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June 8, 2022 25 mins

Understanding how nutrition plays a big role in our self-care can be valuable for maintaining all types of good habits. For Dr. Monica Aggarwal, there was no choice but to alter her eating habits after arthritis drastically changed her life. By exploring both the stressors and positive resources in our lives, Dr. Aggarwal has redefined her medical practice to treat the whole patient and understand how food affects inflammation in our bodies. Touching on simple ways to improve our eating habits and how those small changes produce greater harmony in the body, she shares advice on how to take self-care to the next level.

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Speaker 1 (00:02):
Hi everyone. I'm Holly Robinson, pete actor, author, advocate, do
it All mom, and I'm also a caregiver. And this
is care Walks, a podcast from my Heart Radio and
volterin Arthritis Pain Gel. It's a show for family caregivers
who give everything to everyone and need to make time
for themselves through movement. Every episode is designed for you

to walk as you listen, so just think of me
and my guests as your weekly walking buddies. We'll hear
stories from caregivers and gain tips and insights from health
experts and advocates who know how important it is to
take care of yourself and manage joint pain due to
arthritis that often accompanies being a caregiver. Together, we'll find

community ourselves and maybe even alleviate some joint pain in
the process as we walk together and connect to the
best parts of being a caregiver. Hello, fellow caregivers, Welcome
back to care Walks. Thanks for joining us again. All right, now,

just a reminder. Right now you're listening to the full
version of this episode, but if you don't have time
for a full walk today, then go check out our
bridged version of the same episode. It's like cliff notes
for podcasts. So now that's taken care of, how have
you been. We're a few episodes in now and I
just wanted to check in and see how you're doing.

Have you been asking for help? Have you been taking
a walk every day? Are you reaching out to find community?
Don't forget these are important ways to refill your cup.
And what about your eating habits. Are you getting in
fruits and vegetables and other healthy foods into your daily diet.
I know you have a lot on your plate, but

I just want to say I am so proud of
everything you've done to take care of the ones you
love and the progress you've made and taking care of
yourself too, and now that you've started adding move it
to your daily routine. I want to spend this episode
learning about the role diet and nutrition play and combating
joint pain due to arthritis and improving our quality of life.

To help us better understand how our self care can
be applied to the kitchen, I've invited Dr Monica Agarwall
to join me on today's episode. Dr Agarwall is an
adjunct clinical Associate Professor of Medicine in the University of
Florida Division of cardiovascular medicine. She's been conducting research on
the impact of diet on everything from physical fitness to

mental health. I'm really looking forward to talking to Dr
Agarwall about her work and learning about how we might
be able to use diet to treat the symptoms of
our joint pain. But before I share today's conversation, let's
set out on today's walk. Let's start with loosening your

shoulders and walking with ease and letting go of the
day and just focusing on the in and out of
your breath as you walk, take some time to reflect
what has brought you peace in your body today. This

moment could be anything from a tight hug, to your
morning stretch or the taste of a nourishing meal. Check
in with these feelings, how has this moment of peace
made you feel? Carry that piece with you through our
walk today. I want you to think about all the

aspects of our health that help us stay powerful and strong,
And as you set your pace for the duration of
the walk, we are going to dig into some simple
nutrition strategies that can go a long way and helping
us protect our joints from the inside out. Today I
am joined by Dr Monica Agarwall an adjunct Clinical Associate

Professor of Medicine in the University of Florida Division of
Cardiovascular Medicine. Dr Agarwall's book Body on Fire, How Inflammation
Triggers Chronic Illness and the Tools we have to Fight
it outlines prescriptions to help guide people to better health.
And now she has a cookbook, Body on Fire, Anti
Inflammatory Cookbook, Your Guide to eating plant foods that Fight disease.

