Transcript
Matthew DeVane, DO FACC: [00:00:01] Today, we're going to give you an insider peek into how we, as cardiologists, have adopted the Mediterranean style diet. We want to share with you how using nutrition can help protect you from all sorts of bad things like heart disease, diabetes, dementia, and even many types of cancer. Doctor Lacey and I truly think of food as medicine, and so should you. Right now on our podcast, Living Heart Smart. Hi, I'm Doctor Matt DeVane.
Carolyn Lacey, MD FACC: [00:00:37] And I'm Doctor Carolyn Lacey. We are cardiologists at John Muir Health and this is our podcast, Living Heart Smart.
Matthew DeVane, DO FACC: [00:00:44] Our physician partners and colleagues are going to help guide you through many different and important cardiovascular topics to help keep your heart happy and healthy.
Carolyn Lacey, MD FACC: [00:00:52] Thank you for listening and we hope you enjoy our show. Today, Matt and I want to help help you move your diet to a healthier place. We support and highly recommend moving to a mediterranean style diet. It's. And it's not just us, it's pretty much all cardiologists recommend the Mediterranean style diet now. Now we don't just recommend it. We're actually living it. True.
Matthew DeVane, DO FACC: [00:01:18] We are.
Carolyn Lacey, MD FACC: [00:01:19] And we've both really seen some of the benefits in so many ways. So okay listen up. This is really important. And we have to have some perspective to think about before we actually dive in. So we live in a country where our life expectancy has been increasing over time. And that's good, right?
Matthew DeVane, DO FACC: [00:01:38] That is good. No it is. Living longer is better.
Carolyn Lacey, MD FACC: [00:01:40] True. And in 1900, we were lucky if we made it to 50 years old. And now our life expectancy is about 80. So we're really living longer for sure. But what that's mean, meant for a lot of people is that we're living with chronic diseases, which leads to more doctor's appointments, more pills, more hospitalizations. And Matt and I, we really see the toll that this has on our patients every day. It's it's not easy getting older.
Matthew DeVane, DO FACC: [00:02:11] You got to be tough. That's what I tell my patients all the time. Right.
Carolyn Lacey, MD FACC: [00:02:14] And it makes me think is that cheeseburger and fries really worth it? Because at the end of the day, the the choice ultimately belongs to you. And so our hope is that you always walk out of your doctor's appointment with both of you smiling because you're thriving.
Matthew DeVane, DO FACC: [00:02:29] Yeah, that's that's what I call a win win. So if you're happy, the doctor's happy. We're good. Yay! Happy, doctor! Yay! That's good. And cleaning up your diet in this Mediterranean style diet, I think, is a perfect place for you to begin this journey. Carolyn and I have been living with this diet for about a year. We talk about food. It seems like every single day.
Carolyn Lacey, MD FACC: [00:02:47] All the time.
Matthew DeVane, DO FACC: [00:02:48] We're doing it, and it's been kind of fun. I think we've learned a lot along the way. And so both of us, um, are trying to live the way that we preach to our patients and it's been really good for us. So that's why we want to share some of the things that we do and listen. As cardiologists, we get the same questions from our patients pretty much all day long, right? What is the best diet for my heart? What can I do to get off these pills? I'm taking so many medications. Doctor, what kind of food are you eating? What do you do? And it's not just the patients that are asking me these questions. I mean, constantly, my friends, my family wants to know what we're doing, what's the best diet? And fortunately, the easy answer to all these questions is a slam dunk. The Mediterranean style diet has the data, and it has everything you need to live a heart healthy life.
Carolyn Lacey, MD FACC: [00:03:38] This really is the answer, and our ultimate goal today is to get you to start making some heart healthy changes to your diet. And you can start right now. There is no reason to wait.
Matthew DeVane, DO FACC: [00:03:49] I mean, I would say, yeah, that's true. Carolyn. I mean, everybody wants to find a reason, like next month or we'll start my.
Carolyn Lacey, MD FACC: [00:03:54] New Year's resolution.
