Lifestyle Medicine with Beth Frates M.D. President Elect of American College of Lifestyle Medicine

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 RxChill 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'm so excited to continue my conversation with Dr. Beth Frates. She's a pioneer in lifestyle medicine education and an award-winning teacher at Harvard. She's also the president-elect of the American College of Lifestyle Medicine. Dr. Fredes is passionate about empowering people to adopt healthy habits through research-backed methods in health and wellness coaching. For all the links and resources that we talk about on this podcast and transcript, please go to mindbodyspace.com/episode/94. The last time I spoke to Beth in episode number 92, we talked about sleep and how to get our kids interested in healthy lifestyle behaviors. We continue this conversation today, starting with why prevention is such a hard sell and how we can get around it by talking about healthy behaviors using evidence-backed motivational tools. Stay tuned until the end because she's going to share with us her top 3 most important tips for teens. We also touch upon the topic of substance use and the current recommendations.

Prevention.

Yes.

So prevention is kind of a hard sell sometimes.

Yes. What do you think?

That's right.

In fact, it is, especially for middle schoolers and high schoolers.

What about their parents too? I'm talking about even parents when I say— and then they'll say, "Oh, it's fine. They're so young," or, you know.

Right.

I see. Because they're so young. Well, this is what— yeah. So this is one way to handle that. What we all want is to thrive and feel vitality in the moment. This is honestly teenagers to the octogenarians that I see. It's the same all the way. So from the teens to the 80s, we want to feel— well, we talked about it earlier. We want to feel joyful. We want to feel energized. We want to feel creative and alive at all these ages. This is what we want. So how do we get there? This is what I work on with teens. And actually, to be honest, sometimes with adults. So instead of thinking, if you eat fruits and vegetables, research has shown you will be less likely to suffer a heart attack. Telling my college students that at Harvard Extension School who are taking the Intro to Lifestyle Medicine, I mean, that might impact some of them whose father had a heart attack or mother or something. But what really gets everyone to sit up and start leaning into me, and this is teenagers to the retirees, is when I say creativity increases when we— and I talk about either exercise, after you go for a run, you are more likely to feel relaxed, and then ideas tend to come to us at that time. When we think about things like if we have more positive emotion, if we're experiencing more positive emotion, Barbara Fredrickson's work shows us that we'll be more creative. We can use the broaden and build model.

So can you explain the broaden and build? Yes.

So what Barbara Fredrickson's work is all around creativity. So it started really— her first book was Positivity, The Positivity Ratio 3.0. You need 3 positive thoughts for every negative one, 3 positive emotions for every negative emotion that came in. So you want to, you want to have a balance of more positive, love, pride, awe. These are positive emotions. You want to be able to pull gratitude. You can pull gratitude out from thin air. This is something we can do for ourselves that will help us. Even just now, today, we can all just think, what am I grateful for? I already told you one thing, this relationship, this communication, this connection I have with Juna. This I'm grateful for, and today makes me even more grateful for this. So I hold this, and when I have more positive emotions, I, I am more creative. This is what her research shows. You can think outside the box. Another thing that can help us— research has shown sitting for 20 minutes versus walking for 20 minutes— there was a Stanford study that showed if, if you're walking for 20 minutes, you have an increase in divergent thinking. Divergent thinking is out-of-the-box thinking. So when you're trying to brainstorm ideas for a paper, for example, if you're in high school, or if you're in a company and you have a problem with the finances, you need to brainstorm a new solution. Walking would be a wonderful way to try to increase creativity. When you tell the teenagers this, that this may increase their creativity, they're more likely to want to do it versus If you walk, you won't get a heart attack, you'll meet the guidelines, you'll be less likely to gain weight. Right? And, you know, so speaking to them in their language, teens, that's what we tried to do in the Teen Lifestyle Medicine Handbook. We had teens. We had teens as authors and pediatricians as co-authors so we could really speak to the teen. And yes, the teen is not thinking about dementia.

Yeah.

