May 14, 2024 โข 26 mins
Welcome to Season 2 of the Essence of Health Tea Time podcast!
The three most common cancers in women are Lung Cancer, Breast Cancer, and Ovarian Cancer. Studies show that 13 percent of women will be diagnosed with female breast cancer at some point during their lifetime.
While we know there are a variety of factors that can play a part in the development of cancer, there are ways to reduce your risk and enhance your overall quality of life.
This month on The Essence of Health Tea Time podcast, weโll have a two part episode with guest, Dr. Simran Malhotra. On todayโs episode, Dr. Shayla and Dr. Simran will be spilling โ๐๐ก๐ ๐๐๐ ๐๐๐จ๐ฎ๐ญ ๐ ๐๐ฅ๐๐ง๐ญ ๐๐จ๐ฐ๐๐ซ๐๐ ๐๐ข๐๐๐ฌ๐ญ๐ฒ๐ฅ๐ ๐๐จ ๐๐จ๐ฐ๐๐ซ ๐๐จ๐ฎ๐ซ ๐๐๐ง๐๐๐ซ ๐๐ข๐ฌ๐ค - ๐๐๐ซ๐ญ ๐โ.
Dr. Simran Malhotra is a triple board-certified physician in internal medicine, hospice & palliative care, and lifestyle medicine as well as a certified health and wellness coach. She is a BRCA 1 previvor with a strong family history of breast & female reproductive cancers and has an encouraging story of how she has managed this medical history at such a young age.
She founded Wellness By LifestyleMD, a platform where she aims to educate people, particularly women at high risk of cancer like herself, on the powerful impact that positive lifestyle changes can have on their quality of life and even longevity.
Synopsis:
- Hear Dr. Simranโs and Dr. Shaylaโs plant based journeys and their motivation to put more plants on their plates.
- Discover those important genetic mutations to be aware of for female related cancers.
- Gain an understanding of hereditary versus non-hereditary risk factors for cancer and those details that are most important.
- Explore your family history and those factors that you should be aware of as it relates to your health.
- Get the โcrunchy teaโ on the connection of your nutrition to inflammation and how this plays a part in cancer prevention including those micronutrients to look out for.
- Stay tuned next week to hear part 2 of this episodeโฆ
Connect with Essence of Health:
โ Join the FREE Nourish & Flourish 5 Day Challenge at www.DrShayla.com/NFchallenge
โLearn more about Essence of Health Wellness Clinic & Coaching at www.DrShayla.com/EOH
โClick the SUBSCRIBE button on your favorite podcast platform so that you never miss a moment of the Essence of Health Tea Time Podcast!
โGet your FREE "Healthy Tips For A Healthy Lifestyle" Guide to get you started on your health and wellness path. https://essenceofhealth.link/e-book
โFollow Dr. Shayla on social media at Essence of Health Wellness Clinic on Facebook, Instagram, and YouTube and at DrShayla on TikTok.
โ-----------------------------------------------------------------
Connect with Dr. Simran Malhotra:
Awaken Your Wellness Columnist at Everyday Health: https://www.everydayhealth.com/columns/awaken-your-wellness/
Website: https://www.coachsimranmd.com/
Instagram: @Drsimran.malhotra
LinkedIn: @Simran Malhotra
The Essence of Health is in You!
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:00):
Welcome to the Essence of Health Tea Time Podcast.
(00:12):
I am your host, Dr. Shayla Toons-Whithers.
As a double board certified family and obesity medicine physician with over 12 years of experience
in medicine, I teach motivated individuals how to achieve their desired quality of life
while preventing and reversing chronic diseases.
(00:33):
It's tea time!
What part of your health journey is most challenging?
Is it the actual effort of sticking to a plan?
The cooking and the meal planning?
The exercise routine?
Not enough time for everything you think you need to do?
Or the confusion of it all?
(00:54):
If you said yes to any of these obstacles, then keep listening to learn how you can smash
these problems just by checking your email.
You check your email inbox every day already, but what if checking your inbox brought you
better health instead of the stress it sometimes can bring?
Well, I have news for you.
(01:15):
You can improve your health, get a jump start on improving your health conditions, and start
to feel like a better version of you just by checking your email inbox over the next
5 days when you join the free Nourish and Flourish 5 Day Challenge.
You'll get health tips, actionable videos, a goal and habit tracker, and healthy recipes
(01:38):
every day for 5 days.
Better health is the best investment you'll ever make, and this is only a small investment
of your time.
You have nothing to lose, but everything to gain.
The Nourish and Flourish 5 Day Challenge was designed to set the foundation for healthy
habits for life.
(01:58):
Say yes to yourself today and sign up now at drshayla.com forward slash nfchallenge.
I'll also place these details in the show notes.
The essence of health is in you.
See you in your inbox.
On today's episode of the Essence of Health Tea Time podcast, I have a special guest,
(02:19):
Dr. Simran Nalatra.
Dr. Simran is a triple board certified physician in internal medicine, hospice and palliative
care, and lifestyle medicine, as well as a certified health and wellness coach.
She practices part time in clinical medicine and has been named a top doc for several years
by Baltimore Magazine and Palliative Medicine.
(02:40):
In addition to being a diploma of the American College of Lifestyle Medicine, she has also
completed the T. Colin Campbell Plant-Based Nutrition Certification, the Chef Culinary
Coaching Certification, and the Well Coaches Health and Wellness Certification.
On a personal note, Dr. Simran is a mother of two and a BRCA1 pre-vibrator with a strong
(03:02):
family history of breast and female reproductive cancers and has an encouraging story which
she'll share with us today regarding how she's managed this medical history at such a young
age.