Matthew DeVane, DO FACC: [00:03:56] But everybody should be doing this right away. So there's little things you can do. So that's what our big goal is right.
Carolyn Lacey, MD FACC: [00:04:01] And hopefully we'll give you some ideas that you can start making some small changes and start chipping away at a healthier diet. Or you can go all in, but it really doesn't matter either where you are on your health journey, whether you're trying to lose a few pounds, you're trying to lower your blood sugar, or you're just trying to get your cholesterol's a little lower. Or on the other end of the spectrum, you've had a heart attack. You've had a stent. You can still make these changes to your diet and start improving your nutrition now.
Matthew DeVane, DO FACC: [00:04:28] Now, is it time? Yeah, for sure. And I think what we want to do is just share with everybody today some very actionable things that we've done. And if we can do it, you guys can do it as well. That's true as we've made our change mostly toward this Mediterranean style diet. It's pretty easy to adapt. We're going to provide an overview of what foods you should be eating as part of this style of eating, many that you should be avoiding at almost all costs, right? There's lots of those out there, unfortunately. And along the way, I think we're just going to throw in a little bit of the research we don't want to go crazy with. But there is great data supporting a lot of things that we do.
Carolyn Lacey, MD FACC: [00:05:07] Wait, wait, wait. Before we share all these changes, we really do have to make a disclaimer. We're cardiologists. We're not dietitians. We're not chefs. No, no.
Matthew DeVane, DO FACC: [00:05:20] You're a pretty good chef. But no, I'm not a chef.
Carolyn Lacey, MD FACC: [00:05:22] I'm not a chef. But we do know what has worked for us and what the data shows. So if you're really interested in specific Mediterranean diet recipes or cookbooks, stay tuned till the end. We'll give you some of our favorites. But Matt, why don't you start some things off for us? Give us something specific you've done to adopt the Mediterranean style diet.
Matthew DeVane, DO FACC: [00:05:41] Okay, the first one's pretty easy, and I'm going to just start with eating nuts. Not peanuts, but tree nuts. And so whereas I used to eat nuts maybe once a week, if I was lucky, I now turn to nuts multiple times a day. And here's kind of how I do it. I eat them as a snack during the day. As Carolyn will attest to. I bring true snacks in. I'll tell you how I do that in just a second. Sometimes I just eat nuts for breakfast and that's all I eat. It's just a handful of nuts, which is a little bit weird for some people, but they're pretty filling, so it's a good way for me to start my day because I'm not a big breakfast guy anyway. And then the other thing I do is I just try to throw some nuts on the salads that I eat, just crush them up or whatever, and it really makes all the salads that are even better and healthier.
Carolyn Lacey, MD FACC: [00:06:23] I add them to all of my salads.
Matthew DeVane, DO FACC: [00:06:25] Yeah, nuts are an incredible substitute for many unhealthy snacks, chips and sweets or whatever else you're eating. It's just while you're sitting at your desk, think about nuts instead. Nuts are full of proteins and good fats.
Carolyn Lacey, MD FACC: [00:06:38] Like the monounsaturated fatty acids and the polyunsaturated fatty.
Matthew DeVane, DO FACC: [00:06:42] Acids. Exactly. And they're filling. So it just seems like for me, I just eat a handful or so and I'm stuffed. So it's a nice way to kind of just tamp down those hunger feelings during the day. Unlike many of the carb snacks that you may be for sure. Now, just a bit of a warning here. When I shop around, I see snacks and all sorts of flavors and bags that are pre-mixed with different types of chocolate in it and all sorts of weird coatings. But be aware, those are mostly coated in a lot of sugary things, and honey coated stuff is basically sugar, so don't rely on those as a healthy snack.
Carolyn Lacey, MD FACC: [00:07:15] I agree with that.
