Lifestyle Medicine for Peak Performance with Beth Frates MD

Welcome to the Mind Body Space Podcast, where you can boost your resilience just by listening. You'll get research-backed tools to stress less, be happier and healthier while you work toward your highest potential. Hi, I'm Dr. Juna Bobby MD. I'm a board-certified physician and a mom of two amazing kids. Over 10 years ago, I left one of the most prestigious medical practices in New York City to specialize in mind-body medicine. Since then, I've had the privilege of teaching my Science of Resilience program to students who are curious and motivated to learn how to thrive in an increasingly complex world. I created this podcast to reach all the people who could benefit from the conversations that I have with experts in performance psychology, cognitive neuroscience, and lifestyle medicine. I also share tips on some of my favorite topics like how to train our brains to focus better, and how to get organized for extreme productivity. In my special RX Chill Pill episodes, I guide you through relaxation response exercises using my extra calm voice to counteract your daily stress. I do all this because I love sharing science-backed self-help tools that changed my life and so many others. I do know that there's way too much information out there, so I work hard to curate and share trustworthy sources for free. By subscribing, rating, and sharing this podcast, you are supporting this effort, and I am so grateful to you. I am so excited to have Dr. Beth Frates with me today. She's an MD and a pioneer in lifestyle medicine education. She's also an award-winning teacher at Harvard, and she is now the president-elect of the American College of Lifestyle Medicine. Dr. Frates graduated magna cum laude from Harvard College, majoring in both psychology and biology. She graduated from Stanford Medical School, interned at the Mass General Hospital at Harvard, and she completed her residency in the Department of Physical Medicine and Rehabilitation at Harvard Medical School, where she was chief resident. After residency, Dr. Frates was fascinated about empowering people to adopt healthy habits. So she pursued more training in behavioral change through health and wellness coaching programs, as well as motivational interviewing. She's been on faculty at the Harvard Medical School since 1996, and she's won multiple teaching awards. She's also developed and taught the College of Lifestyle Medicine curriculum at the Harvard Extension School, and she's created a syllabus as a template through the American College of Lifestyle Medicine to guide other instructors and professors to teach their own lifestyle medicine program. She's a true pioneer, and she developed the concept of Lifestyle Medicine Interest Group in 2008 for medical schools. Beth is also an accomplished author, and her books include The Lifestyle Medicine Handbook: An Introduction to the Power of Healthy Habits, which was included in the list of 100 best medicine books of all time by Book Authority. And she created and implemented a 12-step wellness program, Paving the Path to Wellness. Beth also co-wrote the Teen Lifestyle Medicine Handbook: The Power of Healthy Living, which I personally think is one of the most comprehensive lifestyle medicine books for teenagers that I've ever seen, and I highly recommend it. For all the links and resources that we talk about on this podcast, please go to mindbodyspace.com/92.

Hi, Beth.

So good to see you.

I'm so excited to have you here. I'm so honored. I'm so grateful that you're taking the time out to be here with me today.

Thank you.

Juna, it's so, so nice to see you again.

I know, and last week was the ACLM, the annual conference. It was so good, and I was so excited to see you there, even though I don't think you were live, right?

I was only live with Q&A.

Yes, and I was like, Beth, yes! And I'm so excited that you're president-elect.

I'm very excited about that too. Thank you so much.

It's amazing. I couldn't think of a better person, to be honest with you. Um, I do a monthly podcast with my friend and colleague. She's a psychologist from the UK. She's an organizational psychologist, Fiona Murden, and she is really big into mentors, and you are one of my mentors.

Thank you, Juna. That just made my day. That really did. Thank you. I remember meeting you clear as day. Yes, clear as day at the CME conference, and I said to myself, this woman is brilliant, passionate, purpose-driven. She is going to be a mover and a shaker. She can do this.

Oh my gosh. Yes. Now you've made my day and probably my, my year. I'll just listen to this over and over again.

That's terrific.

And I remember meeting you and thinking the energy that you exude is incredible. And, you know, to be honest, I felt like you were such a cheerleader for all of lifestyle medicine and for me personally, even though I met you briefly., and we've been in touch since then, but those minutes that we spent together at the conference, I felt like you were a cheerleader for me.

That's wonderful.

In a way that only— I don't know, you're an MD and you're a mom, so—

Right.

I feel like it was like so mom-like.

Yes.

And you, you inspired me to go out there and start teaching when, um, this was not something that was a mainstay in medical education. And when I went, I had to kind of convince people. And I was teaching at NYU, and you told me to do a lunch and learn.

Yes.