Dr Agarwall, thank you so much for joining us today.
It's my pleasure. Thank you so much for having me.
Tell me what first got you interested in studying nutrition.
You know, I am Indian by birth, so maybe my
whole life my mom told me to eat turmeric or
you know that I would do better if I slept more,

or to you know, eat more kuman and mango powder
beca as it was going to help me with this
or that, And so I always sort of grew up
in that kind of space and when I was in fellowship,
So in training for cardiology, you go to medical school,
then you do three years of internal medicine, and then
you do three years of cardiology fellowship. You're in school forever.
And then during that time I also did an integrative

medicine fellowship, so I was always interested in integrative practices,
trying to maybe I don't know the combination of east
and west, but it really didn't kind of hit home
for me until I myself became sick. So when I
finished my fellowship, I decided to have children. And when
I got pregnant, it was the most amazing thing. But
I decided that, oh my gosh, I you know, I'm

older now, I want to have all these kids. So
I had three kids within four years. Four months after
I had baby number three, I started manifesting joint pain
and it started with a finger and it migrated to
my knees and my shoulders. Within a two week period,
I went from being a runner, active, full time doc
to being unable to climb the stair. You know, very

dark time in my life where I was diagnosed with
a very poor prognostic form of inflammatory rheumatoide authritis, and
I went from nursing a kid, doing all the things
I normally would do, and within a week of my diagnosis,
I was told that I needed to stop nursing my
kid and get on these medications. And that's a humbling

feeling and I remember this feeling of being small and
being told that there was I had an incurable illness
and I needed to get on medications. There was no
way I was going to come off. So I just
needed to accept that. And that's interesting for a doctor
because I thought, you know, it's not that I embrace medications.
I was trained with medications. But isn't there another way?
Isn't there other things? Aren't there other things that we

can do to make our bodies better? So I started
on a path of learning about how lifestyle impacts your body.
I met a woman who said, maybe your nutritions bad.
And it's ironic because I was vegetarian. And I was
probably a jerk to her because I said, like, yeah, no,
I'm vegetarian. I got this, But I was an unhealthy
vegetarian as many of us are. What does that mean?

An unhealthy vegetarian? Stop right there? Yeah, yes, a good question.
I feel seen right now, So tell me what that
tell me what that means? Well, that's a that's a
good question. And so there are many people who call
themselves vegan or vegetarian that eat a lot of unhealthy foods,
And to be fair, veganism is often an ethical choice
and not necessarily a health choice. But we have to

remember that there are many vegetarian and vegan foods that
are not super healthy. Doctors actually get very little education
and nutrition. So it took me years of training after
my training to learn how to educate people and how
to heal my bone body. And so I had to
learn a lot about the impact of what we eat,
how dairy infects your body, how fats affect your body,

how all of this stuff triggers inflammation, how inflammation triggers illness.
And I went through this process over years of educating myself. Well,
let me go back a little bit too. When you're
talking about out being a mom of three and then
you get this diagnosis, I'm a mom of four. I
started off with twins at I'm completely blacked out those years.

I don't remember a whole lot, but what that that
must have been, and you touched on it a little bit,
But that must have been so difficult to be raising
these little ones and then you get this diagnosis. It's remarkable,
but I mean, this is your journey. I want to
shift to the way we can care for ourselves and

how we can take better care of our bodies with nutrition.
So let's talk inflammation because I know you know a
lot about that. What exactly is inflammation? How does food
contribute to or combat it? Yeah, so inflammation. I always
described to people that inflammations like your body is mad
at you. That's why the title of the book is

called Body on Fire, and I always describe it to
people is that your life is full of stresses and resources.
And just think about the stresses in your life. Well,
there are lots of them, especially in two thousand twenty two.
There's our constant dinging of our phone. There's the lack
of sleep, the job stress. Am I going to get
this job? And do I have this job? Do I
have enough money? There's lack of exercise, there's the foods

that we're eating. All of these things are stressors on
our body. But then there are all these resources too,
and that's something that we forget. And there's all these
resources like healthy, clean eating. There's sleep, there's movement, there's
gratitude journaling, there's all these things that you can do
switching off your phone and these are things that you
can do for resources. And it's funny because you know
your cell phone goes to seven percent and you panic, right,

you run over and you're like, I need a charger.
I need a charger. But we've forgotten how to charge ourselves. Right.
We heard so much focused on the demands in our life. God,
I remember when I was in medical school used to
talk to people and be like, pulled an all night
or ace the test. What a jerk I was? You know,
Like who talks like because you're so proud, like you
were as a badge of honor that you didn't need