After her own experience as a patient and her professional experiences in palliative
care, she founded Wellness by Lifestyle MD, a platform where she aims to educate people,
(03:25):
particularly women, at high risk of cancer like herself on the powerful impact that positive
lifestyle changes can have on their quality of life and even longevity.
Welcome to the show, Dr. Simran.
I'm so excited to have you here today.
Thanks, Dr. Shaila.
I appreciate it.
I'm so excited.
We get to talk again after the Vegan Health Summit.
(03:45):
That was so much fun.
It was.
It was.
And so for the audience, you'll have to check out Dr. Simran's page on Instagram.
We'll have those links in the show notes so that you can hear the chat that we shared
a few weeks ago.
Yeah, yeah.
So we'll start.
I want you to share your story with us.
Really, what sparked your interest in plant-based nutrition?
And just give us your story.
So I always say I didn't find lifestyle medicine and plant-based nutrition.
(04:11):
It actually found me when I became the patient.
So I come, this is like a long story, but in a nutshell, I have a very strong family
history of cancer.
My mom's a two-time breast cancer survivor.
She was first diagnosed with breast cancer at the age of 33.
So I was just 13 at the time.
Fast forward to when I was doing my medical residency, we lost another dear family member
(04:32):
on my mom's side of the family.
And that really just set off a whole bunch of flags for me.
And we went down the path of genetic testing.
We found out my mom carried the BRCA1 genetic mutation, which we can talk about.
And shortly thereafter, I was about 26, about to finish residency, decided to get tested.
And I also found out I carried the BRCA1 genetic mutation.
(04:54):
And so that then led to this whole spiral of doctor's appointments, meeting with oncologists
and breast surgeons and genetic counselors and all of that gamut of what comes with that
genetic mutation diagnosis.
And the one question that kept coming up for me over and over again, because remember I
was 26, about to get married, still doing my medical residency, and didn't have kids
(05:17):
yet.
And so while I was getting all this information about screening and surgeries and all these
things I could do to reduce my lifetime risk of breast cancer, the one thing that kept
coming up for me was like, okay, but I'm 26 and I'm not ready to do all these things.
So what is it that's in my control that I can do every day to empower myself to reduce
(05:40):
my risk of these cancers?
And it was just kind of radio silence every single time.
All my doctors said, look, you have a genetic mutation.
There's like lifestyle doesn't matter.
There's nothing you can do.
And that was extremely disempowering for me because I was also going into palliative care
at the time.
So taking care of people at the end of life.
So I had a high stress, high anxiety job, and I really needed, in order to continue
(06:03):
to do my job, I needed something in my life that could help reduce the anxiety that came
with being a patient at the same time.
And so that's when I went down the rabbit hole and did my own research and became my
own advocate and found Dr. Michael Greger, read his book, How Not to Die, probably.
(06:23):
I mean, if you've seen the book, it's like this thick.
I literally read it and then listened to it on audiobook probably like three or four times
in a matter of just a few weeks.
I consumed all of it.
And from there, it's just been a path forward.
And my family and I transitioned to a whole plant-based diet.
(06:44):
I now have two kids who are fully plant-based since birth and really became board certified
in lifestyle medicine, all the things that you said.
So it's really been a 10 year journey to get to where I am, but I just haven't looked
back.
Yeah.
And that is amazing.
It's an amazing journey there.
And it's so, it's kind of funny because our journeys are, you know, tend to be so similar
(07:06):
in a way.
And I don't even think we had chatted about this before.
So my mom is also a breast cancer survivor.
She was not diagnosed as young as yours.
And we have not found that she has the BRC aging, but she was diagnosed when I was in
medical school.
So similar, it kind of put into my mind, like, okay, well, you know, me being her daughter,
what do I need to do now, you know, to make sure that I'm preventing as much as I can.
(07:31):
And so it did put, you know, put that in my mind too.
And then after I had my first baby, it was like, yep, you know, I really need to make
sure I'm staying healthy.
You know, let me on my path to plant-based.
And it's like you said, once you, for me, I listened to the China study first on audiobook
and then Dr. Greger's.
And it's so amazing, right?
Like, I think we live in this modern world and society and, you know, family and so many
(07:58):
different aspects of our lives have so many expectations of us.
And so we just go on this path of the grind, right?
Like school, get married, have children, get a job, climb the ranks of the corporate ladder.
And we just don't stop to think about our health until it hits us in the face that like,
(08:20):
oh man, like I need to think about this.
And that's what I find fascinating about lifestyle medicine.
Cause as you know, and I know that we don't really learn anything about lifestyle or nutrition
science in medical school.
And so most doctors and health practitioners that come to this are people that, you know,
were affected either as a patient themselves or as a family member, like you said.
(08:42):
Yeah, yeah, so true.
And then the other funny thing, my husband always says, he's like, you guys are like
evangelists, you know, you plant based on it.
But it is like, once you know this, it's like, you just can't stop talking about it.
You have to tell people.
You know, like the beautiful thing is because it's not a drug and like, you know, it's not
(09:03):
something that comes with all the side effects and the complications and all that.
Like this is the one thing that we do multiple times a day and there's so much science to
prove that it works.
And not just that I tell people, I'm like, okay, if you don't even want to look at the
science, just go look at the longest living people in the world in the blue zone and look
(09:24):
at the way they eat.
Right.
Like it shows you that this will prevent all of the chronic lifestyle really.
Yeah.
Yeah.
Or even, you know, I will tell them sometimes just try it, give it a try.
Just two weeks, you know, give it a try and tell me how you feel.
And then, you know, I don't think I've ever had anybody who just gave it a try.
I'm like, oh, I felt awful.
(09:44):
They always do.