They're not. They're not thinking, "If I walk, I won't get dementia." But they may be thinking, "If I walk, I'll be more creative." Which is true, by the way.

Even for teens, it increases cognitive functions. So it's not dementia.

And one thing they do like, Juna, one thing they do like is when I say things share with them data that's compelling and they can visualize. For example, research has shown that if you meet the guidelines for exercise or you're exercising 150 minutes in the week and you do this routinely for weeks, you compare antidepressant to that. Okay, so antidepressant, name one, Prozac, doesn't matter. And then compare exercise and placebo. So as it turns out, the antidepressant and the exercise increased serotonin levels the same and decreased depressive symptoms the same. This speaks to them. This kind of data speaks to them.

Amazing.

Everybody, everybody, everybody— okay, not everybody. Most people.

Some people are like, "I'll take the pill." Okay, true.

I just want to cut in here and express my gratitude for medications and surgery. These modern miracles help us and save lives every single day. The only issue is that most of them can have side effects, especially in the long run. So as Benjamin Franklin famously said, "An ounce of prevention is worth a pound of cure." He was talking about a fire, but it definitely applies to our health as well.

But I think most people have felt sad. Yes.

And also there's no side effect and there's good side effects from it.

Exactly. Exactly. And this increase in serotonin is one thing. Another thing it does, and they perk up on this too, is it can change your brain exercise because it increases BDNF. And they say, what's that? Brain-derived neurotrophic factor. What's that? It increases the number of brain cells or neurons in your brain. Neurogenesis. Sometimes they like the term, sometimes they don't, so you go back to, well, those are brain cells. You get more brain cells. And then a part of your brain— hmm, a part of my brain? Yes, a part of your brain called the hippocampus, which is deep in the limbic system of your brain. The hippocampus, it's in charge and very— it's very involved with memory consolidation. So you're trying to learn and memorize for your tests. Well, your hippocampus is critical, and when you exercise, BDNF increases, and when you compare exercisers to non-exercisers, hippocampus is bigger in the exercisers. If you exercise, you can in fact increase the volume of your hippocampus. Now they're thinking, "Okay, so that's not about preventing a heart attack. That's about changing something in my brain that I can do now. It will impact me now. It will increase my creativity." And if I keep exercising, I can increase the volume, the size of my hippocampus.

Mm-hmm. That's awesome. I love that. And it's enhancing their current performance levels. So that's how we speak to most people, right? When they're not actually sick yet.

Exactly. And the teens, we have to think about what's important to them. So you would be interested in this, Juna. It happened after I met you, and it actually was the Really the impetus behind the book.

And you're holding up the book called The Teen Lifestyle Medicine Handbook: The Power of Healthy Living, which I love, and I have my copy here.

Yay!

Oh, I love that. Love it.

So what I decided to do was experiment with this myself, and I went into my boys' school. They were gone. It's never good to teach where your kids are.

I'm waiting.

I mean, you can't—

my daughter's a senior.

Yeah, you can, you can, you can, but in this case I decided to wait till they were gone. So I went to their middle school and I conducted an elective and it filled. It filled. Electives in this small school, it's a small private school in the area, and there are 12 kids to fill the elective.

It filled. Great.

And we went over the pillars of lifestyle medicine and the one that really, really got the most conversation was social connection. And this is a pillar that is so important for all of us, adults and children alike. And COVID showed us this more than anything, right? How we crave connection. So in middle school, there are awkward times where kids are excluded, where kids may exclude others, and where friendships are fragile, and where vulnerability is is scary. So when we open this conversation up in class with these kids and we talk to them about what is it like to invite others in when you're on the playground and you— this happened in this middle school, they were doing basketball and there was someone not playing and one of these students invited them in. Now they weren't a good player and it changed the game, the person that was invited in, "but how did you feel?" The student: "I felt really good because I could see how happy she was to be included. The game changed. It was less competitive, but it was still fun." And talking about ways to help teens be compassionate, work together as a team on the field, in the classroom, outside the classroom, socially, trying to look out for each other and enjoy each other's company and realize the value of diverse ideas, opinions, people. Bringing this in in middle school, I think, I mean, even elementary school. I just happen to start with middle school. I believe is foundational. If we can get these pillars, so talk to them about the sugar cycle. Talk to them about sleep. Talk to them about this creativity with exercise. Talk to them about substances and what they do to the brain. If we do this early on in a format in school, hopefully my dream is that this gets into every public school, health and wellness classes revolving around evidence-based lifestyle medicine pillars. We have health and wellness classes. Let's have every public school teach the same curriculum. We have the PowerPoints at the American College of Lifestyle Medicine. Anyone can— go in, you become a member of the pediatric interest group, and then you download the slides and you use the handbook. And any teacher, any parent can conduct classes this way.