the sleep, But you know, we should honor people who
sleep and who take naps and take time for self
care and recovery. You brought up nutrition, and so what
we're focused on in terms of nutrition. Gosh, there's so
many things you can do with your diet and people
don't realize, like, wait, what, There's so much you can do. Absolutely,
So there's all these toxins we put in our body
right now, and some of those toxins are things like

refined foods and processed foods. So think about all the
instant foods that are out there, or the open up
the box and put it in the microwave for three
seconds and it's made. Those things are very refined and
What happens with all those refined foods is that they
go inside your body and they activate your insulin, your
sugar levels go up, and they process really fast, and

they're actually the foods that give you the high and low.
So if just think about, for instance, you worked all
day and then at midday whatever, you go to lunch
with your friends, you go to olive Garden or something
like that, and maybe I shouldn't have said all of
garden by some restaurant like that, and then I know.
And then you you eat like a pasta meal which
has no fiber in it, and it's loaded in cheese
and fat, and you eat the bread that comes with it.

And so people are like, oh my gosh, I'm so tired,
I'm not getting enough sleep. I know what I need.
I need more protein. Well, actually that's not the case
at all. Most of the time, it's neither of those
things that they just need to cut out their sugar.
So a lot of those refined foods and sugars are
source of inflammation. Another big sources animal fat, unfortunately, and
mostly fried animal fat. People say, well, what am I

supposed to eat if I don't eat that kind of food? Well, gosh,
there's so many things out there, and really the foods
that we want people to eat our anti inflammatory. There
are fruits that are antioxidants, like blueberries and berries in general.
There are spices like turmeric that are super potent in
anti inflammatory. So all these things that you can do
to combat to take out those inflammatory foods, and you

add back some of that anti inflammatory food and boy,
there you go. You know, when you say refined sugars,
it sounds a lot like uh that is also carbohydrates.
Is that accurate? So our carves something that we should
widely avoid. Oh, I'm so glad you asked that because
there's such a fear of carbs and I kind of
added to that just now, and I appreciate you bringing

that up. So, you know, I think the thing that
people need to realize is that carbohydrates are this humongous
bag of different things. And there's complex carbohydrates and then
they're simple carbohydrates. Well, complex corbohydrates or foods that when
you eat them, they take a long time to digest.
And so because of that, your insulin level goes up slowly,
your sugar level goes up slowly, You feel full longer,

and you don't feel hungry. Well, those are complex carbs
like beans and keen wa and whole whole whole grains
that don't have other additives in them. And so when
we tell people we want to avoid cobohydrates, we want
them to avoid those simple carbohydrates and refined carbohydrates. Then
those are things like your candies and your cookies, and

your crackers and your sodas. Those are the foods that
we want people to avoid. Now, one of the caveats
is fruits, because fruits, and while they are simpler, they
are loaded with so many nutrients and fiber which make
them healthier and cleaner. In fact, study show that people
should eat about fifty of their diet on a daily

basis should be carves. I'm curious about what a day
in your life look like for you. What is the
favorite part of your work. I spend an hour long
with my patients and I do a preventive evaluation. And
it's intensive. Isn't it that we're treating the whole person? Right?
We've just forgotten that. And so I find that sometimes

in my practice, the best thing I do is I
teach people how to meditate, or I give them sleep techniques,
or I teach them how to move their body when
they have severe arthritis, or I teach them how to
eat better and cleaner. I talk to people about touch
and intimacy and love and connectedness. And you know, I'm
a hugger, and you know COVID was hard because couldn't

hug for a little while there and write at a
sad story. Recently write a patient. I asked her to
look in the mirror, and I said, what is it
about yourself that you love? And she didn't want to look.
She didn't want to look in the mirror. She didn't
want to see who she was. She said, there's nothing
about me that I love. And you know, I think
that there's a lot of people out there that are

suffering from that sort of lack of self love, the joy.
There's just so many areas there. And so I think
maybe the thing that I love most. You asked me,
what do I love most about my work? I love most.
When people walk out, they say, you know, I feel better,
or they'll say, now that I've talked to you, I
know I can do this. But for me, I think

you can't feel hope until you take time for you,
for that moment for that pause and really sort of
appreciating what it is in your life that you have.
It's the beauty of the earth, It's the people in
your life, the people who give you love and love
you and you love. It's your plan, it's your puppies.
It's those things that allow you to feel like, Okay,