I felt great.
Right.
Right.
Exactly.
And it's like, you don't realize you're feeling bad until you're not feeling bad anymore.
You know, exactly.
So yeah.
Yeah.
If you're frustrated with your weight, taking more medications than you like to have been
told that you are at risk for the development of a chronic preventable disease or just are
(10:08):
not feeling in the best of health, then I'm talking to you.
Why?
Because you're tired of fat dieting.
You know it's time for a change and you want a sustainable plan to improve your health.
If you have found yourself at this place in life, well, I have developed a program that's
just for you.
It's called The Essence of Health and it's your prescription for transformation.
(10:32):
My goal with this program is to give you the tools needed to create sustainable lifestyle
changes within a group coaching setting along with one to one individualized coaching to
give you a personalized path to health that's just for you.
The benefits are priceless.
So join today.
Head on over to eohcoaching.com to learn more.
(10:57):
The Essence of Health is in you.
So share with us a bit more, we've talked about these BRCA genes and so for our audience
out there, share with us more about what that is and how these genetic factors play a part
in female cancer risk.
It's not something that most of us are familiar with, but what I usually say to spark people's
attention is think about Angelina Jolie and some years ago it was all over the news and
(11:22):
she shared that her mother carried and she carried the BRCA1 genefetation and she ended
up doing preventative surgeries.
So what's important for us to know about the BRCA1 gene is that we actually all carry it.
It's a normal gene that we're all born with and when it works properly, its actual role
is it's an oncoprotective gene, meaning it actually protects us from a variety of different
(11:47):
cancers including breast and ovarian and prostate if you're a male.
And when you have a genetic mutation in this gene, that's when you are like at a radically
increased risk of these cancers.
So just an example, the average woman's risk of breast cancer is about 12% over her lifetime,
(12:07):
so that means by the time she's 75.
For someone like me who has a genetic mutation in the BRCA1 gene, my lifetime risk taking
into account my very strong family history was at 26, I was told I have an 87% lifetime
risk of getting breast cancer by the time I'm 75 and for ovarian cancer it was about
50 to 60%.
(12:28):
So we're talking about like radically high numbers here, but what's reassuring to know
if you actually look at the statistic from CDC, only about 5 to 10% of the population
is affected by a hereditary mutation.
So actually most people that come in with a breast cancer diagnosis don't even have
a family history.
(12:48):
So I think that's very empowering for probably your audience and just the general population.
I think it is important and I think this is coming out more and more now, especially as
there was a recent study published showing that the rates of cancer are increasing in
younger people.
(13:09):
And this may, it's probably not like I said, not all like family or hereditary cancers,
more lifestyle related things.
However, I think it is important for us to figure out like, do we have a family history?
And so the only way we can do that is to really recognize the red flags.
(13:30):
So you want to start opening that conversation with your family, like who in your mom's side
of family or your dad's side of family has had cancer, what kind of cancer, what age
were they diagnosed at?
And remember, you can inherit a genetic mutation either from your mom's side or your dad's
side because you'll get one gene from each of them.
So I think it's, most people think like, I only get it from my mom's side, but that's
(13:55):
not true.
And then the other piece I'll say from the genetic mutation perspective is it's especially,
especially important, I think in ethnic communities, because what we see is that the numbers of
known genetic mutation carriers are very low in these communities, but I don't believe
it's because they don't exist.
(14:15):
I think it's because, at least in South Asians and I know African Americans, we just don't
talk about these things.
Culturally, it's also taboo.
I remember back when my mom was diagnosed at 13, it almost felt like she dealt with
cancer behind closed doors.
Everything was just kind of done and then no one talked about like, holy fragility,
(14:35):
like what should happen, you know what I mean?
So I think, you know, there's an underestimation of the prevalence, but that's because of lack
of talking about it, lack of screening.
Women of color tend to generally put themselves less.
So we're not even getting basic women's health issues, all of that.
(14:57):
On the other hand, like you're saying, it's so important because the mortality rate is
higher on African American women.
That mortality rate is higher, even though the rates are lower.
Right.
And I'll tell you from a palliative care perspective, right, because a lot of people are just kind
of also like just scared.
Like I don't want to know.
However, you know, when you're diagnosed with a stage three or four breast cancer or a stage
(15:22):
three or four ovarian cancer, you know, the treatments are not as effective at that stage,
later stage.
And, you know, you end up actually shortening your life and the life that you are living
tends to be in and out of the hospital, even with these very advanced and cool treatments
that we now have.
And so if you're screening, if you're talking about it, if you are risk of genetic mutation,
(15:47):
there's so much that we can do now to empower ourselves to continue to reduce our risk from
a technology perspective, like, you know, screening and surgeries, but also from a lifestyle
perspective.
So I think that that's just really a huge thing to point out.
Yeah, yeah.
And I'm so glad you mentioned, too, for people just to talk to their family members, you
(16:08):
know, as a family doctor, when I'm doing that new patient intake or that history, I would
tell you there's so many times I'll ask, you know, well, do your parents have any health
conditions?
Is this this or this running your family?
And people truly they are like, I don't know, you know, I don't know what my mom had, or
I don't know what, you know, such and such passed away from.
But it's so important to, you know, talk to your family members.
(16:29):
And if you are a parent or grandparent, start writing stuff down so that people can find
it and know this history exists, too.
Yeah.
And I hope for like our next generation, like, you know, with us having these conversations
openly, like our children are just going it's just going to be normal for them to talk about.
(16:49):
So we're breaking we're breaking these generational trauma.
Right.
Exactly.
Exactly.
Now, putting this into the perspective of nutrition and lifestyle, explain for us how
what we eat can specifically impact female related cancers like breast cancer or ovarian
cancer.