That's my dream too.

And that's why we're together today, because you and I—

exactly—

we need to push this forward, you know? We need to push this forward.

My dream is that every kid knows about their brain. If I knew about this myself, I could have turned out differently, although I'm good as I am now, but I was gonna say, I know, I don't know that we want to go backwards with you, but, but right.

And if we thought about what alcohol does to the brain and the research, the research that shows if you expose the brain to alcohol early, you're more likely to have trouble with that substance, substance use disorder called alcoholism, called many different names that we say.

That is, that's why they have 21 as the drinking age, right? Even though even 21 you still have to be careful, but right. That point brings me back to when you were talking about that candy experiment.

Yes.

What do you think about this myth that some parents have? I've been told this, and, you know, I'm not judging anybody, and everybody has their own way of parenting. However, there is science-based evidence, as you just mentioned. So what do you think about parents who feel like their kids have to be, or it's safer to train them on drinking alcohol or toxins. And now it's weed also, because for me, the kids that I talk to in college and high school, they think that it's legal, so it's not something that's dangerous. And I know Dr. Greger, who was just at the ACLM conference, just had a video put up about marijuana, marijuana, and you know how it can be addicting. So I thank him for Speaking out loud about all these things, but I just wanted your opinion on what you thought about this kind of— I think it's a myth to say that you can let your kids experiment and let them, you know, get really sick from it and then learn from it because, as you know, binge drinking is an issue now more than ever.

Right, right. Great point, and I'm glad we brought it back to candy.

Candy's a little different. Candy's toxic, but it's not like you're gonna have like a coma. Well, I guess if you had diabetes you could.

Right, right. And someone could say, "Well, you know, maybe you shouldn't have even done that with sugar." But so I'm just saying that's what I did, but I would not do that.

You wouldn't recommend it as a thing.

Right, right. But I also would not do that with alcohol, with drugs. No, this is an entirely different toxin. Entirely different in my family as well. And I, like you, can't tell people how to parent, but I can I can share that—

That the evidence shows with alcohol.

Right. What you were saying. Exactly. If you're exposed earlier, you're more likely to suffer with some substance use disorder later. So the later the exposure, the better. Now, how do we go about parenting this when everyone around is— well, pot is legal here.

Yeah.

Marijuana is legal here in Massachusetts, and that happened when my kids were teens. And drinking is common. So I did not and have not used any substances. I have had alcohol, but I don't— I've never experimented with any substances. I talked about experimenting in life, and that— not with substances though. I don't promote experimentation with substances. I don't— that's not something I would recommend to anyone, and I didn't recommend it to my kids. So how did I manage this with my own kids? In the middle of this when friends and things— it was going on around them.

Yeah, it's the normal.

And alcohol was happening. I did the lifestyle medicine evidence strategy. So I showed data that I found. Whenever I find research, remember, oh, I see something interesting about marijuana and academic performance. I see something interesting about a gateway— it being a gateway drug to other things. Did you want to see this? I see something interesting with it connected to depression. Did you want to see this? I see something interesting. And I just keep showing them some interesting data, and it's not me saying it. Instead, it's look at what researchers in the field have found. It's very different than me saying it will make you depressed, it will make you unproductive or just, just general things that I want to say. For example, if I just want to say them, I instead, I don't— I just want to share what research is showing. That's what I prefer to do. This is what research is showing.