I'm okay, I'm okay, I can't get through this. And
I think I'm a big fan of gratitude journaling. I
was just gonna say, you feeling so much gratitude listening
to all of the things that you're saying that hope
emanates from, and yes, that's so important. I do that
as well. Oh I'm so glad you do. And I

really encourage that. I tell people, get a journal, doesn't
have to be some fancy thing, and just get, you know,
right every night, right, three things in there that give
them joy or that they're thankful for, and they will
see and you will see and everyone will see how
much they feel better. You know. They's sometimes simple things
that we enjoy in our life are okay to be

happy with. And then it's just starts this process right
of sort of remembering and appreciating the things that we
do have. We'll be right back with more from Dr
Monica ager Wall. And now back to my conversation with

Dr Monica ager Wall. It can be really hard to
change our eating habits. What would you say is the
simplest nutritional adjustment someone can make that would have the
most impact on someone's movement. So I know that change
is hard. People tell me that every day, um and

certainly I have gone through it myself. But I always
remind people that even though change is hard, change is
good and that a little bit of change every day
can be very impactful. So if I were to tell
people something that I would like them to do, to
cut out inflammatory foods or sort of make a choice
so that they can feel better, I would say two things,

and I would know you said one, but I would
say cut out two things. And I would say cut
out your red meat and cut out your instant pro
cess food. Start there as the remove and you will
see I promise. In fact, if I'm wrong, you should
send me an email and tell meybe, and I will
send you a gift certificate to your favorite restaurant, because
I will tell you that in six weeks you're going

to see such an improvement. I mean, this is what
I study. And so in fact I put people on
this dietary change. In six days, I was able to
show people's blood pressure got better, their cholesterol got better,
they felt better, their quality of life was better. It
was incredible. I mean, six days you can make a change.
So if you give people six weeks of a lifestyle change,
the sky's the limit. The other thing that I'm really

not a huge fan of is a dairy. I'm not
a huge fan of dairy. That data in terms of
dairy is controversial, is what I would say. And so
I think that people have this perception that milk it
does your body good. Right, we all grew up with
that I need milk to make healthy bones. But if
you look actually around the world and you look at

the countries that have the most milk intake, well it's America, Sweden, Europe, Australia.
We actually take in the most dairy in the world.
And if you look at the countries that actually have
the highest amount of hip fractures and bone fractures, what
are those countries, Well, it's America, Sweden, Australia. So the

same countries that have the most amount of milk in
take actually have the highest fracture rates. In fact, the
countries that have the lowest fracture rates have the lowest
milk intake, like India, Africa, Peru, where they have very
low amounts of dairy intake and they actually have very
little joint pain. And that just shows to show so
many things that you know, dairy isn't the end all. Yes,

we do need calcium, but we need vitamin D which
comes from the sun. We need vitamin K, which comes
from our green leafy vegetables. And it's the combination of
these kind of things that actually will build bones. And
it's not necessarily the milk and the cow's milk that
people focus on. And I think caregivers and people who
are sick, they off been, you know, they feel stuck too,

and so I think that it's really key to sort
of say, well, gosh, you know, I can make simple
changes and I might feel better. So let's start with
these small things. And um, almond milk is super easy
nowadays because it's everywhere. You just have to be careful
because there are a thousand brands and half of them
have stuff in that I've never even heard of. So
try to get an almond milk where the ingredients are

almonds and water. Um, if you write like so, why
can't almond milky as easy as almonds and water? But
somehow it's just not. So. The other thing you can
do is you can make your own almond milk, which
is super easy. I'm not going to ask you to
soak almonds and peel them off all of what you
can do, but you can just take almond butter, and
you take almond butter, you put a few scoops into