(17:09):
Well, one thing is for sure, even if your oncologist or your family doctor or your whatever
doctor doesn't give nutrition and lifestyle the validation that it deserves because it
works to address the root cause of some of many diseases.
What I will say is if you look at all of the major medical societies, so whether it's the
(17:31):
CDC, the AICR, which is the American Institute of Cancer Research, the like ASCO or NCCN,
which are the major oncology societies, if you actually go to their pages and look at
like lifestyle or nutrition dietary guidelines, almost every single one of them will recommend
to follow a predominantly whole food plant based dietary pattern.
(17:53):
That doesn't mean you have to go vegan.
That doesn't mean you have to go base because we're all unique.
We all have different needs.
And so we may not all be able to follow the same diet.
However, what they all recommend when it comes to cancer risk reduction is to follow a predominantly
plant based diet.
And there's two reasons.
I think, you know, first, cancer is a very complex disease.
(18:14):
You know, I have taken care of people at the end of life who were vegan and who did all
the right things and they still got cancer and they still passed away.
And so this is not to say that if you do a certain thing that it's going to 100% prevent
cancer, but it's really about coming from a place of empowerment and saying, okay, these
are the things that we know can reduce the risk.
(18:34):
So let's, you know, take in that and do what is in our control to reduce our risk.
Right.
So when it comes to cancer, there's two factors that I really think of that are really important.
So one is to optimize your immune system and have a healthy immune system.
And then number two is to reduce inflammation in the body.
(18:56):
And a lot of that really starts in our gut, both of those things.
And so gut health, I really think is so important to optimize for cancer risk reduction.
So when you are eating a mostly whole food plant-based diet, and I mean, I'm assuming
the people that listen, your audience probably already knows what that means because you
(19:17):
probably talk about it, but we're talking about, you know, really in the simplest terms,
eating the rainbow, right?
Right.
Fruit that come from Earth in their natural form that have not been processed, fruits,
vegetables, whole grains, nuts, seeds, beans, legumes, those sorts of things.
Right.
So we know that this sort of dietary pattern is high in nutritional density and is very
(19:39):
anti-inflammatory.
So there's a couple of things when it comes to breast cancer in particular, we don't have
as much data or science for ovarian cancers, but what I'm going to say could actually apply
to all cancer risk reduction.
Right.
But when we're talking specifically for breast cancer, you know, there's a few things that
you get from this dietary pattern.
Number one is antioxidants.
(19:59):
So when you think about, when we say eat the rainbow, what that means is every single,
think about all the different colors you get from different plant foods, those signify
their antioxidant capabilities.
And antioxidants, basically what they do is there's something called free radicals that
(20:20):
develop in our body just from waking up every day and the general processes our body has
to take to keep us alive, our environment and all the different influences that we have
can develop free radicals.
And over time, these free radicals can lead to DNA damage and, you know, ultimately down
the road sometimes can initiate the process of cancer cells.
(20:40):
And so these antioxidants can neutralize these free radicals and destroy them.
And so they're actually very protective for our DNA and for our cells.
So they also support our immune system.
And then number two is fiber.
So when you are eating a whole food plant-based diet, you're getting fiber and fiber is only
found in plant foods.
(21:01):
And I don't think most people realize that.
It actually, it was like one of the first things that like made sense to me.
I was like, oh, wow.
Like, it is.
Once you say it, it's like a light bulb, you know, kind of good stuff.
Right.
Oh, that's true.
Right.
And the reality is, is that if you look at the consumption of fiber in the standard American
diet, the average American takes about 10 to 15 grams of fiber a day.
(21:26):
And if you look at the recommendations from like the American Cancer Institute or, you
know, all of these big cancer societies, you know, they're saying that we should really
be eating anywhere from 25 to 30 grams of fiber a day to reduce our risk of cancer.
And when it comes to breast cancer in particular, there are studies to show that women who have
(21:46):
a high fiber diet actually can like, and we're talking like 30 grams of fiber a day can drop
breast cancer risk by like 40%.
So and fiber is also associated with other cancer risk reduction as well, especially
colorectal cancer.
So I think those are the two things when it comes to plant-based diets that you really,
you really get for cancer risk reduction.
(22:09):
And then, you know, I like, and you know me because we've talked before, but like, I really
like to focus on abundance.
So think about all the things you can eat that are going to reduce your risk of cancer.
However, having said that, there are a lot of foods out there that are pro-inflammatory
and can add to the problem.
(22:30):
They can reduce our-
Even before you get to that Dr. Kramer, I wanted to touch on because what you're mentioning
with the rainbow, and a lot of people don't tend to realize that why we say the rainbow
is for folks listening those color, the different colors of these plant foods, the pigments
actually contain these vitamins and these nutrients and these antioxidants that Dr.
(22:51):
Simran is just talking about, but then the pigments.
So that's why you want to get all these different colors of foods on your plate and into your
body so that you are getting all of those really good things for you, those antioxidants
and those anti-inflammatory properties from the food.
And then the other thing I wanted to just even highlight more what you were saying about
(23:12):
fiber.
Folks have been listening to this podcast and they already know I'm not a keto person.
It's another reason why I say no keto because you need these carbs.
The carbs should be eaten.
It's the reason that it's a macronutrient.
And fiber, fiber is good for us.
So another reason to eat these healthful carbs.
(23:32):
So your fruits, your vegetables, your whole grains, eat these things because they are,
they are helpful for you.
Yeah.
And I think like, you know, society and culture and all those things that kind of made carbs
the enemy.
And so everyone's kind of trying to always limit their carbs for whatever reason, weight
loss, you know, metabolic health, whatever, all the things, but it's really about the
(23:56):
quality of the carb.
