Sep 3, 2019

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A Young Doctor's Turning Point

Dr. Rich Doxey is a culinary medicine expert and physician at the internal medicine clinic of University of Utah Health. He's a young doctor who decided to start taking his health seriously during his undergraduate studies.

Rich had no medical problems at the time, but after reading a book on nutrition he started taking control of his health. He had read about how food interacts with your genes and your body. He learned that the food you put into your body creates chemical changes the same way medicine can, so nutrition needs to be taken seriously.

He swapped out frozen burritos and occasional fast food, for fresh fruits, vegetables, nuts and whole grains. He soon was cooking his own meals from scratch every day.

He feels that he has avoided a lot of illness due to his diet change and taking his nutrition seriously.

What is Culinary Medicine?

Dr. Doxey's early interest in his own diet led him down a path as he entered medical school. He had a strong desire to get engaged with ‘lifestyle medicine' that not only treats and prevents illness in patients, but teaches them how to take control of their own health.

There were not a lot of options available in medical school or this new field of medicine, but that changed in residency. Dr. Doxey searched online and found Dr. Timothy Harlan, a doctor running a website called "Dr. Gourmet." It focused on treating serious health conditions through dietary changes and approaching food as medicine. Dr. Doxey was inspired and after a bit of work, found himself in New Orleans as the first resident to study culinary medicine under Dr. Harlan.

Dr. Doxey would work in the New Orlean's teaching kitchen, running cooking classes that taught members in the community how the skills and nutritional know-how to cook healthy dishes that were cost effective, fast, and - most importantly - delicious. And he would bring the culinary medicine skills he learned in New Orleans back to Utah and apply them to his practice.

The Mediterranean Diet is One of the Best Diets

For patients looking to change their diet, Dr. Doxey will begin with taking a 24 hour diet history to get a feeling of what the patients are already eating. He then prescribes one to two small changes they can make today to help improve their lifestyle.

He makes his recommendations based on science and research. And he has found that the Mediterranean Diet is the most researched, most evidence based diet strategy, to show significant improvement in heart health and promote weight loss.

The second most effective diet is a vegan-whole food plant based diet, but he has found that it is very difficult for most patients to sustain such a drastic change in their daily eating habits.

One of the major strengths of the mediterranean diet is that it is based on a set of principles that can be easily adapted to fit any patient's needs:

  1. Eat a lot of fruits, vegetables, and whole grains
  2. Eat fish a couple times a week
  3. Use more unsaturated fats than saturated fats
  4. Limit dairy and red meat to less than a serving a day
  5. Consume only a moderate amount of alcohol

How to Overcome the Biggest Barriers to Changing Your Diet

Dr. Doxey says there are three major barriers for his patients adopting a healthier diet: Time, cost, and staying power. He explains the challenge each one poses to a patient's efforts and how to overcome them.

  • Time - Time is the biggest challenge to dietary changes. Buying ingredients and cooking your own meals can seem to take a lot of time out of your day, especially if you have a busy job or kids to take care of. But Doxey insists that if you actually compare the time to cook your own food to the time it takes to go out, the difference in negligible. By the time you drive to a restaurant, sit down, wait for the food, pay the bill, and drive home, you could have cooked dinner at home. The secret is to keep your meals simple so they don't take a lot of time to prepare.
  • Cost - Buying fresh produce and whole foods every week can seem to cost more at the checkout line than the processed option, but it doesn't have to be. Doxey repeats to "keep it simple." Don't just buy the expensive so-called superfoods with the fancy packaging. Stick to the basics. The staples of a healthy diet will be legumes and brown rice. Buy them in bulk and they won't hurt your wallet. Also minimize your food waste by learning to repurpose ingredients from one dish to another and actually eat your leftovers. Less food waste means less wasted money. Do it right and cooking at home can cost much less than eating out.
  • Staying power - The first week on a healthy diet can be a bit challenging, but doable. It's the second, third, seventh week where willpower can falter. Dr. Doxey suggest you commit and get social support. Get your spouse, partner, or friends onboard with your healthier diet.

Dr. Doxey's background in culinary medicine has shown him that all of these barriers can be easier to overcome if a patient has the ability to cook. Watch some videos online, take a cooking course. Your ability to eat healthier can best be served having some training to make healthy food quickly and make that healthy food taste delicious.

If a Truck Driver Can Do It, So Can You

One of Dr. Doxey's success stories came from a trucker. The truck driving lifestyle sure doesn't make healthy living easy. Long hours of the day are spent sitting behind a wheel. Fast food and quick bites at gas stations are the norm. It can be tough to stay in shape.

This patient came to Dr. Doxey after getting some blood work test results back. He was in the early stages of diabetes and had gained over 100 pounds from driving and eating road food. If his diabetes progressed, he would have to start taking insulin, which would mean he couldn't drive anymore. He found himself not only in a health crisis, but in danger of losing his job. It was time to make a change.

By adopting the tenants of the mediterranean diet and following Dr. Doxey's nutritional recommendations, this trucker turned things around. Over the course of a few months he started losing a significant amount of weight. His diabetes marker dropped 0.6 points, which kept him in a healthy range. After changing his diet, he prevented himself from developing full diabetes, kept himself from needing insulin, and he kept his job.

For the rest of us, this story should serve as inspiration. Most of us aren't stuck sitting behind the wheel of a truck for most of the day, eating nothing but road food. If a trucker can get their diet and health on track, so can you.

First Steps to Improving Your Diet

Dr. Doxey likes to keep things simple when it comes to diet. Cook simple meals that are cheap and don't take much time. Stick to the handful of rules of the mediterranean diet. His strategy for improving a patient's diet are straight forward too.

First, assess where you are. Write down everything you ate over the past 24 hours. No need for a month's worth of logging food. Just remember the last few meals, snacks, drinks, etc. and write them down. Take a hard look at what you're eating and see if there's anything that needs to change.

Next, start by making one or two small "congruent" dietary changes with your next meal. Dr. Doxey explains that a "congruent change" is one that stay in line with the eating habits and food you already like to eat.

It's near impossible to go directly from eating cheeseburgers and fries for lunch to a small serving of hummus and carrot sticks. Keep it simple. Make small changes and build on them.

Go from eating a cheeseburger and fries, to a hamburger with lots of vegetables and sweet potato fries. Next, replace those sweet potato fries with a baked sweet potatoes. Eventually swap out that hamburger to a chicken sandwich. Slowly but surely, these small congruent changes build up, without the shock of switching to the stereotypical health food overnight.

"Don't go whole hog on your diet," says Dr. Doxey, "It makes it impossible to maintain."

Just Going to Leave This Here

On this episode's Just Going to Leave This Here, Scot has declared war on single use plastics and it's proving harder than he imagined. And Troy is shocked by a new study that shows a spike in avocado related knife injuries. Really. ER docs have seen a 10 fold increase in avocado knife injuries since 2013.

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