Mm-hmm.

And there was a study that I saw probably in 2017 or '18 that connected marijuana use with if you had the likelihood of having— if schizophrenia was anywhere in the family, that was going to come out at all, it would be promoted by the use of marijuana. There was a study that showed that. And that they had known about schizophrenia, so that was jarring, the thought that that might lead them in that direction. So I just use data and I share it with them. Then interestingly, they looked at their friends. And the ones that were using marijuana. And they, they came up with their own conclusions about their affect and their ability to engage, and especially in sports.

And motivation.

How, right, how this was working for them. And how some of them were saying, "I don't know what I'll do when I go to college if I can't find my weed." Yeah, I mean, so this was just letting them talk with their friends and— but again, empowering them. I feel like knowledge is power. I know I've said this before. It's power. It's not powerful enough to instill lasting change, but it is power when— for children and teens and high schoolers who are wondering about options around substances, giving them the information. I also shared with them DSM. When is this substance use disorder? What is withdrawal?

Diagnostic Statistics Manual. Yes, which is what doctors use to basically bill insurance, right? We need that to bill insurance.

Yeah, and diagnose. Yeah, you have to, you have to fit certain categories. So I said, look at this with alcohol. This is, this would be substance use disorder for alcohol if you have these criteria. If you're using, if it's interfering with your work, your school where if you have enough of these checkmarks that you— these are impacting your life, then you would be considered someone with substance use disorder. So sharing them the information— this is also, by the way, in here. That's why I'm talking about it. It's important, and it's in the Teen Lifestyle Medicine Handbook, so that parents can talk to their kids about these things openly. Basically what I'm trying to say, in a non-emotional way— see, I wasn't yelling at them, 'You'll ruin your life! What are you gonna do?' You know, I was not I was not. And you know me, I'm part Greek, right? I can get very passionate and very emotional and all charged up and really happy, and I love being that way. But there's times when we need to tone it down and just get factual.

I do both.

And just have—

I do both.

Yeah, you pick. Well, well, so Juna Bobby MD, but you pick which, which one will work at what time.

My family and my husband's family have alcoholism, so obviously genetics is like 50% of the deal. So I told my kids, you know, this is is genetically, um, you're prone to it, etc. And then the 40 to 50% is lifestyle choices. And literally alcohol and all these other things are toxic to the brain, to the frontal lobe, right? And emotional regulation.

So, and you explain what happens to people and their judgment when they've had alcohol. The judgment is impaired, and driving, of course, is something you cannot do ever if you've had alcohol, you don't drive. So you give certain rules and guidelines. So back to this point, and I've heard the same thing from very, very good friends.

Yeah, intelligent people who are—

yeah, intelligent people that say, well, I want them to drink with me in my house. So that's just something I guess people have to decide. I didn't do that. I don't do that. I did not drink with the boys. I I would just say I did share with them guidelines like if you have one drink in an hour, one drink in two hours, if you have four drinks in an hour, you know, the difference between how many drinks you have per hour and if it's on an empty stomach. So you don't need to actually experience it to understand.

That's why we have a frontal lobe. Yeah, you can imagine what's going to happen.

You can just say, "This is what research shows. This is what the average tells us." This is what we know. And for example, we model though. That's something everyone has to reflect upon. If I drink, I generally don't. I am not a drinker. But if I'm to— if it's Christmas or Thanksgiving and we're with the family and I have a glass of wine, I'll have one glass of wine with my meal. And they've seen that. I don't— they see that it takes an entire meal for me to finish.

Yeah, my husband and I stopped drinking wine every night after my kids were playing waitress and waiter. And then they were like, What kind of wine would you like? And I'm like, oh boy, that's what they think dinner is— wine. So it's like, okay, we need to tone down daily drinking.