your blender with some water pressed blend, and there's your
almond milk. Crazy easy and super cheap. So I like
almond milk there. My husband is a little bit more
into those plant based cheeses that are out there right
now that are um cocon and oil and oil based.
You just have to be careful because they're not healthy

and so they're not going to make your cholesterol go down.
The other thing you can do. Another trick is nutritional yeast,
which is high and beach twelve, which most of us need,
is a great way to get that cheesy flavor. Yes,
we speak to a lot of caregivers on our show
and and with many caregivers. Their time is dedicated to
focusing on the health and wellness of others. How do

you approach nutrition with time boundaries? Like finding fresh veggies,
cooking whole really good meals, snacks on the go. That's
something that I know I struggled with. So a couple
of things you can do is pre cooking. I'm a
huge fan of, So don't be embarrassed used frozen food
first of all, like embrace frozen foods, and then batch

cook like cook ahead of times and buy an instapot.
Insta pot is like heaven on Earth. The other thing
for snacks, you know, I carry those baby carrot bags around,
and I carry tubs of hummus around, and I carry
peanut butters or almond butters, which are really good ways
to get snacks. Those are sort of clever ways to
get them, in very clever Hocken. Movement and physical activity

aid in our approach to nutritions. Specifically, can it help
our bodies absorb nutrients better. So there's nothing negative about movement. Okay,
that's wrong. If you overdo it, as you overdo anything,
you can definitely impact your health negatively. But in general,
movement is going to be really good for your body

in every way because it helps you process your food
is better. It helps your digestion better. If you have
extra sugars in your body, you're going to process them
better when you move. If you're eating those healthy, anti
inflammatory foods, your body will move better. And so the
most important thing that our person can do who has
oustoth right is they can start doing activities that cause impact.

We call those weight bearing exercises. So movement where they
have to walk and move is very good for austro arthritis.
The problem I think where people don't move as much
as because they're so darn tired. People are just tired,
and I think that taking that time for that sleep,
you know, really trying to stay away from television at night.

And I always tell people that if the goal is
to sleep first, first of all, the average person should
sleep seven to adults should sleep seven to nine hours
a night. Most Americans and do not do that. Seven
to nine hours is accurate. And you'll see that the
people will rest more. You rest more, you eat, you'll
be interested in eating more better, You'll want to eat better,

you'll make better choices, and you'll want to move more
just because you slept. You know, the life of the
caregiver is hard, and it's usually women, isn't it. You know,
we as women, we ignore our own health in favor
of taking care of others. In fact, if there's a
random statistics that women actually they hell have symptoms of
angina or chest pain that's related to heart pain for

so much longer before they actually go to the hospital
because they downplay everything. They downplay their own symptoms and
that's very, very common and sort of tragic to me.
Something that's why I really focus on self care. So
it's tricky when you're in that situation where you have
to take care of people and yourself, Like, how do
I do it all? And if I give people anything,
I give people that hope because as a patient myself,

I was given no hope. I was told that I
had an incurable illness, that I would not get better
and I just needed to accept it. And that's not
something that I ever want to do to anyone else.
And so I think maybe if I do anything, I
give them hope. Yes, And that's so important. Dr Monica
Agarwalla has been so awesome speaking with you. I have
been taking notes. Boy, this has this been very very enlightening.

So I really appreciate talking to you today. Thank you
so much for joining us on care Walks and that
was an honor. Thank you so much. I appreciate you
having me. I want to thank dr Agarwall again for
being my guest today. You know, I'm constantly learning about
my own habits and routine with each episode of this show,

and I hope you will take away some valuable lessons
about nutrition for you and your family. And remember keep
walking and don't forget to take care of yourself too.
That's it for today's episode. Don't forget to join me
next week, when we talked to family caregiver Lakida caston
about the importance of finding community to fend off isolation

when you're a caregiver. Care Walks is produced by I
Heart Radio in partnership with al Teren Arthritis Pain Jael
and hosted by me Holly Robinson Pete. Our executive producer
is Molly Sosha. Our head engineer is Matt Stillo. This
episode was written and produced by Sierra Kaiser, with special

thanks to our partners at GSK Platform, GSK, Weber Shandwick
and Omen
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