines and their role in cancer recovery
[00:12:44] Personal and biological benefits of exercise
[00:15:04] Metabolic and immune mechanisms
[00:16:06] Connecting the immune system, cancer, and exercise
[00:17:08] ASCO’s guidelines on diet, weight, and exercise during cancer treatments
[00:18:52] Specificity in patient counseling
[00:19:58] Amy’s program, Paving the Path to Wellness
[00:23:41] Data on lifestyle interventions
[00:27:11] Optimizing exercise outcomes
[00:28:49] Debunking soy intake and cancer risk
[00:29:53] Sleep and stress in cancer outcomes
[00:31:24] Mental health and stress management for cancer patients
[00:33:03] Conveying the importance of exercise to patients
[00:34:39] Social connection’s impact on health

Data and diet combine in this episode as I sit down with Monique Nadeau, the CEO and Co-founder of EatLove. Together, we discuss Monique’s career journey, digital health startup experience, and the importance of personalized nutrition.

Monique’s career journey began in investment banking and politics, two fields that rely heavily on data to inform decision-making and policy. After close family members were diagnosed with diabetes and Celiac disease, Monique saw the challenges in navigating static dietary restrictions amid an individual’s unique needs. She turned to data-driven technology to develop a nutrition platform for all diet types and lifestyles.

“Maybe you're vegetarian, maybe you're 100% plant based, maybe you have a child or yourself allergic to tree nuts… what EatLove does is takes evidence-based science and actually makes it available to you for every eating situation.”

As Monique describes, there is only one dietitian per 5,000 Americans. Given their importance in preventing chronic disease, it is critical that dietitians’ work is accessible to anyone seeking guidance. EatLove collaborates with a team of dietitians so that their recommendations can reach a wider audience.

“We're powering lifestyle medicine programs at different health systems and medical groups and working on various projects that are not just a one-on-one, but a one-to-many.”

Tune in to the full episode to learn more.

Here are the details of our conversation:
[00:02:12] Monique’s career path
[00:03:46] The Hope Street Group and venturing into the health space
[00:06:47] Translating nutrition intelligence to digital health
[00:09:15] Starting a startup
[00:12:30] Finding funds and support
[00:15:25] Challenges in starting a new company
[00:17:42] Startup culture
[00:21:22] Today’s digital health landscape
[00:27:14] EatLove’s innovation
[00:34:47] Tailoring diets to individual needs
[00:40:21] Accessing EatLove
[00:43:29] The future of digital health, AI, and integrated technology

When you think of protein, do you imagine a bicep muscle flexing or a bodybuilder lifting weights at the gym? Maybe you picture plates full of steak, eggs, or cheese. While these are common sources and uses of protein, its range of capabilities extend far beyond the usual associations. The macromolecule is also necessary for bone health and immune functions - and of course, you can obtain plenty of it from a plant-based diet. To uncover the complexities of protein, I am joined by Vesanto Melina, MS, RD.

Vesanto is a registered dietitian and best-selling author of multiple plant-based nutrition books. In this episode, she outlines the amount of protein intake to strive for each day. For a plant-based diet, Vesanto recommends consuming 0.9 grams of protein per kilogram of healthy body weight.

“That's pretty easy to obtain, especially if somebody is on a whole-foods, plant-based diet.”

Some groups, like seniors, children, and pregnant women, may require slightly higher levels of protein intake. Still, this recommendation meets the needs of 97.5% of the population, and as Vesanto describes, the body knows how to economize protein for optimal use.

She also explains how the absorption process for protein is distinct from other nutrients because it can occur throughout several places in the intestine. By following these nutrition guidelines and engaging in regular physical activity, you can improve your musculoskeletal health and your overall longevity.

“You really do need to [use the muscles] to keep them strong, and then it helps to eat some good protein foods, especially ones that have leucine or the branch chain amino acids in them… As we get older, we avoid sarcopenia, or muscle wasting, which happens to some seniors.”

Listen to the full episode to demystify the protein puzzle and learn how you can make informed decisions on your protein intake.

Here are the details of our conversation:
[00:01:12] Why does the body need protein?
[00:02:57] What happens if we don’t get enough protein?
[00:04:21] The protein absorption process
[00:06:21] Recommended protein intake metrics
[00:08:52] What happens if we get too much protein?
[00:09:46] Recommendations for seniors
[00:11:09] Protein, movement, and muscle mass
[00:14:28] Recommendations for athletes
[00:16:17] History of evaluating protein quality
[00:19:40] Obtaining protein through diet
[00:21:36] Comparing plant-based protein to animal-based protein
[00:25:06] Meal-planning for plant-based protein
[00:31:47] Protein powders and supplements
[00:34:22] Health, environmental, and nutritional benefits of plant-based eating