Matthew DeVane, DO FACC: [00:07:16] Another another caveat when you're thinking about nuts is, as many of our patients and many of you may have high blood pressure. So there is salt in most of these bags. So you need to be aware. For me personally, the way I kind of get around that is I'll, I'll buy two big bags of different types of nuts, let's say walnuts and almonds, for example. And then I'll buy a third package of nuts, let's say pistachios that are salted. So the first two will be unsalted, the third is salted. And I just mix them all together. And then I put them in little baggies and bring them bring them into work.
Carolyn Lacey, MD FACC: [00:07:48] You just have to make your own blend. Yeah. It's all good.
Matthew DeVane, DO FACC: [00:07:51] Yeah, it takes a little more work, but it's fun. It's fun Eating nuts provides many incredible heart healthy benefits. So here's a little bit of data. Substituting nuts for one serving of saturated fats lowers your risk of cardiovascular disease by an incredible 45%. That means subbing in nuts for bad snacks. Massive, massive benefit.
Carolyn Lacey, MD FACC: [00:08:15] Now that's.
Matthew DeVane, DO FACC: [00:08:16] Huge. I know it's incredible, right? Other studies have shown an inverse relationship with how many nuts you eat. So even with just a single serving of nuts per week, you can lower your cardiovascular risk by about 10%. No other medicine can do this kind of work. So that's when we talk about food as medicine. This is the kind of thing we're talking about.
Carolyn Lacey, MD FACC: [00:08:37] Oh my goodness. That's a. That's a lot.
Matthew DeVane, DO FACC: [00:08:40] I know it's weird right. The data is but it's very consistent. It's not just one trial that showed this. This is across the board multiple trials.
Carolyn Lacey, MD FACC: [00:08:46] And there there are a lot of nuts in our office. But honestly, like I've started paying attention to that. And when I'm really hungry and it's my morning office and I think I'm not going to make it till lunch, I'm starving. Perfect. Getting a little handful of nuts really helped me get through the power through the rest of the morning.
Matthew DeVane, DO FACC: [00:09:06] I like that power through. Power through. Right.
Carolyn Lacey, MD FACC: [00:09:09] But so one of the things that I've done, actually, in moving towards Mediterranean diet has been a transformation in my salad dressing. So I'm a salad eater. I think I'm doing a good job if I eat salad frequently. I was really guilty. I just didn't pay enough attention to the dressing. And when you really start to look at bottles of salad dressing, they're bad. They're bad. Yeah, there's just not a good way to. What's so sad?
Matthew DeVane, DO FACC: [00:09:36] Because people so many times people bring in salads or they're eating, they think they're doing healthy, and it's either a way too much food or b just killer salad dressing. Right.
Carolyn Lacey, MD FACC: [00:09:47] And the salad dressings, when you actually flip the bottle around and you look at the nutrition label. They have a lot of bad fats, a lot of sugar, salt, too many calories. So one of the major components of the Mediterranean diet diet is extra virgin olive oil. So what I've done is I changed my salad dressing completely. I almost only ever use extra virgin olive oil, some sort of acid like lemon juice or red wine vinegar. And that has transformed my salad dressing completely. So when you look at the fats in extra virgin olive oil, they have the monounsaturated fats. And these are the good fats that really help decrease our risk of stroke heart disease, diabetes. And they promote anti-inflammatory effects and antioxidant effects.
Matthew DeVane, DO FACC: [00:10:34] Yeah that's that's right. So along with nuts, there's data overwhelming data that supports extra virgin olive oil as well as beneficial. Now I get asked this does it have to be extra virgin olive oil. Olive oil. Is that what we're looking for? It is.
Carolyn Lacey, MD FACC: [00:10:47] It's really comes down to the processing of how they press the olives first, and there's no heat or chemicals that are used when they make that first press of the extra virgin olive oil. And so that actually preserves its natural flavors, but it also preserves the nutrients and the aromas. And I love extra virgin olive oil.