Well, because you make a great point right there though. So they see what we do, not just what we say. So if I'm telling the boys this and meanwhile I'm on my fourth drink in the hour, right? I mean, that's not gonna work. We have to model the behavior. I need to sleep well. I need to show the rainbow on the plate. I mean, my kids joke with me all the time that I eat like a bunny rabbit. I'm constantly eating carrots, you know, and I eat all sorts of plants. I mean, I even have seaweed. So I mean, they know that this is— and I don't generally eat desserts because I'm so satisfied with an apple or cherry or grapes. They're so sweet that I don't need that.

And you have so much energy. I don't know, but, but, you know, I have an issue with even the recommendations of like alcohol use disorder, right?

Yes. Yes.

Is it called use disorder?

So substance use? Yeah, alcohol use disorder. Exactly.

Any substance use disorders. So the recommendations I find are even higher than I would like. I am a non-practicing breast cancer specialist, which I knew that every time I talked to my patients about breast cancer and alcohol, it was always under what the recommended daily allowances, which is 1 drink a day for women or, you know, less than 4 a week. It's even less than that. There's actually no threshold where it's healthy for your, you know, healthy for you, basically.

You know what's so interesting? I'm glad you brought that up, Juna, because I was looking at this and back in 2015, in the cancer literature, it said, it said, and it recommended Zero drinks. Zero drinks if you want to avoid cancer. That's just 2015. We're in 2021 and I want to remind people whenever I give these talks to physicians or laypeople, back in the 1980s, as you know, my dad had a heart attack and stroke. He didn't drink. My parents were non-drinkers, but he was told— this was the '80s— have a glass of red wine, it will help you. So he did that, but he's a very disciplined, rigid person. So he had one glass of red wine a night because it was felt that that would help him. Now look at this, years later, right? So 40 years later, 40 years later, look at the American Heart Association guidelines. If you don't drink, don't start. So dad, my dad would never have started. So all they, all their recommendations, American Heart Association, because people always come back and they'll say, wait, for your heart you should do it. And then I'd say, Let's look at what the American Heart Association says because they research everything about heart health. So let's see what their guidelines are. And it's right there. You can look it up today. It says, "If you don't drink, don't start. If you do drink—" "If you do." "Don't start." "Limit yourself to 1 if you're a woman, 2 if you're a man." So the guidelines even—

That seems like a lot to me.

Yes, but that's the limit. So— Yeah. Cancer? They were ahead of it, right? Well, no, I don't know when American Heart Association said this. I don't know when they came out with, "If you don't drink, don't start." But American Cancer Society, it's straightforward, and the research in cancer is— Zero. —has been out for a while. If you're worried about cancer, zero drinks.

Wow. This goes back to the fact that I'm so happy and grateful that people like you and Dr. Greger are are at the forefront of this because, you know, recommendations do lag what's real. I mean, we had ashtrays in our, in our lecture halls. I mean, we weren't smoking, but we knew that a few generations back at our lecture halls at NYU School of Medicine, there were ashtrays. They probably renovated now. They definitely did. But doctors used to smoke, you know?

Well, you know what's fascinating at ACLM, Dr. Bernard, and you know him well from PCRM, Physicians Committee of Responsible Medicine, right? Responsible Juna Bobby MD, responsible medicine.

I would love to talk to him. Yeah.

That's a great guest for you next. Now, and he said this in the conference, so this is not a secret. He said it out loud to 2,000 people. I was a participant receiving the information, so he would share this with you, I'm sure. He did smoke.

Oh, yes. I heard him say that.

Yes, yes, yes, yes. Yes, physicians did smoke. And even having the knowledge, sometimes we have the knowledge But especially with something that's so addicting like nicotine, like alcohol. Once you start, it's really awfully hard to stop. So that's why with teens, it's good to get that message out once— Oh, he did stop, by the way. He quit. Anyone who's wondering, he absolutely quit. But the fact that he even smoked, he's such a healthy man. Yeah. It also shows you one can change.