Right.
So an apple is a carb, but so is a Twinkie.
You know, you have to really look at the quality of the carbs.
So when you're eating whole plant-based foods like the apple or all the things that Dr.
Sheila just mentioned, you're getting the whole package.
So you're getting the antioxidants, you're getting the vitamins and minerals, you're
(24:16):
getting the fiber, you're getting protein, you're getting everything packaged in that
one food.
Whereas when you're eating the Twinkie, you know, this is a highly processed, refined
carb that has been stripped of all its nutritional values.
So you're not going to find any fiber, you're not going to find any vitamins or minerals,
you're not going to find any protein, you're not going to find any of the good stuff.
(24:39):
And in fact, you know, it's been loaded with refined sugar and added oils and all sorts
of ingredients that were made in a factory.
A lot of the things you probably can't even pronounce.
Right, exactly.
Because it's also the flag that you probably don't want to consume it.
Yeah.
Although I will point out there because that's the common thing that you see, I feel like,
on social media where these health influencers that are like, oh, you know, don't eat chemicals,
(25:07):
like foods that have chemicals that you can't pronounce.
And you have to be careful with that because it's true when you eat, when you look at the
package of a Twinkie, there's going to be all these like words that you can't pronounce
and those are highly processed chemicals made in a factory or in a lab or whatever.
But if you look at all the antioxidants that Dr. Shaila was just talking about, so for
(25:29):
example, in carrots, you have beta carotene, in grapes, you have resveratrol, in broccoli,
you have isothiocyanate.
So, I mean, those are all fancy chemical words as well.
And they are, they're phytochemicals, plant chemicals.
However, those are healthy.
So what I'll say is also not all chemicals are bad for you.
(25:49):
Right.
Yeah, yeah.
So, the key is the package because your apple is not going to come on a package.
So it's not even going to have a label on it to begin with.
So yeah, exactly.
Exactly.
Exactly.
Yeah.
Great point.
Yeah.
Thank you for joining me today on the Essence of Health Tea Time podcast.
Click the subscribe button on your favorite podcast platform so that you never miss a
(26:14):
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Check out the show notes to obtain your free tips for Healthy Living Guide to get you started
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Follow me on social media at Essence of Health Wellness Clinic on Facebook, Instagram, and
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(26:39):
Interested in becoming a member of the Essence of Health coaching program?
Go head on over to www.eohcoaching.com.
The Essence of Health is a year.
Welcome to the Essence of Health Tea Time Podcast.
(00:12):
I am your host, Dr. Shayla Toons-Whithers.
As a double board certified family and obesity medicine physician with over 12 years of experience
in medicine, I teach motivated individuals how to achieve their desired quality of life
while preventing and reversing chronic diseases.
(00:33):
It's tea time!
What part of your health journey is most challenging?
Is it the actual effort of sticking to a plan?
The cooking and the meal planning?
The exercise routine?
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Or the confusion of it all?
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If you said yes to any of these obstacles, then keep listening to learn how you can smash
these problems just by checking your email.
You check your email inbox every day already, but what if checking your inbox brought you
better health instead of the stress it sometimes can bring?
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Say yes to yourself today and sign up now at drshayla.com forward slash nfchallenge.
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On today's episode of the Essence of Health Tea Time podcast, I have a special guest,
(02:19):
Dr. Simran Nalatra.
Dr. Simran is a triple board certified physician in internal medicine, hospice and palliative
care, and lifestyle medicine, as well as a certified health and wellness coach.
She practices part time in clinical medicine and has been named a top doc for several years
by Baltimore Magazine and Palliative Medicine.
(02:40):
In addition to being a diploma of the American College of Lifestyle Medicine, she has also
completed the T. Colin Campbell Plant-Based Nutrition Certification, the Chef Culinary
Coaching Certification, and the Well Coaches Health and Wellness Certification.
On a personal note, Dr. Simran is a mother of two and a BRCA1 pre-vibrator with a strong
(03:02):
family history of breast and female reproductive cancers and has an encouraging story which
she'll share with us today regarding how she's managed this medical history at such a young
age.
After her own experience as a patient and her professional experiences in palliative
care, she founded Wellness by Lifestyle MD, a platform where she aims to educate people,
(03:25):
particularly women, at high risk of cancer like herself on the powerful impact that positive
lifestyle changes can have on their quality of life and even longevity.
Welcome to the show, Dr. Simran.
I'm so excited to have you here today.
Thanks, Dr. Shaila.
I appreciate it.
I'm so excited.
We get to talk again after the Vegan Health Summit.
(03:45):
That was so much fun.
It was.
It was.
And so for the audience, you'll have to check out Dr. Simran's page on Instagram.
We'll have those links in the show notes so that you can hear the chat that we shared
a few weeks ago.
Yeah, yeah.
So we'll start.
I want you to share your story with us.
Really, what sparked your interest in plant-based nutrition?
And just give us your story.
So I always say I didn't find lifestyle medicine and plant-based nutrition.
(04:11):
It actually found me when I became the patient.
So I come, this is like a long story, but in a nutshell, I have a very strong family
history of cancer.
My mom's a two-time breast cancer survivor.
She was first diagnosed with breast cancer at the age of 33.
So I was just 13 at the time.
Fast forward to when I was doing my medical residency, we lost another dear family member
(04:32):
on my mom's side of the family.
And that really just set off a whole bunch of flags for me.
And we went down the path of genetic testing.
We found out my mom carried the BRCA1 genetic mutation, which we can talk about.
And shortly thereafter, I was about 26, about to finish residency, decided to get tested.