Matthew DeVane, DO FACC: [00:11:06] Yeah, I'm trying to incorporate that more in my life as well. I don't cook very much, but I'm just kind of pouring it on foods that I eat right. I pour a few tablespoons on my vegetables or my fish or wherever. So I just try to keep it very simple. Okay, good. So we've talked about nuts and how we've added those. We've talked about extra virgin olive oil. I think for me probably the next big change is another big one. I mean, I've moved forward with I probably best described as a plant forward attitude. And it's it means a couple of things for me. I'm not a vegetarian by any means, but I've cut out almost all red meat. Not completely. I still enjoy occasional steak or whatever. Right in place of that. I'm either doing fish or chicken or even try to go just with vegetables and non-meat meals a few days a week. And it's actually been pretty easy for us. So it's been a good transition. So why is fish good for you? Well, fish, unlike a red meat, contains healthy omega three fatty acids, the polyunsaturated fatty acids like EPA and DHA. And these have many cardioprotective effects. So eating fish regularly has been shown to improve your cholesterol, reduce your blood pressure. There are anti-inflammatory effects, antioxidative effects, and even some blood thinning properties too, which is always helpful for sort of from a cardiovascular standpoint. So I mean, for us it's been really a really nice change. But I think that attitude of plant forward has been good for us.
Carolyn Lacey, MD FACC: [00:12:38] I do like that. But let's take a little tangent on fish for a second, okay? I always have patients say, oh, I don't really like to eat fish.
Matthew DeVane, DO FACC: [00:12:48] But I.
Carolyn Lacey, MD FACC: [00:12:49] Really like the fish oil pills.
Matthew DeVane, DO FACC: [00:12:50] Oh, yeah. Oh, yeah. Oh, yeah. They're just not good data behind.
Carolyn Lacey, MD FACC: [00:12:53] There's not. The American Heart Association recommends eating fish twice. At least twice a week, twice a week, twice a week.
Matthew DeVane, DO FACC: [00:12:59] So I only tell people if listen, if you're anti fish for whatever reason, then the the fish oil tablets are probably a good substitute. But we just don't have the good data.
Carolyn Lacey, MD FACC: [00:13:08] Behind it yet. I actually don't even tell them that. Oh okay. I don't. So when when people are asking me about fish oil, I tell them to get omega three seconds from plant based sources like walnuts, chia seed, flax seed. So I, I don't recommend fish. Fish oil tablets.
Matthew DeVane, DO FACC: [00:13:23] Probably a smarter answer than mine, but that's good. Yeah. Yeah. Shucks. Now listen. So we talked about how we're thinking at least me plant forward more fish in my life. But I will say, Carolyn, listen, I'm an empty nester, so my wife and I at home, these changes are pretty, pretty easy to make. We're both on board with it. You have a couple of, I think, pre-teen sons, which may be a little more difficult than what we have. How has it worked for you guys?
Carolyn Lacey, MD FACC: [00:13:49] It's it's a little hard. It was a little hard originally cutting meat down for us. But you can do this even with kids at home. Teenage kids at home. And I found that it was just easier if I plan ahead what we're going to cook, what we're going to eat. And at this point, I'm planning multiple meatless meals a week. And it's been over time that I've done this. But the kids haven't really complained too much, mostly because I'll make them cook if they start complaining.
Matthew DeVane, DO FACC: [00:14:20] That's awesome.
Carolyn Lacey, MD FACC: [00:14:21] But it's been something we've worked on over the years.
Matthew DeVane, DO FACC: [00:14:24] I think people just get in the habit, right? You sit down, there's going to be a piece of meat and some veggies or whatever. So just kind of breaking habits is the hardest part to do. But the food is just as good or better. People enjoy it just as much. It's just a matter of a little pre-thought, a little pre-planning. That's the big difference that I've seen, right?
Carolyn Lacey, MD FACC: [00:14:40] Right. The next change I've made is trying to really reduce sugar and sweets. And so we all know this, right? Sugar sweetened beverages, juice, soda, energy drinks, sports drinks, even diet soda. It's not better for you, but there's so much added sugar in all of these drinks. And then you get into you get into other foods that you're eating, and there's a ton of added sugar. And so some of these easy examples are table sugar, baked goods, ice cream, candies, cookies. But it also gets really sneaky, as I've been looking at as I've been looking at labels more regularly flavored yogurts. We already talked about salad dressings, condiments, and so you really have to flip around the label and you're looking for add the quote unquote added sugars on the nutrition label.
