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Welcome to another episode of The Egg Whisperer Show. I am so excited to have Dr. Sneha Kishore, a dear friend of mine and lifestyle medicine expert join us today.
Dr. Aimee: Thank you for coming on to talk about something that you are so passionate about. I am so passionate about fertility medicine and I know that you are so passionate about lifestyle medicine.
Would you just tell our listeners a little bit more about yourself?
Dr. Sneha Kishore: I have been a hospital-based physician for the last 11 years after training. And in that time, I’ve seen a lot of disease, a lot of illness in the latter stages when they come in needing to be hospitalized, when they’re needing amputations or dialysis or surgeries, cancers, newly diagnosing the cancer. I’ve seen a lot of the horrific turns that health can take. And I was always wondering why. Some of these diseases, why are they happening? They don’t have family history, no genetic markers, what’s going on? And about six years ago, my own journey led me to the practice of lifestyle medicine. Which is really a new up and coming field where it focuses on chronic disease and root causes of those. And I decided that I needed to make a turn and that’s what led me to a lifestyle medicine practice, and here I am.
Dr. Aimee: What’s the name of your practice?
Dr. Sneha Kishore: ARGOW Health. The name comes from the letters of my children’s names. For some reason it just came to me and it always stuck and I never found another name that I wanted to go with. They are my life, and so that’s the name.
Dr. Aimee: You told us a lot so far about why lifestyle medicine is important to you, but what exactly is it and what is your approach to care?
Dr. Sneha Kishore: Lifestyle medicine is the practice of taking lifestyle factors and helping families and individuals make changes that will be meaningful and sustainable to help hopefully prevent and reverse chronic diseases like obesity, diabetes type 2, high blood pressure, coronary artery disease, hopefully cancers, autoimmune disorders.
It consists of six pillars which are:
Sleep — adequate quality and quantity of sleep, which is often neglected.
Physical activity and not a sedentary lifestyle.
Avoidance of risky substances like alcohol, tobacco, vaping and other drugs.
Social connectivity and connectedness.
The sense of belonging and purpose and stress management
Dr. Aimee: One of the things that my patients struggle with as they are taking all these fertility drugs is, they deal with is weight gain. It comes out of nowhere, and it is so difficult for them sometimes to lose weight.
What is your approach to care like that? If let’s say I had a patient and I’m referring her or him to you, what can they expect?
Dr. Sneha Kishore: It is very individualized because everyone comes with their own set of trigger points. Many of these hormonal drugs can affect mood, weight gain, water balance et cetera. In the first few meetings with a patient we look at the individual’s trigger points and what we can do to address them, and then we work from there. It is very individualized and very personal.
It really comes down to the individual’s triggers. Some people may want to eat in moments of stress. Some people don’t eat at all in moments of stress. And when they’re a little bit more happy and relaxed, they may overcompensate and eat. Other people may not be eating the right foods. They may be eating reasonable quantities, but just not the right things.
We go appointment to appointment and work through and talk through issues to guide them in the right direction.
Dr. Aimee: I love that. It sounds like there isn’t one particular diet that you recommend. And the other question I have for you is something personal to me, is, how do you tell your patients to think about calories?
Dr. Sneha Kishore: The good thing is, I don’t. I don’t promote counting calories unless there’s a real medical need, which I can’t even think of one off the top of my head. Calories are really more for the nutrition label. For the individual, it is just about enjoying food and knowing that you’re eating the right foods.
If you are eating the right foods, what you put in automatically sends signals to your satiety center and says, I am full. I don’t need any more nutrition. I’m happy you gave me the right stuff and let’s go. What do we need to do?
It is just when we eat the wrong foods, highly processed, highly sugared, highly caffeinated. That’s when we go down a rabbit hole of excessive food intake and things like that. If you’re eating the right foods, you really don’t need to count calories.
Dr. Aimee: What exactly does that mean? What are the right foods? If I told the patient, eat the right foods, what can I do better as far as giving them bullet points or lists of things to be thinking about?
Dr. Sneha Kishore: The first and foremost is to eat what we call “whole foods.” And the second part of that is eating a predominantly plant-based diet.
“Whole foods” are unprocessed or minimally processed, like steel cut oats or old-fashioned oats, whole grains, like corn, barley. You want to look for fruits and vegetables that are not canned in sugar or syrup. Foods like avocados, nuts, seeds; all of those come under whole foods.
And focus on a plant-based diet because plant-based foods contain all your nutrients, your phytochemicals, your antioxidants, and most importantly fiber. Animal-based foods do not contain any fiber. And we need fiber to feel full, to feel satisfied and to help our gut regulate itself, to keep everything running smoothly.
Dr. Aimee: There are a lot of trends out there, diet trends, and I get these questions and I just don’t necessarily know the answer, because I’m not an expert in the different diets. But the one diet that I hear a lot about right now that my patients are following is the Keto diet.
As an expert, what do you think about the Keto diet?
Dr. Sneha Kishore: The Keto diet is a repackaged version of the Atkins diet. You get rid of a lot of the processed carbohydrates and sugars and things like that, which is great.