And I also found out I carried the BRCA1 genetic mutation.
(04:54):
And so that then led to this whole spiral of doctor's appointments, meeting with oncologists
and breast surgeons and genetic counselors and all of that gamut of what comes with that
genetic mutation diagnosis.
And the one question that kept coming up for me over and over again, because remember I
was 26, about to get married, still doing my medical residency, and didn't have kids
(05:17):
yet.
And so while I was getting all this information about screening and surgeries and all these
things I could do to reduce my lifetime risk of breast cancer, the one thing that kept
coming up for me was like, okay, but I'm 26 and I'm not ready to do all these things.
So what is it that's in my control that I can do every day to empower myself to reduce
(05:40):
my risk of these cancers?
And it was just kind of radio silence every single time.
All my doctors said, look, you have a genetic mutation.
There's like lifestyle doesn't matter.
There's nothing you can do.
And that was extremely disempowering for me because I was also going into palliative care
at the time.
So taking care of people at the end of life.
So I had a high stress, high anxiety job, and I really needed, in order to continue
(06:03):
to do my job, I needed something in my life that could help reduce the anxiety that came
with being a patient at the same time.
And so that's when I went down the rabbit hole and did my own research and became my
own advocate and found Dr. Michael Greger, read his book, How Not to Die, probably.
(06:23):
I mean, if you've seen the book, it's like this thick.
I literally read it and then listened to it on audiobook probably like three or four times
in a matter of just a few weeks.
I consumed all of it.
And from there, it's just been a path forward.
And my family and I transitioned to a whole plant-based diet.
(06:44):
I now have two kids who are fully plant-based since birth and really became board certified
in lifestyle medicine, all the things that you said.
So it's really been a 10 year journey to get to where I am, but I just haven't looked
back.
Yeah.
And that is amazing.
It's an amazing journey there.
And it's so, it's kind of funny because our journeys are, you know, tend to be so similar
(07:06):
in a way.
And I don't even think we had chatted about this before.
So my mom is also a breast cancer survivor.
She was not diagnosed as young as yours.
And we have not found that she has the BRC aging, but she was diagnosed when I was in
medical school.
So similar, it kind of put into my mind, like, okay, well, you know, me being her daughter,
what do I need to do now, you know, to make sure that I'm preventing as much as I can.
(07:31):
And so it did put, you know, put that in my mind too.
And then after I had my first baby, it was like, yep, you know, I really need to make
sure I'm staying healthy.
You know, let me on my path to plant-based.
And it's like you said, once you, for me, I listened to the China study first on audiobook
and then Dr. Greger's.
And it's so amazing, right?
Like, I think we live in this modern world and society and, you know, family and so many
(07:58):
different aspects of our lives have so many expectations of us.
And so we just go on this path of the grind, right?
Like school, get married, have children, get a job, climb the ranks of the corporate ladder.
And we just don't stop to think about our health until it hits us in the face that like,
(08:20):
oh man, like I need to think about this.
And that's what I find fascinating about lifestyle medicine.
Cause as you know, and I know that we don't really learn anything about lifestyle or nutrition
science in medical school.
And so most doctors and health practitioners that come to this are people that, you know,
were affected either as a patient themselves or as a family member, like you said.
(08:42):
Yeah, yeah, so true.
And then the other funny thing, my husband always says, he's like, you guys are like
evangelists, you know, you plant based on it.
But it is like, once you know this, it's like, you just can't stop talking about it.
You have to tell people.
You know, like the beautiful thing is because it's not a drug and like, you know, it's not
(09:03):
something that comes with all the side effects and the complications and all that.
Like this is the one thing that we do multiple times a day and there's so much science to
prove that it works.
And not just that I tell people, I'm like, okay, if you don't even want to look at the
science, just go look at the longest living people in the world in the blue zone and look
(09:24):
at the way they eat.
Right.
Like it shows you that this will prevent all of the chronic lifestyle really.
Yeah.
Yeah.
Or even, you know, I will tell them sometimes just try it, give it a try.
Just two weeks, you know, give it a try and tell me how you feel.
And then, you know, I don't think I've ever had anybody who just gave it a try.
I'm like, oh, I felt awful.
(09:44):
They always do.
I felt great.
Right.
Right.
Exactly.
And it's like, you don't realize you're feeling bad until you're not feeling bad anymore.
You know, exactly.
So yeah.
Yeah.
If you're frustrated with your weight, taking more medications than you like to have been
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The Essence of Health is in you.
So share with us a bit more, we've talked about these BRCA genes and so for our audience
out there, share with us more about what that is and how these genetic factors play a part
in female cancer risk.
It's not something that most of us are familiar with, but what I usually say to spark people's
attention is think about Angelina Jolie and some years ago it was all over the news and
(11:22):
she shared that her mother carried and she carried the BRCA1 genefetation and she ended
up doing preventative surgeries.
So what's important for us to know about the BRCA1 gene is that we actually all carry it.
It's a normal gene that we're all born with and when it works properly, its actual role
is it's an oncoprotective gene, meaning it actually protects us from a variety of different
(11:47):
cancers including breast and ovarian and prostate if you're a male.
And when you have a genetic mutation in this gene, that's when you are like at a radically
increased risk of these cancers.
So just an example, the average woman's risk of breast cancer is about 12% over her lifetime,
(12:07):
so that means by the time she's 75.
For someone like me who has a genetic mutation in the BRCA1 gene, my lifetime risk taking
into account my very strong family history was at 26, I was told I have an 87% lifetime
risk of getting breast cancer by the time I'm 75 and for ovarian cancer it was about
50 to 60%.