And that's what we started with. We started calling it Wellness Wednesdays. And over time, the students became more and more interested in lifestyle medicine. But, you know, sometimes I would have like people out the door trying to get into the classroom. And then they took over and they started, which is what you want, right? They started their own wellness initiative. And every year I felt like they were a lot more well-versed. I don't know if you find this to be true, but I'm sure it's partly because of your work, if not a lot of it. You're, you know, you're out there doing this all the time. So, you know, you're really moving people towards this.

Well, hearing from you does warm my heart because I try so hard to fully connect when I'm in the moment with someone at these conferences. As you know, it's chaotic. Often there's hundreds of people at these conferences, and then you have the joy of speaking with someone one-on-one, maybe strategizing with them a way forward, which to me is an honor and a delight that you would share with me your vision, your goals, and then ask me how I would move forward, what suggestions do I have. That's, that's an honor for me, and I love spending that time and being fully present and mindful in that moment with you, really thinking, knowing your energy level, Juna Bobby MD, and knowing your charisma and knowing your compassion and your heart. It shows immediately upon meeting you. And for me, being able to hear years later that that one interaction, that impactful moment, really did inspire or maybe even motivate movement forward means everything to me. Because sometimes you, you could wonder, what is all this for? Meeting lots and lots of people, going to huge conferences, giving talks. Are you really having an impact? And so when someone circles back with you years later and says, you know, I remember that conversation, and I'm thinking, I know that conversation so well, Juna, I can almost see— I can see us, in fact, together brainstorming. And I remember you're saying, with your specialty, can I do this? And I remember saying, of course, because you're a physician and you have the knowledge of disease processes, you now have developed an entire repertoire of the 6 pillars and practices in these 6 pillars.

The 6 pillars that Dr. Fredes is referring to here include healthful eating, physical activity, stress management, relationships, sleep, and tobacco cessation. But it also includes avoiding toxins other than tobacco too.

So of course, because you exude this yourself. First off, you exude healthy living, healthy habits.

So I, I would say most of the time, maybe not all the time, but that's part of the process. I'm getting there though.

But that's part—

yes, I'm getting there, right?

That's part of the process though, that we're trying, we're learning. Yeah, we're striving, because nobody's perfect.

And I want to tell you, Beth, you are very present just to give you feedback because I remember you looked at my slides and it was like a busy conference room and you were actually looking at my slides going, "This is amazing!" And you pulled over Edward Phillips, Dr. Phillips, and you were like, "Look at these!" And, you know, that just made me feel so much more confident going out there. And yes, you made a big difference and I think about you a lot. And I've seen you since at the MindBody conference, at Harvard also, where you came out on stage with your big ball and hula hoop, I think.

Yes, yes, yes, I love it.

You're amazing. Your energy level is like, I mean, through the roof.

Well, Juna, I do like to have fun, and I do believe life is joyful. Let's have some fun. Let's find the joy in exercise. Let's find the joy in learning. Let's find the joy in connecting, communicating deeply, having high-quality connections. Let's find the joy. That's part of it for me, is allowing people to be joyful again. And yes, if you enjoy hula hooping, which you will remember, a 75-year-old patient of mine introduced me or reintroduced me to the hula hoop. And if she can bring me that joy, let's share it. Widely.

Yeah, you are so exuberant. I love it, I love it. And my son is now, you know, a lot of times I thought my kids don't listen to me.

Yes.

How many kids do you have again?

I have two boys, 22 and 20.

And, oh, is one is still at Harvard? Yes. Or they both graduated?

Yes, he is. He took the COVID year off. Oh, his choice to work instead. So he worked virtually at a company and he did not go to school. So he's a sophomore there.

Oh, wow. Okay. So my son is now a senior. The time is flying like crazy. And I was so excited because he told me, you know what he's taking this year? Sleep with Dr. Seisler and Scheer.

Wonderful. That's fantastic.

Yeah. And he's like saying stuff back to me today. He was like, Mom, they talked about CBT. And I was like, see, I told you. He said they were comparing CBT to medications for sleep.

CBT-I stands for Cognitive Behavioral Therapy for Insomnia. According to the Sleep Foundation, as many as 70 to 80% of patients with primary insomnia experience improvements. The American College of Physicians actually have CBT as the first line of approach now, and in some patients it's more effective than medications.

It's really powerful and I'm so happy he's taking it and—

And that he has Dr. Charles Czeisler as his instructor, that is going to be powerful for him because he is the man here, as you probably know, at Harvard Medical School behind all the research. And whenever I talk, you've probably heard me say this, if you are getting less than 6 hours of sleep, Dr. Czeisler would put you in the sleep-deprived arm of his study at Harvard Medical School. So that's a good thing to remember. You would be in the sleep-deprived part of the study if you don't get 6 hours of sleep. So we, of course, recommend, as you well know, 7 to 9 hours, hopefully 8 hours. But if you're getting less than 6, you're going to be studied as someone who's sleep-deprived.