Matthew DeVane, DO FACC: [00:15:30] I think we need to have a dietician on the show to talk about reading labels, right. So I think that would be fun to have because it's something I'm not very good at. But yes, look at the labels, look for added sugars. And I do think people get fooled a lot of times with these condiments and and not only just dressings, but barbecue sauce and all these things are just loaded, loaded, loaded. So and let's face it, most people sort of go on a diet to begin with to lose weight. And these sort of sugary nightmares are going to be most people. They are they're going to be most people's downfall. And I do have to admit, I don't like to get preachy about this stuff, but there are a few triggers that I see people drinking these sugary drinks. They think they're drinking a healthy juice. They think they're drinking a coffee in the morning. They don't think about it. But these are desserts. That's the way you need to think of all these sugars and liquids. Is this is my dessert for the week really, not just for the day, anyway. I'm a bit of a pain about that, but okay, I'm just preaching for me. I'd say the really last big change I've made is that I've become a madman on this mission to avoid processed and ultra processed foods. That's true.
Carolyn Lacey, MD FACC: [00:16:39] Madman.
Matthew DeVane, DO FACC: [00:16:40] Yeah, but it's they're they're everywhere, and they're in the news a lot. You guys can read about ultra. I'm not going to go through every single one of them, but the way I'm thinking about it is in a bigger picture. It's in order to avoid most of these kind of things. I'm really just trying to look at food differently. And when you start to think of food as nutrition and not just my next meal, then it starts making sense, right? Right. What's healthy? What's not healthy? And if I think of food as nutrition, and if they think of food as even medicine along the lines of some of the data we've been talking about, it seems like picking healthier options has become a whole lot easier for me. So I'm trying to read labels a little bit. I'm trying to generally, generally avoid food with with a lot of preservatives and chemicals. They can sit on shelves and weeks for months at a time. The other thing we're trying to do is spend more time just in the produce aisle. You know, maybe that was a last minute thought for us when we walked through the supermarket before. And so you can really find a lot. We're trying new things all the time, which is great. We also try to go to a farmer's market at least once a month just to try new things. When you think about your plate in front of you, think about produce and fruit and nuts and fish, and then there won't be much room left for any of the bad stuff. No.
Carolyn Lacey, MD FACC: [00:17:53] If it's from a package, a jar, a box, and you can't easily pronounce all of the ingredients, and there's a lot of quote unquote added sugars, it's really high in saturated fat. It's really not good for you. So I actually do have a chemistry degree. Did you know that? I did, I graduated with a chemistry degree. Okay, yeah, I didn't I was a chemistry major when I was.
Matthew DeVane, DO FACC: [00:18:15] Bigger than I thought.
Carolyn Lacey, MD FACC: [00:18:16] But even with my chemistry degree, there's a lot of ingredients that really don't read very well. So if you need the degree, it's probably not very good for you. Yeah.
Matthew DeVane, DO FACC: [00:18:28] So label reading trans fats, saturated fat, added sugars and then weird stuff in there avoid.
Carolyn Lacey, MD FACC: [00:18:34] I think the last thing that we should really talk about is that we're really we've been raised to believe that we need refined grains and the grocery store is just full of them breakfast cereals, crackers, white bread or all breads basically that you can buy in the grocery store. Biscuits, regular pasta, white rice, flour tortillas. All of those refined grains are really not good for you. It's much better to eat the whole grain foods. And so some examples are like barley, farro. Frescas. My favorite word to say.
Matthew DeVane, DO FACC: [00:19:10] I don't know. I've never heard that one either.
Carolyn Lacey, MD FACC: [00:19:12] I just like.
Matthew DeVane, DO FACC: [00:19:13] Saying the word.