And that's why you and I, we're talking about prevention. And that's why you went to middle school because we want to start We want to do this as a preventive method, which brings me to this quote. I don't know if you're familiar with this quote by David Foster Wallace. He said this parable at a graduation speech. There are two young fish swimming along, and they happen to meet an older fish swimming the other way who nods at them and says, "Good morning, boys. How's the water?" And the two young fish swim on for a bit. And then eventually, one of them looks over at the other and goes, 'What the hell is water?' So, wow. So I wanted to mention that quote because that's how I feel about society as a whole and, you know, the food landscape, the lifestyle landscape. I mean, you know, exercise— you were asking people to exercise, but we're a sedentary society. You know, the more and more we develop tools, we don't have to move at all. It's like that movie WALL-E. I don't know if you've ever seen that. But so we're in this sort of like, what the hell is water? And that's what I find that the general public opinion is still even now, you know, people are more and more aware of prevention and healthy lifestyles. And with COVID for example, we all know that being and staying healthy is crucial to mitigating these life-threatening diseases and illnesses. But what are your thoughts on how you don't even have to be in a food desert to feel like you're in a food desert because it's normal to, you know, drink when you're 14 or 13 years old. It's normal to eat junk food regularly. And it's normal to sit all the time. I did it. I was like a desk jockey for decades and still am. And I have to, you know, force myself to get up and do things. So how do we get this message across in this time period that we're living in, which I know is evolving thanks to you and people like you.

It's a great point, and we think about the social ecological model of change. So you have the individual, then you have their family, you have their workplace, you have their neighborhood, you have city and town regulations, you have state regulations, country regulations. So this takes us to, to public policy, taxing drinks, taxing— it takes us to public policy. And what are we going to do as a nation? What are we going to do as a, as a world? But what, what we can control, we can always control that individual approach. And then, like you said, as a mom, we can help empower our own kids. And then as teachers, we get into the environment. As physicians, we get a little bit more influence. So my, my goal is to empower everyone to make changes at the level of influence they're most comfortable. If you're a public policy person, there may be some listening. It would be great to get you out and get you to DC and start talking about the importance of healthy foods in schools. We need that desperately., but we can't ask all citizens to do that. Now, people who are teachers that are listening to this, I would ask you to look at the Lifestyle Medicine Handbook and the PowerPoints that are free and available at American College of Lifestyle Medicine. And for you, that sphere of influence may be teaching a class on health and wellness. If you're a mom, you may get the Teen Lifestyle Medicine Handbook. By the way, I get no proceeds from this book. They all go to the American College of Lifestyle Medicine, but it's a good foundation for anyone who's listening.

So all the links for all of the resources that we talked about will be there. Okay. So I want to ask you about you and your lifestyle, uh, choices, because I think planning and goal setting is so important. And I don't, I don't know that people think that it's so important, but I think it's a way to tell our frontal lobe what we need to do, especially when we're in those stressful moments where we don't want to, um, do the healthy thing, especially in this climate where it's not normal to do the healthy thing most of the time. Like, if you had to recommend 3 tips for teens, what would be the top thing? Or for their parents to say it's non-negotiable?