(12:28):
So we're talking about like radically high numbers here, but what's reassuring to know
if you actually look at the statistic from CDC, only about 5 to 10% of the population
is affected by a hereditary mutation.
So actually most people that come in with a breast cancer diagnosis don't even have
a family history.
(12:48):
So I think that's very empowering for probably your audience and just the general population.
I think it is important and I think this is coming out more and more now, especially as
there was a recent study published showing that the rates of cancer are increasing in
younger people.
(13:09):
And this may, it's probably not like I said, not all like family or hereditary cancers,
more lifestyle related things.
However, I think it is important for us to figure out like, do we have a family history?
And so the only way we can do that is to really recognize the red flags.
(13:30):
So you want to start opening that conversation with your family, like who in your mom's side
of family or your dad's side of family has had cancer, what kind of cancer, what age
were they diagnosed at?
And remember, you can inherit a genetic mutation either from your mom's side or your dad's
side because you'll get one gene from each of them.
So I think it's, most people think like, I only get it from my mom's side, but that's
(13:55):
not true.
And then the other piece I'll say from the genetic mutation perspective is it's especially,
especially important, I think in ethnic communities, because what we see is that the numbers of
known genetic mutation carriers are very low in these communities, but I don't believe
it's because they don't exist.
(14:15):
I think it's because, at least in South Asians and I know African Americans, we just don't
talk about these things.
Culturally, it's also taboo.
I remember back when my mom was diagnosed at 13, it almost felt like she dealt with
cancer behind closed doors.
Everything was just kind of done and then no one talked about like, holy fragility,
(14:35):
like what should happen, you know what I mean?
So I think, you know, there's an underestimation of the prevalence, but that's because of lack
of talking about it, lack of screening.
Women of color tend to generally put themselves less.
So we're not even getting basic women's health issues, all of that.
(14:57):
On the other hand, like you're saying, it's so important because the mortality rate is
higher on African American women.
That mortality rate is higher, even though the rates are lower.
Right.
And I'll tell you from a palliative care perspective, right, because a lot of people are just kind
of also like just scared.
Like I don't want to know.
However, you know, when you're diagnosed with a stage three or four breast cancer or a stage
(15:22):
three or four ovarian cancer, you know, the treatments are not as effective at that stage,
later stage.
And, you know, you end up actually shortening your life and the life that you are living
tends to be in and out of the hospital, even with these very advanced and cool treatments
that we now have.
And so if you're screening, if you're talking about it, if you are risk of genetic mutation,
(15:47):
there's so much that we can do now to empower ourselves to continue to reduce our risk from
a technology perspective, like, you know, screening and surgeries, but also from a lifestyle
perspective.
So I think that that's just really a huge thing to point out.
Yeah, yeah.
And I'm so glad you mentioned, too, for people just to talk to their family members, you
(16:08):
know, as a family doctor, when I'm doing that new patient intake or that history, I would
tell you there's so many times I'll ask, you know, well, do your parents have any health
conditions?
Is this this or this running your family?
And people truly they are like, I don't know, you know, I don't know what my mom had, or
I don't know what, you know, such and such passed away from.
But it's so important to, you know, talk to your family members.
(16:29):
And if you are a parent or grandparent, start writing stuff down so that people can find
it and know this history exists, too.
Yeah.
And I hope for like our next generation, like, you know, with us having these conversations
openly, like our children are just going it's just going to be normal for them to talk about.
(16:49):
So we're breaking we're breaking these generational trauma.
Right.
Exactly.
Exactly.
Now, putting this into the perspective of nutrition and lifestyle, explain for us how
what we eat can specifically impact female related cancers like breast cancer or ovarian
cancer.
(17:09):
Well, one thing is for sure, even if your oncologist or your family doctor or your whatever
doctor doesn't give nutrition and lifestyle the validation that it deserves because it
works to address the root cause of some of many diseases.
What I will say is if you look at all of the major medical societies, so whether it's the
(17:31):
CDC, the AICR, which is the American Institute of Cancer Research, the like ASCO or NCCN,
which are the major oncology societies, if you actually go to their pages and look at
like lifestyle or nutrition dietary guidelines, almost every single one of them will recommend
to follow a predominantly whole food plant based dietary pattern.
(17:53):
That doesn't mean you have to go vegan.
That doesn't mean you have to go base because we're all unique.
We all have different needs.
And so we may not all be able to follow the same diet.
However, what they all recommend when it comes to cancer risk reduction is to follow a predominantly
plant based diet.
And there's two reasons.
I think, you know, first, cancer is a very complex disease.
(18:14):
You know, I have taken care of people at the end of life who were vegan and who did all
the right things and they still got cancer and they still passed away.
And so this is not to say that if you do a certain thing that it's going to 100% prevent
cancer, but it's really about coming from a place of empowerment and saying, okay, these
are the things that we know can reduce the risk.
(18:34):
So let's, you know, take in that and do what is in our control to reduce our risk.
Right.
So when it comes to cancer, there's two factors that I really think of that are really important.
So one is to optimize your immune system and have a healthy immune system.
And then number two is to reduce inflammation in the body.
(18:56):
And a lot of that really starts in our gut, both of those things.
And so gut health, I really think is so important to optimize for cancer risk reduction.
So when you are eating a mostly whole food plant-based diet, and I mean, I'm assuming
the people that listen, your audience probably already knows what that means because you
(19:17):
probably talk about it, but we're talking about, you know, really in the simplest terms,
eating the rainbow, right?
Right.
Fruit that come from Earth in their natural form that have not been processed, fruits,
vegetables, whole grains, nuts, seeds, beans, legumes, those sorts of things.
Right.
So we know that this sort of dietary pattern is high in nutritional density and is very
(19:39):
anti-inflammatory.