But how many days? Like, if you were getting 6 hours 3 days out of 7, you know, like how many days, at what point would you say you are sleep-deprived? Because every teenager that I teach, as you know, I teach at Juilliard Pre-College, and also I teach a lot of teenagers who are high achievers, even though they wouldn't call themselves that. They are not getting as much sleep as they need to. So what— how many days a week are we talking?

That's a great question, and they're scary.

They tell me 4 hours.

I have heard that with younger people, people in college, people in high school, middle school even, and If we look at definitions and if we look at guidelines, they say 7 to 9 hours, and that's supposed to be consistent Monday through the weekend. So you're not supposed to change your sleep habits. It's very hard for students, but this is just the general guidelines. Now, if you are experiencing less than 6 hours of sleep for an extended period of time and, and there's no actual number of days, but you're— that's your routine. If your routine is 5 hours of sleep, then you— that is when you're going to be considered in your— in the sleep-deprived category. I wasn't clear. Just one night, just one night is not going to put you in that. But if you're routinely— so your, your average over— you look at, say, a week, an average is less than 6 hours, say, if you're averaging less than 6 hours, then you'd be in that sleep-deprived category. But what we're really looking for, for 5 days I got 8 hours of sleep and for one I got 6 and for another I got 7. So in general, in that week, you're, you're falling in the category of well-rested, getting enough sleep. Um, if it's just the one day, that's not going to put you in, but if you are sleeping 5 hours 4 hours, 6 hours, 7 hours, 6 hours, 6 hours, 4 hours, 4 hours, 8 hours. Then you can see the pattern. The pattern is basically less than 6 hours.

Okay, awesome.

So you're gonna tell your son to take the sleep class?

That's, that's not a bad idea. I might, but I have learned this through coaching since 2008, as you know, when I was certified as a health coach. And fortunately the boys were young. At that time. Fortunately, I say, for their sake and for ours, for mine and our relationship's sake, because these days I ask them. I, for example, with this that you just mentioned, a wonderful sleep class at Harvard, I might say to my son, who's a sophomore, I might say, John, I was talking with a colleague and I learned that there's a terrific sleep class by a renowned researcher, physician, and professor. That sounds like it's pretty good. I did hear it's also easy. What do you think of that? And I will just hear what he thinks of it. He is an economics major. He's very much into finance and statistics. I think he's taking a computer science class right now. And so I would just mention it to him, but I won't push it. I'll just make him aware, and I will hope that maybe If he's interested, he'll take it, but I've learned, just like with patients, I can't force my children at ages 20, 20, 20, or even when they were really 12 and 14. I guess you could force them to do things, but those changes wouldn't be sustainable, and they wouldn't be things that the children necessarily would select on their own if I'm forcing it. I'd rather they see the value. They feel the benefits on their own so that they'll select it. It's that whole autonomy. They all want autonomy, competence, and connection, right? Back to self-determination theory. I know you teach this.

Mm-hmm.

So we give our kids autonomy, we hope that they feel competent in what they're doing, and then we want them to have connection. We need connection to really feel fully motivated and, and to continue striving towards the goal.

But I'm sure they've seen what you do, so it's by osmosis they must have gathered some of this.

Well, they are both quite healthy and fit and interested in being healthy. I did not, though, say no candy ever, no Halloween for you. Everyone has their own strategies. I'm not saying that's a wrong strategy. I do know people and physicians—

Right.

Celebrities and lots of people that have said they do that with their children. No sugar whatsoever.

You know, I'm with you. I'm with you. I nag them though. I definitely nag, but I did not tell him to take this course. He's the one who texted me and said, look what I'm taking.

See, that's great. That's wonderful, I think.

But they came to all of my lectures. Almost. Really? Yeah, they used to come to a lot of my workshops. Max even played cello for a few of the meditations at NYU Medical School.

That's beautiful.

I paid him.

Smart, smart. That's a good idea because he's using his time to help you as you would compensate another colleague or musician. It sort of makes sense to me. By the way, my son also played the cello. I don't know if you remember that connection. The song—

Well, they have to get together.

Yes.

I interrupted you.

I'm sorry.

What did you do? What was your—

modus operandi.