Carolyn Lacey, MD FACC: [00:19:14] Good. And then there's a lot of oils out there that are really refined vegetable oil, soybean oil, canola oil, corn oil. These foods, think of them like a nutritional void. They don't add any nutrition to us. They just add calories in the other bad stuff that's bad for us.
Matthew DeVane, DO FACC: [00:19:31] I need to learn more about the oils. But yeah, that's a good summary. Okay, good. So all right, we've talked about a lot of things we've done personally that have worked well for us. Hopefully you guys can all learn from that. What are we trying to tell our patients to really take away from most of this? Number one is it's easy. We've done it. Number two is living a mediterranean style life. And eating the right diet has been proven to improve primary cardiovascular disease outcomes. What does that mean include? It means lowering your risk of dying from heart disease. Lowering your risk of heart attacks, lowering your risk of strokes. It does all these things. This is unbelievable. So that's why we're so motivated to share with you what we've done.
Carolyn Lacey, MD FACC: [00:20:15] Food really can truly act as medicine, but it's time to start wrapping this up. What are some of the key components of a mediterranean style diet? So first things first, base your foods on a high consumption of minimally processed, ideally locally grown vegetables, fruits, nuts, legumes, fresh fish, and whole grain carbohydrates. Our bodies actually do need carbohydrates. It's just that most of the carbohydrates that you buy in the grocery store. They're not really good for this. For us, they're the wrong ones, right? Next, you want to add extra virgin olive oil, and you kind of want that to be your principal source of fats in your diet. And finally, no matter what you do with your diet, you also have to add movement. Do something every day. There I am. I'm talking about exercise in every patient appointment, every day exercise.
Matthew DeVane, DO FACC: [00:21:06] It's part of the Mediterranean lifestyle, not just the diet. Also, a couple of things about this diet in general. There is no single ingredient. There's no one component of this diet that accounts for all these great benefits. It seems to be like an additive or cumulative effect that just adds up over time by doing all these good things. So no matter what diet you choose for you and your family, you've got to make a few sacrifices and do a few things right. To be successful, you've got to always avoid the worst of the bad stuff, which is ultra processed foods, trans and saturated fats, sugar sweetened beverages, most sweets, and all forms of tobacco. You need to eat in moderation. Don't supersize anything.
Carolyn Lacey, MD FACC: [00:21:51] No supersizing.
Matthew DeVane, DO FACC: [00:21:52] You got to think about a lot of substitutes, whatever. If you want to make gradual changes, you know, take nuts in for chips, move fish in for red meat, and try substituting fruit for that ice cream instead. So I think substituting the better stuff for the bad stuff makes a big difference. And then of course, as Carolyn mentioned, you've got to move no matter what kind of diet you go on.
Carolyn Lacey, MD FACC: [00:22:16] I totally agree with that. And we did promise you early on a few sources to help you get started moving towards a mediterranean style diet. And so I have a few cookbooks at home. One that I really have enjoyed is the America's Test Kitchen The Complete Mediterranean Cookbook. I also find recipes on eating well, which is a magazine and I've enjoyed learning about blue zones. And there's two blue zones in the world that are actually on the Mediterranean Sea, so it's not surprising.
Matthew DeVane, DO FACC: [00:22:48] I want to do a whole show on Blue Zone. Yeah, it's cool stuff.
Carolyn Lacey, MD FACC: [00:22:51] These are a couple of things that we've started doing, but there's so much more that we haven't even scratched the surface of. So we're really happy that you've listened to us today, and we hope we start getting you pointed in the right direction with your nutrition journey. We'd really love to hear what are some of the things you found, and what are some of the changes you've made, and if there's other topics you'd like us to discuss, just leave us some feedback at your website. At the website. We're really happy to hear about it a lot.
Matthew DeVane, DO FACC: [00:23:18] Thanks for listening and get to that Mediterranean diet right away. This is Doctor Matt DeVane, and on behalf of my co-host, Doctor Carolyn Lacey and our partners at John Muir Health, we hope that you enjoyed the show and we really hope that you keep living heart smart.
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