Okay, so let's do the tips for teens. Okay. The first thing, if you're suffering, speak up and get help. That is the very first thing we need tell every team. I love that. And that is in any way, shape, or form. If you're suffering with friendships, if you're suffering because of schoolwork, if you're suffering because of an injury and you want to play the game but the knee really hurts, if you're suffering in any way, shape, or form— mind, body, soul— speak up. So forming high-quality connections and having a go-to person in your world— this may be your parent, That's terrific. This may be an aunt, this may be a friend, this may be a teacher, this may be a mentor, somebody that you can be open with and share your struggles with. It could be a minister, could be a rabbi, somebody that you can share your struggles with. That's great. That's number one rule for families. Number two, I would say, is to have a growth mindset for teens. This is incredibly important. Growth mindset is One in which we feel mistakes are opportunities to learn and grow. This is really important in academics. We do our best that we can. If it doesn't go as well as we wanted, that's okay. Let's think about how we can improve. Let's think about the lessons learned and let's move forward. This is the same with relationships. Maybe we struggle with a friend. Okay, what happened? Or a boyfriend and there— or girlfriend and there's a breakup. Okay. It's heartbreaking, absolutely. And we have to live that. That's part of life. And then we say, all right, well, how do we learn and grow? And what will we do different? What will we do to improve? What we do better? What we do to be more satisfied in a relationship? What will we look for next? And then also in our own health and wellness. So I'm exhausted. I'm exhausted. I'm gonna try sleeping. I'm gonna try setting my alarm at midnight and going to bed at midnight. I'm going to give that a try. I'm going to experiment with this. It may work, it may not, that's okay. With a growth mindset, we reflect. We're not going to feel blame, shame, and guilt for sleeping 3 hours. We're just going to say, "All right, I slept for 3 hours during exams. I feel miserable. I feel depressed. I'm not even sure I did that well on my exams. I'm falling asleep during the day. What can I do differently to improve my situation?" This is a growth mindset. What can I— let's reflect, what can I do differently to improve? I love it. So reach out, have a growth mindset, and then I would say really the third thing is to think about your own— think about what brings you joy. You're a teen, what brings you the most joy? It perhaps is robotics, or maybe it's cello, or maybe it's Soccer, or maybe it's computer science, or it's programming, or chess, or what is it that brings you joy? And try to do some, some of that in your day, and, and try to think about ways that you can infuse joy into what you're doing. I love it.

I love those 3 tips, especially because they're all mental first. And you didn't say, "Eat fruit and exercise." You have to work from your brain.

Right. And we do want— we do know the guidelines. We do know that movement is healthy. We do know that when we eat well, and for teens, this is probably something that is— I want to say easy, but it's not. Something that doesn't take extra time is eating. Thinking about what you're eating. So you're going to have to eat, in other words, right? You're going to eat breakfast, lunch, and dinner. Focus on eating breakfast, lunch, and dinner, and think about what that plate looks like. And you can look at the Harvard Healthy Plate, where you have half fruits and vegetables, a quarter healthy grains, whole grains, and a quarter healthy protein. If you can do nuts, seeds, legumes for your protein, Tofu, terrific if you can get plant-based proteins in there. But if you think about your, that plate and satisfying the conditions of the Harvard Healthy Plate, that will help you and nourish you. You want to nourish your body, mind, and soul every day. And what you put in your mouth has a big impact on that. That's something that you have to do, eat, so thinking about what what you're eating and what, what you can put on your plate will really help.

Those are great tips. So from the mind to the body, but we have to think about body to mind. But I love that you started with the mind because, you know, when you feed your mind, then you will be able to take care of yourself better by doing all those other things. Exactly. And, um, I can't thank you enough for being here today, and I have so much more to talk to you about, and There was something else, but I forgot.

Let's do it again.

Oh my God, I would love that. I would love it. I would love it. Thank you so much for your time. I will have all the links here.

Oh, you're the best.

To find you online, Beth Fradys MD, and we'll talk soon. Thank you.

Such a pleasure and honor to be with you, Juna Bobby MD. It really was the highlight of my day.

So thank you very, very much. Oh my gosh, same here. And virtual hugs to you. Thank you. Congratulations again.

Thank you, Juna Bobby MD.

That was Dr. Beth Frates, president-elect of the American College of Lifestyle Medicine. You can find out more about Beth at BethFratesMD.com, B-E-T-H-F-R-A-T-E-S-M-D.com. And you can find the link on my show notes as well. I'm so excited. I'm so excited because she's going to be actually joining me on a regular basis. To perform and feel at our best, we need to take care of ourselves and know which day-to-day choices are the best for our health, mental and physical. So tune in to the next episode when I 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. If you enjoyed this, go on over to mindbodyspace.com and opt into my newsletter. You'll get special tips from my neuroscience-based planner and course, which was developed from over 10 years of experience teaching high-performing students of all ages at Juilliard, NYU, Columbia, Achievement First, and many other organizations. I really appreciate you supporting this free podcast by hitting the subscribe, share, and download buttons. Until next time, this is Dr. Juna Bobby MD wishing you and your family wellness.