Yeah, I'll tell you what I did. I— with the boys, well, I like to let them learn by experiment. Peter, my younger one, was little. They go to birthday parties, and one mom thought having a candy sundae birthday party was a great idea. So the kids arrived, and there were different stations, tons of candy. I don't know, gummy bears, Reese's, all over the place. And then lots of ice cream. And the party was that the kids could get their bowls as many times as they wanted, I guess, and fill them with candy and ice cream. And I just thought to myself, this is a complete disaster. I mean, first of all, the sugar high and then low. And I didn't limit my son. I thought, okay, I can say to him, you can only have one bowl. It's a 2-hour party. And this is all that's going on. I thought, well, I could tell him he could only have one bowl, but we all know he's going to sneak another. So I didn't say anything. I let him do his thing. And after 2 hours, we got in the car and he's— it's not funny. I'm sorry for laughing. Hold on. He got in the car and he said, "I don't feel so good." Oh my gosh.

Yeah, he did.

And then, when we got home, he needed to— He needed to vomit.

Wow.

And he, yeah, he ate so much candy that he got sick. And he said, "I'm not doing that again." And he was just little at the time. So it was really natural, his natural consequences of learning that that there is overboard and it is uncomfortable. And so he actually, to this day, he's playing hockey at Williams right now. He's a freshman and he doesn't eat sugar. He's very much interested in what is healthy for the body, what is anti-inflammatory, so he can be at peak performance for school. For school, they just had midterms, and for athletics. Wow.

So he's recruited. So that's a very tough schedule, and you do need to be very organized about your health.

And sleep. And so, again, with that, I don't tell him. He's 20. I don't say to him, You must get your sleep. But guess what? He got this Whoop band, which a lot of the athletes were getting. And so he actually monitors his heart rate, his sleep, and he tells me, "I need more sleep today." And I said, "That's fantastic. Okay, go get it. How are you going to go get it? You know, what are you going to do? How are you going to set yourself up for success?" Now I do share with them, but I— in a very open way. I say, "Hey guys," and they sometimes roll their eyes, so just bear with this. I say, "Hey guys, I just read the coolest article," and then they roll their eyes like, and I say, "It's about sleep. Do you want to hear about it?" And they sort of feel compelled at this point just to say yes. Oh, they say yes. So they let me. They let me share. And then I'll share about the research. And then I'll say, "What do you think of that?" Not, "So you should." Then I don't start wagging my finger and telling them what to do with regards to the research. I just say, "What do you guys think of that? What do you think?" And this was on blue wavelength light, what I'm remembering right now with them.

Okay.

And how it had an impact on melatonin levels, the release of melatonin from the pineal gland, as you know. And so my younger one asked for blue wavelength. Light-blocking glasses. Wow. To try to see if this would help. You can also use an app. There's a lot of—

so for the audience, blue light, can you just explain that a little bit?

Yeah, so there's blue wavelength light that's emitted from devices, computers, televisions, phones. They emit a spectrum of light that's on the blue wavelength. Now we know, science has shown us, that when You— when this enters your eye and you get signals into your brain, a specific part of your brain called the pineal gland, which usually releases melatonin towards the end of the day. At night, you get a high dose of melatonin, and that helps us sleep and sleep soundly. Other people, they take melatonin pills, but this is what you do naturally. You let melatonin rise, your pineal gland releases it. Now, what happens is this can be blocked by blue wavelength light. Blue wavelength light will send signals to the pineal gland. The pineal gland will not release melatonin. So you want to look at your computer, look at your phone, put an app that puts it on night mode, and then that will reduce— or you get these blue wavelength blocking glasses. I, I don't know how— in fact, if they've been researched and which brands have been proven to block the blue wavelength light, but it's an idea. Or you shut your computer and you shut your phone off 2 hours before going to bed and you certainly won't be getting blue wavelength light. That's not possible for a teenager who's studying and trying to work hard on tests. So, for example, that— when we share the research with teenagers and children and we say, "What do you think?" versus, "So you need to." The coach approach here, I believe, really helps, well, them to grow, mature, and to experiment themselves.

That's awesome.

I have so much to talk to you about. It's like, you're gonna have to come back.

Okay, I'd love to. I'd love to.

That was Dr. Beth Frates, president-elect of the American College of Lifestyle Medicine. I'm so excited because she is actually going to be joining me on a regular basis in 2022. So hit that subscribe button and don't miss the continuation of this conversation. Sign up at mindbodyspace.com to get episode links and show notes right into your inbox. You can find out more about Dr. Frates and about all the resources that we talk about in the show notes at mindbodyspace.com.

Junabobbymd.com/92.

To perform and feel at our best, we need to take care of ourselves and know what day-to-day choices are the best for our health, mental and physical. So tune into the next episode when I'm going to talk more about those 6 pillars of lifestyle medicine and define what evidence-based information really is and why that is so important to us. Thank you so much for listening. I really appreciate you supporting this free podcast by hitting the subscribe, share, and download buttons. Until next time, this is Dr. Juna wishing you and your family wellness.