The negative is that you get a lot of saturated fat and a lot of animal products, which is not good. We all know that saturated fat is not good for our arteries and our body. Animal-based foods have a lot of negative effects, including the type of iron found in animal-based meats. Plant-based iron is much more usable to our body.
There is some up and coming research in whole food, plant-based keto diets, which may have a small impact in diabetes. But there is still a lot of research to be done.
The other thing is, ketosis (which you enter when eating a Keto diet, and hence the name) is a state of stress for the body. I do not feel that a Keto diet is a safe diet in the long-term. For a short span, yes it might help you lose weight. But we are not living our life for a short span.
We are trying to live a long healthy and physically active and vibrant life. And if you want to fit into that dress next month, okay. But ultimately we want to fit into a dress for life and we want to be healthy. You can get the same benefits with a whole food plant-based diet without the unknown side effects of a long-term keto diet.
Dr. Aimee: Great. And what about for women who are planning a pregnancy or are pregnant and they are on a plant-based or vegetarian diet? What advice do you have for them? Because maybe their needs are a little bit different now that they’re pregnant.
Dr. Sneha Kishore: Right. You still consider your satiety center and remember to listen to your body’s cues. If you are already on a whole food plant-based diet, that is wonderful. In any plant-based diet, you want to supplement your Vitamins D and B12 along with the other prenatal vitamins that you may be taking. Checking those levels and making sure that they are in range is always sound.
But other than that, you want to listen to your body’s cues, eat whole foods, limit processed foods, and get good physical activity, get a good amount of sleep, and have a social support system.
Often, I see first time mothers go through postpartum blues, or depression. The second time around it seems better. That was my experience. Having a good social support system is critical, and just getting out there and getting physically active is super important.
Dr. Aimee: Yes. When you are pregnant, sometimes you make decisions about what to eat based on your mood. And then when you’re really nauseous, I know this sounds counterintuitive, but sometimes the foods that are the worst for you, like fried donuts and pizza and stuff like that are the ones that can make you feel better.
What would be the danger of having a diet that is just very much excessive of those kinds of things?
Dr. Sneha Kishore: Fried food is extremely dangerous. The chemical structure of food changes when it is fried, and the oil changes with the high heat. It can be toxic. I do understand that during the first trimester especially, cravings can be off the charts.
Try to understand that some of those cravings are not necessarily guiding you the right way. I encourage patients to stick with eating whole foods and avoid the processed food. If you falter once and awhile, it is going to be okay.
You want to stay with fruits and veggies, and whole grains. And who knows, you might find them more satiating and they become tasty in time, despite those cravings.
Dr. Aimee: Trying to be as mindful as possible is tough though because you can get really hungry when you’re pregnant or even when you’re on fertility pills.
How do you teach your patients to be more mindful? Could you talk about that? What are some of the skills patients can learn?
Dr. Sneha Kishore: Some of these things are so basic, yet they are the most overlooked by all. First, slow down because once the baby comes, life is going to go at 90 miles per hour. Take a moment to enjoy the pregnancy. It’s a beautiful time. Most of the time, you’re very catered to, and pampered by friends and family. Enjoy that time and take it easy.
Take your time eating. When you are eating, look at your food, look at the colors, observe the colors, the textures, and the flavors. Notice what you feel on your palate and take a moment and enjoy that. Notice the joy that food can bring.
And, be present in the moment. Go for a walk without your phone. Enjoy the company of your partner or loved one or enjoy the time by yourself.
Right now, with COVID, it is even more important to get outside, with a mask and observing social distancing of course. Getting outdoors and understanding our place with nature is always good to help ground us and bring us back to center. Being out in a wooded forest, or on a beach and hearing the waves helps calm us. It gives perspective that we are one speck in this large, large world. It’s always good to get grounded and helps us to be mindful.
Dr. Aimee: Those all sound like great tips for people who are also dealing with anxiety and depression, and we are seeing that more than ever right now.
Aside from a lifestyle medicine expert, you are also an internal medicine doctor and you are dealing with COVID. What can you tell us about that?
Dr. Sneha Kishore: Unfortunately, we are in the midst of this pandemic and it is not going away any time soon. Herd immunity and/or a vaccine are the two keys to getting back to what we think of as normal. It will probably be a vaccine, because getting to herd immunity would harm too many and take too much time.
Until then, it is really important to limit gatherings, to wear a mask when out in public, to socially distance and be aware. If anyone is having a fever or feeling ill to stay home and seclude. Get tested if you are concerned, because testing is available, and we really need to make use of it. It helps from a public health standpoint and allows for contact tracing.
Seek help if you have symptoms that you cannot control at home. It is important to take the basic measures, hand washing and masks and all of that.
Dr. Aimee: Thank you for all that you are doing. I’d love for you to tell us where patients can find you, and how you work with people? Tell us.
Dr. Sneha Kishore: On Instagram, I am @argowhealth and my website is www.argowhealth.com. There’s a contact page and you can either call me or send me a message and I’ll call you back.
Dr. Aimee: Thank you for being on the show.
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