So there's a couple of things when it comes to breast cancer in particular, we don't have
as much data or science for ovarian cancers, but what I'm going to say could actually apply
to all cancer risk reduction.
Right.
But when we're talking specifically for breast cancer, you know, there's a few things that
you get from this dietary pattern.
Number one is antioxidants.
(19:59):
So when you think about, when we say eat the rainbow, what that means is every single,
think about all the different colors you get from different plant foods, those signify
their antioxidant capabilities.
And antioxidants, basically what they do is there's something called free radicals that
(20:20):
develop in our body just from waking up every day and the general processes our body has
to take to keep us alive, our environment and all the different influences that we have
can develop free radicals.
And over time, these free radicals can lead to DNA damage and, you know, ultimately down
the road sometimes can initiate the process of cancer cells.
(20:40):
And so these antioxidants can neutralize these free radicals and destroy them.
And so they're actually very protective for our DNA and for our cells.
So they also support our immune system.
And then number two is fiber.
So when you are eating a whole food plant-based diet, you're getting fiber and fiber is only
found in plant foods.
(21:01):
And I don't think most people realize that.
It actually, it was like one of the first things that like made sense to me.
I was like, oh, wow.
Like, it is.
Once you say it, it's like a light bulb, you know, kind of good stuff.
Right.
Oh, that's true.
Right.
And the reality is, is that if you look at the consumption of fiber in the standard American
diet, the average American takes about 10 to 15 grams of fiber a day.
(21:26):
And if you look at the recommendations from like the American Cancer Institute or, you
know, all of these big cancer societies, you know, they're saying that we should really
be eating anywhere from 25 to 30 grams of fiber a day to reduce our risk of cancer.
And when it comes to breast cancer in particular, there are studies to show that women who have
(21:46):
a high fiber diet actually can like, and we're talking like 30 grams of fiber a day can drop
breast cancer risk by like 40%.
So and fiber is also associated with other cancer risk reduction as well, especially
colorectal cancer.
So I think those are the two things when it comes to plant-based diets that you really,
you really get for cancer risk reduction.
(22:09):
And then, you know, I like, and you know me because we've talked before, but like, I really
like to focus on abundance.
So think about all the things you can eat that are going to reduce your risk of cancer.
However, having said that, there are a lot of foods out there that are pro-inflammatory
and can add to the problem.
(22:30):
They can reduce our-
Even before you get to that Dr. Kramer, I wanted to touch on because what you're mentioning
with the rainbow, and a lot of people don't tend to realize that why we say the rainbow
is for folks listening those color, the different colors of these plant foods, the pigments
actually contain these vitamins and these nutrients and these antioxidants that Dr.
(22:51):
Simran is just talking about, but then the pigments.
So that's why you want to get all these different colors of foods on your plate and into your
body so that you are getting all of those really good things for you, those antioxidants
and those anti-inflammatory properties from the food.
And then the other thing I wanted to just even highlight more what you were saying about
(23:12):
fiber.
Folks have been listening to this podcast and they already know I'm not a keto person.
It's another reason why I say no keto because you need these carbs.
The carbs should be eaten.
It's the reason that it's a macronutrient.
And fiber, fiber is good for us.
So another reason to eat these healthful carbs.
(23:32):
So your fruits, your vegetables, your whole grains, eat these things because they are,
they are helpful for you.
Yeah.
And I think like, you know, society and culture and all those things that kind of made carbs
the enemy.
And so everyone's kind of trying to always limit their carbs for whatever reason, weight
loss, you know, metabolic health, whatever, all the things, but it's really about the
(23:56):
quality of the carb.
Right.
So an apple is a carb, but so is a Twinkie.
You know, you have to really look at the quality of the carbs.
So when you're eating whole plant-based foods like the apple or all the things that Dr.
Sheila just mentioned, you're getting the whole package.
So you're getting the antioxidants, you're getting the vitamins and minerals, you're
(24:16):
getting the fiber, you're getting protein, you're getting everything packaged in that
one food.
Whereas when you're eating the Twinkie, you know, this is a highly processed, refined
carb that has been stripped of all its nutritional values.
So you're not going to find any fiber, you're not going to find any vitamins or minerals,
you're not going to find any protein, you're not going to find any of the good stuff.
(24:39):
And in fact, you know, it's been loaded with refined sugar and added oils and all sorts
of ingredients that were made in a factory.
A lot of the things you probably can't even pronounce.
Right, exactly.
Because it's also the flag that you probably don't want to consume it.
Yeah.
Although I will point out there because that's the common thing that you see, I feel like,
on social media where these health influencers that are like, oh, you know, don't eat chemicals,
(25:07):
like foods that have chemicals that you can't pronounce.
And you have to be careful with that because it's true when you eat, when you look at the
package of a Twinkie, there's going to be all these like words that you can't pronounce
and those are highly processed chemicals made in a factory or in a lab or whatever.
But if you look at all the antioxidants that Dr. Shaila was just talking about, so for
(25:29):
example, in carrots, you have beta carotene, in grapes, you have resveratrol, in broccoli,
you have isothiocyanate.
So, I mean, those are all fancy chemical words as well.
And they are, they're phytochemicals, plant chemicals.
However, those are healthy.
So what I'll say is also not all chemicals are bad for you.
(25:49):
Right.
Yeah, yeah.
So, the key is the package because your apple is not going to come on a package.
So it's not even going to have a label on it to begin with.
So yeah, exactly.
Exactly.
Exactly.
Yeah.
Great point.
Yeah.
Thank you for joining me today on the Essence of Health Tea Time podcast.
Click the subscribe button on your favorite podcast platform so that you never miss a
(26:14):
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